【Abstract】Objective To explore the different characteristics of tumor recurrence after liver transplantation (LT) and hepatectomy (HC) in patients with hepatocellular carcinoma (HCC). Methods The literatures about tumor recurrence of HCC after LT and HC were reviewed and their characteristics were compared. Results There are distinctions of recurrence rates, time, common sites between the recurred tumors after LT and HC, and their correlation factors and mechanisms of recurrence are also different. Conclusion Preventive measures should be strengthened and treatments should be more targeted according to the different characteristics of tumor recurrence after LT and HC to improve postoperative life quality and increase the survival rate.
【Abstract】ObjectiveTo summarize the study on the feasibility of celiac axis ligation. Methods Literatures about celiac axis ligation were reviewed retrospectively. ResultsCeliac axis branches included common hepatic artery， splenic artery， left gastric artery which had many variation and collateral flow between celiac and mesenteric vessels by gastroduodenal artery and pancreaticoduodenal artery. Celiac axis could be possibly ligated without obvious complications in patients who had celiac axis injuries, celiac artery aneurysms, upper gastrointestinal haemorrhage, excision of carcinoma around the celiac axis and portal hypertension. However, gallbladder necrosis or perforation, focal infarction of the liver even higher mortality had also been reported. ConclusionCeliac axis ligation should not be performed routinely, but it is surgically possible and may be a life saving approach in certain circumstances.
【Abstract】ObjectiveTo investigate the indications, maternal and fetal/neonatal risks and treatments of pregnancy after liver transplantation. Methods The related published literatures were summarized and reviewed.ResultsMost females can recover a regular menstrual cycle. Hypertension, preeclampsia, bacterial and viral infection resulted from immuno-suppression therapy and increasing rate of caesarian section are the major risks for the mother. Abortion and preterm delivery, premature rupture of fetal membrane, hypoadrenalism, abnormality, immune deficiency, hepatitis virus B and cytomegalovirus and bacterial infection are the major risks for the fetus/neonate.ConclusionSatisfactory results can be obtained in most pregnancies after liver transplantation. Evaluation before gestation and surveillance during gestation by the related departments are mandatory. A guideline based on large cases is necessary for pregnancy after liver transplantation.
To address the persistent challenges in surgical clinical research, we provide a comprehensive analysis of the series of articles on randomized controlled trials (RCTs) methodology guidance published in JAMA Surgery from 2022 to 2023. This section contents focus on critical aspects of RCTs, including trial design, selection criteria, ethical considerations, quality control, and budgeting and funding support. The objective is to enhance the understanding of RCTs among researchers, particularly surgeons, thereby guiding them in conducting high-quality and scientifically robust RCTs.