Objective:To investigate the application value of robotic-assisted surgery for pancreatic cancer after neoadjuvant chemotherapy (NAT).Methods:The retrospective and descrip-tive study was conducted. The clinicopathological data of 10 pancreatic cancer patients who underwent robotic-assisted surgery after NAT at The First Affiliated Hospital of Sun Yat-sen University from November 2021 to January 2025 were collected. There were 7 male and 3 female, aged (62±7)years. Observation indicators: (1) NAT conditions; (2) intraoperative conditions; (3) postoperative condi-tions; (4) follow-up. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers. The Kaplan-Meier method was used to calculate survival time. Results:(1) NAT conditions. Of the 10 patients, 4 cases had tumor surrounding the portal vein or superior mesenteric vein more than 180° (no invasion of superior mesenteric artery), 3 cases had concomitant hepatic oligometastasis, and 3 cases had tumor invasion of adjacent organ (2 cases with tumor invasion of left kidney, 1 case with tumor invasion of duodenum). Nine of the 10 patients received chemotherapy of gemcitabine+albumin-paclitaxel, and the other 1 patient received chemo-therapy of fluorouracil + irinotecan + oxaliplatin. After treatment, 3 patients were evaluated as partial remission and 7 patients were evaluated as stable disease. (2) Intraoperative conditions. Of the 10 patients, 5 cases received robotic-assisted pancreatoduodenectomy and 5 cases received robotic-assisted radical antegrade modular pancreatosplenectomy, with no case converted to open surgery. There were 3 cases receiving combined vascular resection and reconstruction, including 2 cases with portal vein resection plus side wall repairing and 1 case with superior mesenteric vein resection plus end to end anastomosis. There were 2 cases receiving combined other organ resection intra-operatively, including 1 case with local hepatectomy and 1 case with left nephrectomy. The operation time of 10 patients was 465(range, 195?565)minutes, volume of intraoperative blood loss was 70(range, 20?350)mL. One case with preoperative anemia required red blood cell transfusion during the operation, while the other cases did not receive any transfusion during the operation. All 10 patients achieved R 0 resection and the number of lymph node dissected was 12±8. Three patients who underwent combined vascular resection and reconstruction had negative margin of the portal vein or superior mesenteric vein. (3) Postoperative conditions. Duration of postoperative hospital stay of 10 patients was (15±8)days, and 1 case developed major complications in grade Ⅲa of Clavein-Dindo classfication. Of the 10 patients, 1 case developed grade B pancreatic fistula, 1 case experienced delayed gastric emptying, and no case had postoperative biliary fistula, chyle leakage, abdominal or anastomotic bleeding, no case underwent reoperation, no case died within postoperative 30 days. (4) Follow-up. All 10 patients were followed up after surgery for 10.0(range, 2.7?40.4)months. All 10 patients underwent postoperative adjuvant chemotherapy, and the time from surgery to the start of adjuvant chemotherapy was (40±12)days. The median overall survival time of 10 patients was 30.4 months, and the median recurrence-free survival time was 10.9 months. Conclusion:Robotic-assisted surgery can be used for pancreatic cancer after neoadjuvant chemotherapy.

Objective:To investigate the application value of robotic-assisted surgery for pancreatic cancer after neoadjuvant chemotherapy (NAT).Methods:The retrospective and descrip-tive study was conducted. The clinicopathological data of 10 pancreatic cancer patients who underwent robotic-assisted surgery after NAT at The First Affiliated Hospital of Sun Yat-sen University from November 2021 to January 2025 were collected. There were 7 male and 3 female, aged (62±7)years. Observation indicators: (1) NAT conditions; (2) intraoperative conditions; (3) postoperative condi-tions; (4) follow-up. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers. The Kaplan-Meier method was used to calculate survival time. Results:(1) NAT conditions. Of the 10 patients, 4 cases had tumor surrounding the portal vein or superior mesenteric vein more than 180° (no invasion of superior mesenteric artery), 3 cases had concomitant hepatic oligometastasis, and 3 cases had tumor invasion of adjacent organ (2 cases with tumor invasion of left kidney, 1 case with tumor invasion of duodenum). Nine of the 10 patients received chemotherapy of gemcitabine+albumin-paclitaxel, and the other 1 patient received chemo-therapy of fluorouracil + irinotecan + oxaliplatin. After treatment, 3 patients were evaluated as partial remission and 7 patients were evaluated as stable disease. (2) Intraoperative conditions. Of the 10 patients, 5 cases received robotic-assisted pancreatoduodenectomy and 5 cases received robotic-assisted radical antegrade modular pancreatosplenectomy, with no case converted to open surgery. There were 3 cases receiving combined vascular resection and reconstruction, including 2 cases with portal vein resection plus side wall repairing and 1 case with superior mesenteric vein resection plus end to end anastomosis. There were 2 cases receiving combined other organ resection intra-operatively, including 1 case with local hepatectomy and 1 case with left nephrectomy. The operation time of 10 patients was 465(range, 195?565)minutes, volume of intraoperative blood loss was 70(range, 20?350)mL. One case with preoperative anemia required red blood cell transfusion during the operation, while the other cases did not receive any transfusion during the operation. All 10 patients achieved R 0 resection and the number of lymph node dissected was 12±8. Three patients who underwent combined vascular resection and reconstruction had negative margin of the portal vein or superior mesenteric vein. (3) Postoperative conditions. Duration of postoperative hospital stay of 10 patients was (15±8)days, and 1 case developed major complications in grade Ⅲa of Clavein-Dindo classfication. Of the 10 patients, 1 case developed grade B pancreatic fistula, 1 case experienced delayed gastric emptying, and no case had postoperative biliary fistula, chyle leakage, abdominal or anastomotic bleeding, no case underwent reoperation, no case died within postoperative 30 days. (4) Follow-up. All 10 patients were followed up after surgery for 10.0(range, 2.7?40.4)months. All 10 patients underwent postoperative adjuvant chemotherapy, and the time from surgery to the start of adjuvant chemotherapy was (40±12)days. The median overall survival time of 10 patients was 30.4 months, and the median recurrence-free survival time was 10.9 months. Conclusion:Robotic-assisted surgery can be used for pancreatic cancer after neoadjuvant chemotherapy.

Objective:To investigate the short-term outcomes of robot-assisted pancreato-duodenectomy (RPD) performed by one single surgeon.Methods:The retrospective and descriptive study was conducted. The clinico-pathological data of 240 patients who were performed RPD by one single surgeon at The First Affiliated Hospital of Sun Yat-sen University from July 2016 to October 2023 were collected. There were 130 males and 110 females, aged 59(19)years. All RPD were performed by the same surgeon. Observation indicators: (1) surgical situations; (2) postoperative pathological examination and outcome of patients. Measurement data with normal distribution were expressed as Mean± SD, and measurement data with skewed distribution were expressed as M(IQR). Count data were expressed as absolute numbers or percentages. Results:(1) Surgical situations. Of 240 patients, 15 cases underwent combined vascular resection and reconstruction, and 13 patients were combined with other operations simultaneously. Of 240 patients, 4 cases converted to open surgery, with the conversion rate as 1.67%. The operation time of 240 patients was 458(152)minutes, volume of intraopera-tive blood loss was 50(50)mL, intraoperative erythrocyte transfusion was required in 17 patients. The R 0 resection rate was 99.17%(238/240), the number of lymph nodes harvested was 10(6) and duration of postoperative hospital stay was 17(12)days. (2) Postoperative pathological examination and outcome of patients. Of 240 patients, 51 cases were pancreatic ductal adenocarcinoma, 41 cases were ampullary carcinoma, 41 cases were neuroendocrine neoplasms, 35 cases were pancreatic cystic neoplasms, 28 cases were duodenal carcinoma and 44 cases were other pathologic types. Of 99 patients with major complications, there were 57 cases with clinically relevant postoperative pancreatic fistula, 44 cases with postoperative delayed gastric empty, 11 cases with postoperative biliary fistula, 8 cases with postoperative chyle fistula, 14 cases with incision infec-tion, and 24 cases with postoperative hemorrhage. Multiple complications might occur to the same patient. Reoperation was performed in 6 of the 240 patients. One patient died within 30 days after surgery. Twenty-four patients returned to hospital within 30 days after discharge. Conclusions:RPD performed by one single surgeon is safe and feasible, with favorable short-term outcomes, which can be performed in medical centers with experiences in robot-assisted pancreatic surgery.

Objective:Focusing on the medical protection of marine sports events at the 19th Asian Games in Hangzhou. This paper analyzes the effect of the development and implementation of the medical protection program to provide a referable summary of experience for the medical protection of future large-scale international maritime events.Method:This paper retrospectively analyzed the medical protection of Ningbo Xiangshan Yafan Center during the preparation stage of the Asian Games Sailing Competition, and during the period from September 21 to September 27, 2023 when the Asian Games Sailing Competition is held. Analyze the organizational structure and scheme of medical support.Results:During this Asian Games sailing competition, there were a total of 14 paramedics, 4 rescue helicopter crews, 2 ambulances and 1 rescue helicopter in and around the competition venues. In the city, the designated hospital has set up a total of 12 working groups, 15 protection outpatient clinics and a number of various types of clinic areas. There are 129 medical and nursing staff directly participating in the medical protection work of the Asian Games. A total of 44 specialized beds were reserved in the designated hospitals. There were also a number of volunteers and logistic staff who relied on the support work. The top three major disease types were trauma with 66 cases (29.2%), upper respiratory tract infection with 34 cases (15.04%) and skin allergy with 19 cases (8.51%). The top two population groups consulted were staff with 95 visits (44.19%) and technical officers with 89 visits (41.40%).Conclusions:During the sailing competitions of the Asian Games, the medical care was smooth and orderly. Trauma, upper respiratory tract infections and skin allergies are the most prominent diseases. The number of medical consultations for staff and technical officials of the Asian Games Sailing Competition accounted for more than 80% of the total number of consultations for all personnel. They should be given priority care.