To investigate the safety of the anterior artery and posterior vein principle in laparoscopic pancreaticoduodenectomy (LPD) of uncinate process after neoadjuvant chemotherapy (NAC).

The clinical data of 136 patients with pancreatic cancer who underwent LPD after completing NAC from June 2018 to June 2023 were retrospectively analyzed, and were divided into study group (n=74 cases, using the principle of prevenous and then venous) and control group (n=62 cases, using the principle of prevenous and then arterial) according to different approach principles during uncinate process resection. The data was processed by SPSS 22.0. Measurement data such as perioperative indexes were represented by (), and independent sample t test was performed. The statistical data of postoperative complications were represented by [cases (%)], Rank Sum test or χ² test. Kaplan-Meier method and Log-Rank test were used for survival analysis. P<0.05 indicated that the difference was statistically significant.

The operative time, uncinate process separation time and intraoperative blood loss in the study group were significantly lower than those in the control group, and the number of lymph node dissection and R0 resection rate were significantly increased in the study group, with statistical significance (P<0.05). There was no significant difference in drainage tube removal time and postoperative hospitalization time between the two groups (P >0.05). The total incidence of postoperative complications in the study group was lower than that in the control group (17.6% vs. 27.4%), but the difference was not statistically significant (P>0.05). The cumulative disease-free survival rate (77.0% vs. 67.7%) and the cumulative overall survival rate (79.7% vs. 71.0%) in the study group were significantly higher than those in the control group, with statistical significance (P<0.05).

The principle of anterior artery and posterior vein resection of uncinate process after NAC is safe and effective. This principle can not only effectively shorten the operation time, reduce intraoperative injury, improve the thoroughness of lymph node dissection and R0 removal rate, but also improve the survival rate of patients without increasing postoperative complications.

By comparing the differences of 18F FDG-PET/CT uptake rate, biochemical indexes and expression of genes related to glucose and lipid metabolism between non-low adhesion and low adhesion gastric cancer, the possibility of low adhesion gastric cancer obtaining energy through fatty acid metabolism was explored.

The clinical data of 94 patients with gastric cancer WHO received PET/CT examination from January 2013 to December 2021 were retrospectively analyzed. According to WHO classification, they were divided into low adhesion cancer (n=28 cases) and non-low adhesion cancer (n=66 cases). SPSS 25.0 statistical software was used for data analysis, and the measurement data between the two groups were measured by t test or Mann-WhitneyU test. The statistical data were measured by χ² test. Kaplan-Meier survival curve was used to analyze the difference in overall survival (OS) between the two groups. P<0.05 indicated that the difference was statistically significant.

The standardized mean uptake (SUVmean) of low-adhesion carcinoma group was significantly lower than that of non-low-adhesion carcinoma group (P = 0.049), and apolipoprotein AI and high-density lipoprotein were significantly higher than those of non-low-adhesion carcinoma group (P<0.05). Kaplan-Meier curve showed that OS in the low adhesion group was significantly lower than that in the non-low adhesion group (P=0.016). The expression of leukocyte differentiation antigen 36 (CD36) and fatty acid binding protein 4 (FABP4) in low-adhesion carcinoma was significantly higher than that in non-low-adhesion carcinoma (P<0.05), and glucose transporter 1 (GLUT1) was significantly lower than that in non-low-adhesion carcinoma (P=0.033). Univariate and multivariate COX regression analysis showed low SUVmean value (<3.25 vs. ≥3.25, HR=4.7, P=0.004), low adhesion cancer (HR=5.1, P=0.031), late stage (stage IV, HR=10.7, P=0.010) and tumor size (≥5 cm vs. <5 cm, HR=5.6, P=0.041) were independent risk factors for OS.

The expression of genes related to glucose metabolism in patients with low adhesion gastric cancer was significantly lower than that of non-low adhesion gastric cancer, and the expression of genes related to lipid metabolism was significantly higher than that of non-low adhesion gastric cancer, and the serum apolipoprotein AI and high-density lipoprotein were significantly increased in patients with low adhesion gastric cancer. Because SUVmean is significantly lower than non-low-adhesion cancers, it often results in non-development during PET/CT examination.

To investigate the risk factors of infectious complications after radical gastrectomy of gastric cancer, and establish a Nomogram prediction model.

Data of 600 patients with gastric cancer who underwent radical gastrectomy from January 2010 to April 2023 were retrospectively analyzed. The 600 patients were randomly divided into a training set and an internal validation set at a ratio of 7∶3. Based on LASSO regression screening variables of the training set, a Nomogram model was constructed by multivariate Logistic regression analysis and verified internally by internal verification set. Receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis (DCA) were used to evaluate the model effect. All statistical analyses were performed using R software (version 4.2.2) and MSTATA software.

Among 600 patients undergoing radical gastrectomy, 109 cases developed postoperative infection, the total number of infections was 132 cases, and the incidence of nosocomial infection was 22.0%. There was no significant difference in clinical features such as age, NRS score, smoking history, hypertension and diabetes between the training set and the internal verification set (P >0.05), except for N stage (P =0.18). Seven potential predictors with non-zero regression coefficients were identified by LASSO regression: age, coronary heart disease, prealbumin, operative time, intraoperative blood loss, operation type, and T stage. Multivariate Logistic regression analysis of the above 7 factors showed that age >60 years old, coronary heart disease, low prealbumin before surgery, operation time >180min, proximal gastric resection or total gastrectomy were independent risk factors for postoperative infection after radical gastrectomy (P <0.05). Finally, a Nomogram prediction model was established based on the above factors. The area under ROC curve (AUC) of the training set and the internal validation set were 0.753 and 0.736, respectively. The calibration curve and DCA indicated that the model had good predictive ability and clinical practicability. An interactive Nomogram application based on online network was established.

In this study, we constructed a simple and practical tool for predicting infectious complications after radical gastrectomy of gastric cancer, which can quantify the individual risk of postoperative infection and promote the implementation of early prevention and treatment.

To investigate the efficacy of laparoscopic D2 radical resection combined with complete mesangectomy (CME) in the treatment of gastric cancer based on the concept of membrane anatomy.

Data of 95 patients with advanced gastric cancer from January 2020 to December 2022 were retrospectively analyzed, all of whom completed surgical treatment for gastric cancer, and 2-year follow-up information was obtained. They were divided into two groups according to different surgical methods: 50 cases in the membrane dissection group (D2 radical resection +CME) and 45 cases in the traditional group (D2 radical resection). SPSS 25.0 software was used to process the data. Measurement data such as perioperative indicators were expressed as () and independent sample t test was used. Chi-square test was used to measure complications within 30 days and recurrence rate within 2 years. P<0.05 indicated that the difference was statistically significant.

The amount of intraoperative blood loss, first exhaust time, defecation time and hospital stay in the membrane dissection group were lower than those in the traditional group, and the number of lymph node dissection was higher than that in the traditional group (P<0.05). There was no significant difference in the incidence of complications between the two groups (P>0.05). The recurrence time of patients in membrane anatomy group was longer than that in traditional group, and the cumulative recurrence cases in 2 years were less than that in traditional group (P<0.05).

D2+CME radical surgery based on membrane anatomy can reduce the amount of intraoperative blood loss, shorten the time of gastrointestinal function recovery and hospital stay, and has the advantage of reducing recurrence.

Discussion on the timing of urinary tube removal after radical resection of right hemicolonic carcinoma by single hole laparoscopy.

Data of patients with right half colon cancer admitted to the hospital from January 2020 to January 2021 were retrospectively analyzed. All patients underwent single-hole laparoscopic radical resection. Clinical data of 45 patients with 2 d catheter removal after surgery were selected as the 2 d group according to relevant standards, and 45 patients with 5d catheter removal after surgery were selected as the 5 d group. SPSS 25.0 software was used to process the data. The statistical data of acute urinary retention, catheter-associated infection, and urinary control rate 72 h after extubation in the two groups were expressed by [cases (%)] and χ² test was used. Measurement data such as urodynamic indexes were expressed as (), and independent sample t test was performed. P < 0.05 was statistically significant.

Within 12 h after extubation, the incidence of acute urinary retention in the 5 d group was 6.7% lower than that in the 2 d group, with statistical significance ( χ²=4.406, P=0.036). Within 48 hours after catheter removal, the catheter-related infection rate in the 5 d group was 17.8% higher than that in the 2 d group ( χ²=4.444, P=0.035). There was no significant difference in urinary control rate, maximum bladder pressure volume (MCC), bladder residual urine volume (RUV) and maximum urine flow rate (Qmax) between the two groups at 72 h after extubation (P > 0.05).

Compared with 2 d postoperative extubation, the incidence of extubation urinary tube-associated infection was higher at 5 d after radical extubation of right colon cancer by single hole laparoscopy, but the incidence of acute urinary retention was lower. Clinically, extubation timing could be selected according to the specific conditions of patients.

To investigate the effect of double mirror combined radical operation and laparoscopic radical operation in early colon cancer patients.

A total of 81 patients with early colon cancer from January 2019 to September 2023 were selected as the study objects, and the patients were divided into group A (n=40 cases) and group B (n=41 cases) by random number table method. Group A was treated with double mirrors combined with radical surgery (i.e. laparoscopic combined with colonoscopy radical surgery), group B was treated with laparoscopic radical surgery. SPSS 25.0 was used to complete all data analysis. The statistical data of postoperative complications were expressed as percentage and χ² test was used. Perioperative indicators, immune function, gastrointestinal function and other measurement data were represented by (). Independent sample t test was used for inter-group comparison and paired sample t test was used for intra-group comparison. P < 0.05 was considered statistically significant.

Compared with group B, the operation time of group A was longer, the postoperative exhaust, getting out of bed and hospitalization time were shorter, and the amount of blood loss was lower (P < 0.05). Compared with the preoperative level, helper T lymphocyte 1 (Th1) and Th1/ helper T lymphocyte 2 (Th2) decreased and Th2 increased in both groups after surgery, and the change range was greater in group B (P < 0.05). Compared with the preoperative level, the levels of gastrin (GAS) and motilin (MTL) were decreased in both groups after surgery (P < 0.05), but there was no statistical significance in the indexes between the two groups after surgery (P > 0.05). There was no significant difference in the incidence of complications between the two groups (P > 0.05).

The two kinds of endoscopic radical operation had similar effects on gastrointestinal function and safety. However, compared with laparoscopic radical surgery, double mirror combined radical surgery can reduce the amount of intraoperative blood loss, shorten the postoperative recovery time of patients, and have less damage to immune function. However, the operation time of double mirror combined radical operation is longer.

To analyze the effects of laparoscopic complete mesocolectomy (CME) and traditional laparotomy on survival of patients with colon cancer.

The clinical data of 104 patients with colon cancer admitted from January 2018 to December 2021 were retrospectively analyzed, and they were divided into endoscopic group (treated with CME) and laparotomy group (treated with traditional radical surgery) according to different operation methods, with 52 patients in each group. SPSS 25.0 was used for data processing. Measurement data such as perioperative indicators and number of lymph nodes dissection were expressed as (), and independent sample t test was performed. The statistical data such as the incidence of complications were shown by [cases (%)] and χ² test was used. The survival period was analyzed by K-M survival curve and tested by Log-Rank. Test level α=0.05.

The intraoperative blood loss, postoperative exhaust time and postoperative defecation time in endoscopy group were lower than those in laparotomy group (P<0.05). The average number of left and right colon lymph nodes and lymph node dissection in endoscopy group were higher than those in laparotomy group (P<0.05). There was no significant difference in the incidence of complications between the two groups (P>0.05). The 5-year survival rate was 63.5% (33/52) in the endoscopic group and 50.0% (26/52) in the laparotomy group. The median OS of the endoscopic group was 4.6 years, which was significantly higher than that of the laparotomy group (3.3 years) (P<0.05).

Laparoscopic CME has significant clinical effects, which can improve surgical indicators and increase the number of lymph node dissection in colon cancer patients, and help to improve the survival of patients.

To investigate the effect of total neoadjuvant therapy (TNT) combined with total mesorectal excision (TME) on the prognosis of locally advanced rectal cancer (LARC).

Fifty patients with LARC who received treatment from January 2019 to December 2020 were selected as the study objects, and the patients were randomly divided into the TNT group (TNT combined with TME, n=25 cases) and the traditional group (traditional neoadjuvant therapy combined with TME, n=25 cases) according to the numerical table method. SPSS 22.0 statistical software was used to analyze the data. The measurement data were expressed as () and independent sample t test was used. The count data were represented by [cases (%)] using Rank Sum test or χ² test. Kaplan-Meier method and Log-Rank test were used for survival analysis. P<0.05 was considered statistically significant.

There was no significant difference in clinical complete response (cCR) rate and adverse reactions between the two groups (P>0.05). Tumor regression grade (TRG) was significantly different between the two groups (P<0.05), and the pCR rate of TNT group was significantly higher than that of traditional group (P<0.05). The R0 removal rate in TNT group was significantly higher than that in traditional group (P<0.05), and there were no significant differences in other perioperative indicators between the two groups (P>0.05). Kaplan-Meier analysis showed that there was no significant difference in the cumulative overall survival rate between the TNT group and the traditional group (P>0.05), and the cumulative disease-free survival rate in the TNT group was significantly higher than that in the traditional group (P<0.05).

Compared with traditional neoadjuvant therapy, TNT combined with TME in the treatment of LARC has significant short-term and long-term efficacy without increasing adverse reactions, postoperative complications and overall survival rate of neoadjuvant therapy. It can not only effectively improve the pCR rate and R0 resection rate of patients' tumors, but also improve the postoperative disease-free survival rate of patients. It is a safe and effective treatment strategy.

To investigate the influencing factors of postoperative complications of hepatic echinococcosis under the concept of rapid rehabilitation surgery (ERAS), and construct a nomogram model for prediction and verification.

The clinical data of 353 patients with hepatic echinococcosis treated by surgery from January 2020 to March 2023 were retrospectively analyzed. According to the Clavien-Dindo classification system, patients with complications of grade Ⅱ and above occurring within 30 days after surgery were classified into the occurrence group (n=120 cases), and other patients were classified into the non-occurrence group (n=233 cases). In this study, SPSS 25.0 software was used to analyze the data and Logistic regression was used to screen the related factors affecting postoperative complications of hepatic echinococcosis. R software is used to build a nomogram, and the decision curve is drawn to test and evaluate the prediction effect of the nomogram model. P < 0.05 was considered statistically significant.

IL-22, maximum diameter of echinococcosis, intraoperative blood loss, operative time, hospital stay and ventilator assisted breathing were the influencing factors for postoperative complications of hepatic echinococcosis (P < 0.05). A postoperative complication risk prediction model was constructed with the nomogram. The verified model showed that the C-index value was 0.957, the model was well distinguished, and the fitting line and calibration curve were closely aligned with the actual observed line. The decision curve was drawn, the threshold was in the range of 0.2-1.0, and the net benefit rate of complications predicted by the prediction model was > 0, which was clinically significant.

The incidence of postoperative complications of hepatic echinococcosis under the ERAS concept is associated with higher IL-22 level, larger maximum diameter of echinococcosis, more intraoperative blood loss, longer operation time, longer hospital stay, and the use of ventilator-assisted breathing. The postoperative complication risk prediction model established according to these factors has certain predictive value and can obtain a higher net benefit rate.

To explore the anatomical classification and clinical application effect of digital minimally invasive technique on biliary tract, hepatic vein and portal vein in patients with complex hepatolithiasis.

Thirty patients with complex hepatolithiasis who underwent hepatectomy based on digital minimally invasive technology from January 2019 to April 2022 were retrospectively selected as the study group, and another 30 patients with complex hepatolithiasis who underwent laparoscopic hepatectomy based on traditional medical imaging during the same period were selected as the control group. SPSS 24.0 was used to complete the data analysis. The classification of biliary tract, hepatic vein, portal vein, postoperative complications, stone residue and recurrence were represented by [n (%)]. χ² test was performed for comparison between groups. Measurement data such as perioperative indexes and liver function indexes were represented by (Mean±SD), and independent t test was performed between groups. P<0.05 was considered statistically significant.

The coincidence rates of preoperative biliary tract, hepatic vein and portal vein were 96.7%, 100.0% and 100.0%, respectively, which were significantly higher than that of control group (73.3%, 76.7% and 73.3%, P<0.05). The operation time and postoperative hospital stay in the study group were significantly shorter than those in the control group, and the amount of intraoperative blood loss and blood transfusion was significantly less than that in the control group (P<0.05). The levels of ALT, AST, ALP and TBil in two groups were significantly lower than before surgery one month after surgery, and the study group was significantly lower than the control group (P<0.05). The total complication rate of the study group was significantly lower than that of the control group (6.7% vs. 26.7%, P<0.05), and there was no significant difference in stone residual rate and recurrence rate between the two groups (P>0.05).

The application of digital minimally invasive technology to guide the treatment of patients with complex hepatolithiasis can accurately distinguish the intrahepatic bile duct and vascular anatomy and variation before surgery. Compared with traditional surgical treatment, the operation time and intraoperative blood loss are significantly reduced, which can protect the liver and its function to the maximum extent, reduce postoperative complications, and accelerate the recovery process of patients.

To study the clinical effect of small endoscopic sphincterotomy (sEST) combined with endoscopic papillary balloon dilation (EPBD) at different dilation times in the treatment of choledocholithiasis.

A total of 80 patients with choledocholithiasis from January 2017 to June 2023 were randomly prospectively selected. All patients were treated with sEST combined with EPBD. The patients were divided into two groups according to the random number table method, with 40 cases in each group. The 30s group performed balloon dilatation for 30s after sEST, while the 60s group received balloon dilatation for 60s after sEST. SPSS 24.0 was used for data analysis. Measurement data such as surgical situation, serum amylase level, serum total bilirubin (TBiL) and direct bilirubin (DBiL) of the two groups were expressed as () and compared by independent t test. The postoperative complications between the two groups were compared by chi-square test. P<0.05 was considered statistically significant.

The length of hospitalization in 30s group was significantly shorter than that in 60s group (P<0.05). At 24h after surgery, the blood amylase levels in both groups were higher than before surgery (P<0.05), but the level in 30s group was significantly lower than that in 60s group (P<0.05). The levels of TBiL and DBiL in both groups at 24h after surgery were declined compared with those before surgery (P<0.05), but there were no statistical differences between groups (P>0.05). The total incidence rate of complications in 30s group was significantly lower than that in 60s group (7.50% vs. 25.0%, P<0.05), and the bleeding rate was significantly lower than that in 60s group (2.5% vs. 20.0%, P<0.05).

sEST combined with EPBD in the treatment of patients with choledocholithiasis has a good success rate of stone removal. EPBD with dilation time of 30s can reduce the blood amylase level at 24h after surgery and the incidence rate of postoperative bleeding.

To analyze the efficacy and safety of retrograde cholangiopancreatography (ERCP)+ endoscopic papillary sphincterotomy (EST)+ endoscopic nasobiliary drainage (ENBD) in the treatment of choledocholithiasis.

The clinical data of 95 patients with choledocholithiasis from January 2019 to June 2022 were retrospectively analyzed, and they were divided into two groups according to different treatment methods: 46 patients received ERCP+EST treatment (control group) and 49 patients received ERCP+EST+ENBD treatment (observation group). IBM SPSS Statistics 26.0 software was used for statistical analysis. Perioperative indicators, serum amylase, C-reactive protein (CRP), interleukin-6 (IL-6) and liver function indicators were expressed as (). Independent sample t test was used between groups. The statistical data of success rate of one operation, complication rate and recurrence rate 1 year after operation were tested by χ² test. Test level α=0.05.

The hospitalization time of observation group was significantly lower than that of control group (P<0.05). 24h after operation, serum amylase, CRP and IL-6 in observation group were significantly lower than those in control group (P<0.05). The total complication rate of observation group was 6.1%, which was lower than 21.7% of control group (P<0.05). The recurrence rate of patients in the observation group was 0.0% one year after surgery, which was not statistically significant compared with 2.2% in the control group (P>0.05).

ERCP+EST combined with ENBD drainage has a higher success rate of one operation, less impact on liver function, less recurrence rate and complications one year after surgery, and can further reduce the risk of acute pancreatitis and biliary tract infection and alleviate inflammation.

To investigate the application value of gastrointestinal filling contrast-enhanced ultrasound in the clinical diagnosis of patients with acid reflux and belching.

A retrospective analysis was performed on 120 patients with reflux and eructation symptoms from December 2020 to December 2022, and 43 cases of gastroesophageal reflux disease (regurgitation group), 44 cases of peptic ulcer and 33 cases of gastric tumor were confirmed by gastroscopy, CT and other routine examination methods and pathological examination. 40 healthy volunteers were selected as the control group. Gastrointestinal filling contrast-enhanced ultrasonography was performed in the two groups. SPSS20.0 was used for statistical analysis. The statistical data of gastrointestinal contrast-enhanced ultrasound detection and conventional gastric detection were compared by [cases (%)] and χ² test was used. P<0.05 was considered statistically significant.

The coincidence rate between gastrointestinal filling ultrasonography and routine screening was 88.4%(38/43) in patients with gastroesophageal reflux disease. Peptic ulcer (23 cases gastric ulcer, 17 cases duodenal ulcer) 90.9% (40/44); Gastric neoplasms (22 malignant and 9 benign) were 93.9%(31/33). There was no significant difference between gastrointestinal filling ultrasonography and other clinical diagnostic methods such as gastroscopy, CT and pathological examination (P > 0.05). There were significant differences in the frequency of reflux within 5 min and the time of reflux within 5min between the reflux group and the control group (P < 0.05). The compliance rate of ultrasound was 91.7%, while that of gastroscopy was only 18.3% (P < 0.05).

Gastrointestinal filling contrast-enhanced ultrasound technology has a high application value in the clinical diagnosis of acid reflux and belching patients, which can greatly improve the accuracy of the diagnosis of stomach diseases and contribute to the early screening of gastric cancer patients.

To explore the effect of establishing "RLN triangle" on RLN exposure in transaxillary approach endoscopic thyroidectomy.

Data of 91 patients with thyroid cancer admitted from December 2021 to October 2022 were retrospectively analyzed, all of whom were treated with axillary approach endoscopic thyroidectomy. The patients were divided into two groups according to different RLN exposure pathways. The observation group (n=48 cases) was exposed in the "RLN triangle" area established in the lower section of the medial wall of the common carotid artery by the lowest approach method. In the control group (n=43 cases), RLN was exposed in the larynx 1.0 cm below the inferior Angle of thyroid cartilage by traditional road approach. SPSS 24.0 statistical software was used to analyze the data. The counting data were represented by [cases (%)], and the comparison between groups was conducted by χ² test. Measurements of perioperative indexes, voice function and swallowing function were expressed as(), and independent sample t test was performed for inter-group comparison. P<0.05 was statistically significant.

The indexes of operation time, RLN exposure time, intraoperative blood loss and postoperative drainage volume in observation group were better than those in control group (P<0.05). The voice disturbance index and swallowing disturbance index in the observation group were significantly lower than those in the control group (P<0.05). There was no significant difference in voice disorder index and swallowing disorder index between the two groups 6 months after operation (P>0.05). There was no significant difference in the total incidence of surgical complications between the two groups (P>0.05).

The use of the lowest approach method in axillary endoscopic thyroidectomy can significantly shorten the exposure time and surgical time of RLN, reduce intraoperative bleeding, and alleviate postoperative vocal and swallowing dysfunction, which is more conducive to RLN protection.

Exploring the feasibility of using endoscopic thyroidectomy via oral vestibular approach (TOETVA) without placement of drainage in patients with stage cT_1-2N₀ papillary thyroid carcinoma (PTMC).

A prospective study was conducted on 86 cT_1-2N₀ stage PTMC patients who visited from January 2020 to May 2023. The patients were randomly divided into two groups using a random number table method, with 43 patients in each group. All patients received TOETVA treatment. Group A did not place drainage after TOETVA surgery, while Group B placed drainage. Use SPSS 22.0 software for analysis, use () to represent perioperative related indicators and other quantitative data, and perform independent sample t test for inter group comparison; Using [examples (%)] to represent postoperative complications and other counting data χ² Inspection. P<0.05 indicates a statistically significant difference.

Compared with group B, the thyroid bed fluid volume and postoperative satisfaction score of group A patients were significantly increased, and postoperative hospitalization time, cost and Visual Analogue Scale (Visual Analogue Scale, visual analogue scale, visual analogue scale) were significantly increased. VAS score and sleep quality on the day of operation decreased significantly with the Pittsburgh Sleep quality index (PSQI) score, and the difference was statistically significant between the three groups (P<0.05). There was no significant difference in other indexes between the two groups (P>0.05).

It is safe and feasible for cT_1-2N₀ PTMC patients to not place drainage after TOETVA, without increasing the risk of postoperative complications, reducing hospitalization time and costs, and ensuring clinical safety and effectiveness.

To analyze the effects of systemic inflammatory response index (SII) on complications and prognosis after neoadjuvant therapy (nCRT) + laparoscopic radical gastrectomy for locally advanced gastric cancer.

The data of 103 patients who underwent nCRT+ laparoscopic radical gastrectomy from January 2018 to December 2020 were retrospectively analyzed, and according to the median preoperative SII, they were divided into high SII group (≥551.9, n=55) and high SII group (<551.9, n=48). SPSS 21.0 was used to complete the data analysis. χ² test was used to compare the count data of complications, rank sum test was used to compare the grade of edema and fibrosis. Measurement data such as perioperative indexes were expressed as (), and independent sample t test was used. Kaplan-Meier survival function was used to analyze the prognosis of patients in different SII groups. P<0.05 was considered statistically significant.

Operation time, gastric/esophago-jejunal Roux-Y anastomosis time and postoperative hospitalization time in high SII group were significantly longer than those in low SII group, and the differences were statistically significant (P<0.05). There were statistically significant differences in the grade of edema and fibrosis in stomach, perigastric lymph nodes and surrounding intestinal duct between the two groups (P<0.05). There was no significant difference in the total incidence of postoperative complications between the two groups (16.4% vs. 8.3%) (P>0.05). However, the proportion of Clavien-Dindo grade Ⅲ patients with complications in the high SII group was significantly higher than that in the low SII group, and the difference was statistically significant (P<0.05). The cumulative OS and DFS in the high SII group were significantly lower than those in the low SII group (Log-rank χ²=4.790, 3.986, P=0.032, 0.044).

After neoadjuvant therapy, patients with higher SII before laparoscopic radical gastrectomy for gastric cancer had more severe edema and fibrosis in the stomach, perigastric lymph nodes and surrounding intestinal duct, which increased the difficulty of surgery and anastomosis, prolonged the operation time, and resulted in higher grade of postoperative complications and worse prognosis.

To investigate the feasibility, safety and effectiveness of laparoscopic splenectomy by tunnel.

The clinical data of 48 patients who underwent laparoscopic splenectomy from January 2022 to December 2022 by the same surgical team were retrospectively analyzed and divided into group A (tunnel laparoscopic splenectomy, n=23) and group B (conventional laparoscopic splenectomy, n=25) according to the method of splenic pedicle amputation. SPSS 22.0 statistical software was used for data analysis. Measurement data such as perioperative indicators of patients were represented by (). Independent sample t test was used for comparison between groups. The χ² test was used to compare the number of postoperative complications among different data groups. P<0.05 was considered statistically significant.

All patients in group A successfully completed the tunnel laparoscopic splenectomy, and no conversion to laparotomy cases. In group B, 23 patients underwent laparoscopic splenectomy and 2 patients underwent laparotomy. Operation time, postoperative hospital stay and intraoperative blood loss in group A were less than those in group B, and the differences were statistically significant (P<0.05). There was no significant difference in the number of postoperative pancreatic fistula, venous thrombosis, hemorrhage and death between the two groups (P>0.05).

Tunnel laparoscopic splenectomy is feasible, safe and effective.

To analyze the clinical features of patients with pathological papillary discharge (PND) and explore the risk factors of intraductal cancer.

The clinical data of 168 patients with PND from January 2020 to August 2023 were retrospectively analyzed. According to the nature of the discharge, the patients were divided into hemorrhagic discharge group (n=71 cases) and non-hemorrhagic discharge group (n=97 cases). According to the pathological results, the patients were divided into benign lesion group (n=155 cases) and malignant lesion group (n=13 cases). SPSS 19.0 software was used to analyze the data. Measurement data were represented by () and independent sample t test was performed. Counting data are represented by [cases (%)] and χ² test is adopted. Multivariate Logistic regression model was used to investigate the independent risk factors for intraductal carcinoma of PND. P<0.05 was considered statistically significant.

PND patients were mostly single-pore, unilateral, hemorrhagic discharge (serous discharge followed), and 13 cases (7.7%) were confirmed as malignant lesions. There were significant differences in the presence of breast mass, microscopic positive indication, postoperative pathological diagnosis and imaging BI-RADS classification between hemorrhagic and non-hemorrhagic discharge groups (P<0.05). Age, bleeding fluid discharge, surface hyperemia, breast mass, tumor size, imaging BI-RADS grade and molybdenum malignant calcification signs were independent risk factors for intraductal carcinoma of PND (P<0.05).

PND patients with unilateral, single-pore discharge, age >50 years, hemorrhagic discharge, breast mass >1 cm, hyperemia on the surface of the ductoperioscopic mass, BI-RADS grade ≥4, and molybdenum target malignant calcification signs have a higher risk of intraductal cancer, and the possibility of early malignant lesions should be vigilant.

To explore the role of biological patch pelvic floor repair and direct suture in pelvic floor reconstruction in patients with low rectal cancer.

Ninety patients with low rectal cancer treated in our hospital from June 2020 to June 2023 were selected as the study objects. All patients received laparoscopic perineal combined radical resection of rectal cancer (ARP), and were divided into biological mesh group (n=45) and direct suture group (n=45) according to intraoperative pelvic floor reconstruction methods. SPSS 22.0 was used for data analysis. Intraoperative conditions, maximum urine output, maximum urine flow rate and other measurement data were expressed as(), and independent sample t test was performed. The statistical data of postoperative complications were expressed by [cases (%)] and χ² test was performed. P<0.05 indicates statistical difference.

The amount of intraoperative blood loss in the biological patch group was less than that in the direct suture group, and the time of extubation and perineal suture removal were significantly shorter than that in the direct suture group (P<0.05). There was no significant difference in the operative time, hospital stay and postoperative mean maximum urine volume (P>0.05). The incidence of postoperative complications in biological mesh group was significantly lower than that in direct suture group, and the maximum urinary flow velocity was higher than that in direct suture group (P<0.05).

Compared with direct suture pelvic floor repair, the application of biological patch after ARP is more effective in wound healing and complication prevention in patients with low rectal cancer.

To investigate the efficacy of single aperture plus one aperture laparoscopic surgery (SILS+1) versus traditional laparoscopic surgery in the treatment of sigmoid carcinoma.

Data of 86 patients with sigmoid carcinoma from March 2019 to May 2021 were retrospectively analyzed and divided into two groups according to different operation methods. Study group (n= 40, SILS+1 surgery) and control group (n=46, traditional 5-hole laparoscopic surgery). SPSS 19.0 software was used for statistical analysis. Measurement data such as perioperative indicators, pathological differences of postoperative specimens and inflammatory indicators before and after surgery were expressed with (). Independent sample t test was used for comparison between groups.

The total incision length, first time of getting out of bed, first defecation time and postoperative hospitalization time in the study group were better than those in the control group (P < 0.05). There was no difference in the pathological status of postoperative specimens between the two groups (P > 0.05). C-reactive protein and tumor necrosis factor α were increased in all patients after operation, but the increases were more significant in control group (P < 0.05). One year after surgery, there was no difference in overall survival rate and recurrence rate between the two groups (P > 0.05).

Single-hole plus one-hole laparoscopic surgery can not only achieve the same radical curative effect as traditional laparoscopic surgery, but also reduce the inflammatory response of the body, thus speeding up the recovery of patients, and does not affect the prognosis of patients, which is worthy of clinical promotion and application.

To analyze the clinical value of submesenteric artery (IMA) classification in laparoscopic low anterior rectal resection.

A total of 107 patients who underwent laparoscopic low anterior rectal resection from May 2019 to May 2022 were retrospectively selected. IMA was divided into type Ⅰ group (n=43), type Ⅱ group (n=24), type Ⅲ group (n=28) and type Ⅳ group (n=12) according to the results of preoperative three-dimensional vascular reconstruction by Murono classification method. SPSS 22.0 was used to analyze the data. Count data such as complications were represented by [cases (%)], χ² test or Fisher exact probability method were used for multi-group comparison, and non-parametric rank sum test was used for rank count data. Measurement data such as perioperative indexes were expressed with (), and t test was used for comparison among multiple groups. P<0.05 was considered statistically significant.

There was no significant difference in LIMA and DIMA among IMA subtypes (P>0.05). In 107 patients, low IMA ligation was performed in type Ⅰ, type Ⅱ and type Ⅲ, and high IMA ligation was performed in type Ⅳ. The first postoperative exhaust time of group Ⅳ was significantly longer than that of group Ⅰ, type Ⅱ and type Ⅲ (P<0.05). The incidence of anastomotic leakage, defecation difficulty and the total incidence of complications in group Ⅳ were significantly higher than those in group Ⅰ to Ⅲ (P<0.05).

Preoperative three-dimensional vascular reconstruction was performed to understand IMA classification and determine the distance between IMA and left colic artery (LCA) and abdominal aorta, so as to select the most appropriate IMA ligation method, reduce the risk of collateral damage caused by blind surgery, and achieve the purpose of accurately preserving LCA, which has a positive effect on promoting the recovery of intestinal function in patients and reducing the incidence of anastomotic leakage.

The cases of congenital malrotation of the intestine in a single center for 10 years were retrospectively analyzed and the experience was summarized.

The clinical data of 155 children with congenital malrotation treated by operation from January 2012 to February 2022 were retrospectively analyzed. According to different surgical methods, they were divided into laparoscopic group (n=60) and open group (n=95). The laparoscopic group was divided into 6 stages according to the sequence of operation time (group A to group F, with an average of 10 cases in each group). SPSS 23.0 was used for statistical analysis. Measurement data such as perioperative indicators were expressed as () and independent sample t test was used. Postoperative complications were represented by [cases (%)] and χ² test was used. P<0.05 was considered statistically significant.

The operation time of laparoscopic group was longer than that of laparotomy group, the intraoperative bleeding was more than that of laparotomy group, and the total hospital stay was shorter than that of laparotomy group (P < 0.05). There was no significant difference in postoperative recurrence of intestinal torsion, adhesive intestinal obstruction and incision infection between the two groups (P > 0.05). The learning curve of laparoscopic operation time was plotted, and it was found that after 20 cases of operation, the operation time changed from the learning period to the proficiency period.

Laparoscopic surgery for malrotation can reduce the length of hospital stay, but the operation time is longer, the learning curve of laparoscopic malrotation reduction is about 20 cases, and it is safe and feasible to perform this procedure by an experienced team.

Combined debridement with three and two mirrors in the treatment of infected necrotizing pancreatitis.

A total of 181 patients with necrotizing pancreatitis admitted to hospital from January 2018 to January 2023 were prospectively selected as the study objects, and the patients were divided into a three-lens combined group (n=91 cases) and a two-lens combined group (n=90 cases) by random number table method. Laparoscopic + choledochoscope + gastroscope debridement was performed in the three-mirror group, and laparoscopic + choledochoscope debridement was performed in the two-mirror group. SPSS 27.0 software was used to analyze the data. Measurement data such as perioperative indicators were described by () and independent sample t test was used. The statistical data of postoperative complication rate and recurrence rate were expressed by [cases (%)] and χ² test was used. P < 0.05 was considered statistically significant.

The length of hospital stay and blood loss in the three-lens combined group were significantly less than those in the two-lens combined group, and the difference was statistically significant (P < 0.05). However, there was no significant difference in hospitalization costs between the two groups (P > 0.05). The conversion rate of patients in the three-lens combination group was significantly lower than that in the two-lens combination group, and the difference was statistically significant (P < 0.05). The incidence of postoperative complications in the three-lens combined group was significantly lower than that in the two-lens combined group, and the difference was statistically significant (P < 0.05). After 6 months of follow-up, the recurrence rate of patients in the three-lens combined group was significantly lower than that in the two-lens combined group, with statistical significance (P < 0.05).

Compared with laparoscopic choledochoscopic debridement, laparoscopic, choledochoscopic debridement can shorten the length of hospital stay, reduce the amount of blood loss, the conversion rate of laparotomy, and reduce postoperative complications and recurrence.