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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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