中华外科杂志最新文献

{"title":"[Jiangsu province coronary artery bypass grafting registry study: a report of 7 475 patients from 16 centers].","authors":"C Zang, H Ding, H W Jiang, X Cao, J K Wang, X Chen, Y F Shao, R Wang","doi":"10.3760/cma.j.cn112139-20260209-00064","DOIUrl":"10.3760/cma.j.cn112139-20260209-00064","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate coronary artery bypass grafting (CABG) in Jiangsu Provinc registry database from 2019 to 2024. <b>Methods:</b> This is a multicenter retrospective registry study. Data of the CABG registry database in Jiangsu Province from January 2019 to December 2024 were retrospectively collected. A total of 7 475 patients who underwent isolated CABG from 16 medical centers. There were 5 484 males and 1 991 females, with an age of (66.7±9.2) years (range: 23 to 92 years) and a body mass index of (24.6±3.2) kg/m<sup>2</sup> (range:15.5 to 39.6 kg/m<sup>2</sup>).Preoperative risk factors, medical history, cardiac function were analyzed (New York Heart Association classification), coronary artery disease, European Heart Surgery Risk Assessment System Ⅱ(EuroSCORE Ⅱ) score, whether CPB was used, whether arterial bridge was used, the number and flow of bridge vessels, postoperative stroke, myocardial infarction and mediastinal infection were analyzed. Independent sample <i>t</i>-test and <i>χ</i>² test were used to compare the differences in clinical data between patients undergoing on-pump coronary artery bypass grafting (ONCABG) and off-pump coronary artery bypass grafting (OPCAB). <b>Results:</b> Left main coronary artery disease was present in 2 181 cases (29.18%), three-vessel disease in 6 212 cases (83.10%), and left main coronary artery disease combined with three-vessel disease in 1 987 cases (26.58%). Left ventricular ejection fraction (LVEF)<50% was observed in 1 544 cases (20.66%), cardiac function class Ⅲ to Ⅳ in 2 654 cases (35.51%), and the EuroSCORE Ⅱ score was (<i>M</i>(IQR)) 1.28% (1.87%) (range: 0.8% to 39.4%). There were a total of 5 214 cases of ONCABG (69.75%) and 2 261 cases of OPCAB (30.25%). The left internal mammary artery (LIMA) was used in 6 407 cases (85.71%), with skeletonized LIMA in 2 949 cases (46.03%) and pedicled LIMA in 3 458 cases (53.97%). Sixteen centers used the radial artery as conduit material. The number of grafts per patient was 3.1±1.1 (range:1 to 7). The intraoperative cardiopulmonary bypass time was (106.0±34.9) min (range:22 to 310 min), and the aortic cross-clamp time was (76.9±26.2) min (range:20 to 205 min). There were 168 in-hospital deaths (2.25%). Reoperations in 110 cases (1.47%), including 86 cases of re-sternotomy for hemostasis and 24 cases of repeat revascularization. Perioperative complications: myocardial infarction 36 cases (0.48%), stroke 73 cases (0.98%), 274 cases of acute kidney injury after operation (3.67%), 100 cases (1.34%) of renal failure requiring dialysis 134 cases (1.79%) of mediastinal infection 6 450 cases were discharged for secondary prevention compared with OPCAB group, ONCABG group had a higher proportion of patients with smoking history, higher proportion of patients with hyperlipidemia, chronic lung disease, carotid artery stenosis, cardiac function Ⅲ to Ⅳ, history of Percutaneous Coronary Intervention higher EuroSCORE Ⅱ score, more left main trunk w","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"64 7","pages":"793-798"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Research progress on the treatment and drug resistance of microsatellite instability-high gastric cancer].","authors":"J T Tang, A Q Wang, Z D Bu","doi":"10.3760/cma.j.cn112139-20250814-00401","DOIUrl":"10.3760/cma.j.cn112139-20250814-00401","url":null,"abstract":"<p><p>Mismatch repair-deficient/microsatellite instability-high (dMMR/MSI-H) gastric cancer represents a distinct molecular subtype of gastric cancer. Although immunotherapy has significantly improved survival outcomes in patients with this subtype, its overall efficacy remains limited by primary and acquired resistance. This review provides a comprehensive overview of recent research progress in dMMR/MSI-H gastric cancer,aiming to provide a reference for individualized and precision therapy. (1) It elucidates the molecular definition of dMMR/MSI-H and summarizes the principles, advantages, clinical applications, and limitations of current detection methodologies. (2) It outlines the clinicopathological and molecular biological characteristics of this subtype, emphasizing its unique immunological features. (3) The review examines the evolution and optimization of therapeutic strategies-from conventional chemotherapy to immune checkpoint inhibitor monotherapy and combination immunotherapy-supported by relevant clinical evidence. (4) It further summarizes the underlying mechanisms of immunotherapy resistance, integrates recent studies and emerging strategies to overcome resistance, discusses the ongoing exploration and prospects of organ-preserving treatment strategies, and outlines future research directions.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"64 6","pages":"628-634"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Define benchmarks for low-risk sleeve gastrectomy: based on the greater China metabolic and bariatric surgery database].","authors":"Y H Hu, M Y Li, P R Tian, Y Liu, W H Yu, F Q Meng, X W Zhao, Y L Ding, M X Ding, B L Jia, S Z Liu, X Y Liang, G L Li, Z Li, B Wang, P Zhang, P Zhang, W H Lou, Z T Zhang","doi":"10.3760/cma.j.cn112139-20251110-00525","DOIUrl":"10.3760/cma.j.cn112139-20251110-00525","url":null,"abstract":"<p><p><b>Objective:</b> To establish benchmark values for the \"optimal\" achievable safety outcomes in low-risk patients undergoing sleeve gastrectomy (SG) in China using a standardized benchmarking methodology. <b>Methods:</b> This retrospective case series study was based on the greater China bariatric and metabolic surgery database. According to predefined inclusion and exclusion criteria,1 029 low-risk patients who underwent SG between January 2018 and December 2023 across 12 participating centers were included. The cohort comprised 773 females(75.12%) and 256 males (24.88%),with an age of (31.6±7.8) years (range:18 to 63 years),preoperative body mass index of (37.2±4.8)kg/m² (range:25.0 to 50.0 kg/m²). Twenty-two perioperative safety indicators (within 90 days post-surgery) were collected and analyzed. The benchmark value for each indicator was defined as the 75th percentile of the median values from all participating centers. <b>Results:</b> The cumulative complication rates (Clavien-Dindo classification system≥grade Ⅰ) for low-risk patients were 1.26% within 7 days, 4.86% within 30 days, and 6.90% within 90 days postoperatively. The most common complications within 90 days included dysphagia (2.24%),wound infection (1.65%),and acid reflux (1.17%). The cumulative complication rate demonstrated a gradual increase over time,reaching 12.73% within 4 years after surgery. A significant negative correlation was observed between the cumulative total surgical volume of the centers and the 90-day cumulative complication rate (<i>R</i>=-0.61, <i>P</i><0.05). The benchmark values were as follows: operative time was 106 minutes,intraoperative conversion-to-laparotomy rate was 0.12%, and cumulative complication rates during hospitalization,within 30 days,and within 90 days were 1.11%,12.37%,and 13.14%, respectively. Specifically,benchmark rates for wound infection were 0.08% during hospitalization, 2.11% within 30 days, and 2.11% within 90 days. Benchmark rates for dysphagia/gastric stenosis were 0 during hospitalization, 1.08% within 30 days,and 1.99% within 90 days. <b>Conclusion:</b> This is the first study to define benchmark values for achievable safety outcomes in low-risk patients undergoing SG in China,providing a critical reference for quality control and benchmarking in Chinese bariatric and metabolic surgery.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"64 6","pages":"674-680"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Perioperative management strategies for inflammatory bowel disease in the era of minimally invasive surgery].","authors":"Y X Gong, W M Zhu","doi":"10.3760/cma.j.cn112139-20260108-00014","DOIUrl":"10.3760/cma.j.cn112139-20260108-00014","url":null,"abstract":"<p><p>With continued advances in therapeutic paradigms for inflammatory bowel disease (IBD),surgical intervention has become an indispensable component of comprehensive IBD care. Compared with conventional open procedures,minimally invasive surgery (MIS) offers a lower operative trauma burden and more rapid recovery,and has increasingly emerged as a standard approach in IBD surgery. Prehabilitation is particularly important for IBD patients at high risk of postoperative complications. By optimizing nutrition,improving intra-abdominal conditions,and controlling inflammation,prehabilitation can significantly reduce postoperative complications and enhance the feasibility of MIS. Optimizing the timing of surgery,selecting an appropriate operative strategy,and delivering effective postoperative management are key determinants of favorable outcomes. In the era of MIS,prehabilitation and enhanced recovery after surgery should be integrated throughout the entire perioperative pathway for IBD to improve clinical outcomes.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"64 6","pages":"635-640"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Expert consensus for the management strategies of patients with acute cervical spinal cord injury combined with traumatic brain injury in adults (2026 edition)].","authors":"","doi":"10.3760/cma.j.cn112139-20260213-00069","DOIUrl":"10.3760/cma.j.cn112139-20260213-00069","url":null,"abstract":"<p><p>Acute cervical spinal cord injury (CSCI) combined with traumatic brain injury (TBI) represents a severe form of polytrauma associated with high mortality and disability. The complex clinical presentation of acute CSCI with TBI poses numerous challenges throughout the diagnostic and therapeutic process. To standardize clinical diagnostic and therapeutic workflows, the Spine Committee, Sports Medicine Branch of the Chinese Medical Doctor Association, in collaboration with a multidisciplinary team of experts, has developed this consensus based on evidence-based medicine and the modified Delphi method. By standardizing diagnostic and treatment procedures, clarifying surgical timing and sequence, optimizing anesthesia and hemodynamic management, and strengthening prevention and treatment of complications, this consensus aims to improve patient survival, promote functional recovery, and reduce complications. The ultimate goals are to enhance overall quality of care and patients' quality of life, while providing theoretical and practical foundations for future research and innovation in this field.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"64 6","pages":"581-588"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Evolving trends in surgical management of adenocarcinoma of the esophagogastric junction].","authors":"Y Xuan, Y Y Chen, J Feng, F L Liu","doi":"10.3760/cma.j.cn112139-20251203-00567","DOIUrl":"10.3760/cma.j.cn112139-20251203-00567","url":null,"abstract":"<p><p>In contrast to the global decline in gastric cancer incidence, the incidence of adenocarcinoma of the esophagogastric junction (AEG) is rising in both Western and Eastern countries. Its anatomically unique location has led to considerable controversy regarding surgical treatment strategies. In recent years, driven by the advancement of laparoscopic and robotic surgical techniques, progress in neoadjuvant treatment modalities, and the deepening of the concept of function preservation, the surgical treatment of AEG has entered an era of precision surgery characterized by an equal emphasis on both radical resection and function preservation. Based on the AEG classification and staging systems, this article outlines the key issues of surgical treatment for AEG, including surgical approaches, resection range, lymph node dissection, and digestive tract reconstruction. It also discusses the evolving concept of function preservation and future directions in AEG surgical treatment.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"64 6","pages":"612-616"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Basic research and clinical applications progress of gastrointestinal developmental anatomy surgery].","authors":"D Song, Y B Zheng","doi":"10.3760/cma.j.cn112139-20260115-00025","DOIUrl":"10.3760/cma.j.cn112139-20260115-00025","url":null,"abstract":"<p><p>Total mesorectal excision (TME), complete mesocolic excision (CME), and other mesenteric surgeries have elevated the precision of radical gastrointestinal tumor treatment. These approaches inherently align with embryonic development laws, relying on natural anatomical landmarks such as embryonically formed fascial spaces to ensure surgical safety and radicality. However, the surgical theory centered on developmental anatomy remains to be improved, currently, the mastery of surgical procedures and the determination of dissection boundaries rely more on surgeons' clinical experience than on theoretical guidance, resulting in a disconnect between clinical practice and applied theory that limits the homogeneous promotion of these surgeries. This paper proposes exploratorily the concept of gastrointestinal developmental anatomy surgery, with \"reverse embryonic development\" as its core logic. Based on a thorough understanding of embryonic development, it deconstructs adult anatomical complexity by retroactively deducing primitive gut rotation, mesenteric fusion, and fascia formation, enabling diseased tissue resection and functional reconstruction after restoring a primitive mesentery-like state. Centered on three principles-total mesentery excision, interruption of mesenteric blood supply, and extra-mesenteric preservation-this approach leverages embryonically formed fused fascial spaces to integrate en-bloc resection and organ function preservation. It has also been validated through radical right hemicolectomy and radical gastrectomy to clarify the role of gastrointestinal developmental anatomical surgery in defining surgical boundaries and anatomical landmarks, reducing operational difficulty, and improving the reproducibility and homogenization of surgical procedures.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"64 6","pages":"596-600"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Standard establishment and standardized implementation of the NOSES type Ⅰ eversion technique for low rectal cancer].","authors":"X Guan, X S Wang","doi":"10.3760/cma.j.cn112139-20251228-00615","DOIUrl":"10.3760/cma.j.cn112139-20251228-00615","url":null,"abstract":"<p><p>Natural orifice specimen extraction surgery (NOSES) represents a significant advancement in the field of minimally invasive surgery. It has garnered widespread attention in colorectal tumor surgery due to its advantages such as minimal trauma,rapid recovery,excellent cosmetic outcomes,and high patient psychological acceptance. The eversion technique of NOSES Ⅰ for low rectal cancer,performed via laparoscopic or robotic platforms,involves everting the rectum transanally after complete rectal mobilization,allowing for precise determination of the distal resection margin and resection of the distal bowel under direct vision. This technique is a classic and hallmark minimally invasive approach in NOSES. It perfectly integrates the oncological radical principles of total mesorectal excision with the concept of extreme minimally invasive surgery,achieving \"no auxiliary abdominal incision\" and preserving the integrity of the abdominal wall as a surface organ to the greatest extent while ensuring tumor radicality. This significantly enhances patients' postoperative recovery experience and cosmetic satisfaction. This article aims to systematically elaborate on the theoretical foundation,classification of surgical techniques,standardized operative procedures,indications,standard technical processes,and other related issues of the eversion technique system. Through a systematic review of the standardized implementation and promotion of this technique, the authors hope to provide clear clinical practice guidance for surgical peers and further advance the development of standardized,homogeneous,and precise sphincter-preserving surgery for low rectal cancer in China.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"64 6","pages":"617-621"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical advantages of robotic surgery in low rectal cancer:a post-hoc analysis of the REAL study].","authors":"F F Shen, Q Y Feng, D X Zhu, W T Tang, G D He, L C Ye, L Ren, J M Xu","doi":"10.3760/cma.j.cn112139-20250101-00002","DOIUrl":"10.3760/cma.j.cn112139-20250101-00002","url":null,"abstract":"<p><p><b>Objectives:</b> To compare the risk of anastomotic leak following robotic-assisted and laparoscopic surgery in patients with mid-low rectal cancer,and to investigate the independent risk factors associated with each surgical approach. <b>Methods:</b> This study is a post-hoc analysis of a multicenter randomized controlled trial (REAL study). A total of 689 patients with mid-low rectal cancer who underwent robotic or laparoscopic sphincter-preserving surgery without prophylactic stoma at 11 medical centers in China from July 2016 to December 2020 were enrolled in this study. There were 396 males and 293 females, with an age of (59.6±10.8) years (range: 18 to 80 years). Patients were divided into the robotic surgery group (359 cases) and the laparoscopic surgery group (330 cases) according to the surgical approach. Univariate and multivariate Logistic regression models were used to analyze the risk factors for anastomotic leak after each surgical technique,and the interaction effect between tumor location and surgical approach was evaluated. <b>Results:</b> Anastomotic leakage occurred postoperatively in 23 patients (6.5%) in the robotic surgery group and 34 patients (10.3%) in the laparoscopic surgery group, with no statistically significant difference between the two groups (<i>χ²</i>=2.949, <i>P</i>=0.088). Univariate and multivariate analysis results showed that low rectal cancer (≤5 cm) and mid-low rectal cancer (>5 to 7 cm) were independent risk factors for anastomotic leakage after laparoscopic surgery (<i>OR</i>=5.102, <i>P</i>=0.006; <i>OR</i>=4.019, <i>P</i>=0.015); the degree of tumor differentiation was an independent risk factor for anastomotic leakage after robotic-assisted mid-low rectal cancer surgery (<i>OR</i>=2.649, 95%<i>CI</i>: 1.037 to 6.891, <i>P</i>=0.042). Interaction analysis revealed that the lower the location of the rectal tumor, the higher the risk of anastomotic leakage after laparoscopic surgery, reaching 5.306 times that of robotic-assisted surgery (<i>OR</i>=5.306, 95%<i>CI</i>: 2.336 to 12.048, <i>P</i><0.01). <b>Conclusions:</b> Robotic-assisted surgery can reduce the risk of postoperative anastomotic leakage in patients with low rectal cancer. Tumor location is a risk factor for anastomotic leakage after laparoscopic surgery.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"64 6","pages":"650-656"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The paradigm shift in perioperative treatment strategies for gastric cancer in the era of precision therapy].","authors":"X P Zhang, Z M Li, Z Y Li","doi":"10.3760/cma.j.cn112139-20260104-00006","DOIUrl":"10.3760/cma.j.cn112139-20260104-00006","url":null,"abstract":"<p><p>Advances in molecular biology and tumor immunology have propelled gastric cancer treatment into the era of precision therapy, leading to profound transformations in perioperative treatment strategies. Based on the latest clinical evidence, this article systematically elaborates on four major transformational directions in gastric cancer treatment under the precision medicine paradigm. First, the establishment of a biomarker-based precision stratification management system, where molecular markers including microsatellite instability-high, PD-L1 combined positive score, human epidermal growth factor receptor 2, and Claudin18.2 have become critical determinants in guiding immunotherapy and targeted therapy, advancing gastric cancer management from the traditional \"stage-oriented\" approach toward a new model that integrates both \"staging and molecular subtyping\". Second, the formation of a clinical decision-making model that balances both \"resectability\" and \"disease controllability\", where improved efficacy of preoperative systemic therapy provides a robust foundation for exploring function-preserving surgery, surgical extent reduction, and even surgery omission. Third, the reassessment of timing and criteria for surgical intervention following systemic therapy, with the timing of surgery after neoadjuvant treatment and the initiation of postoperative adjuvant therapy significantly impacting patient prognosis. Fourth, the gradual transition of stage Ⅳ gastric cancer toward chronic disease management, shifting treatment goals from mere palliation to long-term disease control, where quality of life is considered equally important as survival duration. Together, these transformations signify that gastric cancer treatment is moving from a traditional standardized paradigm toward a new stage of individualized precision therapy.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"64 6","pages":"601-605"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}