Lung cancer is the malignant tumor with the highest global incidence and mortality rates. With the widespread application of chest CT, its detection rate has shown a gradual upward trend. Early-stage lung cancer lesions typically appear on chest CT as pure ground-glass nodules, solid nodules, and mixed ground-glass nodules. Lung cancer associated with cystic airspaces (LCCA), as a subtype with distinctive imaging features, is also being detected with increasing frequency. Pathologically, LCCA is predominantly adenocarcinoma or squamous cell carcinoma, often characterized by thick walls, solid components, and necrotic tissue, suggesting a more aggressive behavior. Given that the early imaging manifestations of LCCA lack specificity, it is prone to clinical misdiagnosis as benign conditions such as pulmonary infection, pulmonary bullae, or tuberculosis, leading to missed or incorrect diagnosis. Currently, related research primarily focuses on its pathogenesis, imaging morphology, and diagnosis, while systematic investigation into its clinical treatment strategies and prognosis remains insufficient. Therefore, this article provides a review of recent research advances in the pathogenesis, imaging features, radiomics and histopathological characteristics, diagnosis, genetic mutation profiles, as well as treatment and prognosis of LCCA.
As an important method for minimally invasive treatment of pulmonary nodules, cryoablation and thermal ablation have the advantages of short hospital stay and low medical cost, with a higher cost-effectiveness ratio. Cryoablation, with its "visual ice ball effect" and lower "heat sink effect", shows unique advantages in the treatment of nodules near large blood vessels, airways and other special areas. Among thermal ablation techniques, microwave ablation, with its high heating efficiency and less influence from blood flow, has become the preferred option for nodules larger than 3 cm or those adjacent to blood vessels; radiofrequency ablation has a higher local control rate in small-volume (less than 1 cm) nodules and subsolid nodules. Through literature review, it is found that there are few studies comparing cryoablation and thermal ablation and systematically and comprehensively elaborating on the application status, safety and management of complications of cryoablation and thermal ablation. Therefore, this article will systematically review the basic principles of cryoablation and thermal ablation, the current clinical application status in pulmonary nodules, the comparison between cryoablation and thermal ablation, and the safety and management of complications.
In recent years, with the improvement of people's awareness of physical examination and the more accurate detection equipment, the detection rate of pulmonary nodules is getting higher and higher. Surgical resection is the first choice for the treatment of malignant pulmonary nodules, but multiple pulmonary nodules, nodules in complex areas and those with surgical contraindications are not suitable for surgery. As an effective, less invasive and low-cost treatment, ablation has developed rapidly in the treatment of multiple pulmonary nodules. This article introduces the progress of several common ablation techniques (radiofrequency ablation, microwave ablation, cryoablation) in the treatment of multiple pulmonary nodules, the indications and contraindications of ablation techniques, the efficacy evaluation and complications after ablation therapy, and the prospects of ablation techniques in the treatment of multiple pulmonary nodules.
ObjectiveTo compare the surgical efficacy of Da Vinci robot-assisted minimally invasive esophagectomy (RAMIE) and video-assisted minimally invasive esophagectomy (VAMIE) on esophageal cancer.MethodsOnline databases including PubMed, the Cochrane Library, Medline, EMbase and CNKI from inception to 31, December 2019 were searched by two researchers independently to collect the literature comparing the clinical efficacy of RAMIE and VAMIE on esophageal cancer. Newcastle-Ottawa Scale was used to assess quality of the literature. The meta-analysis was performed by RevMan 5.3.ResultsA total of 14 studies with 1 160 patients were enrolled in the final study, and 12 studies were of high quality. RAMIE did not significantly prolong total operative time (P=0.20). No statistical difference was observed in the thoracic surgical time through the McKeown surgical approach (MD=3.35, 95%CI –3.93 to 10.62, P=0.37) or in surgical blood loss between RAMIE and VAMIE (MD=–9.48, 95%CI –27.91 to 8.95, P=0.31). While the RAMIE could dissect more lymph nodes in total and more lymph nodes along the left recurrent laryngeal recurrent nerve (MD=2.24, 95%CI 1.09 to 3.39, P=0.000 1; MD=0.89, 95%CI 0.13 to 1.65, P=0.02) and had a lower incidence of vocal cord paralysis (RR=0.70, 95%CI 0.53 to 0.92, P=0.009).ConclusionThere is no statistical difference observed between RAMIE and VAMIE in surgical time and blood loss. RAMIE can harvest more lymph nodes than VAMIE, especially left laryngeal nerve lymph nodes. RAMIE shows a better performance in reducing the left laryngeal nerve injury and a lower rate of vocal cord paralysis compared with VAMIE.
The incidence of rib fracture in patients with chest trauma is about 70%. Simple rib fractures do not need special treatment. Multiple rib fractures and flail chest are critical cases of blunt trauma, which often cause serious clinical consequences and need to be treated cautiously. Nowadays, there is a controversy about the diagnosis and treatment of multiple rib fractures and flail chest. In the past, most of the patients were treated by non-operative treatment, and only less than 1% of the patients with flail chest underwent surgery. In recent years, studies have confirmed that surgical reduction and internal fixation can shorten the hospital stay, and reduce pain and cost for patients with flail chest, but there is still a lack of relevant clinical consensus and guidelines for diagnosis and treatment, which leads to great differences in clinical diagnosis and treatment plans. This article reviewed the treatment, surgical indications and surgical timing of multiple rib fractures and flail chest.
ObjectiveTo summarize and analyze the standardized operational procedure and preliminary clinical outcomes of a "three-dimensional integrated" respiratory training model, and to propose a safe adjunctive intervention for the perioperative management of lung nodule ablation. MethodsClinical data from patients who underwent lung nodule ablation at West China Hospital, Sichuan University from August to December 2025 were consecutively enrolled and analyzed. Results A total of 18 patients were included, comprising 10 males and 8 females, with a mean age of (62.8±11.2) years. Following the implementation of the preoperative "three-dimensional integrated" respiratory training model, the mean breath-holding time significantly increased from (22.9±7.5) s at admission to (32.6±6.9) s preoperatively (P<0.01). The volume measured on the respiratory trainer improved from a mean of(1 247.2±518.9) mL at admission to (1 550.0±546.1) mL preoperatively (P<0.01). Ablation modalities included radiofrequency ablation in 17 (94.4%) patients and cryoablation in 1 (5.6%) patient. During the ablation procedure, the mean number of needle adjustments was (1.4±0.8) times, and the mean localization time was (15.6±4.4) min. All patients successfully completed the ablation therapy, achieving a technical success rate of 100.0% with no intraoperative complications. ConclusionThe "three-dimensional integrated" respiratory training model effectively enhances patients' surgical tolerance, cooperation, and procedural precision. It offers a new, safe, and effective perioperative management strategy, especially for high-risk patients (e.g., the elderly or those with poor lung function) who may be unable to tolerate conventional surgery. This model demonstrates promising potential for widespread clinical application.
