Zhonghua wai ke za zhi [Chinese journal of surgery]
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Zhonghua Wai Ke Za Zhi · Mar 2020
[The clinical efficacy of arthroscopic combined with dual-plane high tibial osteotomy in the treatment of anterior cruciate ligament injury combined with varus deformity of knee joint].
Objective: To explore the short-term effectiveness of arthroscopic combined with dual-plane high tibial osteotomy in the treatment of anterior cruciate ligament injury combined with varus deformity of knee joint. Methods: A retrospective study was performed on 17 patients with anterior cruciate ligament injury combined with varus deformity of knee joint who underwent arthroscopic combined with dual-plane high tibial osteotomy at Department of Bone and Joint, the Affiliated Hospital of Southwest Medical University from January 2017 to June 2018. There were 11 males (11 knees) and 6 females (6 knees), aged 41.3 years (range: 32 to 49 years). ⋯ The KT-1000 side-to-side difference decreased from (7.95±1.19) mm preoperatively to (1.79±0.49)mm postoperatively(t=18.34, P=0.00). At the last follow-up, Lysholm score, Hospital for Special Surgery score, Tegner score, and the IKDC knee evaluation score of patients showed significant improvement from preoperative(P<0.05). Conclusion: Arthroscopic combined with dual-plane high tibial osteotomy can get a good short term efficacy in the treatment of anterior cruciate ligament injury combined with varus deformity of knee joint which can significantly improve the alignment of lower extremity and knee joint stability.
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Zhonghua Wai Ke Za Zhi · Feb 2020
[Application of Chen's pancreaticojejunostomy technique in laparoscopic pancreaticoduodenectomy (116 cases report)].
Objective: To investigate the safety and feasibility of longitudinal transpancreatic U-sutures invaginated pancreatojejunostomy (Chen's pancreaticojejunostomy technique) in laparoscopic pancreaticoduodenectomy (LPD). Methods: Clinical data of 116 consecutive patients who underwent LPD using Chen's pancreaticojejunostomy technique in Hunan Provincial People's Hospital from May 2017 to December 2018 were retrospectively analyzed. Among these patients, 66 were males and 50 were females. ⋯ One patient died of massive abdominal bleeding secondary to Gastroduodenal artery pseudoaneurysm rupture, the other patient died of extensive tumor recurrence and metastasis after surgery. Conclusions: Chen's pancreaticojejunostomy technique is safe and feasible for LPD. It is an option especially for surgeons who have not completed the learning curve of LPD.
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Zhonghua Wai Ke Za Zhi · Dec 2019
[Clinical application of convolutional neural network in pathological diagnosis of metastatic lymph nodes of gastric cancer].
Objective: To examine the value and clinical application of convolutional neural network in pathological diagnosis of metastatic lymph nodes of gastric cancer. Methods: Totally 124 patients with advanced gastric cancer who underwent radical gastrectomy plus D2 lymphadenectomy at Affiliated Hospital of Qingdao University from July 2016 to December 2018 were selected in the study. According to the chronological order, the first 80 cases were served as learning group. ⋯ The CNN-CAD system achieved the same classification results as pathologists. Conclusions: The CNN-CAD system has been constructed to distinguished benign and malignant lymph node slides with high accuracy and specificity. It could achieve the similar classification results as pathologists.
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Zhonghua Wai Ke Za Zhi · Nov 2019
[Progress of immune checkpoint inhibitors in neoadjuvant therapy of non-small cell lung cancer].
Lung cancer carries the highest morbidity and mortality out of all malignancies in the world. About 85% of all cases are non-small cell lung cancer (NSCLC). Surgery is currently the optimal treatment for early-stage NSCLC, however, the postoperative recurrence rate is relatively high and the long-term survival of these patients is still a problem to be overcomed. ⋯ More recent publications indicate that immune checkpoint blockade may have better potential in neoadjuvant therapy, with reported major pathological response rates at 20% to 85%, compared to chemotherapy alone. Phase Ⅲ random clinical trials are being implemented to confirm the effect of neoadjuvant immunotherapy in NSCLC. Meanwhile, a number of questions remain unanswered, including the time and course of neoadjuvant immunotherapy, the evaluation criteria of immune-related efficacy, the standardization of pathological evaluation, and how to avoid delays in surgery or misjudgment caused by pseudo-progression.
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Zhonghua Wai Ke Za Zhi · Nov 2019
[Gastroenteropancreatic neuroendocrine tumor microenvironment and related therapy].
Neuroendocrine tumor(NET) is a kind of highly heterogeneous and ubiquitous tumor, frequently localized in the gastrointestinal tract and pancreas. Surgery combined with regional ablation, endocrine therapy,chemotherapy and targeted therapy presents a favorable prognosis when treated with G1 or G2 gastroenteropancreatic neuroendocrine tumor(GEP-NET). ⋯ Targeting tumor microenvironment therapy is an important method in current systematic therapy, but till now the knowledge of neuroendocrine tumor microenvironment and its related treatment are limited. This article will specifically introduce the characteristics of tumor microenvironment in GEP-NET from the following aspects: the formation of enrichment vascular supply in TME,the role of tumor stroma,immune cells and cancer associacted fibroblast, and immune checkpoint and future trend of immunotherapy.