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 analyze the key procedural steps and technical refinements of laparoscopic Sugarbaker repair for parastomal hernia, and to investigate the incidence of postoperative complications, aiming to further standardize the critical details of the laparoscopic Sugarbaker technique and reduce postoperative complication rates.

A single-center retrospective cohort study was conducted to analyze the clinical data of 161 patients who underwent laparoscopic Sugarbaker repair for parastomal hernia at the Department of Hernia and Obesity Surgery, The First Affiliated Hospital of University of Science and Technology of China, from January 2015 to December 2025. Data such as conversion to open surgery, postoperative complications, operative time, hernia defect size were recorded, and follow-up was completed.

All 161 surgeries were successfully completed, with 2 conversions to open surgery and no perioperative deaths. The median operative time was 135 (110, 180) minutes and the median hernia defect area was 19.6 (12.6, 28.3) cm². The median follow-up time was 24 (12, 36) months. The symptomatic recurrence rate was 5.0% (8/161), and the radiological recurrence rate was 5.6% (9/161). Kaplan-Meier survival analysis showed that, based on 10-year study data (maximum follow-up of 96 months), the 8-year cumulative symptomatic recurrence rate was 7.4% and the 8-year cumulative radiological recurrence rate was 8.1%. The overall incidence of other complications was 7.5% (12/161), including intestinal obstruction (n=3), stoma mucocutaneous separation (n=3), stoma infection (n=2), and one case each of delayed intestinal fistula from the hernia sac, hernia sac effusion, reoperation for recurrence, and poor wound healing.

Optimized key techniques in laparoscopic Sugarbaker repair demonstrate favorable outcomes for parastomal hernia, and can effectively control the incidence of postoperative complications.

To evaluate the clinical application value of CT multiplanar reconstruction (MPR) technology in the preoperative differentiation of inguinal hernia types and prediction of incarceration risk, and to provide a reference for optimizing the clinical preoperative evaluation process.

This was a single-center retrospective diagnostic accuracy study. A total of 102 patients with inguinal hernia (involving 109 hernia sacs) confirmed by surgery at the 73rd Group Army Hospital of the Chinese People's Liberation Army Army from January 2023 to April 2025 were included. All patients underwent preoperative multi-slice spiral CT (MSCT) plain scan and MPR (coronal, oblique coronal, and sagittal planes). The display effects of different reconstruction planes on key anatomical structures in the inguinal region were analyzed, characteristic imaging signs were identified, and the hernia sac neck ratio (the ratio of the maximum width of the hernia sac to the width of the hernia sac neck) was measured. Using surgical findings as the gold standard, receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic performance for hernia classification and the predictive value for incarceration risk.

The complete visualization rate of the inguinal ligament using oblique coronal MPR was significantly higher than that using coronal reconstruction (56.88% vs. 21.10%), while the non-visualization rate (14.68%) was significantly lower than that of coronal reconstruction (40.37%) (P<0.05). The area under the curve (AUC) values of the "lateral crescent sign" and the "direct inguinal hernia triangle filling sign" for differentiating direct from indirect inguinal hernia were 0.812 and 0.843, respectively, while the AUC value of the "femoral triangle filling sign" for distinguishing femoral hernia from other types of hernia was 0.831 (P<0.05). The incarceration rate of femoral hernia (72.00%, 18/25) was significantly higher than that of indirect hernia (14.58%, 7/48) and direct hernia (16.67%, 6/36) (χ²=36.241, P<0.001). The optimal cutoff values of the hernia sac neck ratio for predicting incarceration in indirect, direct, and femoral hernias were 2.40, 3.70, and 3.30, respectively, with corresponding AUC values of 0.852, 0.876, and 0.791.

CT MPR technology can clearly delineate the anatomical structures of the inguinal region. Its characteristic imaging signs enable accurate differentiation of various types of inguinal hernias, and the hernia sac neck ratio can effectively quantify and predict the risk of incarceration, thereby providing a reliable basis for individualized clinical treatment planning.

To investigate the current status of quality of life (QoL) in patients with medium-to-large incisional hernia and its influencing factors, and to provide evidence for improving patients' QoL.

A retrospective survey was conducted among 43 patients with incisional hernia admitted to Shandong Provincial Hospital Affiliated to Shandong First Medical University from January to December 2025. Data were collected using a general information questionnaire, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30), the Generalized Anxiety Disorder-7 (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), and the Sense of Coherence Scale (SOC-9). Rank-sum tests, Spearman correlation analysis, and multiple stepwise linear regression were used to identify factors influencing the QoL summary score.

The median QoL summary score was 87.09 (75.00, 94.23) points. Multiple stepwise linear regression analysis showed that education level, frailty, and anxiety were independent influencing factors of QoL in patients with incisional hernia (P<0.05).

QoL in patients with incisional hernia is affected by multiple factors, including physiological, psychological, and social aspects. Healthcare professionals should emphasize frailty screening and psychological assessment, strengthen health education and psychological support, and implement comprehensive interventions such as prehabilitation to enhance physiological reserve and further improve patients' QoL.

To evaluate the clinical efficacy of laparoscopic total extraperitoneal patch repair (TEP) in the treatment of adult umbilical hernia.

A retrospective cohort study was conducted including 76 patients with umbilical hernias admitted to Hanzhong People's Hospital between February 2022 and February 2025. Patients were assigned to a control group (n=33) and an observation group (n=43). The control group underwent laparoscopic intraperitoneal onlay mesh (IPOM), whereas the observation group underwent laparoscopic TEP. The surgery-related indicators, visual analog scale (VAS) pain score, gastrointestinal function recovery, stress factor indicators, peripheral blood inflammatory factor indicators, complications and recurrence were compared between the two groups.

The observation group had a significantly longer operative time (8.16, 95% CI 0.74–15.58 min) and intraoperative blood loss (0.84, 95% CI 0.12–1.56 ml) compared to the control group, while showing shorter postoperative first out-of-bed time (-1.37, 95% CI -2.33–-0.41 h) (P<0.05). Repeated-measures analysis of variance (ANOVA) for pain VAS scores showed significant main effects of time, group, and their interaction (F_time=454.7, F_group=15.22, F_interaction=3.079; all P<0.05). The overall pain level in the observation group was significantly lower than that in the control group, and pain relief was more rapid in the observation group. For simple effects analysis at each time point revealed that the observation group had significantly lower pain VAS scores at postoperative day 1 and postoperative week 1 (P<0.05). All parameters including first anal gas expulsion time (-0.81, 95% CI -1.51–-0.11 h), first bowel movement time (-2.73, 95% CI -4.62–-0.84 h), intestinal sound recovery time (-1.12, 95% CI -2.11–-0.13 h), and resumption of feeding time (-1.34, 95% CI -2.30–-0.38 h) were significantly shorter in the observation group (P<0.05). On postoperative day 1, serum levels of epinephrine (-8.08, 95% CI -14.18–-1.98 pg/ml), cortisol (-10.69, 95% CI -21.05–-0.33 nmol/L), and noradrenaline (-7.07, 95% CI -12.61–-1.53 pg/ml) were elevated in both groups compared to preoperative levels, with the observation group showing lower values than the control group (P<0.05). No cases of incomplete intestinal obstruction or hernia recurrence were observed in either group at 3 months postoperatively, and there was no statistically significant difference in overall complication rates (P>0.05).

Compared with IPOM, laparoscopic TEP in the treatment of adult umbilical hernia offers advantages in promoting early ambulation and reducing early postoperative pain, is associated with reduced stress levels, and demonstrates a favorable safety profile.

To compare operative outcomes, safety, and feasibility between single-incision (SIL-) and three-port totally extraperitoneal(TEP) inguinal hernia repair.

This was a retrospective cohort study. We retrospectively analyzed the clinical data of 160 adult patients who underwent SIL-TEP or TEP inguinal hernia repair in the Hernia Surgery Group of Putuo Hospital Affiliated with Shanghai University of Traditional Chinese Medicine from December 2020 to December 2023. The patients were divided into the SIL-TEP group (n=80) and the TEP group (n=80) according to the surgical approach. The operative time, postoperative hospital stay, Visual Analogue Scale (VAS) pain scores at 24 h and 48 h postoperatively, the incidence of complications (including seroma, subcutaneous hematoma, wound infection, mesh infection, and recurrence), and patient satisfaction were compared between the two groups.

There were no statistically significant differences between the two groups in terms of postoperative hospital stay, VAS pain scores at 48 hours postoperatively, or the overall incidence of postoperative complications (P>0.05). Compared with the TEP group, the SIL-TEP group had a longer operative time and lower VAS pain scores at 24 hours postoperatively, with both differences being statistically significant (P<0.05). The surgical satisfaction and incision satisfaction scores in the SIL-TEP group were higher than those in the three-port TEP group, and the difference in incision satisfaction scores between the two groups was statistically significant (P<0.05).

SIL-TEP and TEP demonstrate comparable efficacy and safety; however, SIL-TEP is associated with lower VAS pain scores at 24 hours postoperatively and higher patient satisfaction.

To discuss the safety and effectiveness of retrograde puncture following laparoscopic localization to create operative space in totally extra-peritoneal hernia repair (TEP).

A total of 81 adult patients with inguinal hernia who underwent TEP at People's Hospital of Dehong from April 2020 to September 2022 were selected. All patients underwent retrograde puncture following laparoscopic localization to create operative space. The time of creating the preperitoneal space, postoperative complications and recurrence of the patients were observed.

All 81 cases completed TEP surgery, including two cases with low abdominal surgery history. The mean time for creating preperitoneal space was (7.5±2.2) min. There was no case of conversion to laparoscopic trans-abdominal preperitoneal hernia repair. No peritoneum tear and inferior epigastric vessels injury caused by puncture. There were no postoperative bleeding and no hernia recurrence.

Retrograde puncture following laparoscopic localization to create operative space for TEP repair is safe, simple and effective, and can be widely applied.

To investigate the efficacy and safety of domestic biological mesh during laparoscopic transabdominal preperitoneal hernioplasty (TAPP).

Clinical data from 171 patients who underwent TAPP in the Department of General Surgery of Yantai Yuhuangding Hospital between March 2021 and March 2025 were retrospectively analyzed. According to the type of mesh used, the patients were divided into the domestic biological mesh group(adopted BIOSIS HEALING mesh), the imported biological mesh group(adopted COOK mesh), and the polypropylene synthetic mesh group (adopted polypropylene synthetic mesh). Baseline characteristics, operative outcomes, and postoperative complications were compared among the three groups to evaluate the safety and short-term efficacy of the different meshes used in TAPP.

Compared with the polypropylene synthetic mesh group, the biological mesh groups had significantly lower incidences of postoperative pain and local foreign body sensation (P<0.05). However, there were no significant differences in the incidences of postoperative pain or local foreign body sensation between the domestic biological mesh group and the imported biological mesh group (P>0.05). Compared with the polypropylene synthetic mesh group, the biological mesh groups had significantly higher incidences of seroma and fever (P<0.05). However, no significant differences were found in the incidences of seroma or fever between the domestic biological mesh group and the imported biological mesh group (P>0.05). No short-term postoperative complications such as recurrence or mesh infection were observed in any of the three groups.

Domestic BIOSIS HEALING biological mesh is safe and reliable for use in TAPP. Its safety and short-term efficacy are comparable to those of similar imported products. Postoperative seroma and fever are common complications associated with biological mesh, but they are self-limiting and do not lead to adverse outcomes after symptomatic treatment.

To investigate the efficacy of low-frequency electrical stimulation (LFES) of the bladder and its combination with acupuncture in the treatment of postoperative urinary retention (POUR) following pelvic organ prolapse(POP) surgery.

This was a single-center retrospective cohort study. A total of 817 patients who underwent pelvic floor reconstructive surgery or colpocleisis in the Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Capital Medical University, from January 2018 to December 2025 were enrolled. Among them, 90 patients were selected as study subjects who developed POUR after indwelling catheterization for 48-72 hours postoperatively, characterized by dysuria, poor urinary flow, post-void residual urine volume (PVR)≥100 ml, or inability to void spontaneously requiring re-catheterization. Treatment modalities were selected by physicians based on disease conditions and patient preferences. According to the treatment methods, patients were divided into four groups: indwelling catheterization group (n=34), LFES+indwelling catheterization group (n=31), acupuncture+LFES+indwelling catheterization group (n=21), and indwelling catheterization+acupuncture group (n=4). Successful initial treatment was defined as PVR<100 ml after catheter removal 48 hours post-treatment. The general characteristics of POUR patients, influencing factors of initial treatment efficacy, and treatment outcomes among groups were analyzed.

The mean age of the 90 POUR patients was (68.7±7.9) years. All patients had pelvic organ prolapse quantification (POP-Q) of stage Ⅲ-Ⅳ, including 83 cases (92.2%) of anterior pelvic prolapse; 84 cases (93.0%) had preoperative urinary retention. The acupuncture + indwelling catheterization group included only 4 completed cases and discontinued study without comparative analysis. Among the remaining three groups, the acupuncture+ LFES+ indwelling catheterization group had significantly higher proportions of patients with longer preoperative urinary retention duration, POP-Q stage Ⅳ, vaginal closure surgery, concurrent hysterectomy, or tension-free vaginal tape (TVT) procedure than the indwelling catheterization group and LFES+indwelling catheterization group (P<0.05). The overall initial treatment success rate of the three groups was 80.2% (69/86). Compared with the initial treatment success group, the failure group had a higher median PVR and longer catheter indwelling time, with statistically significant differences (P<0.05). All patients in the failure group had the most severe prolapse at the anterior pelvic compartment, which was higher than 89.9% in the success group, but the difference was not statistically significant (P>0.05). All patients with initial treatment failure recovered after subsequent LFES combined with acupuncture treatment. The initial treatment success rates of the indwelling catheterization group, LFES+indwelling catheterization group, and acupuncture+LFES+indwelling catheterization group were 88.2% (30/34), 77.4% (24/31), and 71.4% (15/21), respectively, with no statistically significant difference (P=0.279).

Severe anterior pelvic prolapse (POP-Q stage Ⅲ-Ⅳ) with long-term urinary retention, advanced age and poor physical condition, and complex pelvic floor surgery may be high-risk factors for POUR. High PVR and prolonged catheter indwelling time may affect treatment efficacy. The combined therapy of LFES, acupuncture and indwelling catheterization achieves comparable efficacy in patients with severe POUR to that of simple catheterization and LFES plus catheterization in patients with mild POUR. However, this conclusion still needs to be further verified by multicenter prospective randomized controlled trials.

To explore the anesthetic effect and safety of remimazolam combined with dexmedetomidine nasal drops in pediatric laparoscopic high ligation of hernia sac surgery.

This study was a retrospective cohort study. We retrospectively analyzed the clinical data of 201 children with indirect inguinal hernia who underwent laparoscopic high ligation of the hernial sac at Xi'an Children's Hospital from March to December 2025. The patients were divided into an experimental group (n=101) and a control group (n=100) according to the anesthesia regimen. The experimental group received remimazolam combined with dexmedetomidine nasal drops for anesthesia, while the control group received propofol combined with dexmedetomidine nasal drops for anesthesia. The heart rate, mean arterial pressure (MAP), oxygen saturation (SpO₂), anesthesia induction time, recovery time, length of stay in the post-anesthesia care unit (PACU), and anesthesia-related adverse reactions were compared between the two groups at four time points: before anesthesia induction (T₀), 5 minutes after induction (T₁), 5 minutes after the start of surgery (T₂), and at the end of surgery (T₃).

Repeated-measures analysis of variance showed that there were statistically significant differences in the fluctuation ranges of heart rate and MAP between the two groups of children at different time points in terms of inter-group effect (F_group=5.824, 3.837; P_group=0.005, 0.015), time effect (F_time=2.975, 7.387; P_time=0.018, 0.006), and interaction effect (F_interaction=3.718, 3.539; P_interaction=0.002, 0.025). Further pairwise comparisons with Bonferroni correction in simple effect analysis revealed that, compared with T0, heart rate and MAP decreased at T1 and increased at T2 and T3 in both groups. However, the fluctuation ranges of heart rate and MAP at all time points in the experimental group were significantly smaller than those in the control group (P<0.05). For SpO₂, there were no statistically significant differences in the inter-group effect (F_group=2.141, P_group=0.061), time effect (F_time=6.264, P_time=0.089), and interaction effect (F_interaction=2.911, P_interaction=0.117) (all P>0.05). The anesthesia induction time, awakening time, and PACU stay time in the experimental group were shorter than those in the control group (t=2.362, 19.634, 2.259; all P<0.05). There was no statistically significant difference in the total incidence of anesthesia-related adverse reactions between the experimental group and the control group (7.92% vs 10.00%; χ²=0.266, P=0.606).

Remimazolam combined with dexmedetomidine nasal drops is used for pediatric laparoscopic high ligation of hernia sacs. The anesthetic effect is rapid, the recovery is swift, it can stabilize the perioperative hemodynamics, the incidence of adverse reactions is low, and the safety is high.

To compare the efficacy, rehabilitation and cost-effectiveness of Lichtenstein hernia repair versus laparoscopic trans-abdominal preperitoneal repair (TAPP) for inguinal hernia treatment.

In this retrospective controlled study, clinical data of 260 patients with inguinal hernia who were admitted to Suining Hospital of Traditional Chinese Medicine and Suining Central Hospital between June 2022 and June 2024 were analyzed. According to the different surgical methods, they were divided into the Lichtenstein group (n=132) and the TAPP group (n=128). Surgical outcomes, postoperative recovery metrics, and costs of the two groups of patients were compared.

Baseline characteristics were comparable between the two groups. Both techniques demonstrated equivalent surgical success rates and comparable rates of overall complications and 1-year recurrence (all P>0.05). Compared with the TAPP group, the Lichtenstein group had a shorter operation time [(55.8±11.0) vs. (74.9±12.4) minutes, P<0.001], lower incidence of postoperative gastrointestinal dysfunction (0.8% vs. 6.3%, P<0.05), and superior early recovery evidenced by shorter time to oral intake and ambulation, reduced urinary catheterization rate (all P<0.05), and higher patient satisfaction scores [(8.9±0.8) vs. (7.2±1.1), P<0.05]. Health economic analysis showed significantly lower median total costs for the Lichtenstein group (5510.4 Yuan vs. 9261.3 Yuan, P<0.01), driven predominantly by savings in anesthesia and material expenses.

Lichtenstein and TAPP repairs have comparable success rates, overall complications, and recurrence rates for inguinal hernia. The Lichtenstein approach offers distinct advantages in operative efficiency, enhanced early recovery, and significant cost savings. From a multi-dimensional perspective, the Lichtenstein procedure remains a practical option.

To compare the effect of laparoscopic trans-abdominal preperitoneal repair (TAPP) and traditional tension-free repair in the treatment of inguinal hernia, with emphasis on the effects on postoperative pain, seroma and recurrence.

This was a retrospective cohort study. A total of 81 patients with inguinal hernia admitted to the Second People's Hospital of Bengbu between January 2019 and June 2022 were included. The patients were divided into a laparoscopic group (TAPP, n=43) and an open group (traditional tension-free repair, n=38) according to the different surgical methods. The surgical-related indicators, pain degree, changes in inflammatory factor levels before and after surgery, and the incidence of complications 1-year after surgery were compared between the two groups of patients.

The surgeries were successful in both groups. The surgical time in laparoscopic group was longer than that in open group [(61.59±10.42) min vs (40.31±9.65) min, P<0.05], and the postoperative blood loss was less than that in open group [(12.18±2.59) ml vs (29.04±4.75) ml, P<0.05], and the postoperative ambulation time, postoperative exhaust time and postoperative hospital stay were all shorter than those in open group [(6.75±1.18) h, (16.82±3.75) h, (4.16±0.98) d vs (9.16±1.52) h, (22.04±4.17) h, (4.69±1.21) d, all P<0.05]. The visual analogue scale (VAS) pain scores in laparoscopic group at 6 h, 1 d, 3 d, and 7 d after surgery were (4.53±0.61) points, (3.19±0.35) points, (2.46±0.31) points and (1.81±0.29) points, which were lower than those in open group [(5.27±0.68) points, (3.52±0.39) points, (2.73±0.30) points, (2.14±0.34) points, all P<0.001]. The levels of CRP, IL-6 and MMP-9 in laparoscopic group were lower than those in open group (all P<0.001). In laparoscopic group, there were 3 cases of Morales type Ⅰ and 1 case of type Ⅱ seroma. In open group, there were 7 cases of type Ⅰ, 2 cases of type Ⅱ, 1 case of type Ⅲ and 1 case of type Ⅳ seroma. The degree of seroma in laparoscopic group was milder than that in open group (Z=5.269, P=0.022). Recurrence occurred in 1 case (2.33%) in laparoscopic group and 2 cases (5.26%) in open group within 1 year after surgery. There was no significant difference in recurrence rate between the two groups (χ²=0.488, P>0.05). The total incidence of other complications in the laparoscopic group was lower than that in the open group (4.65% vs 21.05%; χ²=5.015, P=0.025).

Compared with open tension-free repair, TAPP can better relieve the postoperative pain and reduce the incidence of seroma, but the recurrence rates of the two types of surgery are comparable.

To analyze the distribution of comorbidities in elderly female patients aged ≥65 years undergoing surgery for pelvic organ prolapse (POP), and to explore the role of multidisciplinary team (MDT) participation in perioperative management in ensuring medical safety.

A single-center retrospective cohort study was conducted to analyze the clinical data of 237 patients who underwent POP surgery at the Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, from January 2021 to December 2025. The patients were divided into the MDT group (n=185) and the non-MDT group (n=52) based on whether MDT was implemented. To analyze the overall distribution of multidisciplinary comorbidities in patients undergoing POP surgery, and to compare perioperative comorbidity-related complications between the two groups of patients.

Among the 237 patients, the median age was 70 (68.0-73.5) years. The comorbidities included hypertension (62.9%), coronary artery stenosis (47.3%), diabetes (29.1%), old cerebral infarction (21.9%), cerebrovascular stenosis (21.1%), taking drugs for hyperlipidemia (16.5%), osteoarthritis (11.4%), and thrombotic diseases (6.8%). Among them, 185 patients (78.1%) were managed by MDT after initial assessment by attending gynecologists specializing in pelvic floor disorders, who identified severe multidisciplinary comorbidities in these patients. Postoperatively, 81 cases (34.2%) of 237 POP surgery patients developed complications, among which 42 cases (17.7%) were new thrombotic diseases. The proportion of patients transferred to the SICU postoperatively, the incidence of postoperative complications, postoperative urinary retention, and the length of postoperative hospital stay were all higher in the MDT group than in the non-MDT group (20.0% vs 3.8%; 38.9% vs 17.3%; 21.1% vs 7.7%; 7(6-9) days vs 6(5-7) days, and the differences were statistically significant (P<0.05). However, no statistically significant differences were observed in surgical time, postoperative changes in hemoglobin levels, venous thromboembolism scores, or the incidence of new thrombotic diseases between two groups (P>0.05).

Elderly women over 65 years old with POP often have multiple comorbidities. Conducting a preoperative MDT assessment for these patients and involving experts from relevant fields in perioperative management are critical to ensuring their surgical safety.