Source: Xinhua News Agency
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BEIJING, April 7 (Xinhua) -- With the "rhythmic gymnastics" of both hands, the "rhythmic gymnastics" of the hands has been known as the "minimally invasive of minimally invasive" - natural orifice specimen extraction surgery (NOSES), which has reduced the pain of thousands of colorectal cancer patients.
Colorectal cancer is one of the most common cancers in China and the world. According to data from the World Health Organization's International Agency for Research on Cancer (IARC), there were 1.9 million new cases of colorectal cancer worldwide in 2022, ranking among the top three malignant tumors. In the same year, the number of cases and deaths of colorectal cancer in mainland China accounted for 28.73% and 30.59% of the world's total, respectively.
Surgery is one of the most effective means of curing colorectal cancer. For more than ten years, Wang Xishan, director of the Department of Colorectal Surgery of the Cancer Hospital of the Chinese Academy of Medical Sciences, led the team to start from the "micro" and constantly make breakthroughs and innovations, from the traditional laparotomy of a giant wound about 20-25 cm long, to the conventional laparoscopic minimally invasive surgery with several puncture holes and incisions of about 5-10 cm long, and then to the first "zero" incision NOSES surgery, and then to create a series of thoracic, abdominal and The multidisciplinary NOSES surgical system with 76 innovative surgical methods such as pelvic tumors realizes a good combination of radical tumor resection and minimally invasive and scarless.
There are no "micro" NOSES
They were able to walk on the 2nd day after surgery and met the discharge criteria on the 6th day...... Wei Shoucheng, a tumor patient who had just undergone NOSES surgery, said: "I really didn't expect that this disease can be completed without disemboweling and disemboweling, and I don't have to worry so much." ”
Traditional laparotomy is invasive, bleeding, prone to complications, long hospital stay, slow recovery, and poor patient experience, while conventional laparoscopic minimally invasive surgery requires an auxiliary incision to remove the tumor specimen, although the wound surface is greatly reduced. What's even more worrying is that the permanent scars left after surgery, no matter how big or small, will bring lifelong psychological hints and adverse effects to patients.
Every knife the surgeon makes is a trauma. Is there a surgical method that can avoid the pain and scarring of the patient's abdominal wall while ensuring the effect and quality of the operation, so that the patient can feel better? Adhering to this original intention, Wang Xishan led the team to start more than ten years of exploration.
In 2007, a transvaginal cholecystectomy operation by a French doctor gave Wang Xishan a great inspiration: tumor surgery should not only pursue radical cure, but also radical cure, minimally invasive and functional preservation. On the premise of meeting the indications, let tumor patients have both "lining" and "face".
After nearly 3 years of preparation, in 2010, Wang Xishan's team successfully performed transvaginal rectal cancer resection, innovatively achieving the world's first incision-free rectal cancer surgery.
Wang Xishan's team work photo (a group of animated pictures)
The surgeon removes the tumor specimen from the natural orifice through laparoscope and other instruments, and reconstructs the digestive tract in the abdominal cavity. The surgery is known as "minimally invasive in minimally invasive" by the industry due to its outstanding characteristics such as unassisted incision of the abdominal wall, small trauma, light pain and fast recovery, carrying the humanistic care of medical development.
In 2013, Wang Xishan's team carried out the surgery of colorectal tumors to take specimens through the natural orifice, perfected a series of 10 new surgical methods, and put forward the concept of NOSES for the first time in the world. Since then, the relevant theoretical and technical systems have been gradually established and improved.
Gou is new, and every day is new, and every day is new.
Under the continuous development of Wang Xishan's team, the technology and concept of NOSES have been continuously improved.
"In addition to colorectal tumors, NOSES has also achieved clinical application in gastric, small intestine, hepatobiliary, cervical, uterine, urological tumors and other specialties. At present, 21 NOSES colorectal surgeries, 9 gastric surgeries, 6 gynecological surgeries, 3 urology surgeries, 5 hepatobiliary, pancreatic and spleen surgeries, and 32 other difficult and complex NOSES surgeries have been established, basically covering various abdominal and pelvic diseases. Fan Daiming, chairman of the Chinese Anti-Cancer Association and academician of the Chinese Academy of Engineering, said, "This operation interprets the important value of integrative medicine, is an innovation in surgical concepts and technologies, and realizes the perfect combination of patient pain healing and new medical experience with high quality, which is really rare." ”
Fan Daiming introduced that in 2023, with the support of the China Anti-Cancer Association, more than 300 experts in oncology surgery, gynecology, urology, general surgery and other experts will jointly formulate the "Chinese Guidelines for Integrated Diagnosis and Treatment of Oncology (CACA)-NOSES Technology", providing industry guidelines for the application of NOSES in multiple fields.
"At present, NOSES can be used for day surgery, and some patients can be discharged from the hospital on the same day. Wang Xishan said, "New technology is to bring tangible well-being to patients, and patients' requirements are our pursuit." ”
Zhai Xiaohui, Director of the Medical Management Service Guidance Center of the National Health Commission, said: "NOSES is a typical representative of surgical innovation in the field of surgery, which has made a breakthrough in bringing laparoscopic surgery from the era of incision to the era of incision. Patients have less postoperative pain and faster recovery, which is beneficial for patients to return to their families and society as soon as possible and have a higher quality of life. While medical resources can be used more effectively, it has also boosted the high-quality development of health care to a certain extent. ”
Accumulation of "micro" into NOSES
Strengthen doctors, benefit patients, and help the grassroots.
In order to share the advanced technology of NOSES with more grassroots medical institutions and benefit more grassroots patients, in 2017, Wang Xishan's team promoted the establishment of the China NOSES Alliance, an academic organization centered on NOSES surgery, to contribute to the construction of a healthy China with practical actions.
From the snowy plateau to the coast of the East China Sea, from the white mountains and black waters to the land of Lingnan...... For more than ten years, along with the China NOSES Alliance, local medical and health science popularization, one-stop public welfare academic lectures, live broadcasts of clinical surgeries, rounds of practical training for doctors, and free clinics for experts at the grassroots level...... More and more grassroots medical staff are familiar with NOSES and implement NOSES, and tens of thousands of cancer patients have started a new life in the persistent promotion and practice of batches of "NOSES people".
According to the statistics of the national large-scale clinical database of NOSSE, this procedure has covered 559 hospitals and 833 doctors have successfully performed 41,841 cases of NOSES surgery since its launch. In Shanxi Province alone, there are more than 80 doctors who can skillfully carry out NOSES surgery, with a cumulative clinical operation volume of more than 1,200 cases, including more than 10 surgical methods.
Zhang Bo, Secretary of the Party Leadership Group and Director of the Shanxi Provincial Health Commission, told reporters: "NOSES has played an important role in promoting the development of minimally invasive surgery in Shanxi, and has also better benefited the majority of patients in Shanxi, and is an important landmark achievement in response to the construction of national regional medical centers." ”
Every time NOSES tackles a hard time, it is also accompanied by a leap in theory.
Since 2013, Wang Xishan's team has led more than 100 domestic experts in the field of surgery to jointly compile a number of surgical monographs such as "Specimen Surgery through Natural Orifice - Colorectal Tumors", and published more than 140 NOSES academic papers, 3 industry guidelines, 8 expert consensuses, and 7 national patents...... It has greatly promoted the standardized development and comprehensive popularization of NOSES technology.
In 2017, the NOSES theoretical system was officially written into the national "14th Five-Year Plan" textbook "Surgery" and incorporated into the mainland medical education system.
NOSES with "micro" vision
NOSES is not only Chinese, but also global. In recent years, this procedure has become more and more widely used in China, and at the same time, it has continuously exported valuable Chinese experience and wisdom to global cancer diagnosis and treatment.
In 2023, the NOSES surgery series monograph "Surgery for Specimen Extraction through Natural Orifice", published by the People's Medical Publishing House, with Chinese as the main body and English, Korean, Japanese, Russian and French, was unveiled at the 75th Frankfurt International Book Fair and was highly praised by many participating countries.
Du Xian, editor-in-chief of the People's Medical Publishing House, said: "This is an important exploration for Chinese scientists to go to the world with the power of self-improvement, and it is a solid step for China's original surgical technology to move forward to the world. ”
"Fish" and "fishing" are given to the world and the world.
In order to help promote cancer prevention and control work on a global scale, under the guidance of the Chinese Medical Doctor Association, the National Cancer Center of China and other units, Wang Xishan's team took the lead in organizing the establishment of the International NOSES Alliance, which has held the NOSES global academic conference for 6 consecutive years, and more than 100 medical experts from more than 20 countries and regions such as the United States, the United Kingdom, Portugal, and Spain jointly formulated the first international "NOSES Expert Consensus", which provides an important basis for the standardized development of NOSES in the international field.
Sergei Konstantinovich Yefitov, professor of medicine at the First Moscow State Medical University in Russia, said that since Professor Wang Xishan shared NOSES at an international academic conference held in Moscow in 2019, more and more Russian surgical experts have applied this new surgical method, especially the application of NOSES surgery combined with vascular preservation in left-sided colon cancer.
Lang Jinghe, academician of the Chinese Academy of Engineering and honorary director of the Department of Obstetrics and Gynecology at Peking Union Medical College Hospital, said: "Cancer knows no borders. In recent years, China's minimally invasive surgical technology, represented by NOSSE, has made great progress, and the Chinese doctor team has been active in the international medical arena and issued the voice of China's medical innovation. Only by working closely with other countries can NOSES make new and greater contributions to building a community of health for all. (Xinhua News Agency reporters Wen Jing, Chen Mengjie, Xia Ke)
Co-ordinator: Zhang Shuqi
Editors: Zhang Yunmeng, Zhang Yiteng, Gao Han
Video: Zhang Jinshuo and Feng Xiaoyi
Internship: Dai Xinyan, Dong Shengchen, Zhang Can
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