Radiation segmentectomy(RS) is a new approach to90 Y radioembolization that has been designed to increase the safety and efficacy of radioembolization in patients with unresectable hepatic malignancies. With this tech...Radiation segmentectomy(RS) is a new approach to90 Y radioembolization that has been designed to increase the safety and efficacy of radioembolization in patients with unresectable hepatic malignancies. With this technique,high doses(>190 Gy) of radiation are delivered to the tumor through radioembolization performed in a segmental fashion, potentially increasing the radiation dose to the tumor while minimizing injury to the liver parenchyma. The aim of this review is to provide a summary of the indications, device choice, dosimetry, procedure, clinical outcomes, and toxicity of RS based on the clinical series currently available.展开更多
This article comments on the study by Peng et al,published in the World Journal of Gastrointestinal Surgery,representing a notable advancement in hepatobiliary surgery.This article examines laparoscopic anatomical seg...This article comments on the study by Peng et al,published in the World Journal of Gastrointestinal Surgery,representing a notable advancement in hepatobiliary surgery.This article examines laparoscopic anatomical segment VIII resection,a challenging procedure due to the complex liver anatomy and difficulty in accessing deep-seated lesions.Peng and colleagues’experience with caudal and cranial approaches in 34 patients underscores the feasibility of these techniques while sparking debates about the optimal approach.Their study’s strengths lie in technique standardization and comprehensive analysis,although its limitations highlight the need for further research.As minimally invasive liver surgery progresses,larger,prospective trials and integration of advanced technologies are essential for establishing best practices.展开更多
AIM： To design a hand-assisted laparoscopic approach in an attempt to provide an option for laparoscopic resection of abdominal large viscera. METHODS： A 5-6 cm incision （for HandPort） and 2 trocars were employed....AIM： To design a hand-assisted laparoscopic approach in an attempt to provide an option for laparoscopic resection of abdominal large viscera. METHODS： A 5-6 cm incision （for HandPort） and 2 trocars were employed. The main vessel of the target organ was taken as a ＂core＂, and all tissues around the core were taken as peripheral structures. The peripheral structures were dissected first, and the core vessels were treated last. Twenty-six patients underwent laparoscopic deroofing of the hepatic huge cysts, resection of the segments lying at the outer edge of the liver （segments 2 to 6）, splenectomy, hemicolectomy, ileocecectomy and subtotal gastrectomy with HandPort device, harmonic scalpel, or Ligasure. RESULTS： The duration of the procedure was within 2 hours. Blood loss amounted to 8-120 mL. The conversion rate was 3.8% （1/26）. All patients had uneventful postoperative courses with less pain, earlier oral intake, and faster recovery, compared with conventional surgery. CONCLUSION： This method combines the advantages of both open and laparoscopic techniques, achieving better hemostasis effect, shortening the operative time, and is beneficial to the patients.展开更多
文摘Radiation segmentectomy(RS) is a new approach to90 Y radioembolization that has been designed to increase the safety and efficacy of radioembolization in patients with unresectable hepatic malignancies. With this technique,high doses(>190 Gy) of radiation are delivered to the tumor through radioembolization performed in a segmental fashion, potentially increasing the radiation dose to the tumor while minimizing injury to the liver parenchyma. The aim of this review is to provide a summary of the indications, device choice, dosimetry, procedure, clinical outcomes, and toxicity of RS based on the clinical series currently available.
基金Supported by National Natural Science Foundation of China,No.82170406 and No.81970238.
文摘This article comments on the study by Peng et al,published in the World Journal of Gastrointestinal Surgery,representing a notable advancement in hepatobiliary surgery.This article examines laparoscopic anatomical segment VIII resection,a challenging procedure due to the complex liver anatomy and difficulty in accessing deep-seated lesions.Peng and colleagues’experience with caudal and cranial approaches in 34 patients underscores the feasibility of these techniques while sparking debates about the optimal approach.Their study’s strengths lie in technique standardization and comprehensive analysis,although its limitations highlight the need for further research.As minimally invasive liver surgery progresses,larger,prospective trials and integration of advanced technologies are essential for establishing best practices.
文摘AIM： To design a hand-assisted laparoscopic approach in an attempt to provide an option for laparoscopic resection of abdominal large viscera. METHODS： A 5-6 cm incision （for HandPort） and 2 trocars were employed. The main vessel of the target organ was taken as a ＂core＂, and all tissues around the core were taken as peripheral structures. The peripheral structures were dissected first, and the core vessels were treated last. Twenty-six patients underwent laparoscopic deroofing of the hepatic huge cysts, resection of the segments lying at the outer edge of the liver （segments 2 to 6）, splenectomy, hemicolectomy, ileocecectomy and subtotal gastrectomy with HandPort device, harmonic scalpel, or Ligasure. RESULTS： The duration of the procedure was within 2 hours. Blood loss amounted to 8-120 mL. The conversion rate was 3.8% （1/26）. All patients had uneventful postoperative courses with less pain, earlier oral intake, and faster recovery, compared with conventional surgery. CONCLUSION： This method combines the advantages of both open and laparoscopic techniques, achieving better hemostasis effect, shortening the operative time, and is beneficial to the patients.
