Objective To evaluate the methodological quality of clinical practice guidelines and consensuses of robot-assisted surgery. Methods The guidelines and consensuses were screened according to the inclusion and exclusion criteria by searching the domestic and overseas guidelines network and electronic database from 1 January, 2000 to 29 December, 2021. The Appraisal of Guidelines for Research and EvaluationⅡ (AGREEⅡ) instrument was used independently by two evaluators to evaluate the guidelines and consensuses. The consistency test of intraclass correlation coefficient (ICC) was carried out for two evaluators, and the score of guidelines and consensuses in the six domains of AGREEⅡ were calculated. Results A total of 34 guidelines and consensuses were included, including 10 guidelines and 24 consensuses. The ICC was all greater than 0.75, indicating that the consistency of the two evaluators was high. The average scores of the 34 guidelines and consensuses in the six domains of AGREEⅡ (scope and purpose, stakeholder involvement, rigor of development, clarity of presentation, applicability and editorial independence) were 81.0%, 43.5%, 28.2%, 81.5%, 12.7% and 51.7%, respectively. Conclusion These evaluated guidelines and consensuses of robot-assisted surgery still need to be improved in the domains of rigor of development, applicability and editorial independence. With the continuous development of robot-assisted surgery, more guidelines and consensuses based on higher level of evidence will be developed to promote the standardized use of robot-assisted surgery.
Esophageal squamous cell carcinoma is the main histological type of esophageal cancer in China, which seriously threatens the health of people. The application of immunotherapy, mainly immune checkpoint inhibitors, has greatly improved the prognosis of patients with esophageal squamous cell carcinoma, but the efficacy of treatment is still limited. Tertiary lymphoid structure (TLS) is an ectopic organized lymphoid structure that accumulates in non-lymphoid organs. Previous studies have found that TLS in esophageal squamous cell carcinoma is associated with better patient outcomes and enhanced immunotherapy efficacy. Based on current researches about TLS in esophageal squamous cell carcinoma, this paper reviews the relationship between TLS and the prognosis and immunotherapy of patients. We hope to provide reference for the precise immunotherapy of esophageal squamous cell carcinoma.
Surgery is an essential method of comprehensive treatment for lung cancer, but it also impairs patients’ cardiopulmonary function. A subset of patients who undergo surgery may suffer from postoperative complications, and even death. Preoperative pulmonary rehabilitation is a part of enhanced recovery after surgery, and can improve patients' cardiopulmonary function, reduce postoperative complication rate and shorten hospital stay. It has been already demonstrated a great value in lung cancer surgery. In this review, we summarized the three important components of preoperative pulmonary rehabilitation, including smoking cessation, chest physical therapy, and preoperative exercise training. Moreover, this review outlined the development of pulmonary rehabilitation for lung malignancies, aiming to promote its application and standardization.
ObjectiveTo explore the risk factors for lymph node metastasis in patients with T2 stage non-small cell lung cancer.MethodsThe clinical data of 271 patients with non-small cell lung cancer who underwent surgical treatment in our hospital from 2014 to 2017 were collected, including 179 males and 92 females, with an average age of 62.73±0.58 years. The patients were divided into N0, N1, and N2 groups according to the lymph node metastasis status. The clinical data of the patients in different groups were compared.ResultsThe body mass index (BMI, P=0.043), preoperative lymph node enlargement (P<0.001), and tumor diameter (P<0.001) were significantly different among groups. The BMI (OR=1.131, 95%CI 1.001-1.277, P=0.048) and preoperative lymph node enlargement (OR=3.498, 95%CI 1.666-7.342, P=0.001) were independent risk factors for N2 lymph node metastasis, and tumor diameter was an independent risk factor for both N1 (OR=1.538, 95%CI 1.067-2.218, P=0.021) and N2 (OR=1.814, 95%CI 1.196-2.752, P=0.005) lymph node metastasis.ConclusionPatients with high BMI or enlarged lymph nodes before surgery have a high risk for N2 lymph node metastasis, and those with large tumor diameter have a high risk for both N1 and N2 lymph node metastasis.