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 explore the application effects of the intermediate approach and the left anterior approach in laparoscopic radical resection for advanced gastric cancer (AGC) in middle-aged and elderly patients.

The data of 91 middle-aged and elderly patients with localized AGC who underwent laparoscopic radical resection from January to December 2022 were retrospectively analyzed. The patients were grouped according to the surgical approach. 46 patients in the intermediate group received the intermediate approach; 45 patients in the left anterior group received the left anterior approach. Data were analyzed using SPSS 25.0 software. Quantitative data were expressed as (±s), and independent sample t test were used; count data were expressed as [cases (%)], and χ² tests or Fisher’s exact tests were performed; survival analysis was conducted using the Kaplan-Meier method. P<0.05 was considered statistically significant.

There were no statistically significant differences in the number of lymph node dissections during the operation, 24-hour postoperative serum C-reactive protein (CRP), superoxide dismutase (SOD) levels, and complication rates between the two groups (P>0.05); the operation time and intraoperative blood loss of the intermediate group were less than those of the left anterior group (P<0.05). Before closure, the serum dopa decarboxylase (DDC) and carcinoembryonic antigen (CEA) levels of the intermediate group were lower than those of the left anterior group (P<0.05); the 3-year recurrence rate of the intermediate group was lower than that of the left anterior group (P<0.05). The 3-year overall survival rate of the intermediate group was 87.0%, which was higher than that of the left anterior group (68.9%), and the disease-free survival period and overall survival period were longer than those of the left anterior group (P<0.05).

The intermediate approach and the left anterior approach laparoscopic radical resection for AGC in middle-aged and elderly patients have no statistically significant differences in the number of lymph node dissections during the operation, postoperative stress response, and complications. However, compared with the left anterior approach, the intermediate approach has shorter operation time, less intraoperative blood loss, lower 3-year recurrence rate, and longer disease-free survival period and overall survival period.

To investigate the clinical efficacy of complete laparoscopic transabdominal transdiaphragmatic hiatus approach for radical resection of Siewert typeⅡadenocarcinoma of the esophagogastric junction.

A total of 78 patients with Siewert typeⅡadenocarcinoma of the esophagogastric junction (AEG) admitted from January 2021 to December 2023 were prospectively selected as the research subjects. The patients were divided into the control group and the study group by the digital table method, with 39 cases in each group. The control group underwent surgery through the left thoracic-abdominal combined approach, while the study group underwent surgery through the transabdominal transdiaphragmatic hiatus approach. Data were analyzed using SPSS 25.0 statistical software. The surgical time, postoperative complications, cardiac and pulmonary functions, and survival status of the two groups were compared.

The operation time, blood loss, time to first ambulation, time to first defecation, and postoperative hospital stay of the study group were significantly shorter than those of the control group (P<0.05). The total incidence of postoperative complications in the study group (12.8%) was significantly lower than that in the control group (33.3%), and the difference was statistically significant (P<0.05). The levels of SV, LVEF, FVC, and FEV1 of the two groups after surgery were significantly lower than those before surgery, and the levels of each index in the study group were significantly higher than those in the control group (P<0.05). There was no statistically significant difference in the cumulative disease-free survival rate (71.8% vs. 69.2%) and cumulative overall survival rate (76.9% vs. 71.8%) between the two groups (Log-Rank χ²=0.013, 0.063, P=0.909, 0.802).

The complete laparoscopic transabdominal transdiaphragmatic hiatus approach for radical resection of Siewert typeⅡAEG has significant short-term efficacy, does not affect the effect of lymph node dissection and prognosis, can shorten the operation time, reduce intraoperative injury, lower the incidence of postoperative complications, promote postoperative recovery, and has high promotion value.

To explore the feasibility and effectiveness of a standardized parenteral nutrition (PN) treatment process constructed based on an informatized whole-process nutrition management system, evaluate its value in optimizing the rationality of PN prescriptions, improving treatment efficacy, and reducing adverse reactions, and provide a reference for establishing a safer and more effective informatized whole-process nutrition management system for standardized PN treatment processes.

A single-center prospective randomized cluster-controlled study was conducted. A total of 210 patients who required PN support after gastric cancer resection from May to October 2022 were enrolled. A randomized block design was adopted, with the ward medical team as the blocking factor. One group was randomly selected as the intervention group (n=105), and the other groups served as the control group (n=105). In the intervention group, clinical pharmacists formulated PN regimens in accordance with the established standardized PN treatment process; in the control group, clinical physicians formulated PN regimens based on conventional experience. Statistical analysis of data was performed using SPSS 26.0 software. Data were expressed as (±s) or [cases (%)], and independent samples t test or χ² test was used for comparison. P<0.05 was considered statistically significant.

After PN treatment: In the control group, levels of creatinine, hemoglobin, and blood potassium decreased, while levels of estimated glomerular filtration rate (eGFR), triglycerides, platelets, blood sodium, and blood calcium increased (all P<0.05). The intervention group showed the same changing trend of the above indicators as the control group; additionally, levels of aspartate aminotransferase (AST) and total bilirubin decreased, and albumin level increased (all P<0.05). Inter-group comparison showed that levels of albumin, blood phosphorus, and blood potassium in the intervention group were higher than those in the control group (all P<0.05). Compared with the control group, the intervention group had significantly better outcomes in terms of average blood glucose level, daily maximum blood glucose value, and blood glucose fluctuation range (all P<0.05). The incidence of hyponatremia, hypophosphatemia, and hyperglycemia in the intervention group was lower (all P<0.05). There were no cases of unreasonable energy and fluid volume in the intervention group, which was significantly better than the control group (P<0.05). The intervention group had earlier times of first postoperative flatus and defecation, and fewer hospital stays, but the differences were not statistically significant (all P>0.05).

The standardized PN formulation process constructed based on the informatized whole-process nutrition management system significantly improves the rationality of PN prescriptions and enhances the control of patients’ blood glucose and electrolytes, providing a reference for the implementation of a more standardized and comprehensive informatized whole-process nutrition management.

To explore the clinical efficacy of laparoscopic radical resection assisted by a preoperative small incision in the treatment of advanced distal gastric cancer.

The clinical data of 115 patients with advanced distal gastric cancer who underwent surgery from February 2022 to November 2023 were collected retrospectively. According to the different surgical methods, the patients were divided into two groups: Routine Group: 56 patients who underwent conventional laparoscopic radical resection; study Group: 59 patients who underwent laparoscopic radical resection assisted by a preoperative small incision. Data were processed using SPSS 25.0 statistical software. Measurement data conforming to a normal distribution were expressed as (±s) and analyzed by independent samples t test. Postoperative Visual Analogue Scale (VAS) scores were tested by general linear repeated-measures analysis of variance (ANOVA). Recurrence time was analyzed using Kaplan-Meier statistics. Categorical data were expressed as [cases (%)] and analyzed by the χ² test. P<0.05 was considered statistically significant.

The operation time of the Study Group was shorter than that of the Routine Group, and the number of intraoperative lymph node dissections was greater than that of the Routine Group (both P<0.05). There were no statistically significant differences between the two groups in terms of postoperative time to get out of bed, time to first flatus, or length of hospital stay (all P>0.05). At 6h, 12h, 24h, and 48h postoperatively, the VAS scores of both groups decreased gradually (all P<0.05); however, there were no statistically significant differences in VAS scores between the two groups at each postoperative time point (all P>0.05). There were no statistically significant differences between the two groups in the total incidence of postoperative complications or the 12-month postoperative recurrence rate (all P>0.05). The recurrence time of patients with recurrence in the Study Group was longer than that in the Routine Group (P<0.05).

Laparoscopic radical resection assisted by a preoperative small incision can shorten the operation time of advanced distal gastric cancer, increase the number of intraoperative lymph node dissections, without increasing postoperative pain and complications, and can ensure good oncological efficacy. It has value for popularization and application.

To compare the therapeutic effects of different laparoscopic surgical methods for cT₁N₀M₀ gastric cancer.

Clinical data of 81 patients with cT₁N₀M₀ gastric cancer who underwent laparoscopic gastrectomy from January 2021 to January 2024 were collected. According to the surgical method, patients were divided into the LADG group (n=41, laparoscopic distal gastrectomy) and the LAPPG group (n=40, laparoscopic pylorus-preserving gastrectomy). Data were processed using SPSS 25.0 software, and t test or χ² test was used for comparison. P<0.05 was considered statistically significant.

Compared with the LADG group, the LAPPG group had lower hospitalization costs, higher levels of total protein, albumin, and hemoglobin at 3 months postoperatively, a higher incidence of gastric emptying disorders, and a lower incidence of bile reflux gastritis (P<0.05). There were no significant differences in recurrence rate, survival rate, disease-free survival, or overall survival between the two groups during the 12-month postoperative follow-up (P>0.05).

LADG and LAPPG have comparable therapeutic effects for cT₁N₀M₀ gastric cancer. However, compared with LADG, LAPPG is more conducive to improving the postoperative nutritional status of patients, reducing the occurrence of bile reflux gastritis, and has lower hospitalization costs, but it may increase the risk of postoperative gastric emptying disorders.

To explore the effect of 3D laparoscopy in the lymph node dissection for low-stage advanced rectal cancer under three-dimensional reconstruction, and to analyze its impact on postoperative micro-inflammation and intestinal mucosal function of patients.

A total of 120 patients with low-stage advanced rectal cancer from our hospital from January 2019 to January 2023 were retrospectively selected as the research subjects. The patients were divided into the observation group (n=56, who received pelvic structure MRI three-dimensional reconstruction before surgery) and the control group (n=64, who received MRI scan before surgery but did not undergo three-dimensional reconstruction). Data were analyzed using SPSS20.0 statistical software. Quantitative data with normal distribution were analyzed using the independent sample t test; count data were analyzed using the χ² test. P<0.05 was considered statistically significant.

Compared with the control group, the operation time, hospital stay, and intestinal function recovery time of the observation group were shorter, the intraoperative blood loss was less, and the number of resected lymph nodes and positive lymph nodes was higher (P<0.05). There was no statistically significant difference in preoperative micro-inflammatory indicators and intestinal mucosal function indicators between the two groups (P>0.05). Postoperative levels of C-reactive protein (CRP), tumor necrosis factor (TNF)-α, interleukin (IL)-6, diamine oxidase (DAO), D-lactic acid (D-LA), and endotoxin (ET) in both groups increased, while the level of IL-10 decreased. There was no statistically significant difference in ET levels between the two groups (P>0.05), but the levels of CRP, TNF-α, IL-6, DAO, and D-LA in the observation group were lower than those in the control group, and the level of IL-10 was higher in the observation group (P<0.05).

Three-dimensional reconstruction under 3D laparoscopy can improve the effect of lymph node dissection for low-stage advanced rectal cancer, and can also alleviate postoperative micro-inflammation and improve intestinal mucosal function of patients.

To explore the clinical efficacy of emergency laparoscopic resection and stent placement versus definitive laparoscopic resection for obstructive colorectal cancer.

112 patients with obstructive colorectal cancer were divided into the observation group (receiving emergency stent placement followed by definitive laparoscopic resection) and the control group (undergoing emergency laparoscopic surgery) by a 1:1 matching method, with 56 patients in each group. t test or χ² test was used to compare the perioperative indicators, inflammatory indicators, immune function indicators, quality of life, and complication rates between the two groups. P<0.05 was considered statistically significant.

Compared with the control group, the observation group had significantly less intraoperative blood loss, significantly higher primary anastomosis rate, significantly shorter first defecation time, significantly higher total hospitalization cost (P<0.05), and significantly lower positive rate of circumferential resection source. Postoperative levels of C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) in both groups significantly decreased, and the observation group was significantly lower than the control group (P<0.05); CD3⁺, CD4⁺, and CD4⁺/CD8⁺ were significantly lower than before treatment, but the observation group was significantly higher than the control group (P<0.05). The core quality of life scale (EORTC QLQ-C30) of cancer patients in both groups showed significantly lower fatigue symptoms after surgery, and the observation group was significantly lower than the control group (P<0.05); the scores of role function, physical function, and overall health status after surgery were significantly higher in the observation group than in the control group (P<0.05). The total incidence of complications in the observation group was significantly lower than that in the control group (P<0.05).

Emergency stent placement followed by definitive laparoscopic resection for patients with obstructive colorectal cancer can significantly reduce intraoperative trauma, promote postoperative recovery, reduce the body's inflammatory response and protect immune function, improve the quality of life of patients, and effectively reduce the occurrence of complications.

To compare the clinical effects of transvaginal and transanal natural orifice specimen extraction surgery (NOSE) in laparoscopic radical resection of colorectal cancer (CRC) in women.

The clinical data of 112 female CRC patients from June 2023 to May 2025 were retrospectively analyzed. They were divided into the vaginal group (n=41, specimens removed through the vagina) and the anal group (n=71, specimens removed through the anus) based on different NOSE methods. The measurement data conforming to normal distribution were expressed as (±s), and independent sample t test was used; the count data were analyzed by χ² test. P<0.05 was considered statistically significant.

The operation time, postoperative hospital stay, time to first flatus, time to first defecation, and time to start liquid diet in the vaginal group were all shorter than those in the anal group (P<0.05). There were no statistically significant differences in intraoperative blood loss, lengths of proximal and distal resected intestinal segments, number of lymph nodes dissected, and complication rates between the two groups (P>0.05). Three months after surgery, the Female Sexual Function Index (FSFI) of both groups increased compared with that before surgery, and the Pelvic Floor Impact Questionnaire 7 (PFIQ-7) score and Pelvic Floor Distress Inventory 20 (PFID-20) score decreased compared with those before surgery (P<0.05), but there were no statistically significant differences in these indicators between the two groups (P>0.05).

Transvaginal specimen extraction during laparoscopic CRC resection can significantly simplify the surgical procedure, accelerate postoperative gastrointestinal function and physical recovery, without increasing the risk of pelvic floor dysfunction or complications, under the premise of ensuring the radical effect and surgical safety. It can be used as an efficient and safe specimen extraction method in laparoscopic surgery for female CRC patients.

To explore the safety, feasibility and clinical application value of "three-port method" laparoscopic surgery in the treatment of acute sigmoid colon perforation.

The clinical data of 46 patients with sigmoid colon perforation from September 2016 to March 2025 were retrospectively analyzed. The patients were divided into the control group (n=23) and the observation group (n=23) according to different surgical methods. The observation group underwent "three-port method" laparoscopic partial sigmoid colon resection + colostomy, while the control group underwent open surgery for partial sigmoid colon resection + colostomy. Data were processed using SPSS 22.0 statistical software. Quantitative data such as perioperative indicators were expressed as (±s), and t tests were performed. The incidence of postoperative complications was expressed as [cases (%)], and chi-square tests were conducted. P<0.05 was considered statistically significant.

There was no statistically significant difference in intraoperative blood loss and operation time between the two groups (P>0.05). In terms of postoperative time, postoperative hospital stay, postoperative standing time, incision infection and postoperative analgesia, the observation group was significantly better than the control group, and the differences between the two groups were statistically significant (P<0.05). There was no statistically significant difference in preoperative CRP index values between the two groups (P>0.05), but there was a statistically significant difference in CRP index values 3 days after surgery (P<0.05).

Compared with traditional open surgery, the "three-port method" laparoscopic surgery also has safety and operability, and has obvious advantages in postoperative recovery, postoperative pain and incision healing. It is worthy of clinical application and promotion.

To explore the application value of neural monitoring technology in assisting the identification and protection of pelvic autonomic nerves (PAN) and Denonvilliers’ fascia during total mesorectal excision (TME) for male patients with middle and low rectal cancer, and to re-examine the relevant anatomical structures.

A retrospective study was conducted. A total of 78 male patients with middle and low rectal cancer who underwent TME from October 2021 to December 2022 were selected as the observation group (intraoperative pelvic autonomic nerve monitoring was performed). Meanwhile, 80 patients who underwent TME during the same period were included as the control group (intraoperative PAN protection was conducted without neural monitoring). SPSS 27.0 software was used for data analysis. Measurement data conforming to a normal distribution were expressed as (mean±standard deviation). Independent samples t test was used for inter-group comparison, and paired samples t test was used for comparison of data at different time points within the same group. Categorical data were analyzed using the χ² test. P<0.05 was considered statistically significant.

After tumor resection, there were no statistically significant differences in the potential changes of effector organs such as the prostate, seminal vesicles, bladder, and internal/external anal sphincters compared with those before tumor resection (P>0.05). At 6 months postoperatively, the International Prostate Symptom Score (IPSS) of patients in both groups was higher than that before surgery, and the International Index of Erectile Function-5 (IIEF-5) score was lower than that before surgery. Moreover, the IPSS score of the observation group was lower than that of the control group, and the IIEF-5 score was higher than that of the control group, with statistically significant differences (P<0.05). At 12 months postoperatively, the IPSS score of the control group was still higher than that before surgery, and the IIEF-5 score was still lower than that before surgery (P<0.05); however, there were no statistically significant differences between the above scores of the observation group and those before surgery (P>0.05). Additionally, the IPSS score of the observation group was lower than that of the control group, and the IIEF-5 score was higher than that of the control group (P<0.05). There was a statistically significant difference in the total incidence of postoperative complications between the two groups (P<0.05).

Implementing pelvic autonomic nerve monitoring during TME for male patients with middle and low rectal cancer can accurately identify and preserve PAN and their branches during surgery, reduce PAN injury to ensure the integrity of their functions, and improve patients’ postoperative urogenital function. Meanwhile, correct identification of Denonvilliers’ fascia during surgery and mastery of its anatomical techniques are helpful for maintaining the correct surgical anatomical plane, better protecting PAN, thereby further improving patients’ prognosis and promoting the standardized implementation of TME surgery.

To study the value of computed tomography angiography (CTA) in evaluating the classification of the inferior mesenteric artery (IMA) and guiding laparoscopic rectal cancer surgery.

The clinical data of 195 patients with rectal cancer who underwent laparoscopic radical resection of rectal cancer from December 2021 to January 2024 were analyzed retrospectively. The patients were divided into two groups according to the examination method: Observation Group: 107 patients who underwent CTA examination; Control Group: 88 patients who underwent conventional CT examination. Data were analyzed using SPSS 22.0 software. Data were expressed as (±s), [M(IQR)] (median and interquartile range), or [cases (%)] (number of cases and percentage). Statistical tests including t test, nonparametric Rank-Sum test, χ² test, or Fisher’s exact test were used as appropriate. P<0.05 was considered statistically significant.

The operation time, intraoperative blood loss, length of hospital stay, and time to first ambulation after surgery in the Observation Group were significantly better than those in the Control Group, with Cohen’s |d|>0.8 for all indicators, and the differences were statistically significant (all P<0.05). The total incidence of postoperative complications in the Observation Group was lower than that in the Control Group, with a statistically significant difference (P<0.05). The coincidence rate between the intraoperative findings of mesenteric blood vessels and their branches and the preoperative multi-slice spiral computed tomography angiography (MSCTA) results in the Observation Group was significantly higher than that in the Control Group (100% vs. 90.9%, P<0.05). Among patients with IMA classification of Type Ⅰ–Ⅲ, the operation time and intraoperative blood loss in the Observation Group were lower than those in the Control Group, and the differences were statistically significant (all P<0.05).

Performing CTA before radical resection of rectal cancer can assist surgeons in efficiently planning the operation and significantly shortening the operation time; it helps clarify the vascular distribution preoperatively and enables precise intraoperative operation to reduce blood loss; it optimizes the surgical plan, reduces the incidence of postoperative complications, and strongly promotes the postoperative recovery of patients.

Effect of Laparoscopic Radical Resection via Cranial-Caudal Combined Approach for Right-Sided Colon Cancer Objective To explore the short-and medium-term effects of laparoscopic radical resection via the cranial-caudal combined approach versus the complete cranial approach in the treatment of right-sided colon cancer.

Clinical data of 127 patients with right-sided colon cancer admitted from March 2019 to March 2023 were collected. According to the surgical approach, patients were divided into the combined group (n=65, cranial-caudal combined approach) and the cranial group (n=62, complete cranial approach). Data were analyzed using SPSS 25.0 statistical software. Measurement data conforming to normal distribution were expressed as (±s) and compared by independent sample t test; enumeration data were expressed as cases or percentages and compared by χ² test. A two-tailed test with α=0.05 was used for statistical significance.

Compared with the cranial group, the combined group had shorter operation time, less intraoperative blood loss, more dissected lymph nodes, earlier first extubation time, and shorter hospital stay (P<0.05). After surgery, the serum levels of carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), and carbohydrate antigen 19-9 (CA19-9) in both groups were lower than those before surgery (P<0.05), but there was no significant difference between the two groups (P>0.05). There were no statistically significant differences in the total incidence of complications within 30 days after surgery or the recurrence rate within 2 years after surgery between the two groups (P>0.05).

Laparoscopic D3 radical resection for right-sided colon cancer via the cranial-caudal combined approach and the complete cranial approach achieves comparable oncological efficacy. However, the cranial-caudal combined approach can increase the number of dissected lymph nodes, shorten operation time and reduce intraoperative blood loss, and enable earlier extubation and hospital discharge.