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Guidelines for navigation-assisted spine surgery

Liu, Xiaoguang Han, Jingwei Zhao, Mingxing International Society for Computer Assisted Orthopaedic Surgery

《医学前沿（英文）》 2020年 第14卷 第4期   页码 518-527 doi: 10.1007/s11684-020-0775-8

摘要： Spinal surgery is a technically demanding and challenging procedure because of the complicated anatomical structures of the spine and its proximity to several important tissues. Surgical landmarks and fluoroscopy have been used for pedicle screw insertion but are found to produce inaccuracies in placement. Improving the safety and accuracy of spinal surgery has increasingly become a clinical concern. Computer-assisted navigation is an extension and application of precision medicine in orthopaedic surgery and has significantly improved the accuracy of spinal surgery. However, no clinical guidelines have been published for this relatively new and fast-growing technique, thus potentially limiting its adoption. In accordance with the consensus of consultant specialists, literature reviews, and our local experience, these guidelines include the basic concepts of the navigation system, workflow of navigation-assisted spinal surgery, some common pitfalls, and recommended solutions. This work helps to standardize navigation-assisted spinal surgery, improve its clinical efficiency and precision, and shorten the clinical learning curve.

关键词： guidelines     spine surgery     computer-assisted navigation    

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New spinal robotic technologies

Bowen Jiang, Tej D. Azad, Ethan Cottrill, Corinna C. Zygourakis, Alex M. Zhu, Neil Crawford, Nicholas Theodore

《医学前沿（英文）》 2019年 第13卷 第6期   页码 723-729 doi: 10.1007/s11684-019-0716-6

摘要： Robotic systems in surgery have developed rapidly. Installations of the da Vinci Surgical System (Intuitive Surgical, Sunnyvale, CA, USA), widely used in urological and gynecological procedures, have nearly doubled in the United States from 2010 to 2017. Robotics systems in spine surgery have been adopted more slowly; however, users are enthusiastic about their applications in this subspecialty. Spinal surgery often requires fine manipulation of vital structures that must be accessed via limited surgical corridors and can require repetitive tasks over lengthy periods of time — issues for which robotic assistance is well-positioned to complement human ability. To date, the United States Food and Drug Administration (FDA) has approved 7 robotic systems across 4 companies for use in spinal surgery. The available clinical data evaluating their efficacy have generally demonstrated these systems to be accurate and safe. A critical next step in the broader adoption of surgical robotics in spine surgery is the design and implementation of rigorous comparative studies to interrogate the utility of robotic assistance. Here we discuss current applications of robotics in spine surgery, review robotic systems FDA-approved for use in spine surgery, summarize randomized controlled trials involving robotics in spine surgery, and comment on prospects of robotic-assisted spine surgery.

关键词： robotics     spine surgery     Mazor     ExcelsiusGPS     ROSA     pedicle screw    

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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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Advances in tissue state recognition in spinal surgery: a review

Hao Qu, Yu Zhao

《医学前沿（英文）》 2021年 第15卷 第4期   页码 575-584 doi: 10.1007/s11684-020-0816-3

摘要： Spinal disease is an important cause of cervical discomfort, low back pain, radiating pain in the limbs, and neurogenic intermittent claudication, and its incidence is increasing annually. From the etiological viewpoint, these symptoms are directly caused by the compression of the spinal cord, nerve roots, and blood vessels and are most effectively treated with surgery. Spinal surgeries are primarily performed using two different techniques: spinal canal decompression and internal fixation. In the past, tactile sensation was the primary method used by surgeons to understand the state of the tissue within the operating area. However, this method has several disadvantages because of its subjectivity. Therefore, it has become the focus of spinal surgery research so as to strengthen the objectivity of tissue state recognition, improve the accuracy of safe area location, and avoid surgical injury to tissues. Aside from traditional imaging methods, surgical sensing techniques based on force, bioelectrical impedance, and other methods have been gradually developed and tested in the clinical setting. This article reviews the progress of different tissue state recognition methods in spinal surgery and summarizes their advantages and disadvantages.

关键词： spinal surgery     tissue state recognition     image     force sensing     bioelectrical impedance    

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Current progress on natural orifice transluminal endoscopic surgery (NOTES)

null

《医学前沿（英文）》 2012年 第6卷 第2期   页码 187-194 doi: 10.1007/s11684-012-0198-2

摘要：

Natural orifice transluminal endoscopic surgery (NOTES) has received considerable interest in recent years as a novel surgical technique. Here, we aim to review the current progress on NOTES, particularly focusing on the advantages and complications related to NOTES, the recent advances of surgical approaches, new instruments for closure of the natural orifice incision, and the newly developed platform for NOTES. Finally, we make a prediction of the conceivable applications of NOTES on human subjects.

关键词： natural orifice transluminal endoscopic surgery (NOTES)     laparotomy     laparoscopy    

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Achievements in burn surgery over the past 50 years in China

WANG Shiliang

《医学前沿（英文）》 2008年 第2卷 第4期   页码 332-336 doi: 10.1007/s11684-008-0063-5

摘要： This paper reflects on the advancements of clinical and scientific research in the field of burn surgery in China. It includes emergency care of massive burns, resuscitation, anti-infection, prevention and cure of internal organ injuries, metabolic and nutritional support, wound repair and rehabilitation, and special types of burns; it also covers pathology, microbiology, immunology, cell biology, molecular biology, and tissue engineering.

关键词： immunology     scientific     nutritional     microbiology     engineering    

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Lobectomy by video-assisted thoracoscopic surgery (VATS) for early stage of non-small cell lung cancer

null

《医学前沿（英文）》 2011年 第5卷 第1期   页码 53-60 doi: 10.1007/s11684-011-0121-2

摘要：

Video-assisted thoracoscopic surgery (VATS) provides a new approach for treating early-stage lung cancer. Lobectomy by VATS has many advantages over conventional thoracotomy, such as shorter recovery time, less postoperative pain, and faster resumption of a normal lifestyle. However, there is still much debate on the role of VATS in lobectomy for the treatment of lung cancer. Concerns regarding safety, the extent of mediastinal lymph node dissection, and long-term survival have made some surgeons apprehensive of its validity for lung cancer. In this paper, we review the development of thoracoscopy, the present status of VATS for early stage of non-small cell lung cancer (NSCLC), and comparison between VATS and open thoracotomy in the management of NSCLC.

关键词： non-small cell lung cancer     video-assisted thoracoscopic surgery     lobectomy    

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Risk factors for ventilator-associated pneumonia among patients undergoing major oncological surgery

null

《医学前沿（英文）》 2017年 第11卷 第2期   页码 239-246 doi: 10.1007/s11684-017-0509-8

摘要：

Patients undergoing major oncological surgery for head and neck cancer (SHNC) have a particularly high risk of nosocomial infections. We aimed to identify risk factors for ventilator-associated pneumonia (VAP) in patients undergoing SHNC. The study included 465 patients who underwent SHNC between June 2011 and June 2014. The rate of VAP, risk factors for VAP, and biological aspects of VAP were retrospectively evaluated. The incidence of VAP was 19.6% (n=95) in patients who required more than 48 h of mechanical ventilation. Staphylococcus (37.7%), Enterobacteriaceae (32.1%), Pseudomonas(20.8%), and Haemophilus (16.9%) were the major bacterial species that caused VAP. The independent risk factors for VAP were advanced age, current smoking status, chronic obstructive pulmonary disease, and a higher simplified acute physiology score system II upon admission. Tracheostomy was an independent protective factor for VAP. The median length of stay in the ICU for patients who did or did not develop VAP was 8.0 and 6.5 days, respectively (P=0.006). Mortality among patients who did or did not develop VAP was 16.8% and 8.4%, respectively (P<0.001). The potential economic impact of VAP was high because of the significantly extended duration of ventilation. A predictive regression model was developed with a sensitivity of 95.3% and a specificity of 69.4%. VAP is common in patients who are undergoing SHNC and who require more than 48 h of mechanical ventilation. Therefore, innovative preventive measures should be developed and applied in this high-risk population.

关键词： ventilator-associated pneumonia (VAP)     pneumonia     risk factors     surgery for head and neck cancer (SHNC)    

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Evaluation of the harmonic scalpel in open surgery for abdominal aortic aneurysm

null

《医学前沿（英文）》 2012年 第6卷 第1期   页码 85-88 doi: 10.1007/s11684-012-0174-x

摘要：

The harmonic scalpel is a hemostatic device primarily designed for use in laparoscopic surgery. During the last few years, many surgeons have begun to use the harmonic scalpel in open surgery. Several papers have cited the benefits of the device compared with conventional knot-tying techniques; however, no evidence showing the advantages of using the harmonic scalpel in complicated abdominal aortic aneurysm (AAA) surgery has been presented. The aim of the present study is to determine the value of the harmonic scalpel in open operation for AAA. A total of 153 patients who underwent open surgery for AAA at the Department of Vascular Surgery of Guangdong General Hospital, China between January 2001 and December 2010, were retrospectively analyzed. Open surgery performed with the harmonic scalpel on 105 patients was compared with open operation using conventional knot-tying techniques on 48 patients. The operative time, intraoperative blood loss, total postoperative drainage fluid volumes, hospital stay, and postoperative complications between the two groups were compared. The harmonic scalpel group was associated with a shorter operation time (113.2±23.6 min vs. 232.1±39.2 min, P<0.01) and lower intraoperative blood loss (126.1±96.6 ml vs. 592.1±207.2 ml, P<0.01). Postoperative drainage fluid volumes were greater in the conventional surgery group than in the harmonic scalpel group (702.1±192.8 ml vs. 198.5±97.4 ml, P<0.01). The hospital stay was shorter for the harmonic scalpel group than for the conventional surgery group (10.7±3.3 d vs. 16.5±4.7 d, P<0.05). No differences between the postoperative complications or hospital mortality of the two groups were found. The harmonic scalpel is a safe and minimally invasive tool in open surgery for AAA and is associated with shorter operative time, shorter hospital stay, and lower intraoperative blood loss and postoperative drainage fluid volumes compared with conventional knot-tying techniques.

关键词： abdominal aortic aneurysm     harmonic scalpel     minimally invasive    

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Development of splenic surgery in China

JIANG Hongchi, ZHAO Xianqi, GAO Yue

《医学前沿（英文）》 2007年 第1卷 第2期   页码 126-129 doi: 10.1007/s11684-007-0024-4

摘要： Splenic surgery has enjoyed rapid progress for the past decades in China. Based on continuously solidifying theories and clinical practice, many advanced concepts with applicable clinical frameworks have been established, thus making splenic surgery an indispensable division in modern surgery. In this study, the authors try to give an overview of the developments in this field. Spleen function is a key issue that generally guides advances in splenic surgery. The old knowledge of the dispensable spleen has been abandoned, while the exact role that it plays in the body continues to be unveiled. Now, standard grading for splenic injury and the respective guidelines for clinical management have been established, with the use of selective instead of indiscriminate splenectomy being accepted by most experts. Various spleen sparing operations have been developed, while many advanced techniques such as laparoscopy have been introduced to splenic surgery. Spleen transplantation has greatly advanced in China, even though there are still many unsolved mysteries in this field. Altogether, splenic surgery is a new and prosperous discipline, and it is a tremendous stage for young surgeons to be part of.

关键词： function     respective     prosperous discipline     knowledge     indispensable division    

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Laparoscopic hepato-biliary-pancreatic surgery: present practices and prospects

Yongjun Chen, Renyi Qin, Xiaoping Chen

《医学前沿（英文）》 2011年 第5卷 第3期   页码 235-238 doi: 10.1007/s11684-011-0156-4

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Liver surgery and transplantation in China: Progress and Challenges

LAU W Y, LAI E C H

《医学前沿（英文）》 2007年 第1卷 第1期   页码 1-5 doi: 10.1007/s11684-007-0001-y

摘要： From the limited but available information, we traced the history of developments of liver surgery and transplantation in China. Liver surgery first started in the late 1950s in China, and it soon flourished mainly because of the great demand in liver surgery and the emergence of a number of giants in liver surgery. We recognized and honoured the important contributions of these Chinese pioneers in portal hypertension, recurrent pyogenic cholangitis, hepatocellular carcinoma and liver transplantation.

关键词： transplantation     pyogenic cholangitis     available information     important     hypertension    

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Setting up a heart rate alarm limit to decrease oculocardiac reflex during strabismus surgery in children

ZHANG Kangkang, GU Enhua, LU Junjie

《医学前沿（英文）》 2008年 第2卷 第3期   页码 295-297 doi: 10.1007/s11684-008-0056-4

摘要： The aim of this paper is to investigate a method which may decrease the incidence and severity of oculocardiac reflex (OCR) without drugs. One hundred and sixty children undergoing strabismus surgery were allocated to two groups using double-blind randomization. OCR was defined as a decrease of more than 10% from the baseline heart rate during operation. An alarm sounded and a lamp flashed as soon as OCR occurred in group I, and neither of the above happened in group II. OCR occurred (1.151 ± 0.858) times in group I and (2.287 ± 1.371) times in group II ( < 0.05). Heart rate decreased by (23 ± 19) bpm in group I and (35 ± 28) bpm in group II ( < 0.05). The duration of OCR in group I and group II was (4.36 ± 4.26)s and (7.62 ± 6.41)s, respectively ( < 0.05). The recovery time for group I and group II was (15.36 ± 13.28)s and (32.36 ± 19.57)s, respectively ( < 0.05). The numbers of times of interruption were 8 in group I (10%) and 26 in group II (32%) ( < 0.01). This method significantly decreased the incidence and severity of OCR during strabismus surgery in children.
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“Fast Track” nasogastric decompression of rectal cancer surgery

Ka Li, Zongguang Zhou, Zengrong Chen, Yi Zhang, Cun Wang

《医学前沿（英文）》 2011年 第5卷 第3期   页码 306-309 doi: 10.1007/s11684-011-0154-6

摘要： This study evaluates the application of fast track (FT) nasogastric decompression in patients who underwent anterior resection of rectal cancer. A randomized control trial was performed comparing the group with the fast track treatment ( =β57) and the group with traditional nasogastric decompression ( =β84). Preoperative characteristics and postoperative recovery indices were recorded and analyzed. The results indicate no significant differences in gender ( =β0.614), age ( =β0.653), tumor location ( =β0.113), and TNM stages ( =β0.054) were observed between the 2 groups. The differences in the type of resection, anastomosis, and adoption of protective colostomy were all not significant between the FT and the traditional group. During the first 24 hours after surgery, the volume of nasogastric drainage averaged 197 ml in the FT group and 155 ml in the traditional group ( =β0.197). The initiation of test-meal ( =β0.000), semiliquid diet ( =β0.002), and ordinary diet ( =β0.008) were all significantly shorter in the FT group. Furthermore, compared with the other group, the patients in the FT group enjoyed earlier removal of the abdominal drainage, urinary catheter, and shorter hospital stays ( =β0.000). Based on a correlation test, the duration of nasogastric decompression is related to the time of test-meal and semiliquid diet. The routine usage of nasogastric decompression in rectal surgery is unnecessary. The fast track procedure might help in facilitating postoperative functional and diet recovery, reducing the time of catheterization, and shortening hospital stay.

关键词： fast track     nasogastric decompression     rectal cancer     surgery    

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标题 作者 时间 类型 操作

Guidelines for navigation-assisted spine surgery

Liu, Xiaoguang Han, Jingwei Zhao, Mingxing International Society for Computer Assisted Orthopaedic Surgery

期刊论文

New spinal robotic technologies

Bowen Jiang, Tej D. Azad, Ethan Cottrill, Corinna C. Zygourakis, Alex M. Zhu, Neil Crawford, Nicholas Theodore

期刊论文

Laparoscopic surgery for pancreatic lesions: current status and future

Taiping Zhang, Xiao Du, Yupei Zhao

期刊论文

Advances in tissue state recognition in spinal surgery: a review

Hao Qu, Yu Zhao

期刊论文

Current progress on natural orifice transluminal endoscopic surgery (NOTES)

null

期刊论文

hepatectomy: comments on “Expert Consensus on Laparoscopic Hepatectomy (2013 Version) by National Hepatic SurgeryGroup, Society of Surgery, Chinese Medical Association”

null

期刊论文

Achievements in burn surgery over the past 50 years in China

WANG Shiliang

期刊论文

Lobectomy by video-assisted thoracoscopic surgery (VATS) for early stage of non-small cell lung cancer

null

期刊论文

Risk factors for ventilator-associated pneumonia among patients undergoing major oncological surgery

null

期刊论文

Evaluation of the harmonic scalpel in open surgery for abdominal aortic aneurysm

null

期刊论文

Development of splenic surgery in China

JIANG Hongchi, ZHAO Xianqi, GAO Yue

期刊论文

Laparoscopic hepato-biliary-pancreatic surgery: present practices and prospects

Yongjun Chen, Renyi Qin, Xiaoping Chen

期刊论文

Liver surgery and transplantation in China: Progress and Challenges

LAU W Y, LAI E C H

期刊论文

Setting up a heart rate alarm limit to decrease oculocardiac reflex during strabismus surgery in children

ZHANG Kangkang, GU Enhua, LU Junjie

期刊论文

“Fast Track” nasogastric decompression of rectal cancer surgery

Ka Li, Zongguang Zhou, Zengrong Chen, Yi Zhang, Cun Wang

期刊论文