RÉSUMÉ
Thanks to the new surgical approach, transanal total mesorectal excision (taTME) has a better operative field exposure than laparoscopic-assisted total mesorectal excision (laTME), especially for male patients with obesity, pelvic stenosis or prostate hypertrophy. Nevertheless, whether the urogenital function and quality of life after taTME are better as compared to laTME requires further study. According to the existing studies, taTME and laTME are not significantly different in symptoms of the urology system for male patients, but some large sample clinical studies show that the incidence of urethral mechanical injury after taTME is higher. Unfortunately, there is no elaboration on that for females. The sexual function of male patients after taTME and laTME is both impaired. The sexual function of male patients will be relieved to different degrees over time, but there is no significant difference. Compared with laTME, taTME shows advantages in the sexual function for female patients. There is no significant difference in short-term urogenital system function between taTME and laTME at present. As a new surgical approach, the impact on urogenital system function after taTME is acceptable. However, whether there is a significant difference in urogenital function between taTME and laTME needs further research. In addition, functional results still need comprehensive evaluation, and preoperative baseline evaluation also needs to be enhanced. The functional evaluation for male and female should be carried out separately rather than confused. Questionnaire for evaluation of functional results also needs to be verified.
Sujet(s)
Femelle , Humains , Mâle , Laparoscopie/méthodes , Durée opératoire , Complications postopératoires/épidémiologie , Qualité de vie , Tumeurs du rectum/chirurgie , Rectum/chirurgie , Chirurgie endoscopique transanale/méthodes , Résultat thérapeutiqueRÉSUMÉ
In recent years, transanal total mesorectal excision (taTME) has been a hot spot in the field of colorectal surgery. Compared with the traditional laparoscopic technique, taTME has potential advantages in the treatment of rectal diseases. However, the procedural safety and effectiveness of taTME need further verification. In order to ensure the safe and standardized implementation of this procedure, the European Society of Coloproctology, together with 14 international academic organizations related to colorectal surgery and minimally invasive surgery, has developed the international expert consensus guidance on indications, implementation and quality measures for taTME. This paper introduces the background of the international consensus guidance, and interprets its core contents, including the surgical indications (complex pelvic conditions, malignant and benign rectal diseases), surgical quality and outcome evaluation, structured training, and expert center. It is expected to provide reference and guidance for Chinese colorectal surgery colleagues performing taTME.
Sujet(s)
Humains , Consensus , Laparoscopie , Indicateurs qualité santé , Tumeurs du rectum/chirurgie , Rectum/chirurgie , Chirurgie endoscopique transanaleRÉSUMÉ
Cerebral ischemia can induce weak endogenous neurogenesis, which is not enough to repair neural injury after cerebral ischemia.In the treatment of cerebral ischemic diseases with Chinese medicine, different treatment methods based on syndrome differentiation are adopted according to the pathological mechanism of the diseases, and the advantages of neural repair after cerebral ischemia are well shown through comprehen-sive regulation.And in this paper, the effects of inflammation, neurovascular units, exogenous stem cell transplantation, exo- somes and other factors on neurogenesis and repair after cerebral ischemia and the intervention of Chinese medicine are described.
RÉSUMÉ
Cerebral ischemia is a series of clinical symptoms and signs of cerebral ischemia, hypoxia and neuronal damage caused by cerebral artery stenosis or occlusion due to atherosclerosis or thrombosis, which seriously affects human health and quality of life. Cerebral ischemia involves the cascade reaction of the "neurovascular unit" system, and finally affects the normal physiological function of nerve cells and produces a series of pathological changes. And the changes in the structure and function of various ion channels in the cell membrane play an important role during this process. This article illustrates the changes in the ion channel associated with ce-rebral ischemic diseases, such as the potassium ion channels, sodium ion channels, calcium channels and other relevant channels, like AQP, TRPM2, TRPM7, TRPV4, ASICs, Cl~- channel, and explores the intervention effect of traditional Chinese medicine in prevention and treatment of cerebral ischemic diseases from the perspective of ion channels, in order to provide references for potential targets involving in drug development for the future prevention and treatment of cerebral ischemic diseases.