Journal of minimally invasive surgery最新文献

英文中文

Laparoscopic approach in chronic posttraumatic diaphragmatic hernia. 慢性创伤后膈疝的腹腔镜入路。

Journal of minimally invasive surgery

Pub Date : 2022-06-15 DOI: 10.7602/jmis.2022.25.2.77

Aisawan Asumpinawong, Suthep Udomsawaengsup

Chronic posttraumatic diaphragmatic hernia is an unusual disease with challenging diagnosis and treatment. Surgery represents the treatment of choice which can be transabdominal, transthoracic, or combined approach. The principles of surgery consist of herniated visceral organs reduction and diaphragmatic defect closure. This video demonstrates the steps of chronic posttraumatic diaphragmatic hernia repair via a laparoscopic approach and concerning points during the operation.

慢性创伤后膈疝是一种罕见的疾病，具有挑战性的诊断和治疗。手术是治疗的选择，可经腹、经胸或联合入路。手术原则包括脏器突出复位和膈缺损闭合。本视频演示了腹腔镜下慢性创伤后膈疝修复的步骤和手术中的注意事项。

引用次数: 0

Minimally invasive surgery for colorectal cancer, a look back to look forward: a personal history. 结直肠癌微创手术，回顾展望:个人病史。

Journal of minimally invasive surgery

Pub Date : 2022-06-15 DOI: 10.7602/jmis.2022.25.2.41

Gyu-Seog Choi

While laparoscopic colonoscopy was reported by several surgeons in the early 1990s, laparoscopic colorectal surgery has been attempted sporadically since 1992 in Korea. Then, in 2000, the Korean Laparoscopic Colorectal Surgery Study Group was established. Didactic lectures, videos, and live surgery by the early pioneers of this group inspired and helped many surgeons initiate the laparoscopic approach to the treatment of colorectal disease. As a result, the penetration rate of minimally invasive colorectal cancer surgery nationwide is increasing to 80% in 2018. As a witness on this journey, I would like to share my personal minimally invasive colorectal cancer surgery history and perspectives on future surgery in this field.

虽然在20世纪90年代早期有几位外科医生报道了腹腔镜结肠镜检查，但自1992年以来，腹腔镜结直肠手术在韩国一直是零星的尝试。2000年，韩国腹腔镜结直肠手术研究组成立。这个小组的早期先驱者的说教讲座、视频和现场手术启发并帮助了许多外科医生开创了腹腔镜治疗结直肠癌的方法。因此，2018年全国结直肠癌微创手术普及率将提高到80%。作为这一过程的见证者，我想分享我个人的结肠直肠癌微创手术历史和对该领域未来手术的看法。

引用次数: 1

Which one will you choose; open, laparoscopic, or robotic transduodenal ampullectomy?: a case report. 你会选择哪一个?开放式、腹腔镜还是机器人经十二指肠壶胃切除术?一份病例报告。

Journal of minimally invasive surgery

Pub Date : 2022-06-15 DOI: 10.7602/jmis.2022.25.2.73

Dawn Jung, Ji Eun Jung, Chang Moo Kang

Transduodenal ampullectomy (TDA) is the treatment of choice for large premalignant lesions of the ampulla of Vater (AoV). With the development of surgical techniques, various methods, including the open, laparoscopic, and robotic approaches, for performing TDA have emerged. Herein, we report four consecutive cases treated with open, laparoscopic, and robotic TDA, with technical pitfalls and future perspectives of TDA in treating premalignant lesions of the AoV. The surgical techniques and principles for TDA were the same regardless of the surgical approaches. After surgery, none of the patients showed any abnormal findings or complications, except for digestive problems. All these surgical approaches are appropriate for patients requiring TDA; however, minimally invasive TDA, particularly the robotic approach is ideal. Considering the surgical complexity of TDA, the robotic approach is considered to be effective.

经十二指肠壶腹切除术(TDA)是治疗壶腹癌前病变(AoV)的首选方法。随着外科技术的发展，各种方法，包括开放，腹腔镜和机器人的方法，进行TDA已经出现。在此，我们报告了连续4例使用开放、腹腔镜和机器人TDA治疗的病例，以及TDA治疗AoV癌前病变的技术缺陷和未来展望。无论手术入路如何，TDA的手术技术和原则是相同的。手术后，除消化问题外，所有患者均未出现任何异常发现或并发症。所有这些手术入路都适合需要TDA的患者;然而，微创TDA，特别是机器人方法是理想的。考虑到TDA手术的复杂性，机器人入路被认为是有效的。

引用次数: 1

Oncological impact of vascular invasion in colon cancer might differ depending on tumor sidedness. 结肠癌血管浸润的肿瘤学影响可能因肿瘤的侧边性而异。

Journal of minimally invasive surgery

Pub Date : 2022-06-15 DOI: 10.7602/jmis.2022.25.2.53

Moamen Shalkamy Abdelgawaad Shalkamy, Jung Hoon Bae, Chul Seung Lee, Seung Rim Han, Ji Hoon Kim, Bong-Hyeon Kye, In Kyu Lee, Yoon Suk Lee

Purpose: Vascular invasion is a well-known independent prognostic factor in colon cancer and tumor sidedness is also being considered a prognostic factor. The aim of this study was to compare the oncological impact of vascular invasion depending on the tumor location in stages I to III colon cancer.

Methods: A retrospective analysis was performed using data from patients who underwent curative resection between 2004 and 2015. Patients were divided into right-sided colon cancer (RCC) and left-sided colon cancer (LCC) groups according to the tumor location. Disease-free survival (DFS) and overall survival (OS) were compared between the RCC and LCC groups, depending on the presence of vascular invasion.

Results: A total of 793 patients were included, of which 304 (38.3%) had RCC and 489 (61.7%) had LCC. DFS and OS did not differ significantly between the RCC and LCC groups. Vascular invasion was a poor prognostic factor for DFS in both RCC (hazard ratio [HR], 2.291; 95% confidence interval [CI], 1.186-4.425; p = 0.010) and LCC (HR, 1.848; 95% CI, 1.139-2.998; p = 0.011). Additionally, it was associated with significantly worse OS in the RCC (HR, 3.503; 95% CI, 1.681-7.300; p < 0.001), but not in the LCC group (HR, 1.676; 95% CI, 0.885-3.175; p = 0.109). Multivariate analysis revealed that vascular invasion was independently poor prognostic factor for OS in the RCC (HR, 3.186; 95% CI, 1.391-7.300; p = 0.006).

Conclusion: This study demonstrated that RCC with vascular invasion had worse OS than LCC with vascular invasion.

目的:血管侵犯是结肠癌的一个众所周知的独立预后因素，肿瘤侧边性也被认为是一个预后因素。本研究的目的是比较I期至III期结肠癌中不同肿瘤位置的血管浸润对肿瘤的影响。方法:回顾性分析2004年至2015年接受根治性手术的患者资料。根据肿瘤部位将患者分为右侧结肠癌(RCC)组和左侧结肠癌(LCC)组。根据是否存在血管侵犯，比较RCC组和LCC组之间的无病生存期(DFS)和总生存期(OS)。结果:共纳入793例患者，其中304例(38.3%)为RCC, 489例(61.7%)为LCC。DFS和OS在RCC组和LCC组之间无显著差异。在两种RCC中，血管侵犯是DFS的不良预后因素(危险比[HR]， 2.291;95%置信区间[CI]， 1.186-4.425;p = 0.010)和LCC (HR, 1.848;95% ci, 1.139-2.998;P = 0.011)。此外，它与RCC的OS显著恶化相关(HR, 3.503;95% ci, 1.681-7.300;p < 0.001)，但在LCC组没有(HR, 1.676;95% ci, 0.885-3.175;P = 0.109)。多因素分析显示，血管侵犯是RCC发生OS的独立不良预后因素(HR, 3.186;95% ci, 1.391-7.300;P = 0.006)。结论:血管侵犯的RCC比血管侵犯的LCC的OS更差。

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引用次数: 2

Risk of incisional hernia after laparoscopic colorectal surgery: surgeon’s worries and challenges 腹腔镜结直肠手术后切口疝的风险:外科医生的担忧和挑战

Journal of minimally invasive surgery

Pub Date : 2022-03-15 DOI: 10.7602/jmis.2022.25.1.9

Byung Mo Kang

The incidence and risk factors of incisional hernia after laparoscopic surgery for colorectal disease have not yet been fully investigated. The surgeon should always consider several potential risk factors of incisional hernia when closing the abdominal wall in laparoscopic colorectal surgery.

结直肠疾病腹腔镜手术后切口疝的发生率和危险因素尚未得到充分的研究。在腹腔镜结直肠手术中关闭腹壁时，外科医生应考虑切口疝的几个潜在危险因素。

引用次数: 0

Laparoscopic transabdominal preperitoneal and totally extraperitoneal in inguinal hernia surgery: comparison of intraoperative and postoperative early complications of two techniques 腹腔镜经腹腹膜前和全腹膜外技术在腹股沟疝手术中的应用:两种技术术中及术后早期并发症的比较

Journal of minimally invasive surgery

Pub Date : 2022-03-15 DOI: 10.7602/jmis.2022.25.1.18

A. Yıldız

Purpose Totally extraperitoneal (TEP) and transabdominal preperitoneal (TAPP) are laparoscopic techniques frequently used in inguinal hernia surgeries. There are very few studies directly comparing the outcomes of TEP and TAPP. The present study compared both techniques’ technical aspects, intraoperative and postoperative early complications. Methods In this study, 108 patients diagnosed with inguinal hernia underwent laparoscopic surgery between May 2016 and December 2020. Seventy six of these patients (70.4%) underwent TEP, and 32 (29.6%) underwent TAPP. This study was retrospective. However, the data were registered prospectively (including video recordings). Results No significant difference was found between the groups regarding age, sex, body mass index, American Society of Anesthesiologist physical status classification, and duration of hospitalization. Although the TEP group had a higher overall complication rate than TAPP, the difference between the two groups was not significant (TEP, 9.2% vs. TAPP, 3.1%, p = 0.979). Two conversions and two recurrences (2.6% each) were observed in TEP. The hematoma was seen in one case in both techniques (3.1% vs. 1.3%, p = 0.665), respectively. A patient in the TEP group developed a pseudoaneurysm and was treated with endovascular embolization. Conclusion In our study, conversion and intraoperative early postoperative complications were more prevalent in TEP than TAPP. On the other hand, no significant difference was determined between the results of the two techniques. It has been found that TAPP is as safe as TEP in inguinal hernia surgery; however, the superiority of one method over the other was not observed in this study.

目的完全腹膜外(TEP)和经腹腹膜前(TAPP)是腹股沟疝手术中常用的腹腔镜技术。很少有研究直接比较TEP和TAPP的疗效。本研究比较了两种技术的技术方面、术中和术后早期并发症。方法在2016年5月至2020年12月期间，108例诊断为腹股沟疝的患者接受了腹腔镜手术。76例(70.4%)行TEP, 32例(29.6%)行TAPP。本研究为回顾性研究。然而，数据是前瞻性登记的(包括录像)。结果两组患者在年龄、性别、体重指数、美国麻醉医师身体状态分类、住院时间等方面均无显著差异。虽然TEP组的总并发症发生率高于TAPP组，但两组间差异无统计学意义(TEP为9.2%，TAPP为3.1%，p = 0.979)。在TEP中观察到2例转化和2例复发(各2.6%)。两种方法均出现1例血肿(3.1% vs. 1.3%， p = 0.665)。TEP组1例患者出现假性动脉瘤并行血管内栓塞治疗。结论在本组研究中，TEP术中转换及术后早期并发症较TAPP多见。另一方面，两种技术的结果之间没有明显差异。发现TAPP在腹股沟疝手术中与TEP一样安全;然而，在本研究中没有观察到一种方法优于另一种方法。

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引用次数: 6

Prevention and management of intraoperative complication during single incision laparoscopic totally extraperitoneal repair 单切口腹腔镜全腹膜外修复术中并发症的预防与处理

Journal of minimally invasive surgery

Pub Date : 2022-03-15 DOI: 10.7602/jmis.2022.25.1.36

Sungwoo Jung, Jin Ho Lee, Jae Uk Chong, Hyung Soon Lee

Serious complications related to hernia surgeries have rarely been reported. One meta-analysis comparing laparoscopic and open mesh repair reported that 0.4% of potentially serious operative complications were reported. Previous studies have reported that uncommon serious intraoperative complications more frequently occur during laparoscopic inguinal hernia repairs. One study has shown that patients with history of lower abdominal surgery are at an increased risk of visceral injury during laparoscopic hernia repair. Vascular injuries at dissection and mesh fixation or suturing in the preperitoneal space typically involve the epigastric or aberrant obturator vessels crossing the Cooper’s ligament. However, complications can occur at every step of the operation, although only few are reported. Therefore, we report our experiences of intraoperative complications during single-incision laparoscopic totally extraperitoneal hernia repair and how to prevent and manage intraoperative complications.

疝气手术引起的严重并发症很少有报道。一项比较腹腔镜和开放式补片修复的荟萃分析报告了0.4%的潜在严重手术并发症。以往的研究报道了腹腔镜腹股沟疝修补术中不常见的严重术中并发症。一项研究表明，有下腹部手术史的患者在腹腔镜疝修补术中内脏损伤的风险增加。腹膜前间隙剥离、网片固定或缝合时的血管损伤通常涉及穿过库珀韧带的腹壁血管或异常闭孔血管。然而，并发症可能发生在手术的每一步，虽然只有少数报道。因此，我们报告单切口腹腔镜全腹膜外疝修补术中并发症的经验及如何预防和处理术中并发症。

引用次数: 0

Risk factors of incisional hernia after laparoscopic colorectal surgery with periumbilical minilaparotomy incision: a propensity score matching analysis 腹腔镜结直肠手术脐周小切口切口后切口疝的危险因素:倾向评分匹配分析

Journal of minimally invasive surgery

Pub Date : 2022-03-15 DOI: 10.7602/jmis.2022.25.1.24

Yoon-Ji Kim, Ki Hyun Kim, K. Seo, Seung Hun Lee, G. Son

Purpose Incisional hernia is one of the most common complications after abdominal surgery conducted through a midline incision. Considerable debate remains regarding the design, comorbidity, suture material, and method. We investigated the risk factors for incisional hernia after laparoscopic colorectal surgery in the presence of limited surgery-related factors. Methods A retrospective study was designed with 541 patients who underwent laparoscopic colorectal surgery performed by a single operator from January 2015 to December 2017. Due to open conversions, other abdominal operations, or follow-up loss, only 445 patients were included in the study. After propensity score matching, 266 patients were included. The study was based on diagnosis of incisional hernia on computed tomography at 6 and 12 months postoperatively. Results Of the 266 total patients, 133 underwent abdominal closure using PDS (Ethicon), while the remaining 133 underwent closure with Vicryl (Ethicon). Of these patients, nine were diagnosed with incisional hernia at the 12-month follow-up six (4.5%) in the Vicryl group and three (2.3%) in the PDS group (p = 0.309). The incidence of incisional hernia was significantly increased in females (odds ratio [OR], 15.233; 95% confidence interval [CI], 1.905–121.799; p = 0.010), in patients with body mass index (BMI) of >25 kg/m2 (OR, 4.740; 95% CI, 1.424–15.546; p = 0.011), and in patients with liver disease (OR, 19.899; 95% CI, 1.614–245.376; p = 0.020). Conclusion BMI of >25 kg/m2, female, and liver disease were significant risk factors for incisional hernia after elective laparoscopic colorectal surgery performed through a transumbilical minilaparotomy incision.

目的切口疝是腹部中线切口手术后最常见的并发症之一。关于设计、合并症、缝合材料和方法仍有相当大的争论。我们调查了在有限的手术相关因素存在下腹腔镜结直肠手术后切口疝的危险因素。方法回顾性分析2015年1月至2017年12月，541例由单一术者行腹腔镜结直肠手术的患者。由于开腹手术、其他腹部手术或随访缺失，只有445例患者纳入研究。倾向评分匹配后，纳入266例患者。该研究基于术后6个月和12个月的计算机断层扫描对切口疝的诊断。结果266例患者中，133例采用PDS (Ethicon)闭腹术，133例采用Vicryl (Ethicon)闭腹术。在这些患者中，9例在12个月的随访中被诊断为切口疝，Vicryl组6例(4.5%)，PDS组3例(2.3%)(p = 0.309)。女性切口疝的发生率明显增加(优势比[OR]， 15.233;95%置信区间[CI]， 1.905-121.799;p = 0.010)，体重指数(BMI) >25 kg/m2的患者(OR, 4.740;95% ci, 1.424-15.546;p = 0.011)，肝病患者(OR, 19.899;95% ci, 1.614-245.376;P = 0.020)。结论BMI >25 kg/m2、女性、肝病是经脐小切口择期腹腔镜结直肠手术后发生切口疝的重要危险因素。

{"title":"Risk factors of incisional hernia after laparoscopic colorectal surgery with periumbilical minilaparotomy incision: a propensity score matching analysis","authors":"Yoon-Ji Kim, Ki Hyun Kim, K. Seo, Seung Hun Lee, G. Son","doi":"10.7602/jmis.2022.25.1.24","DOIUrl":"https://doi.org/10.7602/jmis.2022.25.1.24","url":null,"abstract":"Purpose Incisional hernia is one of the most common complications after abdominal surgery conducted through a midline incision. Considerable debate remains regarding the design, comorbidity, suture material, and method. We investigated the risk factors for incisional hernia after laparoscopic colorectal surgery in the presence of limited surgery-related factors. Methods A retrospective study was designed with 541 patients who underwent laparoscopic colorectal surgery performed by a single operator from January 2015 to December 2017. Due to open conversions, other abdominal operations, or follow-up loss, only 445 patients were included in the study. After propensity score matching, 266 patients were included. The study was based on diagnosis of incisional hernia on computed tomography at 6 and 12 months postoperatively. Results Of the 266 total patients, 133 underwent abdominal closure using PDS (Ethicon), while the remaining 133 underwent closure with Vicryl (Ethicon). Of these patients, nine were diagnosed with incisional hernia at the 12-month follow-up six (4.5%) in the Vicryl group and three (2.3%) in the PDS group (p = 0.309). The incidence of incisional hernia was significantly increased in females (odds ratio [OR], 15.233; 95% confidence interval [CI], 1.905–121.799; p = 0.010), in patients with body mass index (BMI) of >25 kg/m2 (OR, 4.740; 95% CI, 1.424–15.546; p = 0.011), and in patients with liver disease (OR, 19.899; 95% CI, 1.614–245.376; p = 0.020). Conclusion BMI of >25 kg/m2, female, and liver disease were significant risk factors for incisional hernia after elective laparoscopic colorectal surgery performed through a transumbilical minilaparotomy incision.","PeriodicalId":73832,"journal":{"name":"Journal of minimally invasive surgery","volume":"25 1","pages":"24 - 31"},"PeriodicalIF":0.0,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91071641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Comparison of one-stage laparoscopic common bile duct exploration plus cholecystectomy and two-stage endoscopic sphincterotomy plus laparoscopic cholecystectomy for concomitant gallbladder and common bile duct stones in patients over 80 years old 一期腹腔镜胆总管探查加胆囊切除术与二期内镜括约肌切开术加腹腔镜胆囊切除术治疗80岁以上合并胆囊、胆总管结石的比较

Journal of minimally invasive surgery

Pub Date : 2022-03-15 DOI: 10.7602/jmis.2022.25.1.11

Seung Jae Lee, I. Choi, J. Moon, Y. Choi, Ki-Hyun Ryu

Purpose This study was performed to compare the safety and efficacy of one-stage laparoscopic common bile duct exploration (LCBDE) plus laparoscopic cholecystectomy (LC) with those of endoscopic sphincterotomy (EST) plus LC for concomitant gallbladder (GB) and common bile duct (CBD) stones in elderly patients. Methods This single-center retrospective study reviewed the medical records of patients aged >80 years who were diagnosed with concomitant GB and CBD stones between January 2010 and December 2020. Results Of the 137 patients included in this study, 46 underwent one-stage LCBDE + LC and 91 underwent two-stage EST + LC. The frequency of previous gastrectomy (23.9% vs. 5.5%, p = 0.002) and multiple stones (76.1% vs. 49.5%, p = 0.003) was higher in the LCBDE + LC group than in the EST + LC group. Further, patients in LCBDE + LC group had larger CBD stones (11.9 mm vs. 6.0 mm, p < 0.001). There were no significant differences in the clearance (91.3% vs. 95.6%, p = 0.311) and recurrence (4.3% vs. 8.8%, p = 0.345) rates between the groups. The incidence of posttreatment overall complications (17.4% vs. 22.0%, p = 0.530) and total hospital stay (12.7 days vs. 11.7 days, p = 0.339) were similar in the two groups. Conclusion One-stage LCBDE + LC is a safe and effective treatment for concomitant GB and CBD stones, even in elderly patients, and may be considered as the first treatment option in elderly patients with previous gastrectomy, multiple large (≥ 15 mm) CBD stones, or inability to cooperate with endoscopic procedures.

目的比较一期腹腔镜胆总管探查(LCBDE)加腹腔镜胆囊切除术(LC)与内镜下括约肌切开术(EST)加LC治疗老年合并胆囊结石(GB)和胆总管结石(CBD)的安全性和有效性。方法本研究为单中心回顾性研究，回顾2010年1月至2020年12月期间诊断为GB和CBD合并结石的80岁以上患者的病历。结果本研究纳入的137例患者中，一期LCBDE + LC 46例，二期EST + LC 91例。LCBDE + LC组既往胃切除术发生率(23.9%比5.5%，p = 0.002)和多发结石发生率(76.1%比49.5%，p = 0.003)高于EST + LC组。此外，LCBDE + LC组患者的CBD结石更大(11.9 mm比6.0 mm, p < 0.001)。两组间清除率(91.3%比95.6%，p = 0.311)和复发率(4.3%比8.8%，p = 0.345)差异无统计学意义。两组治疗后总并发症发生率(17.4%比22.0%，p = 0.530)和总住院时间(12.7天比11.7天，p = 0.339)相似。结论一期LCBDE + LC治疗合并GB和CBD结石是一种安全有效的治疗方法，即使在老年患者中也是如此，可以考虑作为既往胃切除术，多发大(≥15 mm) CBD结石或无法配合内镜手术的老年患者的首选治疗方案。

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引用次数: 6

Dome-type carcinoma of the rectum mimicking a submucosal tumor: a case report and literature review 模拟粘膜下肿瘤的直肠圆顶型癌:1例报告及文献复习

Journal of minimally invasive surgery

Pub Date : 2022-03-15 DOI: 10.7602/jmis.2022.25.1.32

Byeong-Joo Noh, Sun Jin Park, J. Jang, Youn Wha Kim

Dome-type carcinoma (DC) has been recognized as a rare variant of adenocarcinoma, which arises in gut-associated lymphoid tissue. It has a specific morphologic feature of a dome-like protrusion associated with lymphoid tissue. We report a case of a DC of the rectum in an asymptomatic 58-year-old male. A 2-cm sized, well-demarcated, round mass masquerading as a submucosal tumor (SMT) was identified in the rectum and was resected by endoscopic submucosal dissection. The tumor was revealed as an adenocarcinoma with submucosal invasion of 3,700 µm, which consisted of dilated cystic glands and the lymphoid stroma with reactive germinal centers. On immunohistochemistry, the tumor cells revealed retained expression for mismatch repair proteins. Laparoscopic surgical resection was subsequently performed. DC is considered a distinctive subtype of colorectal adenocarcinoma with characteristic morphology and low-grade malignant potential. Careful detection of the overlying mucosal lesion is crucial to differentially diagnose DC from SMT.

圆顶型癌(DC)是一种罕见的腺癌，发生于肠道相关淋巴组织。它具有与淋巴组织相关的圆顶状突起的特殊形态学特征。我们报告一例直肠DC在一个无症状的58岁男性。在直肠中发现一个2厘米大小，界限清楚的圆形肿块，伪装成粘膜下肿瘤(SMT)，并通过内镜下粘膜下剥离术切除。肿瘤显示为腺癌，粘膜下浸润3700µm，包括扩张的囊性腺和淋巴样间质，生发中心反应性。免疫组化显示，肿瘤细胞保留了错配修复蛋白的表达。随后行腹腔镜手术切除。DC被认为是结直肠腺癌的一种独特亚型，具有独特的形态和低级别恶性潜能。仔细检查上覆粘膜病变是鉴别DC和SMT的关键。

引用次数: 1

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