Diseases that Harm Require Therapies that Harm Less

---Sir William Osler(1849-1919)
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ISMIVS Newsletter November&December, 2021
Newsletter 2021 November & December
2021年11月及12月简报
About Us 国际微无创医学会简介
The International Society of Minimally Invasive and Virtual Surgery (ISMIVS, previously known as International Society of Minimally Invasive and Noninvasive Medicine) was founded in July 2013 at the gala of the 1st Yangtze International Summit of Minimally Invasive and Noninvasive Medicine in Chongqing, China. ISMIVS envisions to accelerating the progress in minimally invasive and noninvasive medicine by promoting research, education, communication, and international collaboration.
国际微无创医学会(ISMIVS)是在 2013 年 7 月在中国重庆召开的第一届国际微无创医学长江高峰论坛上宣布成立的,旨在通过学术研究、教育、交流以及国际合作加快微无创医学的发展。
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The Personality in the Medical Education World 医学教育界的大人物
From the 2020 July issue of our ISMIVS Newsletter, we would like to introduce some pioneers in the field of minimally-invasive and noninvasive medicine. They are not only prestigious in their field but also willing to share their experience and ideas with younger doctors, hence making a great contribution to medical education. This issue features Professor Zhang Lian, the Secretary General of International Society of Minimally Invasive and Virtual Surgery (ISMIVS).
从 2020 年 7 月刊开始,国际微无创医学会将为大家介绍微无创医学领域的一些领军人物。他们不仅在各自的领域享负盛名,而且非常乐意与年轻医生分享他们的经验、理念和想法,从而为医学教育做出了巨大的贡献。本期月刊要介绍的是国际微无创医学会秘书长张炼教授。
Professor Zhang Lian
Director, Chongqing Haifu Hospital
张炼教授
重庆海扶医院院长
Secretary General of ISMIVS
Professor, Chongqing Medical University, China
Chief Editorial Board Member, International Journal of Hyperthermia
国际微无创医学会秘书长
中国重庆医科大学教授
《国际热疗杂志》首席编委会成员

Prof. Zhang Lian graduated from Chongqing Medical University in 1987, studied in UCSD in 1998, and, after returning to China in 2004, worked in the Oncology Center of the Second Hospital Affiliated to Chongqing Medical University. Since 2005, Zhang has been leading a number of research and development projects related to HIFU and its clinical application. He is in charge of the clinical guidance of the application of HIFU in Chinese and overseas clinical settings (including Italy, Spain, Russia, Ukraine, Germany, South Korea, Thailand, Egypt, South Africa and Singapore), and has trained a number of senior HIFU doctors for many different countries. He has participated in and presided over a number of research projects of the Ministry of Science and Technology of China (MOST).
张炼教授 1987 年毕业于重庆医科大学,1998 年赴美国加州大学圣地亚哥分校(UCSD)留学,2004 年学成回国后在重庆医科大学工作附属第二医院的肿瘤中心工作。2005 年以来,他领导多个HIFU项目的研发及临床应用工作。领导海扶医生团队,负责指导国内及国际聚焦超声消融中心的临床技术支持。亲临意大利、西班牙、俄罗斯、乌克兰、德国、韩国、泰国、埃及、南非、新加坡等国的多家国际知名医院及国内多家医院的海扶中心指导海扶技术的临床应用,已为世界各国培养出几十位高级海扶医生。同时参与或主持多项科技部研究课题。
In recent years, Zhang has been invited as a special expert to deliver speeches on HIFU treatment in different international academic conferences, for example, the Annual Congress of the Cardiovascular and Interventional Radiological Society of Europe (CIRSE), World Conference on Interventional Oncology (WCIO), Annual Congress of Italian Society of Medical and Interventional Radiology (SIRM), Conference of Italian Society of Ultrasound in Medicine and Biology (SIUMB), European Conference on Interventional Oncology (ECIO), and the annual meetings of following societies, the Korean Society of Gynecologic Endoscopy and Minimally Invasive Surgery, the International Ovarian Cancer Consortium (IOCC) and the Symposium on Tumor Microenvironment and Therapeutic Resistance.
近年来,他作为特邀专家,分别在欧洲心血管及放射介入学年会,世界肿瘤介入大会,意大利放射介入学会年会,意大利全国超声代表大会,欧洲肿瘤介入大会,韩国妇科内镜学会年会,国际卵巢癌研究联合会大会及肿瘤微环境国际研讨会等国际大会上作 HIFU 专题演讲。
He has published more than 80 papers in many Chinese and overseas journals, such as Circulation, Journal of Clinical Investigation, Radiology, European Radiology, European Journal of Radiology, AJR, American Journal of Roentgenology, Gastroenterology, Medicine, Ultrasonics, Int J Hyperthermia, Cardiovasc Intervent Radiol, Int J Gynaecol Obstet , Chinese Journal of Obstetrics and Gynecology, and Chinese Journal of the Frontiers of Medical Science, including 60+ SCI-indexed papers with the highest impact factor of the journals up to 16.915.
张炼教授已在Circulation、Journal of Clinical Investigation、Radiology、European Radiology、European Journal of Radiology、AJR, American Journal of Roentgenology、Gastroenterology、Medicine、Ultrasonics、Int J Hyperthermia、Cardiovasc Intervent Radiol、Int J Gynaecol Obstet、中华妇产科杂志、中国医学前沿杂志等国际国内优秀期刊发表论文 80 余篇,SCI收录 60 余篇,单篇最高影响因子 16.915。
Papers and lectures of Prof. Zhang Lian:
点击查看张炼教授的相关学术论文和演讲视频:
Novel therapeutic techniques for the treatment of benign gynaecological diseases
Preganancy outcome of HIFU treatment of uterine fibroids and adenomyosis

Case Studies病例分享
While there are clear limitations to the methodology of case studies in determination of treatment protocol and establishment of new trials, the observation of a single patient can add to our understanding of etiology, pathogenesis, natural history, treatment option and complications to promote the medical development of a particular disease, and to the clinical practice of potential junior investigators.
尽管病例研究方法在确定治疗方案、组织新的临床试验方面存在明显局限性,但对单个病例的观察研究可以帮助我们了解病因、发病机制、自然病程、治疗方法及并发症,从而促进特定疾病的医学发展,并助益初级研究人员的临床实践。
The case below was shared by Prof. Aixingzi Aili from Shanghai First Maternity and Infant Hospital, China, on the webinar “Recent Advances in the Management of Uterine Fibroids and Adenomyosis” launched by ISMIVS on November 16.
本期病例由中国上海市第一妇婴保健院的艾星子•艾里教授在ISMIVS主办的“治疗子宫肌瘤和子宫腺肌症的最新技术进展”研讨会( 2021 年 11 月 16 日)上分享。
- 41yr, 19-year of progressive dysmenorrhea with menorrhagia more than 7 years;
- 41 岁,19 年进行性痛经伴 7 年月经量过多;
- VAS/NRS Score: 7-8; hysterauxesis like three months pregnant; Hb 94g/L; CA125 278.5U/MI before the fifth injection, dropped to 8.9U/mL before HIFU.
- VAS/NRS疼痛评级:7-8;子宫增大像怀孕三个月;Hb 94g/L;第 5 次注射前 CA125 278.5U/MI, HIFU 治疗前下降至 8.9U/mL
- Anterior uterus; lesion sized 76*60*50mm; posterior wall; blood supply abundant.
- 子宫前部;病灶大小 76*60*50mm;后壁;血液供应充足;
- Treatment plan: GnRH+High Intensity Focused Ultrasound (HIFU)+Dienogest+TCRE+LNG-IUS
- 治疗方案:GnRH+高强度聚焦超声(HIFU)+地诺孕素+TCRE+LNG-IUS

Timeline 治疗时间线
2019.12 GnRH-a*5 injection GnRH-a*5 次注射
1. Suppress menstruation to correct anemia 抑制月经量,改善贫血
2. Shrink adenomyotic lesion to shorten the operation time 缩小子宫腺肌病灶,缩短手术时间
2020.4.8 HIFU
1. Ablate the adenomyotic lesion & relieve symptoms 消融腺肌病灶,缓解症状
2. May stimulate immune response to shrink non-ablative lesions 可刺激免疫反应,从而缩小非消融病灶
- 2020.4.9 Dienogest 地诺孕素
1. Atrophy of endometrium to suppress menstruation 子宫内膜萎缩抑制月经
2. Suppress the remaining lesions to delay the recurrence 抑制残留病灶,延缓复发
- 2021.3.9 TCRE+LNG-IUS
1. Remove endometrium to reduce menstruation 去除子宫内膜减少月经
2. Suppress the remaining lesions to delay the recurrence 抑制残留病灶,延缓复发
Watch the Lecture >
观看完整会议 >
News 新闻
HIFU treatment for liver and pancreatic cancer – new option, new hope
Episode 1
“新选择,新希望:高强度聚焦超声治疗肝癌及胰腺癌”系列研讨会
第 1 期
Treatment options for liver and pancreatic cancer have always been a vital part of modern clinical research, and for now, patients with unresectable liver or pancreatic tumors are usually administered with local treatment. As high intensity focused ultrasound (HIFU) enjoys unique strengths of noninvasiveness, repeatability and availability of combined therapy, it has emerged as a new option in the treatment of liver and pancreatic tumors. Therefore, International Society of Minimally Invasive and Virtual Surgery (ISMIVS) launched “New Option, New Hope” webinars to discuss the safety and efficacy of HIFU for liver and pancreatic cancer with global experts, as well as deepen the understanding of its clinical value and application prospect.
肝癌与胰腺癌的治疗是当前临床医学研究的重点方向之一,目前,对于无法进行切除手术的肝癌与胰腺癌患者多应用局部治疗。高强度聚焦超声治疗因其非侵入无创治疗、可反复治疗及可联合其他治疗手段等优势在针对肝癌和胰腺癌的治疗中崭露头角。因此,国际微无创医学会特别举办了“新选择,新希望”系列研讨会,与来自世界各地的专家共同探讨HIFU治疗肝癌与胰腺癌的安全性和有效性,进一步了解其临床价值和应用前景。
The 1st episode finished perfectly on November 18th, on which Prof. Zhang Lian, Prof. Xu Yonghua and Prof. Zhou Kun were invited to be the special guests while Prof. Holdger Strunk and Prof. David Cranston chairing the seminar, attracting 150 worldwide doctors and academics from over 30 countries and regions (UK, Germany, Indonesia, Singapore, Japan, etc.) to attend.
首期研讨会于 11 月 18 日圆满结束,会议邀请到 Holdger Strunk 教授和 David Cranston 教授作为会议主席,张炼教授、许永华教授和周崑教授为演讲嘉宾,吸引了来自英国、德国、印尼、新加坡、日本等 30 余个国家和地区约 150 位国际专家报名参会。
Prof. Zhang Lian, Secretary-General of ISMIVS and Director of Chongqing Haifu Hospital, first introduced the fundamental principle of HIFU. Then, based on the inclusion criteria of HIFU treatment for small hepatocellular carcinoma (HCC) in his institution including patients who were deemed not candidates for surgery, not suitable for local treatment such as radiofrequency ablation (RFA), or with a solitary tumor ≤ 5cm/tumor number ≤ 3 with each tumor ≤ 3 cm in diameter, he shared the characteristics, survival rates and recurrence rates of the 35 patients with small HCC treated with HIFU. Prof. Zhang Lian also compared the survival rates of transcatheter arterial embolization (TAE) and TAE followed by ultrasound-guided HIFU (USgHIFU) for advanced HCC. After the elaboration of several case reports, he concluded that USgHIFU ablation could be considered a safe and effective approach for liver tumors.
国际微无创医学会秘书长及海扶医院院长张炼教授首先介绍了HIFU的基本工作原理,随后他提到,海扶医院筛选HIFU 治疗小肝癌(HCC)病人的纳入标准包括不适宜传统手术、不适合射频消融(RFA)等局部治疗方法、尺寸小于等于 5 厘米的孤立性肿瘤,或肿瘤数小于等于 3 个且每个肿瘤直径小于等于 3 厘米。基于该纳入标准,他分享了35 位接受 HIFU 治疗的 HCC 病人的临床特征,以及相应的存活率和复发率。此外,张炼教授还对比了经导管动脉栓塞术(TAE)治疗和超声引导 HIFU(USgHIFU)结合 TAE 治疗晚期 HCC 病人的存活率,同时详细讲解了数例肝癌患者的病例报告,并以此总结道,USgHIFU 消融治疗肝脏肿瘤安全有效。
Prof. Holger Strunk from the University Hospital Bonn, Germany, discussed the safety and efficacy of HIFU treatment for pancreatic cancer. One of the cases he shared was a 56-year-old male patient with an inoperable pancreatic tumor who received HIFU treatment. Significant pain relief was achieved 2 days after HIFU and tumor remission was observed 12 months after HIFU. Based on the clinical data his institution collected, he summarized that HIFU therapy can bring effective and lasting reduction of cancer-related pain burden in 85% of patients, significant tumor volume reduction persisting over time in 80% of patients and possible tumor regression after the second HIFU procedure. HIFU also seems to provide a possible survival benefit for advanced pancreatic cancer.
来自德国波恩大学医院的 Holger Strunk 教授则探讨了 HIFU 治疗胰腺癌的安全性和有效性。他分享的其中一例病人为 56 岁男性,患有无法进行切除手术的胰腺肿瘤,在其医院接受了 HIFU 治疗。该患者术后 2 天疼痛明显缓解,术后 12 个月肿瘤消退。根据波恩大学医院收集的临床数据,他总结道,在进行 HIFU 治疗后,85% 的患者癌症疼痛得到了有效且持久的缓解,80% 的患者肿瘤体积显著减小且持续时间长。在第二次 HIFU 治疗后,肿瘤还可能会逐渐消退。此外,HIFU 治疗似乎对晚期胰腺癌患者的生存期有一定助益。
Prof. David Cranston, the President of ISMIVS, shared a fascinating story about how HIFU was introduced to his research team in the Surgery University of Oxford and the clinical trials of HIFU therapy conducted therein. He particularly indicated the drug delivery procedure and result for liver tumor by using focused ultrasound to release doxorubicin from circulating thermosensitive liposomes: out of 9 patients with complete radiological assessment, 4 demonstrated PR on CHOI and/or PERCIST. He also talked about HIFU ablation for pancreatic cancer and targeted drug delivery. Among 8 patients with unresectable pancreatic cancer treated with HIFU, total pain relief was observed and the median survival time was 11 month. In his view of the development of HIFU application, advanced machines, faster treatment and more accurate imaging would emerge in the nearer future.
国际微无创医学会主席 David Cranston 教授分享了牛津大学研究团队学习应用 HIFU 的精彩故事,以及牛津大学所进行的 HIFU 治疗临床试验。他特别地提出了该研究团队利用聚焦超声从循环的热敏脂质体中释放阿霉素,从而实现肝脏肿瘤的给药过程和研究结果:9 例接受放射评价的患者中,其中 4 例的 CHO I和/或 PERCIST 评价结果为部分缓解(PR)。他还阐释了针对胰腺癌的 HIFU 消融治疗和给药过程:8例患有不可切除胰腺肿瘤的病人在接受 HIFU 治疗后,疼痛完全缓解,中位生存期为 11 个月。David Cranston 教授在展望HIFU的应用前景时提到,相信未来会出现更加先进的 HIFU 治疗设备,更加高效的 HIFU 治疗方式,以及更加精准的图像定位技术。
Prof. Xu Yonghua from Xuhui Hospital of Fudan University mainly discussed the MRI evaluation for focused ultrasound ablation in the treatment of hepatic and pancreatic cancer. He compared MRI images before and after HIFU therapy of 19 cases with liver cancer. As one of the examples, a 60-year-old male patient with hepatic metastasis after sigmoid colon cancer surgery received HIFU treatment due to the bleeding risks and thrombus for RF ablation, and the lesion was almost completely ablated with intact vessels. He also shared 6 cases with pancreatic cancer and indicated that HIFU was a feasible and safe therapy for liver and pancreatic tumor with less complication, and he believed with the development 5G technology, the remote surgery of HIFU can be performed to benefit more patients around the world.
来自复旦大学附属徐汇医院的许永华教授主要探讨了 HIFU 治疗肝脏及胰腺肿瘤的MRI成像评估,对比分析了 19 例肝癌患者 HIFU 术前及术后的 MRI 图像。其中一例患者为 60 岁男性,乙状结肠癌切除后发现肝转移,因射频消融存在大出血和血栓风险,因此选择接受 HIFU 治疗。HIFU 术后病灶几乎完全消融,周边血管完整无损。此外,他还分享了 6 例胰腺癌病例,并指出 HIFU 治疗肝脏和胰腺肿瘤安全可行,并发症少,相信随着 5G 技术的发展,HIFU 远程手术将造福更多世界各地的患者。
Prof. Zhou Kun from the Second Affiliated Hospital of Chongqing Medical University further shared a surgery video of a patient with pancreatic cancer who were receiving HIFU treatment and elaborated the procedure and precautions, including the patient’s surgical position, sedation administration and imaging analysis. He also shared two case reports of his hospital and concluded that HIFU therapy was a safe minimally invasive treatment which can benefit cancer-related pain release and was an potential option as a pre-surgery for borderline resectable tumor.
来自重庆医科大学第二附属医院的周崑教授则进一步分享了胰腺癌患者进行 HIFU 治疗的手术视频,详细讲解了 HIFU 手术过程和注意事项,包括患者术中体位、麻醉管理方案、影像分析等。他还分享了两例病例报告,并总结道,HIFU 是一种安全的微创治疗,可以缓解癌症引起的疼痛,也可以考虑作为切除交界性肿瘤的术前方案。
Watch the playback:
https://youtu.be/CkOABaKAVVo
点击观看本期研讨会:
http://live.99zigong.com/video/huikan/1164
Episode 2
第 2 期
The 2nd episode kicked off on December 9th which invited 4 special guests including Prof. Mohamed Hamed, Dr. Simon Tsang, Prof Joan Vidal-Jove and Prof. Zhou Kun to share the clinical application and technology development of HIFU for the treatment of liver cancer, as well as Prof. Meng Zhiqiang and Prof. Yang Wuwei to discuss the safety and efficacy of HIFU therapy for pancreatic cancer.
第2期“新选择,新希望”系列研讨会于 12 月 9 日召开,会议邀请到 Mohamed Hamed 教授、Simon Tsang 医生、Joan Vidal-Jov 教授和周崑教授这四位特约专家,分享 HIFU 治疗肝癌的临床应用和技术发展;同时邀请到孟志强教授和杨武威教授探讨 HIFU 治疗胰腺癌的安全性和有效性。
Dr Simon Tsang from the department of surgery at the University of Hong Kong gave a speech themed on High-intensity Focused Ultrasound Treatment of Liver Tumors in Difficult Locations. He first mentioned 6 treatment options for HCC, in which HIFU was included as an emerging and valuable one for small and advanced cirrhosis, and then introduced the eligibility and contraindications for HIFU. Subsequently, Dr. Tsang elaborated the difficult locations of liver tumors for HIFU ablation, with several cases of lesions in the liver dome as well as the ones close to vascular structures and portal pedicles. In his case demonstration, pre-operative and peri-operative preparations in terms of equipment setting, positioning, sonication and general anesthesia were fully presented, along with other tips and tricks. Dr. Tsang concluded that it was safe to ablate the tumors in some particular positions, and the treatment efficacy and the prognosis of patients with liver tumors following HIFU were quite pleasing.
来自香港大学外科学系的 Simon Tsang 医生做了“HIFU 治疗困难部位的肝脏肿瘤”的专题演讲。他首先提到了目前治疗 HCC 的 6 种方法,其中 HIFU 被认为是治疗轻度和重度肝硬化的重要新技术。在介绍 HIFU 的适应症和禁忌症之后,Simon Tsang 医生以肝穹窿部病灶消融,以及靠近血管和肝门静脉蒂的病灶消融为例,阐释了 HIFU 治疗肝脏肿瘤的多个困难部位。在病例讲解过程种,他详细介绍了 HIFU 术前和围术期的准备工作,包括设备设置、定位、超声、麻醉方案,以及其他手术技巧和注意事项。他最后总结道,HIFU 消融特定部位的肿瘤是安全的,肝癌患者接受 HIFU 治疗后的效果和预后都较好。
Prof. Joan Vidal-Jove, the surgical and interventional oncologist of the Comprehensive Tumor Center Barcelona and the Institution Khuab for Interventional Oncology, has performed over 250 oncological cases with HIFU in the last 12 years. He shared his experiences in tackling liver and pancreatic tumors in Spain and clarified some of the most difficult questions in this specific field. Then, he compared the clinical outcomes and survival curves before and after HIFU treatment in patients with liver and pancreatic tumors based on cohort studies. The results revealed that HIFU treatment or HIFU plus chemotherapy was indeed safe and effective, which indicated that it was the right path in such cases. Prof. Joan Vidal-Jove further shared his recommendations in the degree of ablation, reinforce strategies, combined therapies and ideal candidates for HIFU therapy. Prof. Vidal-Jove hoped that there could be a breakthrough both in the equipment and the treatment in the future.
Joan Vidal-Jove 教授是巴塞罗那综合肿瘤中心和 Khuab 介入肿瘤学研究所的外科及介入肿瘤学家,拥有 12 年的临床经验,应用 HIFU 治疗了超 250 例的肿瘤患者。他分享了自己在西班牙治疗肝脏和胰腺肿瘤的经验,并阐明了HIFU消融这一特定领域中的难点问题。随后,他 基于队列研究对比了HIFU治疗肝癌及胰腺癌患者术前与术后的临床结果和生存曲线。结果显示,HIFU 治疗或 HIFU 结合化学药物治疗安全有效,这说明应用 HIFU 治疗此类病例是可行的。Joan Vidal-Jove 教授就消融程度、强化策略、联合治疗和 HIFU 患者理想条件等方面给出了进一步的建议,并表示,希望 HIFU 这一领域的设备和治疗在未来能有所突破。
Prof. Meng Zhiqiang from the Minimally Invasive Treatment Center of Fudan University Shanghai Cancer Center (FUSCC) shared the exploration in his institution of HIFU treatment for pancreatic cancer. He indicated that only 10% pancreatic tumors were resectable and the 5-year survival rate was very poor even after the surgery, which was the main reason HIFU emerged as a new option for pancreatic cancer. After introducing the developing course of HIFU application for locally advanced pancreatic cancer (LAPC) in FUSCC from 2008 to 2019, including the initial success of pain relief in patients with high rate of survival and minus complications, further exploration of treatment for tumor with metastasis, safety evaluation by several HIFU cases, as well as the comparison with other local therapies such as RFA and irreversible electroporation (IRE), he concluded that HIFU appears to be the most attractive option to treat pancreatic cancer, especially pancreatic metastasis in the future, because it’s a repeatable technique with low risk and cost.
来自复旦大学附属肿瘤医院肿瘤微创治疗中心的孟志强教授分享了该中心对 HIFU 治疗胰腺癌的研究和探索。他指出,由于仅有 10% 的胰腺肿瘤可以进行切除手术,且手术后的5年存活率仍然很低,因此 HIFU 成为了治疗胰腺癌的新选择。随后,他介绍了复旦大学附属肿瘤医院自 2008 年至 2019 年应用 HIFU 治疗胰腺癌的发展历程,包括初期成功缓解患者疼痛,提升存活率,减少并发症;进一步研究转移性胰腺癌;多例 HIFU 消融的安全性评估,以及 HIFU 与 RFA、不可逆电穿孔(IRE)等局部治疗方法的比较,并总结道 HIFU 是未来治疗胰腺癌,尤其是转移性胰腺癌的有力选择,因为 HIFU 手术可重复进行,风险小,成本低。
Prof. Mohamed Hamed from Cairo University, Egypt, discussed the local management of HCC. He mentioned that due to the difficulties regarding to the staging system, size and number limitation, as well as the vascular invasion, HIFU was recommended for the treatment of unresectable liver tumors. Through several case analyses, he indicated that HIFU was not only able to ablate the lesion in difficult locations, but also benefited the drug delivery process and the immune response. He further compared HIFU with liver tumour-intervention therapy for HCC and concluded that HIFU would bring a better result to the treatment of HCC with a lower distance, smaller size and less vascularity.
埃及开罗大学的 Mohamed Hamed 教授则探讨了肝癌的局部治疗方法。他提到,对于无法切除的肝脏肿瘤,由于肝癌分期系统、肿瘤大小及数量限制,以及血管入侵等方面存在的问题,建议采用 HIFU 治疗。通过对多个病例的分析,他指出 HIFU 不仅能够消融困难部位的病灶,还有利于给药过程和免疫应答。随后,他进一步对比了 HIFU 和肝脏肿瘤介入疗法,并总结道,HIFU 可治疗位置较低、体积较小、血管较少的肝细胞癌,且能达到更好的治疗效果。
Dr. Zhou Kun, associate professor in the Second Affiliated Hospital of Chongqing Medical University, shared the surgery video of HIFU treatment for liver cancer. He first explained the different roles of HIFU and chemo therapy playing in the treatment for malignancies and shared 7 case reports in detail, for which the tumor recurrence and survival outcome of both small and large HCC were demonstrated. He then concluded that HIFU was one alternative local thermal ablation method that was safe for large blood vessels with no limitation for tumor size.
重庆医科大学附属第二医院的周崑副教授分享了 HIFU 治疗肝癌的手术视频。他首先阐述了 HIFU 和化疗在恶性肿瘤治疗中所起的不同作用,并详细讲解了 7 例病例报告,展示了小肝癌和大肝癌患者的肿瘤复发率和生存结果,随后总结道,HIFU 是一种局部热消融的治疗方案,不损害周围大血管,也不受肿瘤的大小限制。
Prof. Yang Wuwei from the General Hospital of the People’s Liberation Army shared the application of HIFU for the treatment of progressive stage of pancreatic cancer. He indicated that there were 4 local ablation techniques for pancreatic cancer such as RFA, IRE, cryoablation (CA) and HIFU, which enjoyed the significances of tumor progression control, prolonged survival time, symptom alleviation and improving the quality of life. After elaborating the diversity of HIFU effects, he showed a case of a 48-year-old female with significant cancer pain whose pain score decreased from 7 to 2 after FUA treatment with a survival time of 18 months after combined chemotherapy. He believed that HIFU is valuable in the treatment of advanced pancreatic cancer and the comprehensive treatment strategy is worth exploring if it is combined with systemic therapy such as immunotherapy.
来自中国人民解放军总医院的杨武威教授分享了 HIFU 治疗进展期胰腺癌的临床应用。他指出,胰腺癌的局部消融技术主要有射频消融、不可逆电穿孔、冷冻消融术和 HIFU 这四种,对控制肿瘤进展,延长生存时间、缓解症状、提高生活质量有重要意义。在阐述了 HIFU 效应的多样性后,他分享了一例 48 岁的女性患者,癌性疼痛难耐,聚焦超声消融治疗后疼痛评分从 7 分降至 2 分,联合化疗后的存活期为 18 个月。杨教授认为 HIFU 在针对晚期胰腺癌的治疗中很有价值,HIFU 与免疫治疗等系统疗法的综合治疗策略也值得进一步探索。
Watch the playback:
https://youtu.be/Pc7OqcM2vgk
点击观看本期研讨会:
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2021 APAGE-ISMIVS HIFU Series Webinars: HIFU and Fertility, Potential or Not?
Episode 4
2021年国际微无创医学会(ISMIVS)与亚太妇产科内视镜暨微创治疗医学会(APAGE)联合会议
暨2021年高强度聚焦超声(HIFU)系列线上研讨会(AIH)——HIFU与生殖:潜力与否
第 4 期
Episode 4 closing at December 16th marked a wrap for APAGE-ISMIVS 2021 HIFU Series Webinars. Thanks to all of our speakers and audience for attending over the last few months. We hope the 4 webinars would expand your insights in the field of gynaecological surgery and somehow contribute to minimally invasive and noninvasive medicine.
第4期HIFU研讨会在 12 月 16 日成功举行,这也标志着“2021 年APAGE-ISMIVS高强度聚焦超声”系列线上会议的圆满落幕。感谢过去几个月来参加会议的所有演讲者和参与者,我们希望这4场线上研讨会能够拓展您在妇科手术方面的视野,从而助力微无创医学的发展。
Dr. Lee Keen Whye, the Leading Consultant Obstetrician and Gynaecologist at the Gleneagles Medical Centre, Singapore, opened the seminar by emphasizing the importance of treating benign tumors such as fibroid and adenomyosis and introducing the development of gynaecological surgery from laparotomy to HIFU. Then, he brought a lecture themed on The Learning Curve of HIFU, during which he first compared the main differences between MRI-guided HIFU and Ultrasound-guided HIFU which was indicated to be more flexible and efficient with shorter treatment time. Over the last 3 years, he had managed 118 patients with HIFU therapy, among which 83 cases with fibroids, 26 with adenomyosis and 9 mix symptoms with 123 min of average treatment time. Based on such rich clinical experience, he shared a three-stage method to learn HIFU. He also elaborated 4 cases of uterine fibroid and 2 cases of adenomyosis and concluded that HIFU was revolutionary and disruptive to the world of gynaecological surgery which he believed more women would choose in the future.
新加坡鹰阁医院的首席妇产科顾问李建威医生开场致辞,强调了治疗子宫肌瘤、子宫腺肌症等良性肿瘤的重要性,介绍了妇科手术从剖腹手术到 HIFU 的发展历程。随后,他以“HIFU 技术的临床学习曲线”为题,比较了磁共振引导 HIFU 和超声引导 HIFU 的主要区别,指出超声引导 HIFU 更加灵活高效,治疗时间也更短。在过去 3 年中,李建威医生应用 HIFU 共治疗 118 例病人,其中 83 例为子宫肌瘤患者,26 例为子宫腺肌症患者,9 例复杂病症患者,平均治疗时间 123 分钟。以如此丰富的临床经验为基础,他分享了学习 HIFU 技术的三步法,详细讲解了 4 例子宫肌瘤和 2 例子宫腺肌症的治疗案例,并总结道,HIFU 对妇科手术来说是一种革命性、颠覆性的技术,相信未来会成为更多女性的选择。
Prof. Fong Yoke Fai from the Department of Obstetrics and Gynaecology, National University of Singapore, shared his clinical experience using HIFU to treat uterine fibroids and adenomyosis. He introduced the principal of HIFU and indicated that HIFU was an advanced non-invasive and non-surgical technology with little downtime and allowing patient to resume daily activities after treatment. Till December 2021, Farrer Park Hospital Day Surgery Centre had done 173 cases of HIFU in total, for follow-ups of these cases after HIFU treatment, there were no skin burns, 1 case of L4 nerve root radiculopathy (complete recovery after 3 months), 6 cases of pregnancies (3 fibroids, 3 adenomyosis).
新加坡国立大学医学院妇产科冯旭辉教授分享了他利用 HIFU 技术治疗子宫肌瘤和子宫腺肌症的临床经验。他首先介绍了 HIFU 的工作原理,并指出 HIFU 是一种非手术的无创先进技术,术后所需的休养时间较短,让病人能够较快地恢复日常活动。截止 2021 年 12 月,新加坡斐瑞医疗中心共完成 173 例 HIFU 手术,在这 173 例患者的术后随访中,无一例出现皮肤烧伤,1 例 L4 神经根损害(三个月后完全恢复),6 例成功妊娠(3 例子宫肌瘤,3 例子宫腺肌症)。
Dr. P.M. Gopinath, the Director of Obstetrics and Gynecology, SIMS Hospital, India, mainly introduced the pre-treatment of fibroids and adenomyosis in ART. He first explained the mechanism of impaired fertility in case of intramural-submucosal myoma and discussed the impact of myoma on fertility. He also presented the pregnancy rate and miscarriage rate of intramural leiomyoma after IVF and then provided 5 treatment options for fibroids including medical therapy, open surgery, laparoscopy, robotic surgery and HIFU. After comparing the old and new techniques of reduction surgery for adenomyosis, he concluded that HIFU was well tolerated by patients, and the mean uterine volume decreased by 12.7%, the symptom severity score improved significantly and no serious complications were observed.
印度 SIMS 医院妇产科负责人 P.M. Gopinath 医生主要介绍了辅助生殖前的子宫肌瘤和子宫腺肌症治疗,他首先阐释了肌壁间-粘膜下肌瘤导致生育能力受损的机制,并探讨了子宫肌瘤对生育能力的影响。此外,他展示了壁内平滑肌瘤患者在辅助生殖后的妊娠率和流产率,同时提供了5种肌瘤治疗方案包括药物治疗、开腹手术、腹腔镜、机器人手术和 HIFU。通过比较过去的和新的子宫腺肌症病灶减少技术,他总结道,患者对 HIFU 的耐受性良好,子宫体积平均减少 12.7%,症状严重程度评分明显改善,无严重并发症发生。
Dr He Min from Chongqing Haifu Hospital further shared treatment strategies for difficult cases of HIFU. She indicated that to achieve safety, effectiveness and efficiency of HIFU treatment, 6 factors including BMI, the position of the uterus, number and position of the fibroids, blood supply and T2WI should be considered. Then she shared difficult cases of the posterior uterus, multiple fibroids and adenomyosis with hysteromyoma/chocolate cyst, as well as potential responding strategies. As the director of the Training Department, Engineering Research Center of Ultrasound Medicine, China, Dr He Min was also involved in the Q&A part to address the problems and concerns participants had in terms of device operation and treatment planning.

来自重庆海扶医院的何敏医生进一步分享了 HIFU 疑难病例的治疗策略。她指出为了实现 HIFU 治疗的安全性、有效性和高效率,医生需考虑 BMI、子宫位置、肌瘤数量及位置、血供和T2加权图像等六大因素。随后,她分享了后位子宫、多发性肌瘤、子宫腺肌症合并子宫肌瘤/巧克力样囊肿等多个疑难病例及相应的应对策略。此外,作为中国超声医学工程国家重点实验室培训中心的负责人,何敏医生也在问答环节中针对设备操作和治疗方案等方面的问题为大家答疑解惑。

Editors:Yang Zhou, Ren Ronghu, Chen Mingzhu, Ren Yujie, Xia Hang

Watch the playback:
https://youtu.be/2fC5KlyQAvU
点击观看本期研讨会:
http://live.99zigong.com/video/huikan/1160

Data Release数据发布
2021 ISMIVS Data Realease
2021 年国际微无创医学会数据发布
With 2021 coming to a close, ISMIVS wanted to reach out and send our best wishes to you and yours. We hope 2022 holds success and good fortune in any endeavour all the colleagues pursue, may the future of minimally invasive and noninvasive medicine, together with our concerted efforts, be filled with advancement and breakthroughs!
随着 2021 年画上句点,国际微无创医学会希望借此机会向您和您的家人致以最美好的祝愿,愿大家 2022 年事业顺利,好运常伴;也愿在全体同仁的共同努力下,微无创医学的发展能够在未来不断进步,不断突破!
Follow us on Facebook or LinkedIn to explore more up-to-date events:
关注我们的 Facebook 或领英账号,获取最新活动信息:
International Society of Minimally Invasive and Virtual Surgery | Facebook
International Society of Minimally Invasive and Virtual Surgery | LinkedIn
Follow us on Youtube to explore watch past seminars of 2021:
关注我们的 Youtube 账号,回看 2021 年所有会议:
International Society of Minimally Invasive and Virtual Surgery | Youtube
Happy new year!
新年快乐!
2020 Annual Report >
回顾2020年年报 >

HIFU Special Issue 高强度聚焦超声特刊
We are delighted to announce that International Journal of Hyperthermia, the HIFU Special Issue (i.e. Volume 38, 2021), which was partially supported by ISMIVS, was officially released on September. The Special Issue includes 15 articles written and reviewed by world-renowned scholars and pioneers in the minimally invasive and noninvasive medicine, elaborating the status and prospects of the clinical applications of high intensity focused ultrasound on tumors occurred in certain organs. We'll share the 15 articles included in the upcoming newsletters, stay tuned!
我们很高兴地向大家宣布,由国际微无创医学会(ISMIVS)参与并大力支持的《国际热疗杂志:高强度聚焦超声(HIFU)特刊》已于九月正式发布。本期特刊邀请到多位微无创医学领域的国际知名专家和行业先驱参与编撰及审核,共包含15篇学术文章,阐述了高强度聚焦超声(HIFU)治疗人体各器官肿瘤的临床应用现状和发展前景。我们将陆续分享HIFU特刊中的文章,敬请期待!
Preliminary study on ultrasound-guided high-intensity focused ultrasound ablation for treatment of broad ligament uterine fibroids
超声引导下高强度聚焦超声消融治疗阔韧带子宫肌瘤的初步研究
To investigate the feasibility, efficacy and safety of ultrasound-guided high-intensity focused ultrasound (HIFU) ablation for treating the broad ligament uterine fibroid (BLUF).
本文旨在研究超声引导下高强度聚焦超声(HIFU)消融治疗阔韧带子宫肌瘤(BLUF)的可行性、有效性和安全性。
A total of 236 patients with symptomatic uterine fibroids were enrolled and treated between January 2017 and December 2018. Of them, data of 12 patients with 13 broad ligament fibroids were retrospectively analyzed. The patients’ mean age was 38.6 ± 6.3 years. The fibroid size, non-perfusion volume (NPV) ratio, the reduction of fibroid volumes, adverse events, symptom changes, and abnormal MRI findings associated with the HIFU treatment were analyzed.
2017 年 1 月至 2018 年 12 月期间,共计 236 名子宫肌瘤患者接受治疗。其中回顾性分析了12例患者(13个阔韧带肌瘤)的治疗数据,患者的平均年龄为 38.6 ± 6.3 岁。 文章分析了与 HIFU 治疗相关的肌瘤大小、非灌注体积 (NPV) 比率、肌瘤体积减少、不良事件、症状变化和异常 MRI 结果。
Ultrasound-guided HIFU ablation in the twelve patients was technically successful with one session treatment. The mean longest diameter of BLUFs was 6.2 ± 2.3 cm. The mean NPV ratio of fibroids was 84.08%± 9.4%. After HIFU ablation, lower abdominal pain occurred in 7 cases, sacrococcygeal pain in 3 cases, and mild skin pain in 6 cases. There were no severe adverse events and complications associated with the treatment.
12 名患者均只接受一次超声引导 HIFU 消融治疗,且均治疗成功。 BLUF 的平均最长直径为 6.2 ± 2.3 cm。 肌瘤的平均 NPV 比率为 84.08%±9.4%。 HIFU消融后下腹痛7例,骶尾部痛3例,轻度皮肤痛6例。 没有与治疗相关的严重不良事件和并发症。
Read More >
Tech Update in Gynaecological Endoscopy 妇科腔镜技术最新进展
Hysteroscopic myomectomy: The guidelines of the International Society for Gynecologic Endoscopy (ISGE)
宫腔镜子宫肌瘤切除术:国际妇科内镜学会(ISGE)指南
This publication of the International Society for Gynecologic Endoscopy (ISGE) aims to provide the clinicians with the recommendations arising from the best evidence currently available on hysteroscopic myomectomy (HM).
国际妇科内镜学会(ISGE)旨在通过该指南整合宫腔镜子宫肌瘤切除术(HM)方面的最佳证据,并为临床医生提供该方面的相关建议。

There are some highlights:
以下摘选部分重点内容:
1. Hysteroscopic myomectomy is the most effective conservative surgical intervention for submucous leiomyomas.
宫腔镜子宫肌瘤切除术是治疗粘膜下平滑肌瘤最有效的保守性手术。
2. Slicing technique or morcellation for type 0 and slicing technique for type 1 and 2 leiomyomas are recommended.
0型平滑肌瘤推荐切片或分切治疗,1型和2型平滑肌瘤推荐切片治疗。
3. Prevention of complications, including continuous and accurate measurement of absorbed distension fluid, is fundamental.
预防并发症的基本策略之一是持续、准确地测量可吸收的扩张剂。
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