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Fine needle aspiration cytology (FNAC) is commonly used and is essential for diagnosing thyroid diseases. Despite its widespread use, it presents a significant barrier for doctors who lack experience with this procedure, owing to the inherent difficulty involved in identifying and avoiding venous arteries such as the internal jugular vein, common carotid artery, and trachea. At this stage, a universal neck simulator supporting FNAC practice has yet to be developed. This project is based on an earlier simulator developed by the authors. However, a number of significant improvements have been made to bring this closer to what could be potentially a practical simulator for thyroid FNAC practice. Improvements have been made in terms of the accuracy of the organs and the addition of muscle tissue, but the most significant issue is the use of a material that does not require special storage, namely, silicone mixed with a number of compounds as required to sonographically and haptically simulate the neck and thyroid.

A 41-year-old woman who was referred to a previous hospital because of a right breast mass with pain was detected to have a 17-cm right breast tumor with remarkable edema, a skin nodule, and lymph node swelling 6 cm in diameter in the axilla. Fine needle aspiration cytology resulted in scirrhous cancer, ER(-), PgR(-) and HER2 score 3. No distant metastases were seen. The tumor was diagnosed as cT4dN3cM0 and cStage IIIC. A 2-month chemotherapy at the previous hospital gained only PD, so that she was referred to our hospital. Despite chemotherapies with several regimens and radiation therapy for the local control, the breast cancer locally advanced and other organ metastases involving the liver, bones and lung appeared. We thus determined to employ the best supportive care 13 months after the initiation of treatment in our hospital. Soon the breast tumor had penetrated the right thoracic wall. Since her respiratory condition was stable, she was discharged from our hospital in accordance with her hope to receive home treatment. She passed away about one month after discharge. As locally advanced breast cancer eventually penetrating the thoracic wall is extremely rare, we present this case with a review of the literature.

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InstructionIn colon cancer, the incidence of postoperative ileus is reportedly higher for the right‐side than for the left‐side colon, but those studies included small numbers of subjects and contained several biases. Furthermore, risk factors for postoperative ileus remain unclear.MethodsThis multicenter study reviewed 1986 patients who underwent laparoscopic colectomy between 2016 and 2021 for right‐side (n = 907) and left‐side (n = 1079) colon cancer. After propensity score matching, 803 patients in each group were matched.ResultsPostoperative ileus occurred in 97 patients. Before matching, the proportion of female patients and median age were higher and frequency of preoperative stent insertion was lower with right colectomy (P < .001 each). After matching, the number of retrieved lymph nodes (17 vs 15, P < .001) and greater rates of undifferentiated adenocarcinoma (10.6% vs 5.1%, P < .001) and postoperative ileus (6.4% vs 3.2%, P = .004) were higher in right colectomy. Multivariate analysis revealed male gender (hazard ratio, 1.798; 95% confidence interval, 1.049–3.082; P = .32) and history of abdominal surgery (hazard ratio, 1.909; 95% confidence interval, 1.073–3.395; P = .027) as independent predictors of postoperative ileus in right‐side colon cancer.ConclusionThis study revealed a higher risk of postoperative ileus after right colectomy with laparoscopic surgery. Male gender and history of abdominal surgery were risk factors for postoperative ileus after right colectomy.