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Laparoscopic treatment of liver diseases in children

Jia Wei, Jiexiong Feng

《医学前沿(英文)》 2011年 第5卷 第4期   页码 388-394 doi: 10.1007/s11684-011-0165-3

摘要: Laparoscopic liver surgery has been increasingly used for the treatment of pediatric liver diseases over the past decade due to the development of special laparoscopic instruments and improvements in the technique. A number of factors are considered when electing to undergo the surgical process, including age, type of liver disease, and so on. Especially in children with liver masses, the number of trocars used and the position of their placement must be carefully designed to achieve successful outcomes. In the current review, the application of various laparoscopic instruments and the methods used for the laparoscopic treatment of liver diseases in children over the past decade are summarized.

关键词: laparoscopic surgery     liver mass     pediatric    

Towards the optimization of management of hepatocellular carcinoma

Xi Feng, Madhava Pai, Malkhaz Mizandari, Tinatin Chikovani, Duncan Spalding, Long Jiao, Nagy Habib

《医学前沿(英文)》 2011年 第5卷 第3期   页码 271-276 doi: 10.1007/s11684-011-0148-4

摘要: Hepatocellular carcinoma (HCC) is the fifth most common neoplasm in the world, closely correlated with viral hepatitis and liver cirrhosis. The vast majority of HCC patients present at a late stage and are unsuitable for surgery due to limited liver functional reserve. Tumors can involve major vessels or hilar structures, necessitating major liver resection and/or rendering liver resection unfeasible. A series of new technologies have been developed to optimise HCC management. Stem cell therapy improves impaired liver functional reserve prior to liver resection. Intravascular radiofrequency ablation recanalises the portal vein invaded by tumour thrombus and endobiliary radiofrequency ablation restores and extends biliary patency of the bile duct invaded by malignancy. Laparoscopic radiofrequency assisted liver resection minimizes blood loss and avoids liver warm ischemia, while increasing parenchymal sparing. These benefits combined maximize the safety of liver resection.

关键词: management     hepatocellular carcinoma (HCC)     radiofrequency (RF) ablation     laparoscopic liver resection     stem cell     intravascular RF ablation     endobiliary RF ablation    

Adjuvant treatment strategy after curative resection for hepatocellular carcinoma

Wei Zhang, Bixiang Zhang, Xiao-ping Chen

《医学前沿(英文)》 2021年 第15卷 第2期   页码 155-169 doi: 10.1007/s11684-021-0848-3

摘要: Hepatic resection represents the first-line treatment for patients with resectable hepatocellular carcinoma (HCC). However, the 5-year recurrence rates of HCC after surgery have been reported to range from 50% to 70%. In this review, we evaluated the available evidence for the efficiency of adjuvant treatments to prevent HCC recurrence after curative liver resection. Antiviral therapy has potential advantages in terms of reducing the recurrence rate and improving the overall survival (OS) and/or disease-free survival of patients with hepatitis-related HCC. Postoperative adjuvant transarterial chemoembolization can significantly reduce the intrahepatic recurrence rate and improve OS, especially for patients with a high risk of recurrence. The efficacy of molecular targeted drugs as an adjuvant therapy deserves further study. Adjuvant adoptive immunotherapy can significantly improve the clinical prognosis in the early stage. Randomized controlled trial (RCT) studies evaluating adjuvant immune checkpoint inhibitors are ongoing, and the results are highly expected. Adjuvant hepatic artery infusion chemotherapy might be beneficial in patients with vascular invasion. Huaier granule, a traditional Chinese medicine, has been proved to be effective in prolonging the recurrence-free survival and reducing extrahepatic recurrence. The efficiency of other adjuvant treatments needs to be further confirmed by large RCT studies.

关键词: hepatocellular carcinoma     adjuvant treatment     hepatic resection     recurrence    

A step forward in laparoscopic hepatectomy: comments on “Expert Consensus on Laparoscopic Hepatectomy

null

《医学前沿(英文)》 2013年 第7卷 第4期   页码 520-522 doi: 10.1007/s11684-013-0302-2

Improved control of hypertension following laparoscopic fundoplication for gastroesophageal reflux disease

null

《医学前沿(英文)》 2017年 第11卷 第1期   页码 68-73 doi: 10.1007/s11684-016-0490-7

摘要:

This study aims to determine whether successful laparoscopic fundoplication for gastroesophageal reflux disease (GERD) can improve the control of hypertension. We conducted an observational study of GERD patients with hypertension. The esophageal and gastroesophageal symptoms of these patients were successfully treated with laparoscopic fundoplication, as measured by the reduced GERD symptoms and proton pump inhibitor consumption. A hypertension control scale was used to classify the use of antihypertensive medications and the quality of blood pressure control before and after anti-reflux surgery. Wilcoxon signed-ranks test was used for the statistical analyses. Seventy GERD patients were included in the analysis and followed up for a mean period of 3.5±1.4 years. Prior to surgery, all participating patients were taking at least one class of antihypertensive medication, and 56 patients (80%) had intermittently high blood pressure. After surgery, the mean number of antihypertensive medication classes per patient was significantly reduced from 1.61±0.77 pre-procedure to 1.27±0.88 post-procedure (P?<?0.001). The blood pressure of 48 of the 56 cases (86%) with preoperative intermittent high blood pressure returned to normal post procedure. A total of 50 patients (71%) recorded improvements on the hypertension control scale, with the overall mean score decreasing from 3.1±1.0 pre-procedure to 1.4±1.0 post-procedure (P?<?0.001). Therefore, successful laparoscopic fundoplication may result in better blood pressure control in some hypertensive GERD patients. This result suggests a possible connection between gastroesophageal reflux and hypertension.

关键词: gastroesophageal reflux disease     hypertension     blood pressure     laparoscopic fundoplication    

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    

loaded natural extracellular matrix hydrogel for inhibition of glioblastoma recurrence after tumor resection

《化学科学与工程前沿(英文)》 2022年 第16卷 第4期   页码 536-545 doi: 10.1007/s11705-021-2067-5

摘要: Many scientific efforts have been made to penetrate the blood-brain barrier and target glioblastoma cells, but the outcomes have been limited. More attention should be given to local inhibition of recurrence after glioblastoma resection to meet real medical needs. A biodegradable wafer containing the chemotherapeutics carmustine (1,3-bis(2-chloroethyl)-1-nitrosourea, BCNU) was the only local drug delivery system approved for clinical glioblastoma treatment, but with a prolonged survival time of only two months and frequent side effects. In this study, to improve the sustained release and prolonged therapeutic effect of drugs for inhibiting tumor recurrence after tumor resection, both free BCNU and BCNU- poly (lactic-co-glycolic acid) (the ratio of lactic acid groups to glycolic acid groups is 75/25) nanoparticles were simultaneously loaded into natural extracellular matrix hydrogel from pigskin to prepare BCNU gels. The hydrogel was injected into the resection cavity of a glioblastoma tumor immediately after tumor removal in a fully characterized resection rat model. Free drugs were released instantly to kill the residual tumor cells, while drugs in nanoparticles were continuously released to achieve a continuous and effective inhibition of the residual tumor cells for 30 days. These combined actions effectively restricted tumor growth in rats. Thus, this strategy of local drug implantation and delivery may provide a reliable method to inhibit the recurrence of glioblastoma after tumor resection in vivo.

关键词: BCNU     glioblastoma recurrence     tumor resection     nanoparticles     hydrogel    

Single incision laparoscopic cholecystectomy using the one-incision three-trocar technique with all straight

Hongyi Cui

《医学前沿(英文)》 2011年 第5卷 第3期   页码 283-287 doi: 10.1007/s11684-011-0151-9

摘要: Single incision laparoscopic surgery (SILS) is a novel minimally invasive surgical technique that is gaining popularity around the world. One of the most commonly performed procedures is single incision laparoscopic cholecystectomy (SILC). Most reported techniques utilize special purpose-made access port and articulating instruments, rendering the procedure costly and difficult to learn. This article provides a stepwise description of SILC technique using all straight instruments without the need for a special port. It aims to shorten the learning curve for surgeons wishing to adopt a safe and cost-effective SILC technique to their practice.

关键词: laparoscopic cholecystectomy     single incision laparoscopic surgery    

Partial liver transplantation

null

《医学前沿(英文)》 2011年 第5卷 第1期   页码 1-7 doi: 10.1007/s11684-010-0105-7

摘要:

Partial liver transplantation, including reduced-size liver transplantation, split liver transplantation, and living donor liver transplantation, has been developed with several innovative techniques because of donor shortage. Reduced-size liver transplantation is based on Couinaud’s anatomical classification, benefiting children and small adult recipients but failing to relieve the overall donor shortage. Split liver transplantation provides chances to two or even more recipients when only one liver graft is available. The splitting technique must follow stricter anatomical and physiological criteria either ex situ or in situto ensure long-term quality. The first and most important issue involving living donor liver transplantation is donor safety. Before surgery, a series of donor evaluations—including anatomical, liver volume, and liver function evaluations—is indispensable, followed by ethnic agreement. At different recipient conditions, auxiliary liver transplantation and auxiliary partial orthotopic liver transplantation, which employ piggyback techniques, are good alternatives. Partial liver transplantation enriches the practice and knowledge of the transplant society.

关键词: partial liver transplantation     reduced-size liver transplantation     split liver transplantation     living donor liver transplantation    

Design and calibration of a new high-definition three-dimensional laparoscopic system

Jia TANG,Li-qiang WANG,Bo YUAN,Hong JIANG,Qi-ming ZHU

《信息与电子工程前沿(英文)》 2015年 第16卷 第1期   页码 79-84 doi: 10.1631/FITEE.1400149

摘要: We present a high-definition (HD) 3D laparoscopic system including a dual channel optical system, two cameras, a camera control unit (CCU), and an HD 3D monitor. This laparoscopic system is capable of outputting dual high-definition videos and providing vivid 3D images. A modified pinhole camera model is used for camera calibration and a new method of depth measurement to improve precision. The average error of depth measurement measured by experiment (about 1.13 mm) was small in proportion to the large range in distance of the system (10-150 mm). The new method is applicable to any calibrated binocular vision system.

关键词: Dual optical channels     Three dimensional     Camera calibration     Pinhole model     Depth measurement     Laparoscopic system    

γδ T cells in liver diseases

null

《医学前沿(英文)》 2018年 第12卷 第3期   页码 262-268 doi: 10.1007/s11684-017-0584-x

摘要:

γδ T cells display unique developmental, distributional, and functional patterns and can rapidly respond to various insults and contribute to diverse diseases. Different subtypes of γδ T cells are produced in the thymus prior to their migration to peripheral tissues. γδ T cells are enriched in the liver and exhibit liver-specific features. Accumulating evidence reveals that γδ T cells play important roles in liver infection, non-alcoholic fatty liver disease, autoimmune hepatitis, liver fibrosis and cirrhosis, and liver cancer and regeneration. In this study, we review the properties of hepatic γδ T cells and summarize the roles of γδ T cells in liver diseases. We believe that determining the properties and functions of γδ T cells in liver diseases enhances our understanding of the pathogenesis of liver diseases and is useful for the design of novel γδ T cell-based therapeutic regimens for liver diseases.

关键词: γδT cells     liver infection     non-alcoholic fatty liver disease     autoimmune hepatitis     liver fibrosis and cirrhosis     liver cancer     liver regeneration    

Potential indicators predict progress after surgical resection of gastrointestinal stromal tumors

null

《医学前沿(英文)》 2012年 第6卷 第3期   页码 317-321 doi: 10.1007/s11684-012-0203-9

摘要:

In order to find out the potential indicators predicting prognosis of malignant gastrointestinal stromal tumors (GISTs) after surgical resection, we collected clinical records of 80 patients with malignant GISTs. Tumor location, size, mitotic index, necrosis were compared with the prognosis of malignant GISTs by Kaplan-Meier method and log-rank test. After a median follow-up of 844 days (52–2 145), we found that as National Institutes of Health suggested, tumors with intermediate risk had more favorable prognosis than that with high risk. Their 3-year survival rate were 65.3% and 41.3%, respectively (P<0.001). Moreover, tumor size and mitotic index were associated with free survival. The 3-year survival rate for patients with tumor size≤10 cm and>10 cm were 62.3% and 41.8%, respectively (P = 0.002), Tumors with mitotic index≤5/50 HPF had a higher 3-year survival rate than tumors with mitotic index>5/50 HPF (67.1% versus 40.7%, P = 0.005). The presence of necrosis was directly related to the malignant behavior. The 3-year survival rate for presence and absence necrosis were 50.8% and 64.8% (P = 0.008). From the present study, we can conclude that besides tumors size and mitotic index, tumor location and necrosis also influence on the long-term survival of patient with malignant GISTs after surgical resection.

关键词: gastrointestinal stromal tumors     surgery     survival    

Treatment of severe acute pancreatitis through retroperitoneal laparoscopic drainage

Chun Tang, Baolin Wang, Bing Xie, Hongming Liu, Ping Chen

《医学前沿(英文)》 2011年 第5卷 第3期   页码 302-305 doi: 10.1007/s11684-011-0145-7

摘要: A treatment method based on drainage via retroperitoneal laparoscopy was adopted for 15 severe acute pancreatitis (SAP) patients to investigate the feasibility of the method. Ten patients received only drainage via retroperitoneal laparoscopy, four patients received drainage via both retroperitoneal and preperitoneal laparoscopy, and one patient received drainage via conversion to laparotomy. Thirteen patients exhibited a good drainage effect and were successfully cured without any other surgical treatment. Two patients had encapsulated effusions or pancreatic pseudocysts after surgery, but were successfully cured after lavage and B ultrasound-guided percutaneous catheter drainage. SAP treatment via retroperitoneal laparoscopic drainage is an effective surgical method, resulting in minor injury.

关键词: severe acute pancreatitis (SAP)     laparoscope     retroperitoneal drainage     treatment    

Endoscopic resection of a huge Brunner's gland adenoma

ZHANG Binbin, REN Xu, TANG Xiufen, CHI Yuxin, SHI Xuesong

《医学前沿(英文)》 2008年 第2卷 第4期   页码 414-418 doi: 10.1007/s11684-008-0080-4

摘要: Brunner’s gland adenoma is a rare tumour of the duodenum, which is usually benign. A 71-year-old woman presenting with epigastric pain, upper gastrointestinal haemorrhage and melaena was reported in this paper. Upper gastro-intestinal (GI) endoscopy revealed a large pedunculated tumour on the superior part of the duodenal bulb. Endoscopic polypectomy was successfully performed by clipping and nylon thread without any complications. Histological examination revealed a Brunner’s gland adenoma.

关键词: superior     Histological examination     endoscopy     gastro-intestinal     gastrointestinal haemorrhage    

NKT cells in liver diseases

null

《医学前沿(英文)》 2018年 第12卷 第3期   页码 249-261 doi: 10.1007/s11684-018-0622-3

摘要:

Natural killer T cells are innate-like and tissue-resident lymphocytes, which recognize lipid antigens and are enriched in the liver. Natural killer T cells play important roles in infections, tumors, autoimmune diseases, and metabolic diseases. In this study, we summarize recent findings on biology of natural killer T cells and their roles in hepatitis B virus and hepatitis C virus infection, autoimmune liver diseases, alcoholic liver disease, nonalcoholic fatty liver disease, and hepatocellular carcinoma. Controversial results from previous studies are discussed, and indicate the dynamic alteration in the role of natural killer T cells during the progression of liver diseases, which might be caused by changes in natural killer T subsets, factors skewing cytokine responses, and intercellular crosstalk between natural killer T cells and CD1d-expressing cells or bystander cells.

关键词: natural killer T cells     hepatitis B virus and hepatitis C virus infection     autoimmune liver diseases     alcoholic liver disease     nonalcoholic fatty liver disease     hepatocellular carcinoma    

标题 作者 时间 类型 操作

Laparoscopic treatment of liver diseases in children

Jia Wei, Jiexiong Feng

期刊论文

Towards the optimization of management of hepatocellular carcinoma

Xi Feng, Madhava Pai, Malkhaz Mizandari, Tinatin Chikovani, Duncan Spalding, Long Jiao, Nagy Habib

期刊论文

Adjuvant treatment strategy after curative resection for hepatocellular carcinoma

Wei Zhang, Bixiang Zhang, Xiao-ping Chen

期刊论文

A step forward in laparoscopic hepatectomy: comments on “Expert Consensus on Laparoscopic Hepatectomy

null

期刊论文

Improved control of hypertension following laparoscopic fundoplication for gastroesophageal reflux disease

null

期刊论文

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

Li Jiang, Deng Ning, Xiaoping Chen

期刊论文

loaded natural extracellular matrix hydrogel for inhibition of glioblastoma recurrence after tumor resection

期刊论文

Single incision laparoscopic cholecystectomy using the one-incision three-trocar technique with all straight

Hongyi Cui

期刊论文

Partial liver transplantation

null

期刊论文

Design and calibration of a new high-definition three-dimensional laparoscopic system

Jia TANG,Li-qiang WANG,Bo YUAN,Hong JIANG,Qi-ming ZHU

期刊论文

γδ T cells in liver diseases

null

期刊论文

Potential indicators predict progress after surgical resection of gastrointestinal stromal tumors

null

期刊论文

Treatment of severe acute pancreatitis through retroperitoneal laparoscopic drainage

Chun Tang, Baolin Wang, Bing Xie, Hongming Liu, Ping Chen

期刊论文

Endoscopic resection of a huge Brunner's gland adenoma

ZHANG Binbin, REN Xu, TANG Xiufen, CHI Yuxin, SHI Xuesong

期刊论文

NKT cells in liver diseases

null

期刊论文