Conventional views regard malignant tumors simply as abnormal proliferations of somatic cells.However, cutting-edge evidence integrating genomics, proteomics, and immunology indicates that advanced tumors have transcended the realm of simple cellular aberrations, evolving into "neo-organs" with a high degree of histological complexity.Based on the theory of core functional acquisitions in cancer, this article systematically argues that tumors, driven by genomic instability, undergo phenotypic evolution, achieve metabolic reprogramming through the remodeling of protein interaction networks, establish immune evasion by actively sculpting the immune microenvironment, and seek neural contact and invasion to obtain proliferative signals.Tumors not only induce the alteration of surrounding cells to form a supportive stroma but also construct three-dimensional niches in a "cooperative cluster" manner.Building upon this theoretical framework, this paper further proposes forward-looking predictions: this "novel biological entity" will tend towards minimal functional structures in morphology, achieve metabolic autonomy and immune camouflage in its capabilities, and, under specific conditions, possess the potential to detach from the original host and form transmissible lineages.In essence, tumor evolution represents an attempt at "secondary organismal formation" by multicellular life within the host.

Modern medicine is undergoing a profound paradigm shift from mechanical reductionism to organic holism.This article aims to deconstruct the traditional view of life, which is brain-centered and regards the human body as a "precise machine", and to reconstruct a distributed view of life based on the "organ federation" model.Using this as the philosophical and scientific cornerstone, it systematically elaborates the fundamental principles of super minimally invasive surgery (SMIS). We propose that the human body is a collaborative federation composed of numerous "quasi-living" organs possessing autonomous intelligence such as memory, regeneration, adaptation, and intrinsic rhythms.The advanced neural centers unify these autonomies into coherent individual consciousness and behavior through an exquisite mechanism of "integration and obscuration". The principle of SMIS is rooted precisely in a profound respect for this inherent life potential of organs.Its core lies in shifting medical intervention from the traditional logic of "lesion resection" to a "regulation and support" logic aimed at maximally preserving the structural and functional integrity of organs.This article will argue, from four aspects—the scientific evidence for organ autonomy, the obscuration mechanism of high-level control, the revelation of life continuity after control failure, and the reshaping of the surgical paradigm—how this new view of life provides a fundamental theoretical basis for SMIS and guides surgery towards evolving with function preservation as its core.

Super minimally invasive stepwise full-thickness resection (sft-SMIR) is a novel endoscopic technique developed under the guidance of the super minimally invasive surgery concept.This procedure follows a technical sequence of 'double marking, stepwise resection, suturing while resecting, and muscle layer closure’ to achieve en bloc resection of early gastric cancer while maximally preserving the gastric wall anatomy.Based on preliminary clinical research findings, this specification comprehensively introduces the indications, contraindications, preoperative evaluation, standardized surgical procedures, postoperative management, and efficacy evaluation system for sft-SMIR in early gastric cancer.It aims to promote the standardized application of this technique and provide guidance for clinical practice.

To investigate the detection rate of the duodenal papilla using detachable string magnetically controlled capsule endoscopy technology, and to predict the risk of bile duct intubation during endoscopic retrograde cholangiopancreatography (ERCP) by observing the morphology of the duodenal papilla.

A retrospective analysis was conducted on the detection rate of duodenal papilla in 20 patients who underwent ERCP with complete ds-MCE examination before surgery and were admitted to the Fifth Affiliated Hospital of Zunyi Medical University(Zhuhai)from January 2022 to October 2022. Analyze the detection rate of duodenal papilla by this examination and observe its papilla morphology to predict the risk of selective biliary catheterization.

The detection rate of ds-MCE duodenal papilla was 70% (14/20); 11 cases of Type I and 3 cases of Type IV morphology; All patients underwent ERCP, with good selective intubation and an average time of 2.93 minutes.No postoperative pancreatitis or hyperamylasemia occurred.

ds-MCE can improve the detection rate of duodenal papilla and further observe papilla morphology to predict the risk of bile duct catheterization during ERCP.

To evaluate the efficacy and prognosis of endoscopic submucosal resection with ligation (ESMR-L) and endoscopic submucosal dissection (ESD) for the treatment of G1 rectal neuroendocrine tumors (R-NETs).

In this case- control study, 108 patients with G1 stage R-NETs treated endoscopically in endoscopy Department of Northern Theater Command General Hospital from December 2021 to December 2023 wereselected, and were divided into 63 cases in the ESD group and 45 cases in the ESMR-L group according to the different treatment modalities.The hospitalization time, hospitalization cost, operation time, tumor length, tumor depth, and postoperative endoscopic complete resection rate, histopathological complete resection rate, intraoperative perforation, and postoperative delayed hemorrhage rate were compared between the two groups.Binary logistic regression analysiswas performed based on postoperative histopathologic complete resection.

The endoscopic complete resection rates were 98.41% and 95.56%, the histopathologic complete resection rates were 93.65% and 82.22%, and the postoperative delayed hemorrhage rates were 4.76% and 0 in the ESD and ESMR-L groups, respectively.The difference was not statistically significant(P>0.05). Intraoperative perforation rates were 1.59% and 11.11%, respectively, but no infection occurred after intraoperative closure by titanium clips, and the difference was statistically significant(P<0.05). There were no cases of postoperative perforation and tumor recurrence in either group.Compared with the ESD group, the ESMR-L group had shorter hospitalization time, hospitalization cost, and operation time (P<0.001). Binary logistic regression analysis showed that tumor length ≥7 mm and tumor depth to the submucosal layer were risk factors affecting the histopathological complete resection rate and patient prognosis.

Endoscopic resection of R-NETs is safe and effective, but a comprehensive preoperative assessment based on tumor length and infiltration depth is needed.For G1-stageR-NETs with a shallow tumor depth and a diameter of < 7 mm, S-ESMR-L is a more economical and effective treatment option T-than ESD.

To investigate the safety and feasibility of linaclotide combined with low-dose Compound Polyethylene Glycol Electrolytes Powder (PEG) for bowel preparation in constipated patients.

A total of 300 patients scheduled for colonoscopy at the Endoscopy Center of Baoding First Central Hospital from March 2022 to October 2023 were enrolled.Participants were randomly divided into two groups using a random number table.Group A as control group, received 4L-PEG for bowel preparation.Group B as Experimental group, received 870μg linaclotide combined with 3L-PEG for bowel preparation.Bowel cleanliness was evaluated using the Boston Bowel Preparation Scale (BBPS) scores (right colon, mid-colon, distal colon, and total score). Adverse event rates were compared between groups.

Group B demonstrated significantly higher BBPS scores in the right colon, mid-colon, distal colon, and total score compared to Group A (P<0.05). Additionally, the adverse event rate in Group B was significantly lower than that in Group A, with the difference being statistically significant (P<0.05).

The bowel preparation protocol combining 870 μg linaclotide with 3L-PEG provides superior bowel cleanliness to the conventional 4L-PEG regimen, with a lower incidence of adverse events.

To investigate efficacy of Super Minimally Invasive Surgery(SMIS) in treating acute appendicitis in specific populations and the status of postoperative rehabilitation, evaluate the recovery of acute appendicitis patients after treatment with SMIS.

A retrospective analysis was conducted on 76 military patients with acute simple appendicitis who received SMIS treatment at the 980th Hospital and 988th Hospital of the Joint Logistics Support Force from March 2016 to March 2024. Meanwhile, 76 patients were randomly selected as controls from those hospitalized during the same period who underwent laparoscopic surgery for acute appendicitis.The postoperative recovery of the two surgical methods was evaluated by comparing the surgical effects, complications, and indicators related to postoperative recovery between the two groups.

There were no significant differences in gender, age, disease course, or preoperative examination results between the two groups (P>0.05). In the SMIS group, one patient experienced recurrent abdominal pain 4 days after surgery and underwent additional surgery; the postoperative pathology confirmed gangrenous appendicitis.In the laparoscopic surgery group, one patient developed a surgical site infection. The length of hospital stay in the SMIS was 2-6 days, with an average of (4.21±1.03)days, while that in the laparoscopic surgery group was (3-23) days, with an average of (8.29±3.81)days (P=0.000). The SMIS group was significantly superior to the laparoscopic surgery group in terms of postoperative recovery indicators, including time to resume oral intake, postoperative bed rest duration, types and duration of postoperative antibiotic use, application of postoperative analgesics, time to resolution of abdominal pain, recommended rest days in discharge advice, and dressing change time.

Patients with acute appendicitis recover quickly after treatment with Super Minimally Invasive Surgery.They can rapidly resume their normal physiological state and return to work and daily life, which effectively reduces the waste of medical resources.

To systematically evaluate the impact of robotic-assisted digestive endoscopic systems versus conventional manual operation on ESD in animal experimental models.

Searches were performed in databases including PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang Data, VIP, and CBM from inception to December 2025 to identify animal studies comparing robotic-assisted ESD with conventional ESD.According to the intervention methods of the included studies, the experimental subjects were divided into a robotic-assisted group and a conventional group.Two researchers independently screened the literature and extracted data.Meta-analysis was conducted using RevMan 5.4 and StataMP 18.The primary outcome measures were en bloc resection rate and blind dissection rate; secondary outcomes included total procedure time, submucosal dissection time, and dissection speed.

Eleven animal experimental studies (ex vivo and in vivo) were included.Robotic assistance significantly increased the en bloc resection rate (OR=8.35, 95%CI: 2.63, 26.56, P=0.0 003) and reduced the blind dissection rate (MD=-19.49, 95%CI: -25.03, -13.95, P<0.00 001). Total procedure time MD=-14.23 min, 95%CI: -18.99, -9.48, P<0.00 001) and submucosal dissection time (MD=-10.48 min, 95%CI: -16.83, -4.13, P<0.00 001) were significantly shorter in the robotic-assisted group. Dissection speed was also higher (MD=30.85 mm²/min, 95%CI: 18.54, 43.17, P=0.0 003). Egger′s test for the total procedure time indicated no significant publication bias (P=0.147), and publication bias assessment was not performed for the remaining outcome indicators due to the limited number of included studies.

Based on current animal evidence, robotic-assisted endoscopic systems can optimize the surgical field, demonstrating clear advantages in improving the en bloc resection rate of ESD, reducing the risk of blind cutting, and shortening operative time.

To investigate the early detection proportion of gastrointestinal carcinomas (esophageal cancer, gastric cancer and colorectal cancer) in public hospitals in Hunan Province.

We analyzed the data of 2023 collected from the Provincial Medical Quality Control Center for Department of Gastroenterology in Hunan Province, to calculate the early detection proportion of the above three gastrointestinal carcinoma, as well as to explore the risk factors of early detection proportion.

A total of 120 public hospitals reported relevant data, and a total of 3647 cases of esophageal cancers were detected, among whom 555 cases were in early stage with an early detection proportion of 15.22%; a total of 8453 cases of gastric cancers were detected, among whom 1281 cases were in early stage with an early detection proportion of 15.15%; a total of 15416 cases of colorectal cancers were detected, among whom 3278 cases were in early stage with an early detection proportion of 21.26%. And we used 15%, 15% and 20% as the cut-off value to divided the proportion as high and low, and further analysis found that the early detection proportion did not correlate with the grade, teaching hospital or not, city location, numbers of doctors performing endoscopy and the volume of endoscopy in the hospital.

The early detection proportion of gastrointestinal carcinomas (esophageal cancer, gastric cancer and colorectal cancer) in Hunan Province was relatively low, and need improvement.

Rectal neuroendocrine neoplasms (R-NENs) are rare but potentially malignant neoplasms originating from neuroendocrine cells within the intestinal tract.Their detection rate has gradually increased in recent years, making early diagnosis and therapeutic strategy selection crucial for prognosis.As a high-resolution imaging technique, miniprobe endoscopic ultrasound(MEUS) plays a pivotal role in the diagnosis and management of R-NENs.It enables precise assessment of tumor size, depth of invasion, origin layer, and regional lymph node status, providing critical guidance for formulating endoscopic or surgical treatment plans.In differential diagnosis, MEUS effectively distinguishes R-NENs from other submucosal lesions by analyzing lesion echogenicity and its relationship with intestinal wall layers.Although MEUS still has limitations in detecting minute lesions, assessing lymph nodes, and judging deep infiltration, the development of ultra-high-frequency probes, multimodal imaging, and AI-assisted technologies is opening broader application prospects for its precise diagnosis and treatment of R-NENs.This article reviews the current status and challenges of MEUS in the diagnosis, preoperative assessment, and future development of R-NENs.

To construct a perioperative management program for day surgery patients with intestinal polyps in the elderly and evaluate its application effect, so as to provide reference for clinical practice.

Based on literature analysis, combined with the Delphi expert consultation method and a pilot study, a perioperative management protocol for elderly patients undergoing day surgery for intestinal polyps was developed using the 5A model.Employing a quasi-experimental study design, elderly patients undergoing day surgery for intestinal polyps at a tertiary-level general hospital in Shandong Province between June and October 2024 were divided into a control group (receiving routine care) and an experimental group (receiving routine care plus the 5A management protocol). The two groups were compared in terms of anxiety and depression levels, self-management capabilities, bowel preparation quality, and postoperative complications.

A total of 12 literature sources were included.Fourteen experts completed two rounds of correspondence, achieving an expert authority coefficient of 0.939.The final framework comprises 5 primary items, 21 secondary items, and 63 tertiary items.The intervention group (n=64) demonstrated significantly lower anxiety levels and superior self-management capabilities compared to the control group (n=65) both during the intervention (30 minutes preoperatively) and postoperatively (30 days postoperatively). The intervention group also achieved higher bowel preparation quality than the control group. Furthermore, the incidence of postoperative abdominal distension and dizziness was lower in the intervention group than in the control group, with all differences being statistically significant (all P<0.05).

The 5A model-based perioperative management protocol for elderly patients undergoing day surgery for intestinal polyps enhances perioperative self-management capabilities, alleviates anxiety levels, improves bowel preparation quality, and reduces postoperative complications, demonstrating excellent clinical applicability.