ABSTRACT
Endoscopic submucosal dissection (ESD) is a mature method for treating early gastrointestinal tumors. Appropriate submucosal exposure is one of the important factors for the successful operation of effective and safe dissection. This article combines domestic and foreign literature to summarize the background, procedure, prognosis, characteristics and related clinical research of magnetic anchored-guided endoscopic submucosal dissection (MAG-ESD). Generally speaking, compared with traditional ESD, MAG-ESD can shorten the operation time, simplify operation steps, reduce the incidence of complications, and improve the learning curve. Compared with other traction technologies that assist ESD, magnetic anchor-assisted technology can be used in the whole digestive tract mucosal dissection to treat early-staged cancer. The operation has a better operation triangle, is less technically difficult, and is friendly to experienced endoscope operators. It is called the "second hand" of endoscope operators. It can greatly improve the clinical treatment efficiency and patient satisfaction of early gastrointestinal cancer.
ABSTRACT
In recent years, with the popularization of low-dose computed tomography (LDCT) and high-resolution CT (HRCT), the discovery rate of early-staged non-small cell lung cancer has been on the rise, and more thoracic surgeons have explored more reasonable resection scope. Clinical studies have demonstrated that there is a lower rate of local tumor recurrence in patients with negative lung margins compared with positive ones. Therefore, it is of great clinical significance to ensure the negative margin during sublobar resection for early-staged lung cancer. This paper will focus on this area. .
Subject(s)
Humans , Carcinoma, Non-Small-Cell Lung , Pathology , General Surgery , Lung , Pathology , General Surgery , Lung Neoplasms , Pathology , General Surgery , Neoplasm Staging , RecurrenceABSTRACT
OBJECTIVE: Small cell carcinoma of the cervix(SCC) is a rare aggressive tumor with a propensity for rapid distant recurrence and a high mortality rate. The purpose of this study was to review our experience in early stage disease and to perform a meta-analysis of the literature to compare neoadjuvant with adjuvant chemotherapy as prognostic factor. METHODS: Between 1990 and 1998, seven women with FIGO early stage(IB-IIA) SCC were treated with surgery and chemotherapy at our hospital. Medical records were retrospectively reviewed. And thirty-two early-stage SCC patients who similarly treated since 1990 were identified by a Medline search of the English literature and included in the analysis. The Kaplan-Meier method and log-rank test were used for survival analysis. RESULTS: Out of our patients, three patients died at 12-13 months after diagnosis due to distant metastases which were brain in two and was liver and lung in one. Other three are alive with no evidence of disease at 27, 66, and 121 months. From the meta-analysis, the overall 3-year survival rate was 49% in neoadjuvant and 33% in adjuvant chemotherapy, but there were no statistical significance.(log-rank test, 0.80) Neoadjuvant chemotherapy resulted in a high response rates(81.2%), no pelvic recurrence, and a low LN metastasis(18.8%), therefore the pelvic radiation therapy rates was low. CONCLUSIONS: Even in the early stage, SCC treatment must be combined with chemotherapy. There was no significant difference in prognosis between neoadjuvant and adjuvant chemotherapy. But this study showed neoadjuvant may extirpate the primary lesion, evaluate response, and assess more promising postoperative therapy according to pathologic features.