To investigate the prognostic impact of metastasis to supraclavicular lymph nodes（SCLNs） in patients with thoracic esophageal squamous cell carcinoma（ESCC）.
Methods
The clinical and survival information of the patients from 1999 to 2009 with thoracic ESCC who underwent esophagectomy with 3-field lymphadenectomy at the Department of Thoracic Surgery，Fujian Cancer Hospital were collected and analyzed.
Results
Of the 1 812 patients，739（40.8%） had no lymph node metastases，878（48.5%） had at least 1 positive node but were SCLN-negative，and 195（10.8%） had SCLN metastases.The 5-year survival rate was 72.4% for nodenegative patients，43.6% for node-positive patients without SCLN metastases，and 32.3% for patients with SCLN metastases.The difference was significant（P＜0.001）.In the multivariate analysis，the male sex（P＜0.001），a higher T stage（P=0.005），and a higher N stage（P＜0.001） retained statistical significance as adverse prognostic factors for overall survival，while SCLN metastasis did not（P=0.521）.A comparison of the 5-year survival rates among patients with SCLN metastases revealed that the SCLN-positive group was more similar to the N2 group（P=0.281） than to the N3 group（P=0.034）.
Conclusions
SCLN can be used as part of regional lymph node dissection for squamous oesophageal cancer and SCLN metastases can be used as stage N2 in staging to improve the accuracy of staging to improve patient prognosis.
To assess the feasibility and safety of utilizing total laparoscopic gastric tube formation for McKeown in patients with esophageal squamous cell carcinoma.
Methods
Forty patients with esophageal squamous cell carcinoma who underwent McKeown esophagectomy at Shanghai Chest Hospital from December 2023 to April 2024 were enrolled.The patients were divided evenly into two groups according to abdominal procedure，one group undergoing total laparoscopic gastric tube formation and the other group undergoing gastric tube formation with a longitudinal midline abdominal incision of approximately 5-8 cm in length.Perioperative indicators of both groups were retrospectively analysed.
Results
All 40 operations were successful without any conversions to open chest or abdominal incisions.There were no instances of mortality，chylothorax，or reoperation complications in either group.No significant differences were observed between the two groups in terms of operation time （240.00±38.15 vs 229.50±37.90 min，P=0.39），blood loss（188.75±75.4 vs 172.50±52.9 mL，P=0.43），lymph node dissection （23.2±6.12 vs 21.7±5.26，P=0.40），or length of the gastric tube in the neck region （11.70±2.47 vs 11.8±2.07 cm，P=0.89）.Additionally，there was no significant difference in postoperative complications such as anastomotic fistula，pneumonia，and pleural effusion between the two groups （P ＞0.05）.Postoperative hospital stay also did not significantly differ between the two groups （8.30±2.36 vs 8.10±3.09 days，P=0.82）.However，pain scores on the first postoperative day were significantly lower in the total laparoscopic gastric tube formation group （4.35±1.39 vs 8.10±3.09，P = 0.02）.
Conclusions
The use of total laparoscopic gastric tube formation to format gastric tube in McKeown esophagectomy for esophageal squamous cell carcinoma was safe and feasible.
To retrospectively compare and analyze the cases of non-small cell lung cancer receiving uniportal thoracoscopy double sleeve lobectomy with thoracotomy approach in Shanghai Pulmonary Hospital，and explore the advantages and safety of uniportal thoracoscopy double sleeve lobectomy.
Methods
A total of 85 cases of double sleeve lobectomy performed in Shanghai Pulmonary Hospital from June 2018 to December 2022 were included consecutively.Patients were followed up by phone every 6 months after surgery.The surgical duration，intraoperative blood loss，drainage on the first day after surgery，postoperative hospital stay，intraoperative lymph node dissection，postoperative complications，Numeric Rating Scale of pain 3 months after surgery，and survival rates were statistically analyzed.
Results
Fifty cases were included in the uniportal group and 35 cases were included in the thoracotomy group.The proportion of patients with a history of smoking was higher in the thoracotomy group，while there was no difference in baseline data between the two groups.The surgery duration of the uniportal group was shorter than that of the thoracotomy group（2.7±0.8 vs 3.2±0.5，P=0.006）.There was no statistically significant difference in intraoperative blood loss，postoperative drainage on the first day，and postoperative hospital stay between the two groups.There was no statistically significant difference in the number and stations of lymph node dissection during surgery and the number of positive lymph nodes after surgery between the two groups.No postoperative death or life-threatening postoperative complications were observed in both groups 30 days after surgery.The proportion of moderate pain in the thoracotomy group was higher than that in the uniportal group at 3 months after surgery（42.4% vs 13.0%，P=0.008）.The median follow-up time was 28（12-56） months，and the 3-year disease-free survival of the uniportal group and thoracotomy group were 74.9% and 63.8%，respectively（P=0.534）；the 3-year overall survival of the uniportal group and thoracotomy group were 81.4% and 79.9%，respectively（P=0.914）.
Conclusions
Uniportal thoracoscopic double sleeve lobectomy has similar surgical effects and postoperative survival rates as traditional thoracotomy approaches.However，uniportal surgery has a shorter surgical duration and significantly reduce postoperative pain in patients.
To explore the application value of LungPro bronchoscopic navigation injection of indocyanine green （ICG） in the localization of multiple pulmonary nodules during surgery.
Methods
A retrospective analysis of clinical data of 58 patients with multiple pulmonary nodules who underwent LungPro bronchoscopic navigation injection of ICG for localization in our hospital was conducted. The success rate of localization， incidence of complications， and surgical outcomes were summarized.
Results
A total of 128 nodules were localized in 58 patients， with a success rate of 92% （118/128）. No serious complications occurred during the localization procedure.
Conclusions
LungPro bronchoscopic navigation injection of ICG is a safe and effective method for localizing multiple pulmonary nodules during surgery， which can improve the success rate of surgery and reduce the incidence of complications.
Thymoma is the most common pathological type of tumor in the anterior mediastinum.The pleura is the hotspot for thymoma metastasis，known as the “host site”，and pleural implantation metastasis is a special mode of thymoma metastasis.Pleural metastasis of thymoma may already exist in the initial diagnosis，representing stage M1a thymoma； or it may occur during the follow-up period after treatment，indicating pleural recurrence.Surgery is an important treatment for thymoma with pleural dissemination or pleural recurrence.Currently，there is no international expert consensus on the approach，method selection，and other aspects of surgical resection of thymoma.Surgery alone is diきcult to achieve complete resection of thymoma with pleural dissemination or pleural recurrence.Thoracic hyperthermic perfusion chemotherapy is an effective supplementary treatment method.However，the selection and condition settings for thoracic hyperthermic perfusion chemotherapy are still in the exploratory period.Previous studies were mainly small-size，retrospective，and uncontrolled studies，with many confounding factors and limited clinical experience.This article summarizes and analyzes the diagnosis of thymoma with pleural dissemination or pleural recurrence and treatment progress of the combination of surgery and thoracic hyperthermic perfusion chemotherapy，providing a theoretical basis for reasonable treatment selection and developing personalized treatment strategies.
Bronchopleural fistula （BPF） is a rare and life-threatening complication after pneumonectomy and is an abnormal passage formed between the bronchial and pleural cavities.BPF allows gases and secretions to be exchanged between the remaining lung and the thoracic cavity，causing coughing，chest tightness and shortness of breath，leading to complications such as pneumonia，pyothorax，and even tension pneumothorax.Because of the low incidence，complex causes，and various forms of BPF，there are few related studies on diagnosis and treatment，and most of them are individual cases.This review combines relevant domestic and foreign studies to introduce the diagnosis and treatment methods and prevention of postoperative BPF，in order to raise awareness and emphasize its importance.
The precise localization and the reduction of complications resulting from anatomical variations are the primary challenges in pulmonary nodule surgery.As a novel display technology that fuses virtual digital images with the real world，mixed reality has been initially applied in pulmonary nodule surgery，offering a promising new approach to addressing this challenge.Mixed reality technology is poised to become a significant aid in performing accurate and safe pulmonary nodule surgery in the future.It can assist in preoperative nodule localization and adjacent structure assessment and surgical plan development，assist in precise and safe navigation during surgery，facilitate communication between doctors and patients，and promise to shorten the learning curve of pulmonary nodule surgery.This review describes the application and research progress of mixed reality technology in pulmonary nodule surgery and discusses its benefits and drawbacks at current stage.
