Three-dimensional (3D) printing, an emerging rapid prototyping technology, has been widely used in biomedical field. 3D printing was originally used to construct the visualization models and molds in medicine. With the development of 3D printing in biomedical field, the technology was gradually applied in complex tissue regeneration and organ reconstruction. Artificial tissues and organs obtained by 3D printing are expected to be used for organ transplantation, new drug development and drug toxicity evaluation in the field of medicine and health care research. This paper describes the individualized application of 3D printing technology in liver surgery and introduces the research progress of 3D bioprinting technology in liver transplantation, drug metabolism and hepatotoxicity evaluation, and prospects its future development trend to provide a reference for further study.
As a standard of care, lymph node dissection is an indispensible step in lung cancer surgery. The quality of dissection determines completeness of surgery and the accuracy of N staging. Hereby, we suggest labeling all surgically resected nodes according to the new lymph node map in the 8th TNM classification for lung cancer. As systematic lymph node dissection remains the gold standard of lymphadenectomy, at least three mediastinal stations and ten nodes should be removed in an en-bloc fashion, if possible. For patients with stage Ⅰ lung cancer, lymph node dissection via video-assisted thoracoscopic surgery (VATS) or open thoracotomy may has similar oncological outcome. Besides, limited lymph node sampling in selected patients with early staged lung cancer to minimize unnecessary surgical damage still need further investigation.
With the increasing popularity of chest spiral CT screening, the detection rate of lung cancer in China is increasing. According to the characteristics of lung cancer in China and the progress of lung cancer researches at home and abroad, Chinese Medical Association guidelines for clinical diagnosis and treatment of lung cancer are updated once a year. It is of great guiding significance to standardize and improve the clinical diagnosis and treatment of lung cancer for thoracic surgeons. The surgical diagnosis and treatment of lung cancer in the guidelines mainly include: (1) surgical treatment of stage Ⅰ-Ⅱ non-small cell lung cancer (NSCLC); (2) surgical treatment of resectable stage Ⅲ NSCLC; (3) surgical treatment of multiple primary lung cancer; and (4) surgical treatment of locally resectable small cell lung cancer. Based on the Chinese Medical Association guidelines for clinical diagnosis and treatment of lung cancer (2019 edition), this paper interprets the hot issues related to the surgical treatment of lung cancer.
ObjectiveTo explore the research progress of sarcopenia in breast cancer patients, with a view to providing new ideas for the treatment and prognosis of patients with sarcopenia in breast cancer. MethodThe literature relevant to studies on sarcopenia and breast cancer at home and abroad was searched and reviewed in recent years. ResultsSarcopenia was highly prevalent in breast cancer patients and was associated with multiple poor prognoses in breast cancer patients. Exercise, nutritional support, and medication-assisted treatment could significantly improve the survival quality in breast cancer patients with sarcopenia. ConclusionsAs a common concomitant disease of breast cancer, sarcopenia seriously affects the survival quality and prognosis of patients. The development of sarcopenia in breast cancer patients should be closely monitored, and its mechanisms of action should continue to be studied and clarified in order to identify new therapeutic targets.
Objective To investigate the short-term effectiveness of unilateral biportal endoscopy (UBE) in treatment of lumbar lateral saphenous fossa combined with intervertebral foramina stenosis via contralateral sublaminar approach. Methods A clinical data of 15 patients with lumbar lateral saphenous fossa combined with intervertebral foramina stenosis, who were admitted between September 2021 and December 2023 and met selective criteria, was retrospectively analyzed. There were 5 males and 10 females with an average age of 70.3 years (range, 46-83 years). Surgical segment was L4, 5 in 12 cases and L5, S1 in 3 cases. The disease duration was 12-30 months (mean, 18.7 months). All patients were treated by UBE via contralateral sublaminar approach. The operation time, intraoperative blood loss, postoperative hospital stay, and the occurrence of complications were recorded. The visual analogue scale (VAS) score was used to evaluate the degree of lower back and leg pain before and after operation; the Japanese Orthopaedic Association (JOA) score and the Oswestry disability index (ODI) were used to evaluate the lumbar function; and the clinical outcome was evaluated using the MacNab criteria at 6 months after operation. Postoperative MRI and CT were taken to observe whether the lateral saphenous fossa and intervertebral foramen stenosis were removed or not, and the cross-sectional area of the spinal canal (CSA-SC), cross-sectional area of the intervertebral foramen (CSA-IVF), and cross-sectional area of the facet joint (CSA-FJ) were measured. Results The operation time was 55-200 minutes (mean, 127.5 minutes); the intraoperative blood loss was 10-50 mL (mean, 27.3 mL); the length of postoperative hospital stay was 3-12 days (mean, 6.8 days). All patients were followed up 6-12 months (mean, 8.9 months). At 1 day, 1 month, 3 months, and 6 months after operation, the VAS scores of low back and leg pain and ODI scores after operation were significantly lower than preoperative scores and showed a gradual decrease with time; the JOA scores showed a gradual increase with time; the differences in the above indexes between different time points were significant (P<0.05). The clinical outcome was rated as excellent in 10 cases, good in 4 cases, and poor in 1 case according to the MacNab criteria at 6 months after operation, with an excellent and good rate of 93.33%. Imaging review showed that the compression on the lateral saphenous fossa and intervertebral foramina had been significantly relieved, and the affected articular process joint was preserved to the maximum extent; the CSA-SC and CSA-IVF at 3 days after operation significantly increased compared to the preoperative values (P<0.05), and the CSA-FJ significantly reduced (P<0.05). Conclusion The UBE via contralateral sublaminar approach can effectively reduce pressure in the lateral saphenous fossa and the intervertebral foramina of the same segment while preserving the bilateral articular process joints. The short-term effectiveness is good and it is expected to avoid fusion surgery caused by iatrogenic instability of the lumbar spine. However, further follow-up is needed to clarify the mid- and long-term effectiveness.