Objective To investigate the clinical outcome differences between robotic-assisted intramedullary nailing and traditional manual surgery,and to analyze the advantages and feasibility of robotic-assisted intramedullary nail fixation in the treatment of intertrochanteric fractures in elderly patients.Methods From December 2023 to December 2024,elderly patients with intertrochanteric fractures who underwent surgery at Department of Trauma Orthopedics,Beijing Luhe Hospital,Capital Medical University were included.Patients were divided into two groups based on the surgical method.The robotic-assisted group underwent robotic-assisted intramedullary nail fixation,while the traditional group received manual intramedullary nail fixation.Baseline data and observation indicators were collected and compared between the two groups to assess any differences.Results There were no statistically significant differences in baseline data between the two groups(P>0.05).The intraoperative blood loss in the robotic-assisted group was(94.28±9.43)mL,compared to(143.00±11.11)mL in the traditional group(P<0.001).The operative time in the robotic-assisted group was(53.06±9.89)min,while in the traditional group,it was(66.74±10.18)min(P<0.001).The skin incision length for the main nail in the robotic-assisted group was(3.23±0.64)cm,whereas in the traditional group,it was(4.03±0.79)cm(P<0.01).Postoperative hemoglobin levels in the robotic-assisted group decreased by(12.63±4.27)g/L,compared to(17.29±4.32)g/L in the traditional group(P=0.018).At 6 months postoperatively,the Harris hip scores in the robotic-assisted group showed 30 cases of excellent,10 good,and 3 poor outcomes,while in the traditional group,there were 22 excellent,15 good,and 6 poor cases(P=0.198).Conclusion Robotic-assisted intramedullary nailing for intertrochanteric fractures offers advantages such as minimally invasive and precise procedures,shorter operative times,and reduced blood loss.Compared to traditional surgical methods,it demonstrates certain benefits in reducing postoperative complications in elderly patients.

Objective To investigate the clinical outcome differences between robotic-assisted intramedullary nailing and traditional manual surgery,and to analyze the advantages and feasibility of robotic-assisted intramedullary nail fixation in the treatment of intertrochanteric fractures in elderly patients.Methods From December 2023 to December 2024,elderly patients with intertrochanteric fractures who underwent surgery at Department of Trauma Orthopedics,Beijing Luhe Hospital,Capital Medical University were included.Patients were divided into two groups based on the surgical method.The robotic-assisted group underwent robotic-assisted intramedullary nail fixation,while the traditional group received manual intramedullary nail fixation.Baseline data and observation indicators were collected and compared between the two groups to assess any differences.Results There were no statistically significant differences in baseline data between the two groups(P>0.05).The intraoperative blood loss in the robotic-assisted group was(94.28±9.43)mL,compared to(143.00±11.11)mL in the traditional group(P<0.001).The operative time in the robotic-assisted group was(53.06±9.89)min,while in the traditional group,it was(66.74±10.18)min(P<0.001).The skin incision length for the main nail in the robotic-assisted group was(3.23±0.64)cm,whereas in the traditional group,it was(4.03±0.79)cm(P<0.01).Postoperative hemoglobin levels in the robotic-assisted group decreased by(12.63±4.27)g/L,compared to(17.29±4.32)g/L in the traditional group(P=0.018).At 6 months postoperatively,the Harris hip scores in the robotic-assisted group showed 30 cases of excellent,10 good,and 3 poor outcomes,while in the traditional group,there were 22 excellent,15 good,and 6 poor cases(P=0.198).Conclusion Robotic-assisted intramedullary nailing for intertrochanteric fractures offers advantages such as minimally invasive and precise procedures,shorter operative times,and reduced blood loss.Compared to traditional surgical methods,it demonstrates certain benefits in reducing postoperative complications in elderly patients.

Objective    To systematically evaluate the efficacy and safety of nedaplatin versus cisplatin combined with fluorouracil in the treatment of esophageal neoplasms. Methods    PubMed, EMbase, Web of Science, The Cochrane Library, CNKI, WanFang, VIP and CBM databases were searched by computer to investigate the randomized controlled studies about the clinical effects of nedaplatin combined with fluorouracil versus cisplatin combined with fluorouracil in the treatment of esophageal neoplasms. The retrieval time was from the establishment of the database to January 2021. And meta-analysis was performed using RevMan 5.4. Results    A total of 12 randomized controlled studies involving 744 patients were included. The results of meta-analysis showed that the total effective rate of the nedaplatin group was better than that of the cisplatin group (P<0.05). The incidence of nausea, vomiting, diarrhea and renal impairment in the nedaplatin group was lower than that in the cisplatin group (P<0.05), but the incidence of leukopenia and hemoglobin decline was higher than that in the cisplatin group (P<0.05). There was no statistical difference in the incidence of liver injury, or platelet decline between the two groups (P>0.05). Conclusion    Nedaplatin combined with fluorouracil has more advantages than cisplatin combined with fluorouracil in the treatment of esophageal cancer, the incidence of nausea, vomiting and diarrhea is lower, and the damage to kidney function is also smaller.

Objective:To investigate the influence of preoperative thyroid dysfunction on the 30-day postoperative mortality and complications in elderly patients with hip fracture.Methods:A retrospective analysis was conducted of the 349 elderly patients with hip fracture who had been admitted to Department of Orthopedic Trauma, Beijing Luhe Hospital Affiliated to Capital Medical University from January 2018 to December 2019. They were 108 males and 241 females, with an average age of 76.3 years (from 60 to 104 years). There were 190 femoral intertrochanteric fractures and 159 femoral neck fractures. By the preoperative level of thyroid function, the patients were divided into a normal function group of 290 cases and a dysfunction group of 59 cases. The 2 groups were compared in terms of hospital stay, mortality and incidence of complications within 30 days postoperation.Results:In this cohort, the rate of 30-day postoperative mortality was 3.4%(12/349) and the incidence of 30-day postoperative complications 14.6%(51/349). The 2 groups were comparable because there was no significant difference between them in the preoperative general data except for the preoperative comorbidity of coronary heart disease ( P>0.05). In the dysfunction group, the hospital stay averaged (10.2±6.9) d, the rate of 30-d postoperative mortality 1.7%(1/59) and the incidence of 30-day postoperative complications 16.9%(10/59), which were insignificantly different from those in the normal function group [(10.7±7.5) d, 3.8%(11/290) and 14.1%(41/290), respectively] ( P> 0.05). Conclusion:Since preoperative thyroid dysfunction does not affect the 30-day postoperative mortality and postoperative complications in the elderly patients with hip fracture but no definite thyroid disease, routine thyroid function screening is not recommended for them.

Objective:To compare the efficacy of open surgery and arthroscopic assisted surgery in treatment of knee dislocations.Methods:A retrospective case-control study was conducted to analyze the clinical data of 80 patients with knee dislocations admitted to Second Hospital of Lanzhou University from May 2013 to September 2019, including 59 males and 21 females, aged 18-66 years [(42.5±11.6)years]. Open multiple ligament reconstruction was performed in 49 patients (open group) and arthroscopic assisted multiple ligament reconstruction was performed in 31 patients (arthroscopic group). The postoperative hospitalization days, incidence of complications, time needed for recovery of knee range of motion (>0°, >90°, >120°), and time to complete weight-bearing were compared between the two groups. The Lysholm score, international knee documentation committee (IKDC) subjective knee form, Tegner activity level, score of the MOS item short-form health survey (SF-36), patient satisfaction and knee range of motion were compared between the two groups at the last follow-up.Results:All the patients were followed up for 1.2-7.4 years [(3.8±1.5)years]. There was no significant difference in postoperative hospitalization days or incidence of complications between the two groups ( P>0.05). No significant difference was found in time needed for recovery of knee range of motion (>0°, >120°) or time to complete weight-bearing ( P>0.05). The time needed for recovery of knee range of motion (>90°) was 90(60, 90)days in open group and 60(30, 90)days in arthroscopic group ( P<0.05). At the last follow-up, there was no significant difference in Lysholm score, IKDC subjective score, Tegner activity level, SF-36 score, or patient satisfaction between the two groups ( P>0.05). At the last follow-up, the knee range of motion was 120°(90°, 130°) in open group and 135°(120°, 140°) in arthroscopic group ( P<0.05). Conclusion:For treatment of knee dislocations, open surgery and arthroscopic assisted surgery have similar results in the long-term effect, while arthroscopic assisted surgery has benefits in early rehabilitation and ultimately better knee range of motion.

Objective    Through the perioperative outcome analysis of da Vinci robot-assisted sleeve lobectomy, to clarify its efficacy and safety. Methods    A retrospective analysis was performed on 10 patients with centrally located lung cancer undergoing robot-assisted sleeve lobectomy from March to December 2019 in our center, including 9 males and 1 female, aged 45-67 (55.0±8.9) years. Preoperative imaging and bronchoscopy showed central non-small cell lung cancer, involving the right upper lung in 3 patients, right lower lung in 2 patients, the left upper lung in 4 patients, and left lower lung in 1 patient. The operation time, Docking time, intraoperative blood loss volume, bronchial anastomosis time, number of dissected lymph nodes, drainage volume and postoperative hospital stay were analyzed. Results    The da Vinci robot-assisted bronchial sleeve lobectomy was completed smoothly on 10 patients. The operation time was 135-183 (157.8±14.3) min, Docking time 6-15 (10.0±2.9) min, intraoperative blood loss volume 55-250 (124.5±61.8) mL, bronchial anastomosis time 17-40 (27.7±7.3) min, the number of dissected lymph nodes 16-23 (19.7±2.8), the drainage volume 200-600 (348.0±148.4) mL and postoperative hospital stay 7-11 (8.7±1.6) d. All patients had no bronchopleural fistula, pulmonary infection or atelectasis, and there was no perioperative death. Postoperative pathological findings were all squamous cell carcinoma. Conclusion    Da Vinci robot-assisted sleeve lobectomy is safe and effective.

Objective    To collect the data of esophageal foreign body patients, and to evaluate the clinical effects of two different surgical methods in our hospital. Methods    The clinical data of 294 patients who were treated in Gansu Provincal Hospital from January 2012 to June 2018 were analyzed retrospectively. The clinical data were collected and analyzed by SPSS 22.0. In order to to evaluate the efficacy of flexible esophagoscope (FE) and rigid esophagoscope (RE) in the treatment of esophageal foreign bodies.The patients were divided into two groups: a RE group including 118 patients with 62 males and 56 females at age of  6 (3-37) years and a FE group including 176 patients with 84 males and 92 females at age of 6 (3-59) years. Results    There was no significant difference in age, age stratification, gender and foreign body type between the two groups. There was a statistical difference in the initial clinical symptoms (P=0.041) or in esophageal foreign bodies position (P=0.037) between the two groups. The success rate of foreign body removal was similar between the two groups (P=0.632). The success rate was 88.9% (105/118) in the RE group, 87.5% (154/176) in the FE group. The operation time was significantly longer in the RE group than that in the FE group (10.8 ±17.4 min vs. 17.5±21.6 min, P<0.001). The postoperative hospitalization time in the RE groups was longer than that in the FE group (21.5 ±24.2 hours vs. 12.5 ±21.3 hours, P<0.05). There was a statistical difference in the incidence of postoperative complications between the two groups (P=0.034). In the RE group, the main complication was mucosal edema (15.3%). And the rate of bleeding was higher (15.9%) in the FE group. There were 30 patients (25.5%) in the RE group with minor postoperative complications versus the FE group with 40 patients (22.7%); and 1 patient (0.8%) in the RE group with severe complications versus the FE group with 5 paients (2.8%). Conclusion    Based on the analysis of this study, it is found that RE has higher safety. But the indications are strict, the professional requirements of the operator and the selection of patients are stronger. The FE is convenient to use, the operation crowd is wide, and the suitable crowd is wide. Therefore, for specific patients, after improving the relevant examination and preoperative evaluation of patients, clinicians need to choose appropriate surgical methods to ensure the success of the operation, and reduce the postoperative complications as far as possible.

At present, the application of the robot assisted surgery system in the surgical treatment of esophageal cancer is gradually emerging, and it is more and more widely used and recognized in the field of surgery. According to the domestic and foreign literatures, the robot has many advantages, and robotic assisted esophageal cancer surgery has been proved to be safe and effective, and its short-term efficacy is significantly better than thoracotomy. Other studies have shown that in long-term follow-up, the effect is comparable to video-assisted thoracoscopic surgery. In this paper, the author are systematically reviewed the development history of the robot assisted surgery system, the effect of robotic assisted esophagectomy on safety, surgical method, short-term efficacy and long-term prognosis. The traditional open surgery and thoracoscopic laparoscopic esophagectomy has been carried on the detailed comparison to provide some advice and theoretical basis for esophageal cancer surgery robot system.

Objective To evaluate the curative effect of robot-assisted thoracic surgery (RATS) and video-assisted thoracic surgery (VATS) for early stage lung cancer patients. Methods We retrospectively analyzed the clinical data of 80 patients with radical resection of lung cancer in Gansu Provincial Hospital between January 2016 and December 2017. The patients were divided into two groups: 43 patients in a VATS group and 37 in a RATS group. There were 51 males and 29 females. Data were processed with STATA v14.0 statistical software. Results There were significant differences in the operative time, duration of hospital stay and operative costs between the two groups. In the RATS group, operative duration was longer (172.21 minutes versus 162.20 minutes, P=0.018), cost was higher (74 076.69 yuan versus 54 814.73 yuan, P<0.001), and required significantly shorter hospital stay (8.27 daysversus 10.76 days, P=0.001) compared with those of the VATS group. There was no statistical difference between the two groups in terms of conversion (3 versus 0, P=0.144), blood loss during operation (61.29 ml versus 90.63 ml, P=0.213), dissected lymph node number (17.38 versus 12.63, P=0.095), drainage volume (1 406.76 ml versus 1 514.60 ml, P=0.617) and the drainage time (7.92 days versus 7.20 days, P=0.440). Conclusion In the early lung cancer patients who underwent thoracic surgery, the postoperative hospitalization time of the RATS group is shorter than that of the VATS group, and the operation time is longer than that of the VATS group. The other short-term surgical indexes are similar to those of thoracoscopic surgery. However, the robot has great advantages in the treatment of patients with difficult lymph node dissection, serious pleural adhesion and complicated anatomical relationship.

Objective To assess the efficienty of operation in humeral intercondylar fractures by section, reposition, internal fixation by composition nail and replacement of elbow joint. Methods From January, 1999 to May, 2009, Forty-six cases of the humeral intercondylar fracture were treated with operation. Thirty-eight cases were followed for 17 months. Their affected elbow joint function were evaluated by Cassebaum rating system, patients treated with total elbow replacement evaluated by Mayo elbow score, DASH score additionally. Results According to Cassebaum rating system,there were 22 cases rated as excellent,eight cases rated as good,five cases rated as poor,three case rated as poor. The fineness rate is 78. 9% (30/38). Mayo score in patients with joint replacement ranged from 75.0 - 90. 0, averaged 84. 4 ± 1.7. DASH score ranged from 25.0 to 75.0,averaged 41. 1 ±0. 8. There was 1 case of superficial soft tissue nonhealing and 2 cases of ulna nerve symptoms. Myodynamia in elbow joint bend and stretch was Ⅳ in 1 cases. Conclusion It is a good method to treat the humeral intercondylar fracture with rational use of open reduction or elbow replacement according to fracture type and patient condition.