Objective To explore the advantage of transection the cervical muscles at sternal end and flip fixed in therapeutic bilateral huge thyroid surgery. Methods The transection of the cervical muscles at sternal end and flip fixed in 53 cases was observation group， 44 cases of the neck white line incision thyroid surgery completed for the control group. The completion of the surgery by the same group of physicians. The operative time， operation field of exposing effect， amount of bleeding in operation， postoperative complications， and postoperative drainage volume were compared between two groups. Results There was no statistically differences of sex， age， disease composition， and tumor size between two groups （P＞0.05）. Operative time， amount of bleeding， and postoperative drainage volume in observation group were shorter （less） than that in control group （P＜0.01）. The postoperative complication rate in observation group was lower than that in control group（P=0.04）. Surgical field exposure in observation group was better than that in control group （P＜0.01）. Conclusions The huge bilateral thyroid surgery with the sternal end approach is feasible and simple. The operation field exposure is better than the white line neck incision， complications after operation is less. It is worthy of clinical application.
目的 探讨乳房肿物体表定位膜对乳腺彩超结果的影响。方法 回顾性分析2010年12月至2011年1月期间，笔者所在医院乳腺门诊检查触诊阴性的180例患者共236个乳房肿物贴膜前后的彩超检查结果，分析其血运、边界、钙化及分级情况的变化。结果 贴膜后，236个肿物中有2个血运情况有变化，7个边界有变化，5个钙化情况有变化，5个分级有变化，但贴膜前后乳房肿物的血运（P=0.500）、边界（P=0.136）、钙化（P=0.082）及分级（P=0.172）变化情况比较差异均无统计学意义。结论 乳房肿物体表定位膜不影响乳房肿物的彩超检查结果。
ObjectiveTo summarize experiences of diagnosis and treatment of intraperitoneal mass after associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in treatment of hepatocellular carcinoma (HCC).MethodThe clinicopathologic data of a 40 years old case of HCC with intraperitoneal mass after ALPPS in the First Affiliated Hospital of Guangxi Medical University were retrospectively analyzed.ResultsThe patient was admitted to this hospital because of abdominal pain and abdominal distension for 5 d. The intraperitoneal mass was found and its nature was not clear on year 1 after ALPPS on admission. After discussion of multidisciplinary team (MDT), the exploratory laparotomy and abdominal tumor resection were planned to perform. The intraperitoneal mass and appendix were removed, the resected tissues were diagnosed as chronic inflammation and retroperitoneal abscess caused by perforation of suppurative appendicitis, respectively. The anti-infection and symptomatic support treatment were strengthened to perform after operation, the patient discharged after recovery. The patient was followed up so far, the general condition was good, and there was no clinical recurrence.ConclusionsFor patient underwent ALPPS, regular follow-up should be paid attention to. If intraperitoneal mass is found and nature is not clear, MDT discussion should be performed so as to make a more reasonable treatment plan. After exclusion of contraindications, surgical treatment should be carried out to furthest benefit patients.
ObjectiveTo explore the technique of arthroscopic resection of benign tumor in the knee posterior septum and to evaluate its clinical results. MethodsBetween June 2008 and June 2012, 12 cases of benign tumor in the knee posterior septum were treated by arthroscopic surgery. There were 8 males and 4 females with an average age of 36.5 years (range, 22-50 years). The average disease duration was 8.4 months (range, 3 months to 2 years). Of 12 cases, there were 2 cases of chronic synovitis, 5 cases of ganglion, 4 cases of tenosynovial giant cell tumor, and 1 case of synovial hemangioma; solitary tumor involved in the knee posterior septum in 10 cases, and in the posterior septum and other part of the knee in 2 cases. All the patients underwent tumor removal under arthroscope with routine anterolateral and anteromedial portal, additional posteromedial portal and/or posterolateral portal. Trans-septal approach was used in 6 cases because the tumors located in the middle of the posterior septum. ResultsAll wounds healed by first intention with no complications such as infection, haematoma in the knee, injury of vessels and nerves, deep vein thrombosis, osteofascial compartment syndrome, or cutaneous necrosis. All patients were followed up 12-46 months with an average of 18.5 months. All patients achieved relief of knee pain and improvement of knee movement. The range of motion of the knee was significantly improved from (57.08±12.52)° at pre-operation to (120.83±13.95)° at last follow-up (t=-12.84, P=0.00). The visual analogue scale (VAS) score was significantly reduced from 5.00±1.04 at pre-operation to 1.50±0.91 at last follow-up (t=-18.00, P=0.00). The Lysholm score was significantly improved from 49.50±9.07 at pre-operation to 84.58±6.82 at last follow-up (t=-8.04, P=0.00). ConclusionThe benign tumor in the knee posterior septum can be completely resected under arthroscope, and the procedure is minimally invasive and useful to the restore knee function.
Objective To assess the clinical value of a novel surgical technique—Tubeless subxiphoid uniportal video-assisted thoracoscopic surgery with percutaneous suspension technique via balance-shaped sternal elevation device in the resection of anterior mediastinal masses. Methods Patients who underwent tubeless subxiphoid uniportal video-assisted thoracoscopic surgery via balance-shaped sternal elevation device in anterior mediastinal masses process at the Department of Thoracic Surgery, West China Hospital, Sichuan University from March to April 2025 were included, and their clinical data were analyzed. Results A total of 4 patients were included, with 2 males and 2 females, aged 58-75 years. The diameter of the tumor was 2.5-3.0 cm. The operation time was 60.0-150.0 min, intraoperative blood loss was 5-10 mL, pain score on the 3rd day after surgery was 0 points, and postoperative hospital stay was 2-3 days. All patients achieved complete resection of the masses and thymus without perioperative complications. ConclusionThe tubeless subxiphoid uniportal video-assisted thoracoscopic surgery with percutaneous suspension technique via balance-shaped sternal elevation device technique optimizes surgical visualization and instrument maneuverability while avoiding complications related to conventional anesthesia and tubing, thereby markedly enhancing the minimally invasive profile of anterior mediastinal masses resections. In addition to maintaining procedural safety, this approach effectively reduces postoperative pain and accelerates patient recovery, highlighting its potential for widespread clinical adoption.
ObjectiveTo investigate effect of recurrent laryngeal nerve monitoring in video-assisted thyroidectomy for huge thyroid nodules. MethodsThe clinical data of 158 patients with huge thyroid nodules underwent videoassisted thyroidectomy from January 2013 to June 2015 were analyzed retrospectively, the recurrent laryngeal nerves were monitored in 79 cases (monitoring of recurrent laryngeal nerve group) while the recurrent laryngeal nerves were not monitored in the other patients (non-monitoring of recurrent laryngeal nerve group). The operative time, blood loss, postoperative drainage, postoperative hospital stay, and the incidences of transient and permanent recurrent laryngeal nerve injury were observed between these two groups. ResultsThe video-assisted miniincision thyroidectomy was successfully completed in these 158 cases. Compared with the non-monitoring of recurrent laryngeal nerve group, the operative time (min) was shorter (76.2±23.4 versus 89.2±29.8, P < 0.05), the blood loss and the postoperative drainage were less (16.3±13.6 versus 20.6±10.7, P < 0.05; 20.7±9.6 versus 25.5±9.1, P < 0.05) in the monitoring of recurrent laryngeal nerve group. But the postoperative hospital stay (d) had no significant difference between the monitoring of recurrent laryngeal nerve group and the non-monitoring of recurrent laryngeal nerve group (3.2±1.3 versus 3.3±1.9, P > 0.05). Eight weeks later, the incidence of transient recurrent laryngeal nerve injury in the monitoring of recurrent laryngeal nerve group was significantly lower than that in the non-monitoring of recurrent laryngeal nerve group [5.6% (5/90) versus 21.8% (17/78), P < 0.05], while the incidence of permanent nerve injury had no statistical difference between the monitoring of recurrent laryngeal nerve group and the non-monitoring of recurrent laryngeal nerve group [0(0/90) versus 1.3% (1/78), P > 0.05]. ConclusionRecurrent laryngeal nerve monitoring under video-assisted thyroidectomy for huge thyroid nodules could effectively reduce incidence of nerve injury and shorten operation time.
With the adoption of the surgical principles emphasizing minimally invasive, precise, and individualized procedures, the sternum elevation via the subxiphoid approach for thoracoscopic surgery has become an important technique for the resection of anterior mediastinal masses. This method offers significant advantages in terms of increasing surgical field exposure, reducing surgical trauma, alleviating postoperative pain, and improving cosmetic outcomes. To establish a standardized surgical system and promote the consistent implementation of this technique, this consensus integrates the practical experiences of multiple thoracic surgery centers in China and relevant literature reports. It addresses core clinical issues such as surgical indications, preoperative assessment, anesthesia and intraoperative cooperation, key surgical techniques, postoperative management, prevention and treatment of complications, as well as training and quality control systems. The aim is to provide a safer and more effective minimally invasive solution for patients with anterior mediastinal masses and to facilitate the innovation of minimally invasive surgical modalities for the anterior mediastinum.