中华外科杂志最新文献

{"title":"[Advances in the diagnosis and treatment of craniovertebral junction abnormalities].","authors":"L H Ge, N F Xu, Y L Tian, Y Gao, X Y Hou, S L Wang","doi":"10.3760/cma.j.cn112139-20240910-00420","DOIUrl":"https://doi.org/10.3760/cma.j.cn112139-20240910-00420","url":null,"abstract":"<p><p>Craniocervical junction zone malformations often have an insidious onset, a variety of clinical phenotypes, and are often combined with multiple malformations, making their systematic classification and staging more difficult.At present, craniocervical junction area malformations are often classified into congenital and acquired, and can also be classified into skull base malformations, atlantoaxial malformations, and cardinal malformations according to their locations. For patients with obvious occipitocervical or atlantoaxial instability, combined with symptoms of high cervical spinal cord damage, internal fixation and fusion surgery should be performed aggressively to avoid irreversible nerve damage.There is a lack of detailed categorisation and summary of the treatment of diseases associated with craniocervical junction malformations in the literature, and the treatment strategies for some of these malformations are still controversial, with different perceptions and treatment concepts in the national and international literature.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 3","pages":"259-264"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400399","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":"[Neuro-electrophysiological characteristics of patients with primary brainstem hemorrhage].","authors":"L Zhou, J Wang, X Chen, J F Liu","doi":"10.3760/cma.j.cn112139-20240831-00406","DOIUrl":"https://doi.org/10.3760/cma.j.cn112139-20240831-00406","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the neuro-electrophysiological characteristics of patients with primary brain stem hemorrhage (PBSH). <b>Methods:</b> This is a retrospective case series study. The clinical data of 17 PBSH patients with Glasgow Coma Score (GCS) 3 to 8 points who were admitted to the Department of Neurosurgery, Xiangya Hospital of Central South University from January 2022 to December 2023 were retrospectively analyzed. There were 14 males and 3 females, with an age(<i>M</i> (IQR)) of 46.0(14.0) years (range: 18.0 to 70.0 years).All patients underwent electro-physiological monitoring within 28 days after the onset of the disease. According to Glasgow outcome scale(GOS) 6 months after onset, PBSH patients were divided into two groups: unregained consciousness group with (GOS 1 to 2 points, 13 cases) and regained consciousness group (GOS 3 to 5 points, 4 cases). The neuro-electrophysiological indicators involved in this study included short latency somosensory evoked potential (SLSEP) component N20, brainstem auditory evoked potential (BAEP), electroencephalogram (EEG) background activity, EEG reactivity (EEG-R), EEG sleep structure waves, absolute amplitude of N1 at electrode Fz (FzN1A) and Cz (CzN1A), respectively, absolute amplitude of mismatch negativity at electrode Fz (FzMMNA) and Cz (CzMMNA), respectively. Then, the Fisher exact probability test and Mann Whitney <i>U</i> test were used for counting data and measurement data, respectively, to analyze the differences of neuro-electrophysiological indicators between the two groups. <b>Results:</b> The EEG background activity of 17 PBSH patients was mainly α-mode, α-θ mode and θ mode. Four patients with α-mode, 3 of whom regained consciousness (all with EEG-R). There were 3 patients with α-θ pattern. And 5 patients with θ pattern, 2 of whom died. Five patients with background EEG activity of delta pattern had poor prognosis, of which 4 patients died and 1 patient survived but did not regain consciousness 6 months after onset. SLSEP component N20 were absent bilaterally in 12 cases and BAEP in 5 cases. FzN1A and CzN1A were not extracted in 4 cases, and FzMMNA and CzMMNA were not extracted in 6 cases. The study showed that BAEP, EEG background activity, EEG-R, FzN1A, CzN1A, FzMMNA and CzMMNA were different between the two groups (all <i>P</i><0.05), while there was no difference between N20 and EEG sleep structure (all <i>P</i>>0.05). <b>Conclusion:</b> The neuro-electrophysiological indicators including BAEP, EEG background activity, EEG-R, FzN1A, CzN1A, FzMMNA, and CzMMNA may be related to whether PBSH patients can regain consciousness 6 months after onset, and it is best to combine multiple indicators for comprehensive analysis in clinical practice.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 3","pages":"219-226"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400746","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":"[Analysis of relevant factors for rupture of basilar tip aneurysms].","authors":"R Z Ge, X Feng, C Huang, M S Huang, J W Huang, C Li, S X Su, X Zhang, X F Li, C Z Duan","doi":"10.3760/cma.j.cn112139-20240603-00270","DOIUrl":"https://doi.org/10.3760/cma.j.cn112139-20240603-00270","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the relevant factors for rupture of basilar tip aneurysms. <b>Methods:</b> This is a retrospective cohort study. Patients who underwent cerebrovascular digital subtraction angiography at Department of Cerebrovascular Disease Surgery,Zhujiang Hospital of Southern Medical University from July 2008 to February 2023 and were confirmed to have basilar tip aneurysms were retrospectively analyzed. There were 45 males and 56 females, aged (57.5±10.2) years (range: 36 to 76 years); the maximum diameter of the basilar tip aneurysm (<i>M</i>(IQR)) was 6.85 (5.79) mm (range: 1.28 to 27.48 mm). Finally, 101 basilar tip aneurysms were included, and divided into two groups based on whether the basilar tip aneurysm ruptured or not. There were 37 cases (36.6%) in the ruptured group and 64 cases (63.4%) in the unruptured group. Data were analyzed using independent <i>t</i>-test, Mann-Whitney <i>U</i> test, chi-square test, or Fisher's exact test, as appropriate, and predictive factors for rupture of basilar tip aneurysms were explored by Logistic regression analysis. Variance inflation factors was used for analysis of collinearity. <b>Results:</b> The univariate results showed statistically significant differences between the ruptured and unruptured groups in terms of aneurysm neck width, basilar artery diameter, mean diameter of the parental artery, the ratio of neck width to parent artery diameter, aneurysm width and maximum diameter of the aneurysm (all <i>P</i><0.05). In multivariate analysis, basilar artery diameter (<i>OR</i>=0.347, 95%<i>CI</i>:0.176 to 0.687, <i>P</i>=0.002), and NRP (<i>OR</i>=0.366, 95%<i>CI</i>:0.192 to 0.696, <i>P</i>=0.002) were predictive factors for rupture of aneurysms occurring at the basilar tip. There was no multiple covariance between NRP and basilar artery diameter in the analysis of covariance (VIF=1). <b>Conclusion:</b> Smaller basilar artery diameter and smaller NRP are relevant factors for rupture of basilar tip aneurysms.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 3","pages":"227-232"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400666","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 on the diagnosis and treatment of esophageal and gastric variceal rupture bleeding in cirrhotic portal hypertension (2024 edition)].","authors":"","doi":"10.3760/cma.j.cn112139-20241128-00535","DOIUrl":"https://doi.org/10.3760/cma.j.cn112139-20241128-00535","url":null,"abstract":"<p><p>Portal hypertension is a group of syndromes with persistently increased portal pressure from a variety of causes, of which cirrhosis is the most common cause. The primary pathophysiological feature ofportal hypertension in cirrhosis is the obstruction of portal blood flow, resulting in elevated portal pressure and the opening of collateral circulation. Among the many clinical manifestations of cirrhotic portal hypertension, esophageal and gastric variceal rupture bleeding is the most urgent and carries a high mortality rate. The diagnosis and treatment process for esophageal and gastric variceal rupture bleeding in cirrhotic portal hypertension has been standardized by multidisciplinary experts organized by the Chinese Society of Spleen and Portal Hypertension Surgery, Chinese Society of Surgery, and Chinese Medical Association. The \"<i>Expert consensus on the diagnosis and treatment of esophageal and gastric variceal rupture bleeding in cirrhotic portal hypertension</i>（<i>2019 edition</i>）\" was revised and updated to form this consensus, integrating the latest research findings and clinical experience to provide clinicians with scientific and practical diagnostic and treatment recommendations, helping them develop optimal treatment plans to improve patient outcomes and quality of life.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 3","pages":"177-186"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400638","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":"[Mechanical thrombectomy:recent advancement of the clinical trials].","authors":"X M Yang, J Lu, J J Wang, D M Wang","doi":"10.3760/cma.j.cn112139-20241018-00466","DOIUrl":"https://doi.org/10.3760/cma.j.cn112139-20241018-00466","url":null,"abstract":"<p><p>Mechanical thrombectomy has become the first choice for the treatment of acute ischemic stroke caused by large vessel occlusion since 2015. Over the past decade, on the basis of early clinical practice and research,mechanical thrombectomy has advanced rapidly, not only in expanding the therapeutic time window for mechanical thrombectomy but also in the necessity of bridging therapy, the benefits for patients with large infarct cores, basilar artery thrombectomy, thrombectomy for medium vessel occlusion, and the choice of thrombectomy methods. In the future, mechanical thrombectomy will bring benefits to more patients with ischemic stroke,through persistently explore, expanding the indications of mechanical thrombectomy, continuously optimizing patient selection, and improving the recanalization rate.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 3","pages":"203-207"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400656","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":"[Prognostic analysis between endobronchial and invasive bronchial non-small cell lung cancer in sleeve resection].","authors":"B Zhou, X N Xu, X X Xu, K Q Jin, G N Jiang, J Dai","doi":"10.3760/cma.j.cn112139-20240716-00340","DOIUrl":"https://doi.org/10.3760/cma.j.cn112139-20240716-00340","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the prognostic differences between endobronchial and invasive bronchial characteristics in patients with non-small cell lung cancer (NSCLC) undergoing sleeve lobectomy. <b>Methods:</b> This is a retrospective cohort study. A retrospective analysis was conducted on clinical data of 200 NSCLC patients who underwent sleeve lobectomy at the Department of Thoracic Surgery, Shanghai Pulmonary Hospital between January 2014 and December 2016. There were 181 males and 19 females, aged (61.3±8.1) years (range: 30 to 81 years). Based on imaging data, they were divided into the endobronchial group (<i>n</i>=71) and the invasive bronchial group (<i>n</i>=129). Clinical data and prognosis were collected and analyzed. Sex, age, hypertension, diabetes, smoking history, pathology type, tumor size, staging, surgical method, surgical site, and sleeve technique were included as covariates. Propensity score matching was performed with a 1∶1 ratio between the endobronchial and invasive bronchial groups using the nearest-neighbor matching method. The Kaplan-Meier method was used to plot survival curves, and the Log-rank test was applied to compare differences between groups. Independent sample <i>t</i> tests, Mann-Whitney <i>U</i> tests, <i>χ</i>² tests, or Fisher's exact tests was used for group comparisons. <b>Results:</b> After propensity score matching, 71 cases from each group (endobronchial and invasive bronchial) were included, with no significant differences in baseline characteristics between the two groups (all <i>P</i>>0.05). Endobronchial group showed significantly better overall survival (OS) and disease-free survival (DFS) compared to invasive bronchial group(Log-rank test:<i>P</i>=0.014,0.027). Further subgroup analysis revealed that in the minimally invasive surgery subgroup, the DFS of the endobronchial group was significantly better than that of the invasive bronchial group (Log-rank test:<i>P</i>=0.002), while in the open thoracotomy subgroup, there was no significant difference in DFS between the two groups (Log-rank test:<i>P</i>=0.290). In the right upper lobe sleeve resection subgroup, the endobronchial group had significantly better DFS than the invasive bronchial group (Log-rank test:<i>P</i>=0.039). For patients in the stage Ⅱ to Ⅲ subgroup, the endobronchial group had significantly better DFS than the invasive bronchial group (Log-rank test:<i>P</i>=0.005). <b>Conclusion:</b> In sleeve lobectomy, patients with endobronchial NSCLC have better OS and DFS compared to those with invasive bronchial type, particularly in patients undergoing minimally invasive surgery, right upper lobe sleeve lobectomy, and stage Ⅱ to Ⅲ patients.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 3","pages":"240-247"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400765","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":"[Consensus statements on microsurgical treatment of intracranial aneurysms(2025 edition)].","authors":"","doi":"10.3760/cma.j.cn112139-20241205-00554","DOIUrl":"https://doi.org/10.3760/cma.j.cn112139-20241205-00554","url":null,"abstract":"<p><p>Microsurgical treatment of intracranial aneurysms has irreplaceable advantages such as lower recurrence rates, lower costs, and mature strategies for blood flow reconstruction. Currently, open microsurgical faces numerous challenges, including patients' preference for minimally invasive interventions, a decline in the volume of open surgeries, and some interventionalists lacking a surgical background. Additionally, regional disparities within the country lead to a lack of standardized guidelines for microsurgical treatment of intracranial aneurysms. In response, the expert consensus working group on microsurgical treatment of intracranial aneurysms composed of nationwide experts in neurosurgery and interventional fields was formed to discuss and address issues related to the epidemiology, treatment selection and surgical indications, preoperative evaluation, anesthesia management, open clipping techniques, blood flow reconstruction, hybrid surgical applications, complication management and prognosis, as well as nursing and rehabilitation. Using a modified Delphi method to gather expert recommendations, the group developed 62 consensus recommendations across 10 areas, providing scientific and practical clinical guidance for the microsurgical treatment of intracranial aneurysms.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 3","pages":"187-202"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400632","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":"[Analysis of related factors for unexpected positive intraoperative cultures in aseptic hip revision surgery].","authors":"Y Z Hou, Y C Li, Nuerailijiang Yushan, Wuhuzi Wulamu, X B Guo, L Cao, X G Zhang","doi":"10.3760/cma.j.cn112139-20240815-00376","DOIUrl":"https://doi.org/10.3760/cma.j.cn112139-20240815-00376","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate the related factors for unexpected positive intraoperative cultures (UPC) in patients undergoing aseptic hip revision and the long-term prosthesis survival rate in such patients. &lt;b&gt;Methods:&lt;/b&gt; A retrospective cases series analysis was conducted in 397 patients who underwent aseptic hip revision surgery at the Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University from January 2012 to December 2021, including 225 females and 172 males with an age (&lt;i&gt;M&lt;/i&gt;(IQR)) of 58(23) years (range:21 to 89 years) and a body mass index (BMI) of 25(6) kg/m&lt;sup&gt;2&lt;/sup&gt; (range:15 to 39 kg/m&lt;sup&gt;2&lt;/sup&gt;). Based on the culture results of intraoperative specimens, patients were divided into culture-positive group (32 cases) and culture-negative group (365 cases). The clinical data were analyzed including gender, age, BMI, preoperative C-reactive protein, preoperative erythrocyte sedimentation rate, American Society of Anesthesiologists(ASA) classification, preoperative urinary bacteria, preoperative hypoproteinemia; comorbidities of diabetes mellitus, anemia, chronic obstructive pulmonary disease, cerebral infarction; history of allergy to antibiotics, smoking, drinking, previous prosthetic dislocation, previous surgical intervention; and time from symptom onset to admission, duration of surgery, etc. A univariate analysis was performed by Mann-Whitney &lt;i&gt;U&lt;/i&gt; and &lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; test and the independent risk factors were identified by including the independent variables with &lt;i&gt;P&lt;/i&gt;&lt;0.20 in the univariate analysis in a logistic regression analysis of dichotomous variables. The study outcomes were defined as :(1) re-surgical treatment for any reason; (2)symptoms of infection such as sinus and incision seepage; (3) persistent excessive hip pain.The Kaplan-Meier survival curve was plotted using the study outcome of any cause as the endpoint event, and the log-rank test was used to compare the 10-year survival rate of the prosthesis in the culture-negative group with that in the culture-positive group. &lt;b&gt;Results:&lt;/b&gt; Univariate analysis showed statistically significant differences between the culture-negative and culture-positive groups when comparing gender, BMI, ASA classification, and preoperative urinary bacterial results (&lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;=2.37, &lt;i&gt;P&lt;/i&gt;=0.124;&lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;=-1.65, &lt;i&gt;P&lt;/i&gt;=0.098;&lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;=14.13, &lt;i&gt;P&lt;/i&gt;=0.003; and &lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;=7.38, &lt;i&gt;P&lt;/i&gt;=0.007). Logistic regression analysis showed that male, ASA classification Ⅳ, and positive preoperative urinary bacteria were independent risk factors for the development of UPC during aseptic hip revision(&lt;i&gt;OR&lt;/i&gt;=2.35,95%&lt;i&gt;CI&lt;/i&gt;:1.08 to 5.36,&lt;i&gt;P&lt;/i&gt;=0.040;&lt;i&gt;OR&lt;/i&gt;=37.32,95%&lt;i&gt;CI&lt;/i&gt;:1.80 to 1 810.63,&lt;i&gt;P&lt;/i&gt;=0.030;&lt;i&gt;OR&lt;/i&gt;=4.11,95%&lt;i&gt;CI&lt;/i&gt;:1.40 to 11.12,&lt;i&gt;P&lt;/i&gt;=0.012). The follow-up time of the 397 patients included in this study was 70 (134) months (range:12 to 146 months). The Kaplan-Meier sur","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 3","pages":"248-254"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400560","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":"[Analysis of the effect of inflatable mediastinoscopy esophagectomy and minimally invasive Mckeown esophagectomy combined with thoracoscopy and laparoscopy in the treatment of early esophageal cancer].","authors":"Z N Huang, C Q Liu, X Y Mei, G X Wang, M S Wu, S J Cui, X H Sun, M Q Xu, M R Xie","doi":"10.3760/cma.j.cn112139-20240730-00358","DOIUrl":"10.3760/cma.j.cn112139-20240730-00358","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To explore the operioperative and long-term outcomes of inflatable mediastinoscopic resection of esophageal carcinoma (IVMTE) and minimally invasive Mckeown resection of esophageal carcinoma (MIME) in early esophageal cancer. &lt;b&gt;Methods:&lt;/b&gt; This is a retrospective cohort study. A retrospectively analysis was conducted on 176 patients with cT1N0M0 esophageal cancer who underwent IVMTE or MIME at the Department of Thoracic Surgery, Anhui Provincial Hospital Affiliated with Anhui Medical University from April 2017 to April 2019. There were 128 males and 48 females, aged (66.4±7.7) years (range: 45 to 87 years). General data, perioperative outcomes, pathological data of the tumors, and complications were recorded. Independent sample &lt;i&gt;t&lt;/i&gt;-test, &lt;i&gt;χ&lt;/i&gt;² test, or Wilcoxon rank-sum test was used to compare the data between the two groups. Propensity score matching was performed with gender, age, tumor location, differentiation degree, pT stage, pN stage, American Society of Anesthesiologists (ASA) classification, smoking history, and alcohol history were considered as covariates. The IVMTE group and MIME group were matched in a 1∶2 ratio using nearest neighbor match method with a caliper value of 0.02. Kaplan-Meier method was used to plot survival curves, with Log-rank test for univariate survival analysis. The Cox proportional hazards model was applied to analyze prognostic factors for overall survival, and subgroup stratification analysis was performed for pT stage. &lt;b&gt;Results:&lt;/b&gt; After matching, the MIME group consisted of 54 cases, and the IVMTE group consisted of 27 cases. There were no statistically significant differences between the two groups in terms of gender, age, smoking history, alcohol history, ASA classification, tumor location, and other factors. The IVMTE group had shorter surgery time (&lt;i&gt;M&lt;/i&gt;(IQR), 220 (45) minutes &lt;i&gt;vs.&lt;/i&gt; 245 (56) minutes, &lt;i&gt;Z&lt;/i&gt;=2.950, &lt;i&gt;P&lt;/i&gt;=0.003) and less intraoperative blood loss (100 (50) ml &lt;i&gt;vs.&lt;/i&gt; 125 (100) ml, &lt;i&gt;Z&lt;/i&gt;=2.193, &lt;i&gt;P&lt;/i&gt;=0.028) compared to the MIME group. There were no differences between the two groups in the number and quantity of lymph node stations dissected, and the IVMTE group was not at a disadvantage in terms of the number of lymph nodes dissected around the recurrent laryngeal nerve (all &lt;i&gt;P&lt;/i&gt;&gt;0.05). The 1-, 3-, and 5-year overall survival (OS) rates and recurrence-free survival (RFS) rates were not significantly different between the two groups (all &lt;i&gt;P&lt;/i&gt;&gt;0.05). Subgroup analysis showed no significant difference in OS and RFS rates between the pT1 and pT2 subgroups (all &lt;i&gt;P&lt;/i&gt;&gt;0.05). Multivariate Cox regression analysis suggested that ASA classification (&lt;i&gt;HR&lt;/i&gt;=2.516, 95%&lt;i&gt;CI&lt;/i&gt;: 1.126 to 5.624, &lt;i&gt;P&lt;/i&gt;=0.025), pN stage (&lt;i&gt;HR&lt;/i&gt;=2.485, 95%&lt;i&gt;CI&lt;/i&gt;: 0.984 to 6.274, &lt;i&gt;P&lt;/i&gt;=0.046), and whether adjuvant therapy was given postoperatively (&lt;i&gt;HR&lt;/i&gt;=2.915, 95%&lt;i&gt;CI&lt;/i&gt;: 1.304 to 6.515, &lt;i&gt;P&lt;/i&gt;=0.009) were independent risk factor","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 2","pages":"114-123"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967569","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":"[Progress in the study of the surgical management of Crohn disease based on the mesenteric concept].","authors":"P Lan, Z J Zhang, Z He","doi":"10.3760/cma.j.cn112139-20240331-00155","DOIUrl":"10.3760/cma.j.cn112139-20240331-00155","url":null,"abstract":"<p><p>In recent years, with the deepening of mesentery research, it is found that its blood vessels, nerves, lymphoid tissue, adipose tissue and other structures play an important role in the occurrence and development of Crohn disease, and the degree of lesion is related with the disease process, surgical difficulty, the occurrence of intraoperative complications and postoperative recurrence. The optimal surgical strategy of Crohn disease based on mesenteric involvement has received great attention. Multiple retrospective studies found that extended mesenteric resection and Kono-S anastomosis potentially could reduce the rate of postoperative recurrence. However, the latest prospective randomized controlled studies did not achieve the expected results, and the evidence for the surgical strategy based on mesentery is still weak. This review summarises the findings of basic and clinical investigations of the mesentery in Crohn disease so far and explores its role in surgical treatment optimization, and provides new thinking and insights for the further research and surgical options for Crohn disease.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 2","pages":"107-113"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967540","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}