The main aim of this opinion review is to comment on the recent article published by Garg et al in the World Journal of Gastroenterology 2023;29:4593–4603.The authors in the published article developed a new scoring ...The main aim of this opinion review is to comment on the recent article published by Garg et al in the World Journal of Gastroenterology 2023;29:4593–4603.The authors in the published article developed a new scoring system,Garg incon-tinence scores(GIS),for fecal incontinence(FI).FI is a chronic debilitating disease that has a severe negative impact on the quality of life of the patients.Rome IV criteria define FI as multiple episodes of solid or liquid stool passed into the clothes at least twice a month.The associated social stigmatization often leads to significant under-reporting of the condition,which further impairs management.An important point is that the complexity and vagueness of the disease make it difficult for the patients to properly define and report the magnitude of the problem to their physicians.Due to this,the management becomes even more difficult.This issue is resolved up to a considerable extent by a scoring ques-tionnaire.There were several scoring systems in use for the last three decades.The prominent of them were the Cleveland Clinic scoring system or the Wexner scoring system,St.Marks Hospital or Vaizey’s scores,and the FI severity index.However,there were several shortcomings in these scoring systems.In the opinion review,we tried to analyze the strength of GIS and compare it to the existing scoring systems.The main pitfalls in the existing scoring systems were that most of them gave equal weightage to different types of FI(solid,liquid,flatus,etc.),were not comprehensive,and took only the surgeon’s perception of FI into view.In GIS,almost all shortcomings of previous scoring systems had been addressed:different weights were assigned to different types of FI by a robust statistical methodology;the scoring system was made comprehensive by including all types of FI that were previously omitted(urge,stress and mucus FI)and gave priority to patients’rather than the physicians’perceptions while developing the scoring system.Due to this,GIS indeed looked like a paradigm shift in the evaluation of FI.However,it is too early to conclude this,as GIS needs to be validated for accuracy and simplicity in future studies.展开更多
At present,natural orifice specimen extraction surgery(NOSES)has attracted more and more attention worldwide,because of its great advantages including minimal cutaneous trauma and post-operative pain,fast post-operati...At present,natural orifice specimen extraction surgery(NOSES)has attracted more and more attention worldwide,because of its great advantages including minimal cutaneous trauma and post-operative pain,fast post-operative recovery,short hospital stay,and positive psychological impact.However,NOSES for the treatment of gastric cancer(GC)is still in its infancy,and there is great potential to improve its theoretical system and clinical practice.Especially,several key points including oncological outcomes,bacteriological concerns,indication selection,and standardized surgical procedures are raised with this innovative technique.Therefore,it is necessary to achieve an international consensus to regulate the implementation of GC-NOSES,which is of great significance for healthy and orderly development of NOSES worldwide.展开更多
To the Editor:Natural orifice specimen extraction surgery(NOSES)is an actively developing approach for extracting specimens and performing non-incisional colorectal cancer surgery.Previous studies have shown that its ...To the Editor:Natural orifice specimen extraction surgery(NOSES)is an actively developing approach for extracting specimens and performing non-incisional colorectal cancer surgery.Previous studies have shown that its effectiveness and safety in the surgical treatment of rectal cancer are similar to those of conventional laparoscopic surgery.NOSES was demonstrated to be a possible alternative approach to conventional laparoscopy,for which a mini-laparotomy is used to extract the specimen,as there were no differences in surgical characteristics and short-term outcomes.[1]Recently,new promising approaches have been demonstrated for rectal tumors extraction with bowel eversion and extra-abdominal resection.展开更多
Purpose In recent years,natural orifice specimen extraction surgery(NOSES)has gained widespread attention as an alternative approach.Although the safety and feasibility of NOSES have been well documented,many question...Purpose In recent years,natural orifice specimen extraction surgery(NOSES)has gained widespread attention as an alternative approach.Although the safety and feasibility of NOSES have been well documented,many questions remain open for discussion.The aim of this guideline is to provide more evidence for the promotion of NOSES.Methods This guideline has been prepared by the CACA Committee of Colorectal Cancer Society and the International NOSES Alliance,based on the latest evidence.Results The guideline on NOSES for colorectal cancer include the definition,classification,technology requirement,indications,technical difficulties and clinical research.Conclusion The guideline provides a full introduction of the theoretical and technical aspects of NOSES for colorectal cancer which will beneficial to development of NOSES.展开更多
To the Editor:The literature has registered a considerable interest among Western surgeons in the role of extended lymph node dissection in right hemicolectomy.There are a lot of voices of dissent regarding the harves...To the Editor:The literature has registered a considerable interest among Western surgeons in the role of extended lymph node dissection in right hemicolectomy.There are a lot of voices of dissent regarding the harvest of nodes lying dorsally to the superior mesenteric vein(SMV)and superior mesenteric artery(SMA).展开更多
To the Editor:Colorectal cancer(CRC)remains the second most frequent cause of cancer-related deaths worldwide.Since the concept of total mesorectal excision(TME)introduced by Heald et al[1] has become a gold standard ...To the Editor:Colorectal cancer(CRC)remains the second most frequent cause of cancer-related deaths worldwide.Since the concept of total mesorectal excision(TME)introduced by Heald et al[1] has become a gold standard of rectal cancer surgery,there has been a significant improvement in oncological outcomes including diseasefree and overall survival.展开更多
文摘The main aim of this opinion review is to comment on the recent article published by Garg et al in the World Journal of Gastroenterology 2023;29:4593–4603.The authors in the published article developed a new scoring system,Garg incon-tinence scores(GIS),for fecal incontinence(FI).FI is a chronic debilitating disease that has a severe negative impact on the quality of life of the patients.Rome IV criteria define FI as multiple episodes of solid or liquid stool passed into the clothes at least twice a month.The associated social stigmatization often leads to significant under-reporting of the condition,which further impairs management.An important point is that the complexity and vagueness of the disease make it difficult for the patients to properly define and report the magnitude of the problem to their physicians.Due to this,the management becomes even more difficult.This issue is resolved up to a considerable extent by a scoring ques-tionnaire.There were several scoring systems in use for the last three decades.The prominent of them were the Cleveland Clinic scoring system or the Wexner scoring system,St.Marks Hospital or Vaizey’s scores,and the FI severity index.However,there were several shortcomings in these scoring systems.In the opinion review,we tried to analyze the strength of GIS and compare it to the existing scoring systems.The main pitfalls in the existing scoring systems were that most of them gave equal weightage to different types of FI(solid,liquid,flatus,etc.),were not comprehensive,and took only the surgeon’s perception of FI into view.In GIS,almost all shortcomings of previous scoring systems had been addressed:different weights were assigned to different types of FI by a robust statistical methodology;the scoring system was made comprehensive by including all types of FI that were previously omitted(urge,stress and mucus FI)and gave priority to patients’rather than the physicians’perceptions while developing the scoring system.Due to this,GIS indeed looked like a paradigm shift in the evaluation of FI.However,it is too early to conclude this,as GIS needs to be validated for accuracy and simplicity in future studies.
文摘At present,natural orifice specimen extraction surgery(NOSES)has attracted more and more attention worldwide,because of its great advantages including minimal cutaneous trauma and post-operative pain,fast post-operative recovery,short hospital stay,and positive psychological impact.However,NOSES for the treatment of gastric cancer(GC)is still in its infancy,and there is great potential to improve its theoretical system and clinical practice.Especially,several key points including oncological outcomes,bacteriological concerns,indication selection,and standardized surgical procedures are raised with this innovative technique.Therefore,it is necessary to achieve an international consensus to regulate the implementation of GC-NOSES,which is of great significance for healthy and orderly development of NOSES worldwide.
文摘To the Editor:Natural orifice specimen extraction surgery(NOSES)is an actively developing approach for extracting specimens and performing non-incisional colorectal cancer surgery.Previous studies have shown that its effectiveness and safety in the surgical treatment of rectal cancer are similar to those of conventional laparoscopic surgery.NOSES was demonstrated to be a possible alternative approach to conventional laparoscopy,for which a mini-laparotomy is used to extract the specimen,as there were no differences in surgical characteristics and short-term outcomes.[1]Recently,new promising approaches have been demonstrated for rectal tumors extraction with bowel eversion and extra-abdominal resection.
基金supported by National Key R&D Program for Young Scientists(Grant Number:2022YFC2505700)the Sanming Project of Medicine in Shenzhen(Grant Number:No.SZSM201911012).
文摘Purpose In recent years,natural orifice specimen extraction surgery(NOSES)has gained widespread attention as an alternative approach.Although the safety and feasibility of NOSES have been well documented,many questions remain open for discussion.The aim of this guideline is to provide more evidence for the promotion of NOSES.Methods This guideline has been prepared by the CACA Committee of Colorectal Cancer Society and the International NOSES Alliance,based on the latest evidence.Results The guideline on NOSES for colorectal cancer include the definition,classification,technology requirement,indications,technical difficulties and clinical research.Conclusion The guideline provides a full introduction of the theoretical and technical aspects of NOSES for colorectal cancer which will beneficial to development of NOSES.
文摘To the Editor:The literature has registered a considerable interest among Western surgeons in the role of extended lymph node dissection in right hemicolectomy.There are a lot of voices of dissent regarding the harvest of nodes lying dorsally to the superior mesenteric vein(SMV)and superior mesenteric artery(SMA).
文摘To the Editor:Colorectal cancer(CRC)remains the second most frequent cause of cancer-related deaths worldwide.Since the concept of total mesorectal excision(TME)introduced by Heald et al[1] has become a gold standard of rectal cancer surgery,there has been a significant improvement in oncological outcomes including diseasefree and overall survival.
