Current status and thoughts of transanal total mesorectal excision for rectal cancer / 肿瘤

Transanl total mesorectal excision(taTME)combines a series of concepts such as total mesorectal excision(TME),natural orifice transluminal endoscopic surgery(NOTES),single-incision laparoscopic surgery(SILS)and transanal minimally invasive surgery(TAMIS).It has been 1 2 years since its birth,and it has become one of the highlights in colorectal surgery in the recent decade.Its advantages and disadvantages seem so eye-catching,accompanied by controversy while developing.At present,many surgeons in China have performed the taTME operation.Whether it is experimentation or routine,whether it will be popular or outdated in the future,in addition to non-stop surgery,we should also timely reflect.When we have the high-level expected evidence of safety and oncological results,and establish the quality control standards,taTME will move forward with us.And it will play its role in the treatment of middle and low rectal cancer.Unexpected taTME approach also provides us with a new option to ensure surgical safety.

Subphrenic splenic implantation after splenectomy： A case report / 中南大学学报(医学版)

Subphrenic splenic implantation is a rare disease, usually occurred followed the splenic trauma and splenectomy. Surgeries are often necessary for diagnosing and treating it. A 46-year-old male post-splenectomy patient, tolerating abdominal bloating and pain for more than 1 year, was admitted to the Second Xiangya Hospital, Central South University. Fundus bulge suggested a possibility of stromal tumors originating from the muscularispropria layer with endoscopic ultrasound. Slightly stomachic thickness was detected using enhanced computed tomography (CT). Without any improvement for symptoms after medication, the patient strongly requested to undergo an endoscopic therapy. Natural orifice transluminal endoscopic surgery (NOTES) result confirmed it as subphrenic splenic implantation with postoperative pathology. In this case, NOTES helped us to confirm the diagnosis, relieve the symptoms, as well as prevent secondary surgery injury, which would be helpful to other clinicians.

Chinese consensus on transanal endoscopic surgery (2019 version) / 中华胃肠外科杂志

With the promotion of transanal total mesorectal excision (taTME) nationwide, transanal endoscopic surgery has become more and more widely used. However, at present, there is still a situation in the domestic colorectal surgery community that is not uniform, in-depth and not standardized in the understanding of the issues related to transanal endoscopic surgery. In order to clarify the key issues of transanal endoscopic surgery, including definition, indications, contraindications, surgical classification, basic principles of surgery, prevention and treatment of complications, the experts of the writing committee based on the existing evidence combined with clinical practice to verify the definition of transanal endoscopic surgery, indications, contraindications and surgical classification, by means of voting for key issues such as intraoperative sterility, no tumor principle, surgical quality control, specimen removal method, digestive tract reconstruction, how to solve intraoperative pressure instability, how to ensure the safety of anastomosis, and prevention and treatment of complications, aiming at providing guidance for transanal endoscopic surgery in China.

Chinese consensus on transanal endoscopic surgery (2019 version) / 中华胃肠外科杂志

With the promotion of transanal total mesorectal excision (taTME) nationwide, transanal endoscopic surgery has become more and more widely used. However, at present, there is still a situation in the domestic colorectal surgery community that is not uniform, in-depth and not standardized in the understanding of the issues related to transanal endoscopic surgery. In order to clarify the key issues of transanal endoscopic surgery, including definition, indications, contraindications, surgical classification, basic principles of surgery, prevention and treatment of complications, the experts of the writing committee based on the existing evidence combined with clinical practice to verify the definition of transanal endoscopic surgery, indications, contraindications and surgical classification, by means of voting for key issues such as intraoperative sterility, no tumor principle, surgical quality control, specimen removal method, digestive tract reconstruction, how to solve intraoperative pressure instability, how to ensure the safety of anastomosis, and prevention and treatment of complications, aiming at providing guidance for transanal endoscopic surgery in China.

Development status of natural orifice translumenal endoscopic surgery based on bibliometric analysis / 局解手术学杂志

Objective To analyze the related literature of natural orifice translumenal endoscopic surgery(NOTES),discuss the development status and direction of the NOTES.Methods NOTES related documents were retrieved from the China National Knowledge Internet(CNKI),Wanfang Data,China Biomedical Literature Database(CBM) and Superstar Medalink.The related project were statistically analyzed.Status quo and development direction were analyzed.Results The journal of NOTES literature was scattered,involving numerous departments,especially the gastroenterology,urology,oncology,obstetrics and gynecology.The largest number of NOTES were reported in the vagina,followed by the stomach and the rectum.The post agencies and the area were mainly in the developed areas of strong scientific research colleges and universities and clinical teaching hospitals.The most published types of literature at present were the research and review of NOTES combined laparoscopy,and more basic research literature.The directions of collecting the reseach of NOTES by keywords were main from several aspects:NOTES combined with laparoscopy for colorectal cancer,urology,hepatobiliary surgery,cardiothoracic surgery,and so on;NOTES in animal experimental study;the application range included NOTES devices,work space, artificial interface for disease,and development of NOTES.Conclusion NOTES is the current research hotspot.Currently the domestic development is relative lag,which is in the primary stage of development.The basic research of NOTES need further study and clinical application need to strengthen,otherwise,application of NOTES instrument need to speed.

Single-Port Thoracic Surgery: A New Direction

Single-port video-assisted thoracic surgery (VATS) has slowly established itself as an alternate surgical approach for the treatment of an increasingly wide range of thoracic conditions. The potential benefits of fewer surgical incisions, better cosmesis, and less postoperative pain and paraesthesia have led to the technique's popularity worldwide. The limited single small incision through which the surgeon has to operate poses challenges that are slowly being addressed by improvements in instrument design. Of note, instruments and video-camera systems that are narrower and angulated have made single-port VATS major lung resection easier to perform and learn. In the future, we may see the development of subcostal or embryonic natural orifice translumenal endoscopic surgery access, evolution in anaesthesia strategies, and cross-discipline imaging-assisted lesion localization for single-port VATS procedures.