Objective: To determine the feasibility and safety of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) in hysterectomy and sentinel lymph node (SLN) mapping for endometrial cancer by comparing its SLN detection rate and perioperative outcomes with those of laparoscopic staging. Methods: In this multicenter prospective cohort study, 68 patients with early endometrial cancer between 2020 and 2021 in 2 tertiary referral centers in China were grouped to vNOTES (n=33) or laparoscopy (n=35). All the patients underwent hysterectomy with SLN mapping. Results: The total successful SLN detection was 97.0% in the vNOTES group and 91.4% in the laparoscopy group (p=0.32), whereas the bilateral success rates were 81.8% and 80.0%, respectively (p=0.84). There was no difference in SLN detection observed between the 2 groups regarding the side-specific mapping efficacy quotient (89.4% vs 85.7%; p=0.05). The number of harvested SLNs, the location of SLNs, operative time, estimated blood loss, intraoperative and postoperative complications and hospital cost in the 2 groups were similar (p>0.05), but there were differences in the 2 groups; the one was postoperative exhaust time that was 18 vs. 21 hours (p=0.01), the other was median postoperative hospital stay which was 4 vs. 5 days (p=0.05). Conclusion This study suggests that lymph node mapping can be completed through the vNOTES procedure. It can ensure effective surgical staging and show the advantages of a fast recovery and good cosmetic effect.

OBJECTIVETo study the indications, methods and experience of absorbable rib-connecting-pins fixation in the treatment of multiple rib fractures.

METHOD52 cases with multiple rib fractures were performed internal fixation with absorbable rib-connecting-pins under epidural anesthesia.

RESULTSAll cases were followed up for 1 to 12 months, with an average of 5 months. All fractures were achieved healing in 3 to 6 months after the operation and were not found chest wall deformity.

CONCLUSIONSAbsorbable rib-connecting-pins fixation is a simple and effective method and worthies recommending to perform operation for the appropriate cases with multiple rib fractures.

Absorbable Implants ; Adult ; Aged ; Anesthesia, Epidural ; Bone Nails ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Multiple Trauma ; surgery ; Rib Fractures ; surgery

Incontinentia pigmenti (IP) is an X-linked dominant disease affecting the skin, teeth, eyes and central nervous system caused by mutations in the IKBKG gene. 95% of patients are female. Skin rash is the prominent manifestation and main diagnostic basis of IP, while external skin damagesare often the factors affecting the prognosis of IP. The diagnostic criteria for IP have been updated in recent years, and Sanger sequencing remains the gold standard for the detection and analysis of IKBKG mutations. IP patients should be fully evaluated, and active treatment should be given if eye retinopathy and nervous system damage are found.