With the upgrading of minimally invasive surgical concepts and laparoscopic equipment for gastric cancer, single-incision laparoscopic surgery (SILS) had emerged as a new focus of research in gastric cancer surgery. SILS offered advantages such as reduced damage, superior cosmetic outcomes, decreased postoperative pain, and faster recovery as compared with traditional laparoscopic gastrectomy. However, its level of difficulty limited its further promotion and application. Although numerous studies supported the safety and feasibility of SILS, more high-level evidence-based medical research was required to endorse its widespread use. The author reviewed the development history, current status, and prospects of SILS laparoscopic gastric cancer surgery.
【摘要】 目的 探讨椎管内囊肿的手术治疗疗效。 方法 2006年5月-2009年12月对30例患者的临床表现、影像学和治疗情况进行回顾性分析。 结果 30例均行手术治疗，3例为椎管内单侧硬膜下髓外囊肿，3例为脑脊膜囊肿，12例为髓外硬脊膜下囊肿，9例为神经根袖套部囊肿（Tarlov囊肿），3例为脊管内肠源性囊肿。术后21例症状消失；9例好转，其中3例术后发生脑脊液漏，伤口二次缝合未成功，后经内引流后切口愈合。 结论 椎管内囊肿的临床表现及体征复杂，不典型，与椎管内肿瘤及椎间盘突出症的临床表现和体征相似；对症状及体征明显者宜施行手术治疗，手术治疗效果较满意。【Abstract】 Objective To evaluate the therapeutic effect of the surgery on intraspinal cyst. Methods A total of 30 patients from May 2006 to December 2009 were collected, and the clinical manifestations, results of examinations and therapeutic effects were retrospectively analyzed. Results All the patients underwent the surgery, inluding 3 with unilateral intraspinal subdural extramedullary cyst, 3 with meningeal cyst, 12 with subdural extramedullary cyst, 3 with nerve-root oversleeve cyst (Tarlov cyst), and 3 with intra-spinal-canal enterogenous cyst. Afterh the surgery, the symptoms disappeared in 21 patients, alleviated in 9 including 3 with postoperative cerebrospinal-fluid leakage whose wound was not sutured successfully for the second time and healed up after drainage. Conclusions The clinical manifestations of intraspinal cyst are complicated and untypical, which is similar to that of intraspinal tumor and slipped disc. The surgeries should be performed on the patients with obvious symptoms and the therapeutic effect is good.
Objective To compare the oncologic results between laparoscopic and open approach for the treatment of rectal cancer. Methods Five hundred and twenty patients with rectal cancer from Jan. 2003 to Dec. 2008 were non-randomly divided into laparoscopic (LS) and open surgery (OS) group. Local recurrence, distant metastasis and survival rate were compared between two groups. Results One hundred and eighty-six cases received laparoscopic resection and 334 cases received open operation. There were no statistically significant differences (SSD) of demographic data between two groups (Pgt;0.05). Mean follow-up was 30.3 months. No SSD was observed in 3-year cumulative survival rate (83% in LS and 80% in OS, P=0.549), distant metastasis rate (12.5% in LS and 15.6% in OS, P=0.368), incidence of incision seeding (0.6% in LS and 0 in OS, P=0.189), or cumulative survival (P=0.142). The differences of local recurrences rate (4.8% in LS and 10.7% in OS, P=0.028), 3-year cumulative disease-free survival rate (81% in LS and 68% in OS, P=0.009), and cumulative disease-free survival (P=0.010) between two groups were statistical significant. The differences of cumulative survival, cumulative disease-free survival, local recurrences， and distant metastasis according to the TNM stageⅠ or Ⅱ between two groups were not statistical significant. The differences of cumulative disease-free survival and local recurrences according to the TNM stage Ⅲ reached statistical significance (P=0.045 and P=0.047, respectively). Conclusion Oncologic results of laparoscopic resection are similar to those of open resection for rectal carcinoma．