In 2025, the Chinese Medical Association will celebrate its 110th anniversary. Since its establishment by medical pioneers in Shanghai on February 5, 1915, as the most influential academic organization in the Chinese medical community, the Chinese Medical Association has always taken the lead in promoting the high-quality development of China’s medical industry. Over the course of a century, it has created a glorious chapter of medical inheritance and innovation. In this historical context, Chinese Journal of Operative Procedures of General Surgery (Electronic Edition) is a core academic carrier under the Chinese Medical Association's journal lineup, affiliated with China Medical Electronic Audio-Visual Publishing House. After 18 years of cultivation, it has progressed from the initial digital exploration as a foundation, to the expansion and enhancement of academic influence during its growth period, and to the deepening of digital transformation and improvement of academic content in its current development stage. It has become a benchmark platform for digital dissemination of academic exchanges in general surgery in the new era, injecting strong impetus into the promotion of the discipline’s development.

Over the past 20 years, laparoscopic pancreatic surgery has developed rapidly in China, with laparoscopic pancreaticoduodenectomy (LPD) as a representative procedure, ranking among the world’s leading positions in terms of surgical volume, resection rates, safety, and efficacy. However, the application of LPD in the surgical treatment of pancreatic head cancer still faces certain controversies regarding safety, short-term and long-term oncological outcomes, and learning curves. At the technical level, there are also various opinionss on aspects such as surgical approach, pancreaticojejunostomy, and the triangle dissection. This article summarizes the current status of laparoscopic surgical treatment for pancreatic head cancer in China and, combined with our own experience, explores related issues to provides perspectives on the development of minimally invasive pancreatic surgery in China.

In recent years, laparoscopic pancreaticoduodenectomy (LPD) for pancreatic head cancer has developed rapidly in China. However, pancreatic head cancer is characterized by easy invasion of surrounding vascular nerve plexus, high propensity for lymphatic metastasis, and frequent association with chronic pancreatitis. Additionally, the evolution of treatment concepts and the increase in surgical cases following neoadjuvant/conversion therapy have posed numerous challenges to the implementation of LPD. Rapidly overcoming the learning curve, defining a reasonable radical resection margin, and performing simple, efficient, and safe pancreaticojejunostomy are crucial for ensuring surgical safety and ultimately benefiting patients. Standardized training and quality control will further promote the popularization and development of LPD, thereby improving patient outcomes.

In addition to hematogenous and lymphatic metastasis, pancreatic head cancer is highly prone to nerve invasion, and even invasion of the portal vein or superior mesenteric vein. Standard pancreaticoduodenectomy cannot achieve the dissection of the peripancreatic nerve plexus. At present, there is no unified standard for the surgical indications and dissection range of extended dissection combined with peripancreatic nerve plexus for pancreatic head cancer. Our center has performed extended dissection pancreaticoduodenectomy for the treatment of pancreatic head cancer for more than 10 years. The operation requires 360° complete skeletal dissection around the posterior pancreatic head, superior mesenteric artery, celiac trunk, and common hepatic artery. In recent years, laparoscopic pancreaticoduodenectomy has developed rapidly. In our center, laparoscopic radical pancreaticoduodenectomy for pancreatic head cancer follows the standards of open extended dissection, using the superior mesenteric artery first approach. The inferior pancreaticoduodenal artery is preferentially ligated and transected to cut off the arterial blood supply to the pancreatic head, and then portal vein or superior mesenteric vein resection and reconstruction are performed, which can shorten the venous occlusion time.

To explore the application effect of modified pancreatic duct-jejunum bridge-type internal drainage in laparoscopic pancreaticoduodenectomy (LPD).

This study adopted a prospective design, enrolling 95 patients who underwent LPD from January 2021 to May 2023. Patients were divided into two groups using a random number table: 48 cases in the modified group received modified pancreatic duct-jejunum bridge-type internal drainage, and 47 cases in the control group underwent traditional pancreatic duct-jejunum mucosa anastomosis (including internal drainage). Measurement data such as intraoperative blood loss, operation time, and hospital stay were expressed as (±s), and compared between groups using independent sample t tests. Ranked data or enumeration data (e.g., total incidence of postoperative complications, Clavien-Dindo complication grading) were expressed as rates, and compared using the Rank Sum test or χ² test. Survival analysis curves were drawn by Kaplan-Meier, and survival differences between groups were compared by Log-Rank test.

There were no significant differences in intraoperative blood transfusion volume or hospitalization costs between the two groups (P>0.05). The cumulative overall survival rates showed no significant difference between the modified group and the control group (100.0% vs. 95.7%, Log-Rank χ²=1.887, P>0.05). Compared with the control group, the modified group had less intraoperative blood loss, shorter operation time, drainage tube indwelling time, anastomosis time, and hospital stay, as well as lower amylase levels in drainage fluid on the 1st postoperative day (all P<0.05). The total incidence of postoperative complications and Clavien-Dindo gradeⅠ-Ⅲcomplications in the modified group were lower than those in the control group (4.2% vs. 27.7%, P<0.05). The incidence of B/C-grade CR-POPF in the modified group was 2.1% (1/48), significantly lower than 17.0% (8/47) in the control group (P<0.05).

In LPD, modified pancreatic duct-jejunum bridge-type internal drainage optimizes anastomosis operations, shortens operation, anastomosis, and hospital stay durations, reduces intraoperative bleeding, and has a lower risk of postoperative complications. It is safer and more efficient than traditional pancreatic duct-jejunum mucosa anastomosis (including internal drainage).

To compare the clinical effects of modified double purse-string pancreaticojejunostomy and greater omentum-wrapped pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy (LPD).

A prospective analysis was performed on the clinical data of 86 patients who underwent LPD from April 2020 to December 2023. According to the random number table method, the patients were divided into a control group (receiving modified double purse-string pancreaticojejunostomy) and an observation group (receiving greater omentum-wrapped pancreaticojejunostomy), with 43 patients in each group. Data were processed using SPSS 27.0 statistical software. Measurement data such as intraoperative blood loss and drainage time were expressed as (±s) and analyzed by independent sample t test; enumeration data such as the total incidence of postoperative complications and pathological types were expressed as [cases (%)] and analyzed by χ² test; ordinal data such as Clavien-Dindo classification were expressed as frequencies and analyzed by Rank Sum test. P<0.05 was considered statistically significant.

There were no significant differences between the two groups in intraoperative blood loss, drainage time, exhaust time, hospital stay, hospitalization cost, total incidence of postoperative complications, or Clavien-Dindo complication classification (P>0.05). The pancreaticojejunostomy time and operation time in the observation group were shorter than those in the control group (P<0.05). There was no significant difference in the 2-year overall survival rate between the two groups (P>0.05).

In laparoscopic pancreaticoduodenectomy, compared with the modified double purse-string pancreaticojejunostomy, the greater omentum-wrapped pancreaticojejunostomy has shorter pancreaticojejunostomy and operation times, and is equally safe and effective.

This study aimed to explore the expression of BRAF-activated non-protein coding RNA (BANCR) in pancreatic cancer tissues and blood, and evaluate its potential as a biomarker for lymph node metastasis and prognosis.

Clinical data of 68 patients with pancreatic cancer who underwent radical surgery were retrospectively analyzed. Real-time fluorescent quantitative polymerase chain reaction (qRT-PCR) was used to detect BANCR expression levels in paired tumor tissues, adjacent normal pancreatic tissues, and serum samples. Microlymphatic vessel density (MLVD) in tumor tissues was evaluated by immunofluorescence. Paired sample t test was used for statistical analysis to compare differences between pancreatic cancer tissues and adjacent tissues, independent sample t test for differences between LNM(+) and LNM(-) groups, Spearman correlation analysis to assess the correlation between BANCR and MLVD, ROC curve analysis for diagnostic efficacy, and Kaplan-Meier method for survival analysis.

BANCR expression in tumor tissues was significantly higher than that in adjacent normal tissues, and was positively correlated with lymph node metastasis. Peripheral blood BANCR levels were significantly elevated in patients with lymph node metastasis. Preoperative high expression of peripheral blood BANCR showed stronger predictive efficacy for poor prognosis than CA199.

Peripheral blood BANCR expression in pancreatic cancer patients with lymph node metastasis is significantly higher than that in patients without metastasis, suggesting that BANCR may serve as a novel biomarker for predicting lymph node metastasis and evaluating prognosis in pancreatic cancer.

To construct an individualized chemotherapy response scoring system using artificial intelligence technology to provide decision support for precision treatment of gastric cancer patients.

A retrospective analysis was performed on 11 478 patients diagnosed with gastric cancer and treated with radical surgery in the SEER database between 2000 and 2021. The DeepSurv neural network model was used to integrate the clinicopathological characteristics of patients and establish a prognostic prediction model. Survival analysis was applied to evaluate the predictive performance of the model, and a permutation-based method was used to quantify the importance of each input feature for the model’s predictive results.

Patients with high model risk scores showed significantly better prognosis than those with low scores (HR=6.19, 95% CI: 5.83-6.58, Log-Rank P<0.01). The patient group following the model’s chemotherapy recommendations (n=7 367) had significantly better prognosis than those not following the recommendations (n=4 111) (HR=0.46, 95% CI: 0.44-0.49, Log-Rank P<0.01). Variable importance analysis showed that the proportion of positive lymph nodes, T stage, and age were the three most important factors affecting prognosis and chemotherapy recommendations. The proportion of chemotherapy recommended by the model increased with the progression of tumor stage, while it also increased with patient age.

The DeepSurv model constructed based on the SEER database can not only accurately predict the prognosis of gastric cancer patients but also provide valuable guidance for precision chemotherapy decision-making.

To explore the effect of real-scene teaching based on tracer imaging technology on the standardized training of gastrointestinal surgery.

Three-dimensional (3D) CT was used to construct real preoperative vascular imaging scenarios, tracer navigation was applied for real intraoperative scene teaching during surgery observation, and fresh specimens were utilized for real postoperative lymph node identification training. Sixty trainees undergoing standardized training in gastrointestinal surgery were selected and evaluated using a self-controlled before-after comparison method. Paired t tests were used to compare the score differences in theoretical knowledge, 3D gastric CT interpretation, key node interpretation of surgical videos, and postoperative specimen identification ability before and after training.

The average scores of the four abilities before training were (18.5±2.4), (17.1±2.6), (17.6±3.2), and (18.7±2.6), respectively. After training, the scores were (21.2±2.0), (18.6±2.0), (19.7±2.3), and (19.9±1.7), respectively, with statistically significant differences in all items (all P<0.05).

Real-scene teaching based on tracer imaging can effectively improve the teaching effect in standardized training of gastrointestinal surgery.

To investigate the clinical effect of totally laparoscopic distal gastrectomy (TLDG) in the treatment of locally advanced gastric cancer (LAGC).

A retrospective analysis was performed on the clinical data of LAGC patients from May 2021 to May 2023. Patients were divided into the TLDG group and the laparoscopic-assisted distal gastrectomy (LADG) group according to different surgical methods. Propensity score matching was used for 1:1 matching based on general data, with 60 patients enrolled in each group. Data were analyzed using SPSS 25.0 software. Measurement data such as perioperative indicators were expressed as (±s), and independent sample or paired sample t tests were used; enumeration data such as differentiation degree were expressed as (cases), and χ² test was applied; survival analysis was performed by Kaplan-Meier method with Log-Rank test. P<0.05 was considered statistically significant.

The TLDG group had less intraoperative blood loss and shorter incision length than the LADG group (P<0.05). The time to postoperative anal exhaust, feeding, ambulation, postoperative analgesic use, and hospital stay in the TLDG group were all shorter than those in the LADG group (P<0.05). The drainage tube removal time in the TLDG group was earlier than that in the LADG group, and the postoperative drainage volume was smaller (P<0.05). One day after surgery, the serum levels of IL-6, CRP, and WBC in both groups increased compared with those before surgery, but were lower in the TLDG group than in the LADG group (P<0.05). There was no significant difference in 1-year survival rate between the two groups (P>0.05).

TLDG shows good efficacy in the treatment of LAGC patients, with less intraoperative blood loss, shorter incision length, milder postoperative inflammatory response, and less drainage volume. It can shorten the postoperative recovery time, analgesic use time, and drainage tube removal time.

To compare the clinical effects of laparoscopic-assisted radical distal gastrectomy via different approaches in the treatment of advanced distal gastric cancer.

The clinical data of 92 patients with advanced distal gastric cancer who underwent laparoscopic-assisted radical distal gastrectomy from April 2020 to April 2023 were retrospectively collected. According to different surgical approaches, they were divided into the right-sided group (n=47) and the left-sided group (n=45). SPSS25.0 statistical software was used for data analysis. Measurement data such as clinical data were described by (±s), and t test was performed; enumeration data such as gender were described by [cases (%)], and chi-square test was performed. The Kaplan-Meier curve was used to analyze the survival of patients 12 months after operation.

the operation time of the right-sided group was shorter than that of the left-sided group, and the number of lymph nodes dissected was more than that of the left-sided group (P<0.05); there was no significant difference in postoperative exhaust, out-of-bed activity, and hospital stay between the two groups (P>0.05). The tests of group, time point, and interaction effect between group and time point of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) in the two groups were statistically significant (P<0.05); CRP, TNF-α, and IL-6 in the right-sided group were lower than those in the left-sided group at 3 days and 7 days after operation (P<0.05). The levels of carcinoembryonic antigen (CEA), carbohydrate antigen 199 (CA199), and CA125 in the two groups were lower than those before operation at 1 week after operation, but there was no significant difference between the groups (P>0.05). There was no significant difference in the survival of the two groups (P>0.05).

The left-sided approach and the right-sided approach can achieve comparable survival at 12 months after operation, but compared with the left-sided approach, the right-sided approach can increase the number of lymph nodes dissected in laparoscopic-assisted radical distal resection, shorten the operation time, and reduce the degree of perioperative inflammatory response.

To compare the short-term clinical outcomes of totally laparoscopic proximal gastrectomy with double-channel anastomosis and total gastrectomy with Roux-en-Y anastomosis, and to explore the application effect of double-channel anastomotic reconstruction in the treatment of advanced Siewert typeⅡandⅢesophagogastric junction cancer (AEG).

The clinical data of 100 patients who underwent gastradenocarcinoma surgery were retrospectively analyzed. Propensity score matching (PSM) was performed using the 1:1 nearest neighbor matching method, and they were divided into the PG group (n=26) and the TG group (n=26) according to different resection scopes and anastomotic methods. R language software was used for data analysis. For measurement data, t test and Rank Sum test were used for intergroup comparison according to whether they conformed to normal distribution, and χ² test or Fisher’s exact probability method was used for intergroup comparison of categorical variables. Matching was performed by the 1:1 nearest neighbor matching method, and the caliper value was 0.25. P<0.05 was considered statistically significant.

Before PSM, there were statistically significant differences in age and antegrade/retrograde peristaltic anastomosis between the two groups (P<0.05). After PSM, 52 cases were successfully paired, 26 cases in each of the PG group and the TG group. There were no statistically significant differences between the two groups in intraoperative blood loss, time to first postoperative exhaust, T/N staging, intraoperative and postoperative complications, and nutritional indicators such as hemoglobin (Hb) and serum albumin (ALB) levels on the 1st, 3rd, 5th, 7th day and 1 month after surgery. The total number of lymph nodes dissected in the PG group was less than that in the TG group, (42.7±17.8) and (60.7±37.2), respectively, and the difference was statistically significant (P=0.032), but there was no statistically significant difference in the number of positive lymph nodes between the two groups (P>0.05).

Proximal gastrectomy for patients with advanced Siewert typeⅡandⅢAEG is safe and feasible in terms of oncology. Double-channel reconstruction after proximal gastrectomy is not inferior to total gastrectomy reconstruction in terms of postoperative nutritional status and quality of life.

To investigate the clinical significance of total mesorectal excision (TME) with preservation of Denonvilliers’ fascia guided by Wei’s line.

A retrospective analysis was performed on the clinical data of 60 male patients with mid-low rectal cancer from April 2022 to May 2023. The patients were divided into the observation group (n=30, receiving laparoscopic TME with preservation of Denonvilliers’ fascia guided by Wei’s line) and the traditional group (n=30, receiving traditional laparoscopic TME) according to different surgical protocols. Data were processed using SPSS 22.0 statistical software. Measurement data conforming to normal distribution (such as operation time and intraoperative blood loss) were expressed as (±s), and independent sample t tests were used; enumeration data (such as postoperative complications) were expressed as [cases (%)], and χ² test or Fisher’s exact probability method was applied. P<0.05 was considered statistically significant.

The operation time of the observation group was significantly longer than that of the traditional group, the intraoperative blood loss was significantly less, and the time to first anal exhaust and ambulation after surgery were significantly shorter (P<0.05). The total incidence of postoperative complications in the observation group was lower than that in the traditional group (6.7% vs. 16.7%), but the difference was not statistically significant (P>0.05). The free urinary flow rate and urine volume of both groups significantly decreased, and residual urine volume significantly increased compared with those before treatment (P<0.05), and the degree of decline in the observation group was less than that in the traditional group (P<0.05). The incidence rates of erectile dysfunction and ejaculatory dysfunction at 12 months after surgery in the observation group were significantly lower than those in the traditional group (P<0.05).

Laparoscopic TME with preservation of Denonvilliers’ fascia guided by Wei’s line for male patients with mid-low rectal cancer has a low total incidence of complications, can significantly reduce the impact on male urological and sexual functions, and promote early rehabilitation of patients.

To investigate the effect of conformal sphincter-preserving operation (CSPO) on postoperative anal function in patients with low rectal cancer.

Clinical data of 200 patients with low rectal cancer admitted to the hospital from January 2020 to September 2023 were retrospectively collected. According to different laparoscopic procedures, they were divided into group A (n=67, underwent conformal sphincter-preserving operation), group B (n=83, underwent intersphincteric resection), and group C (n=50, underwent modified Bacon procedure). SPSS 24.0 software was used for data processing. Measurement data such as perioperative indicators and quality of life scores were expressed as (±s), and multiple group comparisons were performed using F test. Enumeration data such as the incidence of anastomotic leakage and anastomotic stricture were expressed as [cases (%)], and intergroup comparisons were performed using chi-square test. Ranked data were expressed as the number of cases, and rank-sum test was used. Kaplan-Meier method was used to draw the disease-free survival curve at 12 months after surgery, and Log-Rank test was performed. The test level was α=0.05.

All patients had no conversion to open surgery and underwent R0 resection. There were no statistically significant differences in the number of lymph nodes dissected and Clavien-Dindo grade of postoperative complications among the three groups (P>0.05). The operation time, exhaust time, ambulation time, and hospital stay in group A were shorter than those in groups B and C (P<0.05). The intraoperative blood loss in group C was less than that in groups A and B (P<0.05). The incidence of anastomotic stricture in group B was significantly higher than that in groups A and C (P<0.05). The incidence of anastomotic leakage in group C was significantly higher than that in groups A and B (P<0.05). Before surgery, there was no statistically significant difference in quality of life scores among the three groups (P>0.05). At 12 months after surgery, the functional domain scores of the three groups were higher than those before surgery, and the symptom domain scores decreased, but the improvement in groups A and C was better than that in group B (P<0.05). There was no statistically significant difference in disease-free survival (DFS) among groups A, B, and C at 12 months after surgery (P>0.05).

CSPO can not only significantly improve the postoperative anal function and long-term quality of life of patients with low rectal cancer, shorten the operation time, and promote short-term postoperative recovery, but also effectively reduce the incidence of anastomotic leakage and anastomotic stricture.

To explore the preventive effect of the Three-Precision Management Plan (TPMP) on stoma complications after colostomy for rectal cancer.

A retrospective analysis was performed on the clinical data of 100 rectal cancer patients with colostomy admitted from January 2021 to June 2024. The patients were divided into an intervention group (n=51, receiving TPMP nursing based on routine care, including preoperative stoma positioning, postoperative standardized nursing procedures, and continuous nursing) and a control group (n=49, receiving routine nursing) according to different nursing methods. Data were processed using SPSS 22.0 software. χ² test was used for univariate analysis of enumeration data, and Logistic regression analysis was performed for multivariate analysis. P<0.05 was considered statistically significant.

Univariate analysis showed that preoperative diabetes mellitus, albumin level <35g/L, BMI ≥25kg/m², and different nursing methods were associated with the incidence of stoma complications (P<0.05). Multivariate analysis indicated that the nursing intervention model and preoperative BMI ≥25kg/m² were independent risk factors for complications (P<0.05). The total incidence of complications in the intervention group was significantly lower than that in the control group, and there was a significant difference in the incidence of dermatitis between the two groups (P=0.008).

TPMP can effectively reduce the incidence of stoma complications. Patients with preoperative BMI ≥25kg/m² should receive more attention and corresponding preventive measures to reduce the risk of postoperative complications, which is worthy of clinical promotion.

To investigate the impact of tumor regression grade (TRG) after neoadjuvant therapy on surgical quality and prognosis in patients with locally advanced rectal cancer (LARC) undergoing total mesorectal excision (TME).

A retrospective analysis was performed on the clinical data of 92 LARC patients who received total neoadjuvant therapy (TNT) plus laparoscopic TME from January 2020 to March 2024. According to the Dowrak/Rödel TRG (5-grade) standard, patients were divided into poor regression group (n=54, ≤50% fibrosis in tumor area, TRG0-TRG2) and good regression group (n=38, >50% fibrosis, TRG3-TRG4). Data were analyzed using SPSS 27.0. Normally distributed measurement data (perioperative indicators, etc.) were expressed as (±s) and compared by independent sample t test; enumeration data were expressed as [cases (%)] and analyzed by χ² test. Survival curves were plotted by Kaplan-Meier method, and survival differences were evaluated by Log-Rank test. P<0.05 was considered statistically significant.

There were no significant differences in operation time, first flatus time, hospital stay, or total complication rate between the two groups (P>0.05). The good regression group had fewer dissected lymph nodes and less intraoperative blood loss than the poor regression group (P<0.05). The 2-year disease-free survival rate was significantly higher in the good regression group than in the poor regression group (94.7% vs. 75.9%, P<0.05), while there was no significant difference in overall survival rate between the two groups (97.4% vs. 94.4%, P>0.05).

In LARC patients receiving laparoscopic TME after TNT, those with tumor regression showing >50% regional fibrosis have less intraoperative blood loss, fewer dissected lymph nodes, and a higher disease-free survival rate.

To observe the impact of prophylactic ileostomy via median incision on postoperative recovery and complication incidence in patients undergoing laparoscopic radical resection of rectal cancer.

A retrospective analysis was performed on the clinical data of patients who underwent laparoscopic radical resection of rectal cancer from June 2022 to June 2024. Patients receiving prophylactic ileostomy via median incision were enrolled in the observation group, and those receiving prophylactic ileostomy via traditional incision were included in the control group. Propensity score matching was used for 1:1 matching of the two groups, with 54 pairs of patients showing no significant baseline differences included in the study. Data were analyzed using SPSS24.0 software. Measurement data were expressed as (±s), and independent sample t tests and paired sample t tests were performed; enumeration data were expressed as percentages, and Fisher’s exact probability test or χ² test was applied; Rank Sum test was used for ordinal data comparison. P<0.05 was considered statistically significant.

The interval between stoma reversal surgeries in the observation group was significantly shorter than that in the control group (P<0.05), but there were no significant differences in reversal surgery time or intraoperative blood loss between the two groups (P>0.05). At 72 hours postoperatively, the visual analog scale (VAS) pain scores in both groups were lower than those at 24 hours postoperatively, and the observation group had significantly lower scores than the control group (P<0.05). At 24 hours postoperatively, serum levels of C-reactive protein (CRP), procalcitonin (PCT), tumor necrosis factor-α (TNF-α), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) increased in both groups, but the observation group had lower serum CRP, PCT, and TNF-α levels than the control group (P<0.05). The total incidence of complications in the observation group was significantly lower than that in the control group (P<0.05).

Prophylactic ileostomy via median incision is more conducive to postoperative recovery, alleviates postoperative pain, and reduces the incidence of postoperative complications compared with ileostomy via traditional incision, with no significant impact on stoma reversal surgery time or intraoperative blood loss. Clinically, the appropriate stoma method should be selected based on patients’ needs and actual conditions.

To analyze the impact of preoperative nutritional support combined with early postoperative enteral nutrition (EN) on the prognosis of patients undergoing rectal cancer surgery.

Rectal cancer patients who underwent surgery from May 2022 to May 2024 were enrolled and divided into three groups using a random number table: Group A (preoperative nutritional support + early postoperative EN), Group B (preoperative nutritional support + early postoperative oral carbohydrate and liquid diet transition), and Group C (routine preoperative preparation + liquid diet transition after postoperative exhaust), with 30 patients in each group. Data were analyzed using SPSS 25.0. Measurement data such as postoperative recovery and nutritional status were described as (±s), and analyzed by One-Way ANOVA with LSD-t test for pairwise comparisons between groups; enumeration data such as gender were described as [cases (%)] and analyzed by χ² test. P<0.05 was considered statistically significant.

The (nutritional intake compliance rate) of Groups A, B, and C was 80.0%, 83.3%, and 76.7%, respectively, with no significant difference among groups (P>0.05). The postoperative hospital stay, first exhaust time, and first defecation time in Group A were shorter than those in Groups B and C, and Group B was shorter than Group C (P<0.05). At 7 days postoperatively, serum total protein (TP), albumin (ALB), and prealbumin (PALB) decreased in all three groups, but Group A had higher levels than Groups B and C, and Group B had higher levels than Group C (P<0.05). At 7 days postoperatively, C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) increased in all three groups, but Group A had lower levels than Groups B and C, and Group B had lower levels than Group C (P<0.05).

Preoperative nutritional support combined with early postoperative EN for rectal cancer surgery patients can improve nutritional status, reduce the degree of inflammatory stress, and facilitate early rehabilitation.

To investigate the application effect of laparoscopic right hemicolectomy with ileocecal preservation (LISH) in hepatic flexure and transverse colon tumors.

A retrospective analysis was performed on the clinical data of 124 patients with hepatic flexure carcinoma and transverse colon tumors who underwent laparoscopic right hemicolectomy from February 2020 to February 2023. The patients were divided into the study group (n=56, receiving LISH) and the control group (n=68, receiving conventional laparoscopic right hemicolectomy) according to the surgical method. Data were analyzed using SPSS 20.0 statistical software. Measurement data (such as perioperative indicators and inflammatory factor levels) were expressed as (±s) and analyzed by independent sample t test; enumeration data (such as complications) were expressed as [cases (%)] and analyzed by χ² test; ordinal data (such as clinical stages) were analyzed by Rank Sum test. P<0.05 was considered statistically significant.

Compared with the control group, the study group had a shorter first exhaust time after surgery (P<0.05). Three days after surgery, the levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and C-reactive protein (CRP) in both groups increased significantly compared with those before surgery, but the levels in the study group were lower than those in the control group (P<0.05). Six months after surgery, the gastrointestinal myoelectric indices and quality of life scores in both groups were higher than those before surgery, and the study group showed higher levels than the control group (P<0.05). There was a statistically significant difference in the incidence of diarrhea between the two groups (P<0.05), while no significant difference was found in the disease-free survival rate (P>0.05).

LISH can promote the recovery of gastrointestinal function, reduce the inflammatory response and diarrhea incidence, and improve the quality of life in patients with hepatic flexure and transverse colon tumors, without affecting their short-term survival.

To observe the impact of different surgical approaches for breast cancer on postoperative complications and rehabilitation outcomes.

A retrospective analysis was performed on 210 breast cancer patients who underwent surgery from March 2021 to March 2023. The patients were divided into a breast-conserving group (n=103, treated with breast-conserving mastectomy) and a modified radical group (n=107, treated with modified radical mastectomy) according to the surgical method. Data were analyzed using SPSS 25.0 software. Measurement data and enumeration data were expressed as (±s) and [cases (%)], respectively, and analyzed by independent sample t test and χ² test. P<0.05 was considered statistically significant.

Compared with the modified radical group, the breast-conserving group had significantly shorter operation time, drainage tube indwelling time, wound healing time, and hospital stay (P<0.05). The total incidence of postoperative complications in the breast-conserving group was lower than that in the modified radical group, while the excellent and good rate of breast cosmetic effect and SF-36 dimension scores were higher (P<0.05). However, there was no significant difference in the follow-up results between the two groups (P>0.05).

Compared with modified radical mastectomy, breast-conserving mastectomy causes less trauma to patients, reduces the risk of postoperative complications, maximally preserves the normal breast shape, and improves the quality of life after surgery. However, there is no significant difference in the one-year prognosis between the two surgical approaches.

To investigate the clinical value of a modified vacuum sealing drainage (VSD) device in axillary drainage after modified radical mastectomy for breast cancer.

A total of 108 patients who underwent modified radical mastectomy for breast cancer from January 2021 to December 2023 were prospectively enrolled. Using a block randomization method, independent statisticians generated random sequences via SPSS 25.0 to allocate patients at a 1:1 ratio into a modified group and a control group, with 54 patients in each group. The modified group received drainage using the modified VSD device, while the control group received drainage using a traditional silicone negative pressure drainage ball. Statistical analysis was performed using SPSS 25.0. Enumeration data such as tumor location were expressed as [cases (%)], and intergroup comparisons were conducted using the χ² test or Fisher’s exact probability method. Measurement data conforming to normal distribution, such as shoulder joint mobility, were described by (±s), and independent sample t tests were used. P<0.05 was considered statistically significant.

The ranges of motion for postoperative shoulder joint flexion, abduction, adduction, and extension in the modified group were significantly better than those in the control group (P<0.05). The extubation time, total drainage volume, and drainage tube blockage rate in the modified group were significantly lower than those in the control group, while the first-class wound healing rate was significantly higher (P<0.05). The total incidence of complications in the modified group (5.6%) was significantly lower than that in the control group (18.5%) (P<0.05).

In the clinical application of axillary drainage after modified radical mastectomy for breast cancer, the modified VSD device has achieved favorable clinical effects. It not only significantly improves shoulder joint mobility and the first-class wound healing rate but also significantly shortens the indwelling catheter days, reduces the total drainage volume, and decreases the drainage tube blockage rate and the total incidence of complications, demonstrating high clinical application value.

To investigate the impact of the ratio of common bile duct (CBD) diameter to the diameter of intrahepatic grade I and II bile ducts on the recurrence of CBD stones.

A retrospective analysis was performed on 51 patients with recurrent CBD stones after surgical treatment from January 2017 to December 2023 (recurrence group), and 100 patients without stone recurrence during the same period were randomly selected as the control group. Data were processed using SPSS 25.0 statistical software. Normally distributed data were expressed as (±s), and independent sample t tests were used for intergroup comparisons; χ² tests were applied to count data. P<0.05 was considered statistically significant.

The ratios of CBD diameter to grade I bile duct diameter (3.5±0.8) and to grade II bile duct diameter (5.5±1.0) in the recurrence group were significantly higher than those in the non-recurrence control group [(1.5±0.2) and (2.2±0.4), respectively] (P<0.05).

A significant increase in the ratios of CBD diameter to intrahepatic grade I and II bile duct diameters (ratios of 3.5 and 5.5, respectively) is one of the key factors affecting stone recurrence.

To explore the application value of cold circulation radiofrequency ablation (RFA) under ultrasound guidance in benign thyroid nodules (BTN).

A total of 96 BTN patients from December 2022 to December 2023 were enrolled and divided into a conventional group and an experimental group by envelope randomization, with 48 patients in each group. The conventional group received open surgery, while the experimental group underwent cold circulation RFA under ultrasound guidance. Data were processed using SPSS 23.0. Measurement data were expressed as (±s) and analyzed by independent sample t test; enumeration data were described as [cases (%)] and analyzed by χ² test. The test level was α=0.05.

Compared with the conventional group, the experimental group had shorter operation and postoperative hospital stay, and less intraoperative blood loss (P<0.05). Visual analog scale (VAS) scores at 12 h and 24 h postoperatively were lower than those at 6 h postoperatively in both groups, and the experimental group showed lower VAS scores than the conventional group at 6 h, 12 h, and 24 h postoperatively (P<0.05). The nodule volume in the experimental group gradually decreased at 6 and 12 months postoperatively compared with that before surgery, and the volume shrinkage rate at 12 months postoperatively was higher than that at 6 months postoperatively (P<0.05). Levels of thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) in the experimental group showed no significant changes at 3, 6, and 12 months postoperatively compared with those before surgery (P>0.05), while the conventional group had increased TSH and decreased FT3/FT4 levels at 3 months postoperatively (P<0.05). The experimental group had lower TSH and higher FT3/FT4 levels than the conventional group at 3 months postoperatively (P<0.05). The total incidence of postoperative complications in the experimental group was lower than that in the conventional group (P<0.05).

Cold circulation RFA under ultrasound guidance for BTN can shorten operation time, alleviate postoperative pain, reduce nodule volume, preserve thyroid function, and decrease postoperative complications.

To explore the impact of transumbilical single-port laparoscopic appendectomy and conventional laparoscopic appendectomy on perioperative indicators and postoperative complications in children with appendicitis.

A retrospective analysis was performed on the clinical data of children with acute appendicitis admitted from September 2021 to December 2024. Confounding factors such as gender, age, and time from onset to surgery were excluded by propensity score matching. Sixty children who underwent conventional laparoscopic appendectomy were set as the control group, and 60 children who underwent transumbilical single-port laparoscopic appendectomy were set as the study group. Data were processed and analyzed using SPSS 23.0 software, with normality tests conducted. Measurement data conforming to normal distribution were expressed as (±s), and independent sample t tests were used for intergroup comparisons; gender and adverse reaction data were expressed as [cases (%)], and χ² tests were performed (Fisher’s exact test was used when the theoretical frequency <5); data not conforming to normal distribution were logarithmically transformed. P<0.05 was considered statistically significant.

Compared with the control group, the study group had longer operation time, but shorter incision length, first exhaust time after surgery, first feeding time after surgery, and first defecation time after surgery (P<0.05). There were no significant differences in intraoperative blood loss, hospital stay, or incidence of postoperative complications between the two groups (P>0.05). Three days after surgery, the levels of procalcitonin (PCT), interleukin-6 (IL-6), and C-reactive protein (CRP) increased in both groups, but were lower in the study group than in the control group (P<0.05). After 2 months of follow-up, the Vancouver Scar Scale (VSS) score of the study group was lower than that of the control group (P<0.05).

Compared with conventional laparoscopic appendectomy, transumbilical single-port laparoscopic appendectomy, despite being more difficult and time-consuming, can effectively reduce surgical trauma, accelerate postoperative intestinal function recovery, alleviate inflammatory response, and demonstrate good safety.

Pancreatic cancer (PC) is a malignant tumor with high malignancy and poor prognosis. Chemoresistance and immune escape caused by the hypoxic and immunosuppressive characteristics of its tumor microenvironment (TME) have become important reasons for the low cure rate. In tumor tissues, lymphocytes aggregate to form organized ectopic lymphoid structures, known as tertiary lymphoid structures (TLSs). TLSs exist in both intratumoral and peritumoral tissues of PC. TLSs play a role through anti-tumor immune responses in various tumors including PC, and are associated with favorable prognosis. Inducing the formation of TLSs can promote tumor antigen presentation, maturation and differentiation of T and B cells, enhance the ability to recognize and kill tumor cells, and improve anti-tumor immune responses. TLSs in PC are related to tumor occurrence and development, long-term prognosis, and good treatment responsiveness, providing new strategies and perspectives for PC therapy. This article reviews the formation of TLSs in PC, their anti-tumor effects, and applications in PC prognosis and treatment, providing a reference for in-depth research on TLSs in PC.

Malignant tumors in the pancreatic head region refer to the malignant cell proliferation originating from the head of the pancreas and its surrounding areas, with an increasing incidence year by year. The most common types are pancreatic ductal adenocarcinoma (PDAC), ampullary carcinoma, and distal bile duct carcinoma. The surgical treatment for malignant tumors in the pancreatic head region is pancreaticoduodenectomy (PD) and its modified procedures. Although surgical techniques have advanced, the long-term survival rate of patients remains low. The prognostic differences and advantages of different surgical approaches are still controversial, and they are affected by the experience of surgeons and the surgical volume of medical centers. The main factors affecting the prognosis of surgical treatment for malignant tumors in the pancreatic head region include the lesion site, tumor size, lymph node metastasis, vascular and nerve invasion, and the status of resection margins. Personalized surgical plans and adjuvant treatment strategies can be formulated based on these factors to improve the survival rate and quality of life of patients. This article reviews the current status of the prognosis of surgical treatment for malignant tumors in the pancreatic head region and related factors, aiming to provide a scientific basis for clinical practice.

Colorectal cancer is a common clinical malignant tumor with high incidence and mortality rates worldwide. Currently, surgery is one of the core treatment modalities for colorectal cancer. Although this approach has certain efficacy, postoperative complications remain poorly controlled. The occurrence of complications after colorectal tumor surgery not only prolongs the treatment and hospitalization duration of patients but also severely affects tumor prognosis and the quality of life of patients. Therefore, predicting and preventing the occurrence of complications after colorectal tumor surgery is of great importance. To ensure the surgical efficacy and improve the prognosis of patients, this study will systematically review the prediction and prevention of postoperative complications in patients with colorectal tumors by integrating the latest clinical research, focusing on three aspects: common complications of colorectal cancer, risk factors and prediction of complications, and prevention strategies.

Laparoscopic radical resection of colorectal cancer faces significant challenges in precise operation and postoperative functional preservation during low rectal cancer sphincter-preserving surgery due to the complex pelvic structure and narrow space. Robotic surgery has demonstrated excellent performance in low sphincter-preserving surgery for rectal cancer and precise operation in complex anatomical areas, with patients showing rapid postoperative recovery and definite efficacy. However, it is still constrained by issues such as high cost and complex operation procedures. Based on this, this paper reviews the research progress on the clinical application of robotic-assisted technology in laparoscopic radical resection of colorectal cancer, discusses its clinical value and challenges in intraoperative performance, postoperative recovery, complication control, and future development trends, aiming to provide references for its standardized promotion and further optimization.