Endoscopic submucosal dissection(ESD)represents an organ-preserving alternative to surgical resection of early gastric cancer.However,even with ESD yielding en-bloc resection specimens,there are concerns regarding tum...Endoscopic submucosal dissection(ESD)represents an organ-preserving alternative to surgical resection of early gastric cancer.However,even with ESD yielding en-bloc resection specimens,there are concerns regarding tumor spread such as with larger lesions,ulcerated lesions,undifferentiated pathology and submucosal invasion.Sentinel node navigational surgery(SNNS)when combined with ESD offers a minimally invasive alternative to the traditional extended gastrectomy and lymphadenectomy if lack of lymph node spread can be confirmed.This would have a clear advantage in terms of potential complications and quality of life.However,SNNS,though useful in other malignancies such as breast cancer and melanoma,may not have a sufficient sensitivity for malignancy and negative predictive value in EGC to justify this as standard practice after ESD.The results of SNNS may improve with greater standardization and more involved dissection,technological innovations and more experience and validation such that the paradigm for post-ESD resection of EGC may change and include SNNS.展开更多
Despite declining incidence,gastric cancer remains one of the most common cancers worldwide.Early detection in population-based screening programs has increased the number of cases of early gastric cancer,representing...Despite declining incidence,gastric cancer remains one of the most common cancers worldwide.Early detection in population-based screening programs has increased the number of cases of early gastric cancer,representing approximately 50%of newly detected gastric cancer cases in Asian countries.Endoscopic mucosal resection and endoscopic submucosal dissection have become the preferred therapeutic techniques in Japan and Korea for the treatment of early gastric cancer patients with a very low risk of lymph node metastasis.Laparoscopic and robotic resections for early gastric cancer,including function-preserving resections,have propagated through advances in technology and surgeon experience.The aim of this paper is to discuss the recent advances in minimally invasive approaches in the treatment of early gastric cancer.展开更多
目的探讨直肠癌保肛手术中侧方淋巴结清扫和保留盆腔自主神经的临床疗效。方法回顾性分析124例直肠癌保肛手术患者经侧方淋巴结清扫和保留盆腔自主神经后的排便、排尿、性功能及术后生存情况。结果 112例患者(90.3%)于术后3 d 内拔除尿...目的探讨直肠癌保肛手术中侧方淋巴结清扫和保留盆腔自主神经的临床疗效。方法回顾性分析124例直肠癌保肛手术患者经侧方淋巴结清扫和保留盆腔自主神经后的排便、排尿、性功能及术后生存情况。结果 112例患者(90.3%)于术后3 d 内拔除尿管,平均导尿时间为(58.3±2.1)h。最大尿意尿量为(401.2±23.1)ml,残余尿量为(28.2±2.2)ml。19例术后发生大便失禁,11例经排便训练后基本恢复,2例自行缓解。术后问卷调查98例患者的性功能显示:62.3%的患者可以正常勃起,57.1%的患者有正常的性功能。保留自主神经患者的5年生存率为61.2%。结论直肠癌保肛手术中侧方淋巴结清扫和保留盆腔自主神经能良好保留肛门功能并减少术后排尿及性功能障碍的发生,不影响生存率。展开更多
文摘Endoscopic submucosal dissection(ESD)represents an organ-preserving alternative to surgical resection of early gastric cancer.However,even with ESD yielding en-bloc resection specimens,there are concerns regarding tumor spread such as with larger lesions,ulcerated lesions,undifferentiated pathology and submucosal invasion.Sentinel node navigational surgery(SNNS)when combined with ESD offers a minimally invasive alternative to the traditional extended gastrectomy and lymphadenectomy if lack of lymph node spread can be confirmed.This would have a clear advantage in terms of potential complications and quality of life.However,SNNS,though useful in other malignancies such as breast cancer and melanoma,may not have a sufficient sensitivity for malignancy and negative predictive value in EGC to justify this as standard practice after ESD.The results of SNNS may improve with greater standardization and more involved dissection,technological innovations and more experience and validation such that the paradigm for post-ESD resection of EGC may change and include SNNS.
文摘Despite declining incidence,gastric cancer remains one of the most common cancers worldwide.Early detection in population-based screening programs has increased the number of cases of early gastric cancer,representing approximately 50%of newly detected gastric cancer cases in Asian countries.Endoscopic mucosal resection and endoscopic submucosal dissection have become the preferred therapeutic techniques in Japan and Korea for the treatment of early gastric cancer patients with a very low risk of lymph node metastasis.Laparoscopic and robotic resections for early gastric cancer,including function-preserving resections,have propagated through advances in technology and surgeon experience.The aim of this paper is to discuss the recent advances in minimally invasive approaches in the treatment of early gastric cancer.
文摘目的探讨直肠癌保肛手术中侧方淋巴结清扫和保留盆腔自主神经的临床疗效。方法回顾性分析124例直肠癌保肛手术患者经侧方淋巴结清扫和保留盆腔自主神经后的排便、排尿、性功能及术后生存情况。结果 112例患者(90.3%)于术后3 d 内拔除尿管,平均导尿时间为(58.3±2.1)h。最大尿意尿量为(401.2±23.1)ml,残余尿量为(28.2±2.2)ml。19例术后发生大便失禁,11例经排便训练后基本恢复,2例自行缓解。术后问卷调查98例患者的性功能显示:62.3%的患者可以正常勃起,57.1%的患者有正常的性功能。保留自主神经患者的5年生存率为61.2%。结论直肠癌保肛手术中侧方淋巴结清扫和保留盆腔自主神经能良好保留肛门功能并减少术后排尿及性功能障碍的发生,不影响生存率。
