Chest wall surgery used to be a subspecialty of traditional thoracic surgery, which has an ancient history of research and clinical practice. It has gradually become an independent professional field in recent years. With the change of concept and the progress of interdisciplines, we have deepened our understanding of related diseases, and the treatment of chest wall surgical diseases has also acquired new characteristics. This article reviews the progress in the treatment of chest wall surgical diseases including chest wall trauma, chest wall deformity, chest wall tumor, chest wall infection and chest wall defect from the perspective of chest wall surgery.
軟結腸鏡的臨床應用在腸道疾病的診斷及治療上是一大進步，不但能診斷大腸及末端回腸疾病，更重要的是可以用來治療一些經保守治療無效的下消化道內科疾病以及一些外科疾病，如腸息肉、腸扭轉等需外科手術才能治愈的疾病可用軟結腸鏡治療。我們對1987年7月至2001年8月采用軟結腸鏡診治的低位腸梗阻、乙狀結腸扭轉、假性結腸梗阻、下消化道出血、良性腸狹窄及腸道息肉等9 051例需外科處理的疾病加以探討，以提高軟結腸鏡在治療外科疾病中的安全性及療效。
Objective To analyze hospitalization cost, length of stay, cost composition, hospital-level differences, and mortality burden of solid tumors related to general surgery in Sichuan Province. MethodsData were obtained from publicly released Sichuan Health Statistical Yearbooks. Six hospitalization-cost diseases closely related to general surgery were included: nodular goiter, acute appendicitis, acute cholecystitis, inguinal hernia, gastric cancer, and esophageal cancer. The solid tumor burden analysis included gastric cancer, esophageal cancer, colorectal cancer, liver cancer, pancreatic cancer, and breast cancer. Hospital admissions, bed occupancy rate, average length of stay, and average inpatient expenditure were used as contextual indicators for surgical inpatient services. Descriptive statistics, proportions, hospital-level cost ratios, and 2019-based indices were performed. Results① General surgery-related disease. In 2023, acute appendicitis (90 353 discharges) and inguinal hernia (61 237 discharges) had the largest discharge volumes among the six hospitalization-cost diseases, with average inpatient costs of 8 243.59 yuan and 9 648.75 yuan, respectively. Gastric cancer and esophageal cancer had longer average length of stay (12.96 days and 12.51 days, respectively) and higher average inpatient costs (30 162.44 yuan and 24 310.18 yuan, respectively). Hospital-level cost differences were most evident for gastric cancer (tertiary/county cost ratio: 3.13) and esophageal cancer (tertiary/county cost ratio: 2.73). The cost composition analysis showed that acute cholecystitis had the highest proportion of diagnosis fees (44.2%), inguinal hernia had the highest proportion of material fees (37.1%), and the proportion of material fees for gastric cancer and esophageal cancer were 29.5% and 27.5%, respectively. ② Solid tumors in general surgery. In 2023, the crude mortality rates of solid tumors related to general surgery, ranked from highest to lowest, were as follows: liver cancer (14.25 per 100 000), colorectal cancer (13.61 per 100 000), esophageal cancer (8.06 per 100 000), gastric cancer (8.00 per 100 000), breast cancer (6.56 per 100 000), and pancreatic cancer (6.46 per 100 000). ③ Hospital inpatient service background. In 2023, hospital admissions in Sichuan Province were 16.364 1 million, increasing by 17.03% compared with 13.982 7 million in 2019. The average length of stay decreased from 10.28 days in 2019 to 9.71 days in 2023, a decrease of 5.54%. The hospital bed occupancy rate was 86.01%, a 3.76% decrease from 89.37% in 2019. The average inpatient cost per discharge increased by 0.88%, from 8 528.00 yuan in 2019 to 8 602.67 yuan in 2023. ConclusionGeneral surgery-related diseases in Sichuan Province are characterized by coexistence of high-volume short-stay diseases, high-cost tumor diseases, and solid tumors with high mortality burden.