With the advancement of minimally invasive surgery, pure single-incision laparoscopic surgery (pSILS) has garnered increasing attention in the treatment of gastric cancer. The pSILS has advantages in minimally invasive and cosmetic procedures, but it requires high surgical techniques and has limitations. The Robotic and Laparoscopic Surgery Committee of Chinese Research Hospital Association and Editorial Board of the Chinese Journal of Digestive Surgery have organized domestic gastrointestinal surgery experts to develope the Expert Consensus on Surgical Procedure of Pure Single-incision Laparoscopic Surgery for Gastric Cancer (2025 Edition) based on evidence-based medicine and clinical practice. The aim is to standardize the application of pSILS in gastric cancer treatment, improve surgical safety and effectiveness, and provide scientific guidance for clinical practice.

To investigate the predictive value of postoperative first-day bowel rate changes on the occurrence of serious perioperative complications in patients undergoing colorectal cancer surgery.

A retrospective analysis was carried out of 126 colorectal cancer patients treated surgically in the Second Department of General Surgery of Shaanxi Provincial People’s Hospital from January 2019 to January 2021. The data were collected, changes in bowel rate on the first postoperative day and changes in bowel sound amplitude on the first postoperative day with prolong postoperative ileus (PPOI) were analyzed by receiver operating characteristic (ROC) curves, and meaningful data were grouped by Yuden index to compare the differences in baseline data and perioperative complications among patients in different groups, and to study the risk factors affecting the occurrence of serious complications (grade Ⅱ or above by the Clavien-Dindo classification system).

A total of 126 patients, 72 males and 54 females, were included. Changes in bowel rate on the first postoperative day were found to have predictive values for the occurrence of PPOI by ROC curve analysis, and were divided into two groups according to the Yuden index. Univariate logistic regression analysis revealed that preoperative hypoproteinemia (OR=3.071, P=0.018), tumor N+ stage (OR=2.616, P=0.046), and changes in bowel rate >6.281 cpm (counts per minute, cpm) on the first postoperative day (OR=3.019, P=0.019) were the most important factors in the development of colon factors influencing the occurrence of serious postoperative complications in the perioperative period in patients undergoing radical rectal cancer surgery. The results of multivariate analysis showed that preoperative hypoproteinemia (OR=3.039, P=0.027) and postoperative first-day bowel rate change >6.281 cpm (OR=3.021, P=0.026) were independent risk factors for the occurrence of perioperative complications in patients undergoing radical colorectal cancer surgery.

Routine preoperative and postoperative bowel sound monitoring is clinically relevant in colorectal cancer patients undergoing surgical treatment. By monitoring the changes of bowel rate of patients on the first postoperative day, the occurrence of serious postoperative complications can be predicted to a certain extent.

To compare the safety and short-term outcomes of three different anastomotic techniques in laparoscopic radical right hemicolectomy for colon cancer.

A retrospective analysis was conducted on 257 patients who underwent laparoscopic radical right hemicolectomy in Zhongshan City People’s Hospital between January 2018 and December 2024. The patients were divided into three anastomosis groups: the end-to-side group (54 cases), the FETE group (133 cases), and the Overlap group (70 cases). Intraoperative parameters, postoperative complications, and early postoperative recovery were compared among the three groups.

The basic data of the three groups were not statistically significant. The Overlap group exhibited longer operative time compared to the end-to-side and FETE group, and the FETE group had significantly less intraoperative blood loss than the end-to-side group (P<0.001). No statistically significant differences were observed among the three groups in terms of time to first flatus, postoperative hospital stay, or incidence of complications. The white blood cell counts and neutrophil counts in the end-to-side group were lower than those in the other two groups after the operation (P<0.01).

End-to-side, FETE, and Overlap anastomotic techniques are equally safe and effective for laparoscopic radical right hemicolectomy. The choice of technique shall be individualized based on patient-specific factors and intraoperative conditions.

To compare laparoscopic modified double-tract reconstruction after proximal gastrectomy versus total gastrectomy with Roux-en-Y anastomosis, evaluating the efficacy of this modified technique in adenocarcinoma of esophagogastric junction (AEG) surgery through surgical outcomes, postoperative recovery, and nutritional assessments.

This retrospective cohort study analyzed clinical data from 188 patients undergoing elective AEG resection in Heji Hospital Affiliated to Changzhi Medical College between January 2020 to December 2021. After 1∶1 propensity score matching using Logistic regression to balance baseline characteristics, modified double-tract reconstruction following proximal gastrectomy (modified double-tract group) and total gastrectomy with Roux-en-Y anastomosis (Roux-en-Y group) in treating AEG were compared. Outcomes included operative parameters, postoperative complications (anastomositis, stricture rates), nutritional status, and survival rates.

This retrospective analysis of 188 patients (161 Roux-en-Y vs 27 modified double-tract) achieved balanced cohorts through matching (13 in per group). Compared to Roux-en-Y group, the modified double-tract group demonstrated earlier postoperative recovery (flatus: 48 h vs 72 h, P=0.012; oral intake: 6 d vs 11 d, P<0.001) despite longer reconstruction time (65.46 min vs 46.62 min, P<0.001). While complication subtypes (reflux esophagitis, anastomositis, pulmonary emphysema, pneumonia, intestinal obstruction, pelvic effusion, duodenal stasis) showed comparable incidence, the modified technique exhibited lower overall complication rates (4 cases vs 10 cases, P=0.047). Significant differences emerged in Clavien-Dindo gradeⅠcomplications (P=0.047) and Visick grade 1 quality-of-life scores (P=0.017). Nutritional advantages were observed in the modified double-tract group with superior hemoglobin, albumin, and total protein recovery at 9 and 12 months, alongside higher body mass index restoration at 12 months (all P<0.05). Notably up to November 2024, the modified double-tract technique demonstrated superior 3-year survival rates (P=0.033).

Compared to total gastrectomy with Roux-en-Y anastomosis, modified double-tract reconstruction demonstrates comparable safety and reliability in clinical outcomes for AEG, including postoperative nutrition, complications, and survival rates, while facilitating enhanced postoperative recovery.

To explore the clinical application values of proximal gastrectomy with double-channel anastomosis reconstruction in esophagogastric junction carcinoma.

The clinical data of 79 patients with esophagogastric junction carcinoma who underwent surgical treatment in Zhongshan City People’s Hospital from December 2018 to June 2023 were retrospectively collected. According to the surgical approaches, the patients were divided into the proximal gastrectomy with double-channel anastomosis reconstruction group (trial group, 35 cases) and the total gastrectomy with Roux-en-Y anastomosis reconstruction group (control group, 44 cases). The main observation indicators included the perioperative conditions (operation time, intraoperative blood loss, time to postoperative anal exhaust, and total postoperative hospital stay), short-term postoperative complications (postoperative anastomotic leakage, anastomotic stricture, intestinal obstruction, pulmonary infection, and reflux esophagitis), and postoperative nutritional status including albumin, hemoglobin, prognostic nutritional index (PNI), and skeletal muscle mass index at the 6th month after surgery.

There were no statistically significant differences in the preoperative clinical baseline data between the two groups. Compared with the control group, there were no statistically significant differences in the operation time, intraoperative blood loss, total postoperative hospital stay, and time to postoperative anal exhaust in the trial group (t=-1.613, -0.761, -1.162, Z=-0.848, P=0.111, 0.447, 0.245, 0.396). In terms of short-term postoperative complications, there were no statistically significant differences in the incidences of postoperative anastomotic leakage, anastomotic stricture, intestinal obstruction, pulmonary infection, and reflux esophagitis between the two groups (χ²=1.143, 0.533, 0.152, 0.055, 0.022, P=0.285, 0.465, 0.697, 0.814, 0.883). However, at the 6th month of postoperative follow-up, the postoperative nutritional status of the trial group recovered better. There were statistically significant differences in albumin, hemoglobin, PNI, and skeletal muscle mass index between the two groups (t=2.660, 2.593, 2.706, 2.529, P=0.010, 0.011, 0.008, 0.013).

In the treatment of esophagogastric junction carcinoma, the safety of proximal gastrectomy with double-channel anastomosis is comparable to that of total gastrectomy with Roux-en-Y anastomosis. However, patients undergoing proximal gastrectomy with double-channel anastomosis reconstruction may have better recovery of postoperative nutritional status, which has certain values for clinical application and promotion.

To explore the safety and efficacy of ultrasound-guided vacuum-assisted excision (VAE) in the treatment of benign phyllodes tumor of the breast.

The clinical data of 170 patients with benign phyllodes tumor of the breast admitted to Yixing Hospital Affiliated to Jiangsu University from June 2016 to December 2023 were retrospectively analyzed. The patients were divided into the VAE group and the open excision (OE) group according to the surgical method. Propensity score matching was used to balance the baseline characteristics of the two groups. The clinical characteristics, local recurrence rate, and perioperative data of the two groups were compared.

A total of 170 patients were included before matching (88 in the VAE group and 82 in the OE group); after matching, there were 59 patients in each group, and the baseline data were balanced. The median follow-up period was 28.5 (1-91) months. The local recurrence rate was 16.9% in both groups. There was no statistically significant difference in the cumulative recurrence-free survival rate between the VAE group and the OE group within 2 years after surgery (Log-rank P=0.415) or more than 2 years after surgery (Log-rank P=0.062). Compared with the OE group, the VAE group had shorter incision length, lower score of numeric rating scale, but significantly higher hospitalization costs (P<0.05).

VAE and OE have similar recurrence-free survival periods in patients with benign phyllodes tumor of the breast and are both minimally invasive treatment options for benign phyllodes tumor.

Gastric cancer is a malignant disease originating from the gastric mucosal epithelium, and its incidence and mortality are among the highest ones in the malignant tumors, posing a serious threat to human life and health. The prerequisite for gastric cancer treatment is to accurately diagnose gastric cancer subtypes and propose optimal therapeutic strategies to prolong patients’ survival. In recent years, pathomics, as an emerging histological technology driven by artificial intelligence (AI) algorithms, is capable of identifying cancer subtypes, analyzing the pathological features of tumor microenvironment and nuclear atypia more accurately from full-slice digital scanning images, which not only greatly improves the efficiency and accuracy of pathological diagnosis, but also facilitates the selection of treatment options and the long-term evaluation of prognosis, and has broad clinical application prospects. Although pathomics of gastric cancer now still faces challenges such as scarcity of standardized data, high heterogeneity of modal data quality, lack of interpretability, reproducibility and AI trust issues, there is large amount of sustained work to address these issues and to facilitate the clinical translation of AI-based pathomics. The field of precision diagnosis and treatment of gastric cancer is witnessing a wave of innovation, driven by the widespread use of AI technology and the continuous improvement of pathohistological data in clinical practice.

Colorectal cancer (CRC), the third most common gastrointestinal malignancy, has been becoming increasingly prevalent among younger populations. Despite improved detection and diverse treatments, many molecular mechanisms in CRC progression remain unclear. The phosphatidylinositol 3-kinase (PI3K)/ protein kinase B (PKB/AKT) pathway, regulating cell cycle, metabolism, and cancer metastasis, are closely linked to CRC. Programmed cell death (PCD), a process of cell suicide induced by specific signals or internal mechanisms, often shows abnormalities in cancer cells, contributing to cancer progression and drug resistance. Recent studies have highlighted the close relationship between the PI3K/AKT pathway and PCD in CRC cells, making PI3K/AKT pathway a promising target for CRC therapy. This review firstly introduces the structure and activation mechanisms of the PI3K/AKT pathway. Then, it discusses the role of this pathway in PCD of CRC cells. Finally, it outlines the current research and future prospects of targeted therapies against the PI3K/AKT pathway, providing insights for CRC treatment.