The 2025 version of the Chinese Society of Clinical Oncology (CSCO) guidelines for esophageal cancer have been released, with significant updates to surgery-related recommendations compared to previous versions. The relevant content mainly includes the adjustments to the priority recommendation of minimally invasive surgery and the recommendation level of perioperative treatment mode, etc.

To retrospectively analyze the clinical data of patients undergoing robot-assisted segmentectomy since the implementation of the Da Vinci robotic surgical system at a single center, summarizing its safety, feasibility, and perioperative outcomes, thereby providing data support for the promotion and optimization of this technique.

A total of 472 patients who underwent robot-assisted anatomical segmentectomy in Shanghai Pulmonary Hospital between October 2020 and December 2023 were included. Baseline patient characteristics, surgical details, perioperative indicators, and complications were collected. The primary endpoint was perioperative complications. Secondary endpoints included conversion rate to thoracotomy, operative time, intraoperative blood loss, rates of 30-day readmission and 90-day mortality.

All 472 procedures were completed successfully without conversion to thoracotomy or mortality. The mean patient age was (57.45±11.88) years. The overall surgical volume showed an increasing trend. The dual-port approach was predominant (72.0%), with a rising proportion of single-port surgeries. The mean operative time was (100.19±41.93) min. Fitting of the learning curve was performed based on operative time. Intraoperative blood loss was <100 mL in 98.7% of cases, with only one patient (0.2%) requiring intraoperative blood transfusion. The mean postoperative hospital stay was (3.29±1.54) days. The overall complication rate was low, mainly consisting of persistent air leak (18 patients, 3.8%). The 30-day readmission rate was 0.6%, with no deaths within 90 days. Single-port group had a significantly shorter operative time, hospital stay, and early drainage than the multi-port group.

This study preliminarily confirms that robot-assisted segmentectomy is safe and feasible in experienced centers, with a low perioperative complication rate and favorable short-term outcomes. Robotic surgery is a safe and viable alternative to video-assisted thoracoscopic segmentectomy, although its long-term oncological efficacy requires further validation by prospective studies..

To overcome the limitations imposed by traditional wall-mounted negative pressure thoracic drainage systems on postoperative lung patients’ mobility, we developed a new portable negative pressure thoracic drainage device.

The new portable negative pressure thoracic drainage device is composed of a main unit and a three-chamber closed drainage bottle. The maximum water column height of the pressure regulating chamber of the three-chamber closed drainage bottle is approximately 20 cm. The new device adopts a split structure design: using 3D printing manufacturing, the micro air pump, rechargeable power supply and noise reduction system are integrated into an independent portable main unit, which is fixed to the side wall of the three-chamber closed drainage bottle by means of strong double-sided adhesive tape.

The main unit measures 162 mm × 108 mm × 54 mm and weighs approximately 800 g. The maximum negative pressure is about 20 cmH₂O, and the noise is less than 60 decibels at a flow rate of 3 L/min. The battery life is approximately 3 to 6 hours, and the maximum flow rate is about 9 L/min. The estimated material cost for each device is about 800 RMB, and the cost of disposable consumables (three-chamber closed drainage bottle and strong double-sided tape) is about 48 RMB.

This study developed a new type of closed thoracic drainage device, which has the engineering feasibility to achieve portable negative pressure drainage. It is expected to improve the mobility of patients who need negative pressure drainage in the thoracic cavity after lung surgery, but it still needs to be verified by clinical trials.

To explore the teaching model that combines digital Bridge-in, Objective, Pre-assessment, Participatory learning, Post-assessment, Summary (BOPPPS) with case-based learning (CBL), and evaluate its practical application effects in the clinical teaching of cardiothoracic surgery nursing.

Thirty fourth-year undergraduate nursing students rotating in the Cardiothoracic Surgery Department at Tianjin Medical University General Hospital were selected as the study subjects. They were randomly divided into an experimental group (15 students) and a control group (15 students). During the teaching process, the experimental group received instruction using an online BOPPPS combined with CBL teaching method, while the control group was taught using the traditional teaching model. After the teaching period, the teaching effectiveness of the two groups was compared and analyzed through tests and questionnaires.

The students in the experimental group outperformed those in the control group in assessments of theoretical knowledge, case analysis, and skill operations. Additionally, the experimental group reported higher satisfaction with the teaching and gave more favorable evaluations of this teaching model compared to the control group. These differences were all statistically significant (P<0.05).

The digital-based BOPPPS combined with CBL teaching model can effectively stimulate learners’ interest in learning, enhance their ability to analyze and solve clinical problems, and also help strengthen their teamwork and communication skills, providing strong support for a smooth transition to clinical work in cardiothoracic nursing. This study serves as an initial investigation with a small sample size and limited statistical power, and the generalizability of the conclusions is restricted. Future research should plan to increase the sample size and conduct multicenter studies for additional confirmation..

The success of lung cancer surgery critically depends on the precise identification of complex pulmonary anatomy and the accurate definition of surgical margins. Virtual reality (VR) technology offers a novel technical approach to addressing these key issues by creating immersive, multisensory and interactive virtual simulation environments. In the preoperative planning phase, VR technology enables non-invasive and precise lesion localization through high-fidelity 3D reconstruction and supports individualized surgical simulation, thereby optimizing surgical strategies. During intraoperative navigation, the integration of VR with augmented reality (AR) or mixed reality (MR) technologies allows for the superimposition of virtual scenes onto the real surgical field. This provides real-time spatial guidance for procedures such as lobectomy or segmentectomy and lymphadenectomy, significantly enhancing surgical precision and safety. In the realm of medical education and training, VR simulators create highly realistic surgical scenarios coupled with immediate feedback mechanisms, offering physicians a risk-free, repeatable training platform that effectively shortens the learning curve. Furthermore, as a non-pharmacological intervention, VR technology has also demonstrated positive effects in alleviating perioperative anxiety and pain in patients. This review systematically examines the specific applications and research progress of VR technology in the field of lung cancer surgery, aiming to provide references for related clinical practices and future research.

Stage ⅠA3 non-small cell lung cancer (NSCLC) represents a high-risk subgroup within early-stage lung cancer, characterized by significant prognostic heterogeneity and ongoing controversies in treatment strategies. This review systematically summarizes the prognostic features and driving factors of stage ⅠA3 NSCLC, with a focus on high-risk pathological markers such as spread through air spaces (STAS), lymphovascular invasion (LVI), and tumor-stroma ratio (TSR), and their roles in prognostic stratification. We further analyze their clinical implications in surgical extent selection and adjuvant therapy decision-making. By integrating advanced technologies such as radiomics and artificial intelligence, we discuss recent advances in preoperative prediction and postoperative personalized adjuvant therapy. We propose a precision treatment strategy based on multimodal risk models, aiming to provide evidence-based guidance for clinical practice and facilitate the transition from anatomic staging to biology-driven individualized management for stage IA3 NSCLC.

After more than two decades of rapid development in the new era, the volume of lung transplant surgeries in China now ranks among the top internationally, with the perioperative survival rate now approaching internationally advanced levels. However, the long-term survival rate of lung transplantation in China—particularly the 5-year and beyond survival rate—still lags behind that of leading international transplant centers. This article will analyze three major challenges affecting long-term survival in China: balancing infection and immunosuppression, managing chronic lung allograft dysfunction (CLAD), and establishing a lifelong follow-up system. Based on this analysis, specific strategies centered on "meticulous perioperative management" and "lifelong management" are proposed. Enhancing the long-term survival rate of lung transplantation requires not only continuous breakthroughs in surgical techniques but also the establishment of a lifelong management philosophy aimed at long-term survival, guided by high-level evidence, and founded on multidisciplinary collaboration.

To summarize the clinical nursing experience of patients with thymic tumors and pleural metastasis who underwent pleural tumor resection combined with hyperthermic intrathoracic chemotherapy (HITHOC), so as to provide a reference for perioperative nursing of similar patients.

This study adopted a clinical retrospective study design and included 20 patients with thymic tumors complicated with pleural metastasis who received HITHOC at Shanghai Chest Hospital from January to May 2024. HITHOC was performed during or within 48 hours after pleural stripping surgery. Patients received comprehensive and targeted perioperative nursing care throughout the process, including preoperative assessment and preparation, intraoperative and postoperative precise monitoring, refined respiratory tract management, specialized intravenous hydration care, stepped pain care, personalized psychological support, etc., to ensure a smooth recovery.

None of the 20 patients experienced postoperative atelectasis, electrolyte imbalance, abnormal body temperature and respiratory function, or prolonged catheterization time directly related to nursing operations; 2 patients had postoperative air leakage, 1 patient had paroxysmal atrial fibrillation, and 1 patient developed a kidney injury a month after surgery, all of which improved after symptomatic treatment; all 20 patients were discharged smoothly after relief of clinical symptoms and meeting the discharge criteria with an average postoperative hospital stay of (9.3±3.2) days.

Clinical observation and targeted nursing care for patients with thymic tumor complicated with pleural metastasis undergoing HITHOC are crucial and directly related to the postoperative recovery process. Nursing staff must conscientiously implement the relevant specialized nursing practices during treatment to ensure that patients receive effective and comprehensive perioperative nursing support.

The 3rd webinar of the "Da Vinci Elite Surgeons Salon" series was successfully held. This conference was jointly organized by the Chinese Medical Multimedia Press and the Chinese Journal of Thoracic Surgery (Electronic Edition), focusing on robotic-assisted thoracic surgical intrapericardial management techniques. Experts and scholars in the field of thoracic surgery at home and abroad engaged in in-depth discussions on core topics including intrapericardial management standards for pulmonary resection surgery, pericardial defect reconstruction strategies, optimization of robotic surgical practice, and prevention and control of perioperative risks. This article systematically summarizes the core content of the conference, aiming to provide academic reference and practical guidance for the standardized clinical application of robotic-assisted intrapericardial management techniques.

The 4th webinar of the "Da Vinci Elite Surgeons Salon" series was successfully held. This conference was jointly organized by the Chinese Medical Multimedia Press and the Chinese Journal of Thoracic Surgery (Electronic Edition), focusing on robotic lymph node dissection techniques. Experts and scholars in the field of thoracic surgery nationwide engaged in in-depth discussions on clinical hot topics including pulmonary lymph node dissection, safe use of surgical instruments, application of nerve monitoring technologies, and management of anatomical variations. This article systematically summarizes the core content of the conference, aiming to provide academic reference and practical guidance for the standardized clinical application of robotic lymph node dissection techniques.