Non-small cell lung cancer (NSCLC), as a predominant malignancy in Shandong Province, imposes severe health and economic burdens. Though surgery remains standard care for early-stage NSCLC, high postoperative recurrence rates necessitate enhanced perioperative strategies to improve patient outcomes. This underscores the critical need for perioperative comprehensive treatment strategies to optimize long-term survival outcomes and quality of life for patients. The Thoracoscopic Surgery Committee of the Shandong Endoscopic Surgery Quality Control Center, utilizing provincial oncology expertise and international guidelines, has developed the expert consensus on perioperative immunotherapy for the management of NSCLC in Shandong. This protocol systematizes critical whole-process management components: multidisciplinary team development, preoperative evaluation, neoadjuvant immunotherapy, post-neoadjuvant pathological assessment, adjuvant immunotherapy, follow-up surveillance, and perioperative immune-related adverse events management. This manual is designed to provide thoracic surgeons and multidisciplinary healthcare providers with standardized diagnostic and therapeutic protocols, while advancing the homogenization of lung cancer management practices across the region.

To investigate the occurrence and influencing factors of pneumothorax in co-ablation system therapy for pulmonary nodules, and to provide references for optimizing clinical diagnosis and treatment processes and improving treatment safety.

A retrospective analysis was performed on the clinical data of 105 patients with pulmonary nodules who underwent co-ablation system therapy in the Department of Thoracic Surgery of Haidian Hospital of Beijing from October 2024 to March 2025. General patient information, characteristics of pulmonary nodules, surgical operation parameters, and pneumothorax occurrence (including incidence, severity, time of occurrence, and treatment methods) were collected. Independent sample t-test was used for comparison of quantitative data between groups, and chi-square test or Fisher’s exact test was used for qualitative data. Binary logistic regression was used for multivariate analysis of pneumothorax occurrence. A two-tailed P<0.05 was considered statistically significant.

Among the 105 patients, 58 cases (55.2%) developed pneumothorax, with a total of 60 episodes recorded. Specifically, there were 26 mild cases (43.3%), 13 moderate cases (21.7%), 20 severe cases (33.3%), and 1 tension pneumothorax case (1.7%). The majority of pneumothorax occurred intraoperatively (31 episodes, 51.7%) and within 24 hours after surgery (27 episodes, 45.0%), with 2 episodes of delayed pneumothorax (3.3%). Forty-two episodes (70.0%) required thin-tube closed drainage, with an average indwelling time of (4.4±2.5) days. Univariate analysis showed that patients with a history of ipsilateral thoracic surgery (P=0.018), nodules in the left lower lobe (P=0.041), deeper distance from the deep surface of nodules to the pleura (P=0.037), and shorter puncture path (P=0.002) had a lower incidence of pneumothorax. However, factors such as age, gender, smoking history, history of anti-tumor drug use, history of thoracic radiotherapy, size and type of pulmonary nodules, ablation position, and number of ablation needles were not significantly associated with pneumothorax occurrence. The severity of pneumothorax in male patients was higher than that in female patients (P=0.001) .

A history of ipsilateral thoracic surgery, nodules in the left lower lobe, deeper distance from nodules to the pleura, and shorter puncture path from the skin puncture point to the parietal pleura may be protective factors against pneumothorax. After pneumothorax occurs in co-ablation system therapy for a single pulmonary nodule, male patients have a higher severity.

To compare and evaluate the clinical effect of multi-channel single-hole laparoscopic puncture device in da-Vinci robot-assisted thoracoscopic extended thymectomy, and to discuss its application advantages.

We performed a retrospective review of 45 myasthenia gravies patients who had da-Vinci robot-assisted thoracoscopic extended thymectomy at the Jiangxi Province General Hospital between June 2021 and February 2025. Patients were divided into experimental groups and control group according to surgical approaches. There were 23 patients in the experimental group (using the multi-channel single-hole laparoscopic puncture device duration operation), and the other 22 patients who used the normal robotic endoscopic cannula were treated as the control group. The basic operation conditions and postoperative recovery data were observed and compared.

All the 45 patients successfully completed the surgery and recovered, with no case changed to thoracotomy. There were no statistically significant differences in preoperative clinical data. Compared the experimental group with the control group, the differences in the operation duration [ (158.26±60.51) min vs (207.27±84.07) min], the number of lymph nodes removed during surgery was [ (7.30±5.63) vs (1.91±3.85) ], value of CO₂ by postoperative artery blood gas analysis [ (38.66±5.09) mmol/L vs (42.69±5.39) mmol/L] were statistically significant (P<0.05). There were no statistically significant differences between the two groups in terms of intraoperation bleeding volume, postoperative 24 h chest drainage volume, indwelling time of the thoracic drainage tube, and duration of anodyne use.

Using multi-channel single-hole laparoscopic puncture device in da-Vinci robot-assisted thoracoscopic extended thymectomy can better expose the surgical field, thereby shortening the surgical time. In addition, this application can increase the extent of clearing mediastinum adipose tissue, especially around the deep cervical area, and reduce the postoperative CO₂ retention, without increasing the duration of postoperative pain. The application is simple to handle and inexpensive, which is worth promoting.

To investigate the clinical efficacy of robot-assisted thoracoscopic resection of fibrous dysplasia (FD) of the ribs.

A retrospective analysis was conducted on patients who underwent rib tumor resection in the Department of Thoracic Surgery, Changzhou First People’s Hospital from June 2022 to June 2024. Patients were divided into the thoracoscopic surgery group and robot-assisted surgery group based on the surgical approach. There were 15 cases in the thoracoscopic surgery group and 13 cases in the robot-assisted surgery group. A Gigli saw was used for rib transection in both groups. Perioperative indicators, pain levels, and postoperative complications were evaluated between the two groups.

The intraoperative blood loss in the robot-assisted group was significantly less than that in the thoracoscopic group[ (59.62±17.73) mL vs (88.33±21.27) mL, P<0.05]. The postoperative drainage volume was also less[ (99.23±37.80) mL vs (169.91±32.46) mL, P<0.05]. The indwelling time of the chest tube after surgery was shorter[ (1.15±0.38) days vs (1.40±0.63) days, P<0.05], and the pain visual analogue scores at 12 hours after surgery was lower (5.57±0.41 vs 6.70±0.49, P<0.05). No significant differences were observed in operation time, length of hospital stay, or complication rate between the two groups (P>0.05). All patients recovered well at 1 month postoperatively.

Robot-assisted thoracoscopic resection for the treatment of rib FD is safe and effective, with advantages such as minimal trauma, less bleeding, rapid recovery, and mild pain. It is worthy of widespread adoption and application in the treatment of rib tumors.

To summarize the perioperative outcomes of robot-assisted bilateral transcervical mediastinoscopic and laparoscopic esophagectomy (RBMLE) for esophageal cancer.

The clinical data of 5 patients with esophageal cancer who intentionally underwent RBMLE at Shanghai Chest Hospital from August 2025 to September 2025 were retrospectively analyzed. The cohort included 3 males and 2 females, with a median age of 66 years. Two and three patients were diagnosed with clinical stage Ⅱ and Ⅲ disease, respectively. Three patients received neoadjuvant immunochemotherapy. The perioperative outcomes were analyzed.

All patients achieved R0 resection. The operative time was 330 (200–420) min, and the blood loss was 100 (100–200) mL. The number of mediastinal lymph node stations dissected was 6 (6–7), and the count of mediastinal lymph nodes harvested was 6 (4–10). The total count of lymph nodes dissected was 18 (6–26). One patient (20.0%) developed an anastomotic leak [ (Esophagectomy Complications Consensus Group, ECCG) grade Ⅱ]; and one patient (20.0%) experienced vocal cord paralysis (ECCG grade Ⅰ). The hospital stay was 8 (7–21) days and no readmissions occurred within 30 days postoperatively.

RBMLE is safe and feasible, and is considered as one of the surgical options for selected patients with esophageal cancer.

Esophageal cancer ranks among the top 10 malignant tumors worldwide, with a very poor prognosis, posing a major challenge to global health and representing a critical medical problem to be addressed. Computed tomography (CT) has long played a central role in the preoperative staging, diagnosis and postoperative evaluation of esophageal cancer, it relies on detailed anatomical information to evaluate the progress of the lesion and the response to treatment. However, although CT technology is indispensable, there is still room for improvement in its accuracy. Although biopsy is known as the "gold standard" for diagnosis, it faces significant invasiveness and potential error risks. With the rapid emergence of new imaging techniques, radiomics has garnered significant attention and extensive research in the field of malignant tumors. In particular, radiomics has shown unprecedented application potential in many key areas such as accurate staging of cancer and assessment of tumor heterogeneity. Especially in the TNM staging system of esophageal cancer, the application of CT radiomics is showing extremely broad prospects and practical value. This paper reviews the application and research progress of CT radiomics in TNM staging of esophageal cancer, to provide theoretical support and guidance for future research on accurate diagnosis and treatment of esophageal cancer.