Objective To investigate the feasibilty of the disposable tracheotomy tube as trocar in the electronic bronchoscope instead of thoracoscope. Methods 86 patients with effusion of unknown origin undergoing medical tho-racoscopy from January 2015 to October 2015, 59 male (68.6%) and 27 female (31.4 %), mean age (49.00 ± 20.00) years (15 ~ 83) years, were randomly divided into two groups, Tracheostomy tube group (group T) and Conventional chest tube group (group C). Group T uses disposable cannula tracheostomy tube as trocar, and group C received conventional medical thoracoscopy chest tube. Then compare the positive rate of pathological diagnosis, operation time, inspection fees, and other adverse reactions between the two groups. Results 40 cases (93.0%) in group T were confirmed diagnosis, including 8 cases of lung pleural metastasis, 31 cases of erculous pleurisy, 1 case of empyema, while 4 cases of unknown diagnosis (7.0%). 33 cases (76.7%) in group C were confirmed diagnosis, in-cluding 4 cases of lung pleural metastasis, 29 cases of tuberculous pleurisy, while 10 cases of unknown diagnosis (23.3 %). The difference was statistically significant between the two groups ( < 0.05). Operative time in group T was (23.86 ± 2.45) minutes, while in group C was (29.88 ± 3.67) minutes, the difference was statistically significant ( <0.05). While the complication rate was no significant difference. Conclusions It is demonstrated that the dispos-able tracheotomy tube as trocar in the electronic bronchoscope instead of thoracoscope which can shorten the opera-tion time, improve the diagnosis rate, reduce costs, worthy of promoting.

【Objective】 To explore the safety and efficacy of a modified one-piece posterior laparoscopic total nephroureterectomy with cystic sleeve resection in the treatment of upper urinary tract uroepithelial carcinoma (UTUC). 【Methods】 A total of 24 patients treated during Jan. and Jun. 2022 were involved, including 16 males and 8 females, aged 62 to 90 (average 73) years. The UTUC was in the left side in 15 cases, and in the right side in 9 cases. There were 10 cases of renal pelvis tumor, 6 cases of upper ureteral tumor and 8 cases of lower ureteral tumor. 【Results】 All operations were successful without conversion to open surgery. The operation time ranged from 60 to 100 minutes, average (71.25±9.80) minutes. The intraoperative bleeding volume was 20 to 200 mL, average (30.03±8.13) mL. No significant intraoperative or postoperative complications occurred. The postoperative hospital stay was 4 to 7 days, average (5.83±1.44) days. Bladder perfusion chemotherapy was performed after surgery. 【Conclusion】 The modified one-piece posterior laparoscopic total nephroureterectomy plus cystic sleeve resection for UTUC is an effective and feasible procedure with satisfactory tumor control, which is worth further promotion in clinical practice.

【Objective】 To investigate the efficacy and safety of single position transabdominal and extraperitoneal laparoscopic radical nephroureterectomy in the treatment of upper tract urothelial carcinoma (UTUC). 【Methods】 Clinical data of 31 UTUC cases treated in our hospital during Nov.2018 and Jun.2022 were retrospectively analyzed, including 11 tumors in the right side, and 20 in left side. There were 14 cases of renal pelvic carcinoma, 16 cases of ureter carcinoma, and 1 case of renal pelvic carcinoma plus ureter carcinoma. 【Results】 All surgeries were successfully performed without conversion to open surgery. The mean operation time was (81.45±19.80) min, and the estimated blood loss was (69.03±24.13) mL. No serious perioperative complications were observed. The average postoperative hospital stay was (6.13±2.44) d, and the median follow-up was 28 (3.0-49.0) months. At the last follow-up, 2 patients died, 3 had recurrence, but no contralateral recurrence was observed. 【Conclusion】 Single position transabdominal and extraperitoneal laparoscopic radical nephroureterectomy is safe, effective and feasible in the treatment of UTUC. It is worth clinical popularization.

Radical cystectomy combined with pelvic lymph node dissection is the standard procedure for the treatment of muscle invasive bladder cancer and complex non-muscle invasive bladder cancer.Our department has routinely carried out laparoscopic radical cystectomy (ELRC) through the extraperitoneal approach in 340 cases.This article summarizes the establishment of the peritoneal space, the expansion of the peritoneal space, the operation steps of bladder resection and lymph node dissection through the peritoneal channel, and how to shorten the operation time and reduce the difficulty of the operation. During the surgery, the bladder is removed periperitoneally without destroying the peritoneum to preserve the functions of peritoneum support, secretion, protection and lubrication, which has little impact on the abdominal organs, reduces the incidence of complications, and provides favorable conditions for subsequent treatment.