Overview of the department
General Surgery Department was founded in 1954, which is a national key discipline, a clinical key specialty in Jiangsu Province and a medical key specialty in Nanjing. It is a doctoral and master's degree-granting unit of Nanjing University and Nanjing Medical University. It has five wards of hepatobiliary surgery, endocrine surgery, gastrointestinal surgery, organ transplantation center, minimally invasive surgery and ultrasound interventional therapy center, with 164 beds, and 76 medical and nursing staff, including 9 chief physicians, 20 deputy chief physicians and 10 attending physicians.
Special medical treatment
1. Hepatobiliary tumor treatment. In the mid-eighties, the first to advocate and utilize the modified bloodless hepatectomy at room temperature in China, and in 1993, the first to successfully apply the semi-detached hepatectomy technique in the clinic, breaking through the forbidden zone of liver surgery. 2001, the first to carry out the percutaneous and laparoscopic cold-circulation radiofrequency treatment of primary liver cancer in China. In recent years, he has been the first in China to carry out the new technology of precise liver surgical treatment. At present, it is one of the most influential centers for the diagnosis and treatment of hepatobiliary diseases in China, and completes more than a thousand cases of various complex hepatobiliary surgeries every year.
2. Liver transplantation: In 1996, we were the first to carry out back-pack liver transplantation in East China and improved on it to treat 30 patients with fulminant hepatic failure, with the success rate of the operation being 100% and the survival rate of more than 1 year being 97%. The success rate of liver transplantation and the survival rate of patients are leading in China. The clinical and scientific research work on the combined use of artificial liver support system and liver transplantation for the treatment of severe liver failure as well as combined liver and kidney transplantation has been successful, and has won more than ten scientific and technological progress awards at the provincial and ministerial levels. Through independent innovation, it has taken the lead in carrying out biological artificial liver technology at home and abroad, overcome many technical difficulties, obtained many national patents, and achieved satisfactory clinical efficacy.
3, pancreatic surgery.
(1) Peripancreatic nerve resection technology: this technology was firstly researched by Japanese scholars, and now it has been widely used in pancreatic cancer surgery, which can significantly improve the degree of pathological cure of the surgery in radical surgery and significantly reduce the cancer pain of late recurrence, and significantly reduce the cancer pain in palliative resection and by-pass surgery, and effectively improve the quality of life. Our specialty has been the first to apply this technology in China since 2001, and it has been clinically applied in 80 cases, and was awarded the New Technology Introduction Award by the Department of Health of Jiangsu Province in 2005.
(2), Intraoperative Timing Positioning Technique of Islet Cell Tumor: The research of this project has been started since 1994, the accurate positioning rate is 100%, and the cure rate is 100%, and now this technique has been recognized as the 12th islet cell tumor localization method, which is especially suitable for the cases in which all kinds of preoperative imaging methods can not be localized and the resection range of pancreatic islet cell proliferation can not be confirmed.
(3) Selective shunt technique: This technique retains the compensatory portal shunt vessels formed by the patients themselves, and selectively blocks the penetrating branch veins that cause upper gastrointestinal hemorrhage, i.e., it has the advantages of traditional shunt technique with little damage and maximum protection of liver function, and it also has the advantages of shunt technique to reduce the portal pressure, and it is the shunt technique with shunt effect. The clinical research of this technique has been started since 1996, and the sample size of the database has reached more than 300 cases, which can preserve almost 100% of the portal traffic branch veins, and is in the leading level in China.
(4) Intraoperative radiofrequency or microwave ablation therapy for pancreatic cancer: this technology is mainly for advanced pancreatic body tail cancer patients who cannot be resected after exploration during the operation, and it can be used to perform real-time ultrasound-guided radiofrequency or microwave ablation therapy for pancreatic cancer tumors and the related abdominal ganglia, which can effectively control the rapid growth of the cancer tumors and the pain of the cancer tumors, and partially improve the quality of life. Since 2002, this technology has been applied to more than 30 cases in the clinic, and was awarded the prize of new technology introduction in Nanjing in 2008.
(5) Spleen-preserving pancreatic body-tail resection and mid-pancreatectomy: this technique is mainly used for the treatment of benign or low-grade malignant tumors in the tail of the pancreas body, which can minimize surgical injuries of the patients and maximize the preservation of organs and tissues of the human body, and it is the new technique carried out by the Department of Pancreatic Surgery in recent years. Since the beginning of this clinical study in 2005, more than 10 cases of spleen-preserving pancreatic body-caudal resection and 5 cases of mid-pancreatectomy have been completed.
4, gastrointestinal surgery.
(1) Standardized surgical treatment of gastric cancer: Gastrointestinal Surgery treats an average of more than 250 cases of gastric cancer every year, and adopts comprehensive treatment such as surgery, chemotherapy, immunotherapy and so on together with the Department of Oncology, and the survival rate of 5 years has been significantly improved.
(2) Standardized surgical treatment of colorectal cancer: colorectal cancer is one of the most important cancers that threaten human health. Globally, its incidence and death rate are on the rise, with its incidence and death rate ranking the third and fourth among all cancers, respectively. Gastrointestinal Surgery treats about 300 cases of colon and rectal cancer annually. The surgical treatment of colon cancer is based on the anatomical features of regional lymph nodes and blood vessels, and the standardized surgical resection is performed according to the principle of TME for rectal cancer, and most of the patients with partially obstructed or obstructive colon and rectal tumors are treated with one-stage reconstructive anastomosis, which has greatly alleviated the patients' burdens and pains. We carry out columnar resection for rectal cancer to address radical resection for patients with T3 and T4 stage low rectal cancer. According to the research progress, we adopted a method called columnar transabdominal perineal resection (Cylindrical APR) for patients with T3 and T4 stage low rectal cancer, aiming at making the specimen cylindrical without narrowing the waist by widening the resection in the perineum, increasing the amount of pericarcinoma tissue to be resected, decreasing the rate of CRM positivity and the rate of intraoperative intestinal perforation, and thus decreasing the rate of local recurrence, and the cases have been carried out with The results are good, providing a new way for the treatment of advanced low rectal cancer. In addition, perineal in situ artificial anus surgery after Miles surgery for rectal cancer has also been carried out. The treatment of rectal cancer is still mainly based on surgery, and the traditional Miles surgery is more effective, but the permanent artificial anus in the abdomen can not control the feces at will, and has to carry fecal bags, which seriously affects the life and labor, and the patients' mental burden is very great, and therefore, many patients prefer to refuse the surgery, which leads to a delay in the treatment. Perineal in situ artificial anus after Miles surgery for rectal cancer was created and improved by Professor Gao Chunfang of PLA Anal and Intestinal Research Institute in 1987, and so far 2,600 cases have been reported in a single center, with good therapeutic effect. The core technique of this procedure is to reconstruct the artificial rectal angle with the sigmoid colon and suture in situ with the perineum, which is technically demanding, and we have successfully carried out this procedure with good results.
(3), to carry out minimally invasive laparoscopic gastrointestinal surgery: minimally invasive surgery in recent years has gained rapid development, the technology has covered almost all the traditional surgical procedures, but also the future direction of surgical development. We have already skillfully performed laparoscopic dissection, appendectomy, abdominal drainage, radical treatment of gastric cancer, radical treatment of colorectal cancer, and repair of abdominal wall hernia, etc. We also have all the equipments to carry out this kind of operation.
(4) Surgical treatment of gastrointestinal hemorrhage due to gastrointestinal vascular malformation: gastrointestinal hemorrhage is mostly seen in the stomach, duodenum, and colon, rectum, for the diagnosis of hemorrhage due to small intestinal vascular malformation and its difficulties, we through the preoperative gastroscopy and colonoscopy exclusion, capsule endoscopy preoperative assisted by the preliminary screening, the operation of enteroscopy on small intestinal vascular malformation of the accurate characterization and localization of the diagnosis, the joint use of point-like resection, Wedge resection and segmental resection for small bowel vascular malformation can completely avoid postoperative rebleeding caused by missed diagnosis. Therefore, intraoperative colonoscopy has the most important value in the diagnosis and treatment of small bowel vascular malformations, and it can be used as the main means of diagnosis and treatment of small bowel vascular malformations.
(5), abdominal wall hernia surgery: abdominal wall hernia, including inguinal hernia, abdominal wall incisional hernia, parastomal hernia, umbilical hernia, white line hernia, diaphragmatic hernia, esophageal hiatal hernia, etc., in addition to the traditional surgical repair, relying on the tension-free repair of new materials and new instruments, repair under the laparoscopic hernia has become the direction of development of the hernia surgery, especially incisional hernia, such as acquired hernia, minimally invasive repair has obvious superiority. Our department admits about 350 cases of various types of abdominal wall hernias every year, most of which are tension-free repairs relying on new materials, and we also carry out various types of minimally invasive repairs.
(6), anorectal surgery::: anal and intestinal diseases for the common and frequent diseases, especially Ⅲ, Ⅳ degree cyclic hemorrhoids, seriously affecting the quality of life, the traditional surgery is not only painful, but also a high rate of recurrence, traditional Chinese medicine for this kind of disease is also a lack of effective means. Based on the theory that hemorrhoids are caused by the downward shift of the anal cushion, PPH surgery is able to circumferentially resect 3cm of mucosa and submucosa above the dentate line of the rectum and complete the anastomosis at the same time, completing the uplift of the anal cushion, blocking hemorrhoidal blood vessels, which not only cures the disease, but also prevents it from recurring, and achieves a good long-term efficacy, so the hemorrhoidal surgery has been transformed into a brand new discipline.
(7), nutritional support treatment: Nutritional support for the twentieth century important achievements in the field of medicine, the incidence of malnutrition in surgical hospitalized patients is about 50%. Malnutrition can significantly reduce the tolerance of surgical patients and increase the incidence of surgical complications and mortality. Nutritional support, including parenteral and enteral nutrition, has become an essential treatment measure for surgical patients, especially critically ill patients. At present, our gastrointestinal surgery carries out nutritional support for the following objects: inability to ingest food orally for a longer period of time after major surgery, malnutrition, short bowel syndrome, small bowel transplantation, digestive fistulae, intestinal obstruction, acute pancreatitis, multiple visceral injuries, sepsis, liver failure, renal exhaustion, exhalation failure, tetanus, and so on.
5, breast cancer standardized diagnosis and treatment. We apply high resolution ultrasound, molybdenum target film, CT, magnetic **** vibration and other technologies for early diagnosis of breast cancer, apply hollow needle aspiration biopsy system and ultrasound-guided aspiration biopsy technology, perform preoperative pathological diagnosis and gene expression detection, guide personalized treatment of breast cancer, and standardize comprehensive treatment of breast cancer according to NCCN treatment guidelines. At present, the routine work includes preoperative neoadjuvant therapy, radical surgery, postoperative adjuvant therapy, breast-conserving surgery and its comprehensive treatment, sentinel lymph node detection, and rescue treatment for advanced breast cancer, etc. Other specialties include postoperative breast reconstruction, basic and clinical research on bone marrow micrometastasis of breast cancer, and dendritic cell fusion tumor seedling treatment for advanced breast cancer, etc. In the clinical work, humanistic care has been emphasized, and the Department has set up a new clinical practice to provide comprehensive treatment for breast cancer in accordance with the NCCN treatment guideline. In the clinical work, humanistic care is emphasized, and the Breast Cancer Activity Center of Nanjing Cancer Friends Association has been established to establish long-term communication and contact with breast cancer patients and conduct standardized follow-up work.
6. Surgical diagnosis and treatment of thyroid diseases. It has a long-term and stable contact with the Department of Endocrinology to carry out personalized surgical diagnosis and treatment of thyroid and parathyroid diseases. At present, the work routinely carried out includes functional cervical lymph node dissection for thyroid cancer, regional cervical lymph node dissection, surgical treatment of hyperthyroidism, and qualitative and localized diagnosis and surgical treatment of hyperparathyroidism, etc. The other special diagnostic treatments include minimally invasive surgery of the thyroid gland, Other specialties include minimally invasive thyroid surgery, clinical research on parathyroid transplantation for hypothyroidism, etc. Surgically treated patients undergo personalized follow-up and treatment to ensure the therapeutic effect.
7, laparoscopic minimally invasive surgery. Routinely carry out laparoscopic cholecystectomy, choledochotomy + T-tube drainage, resection of benign and malignant tumors of the stomach, radical treatment of colorectal cancer, splenectomy and liver resection.
8, laparoscopic minimally invasive surgery. Routinely carry out laparoscopic cholecystectomy, choledochotomy + T-tube drainage, gastric benign and malignant tumor resection, colorectal cancer radical treatment, splenectomy and liver resection.
Discipline Leader
Ding Yitao Chief Physician, Professor of Surgery at Nanjing University, Doctoral Supervisor, Recipient of Special Governmental Allowance, Director of Hepatobiliary Research Institute of Nanjing University, and Director of Nanjing Gulou Hospital.
He was the first to advocate and utilize the modified bloodless hepatectomy in China.
In the early nineties, he pioneered the semi-disembodied hepatectomy technique at home and abroad, breaking through the forbidden zone of liver surgery, and was the first one to successfully complete the "backpack" in situ liver transplantation of international advanced level in East China in 1996, and completed the "Artificial Liver Support System Combined with Liver Transplantation to Treat Acute Liver Failure" in 1998. In 1998, we completed the project of "Artificial Liver Support System Combined with Liver Transplantation for Acute Liver Failure", which is at the forefront of the international field, filling the gaps in China and reaching the international advanced level.
In 2001, the research on the construction and clinical application of bio-artificial liver reached the international leading level. He is a member of the International Hepatobiliary and Pancreatic Association, a standing member of the Organ Transplantation Society of the Chinese Medical Association, vice president of the Jiangsu Medical Association, chairman of the Organ Transplantation Society of the Jiangsu Medical Association, chairman of the Liver Surgery Group of Jiangsu Province, director of the Hepatobiliary Surgery Diagnostic and Treatment Center of Jiangsu Province, vice chairman of the Surgical Society of Jiangsu Province, and the editorial board member of more than 20 professional journals, including the Chinese Journal of Organ Transplantation. He has published more than 100 papers and books, and has been awarded 6 major projects such as National 863 and 10 first and second prizes for scientific and technological progress at provincial and ministerial levels (all as the first author). He has been awarded a number of honorary titles such as Expert with Outstanding Contributions at the National Level, Meritorious Minister of Science and Technology of Nanjing, the First Hundred Best Doctors in China, National Outstanding Dean, and China's Highest Physician Award. He was elected as a delegate to the 15th, 16th and 17th Congresses of the Chinese ****.