1.Updates and prospect of da Vinci robotic surgical system in radical resection of colorectal cancer
Sizhe TANG ; Pu WANG ; Dalu KONG
Chinese Journal of Clinical Oncology 2019;46(7):370-374
Introduction of the da Vinci robotic surgical system has revolutionized the field of minimally invasive surgery. Innovative ro-botic technologies have helped surgeons overcome the technical difficulties of conventional laparoscopic surgery. At present, da Vinci robotic colorectal surgery is a safe and feasible option and has shown comparable short-term outcomes with conventional laparoscop-ic surgery. However, it has no oncological advantage despite its significantly higher cost. Promising technologies have been developed to overcome the drawbacks and obstacles of the current robotic systems. Moreover, further randomized controlled clinical trials are re-quired to assess the long-term results and potential benefits of robotic surgery over laparoscopy. This review aimed to elucidate the current developments in robotic colorectal surgery and to explore emerging surgical robotic technologies currently available or in de-velopment.
2.Prevalence and factors influencing adolescent idiopathic scoliosis in Zhongshan City
HUANG Sizhe, LI Fenghua, YANG Junlin, TANG Weiming, HUANG Zifang, GAO Yihao, CHENG Mengyuan
Chinese Journal of School Health 2023;44(6):925-929
Objective:
To investigate factors influencing adolescent idiopathic scoliosis (AIS), and to provide a scientific basis for effective prevention and treatment programs.
Methods:
A questionnaire survey was conducted among 6 757 students who participated in the scoliosis screening program for primary and middle school students in Zhongshan City, China from April 2019 to March 2020. Visual examination and Adams flexion test were used to measure the rotation angle of trunk. For each student, individual and family demographics, family history of scoliosis, daily postural habits, school bag carrying habits, vision, health, school environment, and physical activity were collected by questionnaire. Factors influencing AIS were analyzed using Chi square test and multivariate Logistic regression.
Results:
The positive screening rate for AIS was 2.0%(135 cases). Multivariate Logistic regression analysis revealed that female gender, no family history of AIS, standing with lumbar spine tilted forward, habit of leaning to the left when seated, and a monthly family income of >10 000 yuan were related to the occurrence of AIS in adolescents ( OR =3.01, 0.38, 2.29, 1.74, 0.44, P <0.05).
Conclusion
Female students aged 10-16 years with a family history of scoliosis in Zhongshan are identified as a high risk group for scoliosis screening. Developing proper standing and sitting habits helps to reduce the risk of AIS in adolescents.
3.Multidisciplinary treatment discussion of a personalized approach of laparoscopic right hemicolectomy for variant middle colic artery and ileocolic vein
Sizhe TANG ; Pu WANG ; Fei TIAN ; Hongli LI ; Xubin LI ; Jinru LI ; Dalu KONG
Chinese Journal of Clinical Oncology 2019;46(8):412-415
Objective: To investigate the variants of middle colic artery (MCA) and ileocolic vein (ICV) and their influence on the deci-sion regarding approach of laparoscopic right hemicolectomy. Methods: We analyzed the diagnosis and treatment of one right colon cancer patient with variant MCA and ICV who was admitted to the Tianjin Medical University Cancer Hospital in March 2018. The pa-tient underwent laparoscopic right hemicolectomy via a limited medial approach after a multidisciplinary treatment (MDT) discussion. Following were the observation indicators: 1) surgical and postoperative recovery situations; 2) postoperative pathological examina-tion; and 3) follow-up situation. Results: 1) Surgical and postoperative recovery situations: the patient successfully underwent laparo-scopic right hemicolectomy via a limited medial approach. No intraoperative or postoperative complications occurred. Duration of postoperative hospital stay was 11 days. 2) Postoperative pathological examination: the number of dissected lymph nodes was 39. Postoperative pathological tumor stage was pT3N0. Postoperative pathological tumor type was moderately differentiated adenocarci-noma. 3) Follow-up situation: the patient was followed-up for 10 months with disease-free survival. Conclusions: Individual and stan-dard surgery will be the best choice for treating colon cancer patients. MDT can facilitate clinical decision-making and benefit patients.
4.Clinical efficacy of laparoscopic right hemicolectomy via limited medial approach
Sizhe TANG ; Pu WANG ; Fei TIAN ; Dalu KONG
Chinese Journal of Digestive Surgery 2019;18(1):91-95
Objective To investigate the clinical efficacy of laparoscopic fight hemicolectomy via limited medial approach.Methods The retrospective and descriptive study was conducted.The clinical data of 32 patients [15 males and 17 females,average age 62 years (range,49-70 years] with right colon cancer who were admitted to the Tianjin Medical University Cancer Hospital between July 2016 and April 2018 were collected.All the patients underwent laparoscopic right hemicolectomy via cranial-caudal-medial approach followed no-touch isolation technique.Observation indicators:(1) surgical and postoperative recovery situations;(2) postoperative pathological examination;(3) follow-up situations.Follow-up using outpatient examination and telephone interview to detect postoperative survival of patients and tumor metastasis or recurrence up to May 2018.Measurement data were represented as average (range).Results (1) Surgical and postoperative recovery situations:32 patients underwent successfully laparoscopic right hemicolectomy via limited medial approach,without conversion to open surgery and perioperative death.The operation time,volume of intraoperative blood loss,time to initial anal exsufflation,time for fluid diet intake and duration of postoperative hospital stay were 180 minutes (range,150-260 minutes),100 mL (range,50-350 mL),3 days (range,2-6 days),4 days (range,3-7 days) and 12 days (range,10-22 days),respectively.Of 3 with postoperative complications in the 32 patients,1 with paralytic ileus,1 with wound infection and 1 with diarrhea were improved by symptomatic treatment.(2) Postoperative pathological examination:the number of dissected lymph nodes,number of dissected central lymph nodes and length of surgical specimen were 28 (range,19-43),8 (range,6-12) and 30 cm (range,25-39 cm),respectively,with negative incision margins.Postoperative tumor pathological staging showed that stage pTl,pT2,pT3 and pT4a were detected in 2,8,19 and 3 patients,and stage pN0,pN1 and pN2 in 16,12 and 4 patients,respectively.Postoperative tumor pathological typing showed that 3,7,18 and 4 patients were respectively diagnosed with mucinous adenocarcinoma,high differentiated adenocarcinoma,moderate differentiated adenocarcinoma and low differentiated adenocarcinoma.(3) Follow-up situations:32 patients were followed-up for 1-22 months,with an average time of 11 months.During the follow-up,6 patients were complicated with distant metastasis and the others had disease-free survival.Conclusion Laparoscopic right hemicolectomy via limited medial approach is safe and feasible,with a good short-term outcome.