Over the past two decades, China’s metabolic and bariatric surgery field has experienced rapid growth in surgical volume. However, it still faces numerous challenges, including insufficient standardization of surgical techniques, disparities in treatment concepts between medical and surgical approaches, and the emergence of novel weight-loss medications. Moving forward, it is essential to establish a multidisciplinary integrated treatment system, standardize the application of new surgical techniques, improve the national database, and conduct high-quality clinical research. Through specialized development and quality control, the discipline can transition from quantity-driven to quality-driven growth, thereby contributing to the realization of the "Healthy China 2030" strategic goals.

Laparoscopic sleeve gastrectomy is currently the most popularly performed bariatric technique. Focusing on the technical details of sleeve gastrectomy and striving for standardized procedures are essential to ensure surgical quality and prevent complications. Our different techniques, including placement of trocars, mobilization of the stomach, gastric transection, specimen retrieval, and how to prevent postoperative intrathoracic sleeve migration are described. Whether it’s necessary to do a staple line reinforcement in this procedure, preventive measures for postoperative intrathoracic sleeve migration, and the value of robotic or single-port sleeve gastrectomy are further discussed in this article.

Bariatric and metabolic surgery has been widely adopted both domestically and internationally for the treatment of obesity and its-related metabolic disorders, owing to its excellent efficacy in weight loss and metabolic disease remission. However, unlike other surgical procedures, bariatric and metabolic surgery, by removing a large portion of the stomach tissue and/or bypassing part of the small intestine, increases the risk of malnutrition. Malnutrition is a common clinical problem after bariatric and metabolic surgery, thus it is crucial to prevent complications related to malnutrition while achieving effective weight loss and alleviating metabolic diseases. This article reviews the mechanism, incidence, and postoperative management of malnutrition after bariatric and metabolic surgery, with the aim of providing reference for clinical work.

One anastomotic gastric bypass (OAGB) has become an increasingly adopted bariatric and metabolic surgery in recent years. The International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) and the American Society for Metabolic and Bariatric Surgery (ASMBS) now recognize OAGB as a standard bariatric procedure. Similar to Roux-en-Y gastric bypass (RYGB), OAGB aims to reduce weight, control blood glucose levels, and treat insulin resistance trough decreasing the gastrointestinal tract’s uptake and absorption of nutrients. OAGB features a less complex surgical technique and reduced perioperative risks. However, OAGB is associated with difficult-to-manage bile reflux and higher nutritional deficiency risks than RYGB. The key surgical steps of this procedure include: ①Construction of an 18–20cm gastric pouch along the lesser curvature below the incisura angularis, isolating the gastric fundus; ②Measurement of total small bowel length with 30% bypassed as biliopancreatic limb, maintaining ≥400cm common channel; ③Creation of a Billroth Ⅱ gastrojejunal anastomosis with stoma diameter <3.0cm; ④Placement of the anastomosis at the gastric antrum to minimize torsion risk.

Gastroesophageal reflux caused by intrathoracic sleeve migration is a common long-term complication after sleeve gastrectomy. Its essence is the displacement of the lower esophagus or part of the stomach into the mediastinum, leading to symptoms of gastroesophageal reflux, which belongs to type I sliding hiatal hernia. This video introduces our surgical approachs: reducing lower esophagus or part of the stomach back into the abdominal cavity, repairing the esophageal hiatus, followed by posterior gastric wall fixation, phrenoesophageal ligament reconstruction, left diaphragmatic crus-stomach fixation, and anterior gastric wall fixation. The patient’s acid reflux symptoms were immediately relieved after surgery. Four-points fixation can effectively prevent the recurrence of gastroesophageal displacement after the surgery.

To explore the clinical efficacy of laparoscopic radical resection via the right anterior approach versus the left posterior approach in the treatment of locally advanced gastric cancer (LAGC).

A total of 102 patients with LAGC who were scheduled to undergo laparoscopic radical resection in our hospital from February 2023 to May 2024 were prospectively enrolled. They were divided into the right group (undergoing the right anterior approach) and the left group (undergoing the left posterior approach) using a random number table method, with 51 patients in each group. Statistical analysis was performed using SPSS 25.0 software. For measurement data such as perioperative indicators and the number of dissected lymph nodes, the Kolmogorov-Smirnov (K-S) normality test was conducted first, and the data were expressed as (±s). The independent samples t test was used for inter-group comparison, and repeated-measures analysis of variance (ANOVA) was applied for repeated measurement data. Categorical data such as the positive margin rate and the incidence of postoperative complications were expressed as [cases (%)], and were analyzed using the χ² test, continuity-corrected χ² test, or Fisher’s exact test. P<0.05 was considered statistically significant.

There were no statistically significant differences between the two groups in terms of surgical incision length, number of dissected lymph nodes, number of positive lymph nodes, positive margin rate, or incidence of postoperative complications (all P>0.05). Compared with the left group, the right group had shorter operation time, less intraoperative blood loss, and lower Numerical Rating Scale (NRS) scores at all postoperative time points (all P<0.05).

Both laparoscopic radical resection via the right anterior approach and the left posterior approach can achieve favorable outcomes in the treatment of LAGC. However, compared with the left posterior approach, the right anterior approach has potential advantages, including shorter operation time, less intraoperative blood loss, and possibly lower postoperative pain intensity in patients.

To compare the effects of different perioperative blood management measures in single-port laparoscopic sleeve gastrectomy.

The clinical data of 86 patients who underwent single-port laparoscopic sleeve gastrectomy in the Department of Bariatric and Metabolic Surgery, Nanjing Drum Tower Hospital, Nanjing University Medical School from January 2024 to October 2024 were retrospectively analyzed. The patients were divided into the experimental group (n=40 perioperative blood management was implemented, including intravenous iron infusion, etc.) and the control group (n=46, no perioperative blood management was implemented). Data were analyzed using SPSS 27.0 software. Data were expressed as (±s) or [cases (%)]. t test, χ² test or Fisher’s exact probability test were used. P<0.05 was considered statistically significant.

The operation time, postoperative exhaust time, postoperative hemoglobin level decline and intraoperative blood loss in the experimental group were all less than those in the control group (P<0.05); the postoperative D-dimer and fibrinogen levels in the experimental group were higher than those in the control group, but the difference was not statistically significant (P>0.05); the postoperative neutrophil percentage and C-reactive protein level in the experimental group were significantly lower than those in the control group (P<0.05); the incidence of postoperative complications and adverse reactions in the control group was slightly higher than that in the experimental group, but the difference was not statistically significant (P>0.05).

Perioperative blood management measures in single-port laparoscopic sleeve gastrectomy play a crucial role in the prognosis of patients. For patients with preoperative anemia and abnormal coagulation indicators, corresponding blood management measures should be routinely implemented to improve surgical efficacy and patient prognosis.

To explore the application and efficacy of total laparoscopic λ-shaped uncut jejunojejunostomy in digestive tract reconstruction after proximal gastrectomy, and to provide a new option for digestive tract reconstruction following proximal gastrectomy.

A retrospective analysis was conducted on the clinical data of 11 patients who underwent total laparoscopic proximal gastrectomy with digestive tract reconstruction via λ-shaped uncut jejunojejunostomy from October 2023 to April 2024. Their clinical characteristics, perioperative indicators, postoperative outcomes, and follow-up results were analyzed. Gastroscopy, upper gastrointestinal radiography, and nutritional scoring were combined to evaluate postoperative reflux esophagitis and nutritional status of the patients.

All 11 patients successfully underwent the target surgical anastomosis for digestive tract reconstruction. The perioperative indicators were as follows: mean operation time (192.9±36.2) minutes, intraoperative blood loss (104.5±47.2) ml, time to first postoperative flatus (3.5±0.5) days, time to first oral intake (4.5±0.5) days, length of hospital stay (15.3±1.7) days, and the number of lymph nodes dissected was 44. The mean prognostic nutritional index (PNI) was (54.7±6.1) preoperatively, (45.2±6.3) at 1 month postoperatively, (49.7±3.5) at 6 months postoperatively, and (52.8±4.2) at 12 months postoperatively. No early complications occurred in the 11 patients. The total incidence of late complications was 27.2% (3/11): 1 case of esophageal anastomotic stricture, which improved after endoscopic dilation therapy; 1 case of reflux esophagitis (LA-B grade) and 1 case of gastroesophageal reflux symptoms, both of which were relieved after dietary education and drug treatment.

For early adenocarcinoma of the upper one-third of the stomach and Siewert type Ⅱ/Ⅲ adenocarcinoma of the esophagogastric junction with a tumor diameter ≤ 4cm, total laparoscopic proximal gastrectomy combined with digestive tract reconstruction via λ-shaped uncut jejunojejunostomy is technically feasible and safe, with favorable short-term postoperative efficacy. This surgical approach is expected to provide a new option for digestive tract reconstruction after proximal gastrectomy.

To evaluate the application effect of laparoscopic complete mesocolic excision (LCME) via the cranial-caudal-middle approach in the treatment of right-sided colon cancer.

A retrospective analysis was conducted on the clinical data of 110 patients with right-sided colon cancer who underwent LCME from November 2021 to November 2024. According to the surgical approach, patients were divided into the combined approach group (n=49, treated with cranial-caudal-middle approach) and the medial approach group (n=52, treated with medial approach). Data were analyzed using SPSS 27.0 statistical software. Measurement data were described as (±s) and compared by t test; enumeration data were described as [cases (%)] and compared by χ² test. P<0.05 was considered statistically significant.

Compared with the medial approach group, the combined approach group had shorter operation time and less intraoperative blood loss (P<0.05); there were no significant differences in postoperative recovery-related indicators between the two groups (P>0.05); the incidence of complications in the combined approach group was lower than that in the medial approach group (P<0.05).

Compared with the medial approach, LCME via the cranial-caudal-middle approach in the treatment of right-sided colon cancer can shorten operation time, reduce intraoperative blood loss and postoperative complications, and has certain advantages in clinical application. Note: "LCME" (laparoscopic complete mesocolic excision) is the standard international abbreviation for laparoscopic complete mesocolic excision, which emphasizes the complete removal of the colonic mesentery along the embryonic fascia plane, consistent with the surgical principle of "complete mesocolic excision (CME)" for colon cancer. The term accurately reflects the surgical technique described in the study.

To compare the short-and mid-term efficacy of laparoscopic radical resection for right-sided colon cancer via the "Hui" -shaped inferior right approach and the conventional median approach.

Clinical data of 81 patients with right-sided colon cancer who underwent laparoscopic radical resection for colon cancer were collected. According to the surgical approach, the patients were divided into the median approach group (n=40) and the inferior right approach group (n=41). Statistical software SPSS 25.0 was used for data analysis. Measurement data, such as perioperative indicators and gastrointestinal hormones, were expressed as (±s) and analyzed by independent samples t test; count data, including postoperative complications and disease-free survival rate, were analyzed by χ² test. P<0.05 was considered statistically significant.

Compared with the median approach group, the inferior right approach group had less intraoperative blood loss, and shorter operation time and time to first flatus (all P<0.05). After surgery, the serum levels of gastrin (GAS) and motilin (MOT) in both groups were lower than those before surgery, while the levels in the inferior right approach group were higher than those in the median approach group (P<0.05). The total incidence of postoperative complications was 4.9% in the inferior right approach group and 7.5% in the median approach group, with no statistically significant difference between the two groups (P>0.05). The 1-year and 3-year disease-free survival rates were 92.7% vs. 87.5% and 65.9% vs. 60.0% in the inferior right approach group and the median approach group, respectively, and there were no statistically significant differences between the two groups (P>0.05).

Both laparoscopic radical resection via the "Hui" -shaped inferior right approach and the conventional median approach are safe and feasible for the treatment of right-sided colon cancer. However, compared with the latter, the former has lower surgical difficulty, shorter operation time, less intraoperative blood loss, and faster postoperative recovery.

To explore the effect of laparoscopic mesenteric resection via the combined median-caudal approach on inflammatory and stress responses in patients with right-sided colon cancer complicated by intestinal obstruction.

A retrospective analysis was conducted on the clinical data of 138 patients with right-sided colon cancer complicated by intestinal obstruction who were treated from August 2023 to August 2024. According to the different surgical approaches, the patients were divided into a control group and a study group, with 69 cases in each group. Patients in the control group received the traditional cranial-median approach during surgery, while those in the study group received the combined median-caudal approach. Statistical software SPSS 23.0 was used for data analysis. Measurement data were described as(±s) and analyzed by t test; count data were described as percentages (%) and analyzed by χ² test. Surgical indicators, inflammatory factors, stress responses (before and after surgery), and complications were compared between the two groups. P<0.05 was considered statistically significant.

The intraoperative blood loss and operation time of the study group were lower than those of the control group (P<0.05). After surgery, the serum levels of C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), norepinephrine (NE), adrenaline (AD), and cortisol (Cor) in both groups were higher than those before surgery, and the above indicators in the study group were lower than those in the control group (P<0.05). There was no significant difference in the incidence of postoperative adverse complications between the two groups (2.9% vs. 1.4%, P>0.05).

For patients with right-sided colon cancer complicated by intestinal obstruction, laparoscopic mesenteric resection via the combined median-caudal approach can effectively reduce the postoperative inflammatory level and stress response of the body, accelerate the postoperative recovery process of patients, and has high clinical application value.

To explore the clinical efficacy and impact on patient prognosis of laparoscopic common bile duct exploration and stone removal (LCBDE) and endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of common bile duct middle and lower segment stones combined with acute cholangitis.

The clinical data of 113 patients with common bile duct middle and lower segment stones combined with acute cholangitis from January 2023 to December 2024 were retrospectively analyzed. The patients were divided into the LCBDE group (treated with LCBDE) and the ERCP group (treated with ERCP) based on the surgical method. Fifty-four patients were selected from each group using the propensity score matching method. Statistical analysis was performed using SPSS 28.0 software to process the data. The Mann-Whitney U test, χ² or t test were used. P<0.05 was considered statistically significant.

The stone clearance rates in the LCBDE group and the ERCP group were 94.4% and 88.9%, respectively, with no statistically significant difference (P>0.05). The operation time, intraoperative blood loss, postoperative defecation time, recovery activity time and hospital stay of the ERCP group were shorter than those of the LCBDE group (P<0.05). On the 3rd day after surgery, the levels of C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), heparin-binding protein (HBP), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and bilirubin (TBIL) in both groups were lower than those before surgery (P<0.05), but there was no statistically significant difference between the two groups (P>0.05). The total incidence of postoperative complications between the two groups was not statistically significant (P>0.05).

LCBDE and ERCP have comparable efficacy and safety in the treatment of common bile duct middle and lower segment stones combined with acute cholangitis, and ERCP has more advantages in shortening the perioperative period and reducing intraoperative bleeding.

To compare and analyze the clinical efficacy of ERCP sequential surgery versus one-stage surgery in the treatment of hepatic cystic echinococcosis (CE) with biliary rupture.

A total of 28 patients with hepatic CE complicated by biliary rupture, treated from January 2016 to August 2021, were selected. According to the different surgical methods, they were divided into the observation group (ERCP sequential surgery, n=13) and the control group (one-stage surgery, n=15). Inflammatory indicators, liver function, primary lesion management methods, surgical indicators, recurrence rate, and complications were compared between the two groups. Statistical software SPSS 25.0 was used for data analysis. Normality test was first performed on the measurement data: those conforming to normal distribution were expressed as (±s), and independent samples t test was used for inter-group comparison; those not conforming to normal distribution were expressed as median (interquartile range) and analyzed by non-parametric rank-sum test. Chi-square test or exact probability method was used for inter-group comparison of count data. P<0.05 was considered statistically significant.

After treatment, the inflammatory indicators and liver function indicators of both groups improved (P<0.05), but there was no statistically significant difference in these indicators between the two groups (P>0.05). The operation time, intraoperative blood loss, and postoperative extubation time in the observation group were shorter than those in the control group (P<0.05). The recurrence rate in the observation group (7.7%) was lower than that in the control group (20.0%), but the difference was not statistically significant (P>0.05). There was no statistically significant difference in the incidence of complications between the two groups (P>0.05), but the severity of complications in the observation group was milder.

ERCP sequential surgery has significant clinical efficacy. It can effectively control biliary infection, relieve obstruction, and improve patients’ symptoms. It enables patients with severe conditions who cannot tolerate surgery to undergo treatment, effectively reduces surgical risks, and accelerates patient recovery, which is worthy of clinical promotion.

To explore the risk factors for axillary lymph node burden (ALNB) after breast cancer surgery, and to construct and validate a risk prediction model.

A retrospective study was conducted on the clinical data of 363 breast cancer patients treated from January 2020 to December 2023. All patients underwent axillary lymph node dissection (ALND) or sentinel lymph node biopsy (SLNB). According to the postoperative pathological results, the patients were divided into the high nodal burden (HNB) group (≥3 metastatic lymph nodes) and the non-HNB group (≤2 metastatic lymph nodes). Multivariate Logistic regression analysis was used to identify independent risk factors, which were then incorporated into R software to construct a risk nomogram. The Bootstrap method was applied to verify the discriminative ability of the model. Calibration curves and receiver operating characteristic (ROC) curves were plotted to evaluate the goodness of fit and predictive performance of the model.

Compared with the non-HNB group, the HNB group had a higher proportion of patients with tumor size>2 cm, abnormal axillary lymph node ultrasound, pathological TNM stage Ⅲ-Ⅳ, HER-2 overexpression subtype of breast cancer, positive HER-2 expression, nerve invasion, lymphovascular invasion (LVI), and skin infiltration (all P<0.05). In contrast, the proportions of Luminal A subtype and histological grade Ⅰ were lower in the HNB group than in the non-HNB group (both P<0.05). Multivariate Logistic regression analysis showed that tumor size>2 cm, abnormal axillary lymph node ultrasound, clinical stage Ⅲ-Ⅳ, nerve invasion, and lymphovascular invasion (LVI) were independent risk factors for axillary lymph node HNB in patients (all P<0.05). A risk nomogram for axillary lymph node HNB was constructed using the 5 independent risk factors identified by Logistic regression analysis. Internal validation demonstrated a good goodness of fit of the nomogram. The area under the curve (AUC) of the predictive model constructed based on the risk factors for axillary lymph node HNB in breast cancer patients was 0.963 (95%CI: 0.942-0.984), indicating good predictive performance.

The risk prediction model constructed based on axillary lymph node HNB in breast cancer patients has good performance, and provides high clinical value for selecting appropriate axillary lymph node management strategies in breast cancer treatment.

To analyze and compare the clinical efficacy of supraclavicular open thyroidectomy (SOT) and transaxillary gasless endoscopic thyroidectomy (TGET) in the treatment of papillary thyroid microcarcinoma (PTMC).

A single-center retrospective cohort study was conducted, enrolling 160 PTMC patients from January 2023 to 2025. According to the surgical method, patients were divided into the SOT group (n=74 cases, undergoing supraclavicular open thyroidectomy) and the TGET group (n=86 cases, undergoing transaxillary gasless endoscopic thyroidectomy). Data were analyzed using SPSS 26.0 statistical software. Measurement data conforming to a normal distribution were expressed as (±s) and analyzed by independent samples t test or repeated measures analysis of variance. Categorical data were analyzed by χ² test or Fisher’s exact test. P<0.05 was considered statistically significant.

The operation time, postoperative extubation time, and hospital stay in the TGET group were longer than those in the SOT group, and the intraoperative blood loss and postoperative drainage volume were greater in the TGET group than in the SOT group (P<0.05). However, there was no significant difference in the number of dissected central lymph nodes between the two groups (P>0.05). The visual analog scale (VAS) scores at all postoperative time points in the TGET group were lower than those in the SOT group (P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05). At 3 months postoperatively, the Patient and Observer Scar Assessment Scale (POSAS) scores and the symptom domain scores of the Thyroid Cancer-Specific Quality of Life Questionnaire (THYCA-QoL) in the TGET group were lower than those in the SOT group, while the psychological and social function domain scores of THYCA-QoL in the TGET group were higher than those in the SOT group (P<0.05).

TGET and SOT are comparable in terms of tumor radicality and surgical safety in the treatment of PTMC. However, TGET has significant advantages in reducing postoperative pain, improving satisfaction with neck appearance, and enhancing quality of life in patients.

To explore the influencing factors of surgical efficacy in patients with nodular goiter after unilateral thyroid lobectomy, and to provide a theoretical basis for optimizing surgical outcomes and postoperative management.

A total of 98 patients with nodular goiter who underwent unilateral thyroid lobectomy in our hospital from January 2021 to May 2024 were selected. Their clinical data were collected, including age, gender, preoperative thyroid function status, intraoperative pathological results, and postoperative recovery. According to the postoperative recovery, the patients were divided into a good efficacy group and a poor efficacy group. Univariate analysis and multivariate Logistic regression analysis were used to identify the influencing factors of surgical efficacy.

Among the 98 patients, 23 cases (23.5%) had poor postoperative efficacy. Univariate analysis showed that age, nodule type, maximum nodule diameter, preoperative thyroid-stimulating hormone (TSH) level, and positive preoperative thyroid peroxidase antibody (TPOAB) were significantly correlated with surgical efficacy (P<0.05). Multivariate Logistic regression analysis revealed that patients with the following characteristics had relatively poor surgical efficacy: age≥60 years (OR=14.578, P=0.003, 95%CI: 2.453-86.619), solid nodules (OR=7.600, P=0.037, 95%CI: 1.129-51.150), maximum nodule diameter≥3 cm (OR=7.621, P=0.027, 95%CI: 1.262-46.025), abnormal preoperative TSH level (OR=3.906, P=0.001, 95%CI: 1.798-8.485), and positive preoperative TPOAB (OR=6.894, P=0.040, 95%CI: 1.089-43.628).

The efficacy of unilateral thyroid lobectomy in patients with nodular goiter is affected by multiple factors. Among them, age ≥60 years, solid nodules, maximum nodule diameter≥3 cm, preoperative TSH level, and positive preoperative TPOAB are independent influencing factors.

To explore the preventive effect of proximal splenic vein ligation during laparoscopic splenectomy on postoperative portal vein thrombosis.

The clinical data of 58 patients with portal hypertension who underwent surgical treatment from January 2022 to January 2025 were analyzed retrospectively. According to whether proximal splenic vein ligation was performed during the operation, the patients were divided into Group A (n=22, with intraoperative splenic vein ligation) and Group B (n=36, without intraoperative splenic vein ligation). Statistical software SPSS 22.0 was used for data analysis. Measurement data, such as perioperative indicators, were expressed as (±s) and analyzed by independent samples t test; count data, such as postoperative complications, were analyzed by χ² test. P<0.05 was considered statistically significant.

All patients in both groups successfully completed laparoscopic splenectomy, with no conversion to open surgery or deaths. In Group B, 1 patient developed bleeding due to pancreatic fistula after surgery and was cured and discharged after conservative treatment. The operation time in Group A was longer than that in Group B, while the number of cases with postoperative portal vein thrombosis in Group A was fewer than that in Group B (Note: There is a typo in the original text; B-ultrasound should be Group B), with statistically significant differences (both P<0.05). There were no statistically significant differences between the two groups in hospitalization costs, length of hospital stay, intraoperative blood loss, or postoperative pancreatic fistula (all P>0.05).

Proximal splenic vein ligation during laparoscopic splenectomy is safe and feasible, and can effectively prevent the formation of postoperative portal vein thrombosis.

To study the application effect of 3D-printed anatomical models combined with laparoscopic surgery videos in the clinical teaching of laparoscopic hepatectomy (LH).

A total of 40 fifth-year undergraduate interns from January 2023 to December 2024 were included as research subjects. They were divided into a traditional group and a combined group using a random number table method, with 20 interns in each group. The traditional group adopted conventional teaching methods, while the combined group used 3D-printed anatomical models combined with laparoscopic surgery videos for teaching. The theoretical test scores, operational skill scores (before and after teaching), students’ recognition of the teaching method, and teaching effectiveness were compared between the two groups.

After teaching, the theoretical test scores and operational skill scores of the combined group were significantly higher than those of the traditional group (P<0.05); the students’ recognition of the teaching method in the combined group was higher than that in the traditional group (P<0.05); the learning interest, understanding of theoretical knowledge, teaching satisfaction, and comprehensive scores of the combined group were all higher than those of the traditional group (P<0.05).

The teaching method of 3D-printed anatomical models combined with laparoscopic surgery videos helps to improve interns’ understanding of LH theoretical knowledge, master operational skills, and enhance their interest in transitioning from theoretical learning to practical learning. It also achieves high teaching recognition and satisfaction.

To explore the clinical efficacy and treatment experience of laparoscopic placement of IPST-specific hernia patch and open ostomy reconstruction in the treatment of stoma-side hernia.

: The clinical data of 52 patients with stoma-side hernia who underwent laparoscopic placement of IPST-specific hernia patch and open ostomy reconstruction from 2016 to 2024 were retrospectively analyzed. The size of the hernia ring, operation time, recovery time of intestinal function, postoperative hospital stay, and occurrence of postoperative complications were analyzed.

All 52 patients successfully completed the surgery. The size of the hernia ring was 5.5 (4~10)cm × 4.2 (3~8)cm. The operation time was 110 (90~120) minutes. The recovery time of intestinal function was 2 (1~5) days. The postoperative hospital stay was 6 (4~8) days. Postoperative follow-up was conducted for 30 (3~54) months. The incidence of postoperative complications was 1 case of exposed stoma intestinal perforation (see surgical complications ①) and 1 case of poor healing of the abdominal wall incision at the stoma site (see surgical complications ②). After conservative treatment, they improved. There was no infection, recurrence, seroma, intestinal obstruction, or stoma stenosis.

Laparoscopic placement of IPST-specific hernia patch and open ostomy reconstruction is a safe and effective surgical method for treating stoma-side hernia. It is more recommended for patients with large defects and stoma prolapse at the stoma side.

To explore the impact of the establishment of the abdominal pain center on the efficiency and prognosis of patients with acute abdominal diseases.

A retrospective analysis was conducted on patients with acute abdominal diseases admitted from March 2023 to February 2025. The patients were divided into the conventional consultation group (n=643) and the abdominal pain center group (n=809) based on the treatment mode. Data were analyzed using SPSS 27.0 software. Count data were expressed as [cases (%)], and χ² test or Fisher’s exact test was used; measurement data with normal distribution were expressed as (±s), and independent sample t test was used for group comparison; measurement data with non-normal distribution were expressed as M(Q₁, Q₃), and Mann-Whitney U test was used for group comparison. P<0.05 indicated statistically significant differences.

The median time from consultation to admission and the median time from admission to entering the operating room in the abdominal pain center group were significantly shorter than those in the conventional consultation group (P<0.05); the median operation time for patients with acute appendicitis, acute cholecystitis, digestive tract perforation, and intestinal necrosis was significantly shorter (P<0.05); the median hospitalization time for patients with acute appendicitis, acute cholecystitis, intestinal obstruction, digestive tract perforation, and abdominal hernia was also significantly reduced (P<0.05); the postoperative complication rate in the abdominal pain center group was significantly lower, and the median hospitalization cost was significantly lower than that in the conventional consultation group (P<0.05).

The abdominal pain center model significantly optimized the treatment process of acute abdominal diseases, providing higher-level clinical evidence and practical references for the establishment of a standardized and efficient emergency abdominal disease diagnosis and treatment system.

To explore the feasibility and efficacy of laparoscopic partial splenectomy in the treatment of sclerosing angiomatoid nodular transformation (SANT).

A patient was found to have a space-occupying lesion in the upper pole of the spleen during a physical examination via ultrasound. Enhanced computed tomography (CT) suggested a benign lesion, and subsequent laparoscopic partial splenectomy was performed.

The surgery was successful, and the patient recovered well postoperatively. Pathological diagnosis confirmed sclerosing angiomatoid nodular transformation of the spleen. Follow-up CT examinations at 3 months, 1 year, and 3 years after surgery showed no tumor recurrence, and routine blood tests were normal.

Laparoscopic partial splenectomy is a safe and effective surgical method for the treatment of sclerosing angiomatoid nodular transformation of the spleen. It is particularly suitable for lesions located at the marginal parts of the spleen and helps preserve various physiological functions of the spleen.

Gastric cancer metachronous liver metastasis (MLM) progresses relatively slowly, but the prognosis remains poor. In recent years, the application of surgical procedures, especially laparoscopic surgery and robot-assisted surgery, has significantly improved surgical accuracy and enhanced the quality of life for patients. Combined with the conversion treatment strategy, the survival period and disease-free survival period of patients have been further prolonged. This article reviews the progress in surgical and conversion treatment for gastric cancer MLM, discusses the current surgical methods, conversion treatment strategies, and their impact on patient prognosis, providing a basis and reference for clinical treatment decisions.

Gastric cancer is a common malignant tumor in the digestive system. Total gastrectomy is an important treatment method for advanced gastric cancer. Postoperative digestive tract reconstruction is a key part of the surgery, and the choice of the method directly affects the prognosis and quality of life of the patients. There are numerous methods for digestive tract reconstruction after total gastrectomy. Although most patients can restore basic digestive functions through reasonable reconstruction methods, or only experience mild digestive discomfort, which can be improved through postoperative adjustment, when patients suffer from severe complications such as malnutrition, refractory reflux, and anastomotic fistula, the treatment plan often needs to be adjusted or re-surgery is required. The surgical reconstruction methods mainly include Billroth-I anastomosis, Billroth-II anastomosis, and Roux-en-Y anastomosis, etc. This article aims to analyze the advantages and disadvantages, clinical application effects, and applicable scopes of each method, in order to provide a reference basis for the selection of clinical surgical methods.

With the increasing incidence of thyroid cancer complicated by cervical lymph node metastasis, cervical lymph node dissection has become a primary treatment for such diseases. However, the cervical lymphatic network is intricate and complex, making intraoperative injury to lymphatic vessels likely, which leads to postoperative chylous fistula. This not only affects the patient's prognosis but also increases their psychological burden. Currently, there are various preventive and therapeutic measures for chylous fistula at home and abroad, yet these measures are complex to operate and lack clear indications to guide clinical selection. This article aims to review the relevant measures for reducing the drainage volume after cervical lymph node dissection and lowering the incidence of chylous fistula.

With the continuous advancement of fluorescence imaging technology, Indocyanine Green (ICG), as a near-infrared fluorescent dye, has demonstrated broad application prospects in the field of hepatobiliary and pancreatic surgery. This article conducts a comprehensive collation and in-depth exploration of the applications of ICG in this field. Leveraging its unique fluorescent properties, ICG achieves real-time dynamic monitoring of liver uptake and excretion functions in terms of liver function assessment, providing clinicians with more accurate information on the functional status of the liver. In the diagnosis and treatment of liver tumors, ICG fluorescence imaging technology, with its high sensitivity and specificity, clearly displays tumor boundaries and tiny lesions, strongly supporting precise surgical resection. In biliary applications, ICG enhances the clarity of cholangiography, effectively reducing the risk of biliary tract injury, and plays a unique role in bile leakage monitoring, facilitating the timely detection and management of postoperative complications. In pancreatic applications, ICG has opened up new avenues for the diagnosis of pancreatic tumors and surgical navigation.