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A new minimally invasive treatment for anal fistula

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《医学前沿（英文）》 2015年第9卷第1期页码 77-81 doi: 10.1007/s11684-014-0352-0

摘要：

In colorectal surgery, eradicating the fistula and maintaining continence are still complex challenges for a colorectal surgeon. A minimally invasive method using a novel device was performed to consecutively treat 14 patients with anal fistula from August 2008 to November 2009. After a follow-up period of 36 months, 13 patients achieved successful closure of their fistula tracts, and recurrence occurred only in one patient. Recurrence was due to the delay of dressing change. No patient had interference with continence, and no major intra- and post-operative complications were identified. Using the novel device with invasive methods can be a promising alternative for managing anal fistulas.

关键词： anal fistula surgery device

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Prevention and treatment of pancreatic fistula after pancreatic body and tail resection: current status

Li Jiang, Deng Ning, Xiaoping Chen

《医学前沿（英文）》 2020年第14卷第3期页码 251-261 doi: 10.1007/s11684-019-0727-3

摘要： Postoperative pancreatic fistula (POPF) is the most common and critical complication after pancreatic body and tail resection. How to effectively reduce the occurrence of pancreatic fistula and conduct timely treatment thereafter is an urgent clinical issue to be solved. Recent research standardized the definition of pancreatic fistula and stressed the correlation between POPF classification and patient prognosis. According to the literature, identification of the risk factors for pancreatic fistula contributed to lowering the rate of the complication. Appropriate management of the pancreatic stump and perioperative treatment are of great significance to reduce the rate of POPF in clinical practice. After the occurrence of POPF, the treatment of choice should be determined according to the classification of the pancreatic fistula. However, despite the progress and promising treatment approaches, POPF remains to be a clinical issue that warrants further studies in the future.

关键词： pancreatic fistula pancreatic body and tail resection distal pancreatectomy

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Synchronous rectal adenocarcinoma and anal canal adenocarcinoma

GU Jin, YAO Yunfeng, LI Jiyou, LU Aiping, WANG Hongyi

《医学前沿（英文）》 2007年第1卷第3期页码 333-337 doi: 10.1007/s11684-007-0064-9

摘要： It is difficult to distinguish a rectal carcinoma with anal metastases from coexistent synchronous anorectal carcinomas. The therapeutic strategy for rectal and anal carcinoma is so different that it should be clearly identified. Here, we report on the case of a 63-year-old man who presented with an upper-third rectal adenocarcinoma. Five months after resection, he developed an adenocarcinoma in the anal canal. The histological slides of both tumors were reviewed and immunohistochemical studies for cytokeratins (CKs) 7 and 20 were performed. The index tumor demonstrated CK 7 /CK 20+ and the second showed CK7+/CK20+. For this reason, we believe the present case had synchronous adenocarcinomas arising from anal canal and the rectum separately. It is very important to differentiate the anorectal lesions pathologically because of the impact on the therapeutic options available, especially for the lesion arising in the anal canal.

关键词： CK7+/CK20+ resection different therapeutic strategy upper-third

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Gastrointestinal damage caused by swallowing multiple magnets

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《医学前沿（英文）》 2012年第6卷第3期页码 280-287 doi: 10.1007/s11684-012-0207-5

摘要：

Swallowing multiple magnets is not uncommon worldwide and it frequently leads to serious consequences. However, most patients fail to receive timely and correct diagnosis and treatment. A literature search was performed to establish an algorithm for these accidents by the authors to identify relevant articles published from June 1987 to October 2010 in Google, Medline, ISI Web of Knowledge Ovid, CNKI, Korea Med and library document delivery, using search terms “magnet ingestion, ” “fistula, ” and “perforation. ” A total of 149 patients with ingestion of magnetic foreign bodies from 20 countries and areas were identified. 22 of them were companioned with neurological and psychiatric disorders. Swallowing magnets occurred throughout childhood and adolescent, mostly ranging 2 to 4 years in age. Various gastrointestinal damages such as necrosis and intestinal perforation or fistula were encountered. Damage from swallowing multiple magnets carries a significant risk of morbidity and even mortality throughout childhood to adolescent worldwide. Older children and adults with neurological and psychiatric problems may be at high risk for such accidents. Early intervention is crucial.

关键词： magnet ingestion fistula perforation

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Laparoscopic surgery for pancreatic lesions: current status and future

Taiping Zhang, Xiao Du, Yupei Zhao

《医学前沿（英文）》 2011年第5卷第3期页码 277-282 doi: 10.1007/s11684-011-0147-5

摘要： Laparoscopic pancreatic surgery has been gaining increasing recognition in recent years, and its practice has increased despite its highly complex procedure and longer learning curve compared with surgeries for other abdominal organs. Laparoscopic distal pancreatectomy and tumor enucleation are two of the fastest-growing techniques and are currently in wide use because of their comparable technical simplicity. Literature review showed that laparoscopic distal pancreatectomy and enucleation are safe and efficient approaches for benign and low-degree malignant tumors; however, the indication for malignant tumors remains controversial. Laparoscopic pancreaticoduodenectomy is practiced in a limited number of surgical centers and presented as case reports or in small series. Although its feasibility was demonstrated by many surgeons, whether the laparoscopic procedure can achieve benefits comparable to or even more prominent than those of an open procedure has not been clinically proven. Prospective, randomized, controlled trials of laparoscopic operation versus open pancreatic surgery are necessary to justify the wide application and routine practice of the laparoscopic procedure for pancreatic lesions.

关键词： minimally invasive surgery pancreatic surgery pancreatic neoplasm distal pancreatic lesions pancreatic fistula

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The role of prophylactic transpapillary pancreatic stenting in distal pancreatectomy: a meta-analysis

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《医学前沿（英文）》 2013年第7卷第4期页码 499-505 doi: 10.1007/s11684-013-0296-9

摘要：

Pancreatic fistula (PF) is the most frequent complication after distal pancreatectomy (DP). Prophylactic transpapillary pancreatic stenting (PTPS) has been proposed recently for the prevention of PF after DP. In this meta-analysis, a comprehensive search was performed in the PubMed, Embase, and Cochrane Library databases. Studies analyzing the results of PTPS in DP were considered eligible for this meta-analysis. The analyzed outcome variables included PF rate, postoperative morbidity, non-PF-related complications, mortality, operation duration, and hospital stay. Four studies with 200 patients were included in this review. Only one was a randomized controlled trial (RCT). The results showed that PTPS was associated with less PF formation (odds ratio, 0.45; 95% confidence interval [CI], 0.22–0.94; P = 0.03) and shorter hospital stay (mean difference, -6.31; 95% CI, -6.99 to -5.62; P<0.00001). There was no significant difference in terms of the other variables. In conclusion, current evidence indicates that PTPS could reduce PF incidence and hospital stay after DP, without increasing other complications or operative time. However, the evidence is not solid, because the single RCT conflicted with the other three retrospective reports. Thus, considering the limitation, more well-designed RCTs on this topic are needed in the future.

关键词： pancreatic fistula distal pancreatectomy pancreatic stent meta-analysis