RESUMO
Due to the unique nature of its anatomical location, the adenocarcinoma of esophagogastric junction (AEG) has been a subject of controversy and disagreement including its definition, staging, and treatment strategies. Chinse expert Consensus on Surgical Treatment of Adenocarcinoma of Esophagogastric Junction in China (2018 Edition) had been released in September 2018 and had played a pioneering role in unifying thoracic and general surgeons in China on surgical treatment strategies for AEG. Over the past five years, the emergence of several clinical research results on AEG has provided new clinical evidence for the selection of key surgical treatment strategies. Therefore, to further standardize the surgical treatment of AEG in China, Chinese Expert Consensus on Surgical Treatment of Adenocarcinoma of Esophagogastric Junction in China (2024 Edition) was released in 2024 by Chinese expert panel including 25 gastrointestinal surgeons and 24 thoracic surgeons. Based on the highest-level clinical research evidence in recent 5 years, this consensus ultimately formulates 29 recommendations on hotspots and key points on surgical treatment of AEG and summary 5 issues that are still awaiting further exploration. This review will provide a summary and detailed interpretation of the recommendations outlined in this consensus.
Assuntos
Adenocarcinoma , Neoplasias Esofágicas , Neoplasias Gástricas , Humanos , Consenso , Neoplasias Gástricas/patologia , Adenocarcinoma/patologia , Neoplasias Esofágicas/patologia , Junção Esofagogástrica/cirurgia , Junção Esofagogástrica/patologiaRESUMO
With the widespread application of colorectal cancer screening, the surveillance and management of the increasing number of screened population has become a pivotal aspect in preventing and controlling colorectal cancer. In recent years, researches have been conducted on the risk of colorectal cancer incidence and mortality in the population after screening. At the same time, various organizations in Europe and the United States have continuously updated colonoscopy surveillance after screening and polypectomy based on the latest research evidence. In this review, we summarized the current progress of studies on colorectal cancer risk in post-screening colorectal cancer populations and the key points of relevant guideline updates, in order to provide a reference for conducting relevant studies and formulating surveillance guidelines or consensus in China.
Assuntos
Colonoscopia , Neoplasias Colorretais , Humanos , China , ConsensoRESUMO
Objective: To compare the application effect of domestic and imported intravenous radiofrequency closure system in the treatment of primary varicose veins of lower extremities. Methods: This single-center prospective, non-inferiority randomized controlled trial was performed in the Department of Vascular Surgery, the Fourth Affiliated Hospital, Zhejiang University School of Medicine from January 2021 to January 2022. Patients with primary varicose veins of lower extremities who met the ataxation criteria were randomly assigned to the experimental group(domestic novel venous radiofrequency closure system) or the control group(imported venous radiofrequency closure system) in a ratio of 1â¶1. The two groups of subjects were compared in terms of target vein closure rate, technical success rate, system operation performance, incidence of adverse events and incidence of serious adverse events(SAE) within 6 months after surgery. Quantitative data were compared by Mann-Whitney U test, and categorical data were compared by χ2 test and non-inferiority test. Results: A total of 80 subjects were included in the trial (41 in the experimental group and 39 in the control group), including 27 males and 53 females, aged (M(IQR)) 55(23) years (range:40 to 78 years). There were 48 cases of left lower limb and 32 cases of right lower limb. The technical success rate and system control performance between the groups were 100%.The incidence of adverse events (58.5% (24/41) vs. 61.5% (24/39), χ2=0.075, P=0.784), and the incidence of SAE (7.3% (3/41) vs. 5.1% (2/39), χ2=0.163, P=0.686) within 6 months after surgery in experimental group and control group had no statistical significance. There was one device-related adverse event in each of the two groups. In the experimental group, one patient developed endovenous heat-induced thrombosis after surgery and recovered after taking rivaroxaban tablets. One patient in the control group had pain in the upper right thigh for more than 1 day after operation, which was cured after using analgesic cream. No device-related SAE occurred. The venous closure rate of the experimental group was 100% (38/38) at 6 months after surgery, and that of the control group was 97.4% (37/38). The difference between the two groups was 2.63% (95%CI:-3.19 to 8.45, Z=4.865, P<0.01), and the 95%CI lower limit of the difference in target venous closure rate between two groups was greater than the non-inferiority threshold of -10.00%. Conclusion: The early application effect of the new domestic intravenous radiofrequency closure system in patients with primary varicose veins of lower extremities is in line with expectations, it is not inferior to the imported system.