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亦师亦友,教学相长——专访Steven Wexner教授

Published at: 2015年第1卷第S1期

钟珊珊 , 冯雁萍
关键词:

导语:由美国Cleveland Clinic主办的一年一度的消化疾病周(Digestive Disease Institute Week,简称DDI Week)于2月14日至18日在美丽的阳光之州佛罗里达Boca Raton成功举行。该会议是消化病领域的世界级顶尖盛会,历经38年的发展和推广,目前已经成为全球消化病领域过去与未来、热点与难点、东方与西方争锋亮剑的平台。此次,AME出版社有幸邀请到Steven Wexner教授给我们解读本次会议的亮点,以及荧光显像和TaTME在结直肠外科手术中的应用。

本次采访安排了别具一面的师生对话模式,让我们跟随着Prof. Steven Wexner(fig 1)的得意门生——来自复旦大学附属上海市第五人民医院的陈骏医生更深入地了解该会议的热点内容。采访中,作为此次DDI Week会议的主席,Prof. Wexner认为此次会议不仅议程讨论热点丰富,而且更邀请了来自国际的多位消化领域大腕专家共同参与,从质与量上都达到了高水平,对消化疾病治疗的发展有一定影响力。

fig 1

演讲中,Prof. Wexner说到,关于荧光显像,目前美国FDA唯一认可使用并效果明显的适应症是观察肠道的灌注。自从使用了荧光显像技术,吻合口瘘的几率下降至2%以下,已成为一项在结肠直肠及结肠肛门吻合中常规使用的技术了。特别指出的是,荧光显像技术的使用,不是由肿瘤的位置而决定,而是根据吻合口的位置而定的。

至于本次会议的大热——TaTME, Prof. Wexner则认为该项技术传播得很快,欧美地区得以广泛应用和研究,大部分医生将其用于恶性肿瘤的治疗。但是目前进行该手术操作的机械并不完善,医生对手术解剖平面并不熟悉,因此Prof. Wexner推荐医生以熟悉的标准的经肛手术以及标准的经肛TME为先,在目前高精尖的技术上,以此(完全经肛TME)为下一步发展的前沿方向。

最后,作为大会主席,Prof. Wexner认为该次会议最热点的内容就是荧光导向、经肛手术,其他的还有团队合作精神、精神准备外科,能够提高病人安全以及手术结果,以及关于大便失禁的胫后神经调节、肛门括约肌磁性治疗、射频消融等新选择。其次,AIS Channel上会同步播出该会议,也方便了其他无法亲临现场的医生学习。

详情请猛戳视频观看:

采访问题:

In terms of fluorescent imaging, what are the main indications in the field of colorectal surgery?

In your clinic, you routinely use it. Are there any other factors you have to take into consideration before using fluorescent imaging? About the location of the tumor, which location do you prefer to use, or was it used on all locations and colorectal surgeries, no matter rectal cancer, colon cancer or IBD surgeries?

Could you help to introduce the progress of TaTME and its future?

What do you think of the completely TaTME and the hybrid TaTME? There was a lecture from Dr. Marks and he introduced Total TaTME about mobilization of the splenic flexure, ligation of IMA from the bottom. What do you think of this technique?

In some presentations, TaTME was introduced just being used in rectal cancer less than 10cm from the anal verge. What’s your suggestions?

What are the highlights of the meeting?

What’s your suggestion on performing formal influence clinical studies?

专家介绍:

Prof. Steven. Wexner is the Director of the Digestive Disease Center and has been on Staff at Cleveland Clinic Florida since 1988. He has been the Chairman of the Department of Colorectal Surgery since 1993. Dr. Wexner was Chief of Staff from 1997-2008, Chief Academic Officer from 2008-2012, and Chairman of the Division of Research and Education from 1995-2012. Dr. Wexner holds many academic appointments, such as Affiliate Professor at Florida Atlantic University; Clinical Professor at Florida International University; Affiliate Professor of Surgery at the University of South Florida, Tampa, Florida.

Jun Chen, MD 

Dr. Chen serves as a colorectal surgeon in the Hospital of Shanghai which is affiliated to Fudan University for couple of years. He got his MD and MSC degree both from Chinese TOP 5 Medical University with excellent GPT and performance. Currently he is a research fellow and senior visiting scholar of Cleveland Clinic Florida, under the supervising of one of most leading experts and pioneers——Dr. Steven D Wexner.

采访编辑:钟珊珊、冯雁萍

视频剪辑:麦雪芳

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