Mixed neuroendocrine non-neuroendocrine neoplasms(MiNENs)are a hetero-geneous group of malignant neoplasms that can settle in the gastroenteropan-creatic tract.They are composed of a neuroendocrine(NE)and a non-NE com...Mixed neuroendocrine non-neuroendocrine neoplasms(MiNENs)are a hetero-geneous group of malignant neoplasms that can settle in the gastroenteropan-creatic tract.They are composed of a neuroendocrine(NE)and a non-NE compo-nent in at least 30%of each tumour.The non-NE component can include different histological combinations of glandular,squamous,mucinous and sarcomatoid phenotypes,and one or both of the components can be low-or high grade malignant.Recent changes in the nomenclature of these neoplasms might lead to great deal of confusion,and the lack of specific clinical trials is the main reason why their management is difficult.The review aims to clarify the definition of MiNEN and analyze available evidence about their diagnosis and treatment options according to their location and extension through careful analysis of the available data.It would be important to reach a general consensus on their diagnosis in order to construct a classification that remains stable over time and facilitates the design of clinical trials that,due to their low incidence,will require long recruitment periods.展开更多
Aim: To study common cause of digestive tract hemorrhage and the relationship between etiology and age. Methods: Retrospective analysis about the data of 419 cases of digestive tract hemorrhage in digestive internal m...Aim: To study common cause of digestive tract hemorrhage and the relationship between etiology and age. Methods: Retrospective analysis about the data of 419 cases of digestive tract hemorrhage in digestive internal medicine from January 2016 to January 2018 in Jingzhou Central Hospital. Results: 419 cases of digestive tract hemorrhage include 305 cases of hemorrhage in upper digestive tract and 114 cases of hemorrhage in lower digestive tract. The first 5 causes of upper digestive tract hemorrhage in middle-aged and young group were: duodenal bulb ulcer, gastric ulcer, esophageal and stomach bottom varices bleeding in cirrhosis of schistosomiasis, compound ulcer, esophageal and stomach bottom varices bleeding in hepatitis B cirrhosis. The first 5 causes of upper digestive tract hemorrhage in elderly group were: gastric ulcer, duodenal bulb ulcer, esophageal and stomach bottom varices bleeding in hepatitis B cirrhosis, esophageal and stomach bottom varices bleeding in cirrhosis of schistosomiasis, gastric cancer. The first 5 causes of lower digestive tract hemorrhage in middle-aged and young group were: ulcerative colitis, colorectal polyps, hemorrhoids, crohn’s disease, ischemic bowel disease. The first 5 causes of lower digestive tract hemorrhage in elderly group were: colorectal polyps, colon cancer, ulcerative colitis, ischemic bowel disease, hemorrhoids. Conclusion: In the cases of upper digestive tract hemorrhage, peptic ulcer should be paid attention to in middle-aged and young people, and elderly should be noted in gastric cancer. Ulcerative colitis should be paid attention to in middle-aged and young people with lower digestive tract hemorrhage, and elderly should be noted in colorectal polyps and colon cancer.展开更多
INTRODUCTIONStomach carcinoma is still the leading cause of cancer deathin China and the second one in the world.Its possiblecauses include:A)chemical factors such as intragastricformation of N-nitroso compounds(NOC)a...INTRODUCTIONStomach carcinoma is still the leading cause of cancer deathin China and the second one in the world.Its possiblecauses include:A)chemical factors such as intragastricformation of N-nitroso compounds(NOC)and high saltintake;B)biological factors such as infection展开更多
INTRODUCTIONChina is a country with a high incidence of liver cancer insome areas.Liver cancer has a wide distribution andthreatens human health seriously.A rough estimationshows that out of a population of 1.2×1...INTRODUCTIONChina is a country with a high incidence of liver cancer insome areas.Liver cancer has a wide distribution andthreatens human health seriously.A rough estimationshows that out of a population of 1.2×10~8 in liver展开更多
BACKGROUND Mixed neuroendocrine non-neuroendocrine neoplasm(MiNEN)is a rare diagnosis,mainly encountered in the gastro-entero-pancreatic tract.There is limited knowledge of its epidemiology,prognosis and biology,and t...BACKGROUND Mixed neuroendocrine non-neuroendocrine neoplasm(MiNEN)is a rare diagnosis,mainly encountered in the gastro-entero-pancreatic tract.There is limited knowledge of its epidemiology,prognosis and biology,and the best management for affected patients is still to be defined.AIM To investigate clinical-pathological characteristics,treatment modalities and survival outcomes of a retrospective cohort of patients with a diagnosis of MiNEN.METHODS Consecutive patients with a histologically proven diagnosis of MiNEN were identified at 5 European centres.Patient data were retrospectively collected from medical records.Pathological samples were reviewed to ascertain compliance with the 2017 World Health Organisation definition of MiNEN.Tumour responses to systemic treatment were assessed according to the Response Evaluation Criteria in Solid Tumours 1.1.Kaplan-Meier analysis was applied to estimate survival outcomes.Associations between clinical-pathological characteristics and survival outcomes were explored using Log-rank test for equality of survivors functions(univariate)and Cox-regression analysis(multivariable).RESULTS Sixty-nine consecutive patients identified;Median age at diagnosis:64 years.Males:63.8%.Localised disease(curable):53.6%.Commonest sites of origin:colon-rectum(43.5%)and oesophagus/oesophagogastric junction(15.9%).The neuroendocrine component was;predominant in 58.6%,poorly differentiated in 86.3%,and large cell in 81.25%,of cases analysed.Most distant metastases analysed(73.4%)were occupied only by a poorly differentiated neuroendocrine component.Ninety-four percent of patients with localised disease underwent curative surgery;53%also received perioperative treatment,most often in line with protocols for adenocarcinomas from the same sites of origin.Chemotherapy was offered to most patients(68.1%)with advanced disease,and followed protocols for pure neuroendocrine carcinomas or adenocarcinomas in equal proportion.In localised cases,median recurrence free survival(RFS);14.0 months(95%CI:9.2-24.4),and median overall survival(OS):28.6 months(95%CI:18.3-41.1).On univariate analysis,receipt of perioperative treatment(vs surgery alone)did not improve RFS(P=0.375),or OS(P=0.240).In advanced cases,median progression free survival(PFS);5.6 months(95%CI:4.4-7.4),and median OS;9.0 months(95%CI:5.2-13.4).On univariate analysis,receipt of palliative active treatment(vs best supportive care)prolonged PFS and OS(both,P<0.001).CONCLUSION MiNEN is most commonly driven by a poorly differentiated neuroendocrine component,and has poor prognosis.Advances in its biological understanding are needed to identify effective treatments and improve patient outcomes.展开更多
Endoscopic submucosal dissection(ESD)is a wellestablished treatment for superficial esophageal squamous cell neoplasms(SESCNs)with no risk of lymphatic metastasis.However,for large SESCNs,especially when exceeding two...Endoscopic submucosal dissection(ESD)is a wellestablished treatment for superficial esophageal squamous cell neoplasms(SESCNs)with no risk of lymphatic metastasis.However,for large SESCNs,especially when exceeding two-thirds of the esophageal circumference,conventional ESD is time-consuming and has an increased risk of adverse events.Based on the submucosal tunnel conception,endoscopic submucosal tunnel dissection(ESTD)was first introduced by us to remove large SESCNs,with excellent results.Studies from different centers also reported favorable results.Compared with conventional ESD,ESTD has a more rapid dissection speed and R0 resection rate.Currently in China,ESTD for large SESCNs is an important part of the digestive endoscopic tunnel technique,as is peroral endoscopic myotomy for achalasia and submucosal tunnel endoscopic resection for submucosal tumors of the muscularis propria.However,not all patients with SESCNs are candidates for ESTD,and postoperative esophageal strictures should also be taken into consideration,especially for lesions with a circumference greater than three-quarters.In this article,we describe our experience,review the literature of ESTD,and provide detailed information on indications,standard procedures,outcomes,and complications of ESTD.展开更多
The main objective of this work was to update the data on the epidemiological, clinical, etiological and prognostic aspects of these acute upper digestive hemorrhages. It was a prospective study for a period of 11 mon...The main objective of this work was to update the data on the epidemiological, clinical, etiological and prognostic aspects of these acute upper digestive hemorrhages. It was a prospective study for a period of 11 months (from March 2013 to January 2014) at the digestive endoscopy center of Gabriel Touré University Hospital in Bamako. At the end of this study, 63 patients had acute upper digestive bleeding (AUDB) among 954 hospitalized patients, that is to say a frequency of 6.7%. The sex ratio was 3.5. The average age of our patients was 45 ± 16.57 years with extremes of 15 and 84 years. A notion of smoking, epigastralgia and none steroid anti-inflammatory drugs (NSAIDs) were more reported in the history with respectively 14 patients (22.3%), 10 patients (15.9%) and 4 patients (6.3%), but haematemesis had occurred in 24 (38.1%) patients without any antecedent. The main causes of hemorrhage were rupture of oesophageal varices in 34 (57.6%) patients and peptic ulcers in 18 (30.5%) patients. Early recurrence occurred in 7 (11.1%) patients resulting in the death of 5 patients for an overall mortality of 9 patients among 63 (14.3%). Acute high digestive hemorrhages are always serious. The correct management of the hemorrhagic episode by haemostatic gestures when available and the causes of haemorrhage improve the prognosis.展开更多
<strong>Background:</strong> Gastrointestinal tract (GIT) surgical emergencies represent a significant amount within surgical pathologies, in Africa and throughout the world. Our study was aimed to assess ...<strong>Background:</strong> Gastrointestinal tract (GIT) surgical emergencies represent a significant amount within surgical pathologies, in Africa and throughout the world. Our study was aimed to assess the etiological, therapeutic and prognostic aspects of GIT surgical emergencies in patients from two hospitals in Douala, Cameroon. <strong>Patients and Method:</strong> A longitudinal prospective study was conducted from December 2018 to May 2019, including 203 patients of all ages and both sexes who presented with a GIT surgical emergency in any clinical form, and who underwent surgery within one of our hospitals. We collected patients’ parameters through a survey, from complete history to clinical examination, then followed them up from surgery to post-operative time. Gathered information was analyzed by IBM Statistical Package for Social Science (SPSS) 23.0 software version. <strong>Results:</strong> GIT surgical emergencies accounted for 27.5% of all surgical emergencies. Our target population included 55.2% (n = 112) of men, and 44.8% (n = 91) of women, observing a sex-ratio of 1.23. The mean age of the patients was 36.3 ± 17.1 years, with extreme values of 6 months and 86 years. Abdominal pain was the most common symptom, vomiting and lack of bowel movement or gas pass, were the main associated symptoms in 27.6% and 16.7% of cases, respectively. Etiologically, leading pathologies were intestinal obstruction (32.0%, 64 cases), acute appendicitis (24.6%, 50 cases), then came peritononitis and abdominal trauma with respectively 22.7% (46 cases) and 21.7% (43 cases). Most patients underwent surgery within 24 hour. Laparotomy was the primary method used in 90.6%, and laparoscopy (9.4%). Post-operative suture breakage and parietal suppuration were the most common complications post-operatively. Totally, the overall morbidity and mortality rates were respectively 8.9% and 0.98% among our patients. <strong>Conclusion:</strong> Acute surgical abdomens occupy an important place in surgical pathology because of their frequency. They have various aetiologies and require a diagnostic evaluation and multidisciplinary management without delay.展开更多
BACKGROUND: This study was to clarify the high riskfactors for subphrenic infection (SI) after liver resection forpatients with hepatic malignancy.METHODS: Three hundred and sixty-eight patients whohad undergone hepat...BACKGROUND: This study was to clarify the high riskfactors for subphrenic infection (SI) after liver resection forpatients with hepatic malignancy.METHODS: Three hundred and sixty-eight patients whohad undergone hepatectomy from January 1985 throughJune 2002 were randomly divided into 2 groups accordingto resection of liver parenchyma, hepatic cirrhosis, primaryliver cancer, intraoperative blood loss, and subphrenicdrainage. The chi-square was used for statistical analysis.RESULTS: Thirteen patients (3.53%) of the 368 patientshad SI. The high-risk factors for SI after hepatectomy wererelated to resection of liver parenchyma and hepatic cirrho-sis ; but the course or stage of primary liver cancer was notrelated to the incidence of SI. Intraoperative blood loss ofover 1500 ml was found to be a significant risk factor forpostoperative SI. Adequate drainage of the subdiaphragmand the raw surface of the liver after operation was essentialto decreasing SI after liver resection.CONCLUSION: Inadequate subphrenic drainage maylargely contribute to SI in patients with hepatic malignancyundergoing hepatectomy apart from other factors. Com-prehensive measures should be taken to prevent the infec-tion after hepatectomy.展开更多
目的 口腔菌群与人类健康之间的关系已被学界广泛认识,本研究采用系统评价的方法总结分析牙龈卟啉单胞菌在消化系统恶性肿瘤中的作用。方法 检索PubMed、Embase、MEDLINE、Cochrane图书馆、Scopus和Web of Science数据库,检索时限均从...目的 口腔菌群与人类健康之间的关系已被学界广泛认识,本研究采用系统评价的方法总结分析牙龈卟啉单胞菌在消化系统恶性肿瘤中的作用。方法 检索PubMed、Embase、MEDLINE、Cochrane图书馆、Scopus和Web of Science数据库,检索时限均从建库至2023年8月25日。由2位评价员独立筛选文献、提取资料并评价纳入文献的偏倚风险。遵循系统评价和荟萃分析的首选报告项目(preferred reporting items for systematic reviews and Meta-analyses,PRISMA)方法对纳入文献进行系统评价,分析牙龈卟啉单胞菌在各消化道恶性肿瘤中的致癌机制。结果 共计28篇文献(包括2项前瞻性队列研究,26项病例对照研究)被纳入本次系统评价,包括胃癌、食管癌、结直肠癌、胰腺癌、肝癌等多种类型。其中研究食管癌的文献有5篇,胃癌有5篇,结直肠癌有9篇(其中1篇同时研究胃癌),胰腺癌有7篇,肝癌有2篇。全部的纳入文献均报道了口腔菌群失调(包括牙龈卟啉单胞菌)与消化系统恶性肿瘤之间的风险关联。结论 本研究系统阐述了牙龈卟啉单胞菌在消化系统恶性肿瘤中的作用,对其可能的致病机制进行分析评价。展开更多
文摘Mixed neuroendocrine non-neuroendocrine neoplasms(MiNENs)are a hetero-geneous group of malignant neoplasms that can settle in the gastroenteropan-creatic tract.They are composed of a neuroendocrine(NE)and a non-NE compo-nent in at least 30%of each tumour.The non-NE component can include different histological combinations of glandular,squamous,mucinous and sarcomatoid phenotypes,and one or both of the components can be low-or high grade malignant.Recent changes in the nomenclature of these neoplasms might lead to great deal of confusion,and the lack of specific clinical trials is the main reason why their management is difficult.The review aims to clarify the definition of MiNEN and analyze available evidence about their diagnosis and treatment options according to their location and extension through careful analysis of the available data.It would be important to reach a general consensus on their diagnosis in order to construct a classification that remains stable over time and facilitates the design of clinical trials that,due to their low incidence,will require long recruitment periods.
文摘Aim: To study common cause of digestive tract hemorrhage and the relationship between etiology and age. Methods: Retrospective analysis about the data of 419 cases of digestive tract hemorrhage in digestive internal medicine from January 2016 to January 2018 in Jingzhou Central Hospital. Results: 419 cases of digestive tract hemorrhage include 305 cases of hemorrhage in upper digestive tract and 114 cases of hemorrhage in lower digestive tract. The first 5 causes of upper digestive tract hemorrhage in middle-aged and young group were: duodenal bulb ulcer, gastric ulcer, esophageal and stomach bottom varices bleeding in cirrhosis of schistosomiasis, compound ulcer, esophageal and stomach bottom varices bleeding in hepatitis B cirrhosis. The first 5 causes of upper digestive tract hemorrhage in elderly group were: gastric ulcer, duodenal bulb ulcer, esophageal and stomach bottom varices bleeding in hepatitis B cirrhosis, esophageal and stomach bottom varices bleeding in cirrhosis of schistosomiasis, gastric cancer. The first 5 causes of lower digestive tract hemorrhage in middle-aged and young group were: ulcerative colitis, colorectal polyps, hemorrhoids, crohn’s disease, ischemic bowel disease. The first 5 causes of lower digestive tract hemorrhage in elderly group were: colorectal polyps, colon cancer, ulcerative colitis, ischemic bowel disease, hemorrhoids. Conclusion: In the cases of upper digestive tract hemorrhage, peptic ulcer should be paid attention to in middle-aged and young people, and elderly should be noted in gastric cancer. Ulcerative colitis should be paid attention to in middle-aged and young people with lower digestive tract hemorrhage, and elderly should be noted in colorectal polyps and colon cancer.
文摘INTRODUCTIONStomach carcinoma is still the leading cause of cancer deathin China and the second one in the world.Its possiblecauses include:A)chemical factors such as intragastricformation of N-nitroso compounds(NOC)and high saltintake;B)biological factors such as infection
基金National Natural Science Foundation of China,№48970193
文摘INTRODUCTIONChina is a country with a high incidence of liver cancer insome areas.Liver cancer has a wide distribution andthreatens human health seriously.A rough estimationshows that out of a population of 1.2×10~8 in liver
文摘BACKGROUND Mixed neuroendocrine non-neuroendocrine neoplasm(MiNEN)is a rare diagnosis,mainly encountered in the gastro-entero-pancreatic tract.There is limited knowledge of its epidemiology,prognosis and biology,and the best management for affected patients is still to be defined.AIM To investigate clinical-pathological characteristics,treatment modalities and survival outcomes of a retrospective cohort of patients with a diagnosis of MiNEN.METHODS Consecutive patients with a histologically proven diagnosis of MiNEN were identified at 5 European centres.Patient data were retrospectively collected from medical records.Pathological samples were reviewed to ascertain compliance with the 2017 World Health Organisation definition of MiNEN.Tumour responses to systemic treatment were assessed according to the Response Evaluation Criteria in Solid Tumours 1.1.Kaplan-Meier analysis was applied to estimate survival outcomes.Associations between clinical-pathological characteristics and survival outcomes were explored using Log-rank test for equality of survivors functions(univariate)and Cox-regression analysis(multivariable).RESULTS Sixty-nine consecutive patients identified;Median age at diagnosis:64 years.Males:63.8%.Localised disease(curable):53.6%.Commonest sites of origin:colon-rectum(43.5%)and oesophagus/oesophagogastric junction(15.9%).The neuroendocrine component was;predominant in 58.6%,poorly differentiated in 86.3%,and large cell in 81.25%,of cases analysed.Most distant metastases analysed(73.4%)were occupied only by a poorly differentiated neuroendocrine component.Ninety-four percent of patients with localised disease underwent curative surgery;53%also received perioperative treatment,most often in line with protocols for adenocarcinomas from the same sites of origin.Chemotherapy was offered to most patients(68.1%)with advanced disease,and followed protocols for pure neuroendocrine carcinomas or adenocarcinomas in equal proportion.In localised cases,median recurrence free survival(RFS);14.0 months(95%CI:9.2-24.4),and median overall survival(OS):28.6 months(95%CI:18.3-41.1).On univariate analysis,receipt of perioperative treatment(vs surgery alone)did not improve RFS(P=0.375),or OS(P=0.240).In advanced cases,median progression free survival(PFS);5.6 months(95%CI:4.4-7.4),and median OS;9.0 months(95%CI:5.2-13.4).On univariate analysis,receipt of palliative active treatment(vs best supportive care)prolonged PFS and OS(both,P<0.001).CONCLUSION MiNEN is most commonly driven by a poorly differentiated neuroendocrine component,and has poor prognosis.Advances in its biological understanding are needed to identify effective treatments and improve patient outcomes.
基金Supported by National Natural Science Foundation of China,No.81370584Military Major Projects of Clinical High-Tech Techniques,No.431EG63G
文摘Endoscopic submucosal dissection(ESD)is a wellestablished treatment for superficial esophageal squamous cell neoplasms(SESCNs)with no risk of lymphatic metastasis.However,for large SESCNs,especially when exceeding two-thirds of the esophageal circumference,conventional ESD is time-consuming and has an increased risk of adverse events.Based on the submucosal tunnel conception,endoscopic submucosal tunnel dissection(ESTD)was first introduced by us to remove large SESCNs,with excellent results.Studies from different centers also reported favorable results.Compared with conventional ESD,ESTD has a more rapid dissection speed and R0 resection rate.Currently in China,ESTD for large SESCNs is an important part of the digestive endoscopic tunnel technique,as is peroral endoscopic myotomy for achalasia and submucosal tunnel endoscopic resection for submucosal tumors of the muscularis propria.However,not all patients with SESCNs are candidates for ESTD,and postoperative esophageal strictures should also be taken into consideration,especially for lesions with a circumference greater than three-quarters.In this article,we describe our experience,review the literature of ESTD,and provide detailed information on indications,standard procedures,outcomes,and complications of ESTD.
文摘The main objective of this work was to update the data on the epidemiological, clinical, etiological and prognostic aspects of these acute upper digestive hemorrhages. It was a prospective study for a period of 11 months (from March 2013 to January 2014) at the digestive endoscopy center of Gabriel Touré University Hospital in Bamako. At the end of this study, 63 patients had acute upper digestive bleeding (AUDB) among 954 hospitalized patients, that is to say a frequency of 6.7%. The sex ratio was 3.5. The average age of our patients was 45 ± 16.57 years with extremes of 15 and 84 years. A notion of smoking, epigastralgia and none steroid anti-inflammatory drugs (NSAIDs) were more reported in the history with respectively 14 patients (22.3%), 10 patients (15.9%) and 4 patients (6.3%), but haematemesis had occurred in 24 (38.1%) patients without any antecedent. The main causes of hemorrhage were rupture of oesophageal varices in 34 (57.6%) patients and peptic ulcers in 18 (30.5%) patients. Early recurrence occurred in 7 (11.1%) patients resulting in the death of 5 patients for an overall mortality of 9 patients among 63 (14.3%). Acute high digestive hemorrhages are always serious. The correct management of the hemorrhagic episode by haemostatic gestures when available and the causes of haemorrhage improve the prognosis.
文摘<strong>Background:</strong> Gastrointestinal tract (GIT) surgical emergencies represent a significant amount within surgical pathologies, in Africa and throughout the world. Our study was aimed to assess the etiological, therapeutic and prognostic aspects of GIT surgical emergencies in patients from two hospitals in Douala, Cameroon. <strong>Patients and Method:</strong> A longitudinal prospective study was conducted from December 2018 to May 2019, including 203 patients of all ages and both sexes who presented with a GIT surgical emergency in any clinical form, and who underwent surgery within one of our hospitals. We collected patients’ parameters through a survey, from complete history to clinical examination, then followed them up from surgery to post-operative time. Gathered information was analyzed by IBM Statistical Package for Social Science (SPSS) 23.0 software version. <strong>Results:</strong> GIT surgical emergencies accounted for 27.5% of all surgical emergencies. Our target population included 55.2% (n = 112) of men, and 44.8% (n = 91) of women, observing a sex-ratio of 1.23. The mean age of the patients was 36.3 ± 17.1 years, with extreme values of 6 months and 86 years. Abdominal pain was the most common symptom, vomiting and lack of bowel movement or gas pass, were the main associated symptoms in 27.6% and 16.7% of cases, respectively. Etiologically, leading pathologies were intestinal obstruction (32.0%, 64 cases), acute appendicitis (24.6%, 50 cases), then came peritononitis and abdominal trauma with respectively 22.7% (46 cases) and 21.7% (43 cases). Most patients underwent surgery within 24 hour. Laparotomy was the primary method used in 90.6%, and laparoscopy (9.4%). Post-operative suture breakage and parietal suppuration were the most common complications post-operatively. Totally, the overall morbidity and mortality rates were respectively 8.9% and 0.98% among our patients. <strong>Conclusion:</strong> Acute surgical abdomens occupy an important place in surgical pathology because of their frequency. They have various aetiologies and require a diagnostic evaluation and multidisciplinary management without delay.
文摘BACKGROUND: This study was to clarify the high riskfactors for subphrenic infection (SI) after liver resection forpatients with hepatic malignancy.METHODS: Three hundred and sixty-eight patients whohad undergone hepatectomy from January 1985 throughJune 2002 were randomly divided into 2 groups accordingto resection of liver parenchyma, hepatic cirrhosis, primaryliver cancer, intraoperative blood loss, and subphrenicdrainage. The chi-square was used for statistical analysis.RESULTS: Thirteen patients (3.53%) of the 368 patientshad SI. The high-risk factors for SI after hepatectomy wererelated to resection of liver parenchyma and hepatic cirrho-sis ; but the course or stage of primary liver cancer was notrelated to the incidence of SI. Intraoperative blood loss ofover 1500 ml was found to be a significant risk factor forpostoperative SI. Adequate drainage of the subdiaphragmand the raw surface of the liver after operation was essentialto decreasing SI after liver resection.CONCLUSION: Inadequate subphrenic drainage maylargely contribute to SI in patients with hepatic malignancyundergoing hepatectomy apart from other factors. Com-prehensive measures should be taken to prevent the infec-tion after hepatectomy.
文摘目的 口腔菌群与人类健康之间的关系已被学界广泛认识,本研究采用系统评价的方法总结分析牙龈卟啉单胞菌在消化系统恶性肿瘤中的作用。方法 检索PubMed、Embase、MEDLINE、Cochrane图书馆、Scopus和Web of Science数据库,检索时限均从建库至2023年8月25日。由2位评价员独立筛选文献、提取资料并评价纳入文献的偏倚风险。遵循系统评价和荟萃分析的首选报告项目(preferred reporting items for systematic reviews and Meta-analyses,PRISMA)方法对纳入文献进行系统评价,分析牙龈卟啉单胞菌在各消化道恶性肿瘤中的致癌机制。结果 共计28篇文献(包括2项前瞻性队列研究,26项病例对照研究)被纳入本次系统评价,包括胃癌、食管癌、结直肠癌、胰腺癌、肝癌等多种类型。其中研究食管癌的文献有5篇,胃癌有5篇,结直肠癌有9篇(其中1篇同时研究胃癌),胰腺癌有7篇,肝癌有2篇。全部的纳入文献均报道了口腔菌群失调(包括牙龈卟啉单胞菌)与消化系统恶性肿瘤之间的风险关联。结论 本研究系统阐述了牙龈卟啉单胞菌在消化系统恶性肿瘤中的作用,对其可能的致病机制进行分析评价。
