To the Editor:Laparoscopic liver resection(LLR)is widely used as a standard procedure for liver malignancies and benign diseases.Consensus guidelines stated that LLR may be feasible and safe in experienced centers.Evi...To the Editor:Laparoscopic liver resection(LLR)is widely used as a standard procedure for liver malignancies and benign diseases.Consensus guidelines stated that LLR may be feasible and safe in experienced centers.Evidence has shown that LLR is less invasive and has bet-ter patient prognosis than conventional procedures[1].However,laparoscopic anatomic liver resection(LALR)such as segment 8(S8)resection is still challenging due to difficulties in segmental mapping and surgical techniques[2,3].Liver S8 is in a deep-seated area surrounded by the ribs and the diaphragm,and closely con-nected to the right and middle hepatic veins and inferior vena cava.Furthermore,the Glissonean pedicle of segment 8(G8)is lo-cated deep in the liver parenchyma,lacking anatomical landmarks,and making forceps manipulation difficult.Therefore,LALR-S8 has been described as the most challenging procedure[4].展开更多
BACKGROUND Small pulmonary nodules are tissue shadows and thoracoscopic segmentectomy in China is still at the exploratory stage with limited application.AIM To evaluate the efficacy of thoracoscopic anatomical segmen...BACKGROUND Small pulmonary nodules are tissue shadows and thoracoscopic segmentectomy in China is still at the exploratory stage with limited application.AIM To evaluate the efficacy of thoracoscopic anatomical segmentectomy for small pulmonary nodules.METHODS Medical records of 86 patients with small pulmonary nodules treated at our hospital between August 2016 and October 2019 were retrospectively analyzed;40 cases who underwent thoracoscopic lobectomy were set as a reference group,and 46 cases who underwent thoracoscopic anatomical segmentectomy were set as an observation group.Preoperative and postoperative parameters were measured in both groups,including the percentage of forced expiratory volume in the first second(FEV1%),the percentage of forced vital capacity(FVC%),and the FEV1/FVC ratio(FEV1/FVC).Patients with positive pathological diagnosis received tests for neuron-specific enolase,carbohydrate antigen 125(CA125),CA19-9,and squamous cell carcinoma antigen.Intraoperative bleeding volume,drainage volume,the number of dissected lymph nodes,drainage time,hospital stay,treatment cost,postoperative complications,and postoperative pain condition were compared between the two groups.RESULTS No significant difference was observed in the results of four serum tumor marker(CA125,CA19-9,squamous cell carcinoma antigen,and neuron-specific enolase),the number of dissected lymph nodes,treatment cost,or preoperative pulmonary ventilation index between the two groups.Intraoperative bleeding volume,drainage volume,drainage time,hospital stay,and visual analogue scale score were significantly lower in the observation group(P<0.05).The results of FEV1%,FVC%,and FEV1/FVC were significantly higher in the observation group(P<0.05).CONCLUSION The efficacy of thoracoscopic anatomical segmentectomy and lobectomy for small pulmonary nodules shows no significant difference in terms of lesion removal,but anatomical segmentectomy is less invasive with fewer postoperative complications and less influence on lung function.展开更多
This article comments on the study by Peng et al,published in the World Journal of Gastrointestinal Surgery,representing a notable advancement in hepatobiliary surgery.This article examines laparoscopic anatomical seg...This article comments on the study by Peng et al,published in the World Journal of Gastrointestinal Surgery,representing a notable advancement in hepatobiliary surgery.This article examines laparoscopic anatomical segment VIII resection,a challenging procedure due to the complex liver anatomy and difficulty in accessing deep-seated lesions.Peng and colleagues’experience with caudal and cranial approaches in 34 patients underscores the feasibility of these techniques while sparking debates about the optimal approach.Their study’s strengths lie in technique standardization and comprehensive analysis,although its limitations highlight the need for further research.As minimally invasive liver surgery progresses,larger,prospective trials and integration of advanced technologies are essential for establishing best practices.展开更多
文摘To the Editor:Laparoscopic liver resection(LLR)is widely used as a standard procedure for liver malignancies and benign diseases.Consensus guidelines stated that LLR may be feasible and safe in experienced centers.Evidence has shown that LLR is less invasive and has bet-ter patient prognosis than conventional procedures[1].However,laparoscopic anatomic liver resection(LALR)such as segment 8(S8)resection is still challenging due to difficulties in segmental mapping and surgical techniques[2,3].Liver S8 is in a deep-seated area surrounded by the ribs and the diaphragm,and closely con-nected to the right and middle hepatic veins and inferior vena cava.Furthermore,the Glissonean pedicle of segment 8(G8)is lo-cated deep in the liver parenchyma,lacking anatomical landmarks,and making forceps manipulation difficult.Therefore,LALR-S8 has been described as the most challenging procedure[4].
文摘BACKGROUND Small pulmonary nodules are tissue shadows and thoracoscopic segmentectomy in China is still at the exploratory stage with limited application.AIM To evaluate the efficacy of thoracoscopic anatomical segmentectomy for small pulmonary nodules.METHODS Medical records of 86 patients with small pulmonary nodules treated at our hospital between August 2016 and October 2019 were retrospectively analyzed;40 cases who underwent thoracoscopic lobectomy were set as a reference group,and 46 cases who underwent thoracoscopic anatomical segmentectomy were set as an observation group.Preoperative and postoperative parameters were measured in both groups,including the percentage of forced expiratory volume in the first second(FEV1%),the percentage of forced vital capacity(FVC%),and the FEV1/FVC ratio(FEV1/FVC).Patients with positive pathological diagnosis received tests for neuron-specific enolase,carbohydrate antigen 125(CA125),CA19-9,and squamous cell carcinoma antigen.Intraoperative bleeding volume,drainage volume,the number of dissected lymph nodes,drainage time,hospital stay,treatment cost,postoperative complications,and postoperative pain condition were compared between the two groups.RESULTS No significant difference was observed in the results of four serum tumor marker(CA125,CA19-9,squamous cell carcinoma antigen,and neuron-specific enolase),the number of dissected lymph nodes,treatment cost,or preoperative pulmonary ventilation index between the two groups.Intraoperative bleeding volume,drainage volume,drainage time,hospital stay,and visual analogue scale score were significantly lower in the observation group(P<0.05).The results of FEV1%,FVC%,and FEV1/FVC were significantly higher in the observation group(P<0.05).CONCLUSION The efficacy of thoracoscopic anatomical segmentectomy and lobectomy for small pulmonary nodules shows no significant difference in terms of lesion removal,but anatomical segmentectomy is less invasive with fewer postoperative complications and less influence on lung function.
基金Supported by National Natural Science Foundation of China,No.82170406 and No.81970238.
文摘This article comments on the study by Peng et al,published in the World Journal of Gastrointestinal Surgery,representing a notable advancement in hepatobiliary surgery.This article examines laparoscopic anatomical segment VIII resection,a challenging procedure due to the complex liver anatomy and difficulty in accessing deep-seated lesions.Peng and colleagues’experience with caudal and cranial approaches in 34 patients underscores the feasibility of these techniques while sparking debates about the optimal approach.Their study’s strengths lie in technique standardization and comprehensive analysis,although its limitations highlight the need for further research.As minimally invasive liver surgery progresses,larger,prospective trials and integration of advanced technologies are essential for establishing best practices.
