Esophageal cancer, a malignant tumor that seriously threatens the health of Chinese residents, ranks among the top in the spectrum of digestive tract malignant tumors in China in terms of incidence and mortality. Perioperative nutritional management is an important link in the comprehensive treatment system for esophageal cancer. Many patients with esophageal cancer suffer from malnutrition and nutritional risks, which will significantly increase the incidence of postoperative complications, medical expenses, and directly affect the prognosis and long-term quality of life of patients. Based on the core principles of nutritional support therapy guidelines for digestive tract tumors at home and abroad, the construction of a standardized nutritional intervention pathway needs to be based on the establishment of a safe and effective enteral nutrition pathway. This consensus was jointly formulated by multidisciplinary experts, systematically elaborating the evidence-based selection strategies for enteral nutrition catheterization methods in patients with esophageal cancer during the perioperative period. It innovatively proposes a full-cycle access management solution covering preoperative assessment, intraoperative decision-making, and postoperative maintenance. The aim is to reduce the incidence of catheterization and access-related complications and optimize the therapeutic effect of nutritional support through a systematic operation process, in order to provide practical guidance for improving the prognosis of patients.

To investigate the safety and feasibility of improving incision suture and drainage tube fixation after thoracoscopic surgery.

A total of 210 patients who underwent thoracoscopic surgery for pulmonary or mediastinal diseases from January 2025 to January 2026 were prospectively included. They were divided into Group 1, Group 2, and Group 3 according to the different incision suture and drainage tube fixation methods. Group 1 (70 patients) received layered suture with double-layer barbed suture combined with fixation under the suture of the deep tissue within the incision (method 1); Group 2 (70 patients) received layered suture combined with fixation in the Trocar tunnel independent of the incision (method 2); Group 3 (70 cases) received traditional interrupted suture combined with fixed catheter placement at the same incision skin layer (method 3). The incision healing time, total postoperative drainage volume, pain Visual Analog Score (VAS) in the first 3 days after surgery, scar score [Vancouver Scar Scale (VSS) and Observer Scar Assessment Scale (OSAS)] at one month after surgery and the incidence of postoperative incision complications were analyzed and compared among the three groups.

Finally, 185 patients were included in the study—Group 1 (58 patients), Group 2 (62 patients), and Group 3 (65 patients). There were no statistical differences between Group 1 and Group 2 in terms of scar scores (OSAS, VSS) and the incidence of complications such as suture knot reaction, early incision infection, subcutaneous emphysema, and poor incision healing (P>0.05), but both groups were lower than Group 3 (P<0.05). In terms of the incidence of incision exudation or the number of days of incision healing, Group 2 < Group 1 < Group 3 (P<0.05). For postoperative days 1 and 2, the VAS pain scores followed a pattern of Group 1 < Group 3 < Group 2 (P<0.05). There were no statistically significant differences among the three groups on postoperative day 3 (P>0.05), nor in total postoperative drainage volume (P>0.05) or the incidence of complications such as fat liquefaction (P>0.05) and tube dislodgement (P>0.05).

Compared with traditional suture and fixation methods, methods 1 and 2 have better safety and effectiveness, reduce the incidence of related incision complications, reduce excessive scar hyperplasia, and promote primary healing of the incision. Among them, method 2 has advantages in reducing the incidence of incision exudation and accelerating incision healing time, but it has poor postoperative pain control, and still needs further exploration and improvement. To sum up, the first two suture and fixation methods proposed in this study are effective, feasible and worthy of application in clinical practice in specific environments.

To analyze the causes, clinical characteristics and key points of reoperation for thoracic deformity.

From January 2018 to December 2025 in The Affiliated Guangdong Second Provincial General Hospital of Jinan University, the clinical data of patients with thoracic deformity who underwent reoperation after failed surgery outside the hospital were retrospectively analyzed, including general information of patients, deformity characteristics, imaging results, operation time, intraoperative blood loss, postoperative hospital stay, and postoperative complications. The above results were statistically analyzed.

A total of 312 patients were enrolled, including 258 males and 54 females, aged from 3 to 49 (19.98±9.83) years old. There were 270 cases of pectus excavatum, 18 cases of pectus carinatum, 9 cases of compound deformity, and 15 cases of unknown type. The patients were treated with Wang procedure, Wung procedure, Wenlin procedure, Wang + Wung procedure, Wang + Wenlin procedure, Wung + Wenlin procedure and comprehensive procedure, respectively. The total operation time was 55–285 (134.21±52.04) min, the intraoperative blood loss was 2–500 (74.63±114.48) mL, and the postoperative hospital stay was 4–60 (10.54±6.78) days. The longest follow-up time was 93 months, in which the steel plate had been removed in 126 cases, and there was no obvious recurrence of deformity during the follow-up after removal of the steel bars.

Once the thoracic deformity surgery fails, the risk of reoperation is high, and the procedure is technically difficult. Special methods are required for reoperation.

To explore the associations between changes in skeletal muscle index (SMI) and subcutaneous adipose index (SAI) during neoadjuvant immunotherapy combined with chemotherapy and treatment response, treatment-related adverse events, and perioperative outcomes in patients with locally advanced esophageal squamous cell carcinoma (ESCC).

This retrospective study included 109 patients with locally advanced ESCC who received neoadjuvant immunotherapy combined with chemotherapy followed by radical surgery between January 2020 and January 2025 at The First Affiliated Hospital of Suchow University and The Fourth Affiliated Hospital of Suchow University. SMI and SAI were measured on abdominal computed tomography (CT) images at the third lumbar vertebra (L3) level before and after neoadjuvant treatment. Percentage changes (ΔSMI% and ΔSAI%) were calculated, and patients were stratified according to body composition changes. Radiological response, pathological tumor regression grade (TRG), treatment-related adverse events, and perioperative outcomes were compared among groups.

Baseline clinical characteristics were comparable across different ΔSMI% and ΔSAI% groups. No significant associations were observed between changes in SMI or SAI and radiological response or TRG. Patients with decreased SMI experienced a significantly higher incidence and severity of leukopenia. Regarding perioperative outcomes, the group with decreased SMI had a significantly longer postoperative hospital stay and a higher incidence of pleural effusion and pneumonia. Although the overall complication rate tended to be higher in this group, the difference did not reach statistical significance. In contrast, changes in SAI were not significantly associated with perioperative outcomes or complication rates.

Dynamic changes in SMI during neoadjuvant immunotherapy combined with chemotherapy are closely associated with perioperative recovery and postoperative complications in patients with locally advanced ESCC, whereas their correlation with radiological and pathological response is limited. Changes in SAI show limited predictive value for perioperative outcomes. Monitoring skeletal muscle dynamics during neoadjuvant treatment may aid in preoperative risk stratification and optimization of perioperative management.

To establish and compare three prediction models for pulmonary infection after thoracoscopic surgery in lung cancer patients based on multivariate logistic regression, decision tree, and neural network.

Patients with lung cancer who underwent thoracoscopic lung resection in Zhenjiang Third People’s Hospital, Jurong People’s Hospital, and Danyang Third People’s Hospital from October 1, 2022 to March 31, 2025 were selected. Data on patient demographics, physical examination findings, past medical history, pulmonary function indices, surgical conditions, and tumor conditions of the patients were collected. The patients were divided into a pulmonary infection group and a non-pulmonary infection group based on the occurrence of pulmonary infection. The differences between the two groups were compared through univariate analysis. The variables with statistical significance in the univariate analysis were selected as independent variables for multivariate logistic regression, decision tree, and neural network to construct the prediction models, and the sensitivity, specificity, Youden index, and area under the receiver operating characteristic (ROC) curve (AUC) of the three models were compared.

A total of 1 262 patients were included in the study, of whom 230 cases had pulmonary infection, with an incidence of 18.22%. Multivariate logistic regression showed that age (≥60 years), gender, smoking history, history of chronic pulmonary diseases, and hospitalization time (≥10 days) were independent risk factors for postoperative pulmonary infection. The decision tree model obtained 4 explanatory variables: age (≥60 years), serum albumin level (<35 g/L), hospitalization time (≥10 days), and smoking history. The neural network model suggested that the top five risk factors were age (≥60 years), serum albumin level (<35 g/L), history of chronic pulmonary diseases, hospitalization time (≥10 days), and smoking history. The accuracy of the three models was 84.9%, 81.5%, and 86.7%, respectively. The sensitivity was 77.2%, 73.2%, and 75.4%; specificity was 80.3%, 76.8%, and 82.7%; Youden index was 0.575, 0.520, and 0.581; and the AUC was 0.831, 0.796, and 0.857, respectively (all P<0.05).

Compared with the multivariate logistic regression model and the decision tree model, the neural network model has better predictive performance for pulmonary infection after thoracoscopic surgery in lung cancer patients.

To explore the application effect of the BOPPPS model integrated with multimedia surgical videos in the clinical teaching of minimally invasive esophageal carcinoma surgery, clarify the auxiliary role of this teaching mode in enhancing students’ mastery of key concepts and provide practical basis for the optimization of teaching strategies in thoracic surgery.

Students from two parallel classes of clinical medicine majors from the School of Medicine of Sun Yat-sen University were selected as the research objects, and the students were divided into the experimental group and the control group respectively. This study employed a single-blind design, and all participating students were unaware of their assigned group. Minimally invasive esophageal carcinoma surgery thematic teaching with the core focus on "lymph node dissection in radical esophageal carcinoma surgery" and "endoscopic submucosal dissection (ESD)" was carried out in both groups. The control group adopted the traditional teaching model, which combined anatomical atlases with theoretical explanations. The experimental group applied the BOPPPS teaching model with the aids of surgical videos, with the course designed into pre-class, in-class and post-class stages. Pre-class quizzes were used to identify students’ knowledge weaknesses on esophageal carcinoma TNM staging, related treatments and lymph node dissection. During the course, additional multimedia videos of lymph node dissection in radical esophageal carcinoma surgery and ESD surgery were introduced to assist teaching by dynamically demonstrating the surgical operation process, anatomical structure and key operational points. After the course, students from both the experimental group and the control group took a unified post-class test, an Objective Structured Clinical Examination (OSCE) after one week, and another post-class test after one month to evaluate their mastery of knowledge of esophageal carcinoma TNM staging, related treatments and lymph node dissection. At the same time, anonymous questionnaires were used to collect feedback on teaching satisfaction.

There were 70 students each in both the experimental group and the control group. Short-term teaching effectiveness evaluation: the scores of the post-class quiz in the experimental group were significantly higher than those in the control group (P<0.01). In addition, the post-class quiz scores of the experimental group were significantly higher than the pre-class quiz scores (P<0.01). Furthermore, the scores of the experimental group in the TNM staging and lymph node dissection sections of the post-class quiz were significantly higher than those in the pre-class quiz (P<0.01), but there was no significant difference in the ESD section scores between pre-class and post-class quizzes (P=0.47). Objective comprehensive evaluation: the OSCE scores of the experimental group were significantly higher than those of the control group (P=0.015). Long-term teaching effectiveness evaluation: the quiz scores of the experimental group one month after class were significantly higher than those of the control group (P<0.01), but neither in the experimental group nor the control group was there a significant difference between the post-class quiz scores and the quiz scores one month after class. Teaching satisfaction survey: Most students in the experimental group affirmed the teaching model, believing that it had positive impact on helping them master the theoretical knowledge comprehensively and was conducive to constructing a systematic knowledge system.

The application of multimedia surgical videos combined with the BOPPPS model in minimally invasive esophageal carcinoma surgery teaching can significantly enhance students’ comprehension and mastery of complex surgical procedures, leading to markedly improved teaching outcomes. This approach provides a valuable reference for innovating and optimizing clinical teaching models in thoracic surgery.

The early diagnosis and treatment of pulmonary nodules still faces technical challenges, such as imaging misdiagnosis, inaccurate localization, and difficulties in postoperative evaluation. The application of artificial intelligence (AI) in preoperative assessment, intraoperative navigation, and postoperative monitoring has gradually provided new solutions to address these issues. Preoperatively, AI models significantly improve the accuracy of nodule recognition and risk stratification; intraoperatively, through the integration of virtual reality, augmented reality, and robot-assisted surgery techniques, AI enhances surgical planning and operative stability; postoperatively, AI-based predictive models enable dynamic assessment of complications and the risk of recurrence, promoting the development of personalized rehabilitation strategies. This review summarizes the latest advances in AI applications in pulmonary nodule surgery, aiming to provide insights for the integration of future technological advancements with clinical practice.

Anaplastic lymphoma kinase (ALK)-rearranged non-small cell lung cancer (NSCLC) constitutes 4%–5% of all NSCLC cases and is frequently identified in young, never- or light-smoking patients with lung adenocarcinoma. Although surgical resection offers a curative opportunity for early-stage patients, the risk of postoperative recurrence remains high, particularly in ALK-positive patients due to their more aggressive biological characteristics. In recent years, with the continuous development of ALK tyrosine kinase inhibitors (TKIs), postoperative adjuvant targeted therapy has become a crucial strategy for improving the prognosis of the patient population. This review summarizes recent clinical studies on postoperative adjuvant targeted therapy for ALK-positive NSCLC, with a focus on the QEELIN study. It analyzes the efficacy and safety profiles of drugs such as ensartinib and alectinib in adjuvant settings, addresses current challenges in clinical practice, and aims to provide clinical guidance for the management of ALK-positive NSCLC patients.

The series of webinars entitled the "Da Vinci Elite Surgeons Salon" was successfully launched on July 13th, 2025, which is jointly organized by the Chinese Medical Multimedia Press and the Chinese Journal of Thoracic Surgery (Electronic Edition). The first session focused on cutting-edge techniques in robotic tracheal surgery, with opening remarks delivered by Professor Zhigang Li from Shanghai Chest Hospital and Professor Wenjie Jiao from the Affiliated Hospital of Qingdao University. Experts and scholars from the field of thoracic surgery nationwide conducted in-depth discussions on topics including robot-assisted tracheal tumor resection and reconstruction, the full-port artificial pneumothorax technique, and perioperative airway management. This article systematically summarizes the core contents of this conference, aiming to provide insights for the standardized application and promotion of techniques of robotic tracheal surgeries.

The second webinar of the "Da Vinci Elite Surgeons Salon" series was successfully held on September 14th, 2025. This conference was jointly organized by the Chinese Medical Multimedia Press and the Chinese Journal of Thoracic Surgery (Electronic Edition), focusing on robotic pulmonary surgery techniques following neoadjuvant immunotherapy. Experts and scholars from the field of thoracic surgery nationwide engaged in in-depth discussions on core topics including the assessment of surgical difficulty after neoadjuvant therapy, management of tissue adhesion, decision-making regarding the extent of surgical resection, and strategies of perioperative management. This article systematically summarizes the core contents of this conference, aiming to provide technical guidance for the standardized implementation of robotic pulmonary surgery following neoadjuvant immunotherapy.