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 探討椎管內囊腫的手術治療療效。 方法 2006年5月-2009年12月對30例患者的臨床表現、影像學和治療情況進行回顧性分析。 結果 30例均行手術治療，3例為椎管內單側硬膜下髓外囊腫，3例為腦脊膜囊腫，12例為髓外硬脊膜下囊腫，9例為神經根袖套部囊腫（Tarlov囊腫），3例為脊管內腸源性囊腫。術后21例癥狀消失；9例好轉，其中3例術后發生腦脊液漏，傷口二次縫合未成功，后經內引流后切口愈合。 結論 椎管內囊腫的臨床表現及體征復雜，不典型，與椎管內腫瘤及椎間盤突出癥的臨床表現和體征相似；對癥狀及體征明顯者宜施行手術治療，手術治療效果較滿意。【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．