2020年 · 第58卷第09期

Breast mass is one of the common tumor diseases, of which benign breast lesions account for about 80%^[1,2]。 Vacuum-assisted minimally invasive rotational resection has the advantages of simple operation, precise positioning, small trauma, quick recovery and good cosmetic effect^[3]； It is generally performed under local anesthesia, with low surgical risk, and is suitable for day surgery centers. We performed vacuum-assisted rotational resection for patients with benign breast tumors in the day surgery mode. The safety, feasibility and medical quality of the day surgery mode are analyzed and summarized as follows.

Day surgery can improve the efficiency of clinical diagnosis and treatment, speed up bed turnover and improve the structure of medical resources. Some studies have shown that day surgery and inpatient surgery have similar vein closure rate and complication rate in the case of accurate and rigorous diagnosis and treatment procedures^[1]。 Ultrasound-guided endovascular radiofrequency ablation of great saphenous vein is a widely used minimally invasive surgery for the treatment of varicose veins in recent years. Its short-term and long-term efficacy is comparable to that of traditional surgery, and it has the advantages of less trauma, less incision and fast recovery. Patients can move out of bed immediately after surgery^[2,3,4]； It has become a routine treatment for varicose saphenous veins in Europe and America^[5,6]。 The effectiveness, safety, diagnosis and treatment process of ultrasound-guided endovascular radiofrequency ablation of great saphenous vein in our hospital are reported as follows.

Gastroesophageal reflux disease is a common clinical disease, and laparoscopic hiatal hernia repair combined with anti-reflux surgery is the "gold standard" for its surgical treatment^[1,2]。 The method has less trauma, short operation time, low incidence of complications and fast postoperative recovery^[2,3]It meets the requirements of day surgery, but it has not been included in the catalogue of diseases suitable for day surgery in China. Our experience shows that laparoscopic hiatal hernia repair combined with anti-reflux surgery can achieve admission, surgery and discharge within 24 hours, and it is expected to be a type of daytime surgery. The development of this surgery in daytime mode is reported below.

At present, surgical resection is still the most important treatment for periampullary malignant tumors, but extended resection and enlarged lymph node dissection do not significantly prolong the survival time of patients^[1]。 In recent years, with the advancement of diagnostic technology and the deepening of understanding of neoadjuvant chemoradiotherapy, the diagnosis and treatment model of periampullary malignant tumors has gradually changed to "multi-disciplinary team (MDT) model"^[2]。 With the development of technology and the renewal of concept, abdominal surgery gradually becomes minimally invasive and precise^[3], but the use of laparoscopic and robotic surgery in periampullary malignancies is still controversial. In order to more reasonably apply minimally invasive techniques in the diagnosis and treatment of periampullary malignant tumors, our team proposed "minimally invasive MDT model as the core"^[4]。 Now share relevant experiences in combination with specific cases.

Achalasia is a primary esophageal motor dysfunction disease, which is characterized by the disappearance of primary peristalsis of the esophageal body, synchronous contraction, inability to relax or incomplete relaxation of the lower esophageal sphincter (LES) when swallowing. Due to the lack of peristalsis of the esophagus and the inability of LES to relax, the passage of food through the esophagus is blocked, and the main symptoms of the patient are gradually worsening dysphagia and vomiting. The etiology of the disease is unknown, and its main pathological change is the destruction of myosenteric ganglion cells. The intermuscular ganglion cells cannot recover after destruction. In treatment, the method of relieving the obstruction of the esophagogastric junction is mostly used, so that food can pass through the esophagus smoothly, thus improving the symptoms. Current treatment methods have good near-term effects, but there are differences in long-term effects, and patients often need to receive multiple treatments.