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Annals of Laparoscopic and Endoscopic Surgery最新文献

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Role of laparoscopic/robotic approaches for urologic surgeries 腹腔镜/机器人方法在泌尿外科手术中的作用
IF 0.5 4区 医学 Q3 Medicine Pub Date : 2024-01-01 DOI: 10.21037/ales-23-72
Nitin Sharma
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引用次数: 0
Narrative review of flaps and grafts in robotic reconstructive urologic surgery 机器人泌尿外科整形手术中皮瓣和移植物的叙述性综述
IF 0.5 4区 医学 Q3 Medicine Pub Date : 2024-01-01 DOI: 10.21037/ales-23-36
K. Doersch, Laena Hines, Divya Ajay
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引用次数: 0
Colon cancer: is the robot a better option? 结肠癌:机器人是更好的选择吗?
4区 医学 Q3 Medicine Pub Date : 2023-10-01 DOI: 10.21037/ales-23-16
Felipe F. Quezada-Diaz, J. Joshua Smith
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引用次数: 0
Endoscopic submucosal dissection of neoplastic lesions of the colon: clinical application and techniques 内镜下结肠肿瘤性病变的粘膜下剥离:临床应用与技术
4区 医学 Q3 Medicine Pub Date : 2023-10-01 DOI: 10.21037/ales-23-12
Thomas J. Wang, Hiroyuki Aihara
: Endoscopic submucosal dissection (ESD), first developed in Japan, is increasingly performed worldwide to allow en bloc removal of large lesions from the gastrointestinal tract. Colorectal ESD results in higher en bloc and R0 resection rates than those in endoscopic mucosal resection (EMR), thus reducing the risk of local recurrence and allowing accurate pathological evaluations. Compared with surgical resection, ESD is better tolerated by patients, with reduced adverse event rates, hospitalization durations, and costs. Colorectal ESD is most appropriate for lesions larger than 20 mm with a risk of submucosal invasion and that are difficult to remove en bloc or for lesions in which previous EMR had failed or was not possible. However, inferior en bloc and R0 resection rates of colorectal ESD have been reported in the US compared to those in Japan, potentially due to increased technical challenges secondary to higher prevalence of obesity and significantly greater occurrence of fibrotic lesions in the US due to previous resection attempts. Recently, colorectal ESD guidelines have been updated, and various techniques and technologies have been developed to improve colorectal ESD outcomes, reduce procedure time, and overcome technical challenges. This article will discuss updated indications, new devices, resection strategies, technique variations, and clinical outcomes of colorectal ESD with regional comparisons (i.e., North America, Europe, and Japan).
内镜下粘膜剥离术(ESD)最早在日本开发,在世界范围内越来越多地应用于胃肠道大病变的整体切除。与内镜下粘膜切除术(EMR)相比,结肠直肠ESD的整体和R0切除率更高,从而降低了局部复发的风险,并可以进行准确的病理评估。与手术切除相比,患者对ESD的耐受性更好,不良事件发生率、住院时间和费用都降低了。结肠直肠ESD最适用于大于20mm且有粘膜下浸润风险且难以整体切除的病变,或既往EMR失败或无法切除的病变。然而,据报道,与日本相比,美国结肠直肠ESD的整体和R0切除率较低,这可能是由于美国肥胖患病率较高导致的技术挑战增加,以及由于先前的切除尝试导致的纤维化病变发生率显著增加。近年来,结肠直肠ESD指南不断更新,并开发了各种技术和技术来改善结肠直肠ESD的效果,缩短手术时间,并克服技术挑战。本文将讨论结肠直肠ESD的最新适应症、新设备、切除策略、技术变化和临床结果,并进行区域比较(即北美、欧洲和日本)。
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引用次数: 0
Minimally invasive colorectal surgery—the sky is the limit 微创结直肠手术——前途无量
4区 医学 Q3 Medicine Pub Date : 2023-10-01 DOI: 10.21037/ales-23-47
Alessandro Fichera
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引用次数: 0
Detection and surveillance of gastric cancer precursors: evolving guidelines and technologies 胃癌前体的检测和监测:不断发展的指南和技术
4区 医学 Q3 Medicine Pub Date : 2023-10-01 DOI: 10.21037/ales-23-13
Jennifer Koh, Miranda V. Shum, Joo Ha Hwang, Robert J. Huang
: Non-cardiac gastric adenocarcinoma (NCGA) remains a leading source of global morbidity and mortality. Despite its lower incidence in the United States and Western Europe, the overall poor survival and prognosis from this cancer suggest a need for earlier detection. NCGA develops through a well-known stepwise progression of precursor lesions, including chronic gastritis, atrophic gastritis, intestinal metaplasia, and dysplasia. Identification and surveillance of high-risk individuals carrying these precursors may be one important avenue to improve NCGA outcomes through earlier detection. In addition, identifying NCGA precursors creates an opportunity for definitive management with early endoscopic resection, and therefore a potential for reduction in cancer morbidity and mortality. This review has two main objectives. The first aim is to describe and evaluate various imaging technologies that are currently used to aid and improve the endoscopic detection of NCGA precursor lesions. These modalities include image-enhanced endoscopy (both dye-based and virtual), confocal laser endomicroscopy, and auto-fluorescence imaging. The second aim is to appraise current surveillance strategies for individuals carrying precursor lesions, with an emphasis on synthesizing recommendations from several recent surveillance guidelines published in the United States and Europe. In this review, we also highlight future innovative technologies and directions, including the utilization of artificial intelligence for rapid lesion recognition and molecular-based individual risk stratification.
非心性胃腺癌(NCGA)仍然是全球发病率和死亡率的主要来源。尽管其在美国和西欧的发病率较低,但这种癌症的总体生存率和预后较差,这表明需要早期发现。NCGA通过众所周知的前体病变逐步发展,包括慢性胃炎、萎缩性胃炎、肠化生和不典型增生。识别和监测携带这些前体的高危个体可能是通过早期检测改善NCGA结果的一个重要途径。此外,识别NCGA前体为早期内镜切除的明确治疗创造了机会,因此有可能降低癌症发病率和死亡率。这次审查有两个主要目标。第一个目的是描述和评估各种成像技术,目前用于帮助和改进内镜检测NCGA前驱病变。这些方式包括图像增强内窥镜检查(染料和虚拟),共聚焦激光内窥镜检查和自动荧光成像。第二个目的是评估目前对携带前体病变个体的监测策略,重点是综合美国和欧洲最近发表的几项监测指南的建议。在这篇综述中,我们还强调了未来的创新技术和方向,包括利用人工智能进行快速病变识别和基于分子的个体风险分层。
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引用次数: 0
Robotic approaches for vascular and endovascular procedures: a narrative review 血管和血管内手术的机器人方法:叙述性回顾
4区 医学 Q3 Medicine Pub Date : 2023-10-01 DOI: 10.21037/ales-23-24
Michael A. Huber, Justin M. Robbins, Stacy M. Sebastian, Alexander Hien Vu, George Ferzli, Richard Schutzer, Anil Hingorani
Background and Objective: The use of robot technology has greatly expanded the field of general surgery. While robot technology has become almost standard for many general surgeons, there is an increasing interest in how this same technology may be utilized within more specialized fields. We sought to explore the advances and current uses of robot technology within the field of vascular surgery. We evaluated this topic broadly in the context of both open and endovascular approaches.
背景与目的:机器人技术的应用极大地拓展了普外科的领域。虽然机器人技术几乎已经成为许多普通外科医生的标准,但人们对如何将同样的技术应用于更专业的领域越来越感兴趣。我们试图探索机器人技术在血管外科领域的进展和当前应用。我们在开放和血管内入路的背景下广泛评估了这一主题。
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引用次数: 0
Colon polyp characterization (morphology and mucosal patterns): clinical application and techniques 结肠息肉的特征(形态学和粘膜模式):临床应用和技术
4区 医学 Q3 Medicine Pub Date : 2023-10-01 DOI: 10.21037/ales-23-10
Kunzah A. Syed, Mako Koseki, Sera Satoi, Erica Park, Priya Simoes, Makoto Nishimura
: The endoscopic treatment of neoplastic colorectal lesions has evolved over time to include technically challenging methods such as endoscopic submucosal dissection (ESD), which is slowly gaining traction in the U.S. after relatively widespread implementation in Japan. This review broadly covers the utility and main characteristics of several modalities for the endoscopic diagnosis and treatment of colorectal polyps including white light imaging (WLI), chromoendoscopy, and narrow band imaging (NBI). The increasing utilization of these techniques has unearthed a need for comprehensive and accurate classification systems of assessment, such as Kudo’s pit pattern, the Paris classification, NBI International Colorectal Endoscopic (NICE) classification, and the more recent Japan NBI Experts Team (JNET) classification. The inception and current impact of magnifying endoscopy is also considered, as it has transformed the endoscopist’s ability to inspect microsurfaces and critically evaluate mucosal microstructures to attain an endoscopic prediagnosis. Though there are many clear advantages to existing methods of optical diagnosis, this space has not been devoid of potential problems, and the benefits as well as shortcomings are described herein. The current literature surrounding some promising applications of artificial intelligence (AI) in the detection and management of polyps, as well as in the screening of colorectal cancer (CRC), is also discussed.
随着时间的推移,内镜下治疗肿瘤性结直肠病变已经发展到包括技术上具有挑战性的方法,如内镜下粘膜剥离(ESD),在日本相对广泛地实施后,在美国逐渐获得关注。本文综述了几种内镜诊断和治疗结肠直肠息肉的方法的用途和主要特点,包括白光成像(WLI)、彩色内镜和窄带成像(NBI)。随着这些技术的应用越来越广泛,对全面、准确的分类系统的需求越来越大,例如工藤坑模式、巴黎分类、NBI国际结直肠内镜(NICE)分类以及最近的日本NBI专家小组(JNET)分类。放大内窥镜的起源和目前的影响也被考虑,因为它已经改变了内窥镜医师检查微表面和批判性评估粘膜微观结构的能力,以获得内窥镜预诊断。尽管现有的光学诊断方法有许多明显的优点,但这一领域并非没有潜在的问题,本文将介绍其优点和缺点。本文还讨论了目前有关人工智能(AI)在息肉的检测和治疗以及结直肠癌(CRC)筛查方面的一些有前景的应用。
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引用次数: 0
Disparities in the impact of access to and outcomes of bariatric surgery among different ethnoracial and socioeconomic populations: a narrative review of the literature 不同种族和社会经济人群对减肥手术的影响和结果的差异:文献的叙述性回顾
4区 医学 Q3 Medicine Pub Date : 2023-10-01 DOI: 10.21037/ales-22-81
Monika K. Masanam, Danielle A. Grossman, Jacob Neary, Yewande R. Alimi
Background and Objective: Obesity and its associated chronic medical conditions such as diabetes and hypertension are among the leading health concerns in the developed world. Bariatric and metabolic surgery has emerged as an established and definitive treatment for severe obesity. Given the disproportionate burden of obesity and diabetes on different racial and socioeconomic populations, studies have assessed the impact of these disparities in bariatric surgery patients.
背景与目的:肥胖及其相关的慢性疾病,如糖尿病和高血压,是发达国家主要的健康问题之一。减肥和代谢手术已经成为治疗严重肥胖的一种确定和明确的方法。鉴于肥胖和糖尿病对不同种族和社会经济人群的不成比例的负担,研究已经评估了这些差异对减肥手术患者的影响。
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引用次数: 0
A narrative review: complete mesocolic excision in right-sided colonic cancer resections—present paradigm and future directions 一篇叙述性的综述:完全肠系膜切除在右侧结肠癌切除术-目前的范例和未来的方向
4区 医学 Q3 Medicine Pub Date : 2023-10-01 DOI: 10.21037/ales-23-4
Retnagowri Rajandram, Tak Loon Khong, Nora Abdul Aziz, Mohamed Rezal Abdul Aziz, April Camilla Roslani
Background and Objective: Complete mesocolic excision (CME) is thought to achieve better oncological outcomes in colon cancer surgery, but adoption in right-sided colon resections has not been as complete as total mesorectal excision (TME) in rectal cancers, and the technique is not as standardized. In addition, higher rates of intra-operative complications in early studies have limited its wide-scale adoption in routine surgical practice. We aim to determine if the literature supports a universal or selective application of CME in right-sided colonic cancer resections.
背景与目的:在结肠癌手术中,完全肠系膜切除术(CME)被认为可以获得更好的肿瘤预后,但在直肠癌中,右侧结肠切除术的采用并不像直肠全肠系膜切除术(TME)那样彻底,而且技术也不标准化。此外,早期研究中较高的术中并发症率限制了其在常规外科实践中的广泛应用。我们的目的是确定文献是否支持CME在右侧结肠癌切除术中的普遍应用或选择性应用。
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Annals of Laparoscopic and Endoscopic Surgery
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