All four patients were female, with an average age of 28.8 days and an average weight of 3.64 kg. Only case 4 was born prematurely at 34 W+5 and was treated conservatively until 71 days to complete operation. All the others completed primary corrective surgery in the neonatal period, and all survived after operation. Two different surgical techniques were used to repair the aortic-pulmonary window and the aortic origin of the right pulmonary artery, including 1 case using the aortic internal baffle technique and another 3 cases underwent replantation of the right pulmonary artery (1 case was reconstructed in situ, and the other 2 cases were reconstructed by moving the right pulmonary artery in the anterior of aorta). Case 2 who received aortic internal baffle technique underwent two reoperation because of right pulmonary artery stenosis. While, right pulmonary artery of cases 3 and 4 developed well after being reconstructed the right pulmonary artery anterior translocation. After the diagnosis of Berry syndrome through cardiac color ultrasound and CT angiography, a primary surgical radical treatment should be performed as soon as possible at an experienced pediatric cardiac center. Although the surgery is high-risk and complex, it is safe and effective.

Background and Aims:Minimally invasive surgery,represented by laparoscopic techniques,plays a vital role in the treatment of gastric cancer.However,postoperative infectious complications remain a key factor affecting patient recovery and prognosis.This study was performed to identify the risk factors associated with early(≤1 month)infectious complications after laparoscopic surgery for gastric cancer,providing a reference for clinical prevention strategies.Methods:A retrospective analysis was conducted on 1 572 patients who underwent laparoscopic surgery for gastric cancer at the First Affiliated Hospital of Xi'an Jiaotong University from March 2020 to February 2024.Patients were divided into infection and non-infection groups based on the occurrence of postoperative infectious complications.Univariate and multivariate Logistic regression analyses were performed to identify related risk factors.Results:Among the 1 572 patients,194 cases(12.3％)developed early postoperative infectious complications,including intra-abdominal infections(4.1％),surgical site infections(3.7％),and pulmonary infections(5.6％).Univariate analysis revealed that a history of diabetes,pulmonary disease,smoking,and preoperative anemia and hypoalbuminemia were significantly associated with postoperative infections(all P＜0.05).Multivariate analysis indicated that a history of diabetes(OR=6.927,95％CI=4.194-12.935),smoking(OR=3.079,95％CI=2.261-4.913),and preoperative albumin＜35 g/L(OR=0.572,95％CI=0.302-1.578)were independent risk factors for early postoperative infectious complications.Conclusion:A history of diabetes,smoking,and preoperative hypoalbuminemia are closely associated with the occurrence of early postoperative infectious complications after laparoscopic gastric cancer surgery.Clinical attention should be paid to perioperative metabolic,nutritional,and lifestyle management,and early intervention for high-risk patients may help reduce the incidence of complications,improve recovery,and enhance treatment outcomes.

Objective:Coarctation of the aorta is a genetically related diffuse aortic disease. Even after successful repair and with normal blood pressure, patients have a significant increase of risk in long-term cardiovascular events. Coarctation of the aorta accounts for 6%-8% of congenital heart diseases. Although the results of surgery and interventional treatment are satisfactory, the long-term survival rate of patients is still lower than that of health people, and there is a high proportion of re-intervention. Factors affecting prognosis include concomitant diseases, genetic characteristics, restenosis, hypertension, heart failure, neurodevelopmental disorders, obesity, psychology, etc. Therefore, people with coarctation of the aorta need cardiovascular monitoring throughout their life cycle. Currently, there are relevant guidelines of follow-up management for adult patients, but there is still no clear cardiovascular monitoring strategy for child and adolescent patients in transition. Based on a large number of domestic and foreign literature and clinical experience, this article summarizes the follow-up management strategies for full-life cardiovascular monitoring immediately after the repair of coarctation of the aorta in infancy and childhood from the perspective of concomitant diseases, genetic characteristics and long-term complications.

The advancement of surgical techniques enables effective treatment for many patients with oral and maxillofacial tumors.How-ever,post-surgery problems such as chewing,swallowing and speech difficulty may arise due to the defects in speech organs and inade-quate compensatory function of tissue flap repair.Speech disorders,in particular,isolate patients by making it difficult for them to com-municate with others,not only impact their quality of life but also potentially lead to psychological problems and social interaction disor-ders.Although the decline in life quality and other related issues caused by speech dysfunction due to surgery and radiotherapy or chemo-therapy have been widely recognized,there is currently no standardized and universally applicable assessment method and standardized re-habilitation treatment management guideline or consensus for speech disorders following oral and maxillofacial tumor surgery at home and abroad.Based on previous clinical practice,combined with the characteristics of speech disorders in patients after oral and maxillofacial tumor surgery,the clinical experience of the experts in maxillofacial tumor surgery and rehabilitation and the relevant domestic and foreign literature,relevant experts organized discussions and modifications,reach a consensus on core content such as the assessment of speech disorders and the implementation plan for early rehabilitation treatment management,providing a reference for clinical practice,in order to improve patients'speech-related life quality and enhance the assessment and rehabilitation treatment techniques for speech disorders after oral and maxillofacial tumor surgery.

The advancement of surgical techniques enables effective treatment for many patients with oral and maxillofacial tumors.How-ever,post-surgery problems such as chewing,swallowing and speech difficulty may arise due to the defects in speech organs and inade-quate compensatory function of tissue flap repair.Speech disorders,in particular,isolate patients by making it difficult for them to com-municate with others,not only impact their quality of life but also potentially lead to psychological problems and social interaction disor-ders.Although the decline in life quality and other related issues caused by speech dysfunction due to surgery and radiotherapy or chemo-therapy have been widely recognized,there is currently no standardized and universally applicable assessment method and standardized re-habilitation treatment management guideline or consensus for speech disorders following oral and maxillofacial tumor surgery at home and abroad.Based on previous clinical practice,combined with the characteristics of speech disorders in patients after oral and maxillofacial tumor surgery,the clinical experience of the experts in maxillofacial tumor surgery and rehabilitation and the relevant domestic and foreign literature,relevant experts organized discussions and modifications,reach a consensus on core content such as the assessment of speech disorders and the implementation plan for early rehabilitation treatment management,providing a reference for clinical practice,in order to improve patients'speech-related life quality and enhance the assessment and rehabilitation treatment techniques for speech disorders after oral and maxillofacial tumor surgery.

Objective:To explore the feasibility, practicality, and safety of the day surgery management model for the treatment of patent ductus arteriosus with Da Vinci robotic surgery in children.Methods:A non-randomized controlled study was conducted.The clinical data of children with patent ductus arteriosus who underwent Da Vinci robotic surgery at Children′s Hospital, Zhejiang University School of Medicine from August 2020 to December 2023 were collected and retrospectively analyzed.The patients were divided into day surgery group and non-day surgery group according to whether they had discharged within 24 hours. t-test and Chi-square tests were used to compare the differences in clinical features, perioperative complications and prognosis between the two groups of patients.In addition, the satisfaction of the treatment effect was surveyed. Results:A total of 276 children were included in this study, with an age ranging from 6 to 154 months with a median of 34 months.The weight ranged from 6.2 to 63.2 kilograms, with a median of 13.5 kilograms.The operation time ranged from 23 to 90 minutes, with a median of 45 minutes.One hundred and thirty-five patients underwent day surgery and 141 patients underwent non-day surgery.The average age and average weight of the patients in the day surgery and non-day surgery groups was (43.7±30.8) months vs.(42.4±30.2) months and (15.0±6.4) kg vs.(14.8±6.9) kg, respectively.There was no statistically significant difference in age and weight between the two groups (all P>0.05).There was no difference in perioperative data and incidence of perioperative complications between the two groups (all P>0.05).However, the length of hospital stay of the day surgery group was significantly shorter than that of the non-day surgery group[(1.0±0) days vs.(2.5±0.9) days, t=-20.993, P<0.001], and the hospitalization cost of the day surgery group was also significantly lower than that of the non-day surgery group[(50 800±1 100) yuan vs.(53 500±3 900) yuan, t=-10.040, P<0.001].Both families of the two groups were satisfied with the treatment results, and there was no difference in satisfaction between the two groups ( χ2=0.501, P=0.479). Conclusions:The day surgery management model of Da Vinci robotic surgery for the treatment of pediatric patent ductus arteriosus is safe and feasible.To a certain extent, it can reduce the length of hospital stay, treatment costs, and treatment burden.

Objective:To explore the feasibility, practicality, and safety of the day surgery management model for the treatment of patent ductus arteriosus with Da Vinci robotic surgery in children.Methods:A non-randomized controlled study was conducted.The clinical data of children with patent ductus arteriosus who underwent Da Vinci robotic surgery at Children′s Hospital, Zhejiang University School of Medicine from August 2020 to December 2023 were collected and retrospectively analyzed.The patients were divided into day surgery group and non-day surgery group according to whether they had discharged within 24 hours. t-test and Chi-square tests were used to compare the differences in clinical features, perioperative complications and prognosis between the two groups of patients.In addition, the satisfaction of the treatment effect was surveyed. Results:A total of 276 children were included in this study, with an age ranging from 6 to 154 months with a median of 34 months.The weight ranged from 6.2 to 63.2 kilograms, with a median of 13.5 kilograms.The operation time ranged from 23 to 90 minutes, with a median of 45 minutes.One hundred and thirty-five patients underwent day surgery and 141 patients underwent non-day surgery.The average age and average weight of the patients in the day surgery and non-day surgery groups was (43.7±30.8) months vs.(42.4±30.2) months and (15.0±6.4) kg vs.(14.8±6.9) kg, respectively.There was no statistically significant difference in age and weight between the two groups (all P>0.05).There was no difference in perioperative data and incidence of perioperative complications between the two groups (all P>0.05).However, the length of hospital stay of the day surgery group was significantly shorter than that of the non-day surgery group[(1.0±0) days vs.(2.5±0.9) days, t=-20.993, P<0.001], and the hospitalization cost of the day surgery group was also significantly lower than that of the non-day surgery group[(50 800±1 100) yuan vs.(53 500±3 900) yuan, t=-10.040, P<0.001].Both families of the two groups were satisfied with the treatment results, and there was no difference in satisfaction between the two groups ( χ2=0.501, P=0.479). Conclusions:The day surgery management model of Da Vinci robotic surgery for the treatment of pediatric patent ductus arteriosus is safe and feasible.To a certain extent, it can reduce the length of hospital stay, treatment costs, and treatment burden.

Objective:Coarctation of the aorta is a genetically related diffuse aortic disease. Even after successful repair and with normal blood pressure, patients have a significant increase of risk in long-term cardiovascular events. Coarctation of the aorta accounts for 6%-8% of congenital heart diseases. Although the results of surgery and interventional treatment are satisfactory, the long-term survival rate of patients is still lower than that of health people, and there is a high proportion of re-intervention. Factors affecting prognosis include concomitant diseases, genetic characteristics, restenosis, hypertension, heart failure, neurodevelopmental disorders, obesity, psychology, etc. Therefore, people with coarctation of the aorta need cardiovascular monitoring throughout their life cycle. Currently, there are relevant guidelines of follow-up management for adult patients, but there is still no clear cardiovascular monitoring strategy for child and adolescent patients in transition. Based on a large number of domestic and foreign literature and clinical experience, this article summarizes the follow-up management strategies for full-life cardiovascular monitoring immediately after the repair of coarctation of the aorta in infancy and childhood from the perspective of concomitant diseases, genetic characteristics and long-term complications.

Background and Aims:Minimally invasive surgery,represented by laparoscopic techniques,plays a vital role in the treatment of gastric cancer.However,postoperative infectious complications remain a key factor affecting patient recovery and prognosis.This study was performed to identify the risk factors associated with early(≤1 month)infectious complications after laparoscopic surgery for gastric cancer,providing a reference for clinical prevention strategies.Methods:A retrospective analysis was conducted on 1 572 patients who underwent laparoscopic surgery for gastric cancer at the First Affiliated Hospital of Xi'an Jiaotong University from March 2020 to February 2024.Patients were divided into infection and non-infection groups based on the occurrence of postoperative infectious complications.Univariate and multivariate Logistic regression analyses were performed to identify related risk factors.Results:Among the 1 572 patients,194 cases(12.3％)developed early postoperative infectious complications,including intra-abdominal infections(4.1％),surgical site infections(3.7％),and pulmonary infections(5.6％).Univariate analysis revealed that a history of diabetes,pulmonary disease,smoking,and preoperative anemia and hypoalbuminemia were significantly associated with postoperative infections(all P＜0.05).Multivariate analysis indicated that a history of diabetes(OR=6.927,95％CI=4.194-12.935),smoking(OR=3.079,95％CI=2.261-4.913),and preoperative albumin＜35 g/L(OR=0.572,95％CI=0.302-1.578)were independent risk factors for early postoperative infectious complications.Conclusion:A history of diabetes,smoking,and preoperative hypoalbuminemia are closely associated with the occurrence of early postoperative infectious complications after laparoscopic gastric cancer surgery.Clinical attention should be paid to perioperative metabolic,nutritional,and lifestyle management,and early intervention for high-risk patients may help reduce the incidence of complications,improve recovery,and enhance treatment outcomes.

Objective:To investigate the application value of biological muscle flap in laparo-scopic radical proximal gastrectomy with esophagogastric anastomosis.Methods:The retrospec-tive and descriptive study was conducted. The clinicopathological data of 10 patients with adeno-carcinoma of esophagogastric junction who were admitted to The First Affiliated Hospital of Xi′an Jiaotong University from May 2023 to August 2023 were collected. All patients were males, aged (65±5)years. All patients underwent laparoscopic radical proximal gastrectomy and esophagogastric anastomosis with digestive tract reconstruction using the esophagogastric biological muscle flap. Observation indicators: (1) surgical situations and early complications; (2) follow-up and late com-plications. Measurement data with normal distribution were represented as Mean± SD, and measure-ment data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Results:(1) Surgical situations and early complications. All 10 patients success-fully completed the surgery without conversion to open surgery, and the operation time was (166±18)minutes. Cases with digestive tract reconstruction as end-to-side anastomosis and Overlap anas-tomosis were 1 and 9, respectively. The time of digestive tract reconstruction, the number of lymph node dissected, volume of intraoperative blood loss, time to postoperative first anal exhaust, time to postoperative first intake of liquid food, duration of postoperative hospital stay were (40±12)minutes, 24±6, (41±9)mL, (3.4±0.5)days, (4.1±1.0)days, (8.3±0.7)days in the 10 patients. Of 4 cases with postoperative early complications, 1 case developed pulmonary infection (Clavien-Dindo grade Ⅱ) on the second day after surgery, with pulmonary infection absorbed after 5 days of antibiotic treat-ment. Two cases experienced chest distress and shortness of breath on the third day after surgery, with the diagnosis of a small to moderate amount of pleural effusion after chest B-ultrasound examination. After pleural puncture and active treatment, the symptoms of them were improved and the pleural effusion disappeared. There was 1 case with choking sensation when eating solid food, which was started from the third week after surgery. Upper gastrointestinal imaging revealed mild anastomotic stenosis of Clavien-Dindo grade Ⅰ in the patient, who was improved after conservative treatment. On the 7th day after surgery, all 10 patients underwent upper gastrointestinal angiography, and no anastomotic leakage or stenosis occurred. There was no sign of contrast agent reflux in the supine position and 30° head down position. (2) Follow-up and late complications. All 10 patients were followed up for 59.5(range, 31.0-127.0)days. The esophageal reflux scale score of 10 patients was 1.4±0.3. During the follow-up, 1 case underwent gastroscopy on 40 days after surgery, which showed reflux esophagitis with Los Angeles grade as B and the Clavien-Dindo grade as Ⅰ. There was no clinical symptom such as heartburn or acid reflux. Results of 24-hour pH monitoring showed that the patient experienced 24 instances of reflux in an upright position and 15 instances of reflux in a supine position, with no prolonged reflux. The total reflux time within 24 hours was 75 minutes. The DeMeester score was 38.3. Results of esophageal pressure measurement showed that the esophageal contraction morphology was normal, but the anastomotic opening was not well relaxed. The rest of 9 cases had no complication such as reflux esophagitis.Conclusion:Biological muscle flap applied in the laparoscopic radical proximal gastrectomy with esophagogastric anastomosis is safe and feasible, with satisfied short-term efficacy.