To evaluate the features of carotid web (CW) by ultrasonography.

A total of 66 patients with CW were retrospectively enrolled from January 2018 to June 2019 at Xuanwu Hospital, Capital Medical University. All patients were examined by both ultrasonography and CTA, and were divided into either a<50% stenosis group (54 cases) or a ≥50% stenosis group (12 cases). The ultrasonographic characteristics of CW, including the length, thickness, direction (forward or backward to the flow), acute angle between the web and carotid wall, and thrombus between the web and carotid wall were compared between the two groups. The stenosis degrees of carotid artery were compared between patients with and without ischemic stroke.

Forty-two (42/66, 63.6%) patients were diagnosed with CW by initial CDFI examination, of whom 21 (21/66, 31.8%) were diagnosed with ulcerative plaque and 3 (3/66, 4.5%) were diagnosed with carotid dissection at first but confirmed by second examination. There were no differences in the web length, thickness, direction, or thrombus detected between the two groups (P>0.05). The angle between the web and carotid wall in the<50% stenosis group was significantly smaller than that of the ≥50% stenosis group (median angel 39o vs 73o, P=0.002), and the percentage of patients with an angle≤ 60o in the<50% stenosis group was significantly higher than that of the ≥50% stenosis group (74.1% vs 41.7%, P=0.042). The diameter of the residual carotid artery at CW location in the<50% stenosis group was significantly larger and peak systolic velocity was significantly higher in the<50% stenosis group than in the≥50% stenosis group (P<0.001). The stenosis degrees of carotid artery were not statistically different between patients with and without ischemic stroke (P=0.321).

Ultrasonography can be used to evaluate the characteristics of carotid web in 2D and color mode. When the angle between the CW and carotid wall is large, the carotid artery stenosis ≥ 50% is more likely to happen, but carotid artery stenosis is not the main cause of ischemic stroke.

The aim of the present study was to evaluate the efficiency of sling exercise, therapeuticultrasound, therapeuticultrasound and sling exercise in patients to alleviate pain and improve lumbar function with lumbar disc herniation.

Individuals were selected from a list of patients being followed at the department of Rehabilitation in the third hospital of Hebei Medical University. 30 patients who were diagnosed with lumbar disc herniation were collected, the diagnoses were established upon medical history, physical examination, and results of imaging studies. The patients were randomly divided into three groups: therapeuticultrasound group received 14 sessions of ultrasonic therapy to the lumbar region, Sling exercise group received 14 sessions of sling exercise, and therapeuticultrasound and sling exercise group received therapeuticultrasound and sling exercise therapy 14 sessions of therapeuticultrasound to the lumbar region,7 sessions per week, 2 weeks. The VAS and ODI were compared with the assessment of the patients before and at the end of the therapy.

At the end of treatment, three groups VAS scores (F=3.069, P=0.043) and ODI scores (t=12.676, P<0.001) was lower than that at the beginning of treatment (P<0.05), at the end of treatment the VAS scores (F=59.400, P<0.001) and of the ODI scores (t=12.737, P<0.001) of ultrasonic and sling exercise therapy group was lower than the other group, the difference is significantly.

All three groups could reduce pain and improve lumbar function, and the ultrasonic and sling exercise therapy was most effective for lumbar disc herniation treatment in the three groups.

To analyze the treatment of different types of traumatic cerebral infarction in children, and explore its pathogenesis in combination with literature so as to improve the cure rate and reduce disability rate.

The clinical data of 42 cases of traumatic cerebral infarction in children were retrospectively analyzed in The Hospital of 81^st Group Army PLA from January 2015 to December 2019. The diagnosis of traumatic cerebral infarction in children was made by CT scan and MRI scan. According to different conditions, children with traumatic cerebral infarction were classified, and different treatment strategies were selected. Children with lacunar infarction were treated with calcium antagonists and neurotrophic drugs, supplemented by hyperbaric oxygen and exercise rehabilitation. The children of focal cerebral infarction and complex cerebral infarction treated by junior dehydrant and hormone also included the calcium antagonist and nutritional nerve drugs. The therapeutic regimen perhaps adjusted by the evolution of the disease. The children of extensive cerebral infarction underwent emergency cranial decompression, and was treated by reducing intracranial pressure and preventing complications after operation. The treatment results and recovery were observed.

In 42 cases of traumatic cerebral infarction in children, 35 cases (83.3%) were good recovery, 4 cases (9.5%) were moderate disability, 2 cases (4.8%) were severe disability, 1 case (2.4%) died, and no vegetative state. The good recovery rate of lacunar infarction was 100%, that of focal cerebral infarction was 62.5%, that of mixed cerebral infarction was 60%, and that of extensive cerebral infarction was 50%.

It is of great significance to improve the therapeutic effect and prognosis of children with traumatic cerebral infarction to adopt different treatment schemes for different types of cerebral infarction.

To characterize the patients with supratentorial hypertensive intracerebral hemorrhage (ICH) in the Tibetan Plateau over an altitude of 4000 meters.

A total of 68 cases with supratentorial hypertensive ICH were retrospectively included in Ali Regional People’s Hospital from January 2017 to September 2018. The clinical and laboratory data were collected. A simple linear correlation analysis was applied to analyze the correlation between the amount of bleeding and sex, age, nationality, time from onset , systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), serum triglyceride (TG), and cholesterol. According to computed tomography (CT) findings, 68 cases were divided into the basal ganglia ICH group (33 cases) and the lobar ICH group (35 cases). The characteristics between two groups were analyzed using t-test or χ² test.

The data of sex, age, nationality, time from onset, SBP, DBP, Hb, TG, and cholesterol of 68 cases on admission did not show any definitive correlation with the hematoma volumes (P＞0.05). The SBP and DBP of patients in the basal ganglia ICH group were significantly higher than that in the lobar ICH group, respectively [(184.9±28.5) mmHg vs (164.6±24.4) mmHg; (113.0±18.1) mmHg vs (103.0±18.4) mmHg] (t=0.499, 0.486; P=0.002, 0.033).

The relevant factors of hematoma volumes in patients with ICH in plateau area were not yet clear. Diastolic and systolic blood pressure of patients in the basal ganglia ICH group was higher than that in those in lobar ICH group.

To compare the efficacy evaluation of electrospun composite biomaterials and a porcine small intestine submucosa mesh for hernia repair.

A randomized, single-blind, controlled multicenter trial was performed in 3 hospitals in Shanghai. Eligible adult patients with primary unilateral reducible groin hernias were randomly assigned (1∶1) to electrospun composite biomaterials (experimental group) or porcine small intestine submucosa (control group) mesh groups. Patients were treated with the tARB technique and assessed at 1,3 and 6 months after the surgery. The primary endpoint was hernia recurrence. The secondary endpoints were postoperative complications including groin pain and operative site infections.

172 patients were assigned to experimental (n=86) and control (n=86) groups. At 6 months follow-up, postoperative complications occurred in 5 patients (5/86, 5.95%) and 2 (2/86, 2.35%) patients in the control and experimental groups, respectively (P>0.05). There was no significant difference in VAS or SVS score between the two groups.

We demonstrate that electrospun composite biomaterial mesh can be used as a ideal choice for inguinal hernia repair. Electrospun composite biomaterial has the characteristics of low recurrence rate, absorbability and long-term comfort.It can be further applied in clinical practice in the future.

Pancreaticoduodenectomy(PD)remains one of the most complicated hepatobiliary operations. The development of minimally invasive surgery for PD has always been an hot spot. Laparoscopic pancreaticoduodenectomy(LPD) has not been widespread carried out due to its difficulty and long learning curve. LPD accounts for 9% of all PD, according to the National Cancer Data base. Compared with laparoscopic surgery, robotic surgery system has significant advantages in the field of minimally invasive PD, including stereotactic amplified vision, filtering hand tremor and simulating the wrist. The article would review the surgical techniques and notes, which could provide clinical reference for other surgeons.

To investigate the application value of preoperative endoscopic biliary and pancreatic stenting in local resection of pancreatic head and neck tumors.

A retrospective descriptive study was conducted. Clinical data of 26 patients who underwent local resection of pancreatic head and neck tumors from January 2019 to December 2022 were collected, including 10 males and 16 females, with a median age of 54 years (range, 17~72 years). All patients received preoperative endoscopic stent placement. Observation indicators: (1) perioperative conditions; (2) postoperative conditions. Measurement data were expressed as absolute numbers.

(1) Perioperative conditions: All patients underwent endoscopic retrograde cholangiopancreatography (ERCP) for stent placement before surgery, among whom 20 received stent placement on the day of surgery. A pancreatic duct stent was placed in all patients, and a biliary stent was additionally placed in 21 patients. Two patients with multiple lesions in the pancreatic head and tail underwent distal pancreatectomy plus local resection of the pancreatic head, while the others with single lesions underwent local resection of pancreatic tumors only. Eleven patients underwent Roux-en-Y pancreaticojejunostomy during local tumor resection. (2) Postoperative conditions: No surgery-related death occurred in the 26 patients, with a mean hospital stay of 20.8 days. Grade B pancreatic fistula occurred in 13 patients, biochemical fistula in 7, and no grade C fistula was observed. Delayed gastric emptying occurred in 3 patients (grade C in 2, grade A in 1). Postoperative hemorrhage occurred in 4 patients (grade A in 1, grade B in 3). Biliary fistula occurred in 1 patient. Five patients had intra-abdominal encapsulated effusion.

Preoperative endoscopic biliary and pancreatic stenting is safe and feasible in local resection of pancreatic tumors. It extends the indications of local resection, helps protect the biliary and pancreatic ducts, reduces surgical difficulty, improves surgical success rate, accelerates postoperative recovery, and reduces the incidence of postoperative pancreatic fistula and biliary fistula.

Compare the prognostic effects of laparoscopic common bile duct exploration with "T" tube drainage (LCBDE) and laparoscopic common bile duct exploration and stone extraction via cystic duct (LTCBDE) in patients with secondary common bile duct stones.

A total of 116 patients with secondary common bile duct stones admitted to our hospital from February 2020 to February 2023 were selected as the research subjects. According to the surgical methods, the patients were categorized into the LTCBDE group (n=57) and the LCBDE group (n=59). The propensity score matching method was used to balance the differences between the two groups. After reducing the potential confounding factors, the basic data, perioperative indicators, stress indicators and complications of the two groups of patients were analyzed by t test, χ² test or Fisher's exact probability test. P<0.05 was considered statistically significant.

After matching, there were statistically significant differences between the two groups in postoperative drainage time, postoperative 24 h visual analogue scale score, postoperative fluid infusion volume, incision length, postoperative hospital stay, gastrointestinal function recovery time, intraoperative blood loss, return to normal life time, operation time, anal exhaust recovery time (P<0.05). Three days after surgery, the levels of interleukin-6 (IL-6) in the two groups were lower than those before surgery (P<0.05), and the levels of adrenocorticotropic hormone (ACTH), cortisol (Cor), natural killer cell (NK) and norepinephrine (NE) in the two groups were higher than those before surgery (P<0.05). However, the levels of IL-6, ACTH, Cor, NK and NE in LTCBDE group were lower than those in LCBDE group (P<0.05). The total incidence of complications in LCBDE group was higher than that in LTCBDE group, and the difference was statistically significant (P< 0.05). There was no significant difference in recurrence rate between LTCBDE group and LCBDE group (25.0% vs. 27.8%) (χ²=0.071, P=0.789).

Compared with LCBDE, LTCBDE has advantages such as low stress response and low complication rate. This study more strongly recommends LTCBDE for the treatment of secondary common bile duct stones.

To investigate the efficacy and safety of laparoscopic cholecystectomy in elderly patients.

Clinical data of 621 patients who underwent cholecystectomy for acute cholecystitis from January 2023 to December 2024 were retrospectively analyzed. Patients were divided into an elderly group (n=82, age ≥70 years) and a control group (n=539, age <70 years). Statistical analysis was performed using SPSS 22.0 software. Categorical data were analyzed using the χ² test or exact test. Normally distributed continuous data were presented as (

There were significant differences between the two groups in age, body mass index (BMI), ASA classification, comorbidities [cardiovascular disease, diabetes mellitus, chronic obstructive pulmonary disease (COPD), renal insufficiency], operation time, and length of hospital stay (P<0.05). The elderly group had higher incidences of postoperative pulmonary infection, intra-abdominal infection, and overall complications, as well as a longer postoperative hospital stay (P<0.05). The higher proportion of comorbidities (e.g., cardiovascular disease, diabetes mellitus) and poorer ASA classification in the elderly group may be important contributors to the increased incidence of postoperative pulmonary and intra-abdominal infections. Multivariate analysis showed that diabetes mellitus, ASA grade Ⅲ, and operation duration >80 minutes were independent risk factors for increased postoperative morbidity. Cardiovascular disease, chronic renal insufficiency, and length of hospital stay were factors independently associated with discharge rate.

Laparoscopic cholecystectomy is relatively safe in elderly patients under the premise of adequate evaluation of comorbidities and optimized perioperative management (such as blood glucose control and shortening operation time by an experienced surgical team). The risk of postoperative complications is acceptable.

To investigate the efficacy of laparoscopic common bile duct exploration (LCBDE) and endoscopic retrograde cholangiopancreatography combined with endoscopic sphincterotomy and stone extraction (ERCP+EST), each combined with laparoscopic cholecystectomy (LC), in the treatment of cholecystolithiasis complicated with choledocholithiasis.

Clinical data of patients with cholecystolithiasis and choledocholithiasis admitted from January 2022 to January 2025 were retrospectively analyzed. Patients were divided into the LCBDE group (treated with LCBDE combined with LC) and the ERCP+EST group (treated with ERCP+EST combined with LC) according to different surgical procedures. Propensity score matching was used to eliminate confounding factors of baseline data, with 45 cases in each group. Data were analyzed using SPSS 24.0 software. Enumeration data were expressed as [cases (%)] and analyzed by the χ² test or Fisher's exact test. Measurement data conforming to normal distribution were expressed as (

There were no significant differences in the one-time stone clearance rate, stone residual rate, and recurrence rate within half a year between the LCBDE group and the ERCP+EST group (P>0.05). The drainage tube indwelling time in the LCBDE group was significantly longer than that in the ERCP+EST group (P<0.05), while the hospital stay was significantly shorter (P<0.05). There were no significant differences in operation time, blood loss, or conversion rate to laparotomy between the two groups (P>0.05). At 2 days after operation, the levels of CRP and TBIL in both groups were significantly increased (P<0.05), while CRP in the LCBDE group was significantly lower than that in the ERCP+EST group (P<0.05). There was no significant difference in TBIL between the two groups (P>0.05). The incidence of pancreatitis in the LCBDE group was significantly lower than that in the ERCP+EST group (P<0.05), and the incidence of biliary fistula was significantly higher (P<0.05). There were no significant differences in the rates of abdominal infection or biliary stricture between the two groups (P>0.05).

Both LCBDE and ERCP+EST combined with LC are effective in the treatment of cholecystolithiasis complicated with choledocholithiasis. LCBDE is more advantageous in postoperative recovery and is suitable for young patients or those with large stones. ERCP+EST is relatively difficult to perform and carries a risk of pancreatitis, but is suitable for patients who cannot tolerate general anesthesia and pneumoperitoneum, or those with severe obstructive jaundice. The appropriate surgical procedure can be selected clinically according to individual patient conditions.

To investigate the expression and clinical significance of pyruvate kinase M2 (PKM2) and heat shock protein 90α (HSP90α) in cholangiocarcinoma.

The expression of PKM2 and HSP90α was detected in 54 cholangiocarcinoma tissues and 20 adjacent normal tissues using the EliVision^TM plus two-step method of immunohistochemistry (IHC). Serum concentrations of PKM2 and HSP90α were measured by enzyme-linked immunosorbent assay (ELISA) in 54 cholangiocarcinoma patients, 32 choledocholithiasis patients, and 25 healthy individuals. The correlations between the two markers and clinicopathological parameters were statistically analyzed. Data were processed using SPSS 22.0. Measurement data conforming to a normal distribution were expressed as (

The positive rates of PKM2 and HSP90α expression in cholangiocarcinoma tissues were significantly higher than those in adjacent normal tissues (P<0.05). PKM2 expression was significantly correlated with lymph node metastasis and TNM stage (P<0.05). HSP90α expression was significantly correlated with tumor differentiation, lymph node metastasis, and TNM stage (P<0.05). At 3 days preoperatively, serum levels of PKM2 and HSP90α in cholangiocarcinoma patients were significantly higher than those in choledocholithiasis patients and healthy individuals. At 10 days postoperatively, both were significantly lower than the preoperative levels (P<0.05). There was no significant difference in PKM2 between cholangiocarcinoma patients and choledocholithiasis or healthy individuals (P>0.05), whereas HSP90α remained higher in cholangiocarcinoma patients (P<0.05). At 3 days preoperatively, serum PKM2 and HSP90α levels in choledocholithiasis patients were higher than those in healthy individuals (P<0.05). Diagnostic accuracy analysis of serum PKM2 and HSP90α in cholangiocarcinoma showed that the combined detection had a sensitivity of 85.2% and a specificity of 72.0%. The Kappa test showed consistent expression between IHC and ELISA.

PKM2 and HSP90α levels are elevated in both tumor tissues and serum of cholangiocarcinoma patients, and their upregulation is closely associated with the malignant progression of cholangiocarcinoma. Combined detection of the two markers is valuable for the early diagnosis, therapeutic effect evaluation, and prognosis assessment of cholangiocarcinoma.

To compare the clinical efficacy of laparoscopic precise hepatic pedicle dissection resection and conventional resection in the treatment of primary hepatocellular carcinoma (HCC).

The data of 113 patients with primary HCC who underwent laparoscopic liver cancer resection from May 2021 to May 2024 in our hospital were retrospectively analyzed. According to the different surgical methods, the patients were divided into the observation group (n=55, underwent laparoscopic precise hepatic pedicle dissection resection) and the control group (n=58, underwent laparoscopic conventional liver resection). Data were processed and analyzed using SPSS 27.0 software. Quantitative data were expressed as (

Compared with the control group, patients in the observation group had less intraoperative blood loss, less postoperative drainage volume, shorter postoperative extubation time, and shorter hospital stay (P<0.05). At 24 hours after surgery, the levels of serum C-reactive protein (CRP), interleukin-6 (IL-6), cortisol (Cor), and norepinephrine (NE) in both groups were higher than those before surgery; at 7 days after surgery, the levels of each indicator in both groups were lower than those at 24 hours after surgery, and the levels in the observation group at 24 hours and 7 days after surgery were lower than those in the control group (P<0.05). At 24 hours after surgery, the levels of serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), and total bilirubin (TBIL) in both groups were higher than those before surgery; at 7 days after surgery, the levels of each indicator in both groups were lower than those at 24 hours after surgery, and the levels in the observation group at 24 hours and 7 days after surgery were lower than those in the control group (P<0.05). At 3 months after surgery, the levels of serum alpha-fetoprotein (AFP), carbohydrate antigen 19-9 (CA19-9), and soluble intercellular adhesion molecule-1 (sICAM-1) in both groups were lower than those before treatment, and the levels in the observation group were lower than those in the control group (P<0.05). The incidence of postoperative complications in the observation group was 5.5%, which was lower than 19. 0% in the control group (P<0.05). At 1 year after surgery, the disease-free survival rate of patients in the observation group was 74. 6%, which was higher than 55.2% in the control group (P<0.05).

Compared with traditional laparoscopic conventional liver resection, laparoscopic precise hepatic pedicle dissection resection for primary HCC has the advantages of less intraoperative bleeding and less surgical trauma, which can reduce postoperative inflammatory stress and liver function damage, significantly inhibit the expression of tumor factors, and improve the postoperative disease- free survival rate.

To explore the types, risk factors, prevention strategies and clinical management methods of common complications after laparoscopic radical resection of colorectal cancer, and to provide theoretical basis and practical guidance for reducing the incidence of complications and improving patient prognosis in clinical practice.

A retrospective analysis was conducted on relevant research literature from domestic and international sources (a total of 24 eligible studies were included in this study). The literature was analyzed using the methods of literature research, induction analysis, and comparative analysis to summarize the characteristics of complication occurrence, analyze risk factors, and summarize prevention and management plans. The quality of the included literature was evaluated, and the clinical effects of different prevention methods were compared.

The overall incidence of complications after laparoscopic radical resection of colorectal cancer ranged from 13.9% to 23.4%, significantly lower than that of open surgery (23.4% to 45.76%). Common complications included infection, anastomotic leakage, and intestinal obstruction, among others. There were also specific complications unique to laparoscopy, such as hypercapnia. The GPS2 score was an independent risk factor for total and severe complications after surgery. Age, operation time, and nursing intervention were also closely related to the occurrence of complications. Through comprehensive prevention measures throughout the entire process, such as preoperative rehabilitation, standardized operation during surgery, and personalized postoperative care, the incidence of complications can be significantly reduced, and the rehabilitation outcome can be improved.

Complications after laparoscopic radical resection of colorectal cancer are influenced by multiple factors. Clinically, a comprehensive prevention management system throughout the entire process needs to be established. High-risk patients can be screened using predictive models and targeted interventions can be implemented. Strengthening multidisciplinary cooperation is a key means to improve surgical safety and patient prognosis.

The optimal adjuvant therapy for patients with microvascular invasion (MVI)-positive hepatocellular carcinoma (HCC) after radical resection remains highly controversial. This study aimed to investigate the clinical efficacy of postoperative transcatheter arterial chemoembolization (TACE) in patients with MVI-positive HCC.

Clinical data of 130 patients who underwent radical resection for HCC and were pathologically confirmed as M-positive between March 2019 and May 2024 were retrospectively analyzed. Among them, 77 patients were included in the postoperative TACE group and 53 in the control group. Statistical analyses were performed using SPSS 26.0 and R Studio 4.4.3. Normally distributed continuous data were presented as (mean ± standard deviation) and analyzed by independent samples t test; non-normally distributed continuous data were analyzed by Mann-Whitney U test. Categorical data were analyzed by chi-square test. Univariate and multivariate COX regression analyses were used to identify risk factors affecting disease-free survival (DFS) after surgery in MVI-positive HCC patients. The Kaplan-Meier method was used to plot DFS curves, and differences between groups were analyzed by the Log-Rank test. A P-value <0.05 was considered statistically significant.

Univariate COX regression analysis showed that tumor diameter >5 cm (P=0.001), MVI grade 2 (P<0.001), AFP >400 ng/ml (P=0.001), satellite nodules (P<0.05), vascular tumor thrombus (P<0.05), and BCLC stage B (P<0.05) were potential risk factors for DFS. Multivariate COX regression analysis demonstrated that MVI grade 2, tumor diameter >5 cm, AFP >400 ng/ml, and vascular tumor thrombus were independent risk factors for DFS in MVI-positive HCC patients, whereas postoperative adjuvant TACE was an independent protective factor for DFS. Kaplan-Meier analysis showed that the median DFS was 19.8 months in the TACE group (95%CI: 13.4-26.8 months) and 10.5 months in the control group (95%CI: 9.0-16.6 months). The median DFS was significantly better in the TACE group than in the control group (P<0.05).

Postoperative adjuvant TACE can improve DFS in patients with MVI-positive HCC after radical resection.

To investigate the efficacy and prognostic impact of preserving the left colic artery during laparoscopic radical resection for rectal cancer.

A total of 108 patients with rectal cancer admitted from January 2021 to December 2021 were enrolled and randomly divided into an observation group (n=54) and a control group (n=54). All patients underwent laparoscopic radical resection for rectal cancer. The left colic artery was preserved in the observation group but not in the control group. Perioperative indicators, incidence of postoperative complications, gastrointestinal function, anal function, recurrence rate, and liver metastasis rate were compared between the two groups. Statistical analysis was performed using SPSS 22.0 software. Enumeration data were expressed as rates (%) and analyzed by the χ² test. Measurement data conforming or approximately conforming to a normal distribution were expressed as (

The length of hospital stay was significantly shorter in the observation group than in the control group (t=3.638, P<0.001). At 1 month after surgery, the complication rate in the observation group was 7.4% (4/54), which was significantly lower than 22.2% (12/54) in the control group (χ²=4.696, P=0.030<0.05). The levels of gastrointestinal function and anal function indexes in the observation group were significantly higher than those in the control group (t=5.017, 4.208, 3.424, 3.287, P<0.05). At 2 years after surgery, there were no significant differences in the recurrence rate and liver metastasis rate between the two groups (χ²=2.080, 0.101; P=0.149, 0.750>0.05).

Preserving the left colic artery during laparoscopic radical resection for rectal cancer can reduce the incidence of complications and promote postoperative recovery.

To investigate the learning curve and short-term outcomes of two minimally invasive procedures for low rectal cancer: transanal total mesorectal excision (TaTME) versus laparoscopic radical resection for middle and low rectal cancer.

A total of 149 patients with low rectal cancer were prospectively enrolled from January 2022 to January 2025. They were randomly divided into the observation group (n=75, treated with TaTME) and the control group (n=74, treated with laparoscopic radical resection for middle and low rectal cancer) using a random number table method. The χ² test or t test was used to compare baseline characteristics and learning curves between the two groups, as well as perioperative indicators, short-term outcomes, and postoperative complication rates at different learning stages.

The inflection point of the learning curve appeared later in the observation group (at the 40th case) and earlier in the control group (at the 20th case). The learning curve of TaTME showed a steeper slope during the learning phase (before the inflection point), with a more excessive increase in operative time. In contrast, the learning curve of laparoscopic radical resection rose more gently. In the observation group, operative time, extubation time, and hospital stay were significantly shorter in the plateau phase than in the ascending phase; intraoperative blood loss and intraoperative drainage volume were also significantly reduced (P<0.05). During the ascending phase, operative time was significantly longer, and intraoperative blood loss and drainage volume were significantly higher in the observation group than in the control group (P<0.05). In the plateau phase, operative time remained significantly longer in the observation group, but intraoperative blood loss and drainage volume were significantly lower than those in the control group (P<0.05).In the observation group, time to first ambulation and time to first flatus were significantly shorter in the plateau phase than in the ascending phase. The complete mesorectal excision rate was significantly higher in the plateau phase, while the positive circumferential resection margin rate and anal function score were significantly lower (P<0.05). The incidence of anastomotic leakage and overall complications in the observation group was significantly higher in the ascending phase than in the plateau phase, and also significantly higher than that in the control group at the same stage (P<0.05).

TaTME has a longer learning curve and greater technical difficulty in the early phase, with longer operative time and significantly higher complication risk during the ascending phase. However, the plateau phase is associated with significantly better intraoperative hemostasis, postoperative recovery, and oncological quality compared with the ascending phase, and is partially superior to the laparoscopic procedure. These findings indicate that TaTME has favorable clinical value and safety after proficient mastery.

To compare the clinical efficacy and safety of retro-peristaltic and pro- peristaltic intracavitary ileocolic-cecal anastomosis in total laparoscopic right hemicolectomy (TLRC).

A retrospective cohort design was adopted to collect the clinical data of 94 patients with right- sided colon cancer from January 2020 to December 2024. All patients underwent TLRC and intracavitary ileocolic-cecal side-to-side anastomosis (ⅡA-SS) for digestive tract reconstruction. The patients were divided into two groups based on different ⅡA-SS anastomosis methods: Anti-Peristaltic group (n=47, retro-peristaltic ileocolic-cecal anastomosis) and Overlap group (n=47, pro-peristaltic ileocolic-cecal anastomosis). Data were analyzed using statistical software SPSS 27. 0. Continuous variables were expressed as (

There were no statistically significant differences in intraoperative blood loss, operation time, hospital stay, Clavien-Dindo grade Ⅰ-Ⅲ complications, and postoperative complications (infection, chronic diarrhea, intestinal obstruction, etc.) between the two groups, as well as in the preoperative EORTC QLQ-C30 scores of the four dimensions (function, overall health, symptoms, and trauma), and the postoperative 6-month scores of the functional and overall health dimensions. Compared with the Overlap group, the Anti-Peristaltic group had a longer digestive tract reconstruction time, shorter ventilation time, and shorter defecation time (P<0.05). There was no interaction effect between time and method in the GIQLI score (P>0.05), the main effect of time on the GIQLI score was significant (P<0.05), the main effect of the method on the GIQLI score was significant (P<0.05); at 6 months postoperatively, the symptom and trauma scores of the EORTC QLQ-C30 scale in the Anti-Peristaltic group were lower than those in the Overlap group (P<0.05).

Anti-Peristaltic anastomosis can promote the recovery of intestinal function after TLRC and improve long-term quality of life, but caution should be exercised regarding the risk of anastomotic leakage. It is recommended to apply under strict operational control.

To clarify the impact of postoperative complications on quality of life in patients undergoing gastric cancer surgery.

Clinical data of 200 patients who underwent gastric cancer surgery from January 2021 to December 2024 were collected, and a follow-up database including clinical information and the Functional Assessment of Cancer Therapy-General (Chinese version, FACT-G) scale was established. The FACT-G scale consists of four domains: physical well-being (7 items), social/family well-being (7 items), emotional well-being (6 items), and functional well-being (7 items). Statistical analysis was performed using SPSS 27.0 software. Measurement data were expressed as (mean ± standard deviation) and analyzed using the t test; enumeration data were expressed as rates and analyzed using the chi-square test. Binary Logistic regression was used to analyze risk factors affecting quality of life. A P-value < 0.05 was considered statistically significant.

Among the 200 patients, 22.5% (45/200) had no postoperative complications and 77.5% (155/200) had complications, who were assigned to the non-complication group (n=45) and complication group (n=155), respectively. There were statistically significant differences in all domain scores of quality of life at 3, 6, and 12 months postoperatively between the two groups (P<0.05). Logistic regression analysis showed that postoperative complications, pathological classification of gastric cancer, surgical approach, number of tumors, tumor size, and length of hospital stay were independent risk factors for postoperative quality of life (P<0.05).

Postoperative complications in gastric cancer patients adversely affect postoperative quality of life, leading to prolonged hospital stay and increased medical costs. Postoperative quality of life is influenced by multiple factors, including postoperative complications, pathological classification of gastric cancer, surgical approach, number of tumors, tumor size, and length of hospital stay. The main complications affecting quality of life include anastomotic leakage, malnutrition, intra-abdominal infection, delayed gastric emptying, and intestinal obstruction.