Abdominal wall tumor–related diseases include both primary and metastatic lesions. Their diagnosis and treatment require the formulation of individualized therapeutic strategies based on the tumor’s biological behavior while simultaneously addressing the reconstruction of abdominal wall defects caused by surgical resection. Within this complex clinical context, a multi-disciplinary team model plays a pivotal role in therapeutic decision-making, facilitating the dual goals of tumor control and functional restoration. In recent years, the development of novel reconstructive materials—such as composite meshes and drug-loaded meshes—has diversified abdominal wall reconstruction techniques, offering new technological approaches to reduce postoperative recurrence, improve tissue healing quality, and enhance reconstruction success rates. These advances hold promise for achieving superior overall treatment outcomes in patients with abdominal wall diseases related to tumors.

Retroperitoneal tumors (RPT), originating from the retroperitoneal space, are characterized by their deep anatomical location, complex origins, and high heterogeneity. These tumors often lack specific clinical manifestations and exhibit diverse pathological subtypes, yet they share similar imaging features across subtypes, making it difficult to achieve early and precise diagnosis. Surgical resection remains the primary treatment for RPT, while pharmacological interventions have shown limited efficacy. Artificial intelligence technologies can offer innovative pathways for RPT precise diagnosis and prognosis assessment through automated feature extraction and integration of multi-dimensional data. This review aims to summarize the applications of artificial intelligence in RPT imaging, pathology, and molecular diagnostics, as well as the advancements in multi-modal and multi-omics integration, thereby highlighting its development prospects in precise diagnosis and treatment for RPT.

Retroperitoneal sarcomas (RPS) are characterized by a predominant progressive- pattern of local recurrence, making radiotherapy a cornerstone of adjuvant management. Advances in radiation delivery—such as image-guided radiotherapy, intensity-modulated radiotherapy and proton therapy—have significantly enhanced therapeutic precision, enabling improved tumor targeting while minimizing collateral damage to adjacent tissue. This review investigates the value of perioperative radiotherapy for resectable RPS, focusing on the indications, efficacy, and technical optimization strategies. Studies indicate that preoperative radiotherapy significantly improves local control rates, with varying efficacy across histological subtypes, whereas the benefits of postoperative radiotherapy remain controversial and require careful risk-benefit evaluation. In addition, we explore the potential advantages of intraoperative radiotherapy and hypofractionated regimens, as well as forecast the future prospects for integrating radiotherapy with systemic therapies, aiming to optimize RPS management and improve patient prognosis.

Primary retroperitoneal tumor has brought great challenges to clinical diagnosis and treatment because of its concealed anatomical location, diverse pathological types and complex diagnosis. In recent years, with the development of imaging technology and the progress of surgery, the research in this field has been deepening. However, there are still some problems such as difficulties in early diagnosis, unclear treatment options and high postoperative recurrence rates. This article reviews the latest progress in the pathological types, imaging diagnosis, perioperative management, surgical strategies, prognostic factors and future development of retroperitoneal tumors, focusing on the diagnosis and treatment techniques and strategies from the perspective of surgery. By comprehensively analyzing the biological behavior of tumors and surgical resection technology, this paper discusses the important role of the multidisciplinary cooperation mode in improving the prognosis of patients, aiming to provide a systematic and cutting-edge reference for clinicians, and promote the standardized diagnosis and treatment of retroperitoneal tumors.

Retroperitoneal tumors (RPT) represent a rare and highly heterogeneous group of diseases, with the majority being malignant neoplasms such as liposarcoma and leiomyosarcoma. Because of their deep-seated anatomical location and subtle early symptoms, diagnosis relies on techniques such CT/MRI and puncture biopsy confirmation. The cornerstone of RPT clinical treatment remains surgical resection, with emphasis on achieving initial R0 resection for prognostic optimization. However, treatment is challenged by complex anatomical constraints and high recurrence risks, multidisciplinary collaboration is required to formulate individualized treatment plans. Radiotherapy, chemotherapy, and targeted therapies demonstrate limited efficacy, and the clinical drug selection must be tailored to specific pathological subtypes. Although the treatment for RPT has become increasingly standardized and well-defined, it still faces numerous challenges. This article aims to systematically elaborate on the current diagnostic and treatment of RPT, integrating relevant research progress and the latest guidelines, to provide a reference for formulating optimal clinical treatment strategies.

Presacral cyst is a category of cystic lesions located in the pelvis between the rectum and the sacrum, exhibiting diverse pathological types with a predominance of benign cases. In recent years, with advancements in imaging technology and the widespread adoption of health screening, its detection rate has shown a significant upward trend. However, due to its deep anatomical location and proximity to critical nerves and blood vessels, surgical intervention carries high risks, and treatment strategies remain highly controversial. Accurate diagnosis of presacral cyst and the formulation of reasonable treatment plans are crucial factors affecting patient prognosis and quality of life. At present, although a domestic expert consensus on presacral cyst has been released in China, standardized diagnostic and therapeutic protocols remain contentious, constrained by the low clinical incidence rate and variations in surgeons' understanding. This article systematically reviews the clinical characteristics, imaging findings, pathological types, and mainstream surgical approaches for presacral cyst. It focuses particularly on the controversies in the surgical management of presacral cyst, aiming to draw clinical attention and enhance the standardization level of diagnosis and treatment of presacral cyst.

To summarize the treatment experience in reconstruction of abdominal wall defect following surgical resection of abdominal wall tumors in Zhongshan Hospital, Fudan University over the past three years, and to provide reference for subsequent clinical diagnosis and treatment of abdominal wall tumors.

Clinical data including patients' baseline characteristics, abdominal wall tumor characteristics, surgical details and postoperative recovery data from 39 patients who underwent surgical treatment for malignant and borderline abdominal wall tumors in Zhongshan Hospital, Fudan University between January 2022 and March 2025 were retrospectively collected, sorted, and analyzed. Further univariate analysis was conducted on the influence of abdominal wall tumors and surgical factors on postoperative complications.

Among the 39 patients, the average maximum width of malignant tumors in the abdominal wall was (4.9±3.0) cm, and the average maximum width of abdominal wall defects was (7.0±3.3) cm. There were 11, 16, and 12 cases of Type Ⅰ, Ⅱ, and Ⅲ abdominal wall defects respectively. Type Ⅱ defects were more common. There were 8 patients with defects located in the U-zone, 10 in the M-zone, 20 in the L-zone, and 1 in the M+L-zone, with the L area being the most common, accounting for 51.3%. Grade 1 defects were more common (66.7%, 26/39), grade 2 and 3 defects were 7.7% (3/39) and 25.6% (10/39), respectively. There were 13 types of tumors on postoperative pathology. Most of the tumors originated from primary tumors (46.2%, 18/39). Intraoperatively, 20 patients underwent simple suture closure, 16 received mesh repair, and 3 underwent free flap reconstruction of the abdominal wall after tumor resection. Postoperatively, the incidence of Clavien-Dindo Grade Ⅱ and Ⅲ complications were both 2.6% (1/39) and no mesh-related complications occurred. The median of hospital stay was 4 (2, 5) days, and no patients required unplanned readmission within 30 days after discharge. Within three months after discharge, 30.8% (12/39) of patients developed tumor metastasis, 21.3% (9/39) experienced abdominal wall tumor recurrence, and no patients died during follow-up. Univariate analysis found that grade 3 abdominal wall defect was associated with the occurrence of postoperative complications (P=0.043).

The clinical management of abdominal wall tumors is complicated and variable, because of diverse patient-specific factors, tumor size, and disease progression, which require individualized selection of repair methods and materials. This study shows that mesh repair for abdominal wall defects after tumor resection is safe and reliable, but further clinical studies are needed to provide additional data for reference.

To evaluate the clinical efficacy and feasibility of abdominal wall reconstruction using the Sublay technique following radical resection of abdominal desmoid-type fibromatosis.

We conducted a retrospective analysis on the clinical data of 78 patients who underwent radical resection for abdominal wall desmoid-type fibromatosis followed by Sublay mesh reconstruction at West China Hospital, Sichuan University between June 2012 and June 2023. Demographics, surgical parameters, hospitalization duration were analyzed, and postoperative outcomes (including recurrence, incisional hernia formation, and seroma development) of patients were followed up and recorded.

All patients successfully completed the Sublay abdominal wall mesh reconstruction. Intraoperative findings revealed that the average tumor size was (7.56±2.58) cm×(5.54±1.99) cm, and the post-resection abdominal wall defects averaged (13.61±2.25) cm×(11.46±1.42) cm. Postoperative hospitalization averaged (7.70±2.90) days (range 3-38 days). Postoperative complications included hematoma (1 case) and tumor recurrence (1 case). During the 2-year follow-up period, no cases of incisional hernia were observed.

The Sublay technique demonstrates safety and efficacy for abdominal wall large defect reconstruction following radical resection of abdominal wall desmoid-type fibromatosis.

To explore the feasibility and effectiveness of bridging technique in repairing complex abdominal wall defect.

The clinical data of 73 patients with complex abdominal wall defect who underwent bridging repair surgery were retrospectively collected. These patients were admitted by the same surgical team from Huadong Hospital Affiliated to Fudan University and the Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine between January 2016 and December 2024. A retrospective case-control study was conducted. According to the different surgical procedures, they were divided into three groups: the single-layer bridging group (single mesh bridging repair, n=23), double-layer bridging group (double-mesh bridging repair, n=21) and BOSS bridging group [biological-omentum-synthetic sandwich (BOSS) bridging repair, n=29]. The data of postoperative drainage days, average drainage volume 7 days after surgery, postoperative hospital stay, postoperative abdominal wall hernia recurrence/bulging rate and the incidence of incision complications in three groups of patients were analyzed.

All patients met the surgical indications and completed the operation successfully. The average length×width of abdominal wall defects for patients in the single-layer bridging group, double-layer bridging group and BOSS bridging group were (16.6±6.0) cm× (13.3±4.3) cm, (13.8±3.8) cm×(10.9±3.3) cm and (20.9±7.7) cm×(13.6±5.4) cm. The mean time of drainage tube was (18.7±8.2) days, (14.5±6.1) days and (15.6±6.4) days, respectively, and the difference was not statistically significant (P=0.111). The average drainage volume 7 days after surgery was (169.0±105.7) ml, (108.4±45.4) ml and (164.8±76.5) ml, respectively, and the difference was statistically significant (P=0.023). The average hospital stay was (26.2±19.7) days, (15.1±10.2) days, and (21.2±8.9) days, respectively, and the difference was statistically significant (P=0.010). The mean follow-up period was (54.0±23.6) months. The recurrence/bulging rate of abdominal wall hernia was 87.0%, 23.8% and 6.9% in the single-layer bridging group, double-layer bridging group and BOSS bridging group, respectively, with statistically significant differences (χ²=37.427, P<0.001). The incidence of incision complications was 43.5%, 19.0% and 17.2%, respectively, with statistically significant differences (χ²=4.282, P=0.028).

BOSS bridging technique can significantly reduce the postoperative recurrence rate and the incidence of incisional complications. This technique provides a new solution for bridging repair of complex abdominal wall defects.

To evaluate the safety and efficacy of laparoscopic hiatal hernia repair (LHHR) based on infracardiac bursa in the treatment of massive hiatal hernia (MHH), and to provide evidence-based reference for clinical practice.

A retrospective analysis of clinical data from January 2021 to December 2024 of 40 MHH patients in Hernia and Obesity Surgery at the First Hospital, Affiliated with the University of Science and Technology of China, who received surgical treatment based on infracardiac bursa for massive hiatal hernia repair under laparoscopy. The changes of reflux symptoms before and after surgery were assessed by gastroscopy and the gastroesophageal reflux disease questionnaire (GERD-Q). The main study indicators were right-sided pleural rupture and esophageal muscle injury results during surgery, and diverticulation. Secondary indicators included postoperative complications and length of hospital stay.

Of the 40 patients, 2 (5%) were lost to follow-up, and the median follow-up time was 24 (4-48) months. One died of acute cerebral infarction two months after discharge. Twenty-eight patients successfully identified the structure of the infracardiac bursa during surgery, and none suffered rupture of the right pleural membrane or damage to the oesophageal muscles. A further 12 patients failed to identify the infracardiac bursa, including five with a rupture of the right pleural membrane and one with damage to the oesophageal muscle. The median hernia defect diameter was 4.5 (4.5-5.0) cm, the median operative duration was 108 (60-310) min, and the median intraoperative bleeding was 10 (10-50) ml. The median indwelling time was 2 (1-7) days, and the median postoperative hospital stay was 3.5 (2.5-4.5) days. The average score of GERD-Q was (11.38±0.98) points preoperatively and decreased to (7.57±0.73) points postoperatively (P<0.001).

Based on infracardiac bursa, laparoscopic hiatal hernia repair can effectively reduce the rupture of the pleura and damage to the muscles of the esophagus during surgery, and improve surgical safety.

To explore the application value of laparoscopic diaphragmatic plication in adults with diaphragmatic eventration.

A retrospective analysis was conducted on the clinical data of 10 adult patients with diaphragmatic eventration treated at The Sixth Affiliated Hospital of Sun Yat-sen University from January 2018 to June 2024. All patients underwent laparoscopic diaphragmatic plication which included standardized trocar placement, diaphragmatic incision, plication and suture, mesh reinforcement, and postoperative management. Patients were followed up for 1 year to observe symptom relief, pulmonary function improvement, and recurrence rate.

All 10 patients successfully completed the surgery, with an operative time ranging from 90 to 180 minutes (mean, 130 minutes), intraoperative blood loss of 15-40 ml, and postoperative hospital stay of 7-9 days. The pulmonary function indicators (forced vital capacity, forced expiratory volume in one second) significantly improved by 25%-40%. No anatomical recurrence was observed during the 1-year follow-up, and diaphragmatic position remained stable. However, one obese patient (body mass index 32 kg/m²) still experienced mild dyspnea after activity postoperatively.

Laparoscopic diaphragmatic plication is a safe and effective minimally invasive treatment option that significantly improves clinical symptoms and pulmonary function in patients with adult diaphragmatic eventration, with no recurrence observed in short-term follow-up. This technique provides a new strategy for the treatment of diaphragmatic eventration. However, due to the small sample size, lack of a control group, and short follow-up duration, the long-term efficacy and safety of mesh application need to be further verified through large-sample, long-term follow-up studies.

To evaluate the safety and feasibility of inguinal hernia repair surgery in patients over 70 years old under day surgery mode.

Clinical data of patients who underwent inguinal hernia repair surgery in the Department of Gastrointestinal Hernia Surgery of Nanchong Central Hospital from January 2021 to December 2023 was retrospectively collected. According to the different admission methods and ages of patients, they were divided into three groups: ≥70 years old day surgery group, ≥70 years old hospitalization surgery group, and <70 years old day surgery group. Propensity score matching (PSM) method was used to match the ≥70 years old day surgery group with the ≥70 years old hospitalization surgery group, and the ≥70 years old day surgery group with the <70 year old day surgery group pairwise. The clinical indicators of postoperative recovery period between the two groups of patients after matching were compared respectively.

In this study, 219 patients ≥70 years old who underwent day surgery, 612 patients ≥70 years old who underwent ordinary in-patient surgery, and 531 patients <70 years old who underwent day surgery were included. Through a 1:1 PSM, 208 patients were included in the ≥70 years old day surgery group and the ≥70 years old hospitalization surgery group as a comparative study. There was no significant difference between the two groups in bleeding, operation time, postoperative fever, nausea, vomiting, urinary retention, venous thromboembolism (VTE), seroma, wound healing, discharge visual analogue scale (VAS) pain score, and recurrence (P>0.05). However, in the comparison of hospitalization costs between the two groups of patients[≥70 years old day surgery group (12 949.88±3439.28) yuan, ≥70 years old hospitalization surgery group (15 070.09±3090.63) yuan, P<0.001], the hospitalization surgery group had higher costs than the day surgery group, and the difference was statistically significant (P<0.05). Similarly, after a 1:1 PSM, 152 patients were included in the day surgery group ≥70 years old and the day surgery group <70 years old as a comparative study. There was no significant difference between the two groups in bleeding, operation time, hospital costs, postoperative fever, nausea, vomiting, urinary retention, VTE, seroma, incision healing, discharge VAS pain, and recurrence (P>0.05).

This retrospective study based on PSM showed that elderly patients over 70 years old who have good anesthesia risk assessment (as required by the guidelines for inguinal hernia day surgery), have underlying diseases, and do not require complex multidisciplinary cooperation for diagnosis and treatment, are safe and feasible to undergo hernia day surgery.

To investigate the clinical application of colostomy reduction combined with the placement of biological mesh to prevent stomal site incisional hernia.

Clinical data of patients who underwent colostomy reduction combined with biological mesh placement in the Department of Colorectal Surgery of Nanjing Drum Tower Hospital from January 2022 to December 2023 were analyzed. Surgical time, intraoperative blood loss, postoperative hospital stays, follow-up time, etc. were recorded. The incidence of stomal site incisional hernia (SSIH) was observed, along with postoperative incision infection, mesh infection, hematoma, seroma, intra-abdominal bleeding, intra-abdominal organ injury, congestion in the surgical area, foreign body sensation in the surgical area, pain in the surgical area, urinary retention, etc.

Eighteen patients were included, all of whom had the mesh placed in the preperitoneal space (Onlay technique). The surgeries were successful, with postoperative pain well-controlled (either by oral medication or by intravenous analgesia). Significant improvement was observed within 3 days. And by around 7 days, patients were mostly back to normal. None of the patients developed SSIH, incision infection, mesh infection, hematoma, intra-abdominal bleeding, intra-abdominal organ injury, congestion in the surgical area, foreign body sensation in the surgical area, or urinary retention. One patient experienced seroma, which improved after one week of local drainage tube placement. The tube was successfully removed and the patient was discharged, with subsequent good recovery.

Colostomy reduction combined with biological mesh placement is a safe and effective method for preventing SSIH. It can be considered for clinical application in similar patients.

To summarize the surgical experience and techniques of laparoscopic transabdominal preperitoneal (TAPP) hernia repair and its influence on the postoperative seroma.

A retrospective analysis was conducted on the clinical data of 52 inguinal hernia patients undergoing TAPP hernia repair in Qingdao Cardiovascular Hospital and the south hospital of Qingdao University from January 2023 to November 2024. The surgical path of TAPP, anatomic landmarks, fat tissue management, layer transition, membrane dissection, mesh selection, wound management, suturing techniques for the parietal peritoneum, application of the greater omentum were described and analyzed.

All patients successfully completed the TAPP surgery. One patient was converted to open surgery. None of the patients had drainage tubes. Within 24 hours after the operation, the groin operation area was routinely pressurized with a 500 g salt bag (the salt bag was wrapped in a dry cotton towel and the swimming underwear was tightened). The patients were followed up for one month after the operation, no seroma occurred.

The surgical experience and techniques such as proper fat tissue management and clear dissection of layers can effectively avoid the seroma after TAPP. Mastering small techniques proficiently is helpful to shorten the operation time, and is beneficial to both the surgeon and the patient.

To identify independent risk factors for postoperative urinary retention (POUR) following transabdominal preperitoneal inguinal hernia repair (TAPP), and to develop and evaluate a predictive model for POUR risk.

Clinical data of 598 patients who underwent TAPP for inguinal hernia in the Department of General Surgery, Affiliated Liupanshui People's Hospital of Zunyi Medical University, from January 2017 to December 2023 were retrospectively collected. Patients were randomly divided into a training cohort and a validation cohort at a ratio of 7:3. In the training cohort, patients were grouped into the POUR group (n=38) and the non-POUR group (n=381) according to the occurrence of POUR. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for POUR, and a nomogram prediction model was constructed. Model performance was assessed in both cohorts. Discrimination was evaluated by calculating the area under the receiver operating characteristic (ROC) curve (AUC), calibration was assessed using calibration plots and the Hosmer-Lemeshow goodness-of-fit test, and clinical utility was analyzed using decision curve analysis (DCA).

Multivariate logistic regression analysis revealed that recurrence status (OR=0.279, 95% CI: 0.105-0.805; P=0.013), benign prostatic hyperplasia (BPH) (OR=15.09, 95% CI: 2.658-96.282; P=0.002), operative duration (OR=1.015, 95% CI: 1.006-1.023; P<0.001), and postoperative use of opioid analgesics (OR=2.224, 95% CI: 1.021-5.222; P=0.048) were independent risk factors for POUR after TAPP, whereas intraoperative urinary catheterization (OR=0.087, 95% CI: 0.012-0.370; P=0.004) was a protective factor. In terms of discrimination, the AUC was 0.763 (95% CI: 0.684-0.842; P<0.001) in the training cohort and 0.812 (95% CI: 0.677-0.947; P<0.001) in the validation cohort, both exceeding 0.75. Calibration assessment showed good agreement, with Hosmer-Lemeshow test results of χ²=5.566 (P=0.696) for the training cohort and χ²=11.132 (P=0.194) for the validation cohort.

Recurrent hernia, benign prostatic hyperplasia, absence of urinary catheterization, prolonged operative time, and postoperative opioid analgesic use are independent risk factors for POUR after TAPP. The nomogram model established based on these factors demonstrated good predictive performance and may assist clinicians in early identification of high-risk patients, enabling timely preventive and therapeutic interventions.

To analyze the value of the multi-planar reconstruction (MPR) technique of multi-slice spiral computed tomography (MSCT) in the identification of inguinal hernia and prediction of incarcerated hernia.

Retrospectively analyze the preoperative MSCT images of 110 cases of surgically confirmed inguinal hernia at the Affiliated Suzhou Hospital of Nanjing Medical University from January 2017 to December 2022, including 49 cases of indirect inguinal hernia, 36 cases of direct inguinal hernia, and 25 cases of femoral hernia. To observe the following targets in coronal and oblique coronal MPR images: inguinal ligament, inferior epigastric artery, Hesselbach's triangle, femoral triangle, hernia contents, the ratio of the hernia sac to the neck and special CT signs.

In coronal MPR and oblique coronal MPR images, the inguinal ligament was completely displayed in 24 (20.7%) and 63 (54.3%) cases respectively, partially displayed in 43 (37.1%) and 33 (28.4%) cases respectively, and not displayed in 49 (42.2%) and 20 (17.2%) cases respectively. The complete display rate of the inguinal ligament in oblique coronal MPR was better than that in coronal MPR, and the difference was statistically significant (P<0.05). The contents of three types of inguinal hernia included small intestine, fluid, mesentery, fat, etc. The incidence of fluid accumulation in the femoral hernia sac was higher than that in indirect inguinal hernias and direct inguinal hernias (P<0.05). The incidence of fat in the indirect inguinal hernia sac was lower than that in direct inguinal hernias and femoral hernias (P<0.05). The lateral crescent sign and Hesselbach's triangle filling sign only appeared in direct inguinal hernias (P<0.05). The femoral triangle filling sign only appeared in femoral hernia (P<0.05). Seven (7/51, 13.7%) indirect inguinal hernia sacs were incarcerated, 6 (6/39, 15.4%) direct inguinal hernia sacs incarcerated, and 19 (19/26, 73.1%) femoral hernia sacs were incarcerated. The incidence of incarceration in femoral hernia was higher than that in indirect inguinal hernias and direct inguinal hernias (P<0.05). The incidence of fluid accumulation in the hernia sac of incarcerated indirect hernia and direct hernia was higher than that in non-incarcerated hernia (P<0.05). The median of the ratio of the hernia sac to the neck in incarcerated and non-incarcerated indirect inguinal hernias was 3.1 and 1.3, respectively. The differences between the two groups were statistically significant (P<0.05). When the critical value was 2.3, the area under the receiver operating characteristic curve (AUC) was 0.97. The median of the ratio of the hernia sac to the neck in incarcerated and non-incarcerated direct inguinal hernias was 4.5 and 2.8, respectively. The differences between the two groups were statistically significant (P=0.03). When the critical value was 3.9, AUC was 0.98. The median of the ratio of the hernia sac to the neck in incarcerated and non-incarcerated femoral hernias was 3.8 and 2.3, respectively. The differences between the two groups were statistically significant (P<0.05). When the critical value was 3.2, the AUC was 0.84.

MSCT MPR technology is advantageous in displaying the anatomical structure of the inguinal area and determining the type of inguinal hernia. The presence of fluid accumulation in the hernia sac and an increase in the ratio of the hernia sac to the neck can provide clues for incarcerated hernia.

To assess the predictive value of the systemic immunoinflammatory index (SII) for intestinal tissue viability in patients with incarcerated inguinal hernia.

Case data of 140 patients who underwent surgery for incarcerated inguinal hernia in the emergency department of the Affiliated Hospital of Chuanbei Medical College from January 2014 to April 2023 and whose hernia contents were only intestinal tubes were retrospectively analyzed. According to intraoperative intestinal tissue viability, they were divided into non-ischemic necrosis group (49 cases) and ischemic necrosis group (91 cases). Univariate analysis of factors influencing intestinal ischemic necrosis was performed using the independent-samples t-test, Mann-Whitney U test, χ² test, or Fisher's exact probability test. Multivariate analysis was conducted with logistic regression. Spearman correlation analysis was applied to explore the relationship between the systemic immune-inflammation index (SII) and inflammation. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cut-off value of SII and to evaluate its diagnostic value in predicting intestinal ischemic necrosis.

Of the 91 patients in the ischemia group, irreversible intestinal ischemia for colectomy occurred in 59 patients, accounting for 42.1% (59/140) of all patients. The results of multifactorial analysis showed that elevated leukocyte count, incarceration duration of more than two days, increased SII, and elevated serum phosphorus (P<0.05) were independent risk factors for the development of intestinal ischemic necrosis in patients with incarcerated hernia in the inguinal area. Leukocyte count was positively correlated with SII (P<0.001) with a correlation coefficient of r=0.636. ROC curve analysis showed that the area under the curve of the SII index predicting intestinal tissue viability was 0.820, with a 95.0% credible interval (0.744~0.895, P<0.001, and the optimal cut-off value was 1128.1127, with a specificity of 79.6% and a sensitivity of 75.8%.

An early SII index of more than 1128.1127 is highly correlated with poor intestinal tissue ischemic necrosis in patients with incarcerated inguinal hernias and can be used to predict intestinal tissue viability in patients with incarcerated inguinal hernias.

To analyze the effect of holistic nursing intervention on the postoperative recovery of elderly patients with inguinal hernia.

Clinical data of 64 patients with inguinal hernia admitted to Linquan County People's Hospital from June 2021 to June 2024 were selected. According to the admission time and voluntary principle, patients were randomly divided into a control group and an experimental group in a 1:1 ratio, with 32 cases in each group. The control group received routine perioperative care; The experimental group received holistic nursing intervention. The pain level of patients was evaluated using the pain numeric score (NRS) method, and the presence of deep vein thrombosis after surgery was observed. The Barthel index was used to assess the patient's postoperative self-care ability. The NRS scores, postoperative self-care ability and hospitalization time between two groups were compared.

The experimental group had 22 cases (68.75%), 7 cases (21.87%), 3 cases (9.37%), and 0 cases (0.00%) of postoperative 0, 1-3、4-6、7-10 pointspain, respectively. The control group had 13 cases (40.62%), 11 cases (34.37%), 6 cases (18.75%), and 6 cases (18.75%), respectively. The pain level in the experimental group was significantly milder than that in the control group, and the difference was statistically significant (P<0.05). Both groups of patients had no postoperative deep vein thrombosis. There was no statistically significant difference in preoperative self-care ability scores between the two groups of patients (P>0.05). On the day of surgery and the second day after surgery, the self-care ability of the experimental group was significantly higher than that of the control group, and the difference was statistically significant (P<0.05). The hospitalization time was less than that of the control group, and the difference was statistically significant (P<0.05).

Holistic nursing intervention can effectively improve postoperative pain in elderly patients with inguinal hernia, promote rapid recovery of self-care ability, and is worthy of clinical promotion.

Robotic fundoplication is primarily performed through fully robotic or robot-assisted approach. It has emerged as one of the most important surgical interventions for gastroesophageal reflux disease (GERD). Robotic surgery is characterized by enhanced surgical precision and improved operational accuracy. In recent years, with the increasing adoption of robotic technology, there has been a progressive expansion in the number of cases, methods and application institutional of robotic fundoplication. This article aims to provide a comprehensive overview of the evolutionary trajectory of robotic surgical technology, the technical distinctiveness of robotic fundoplication procedures, and key considerations in perioperative management.

Hiatal hernia (HH) is a gastrointestinal disease related to gastroesophageal reflux disease, with various surgical repair methods, including endoscopic treatment and surgical treatment. Among them, laparoscopic HH repair has become the standard surgical method due to its minimal invasiveness and rapid recovery. The application of biological mesh in the repair of HH has shown advantages in reducing the short-term postoperative recurrence rate versus simple HH repair. Compared with synthetic mesh, biological mesh has performed better in reducing the incidence of mesh erosion and dysphagia. Future research will focus on the long-term effectiveness evaluation of biological mesh, optimization of mesh shape and materials, etc., to further improve the postoperative efficacy and quality of life of patients with HH. This article reviews and summarizes the hot issues in the application of biological mesh in the repair of HH.

As the key pathophysiological problem of external abdominal hernia, the current theory of abdominal transverse fascia weakness has obvious defects, and new theories need to be developed to promote the development of hernia and abdominal wall surgery. The relationship between sarcodynia and external abdominal hernia has been noticed by scholars and related studies have been conducted. Therefore, this paper summarized the current literature and combined clinical observation, and that put forward the theoretical hypothesis that sarcopenia is the key pathophysiological link of external abdominal hernia.

To explore the application of standard operating procedures (SOP) in the management of laparoscopic instruments for hernia and abdominal wall surgery.

From April 2023 to October 2023, 360 sets of laparoscopic instruments for hernia and abdominal wall surgery in Beijing Chaoyang Hospital affiliated to Capital Medical University were selected and randomly divided into study group and control group. SOP were used to clean and manage laparoscopic instruments in the study group. The control group was cleaned according to the technical operation specification for endoscopic cleaning and disinfection 2023 edition, and managed according to conventional methods. The qualified rate of cleaning, the integrity rate of equipment, the normal rate of mechanical function and the correct rate of assembly were compared between the two groups.

The qualified rate of cleaning in the study group was higher than that in the control group, the difference was statistically significant (P<0.001). The integrity rate, normal rate of mechanical function and correct assembly rate of the study group were higher than those of the control group, and the differences were statistically significant (P<0.05).

The establishment of SOP can significantly improve the cleaning effect of external hernia endoscopic instruments and avoid the possible risk of infection, ensure the quality of laparoscopic instruments and reduce the occurrence of errors, improve the assembly accuracy of endoscopic instruments, so as to effectively ensure the medical safety of patients.