To explore the feasibility of using indocyanine green(ICG) visualizing the deep infiltrating endometriosis (DIE) during robotic surgery.

A patient with DIE in Department of Genecology and Obstetrics, Chinese PLA General Hospital was selected and underwent total hysterectomy with bilateral adnexectomy and endometriosis lesion excision with perfect preoperative examination and no surgical contraindication. Near-infrared fluorescence imaging with indocyanine green was used in the operation to visualize the endometriosis lesions.

The location of the lesions were accurate and the patient discharged from hospital successfully.

Near-infrared fluorescence imaging system with indocyanine green may clearly visualize the deep infiltrating endometriosis during robotic surgery. It is characterized by brief operation, accuracy and real time. With this technique, we can comprehensively evaluate the scope of our surgery.

To explore the application value of imaging examinations and digestive endoscopy in the diagnosis and treatment of gastrointestinal foreign body in children, especially in complicated cases with unclear history and protracted course.

Two cases of esophageal stenosis in children with dysphagia and no clear history of foreign body ingestion were reported, and the diagnosis and treatment process was shared.The specific application of imaging and endoscopic techniques in diagnosis and treatment was analyzed, providing ideas for clinical diagnosis and treatment.

Both cases were ultimately diagnosed with esophageal foreign bodies via electronic gastroscopy, which revealed impacted foreign bodies at the stricture sites (the parents later recalled histories of foreign body ingestion over 6 months and 2 years prior, respectively).Both children underwent endoscopic foreign body removal in the operating room.Intraoperatively, hook knives were used for gradual radial incisions, and snare devices were employed to piecemeal resect locally hyperplastic granulation tissue.After dissection and exposure of the foreign bodies, they were successfully removed using foreign body forceps combined with guidewires.In Case 1, esophageal perforation and pneumothorax were detected during the procedure, and closed thoracic drainage with placement of a covered retrievable esophageal stent was performed for perforation sealing.In Case 2, esophageal perforation and ulceration were complicated, and a nasogastric feeding tube along with an esophageal drainage tube was inserted. Postoperatively, both patients received regular endoscopic treatment for secondary esophageal strictures.To date, both patients are able to eat normally via the oral route and show satisfactory growth and development.

Esophageal foreign body impaction is a common cause of acquired esophageal stenosis in children.For cases with unclear history of foreign body ingestion, long time of impaction, and high risk of complications, attention should be paid to the detailed evaluation of imaging and digestive endoscopy to obtain key diagnostic clues and assist in making the optimal treatment decision.Multidisciplinary preoperative evaluation and precise endoscopic operation during surgery can help effectively deal with complications and avoid unnecessary surgical operations.At the same time, public health education should be strengthened to raise awareness of gastrointestinal foreign bodies in children and promote early diagnosis and treatment.

全内脏反位（SIT）作为罕见先天性解剖畸形，其胸腹腔器官“镜像”分布及伴随的血管、胆道结构变异，给胃癌合并SIT的诊疗带来了区别于常规胃癌的独特挑战。本文聚焦该病核心议题，整合2014—2024年通过系统检索PubMed、CNKI、Embase数据库获取的89例病例数据（其中2021—2024年41例，2014—2020年48例），系统梳理临床病理特征、多模态诊断体系、个体化手术策略、预后影响因素及多学科团队（MDT）协作价值，提出“精准诊断—个体化手术—全程MDT管理”的诊疗框架，为临床医师提供标准化参考，助力诊疗指南制定。

This paper reports the diagnosis and management of two elderly male patients with recurrent pneumothorax who developed the rare complication of chest tube misplacement into lung tissue after insertion of a 24-Fr chest tube. Both patients presented with poor drainage and subcutaneous emphysema following tube placement, and the diagnosis was confirmed by chest computed tomography (CT). As conservative management, we adopted a strategy of reinserting a new chest tube at an alternative site to promote lung re-expansion. Both patients were discharged uneventfully, with good lung re-expansion observed during follow-up. These cases suggest that for elderly patients with recurrent pneumothorax and those at high risk of pleural adhesions who require chest tube drainage, preoperative chest CT evaluation, selection of an appropriate insertion site, digital exploration of the pleural cavity during the procedure, and avoidance of chest tubes with an introducer stylet are crucial for preventing this complication. When chest tube misplacement into the lung tissue occurs, leaving the original tube in place to provide a partial tamponade effect while simultaneously inserting a new chest tube may serve as a safe and effective first-line conservative strategy.

Primary pulmonary choriocarcinoma (PPC) is an extremely rare, highly malignant extragonadal epithelial neoplasm of non-gestational origin. As an aggressive trophoblastic tumor, it can secrete β-human chorionic gonadotropin (β-hCG). By reviewing domestic and foreign literature as well as recent research advances, this article analyzes the clinical manifestations, laboratory and imaging findings, pathological features, diagnosis and treatment regimens of one PPC case, and summarizes the characteristics of the disease. The aim is to improve clinicians’ understanding of PPC, reduce misdiagnosis and missed diagnosis, and standardize the diagnostic and therapeutic workflows for this disease.

To investigate the application value of Unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF) in the treatment of 98 cases of obesity-related single-segment degenerative lumbar disease, compared with Minimally invasive surgery-transforaminal lumbar interbody fusion (MIS-TLIF).

A total of 98 obese patients with single segment degenerative lumbar disease admitted to Guangdong second traditional Chinese medicine hospital from January 2022 to January 2024 were selected for a prospective randomized controlled study. They were randomly divided into UBE-TLIF group and MIS-TLIF group using randomised numerical table method, 49 cases in each group. The perioperative conditions of the two groups were compared, as well as the visual analog scale (VAS) scores for waist and leg pain, lumbar lordotic angle (LL), disc height (DH), and Oswestry Disability Index (ODI) scores before surgery, and at 1 month and 6 months after surgery. The functional prognosis at 6 months after surgery and the incidence of postoperative complications were statistically analyzed.

All 98 patients were followed up for a complete period of 6 months postoperatively, with a follow-up rate of 100%. The total follow-up duration ranged from 6 to 29 months, with an average of (19.96±2.87) months. There were 56 males and 42 females, with an average age of 46.95±3.98 years. In the UBE-TLIF group, the intraoperative blood loss, postoperative drainage volume, and hospital stay were (249.68±31.59) ml, (94.23±18.55) ml, and (5.69±1.65) days, respectively, which were lower than those in the MIS-TLIF group [(327.95±28.11) ml, (123.61±20.39) ml, and (7.58±1.43) days], the operation time was (155.27±14.00) minutes, which was longer than that in the MIS-TLIF group [(136.39±11.94) minutes] (P<0.05). One month postoperatively, the VAS scores for low back pain and leg pain in the UBE-TLIF group were (2.00±0.51) and (1.78±0.48), respectively, both of which were lower than those in the MIS-TLIF group [(2.61±0.43) and (2.45±0.56)] (P<0.05). There were no significant differences in ODI, DH, and LL between the UBE-TLIF group and the MIS-TLIF group at 1 month and 6 months after surgery (P>0.05). The excellent and good rate of functional prognosis in the UBE-TLIF group at six months postoperatively was 95.92%, which was not significantly different from that in the MIS-TLIF group (91.84%) (P>0.05). The total incidence of complications in the UBE-TLIF group was 2.04%, which was not significantly different from that in the MIS-TLIF group (4.08%) (P>0.05).

The treatment of single-segment degenerative lumbar disease in obese patients using UBE-TLIF and MIS-TLIF procedures can achieve good efficacy and high safety. UBE-TLIF has the advantages of minimal intraoperative trauma, rapid postoperative recovery, and improved early pain relief. However, its surgical time is longer, and clinicians can choose the appropriate procedure based on specific circumstances.