Citation: | LAU Wan Yee, YEUNG Chung Kwong. Whether China has stepped into 'Surgery 4.0' in diagnosis and treatment of hepatocellular carcinoma[J]. Chinese Journal of Digestive Surgery, 2021, 20(1): 35-39. DOI: 10.3760/cma.j.cn115610-20201118-00730 |
This article aims to explore whether clinicians and surgeons in China have made enough progress to step into 'Surgery 4.0' in management of primary hepatocellular carcinoma (HCC). As for 'Surgery 4.0', the term was first introduced in 2018 by Hooshair A to describe the four important stages of development in surgery, and each of these stages developed as a result of new scientific inventions and applications at the material time periods. These four stages of surgical developments are: Surgery 1.0 (from 18th to 20th centuries, also called the era of scientific surgery); Surgery 2.0 (1950 to 1980, the era of ultra-major and transplant surgery); Surgery 3.0 (1980 to early 21st century, the era of minimally invasive surgery); and Surgery 4.0 (from early 21st century, the era of digital surgery). Digital science brings drastic changes in medicine and health-care. Surgery 4.0 is driven by the use of big data, artificial intelligence, automation, modern robots and 5G communication, which achives a preliminary success in surgical field. However, the application of Surgery 4.0 in diagnosis and treatment of HCC is still at its embryonic stage.
[1] |
刘允怡,林伟棋,杨重光.从工业革命(工业1.0)到外科4.0[J].中华消化外科杂志,2020,19(9):919-924.DOI: 10.3760/cma.j.cn115610-20200821-00573.
|
[2] |
Wikipedia. Industry 4.0 [EB/OL].[2020-08-21]. https://zh.wikipedia.org/wiki/industry4.0.
|
[3] |
HooshairA.In the wake of Industry 4.0, it's time for surgery4.0 [EB/OL]. (2018⁃12⁃07) [2020⁃08⁃21]. http://robosurgelab.com/in-the-wake-of-industry-4-0-its-time-for-surgery-4-0/.
|
[4] |
WangFS, FanJG, ZhangZ, et al. The global burden of liver disease: the major impact of China[J]. Hepatology,2014,60(6):2099-2108. DOI: 10.1002/hep.27406.
|
[5] |
ChenMS, LiJQ, ZhengY, et al. A prospective randomized trial comparing percutaneous local ablative therapy and partial hepatectomy for small hepatocellular carcinoma[J]. Ann Surg,2006,243(3):321-328. DOI:10.1097/01.sla. 0000201480.65519.b8.
|
[6] |
CaoJ, LiWD, ZhouR, et al. Totally laparoscopic anatomic S7 segmentectomy using in situ split along the right intersectoral and intersegmental planes[J]. Surg Endosc,2021,35(1):174-181. DOI: 10.1007/s00464-020-07376-z.
|
[7] |
AiJH, LiJW, ChenJ, et al. Feasibility and safety of laparoscopic liver resection for hepatocellular carcinoma with a tumor size of 5-10 cm[J]. PLoS One,2013,8(8):e72328. DOI: 10.1371/journal.pone.0072328.
|
[8] |
CaiX, PengS, DuanL, et al. Completely laparoscopic ALPPS using round-the-liver ligation to replace parenchymal transection for a patient with multiple right liver cancers complicated with liver cirrhosis[J]. J Laparoendosc Adv Surg Tech A,2014,24(12):883-886. DOI: 10.1089/lap.2014.0455.
|
[9] |
LiuQ, ZhangT, HuM,et al. Comparison of the learning curves for robotic left and right hemihepatectomy: a retrospective cohort study[J]. Int J Surg,2020,81:19-25. DOI: 10.1016/j.ijsu.2020.07.022.
|
[10] |
ZhangL, WangH, LiQ, et al. Big data and medical research in China[J]. BMJ,2018,360:j5910. DOI: 10.1136/bmj.j5910.
|
[11] |
AustinC, KusumotoF. The application of Big Data in medicine: current implications and future directions[J]. J Interv Card Electrophysiol,2016,47(1):51-59. DOI:10. 1007/ s10840-016-0104-y.
|
[12] |
AgrawalR, PrabakaranS. Big data in digital healthcare: lessons learnt and recommendations for general practice[J]. Heredity (Edinb),2020,124(4):525-534. DOI: 10.1038/s41437-020-0303-2.
|
[13] |
The State Council. The People's Republic of China. China to boost big data application in health and medical sectors[EB/OL].(2016-06-24)[2020-08-21]. http://english.www.gov.cn/policies/latest_releases/2016/06/24/content_2814 75379018156.htm.
|
[14] |
O'MearaSarah. Big data helps to tackle diabetes in Shanghai[EB/OL].[2020-08-21]. https://www.nature.com/ articles/d41586-020-00281-4.
|
[15] |
ZhangL, LongJ, JiangW, et al. Trends in Chronic Kidney Disease in China[J]. N Engl J Med,2016,375(9):905-906. DOI: 10.1056/NEJMc1602469.
|
[16] |
WuH, XingH, LiangL, et al. Real-world role of perfor-mance status in surgical resection for hepatocellular carcinoma: a multicenter study[J]. Eur J Surg Oncol,2019,45(12):2360-2368. DOI:10.1016/j.ejso.2019. 09.009.
|
[17] |
方驰华, 李克晓, 范应方,等.医学图像三维可视化系统在精准肝切除中的应用价值[J].中华消化外科杂志,2011,10(1):29-32. DOI:10.3760/cma.j.issn.1673-9752.2011. 01. 008.
|
[18] |
NoëlS. AI in the healthcare sector in China: current trends and applications/Daxue consulting. [EB/OL].(2019-07-22)[2020-08-21]. https://daxueconsulting.com/ai-health care-china/.
|
[19] |
RasmiA. China has produced another study showing the potential of AI in medical diagnosis[EB/OL].(2019-02-13)[2020-08-21]. https://finance.yahoo.com/news/china-produced-another-study-showing-194643632.html.
|
[20] |
FengLH, DongH, LauWY, et al. Novel microvascular invasion-based prognostic nomograms to predict survival outcomes in patients after R0 resection for hepatocellular carcinoma[J]. J Cancer Res Clin Oncol,2017,143(2):293-303. DOI: 10.1007/s00432-016-2286-1.
|
[21] |
XingH, ZhangWG, CesconM, et al. Defining and predic-ting early recurrence after liver resection of hepatocellular carcinoma: a multi-institutional study[J]. HPB (Oxford),2020,22(5):677-689. DOI:10.1016/j.hpb. 2019.09.006.
|
[22] |
YangT, XingH, WangG, et al. A novel online calculator based on serum biomarkers to detect hepatocellular carcinoma among patients with hepatitis B[J]. Clin Chem,2019,65(12):1543-1553. DOI:10.1373/clinchem.2019. 308965.
|
[23] |
Wikipedia [EB/OL]. [2020-08-21]. https://en.m.wikipedia.org/wiki/Automation.
|
[24] |
CarfagnoJ. Automated Medicine: China Using AI Ambu-lances and Other Technologies in Healthcare[EB/OL].(2018-06-29)[2020-08-21]. https://www.docwire news.com/future-of-medicine/automated-medicine-china- using-ai-ambulances-and-other-technologies-in-healthcare/.
|
[25] |
FarooqI.Automation could help China's pharmaceutical manufacturing market[EB/OL].(2018-11-05)[2020-08-21]. https://www.europeanpharmaceuticalreview.com/news/80988/automation-china/.
|
[26] |
DailyChina. Magnificent robots make medical magic in China. [EB/OL].(2020-02-19)[2020-08-21]. http://www.chinadaily.com.cn/a/202002/19/WS5e4c9dbea310128217278a21_2.html.
|
[27] |
LiDong. 5G and intelligence medicine-how the next generation of wireless technology will reconstruct health-care?[J]. Previs Clin Med,2019,2(4):205-208. DOI:10.1093/ pcmedi/p62020.
|
[28] |
DaiS. How China is counting on 5G to improve health care[EB/OL].(2019-06-18)[2020-08-21]. https://www.tech inasia.com/china-counting-5g-improve-health-care.
|
[29] |
DailyChina. How 5G can transform financial, healthcare in China[EB/OL].(2019-12-30)[2020-08-21]. http://www. chinadaily.com.cn/a/201912/30/WS5e096ec2a310cf3e3558176c.html.
|
[30] |
South China Morning Post. How China is counting on 5G to improve health care[EB/OL].[2020-08-21]. www.scmp. com/tech/bigtech.
|