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A step forward in laparoscopic hepatectomy: comments on “Expert Consensus on Laparoscopic Hepatectomy(2013 Version) by National Hepatic Surgery Group, Society of Surgery, Chinese Medical Association”

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《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

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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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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

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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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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

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Robotic distal pancreatectomy versus conventional laparoscopic distal pancreatectomy: a comparative study

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《医学前沿（英文）》 2015年第9卷第3期页码 356-360 doi: 10.1007/s11684-015-0404-0

摘要：

Robotic system has been increasingly used in pancreatectomy. However, the effectiveness of this method remains uncertain. This study compared the surgical outcomes between robot-assisted laparoscopic distal pancreatectomy and conventional laparoscopic distal pancreatectomy. During a 15-year period, 35 patients underwent minimally invasive approach of distal pancreatectomy in our center. Seventeen of these patients had robot-assisted laparoscopic approach, and the remaining 18 had conventional laparoscopic approach. Their operative parameters and perioperative outcomes were analyzed retrospectively in a prospective database. The mean operating time in the robotic group (221.4 min) was significantly longer than that in the laparoscopic group (173.6 min) (P = 0.026). Both robotic and conventional laparoscopic groups presented no significant difference in spleen-preservation rate (52.9% vs. 38.9%) (P = 0.505), operative blood loss (100.3 ml vs. 268.3 ml) (P = 0.29), overall morbidity rate (47.1% vs. 38.9%) (P = 0.73), and post-operative hospital stay (11.4 days vs. 14.2 days) (P = 0.46). Both groups also showed no perioperative mortality. Similar outcomes were observed in robotic distal pancreatectomy and conventional laparoscopic approach. However, robotic approach tended to have the advantages of less blood loss and shorter hospital stay. Further studies are necessary to determine the clinical position of robotic distal pancreatectomy.

关键词： distal pancreatectomy pancreatic neoplasm robotic surgery

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Improved control of hypertension following laparoscopic fundoplication for gastroesophageal reflux disease

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《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

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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

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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)

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《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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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

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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

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《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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Comparative cost analysis of three different anesthesia methods in gynecological laparoscopic surgery

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《医学前沿（英文）》 2012年第6卷第3期页码 311-316 doi: 10.1007/s11684-012-0205-7

摘要：

In the current study, we assessed and evaluated the costs and benefits of three popular methods of general anesthesia practiced in our department for gynecological laparoscopic surgery in recent years. Sixty adult female patients who underwent elective gynecological laparoscopic surgery under general anesthesia were randomly divided into three groups: group V, group I and group C. In group V, anesthesia was induced intravenously with midazolam, remifentanil, propofol and vecuronium, and maintained with continuous infusion of propofol and remifentanil. In group I, anesthesia was intravenously induced with midazolam, fentanyl, propofol and vecuronium, and maintained with inhaled isoflurane and intravenous bonus of fentanyl. In group C, anesthesia was induced as in group I, but maintained with isoflurane inhalation combined with propofol-remifentanil infusion. All patients received vecuronium for muscle relaxation. Perioperative incidences of complications and total anesthesia costs for patients in all groups were recorded. In addition, postoperative satisfaction of the patients was also noted, and similar outcomes of the satisfaction were reported in all 60 patients. Although there was no statistical significance among groups, the incidence of postoperative nausea and vomiting were higher in group C, and the rates of shivering and the needs for analgesics were higher in group V. Anesthesia costs in group I were the lowest. Therefore, it is concluded that the costs of anesthesia induced with midazolam, fentanyl, propofol, vecuronium, and maintained with isoflurane, fentanyl and vecuronium are cheapest, and there is no significant difference in patients’ satisfaction and safety among the three above-mentioned methods of anesthesia in our department.

关键词： general anesthesia economics cost

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

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《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)