ObjectiveTo systematically evaluate the effectiveness and safety of computer-aided detection (CADe) and conventional colonoscopy in identifying colorectal adenomas and polyps. MethodsThe PubMed, Embase, Cochrane Library, Web of Science, WanFang Data, VIP, and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) comparing the effectiveness and safety of CADe assisted colonoscopy and conventional colonoscopy in detecting colorectal tumors from 2014 to April 2023. Two reviewers independently screened the literature, extracted data, and evaluated the risk of bias of the included literature. Meta-analysis was performed by RevMan 5.3 software. ResultsA total of 9 studies were included, with a total of 6 393 patients. Compared with conventional colonoscopy, the CADe system significantly improved the adenoma detection rate (ADR) (RR=1.22, 95% CI 1.10 to 1.35, P<0.01) and polyp detection rate (PDR) (RR=1.19, 95% CI 1.04 to 1.36, P=0.01). It also reduced the missed diagnosis rate (AMR) of adenomas (RR=0.48, 95% CI 0.34 to 0.67, P<0.01) and the missed diagnosis rate (PMR) of polyps (RR=0.39, 95% CI 0.25 to 0.59, P<0.01). The PDR of proximal polyps significantly increased, while the PDR of ≤ 5mm polyps slightly increased, but the PDR of >10mm and pedunculated polyps significantly decreased; The AMR of the cecum, transverse colon, descending colon, and sigmoid colon was significantly reduced. There was no statistically significant difference in the withdrawal time between the two groups. Conclusion The computer-aided detection system can increase the detection rate of adenomas and polyps, and reduce the missed diagnosis rate. The detection rate of polyps is related to their location, size, and shape, while the missed diagnosis rate of adenomas is related to their location.
Objective To explore method of jejunum nutrition tube implantation in total laparoscopic radical gastrectomy for distal gastric cancer (GC). Methods The clinical data of 30 patients with distal GC underwent the total laparoscopic radical gastrectomy from October 2017 to March 2018 in the Departmeng of Tumor Surgery, Lanzhou University Second Hospital were retrospectively analyzed, the total laparoscopic radical distal gastrectomy were performed in all the patients and the jejunum nutrition tube were implanted during the operation. Results Thirty patients with distal GC were successfully treated with the total laparoscopic radical gastrectomy and the jejunum nutrition tubes were implanted into under the total laparoscopy through the intraoperative guidance by the gastric tube, firstly fastening the nutrition tube to the gastric tube in vitro, and then separating them in vivo, finally the nutrition tube was smoothly implanted into the jejunum under the direct vision. The implantation time was 10 to 15 min with an average of 13.5 min. The jejunal nutrition tube retention time was 5 to 7 d with an average of 6 d. There were no complications such as the bleeding, anastomotic leakage, anastomotic obstruction, stenosis, intestinal leakage, intestinal obstruction, and other complications after the operation in the 30 patients. Conclusions Method of jejunum nutrition tube implantation in total laparoscopic radical gastrectomy for distal GC is easy to be performed. Intraoperative and postoperative complications are few. It provides a favorable guarantee for improving postoperative nutritional status of patient with distal GC.