Vision transformer network discovers the prognostic value of pancreatic cancer pathology sections via interpretable risk scores.

Pathological sections hold rich diagnostic information, yet their prognostic potential is underutilized. This study leverages deep learning to predict outcomes, advancing precision oncology of pathological sections with focus on pancreatic cancer. We analyzed H&E-stained whole section images of 125 cases from public databases as well as 28 real-world patients with pancreatic cancer and precancerous lesions.

Survival Study: International Multicentric Pancreatic Left Resections (SIMPLR-2): Does Surgical Approach Matter for Recurrence-Free Survival and Overall Survival?

: SIMPLR-2 is a follow-up to the international, multicenter SIMPLR-1 study evaluating long-term oncological outcomes after open (OLP), laparoscopic (LLP), and robotic (RLP) left pancreatectomy for pancreatic ductal adenocarcinoma (PDAC). : A retrospective analysis of 71 PDAC patients from three high-volume centers was performed. Surgical approaches were stratified into open, laparoscopic, and robotic.

Evaluating T1/T2 Relaxometry with OCRA Tabletop MRI System in Fresh Clinical Samples: Preliminary Insights into ZEB1-Associated Tissue Characteristics.

IntroductionThe OCRA Tabletop MRI System is a compact, low-field (0.24T) magnetic resonance platform originally developed as an educational device to teach MR physics using chemical test tube-sized samples. Given its capabilities, we explored its diagnostic potential by performing relaxometric analysis on freshly resected human tissue specimens.

Complicated appendicitis: value of inflammatory markers based on EAES 2015 guidelines.

Background: The clinical course of phlegmonous appendicitis (PHL) appears less severe than other complicated forms, which led to the discussion if PHL should be classified as complicated acute appendicitis (CAA). According to the guidelines of the European Association for Endoscopic Surgery (EAES) from 2015, PHL is classified as a CAA, which requires usually surgery. Therefore, this study aimed to evaluate the relevance of classifying PHL as CAA, with a focus on inflammatory markers, postoperative complications, and hospital length of stay.

Benefit of Chemoradiotherapy Versus Chemotherapy After Induction Therapy for Conversion of Unresectable Into Resectable Pancreatic Cancer: The Randomized CONKO-007 Trial.

Purpose: To determine the benefit, measured as complete removal of a tumor so that no tumor cells are detectable during histopathologic examination of the resection margin (R0 resection rate), of induction chemotherapy plus chemoradiotherapy (CRT) compared with chemotherapy alone for unresectable pancreatic tumors.

Patients And Methods: CONKO-007, an investigator-initiated open-label, multicentric, phase III randomized clinical trial, enrolled 525 patients with unresectable tumors, and 495 patients received induction chemotherapy (402 with fluorouracil, irinotecan, and oxaliplatin [FOLFIRINOX] and 93 with gemcitabine). Patients without progression after 3 months of induction chemotherapy (n = 336) were randomly assigned for continuation of the same chemotherapy (n = 167) or CRT (n = 169; 50.

Real-world data of single-incision laparoscopic appendectomy: a German-wide prospective cohort study among 276 individuals.

Background: Acute appendicitis is a common surgical emergency, with a lifetime risk of 8.6% in men and 6.7% in women.

International expert consensus on a structured approach to robotic multiport right hemicolectomy with complete mesocolic excision and intracorporeal anastomosis.

Aim: To develop and operationally define 'performance metrics' that characterize a reference approach to robotic multiport right hemicolectomy with complete mesocolic excision (CME) and intracorporeal anastomosis (ICA) and to obtain evidence supporting face and content validity through a consensus meeting.

Method: Three expert colorectal surgeons with advanced minimally invasive surgical experience, a senior behavioural scientist and a colorectal surgeon with experience in performance metrics development formed the Metrics Group. Published guidelines, clinical evidence, training materials and unedited videos of robotic multiport right hemicolectomy were used to deconstruct the task-robotic right hemicolectomy with CME and ICA-into defined, observable performance units or metrics (i.

Human multiethnic radiogenomics reveals low-abundancy microRNA signature in plasma-derived extracellular vesicles for early diagnosis and molecular subtyping of pancreatic cancer.

Pancreatic cancer (PC) is a highly aggressive malignancy in humans, where early diagnosis significantly improves patient outcomes. However, effective methods for accurate and early detection remain limited. In this multiethnic study involving human subjects, we developed a liquid biopsy signature based on extracellular vesicle (EV)-derived microRNAs (miRNAs) linked to radiomics features extracted from patients' tumor imaging.

Defining Global Benchmarks for Robotic Liver Resections: An International Multicenter Study.

Objective: This study aimed to establish global benchmark outcomes indicators for robotic liver resections (R-LR).

Background: In recent years, minimally invasive liver resections and in particular R-LR has seen an increase in uptake in recent years. Although, benchmark outcomes have been recently established for laparoscopic (L) -LR, this has not been established for R-LR.

The impact of indocyanine green on tumor visualization and procedural adjustment in minimally invasive liver surgery.

Background: Minimally invasive hepatobiliary surgery is performed increasingly either with robotic assistance or conventional laparoscopy. The lack of haptic feedback is one of the main challenges which has to be addressed during these procedures. Especially in oncological minimally invasive liver surgery Indocyanine green (ICG) can help to gain additional information for improved oncological quality.

Validation of the Iwate scoring system for the stratification of laparoscopic liver resections: An international multicenter study.

Introduction: The Iwate difficulty scoring system (DSS) is one of the most widely validated DSS for laparoscopic liver resection (LLR). However, these studies only validated the 4 difficulty levels and did not validate the 12-point difficulty index of the system. To address current limitations in the studies validating the Iwate difficulty scoring system (DSS), we performed an international multicenter study to validate the Iwate DSS across both its four difficulty levels and 12-point difficulty index.

Prediction of Basic Robotic Competence for Robotic Visceral Operations Using the O-Score within the "Robotic Curriculum for Young Surgeons" (RoCS).

Introduction: Surgical residency programs lack structured assessments of robotic surgery. The validated O-Score is an assessment tool for tracking robotic operative proficiency consisting of 9 items on a 5 point Likert scale. Surgical autonomy is one comprehensive binary item.

Learning curve analysis of 100 consecutive robotic liver resections.

Background: Robotic liver surgery, as part of minimally invasive liver surgery (MILS), offers advantages like enhanced dexterity and stable camera and instrument control. However, the learning curve - particularly the number of cases required for proficiency - remains underexplored. This study analyzes 100 consecutive robotic liver resections performed by a single surgeon to assess the learning curve and outcomes.

Thromboembolic prophylaxis in bariatric and metabolic surgery: state-of-the-art according to the results of a nationwide registry study.

The present study employed a large scaled multicenter nationwide study data analysis to elucidate the impact of thromboembolism prophylaxis (TEP) in the context of bariatric and metabolic surgery and to investigate the peri- and postoperative complications associated with TEP. A total of 63,909 patients who underwent primary bariatric surgery between 2005 and 2020 were included in the analysis. The data were collected prospectively and multicentrically in the German Bariatric Surgery Registry (GBSR) and subsequently analyzed retrospectively.

Ethics and trustworthiness of artificial intelligence in Hepato-Pancreato-Biliary surgery: a snapshot of insights from the European-African Hepato-Pancreato-Biliary Association (E-AHPBA) survey.

Background: Hepato-Pancreato-Biliary (HPB) surgery is a complex specialty and Artificial Intelligence (AI) applications have the potential to improve pre- intra- and postoperative outcomes of HPB surgery. While ethics guidelines have been developed for the use of AI in clinical surgery, the ethical implications and reliability of AI in HPB surgery remain specifically unexplored.

Methods: An online survey was developed by the Innovation Committee of the E-AHPBA to investigate the current perspectives on the ethical principles and trustworthiness of AI in HPB Surgery among E-AHPBA membership.

[Reconstruction of Oncological Defects in the Pelvic-perineal Region: Report on the Consensus Workshop at the 44th Annual Meeting of the DAM 2023 in Bern, CH].

The surgical-oncological treatment of pelvic and perineal malignancies is associated with a high complication rate and morbidity for patients. Modern multimodal treatment modalities, such as neoadjuvant radio-chemotherapy for anal or rectal cancer, increase the long-term survival rate while reducing the risk of local recurrence. Simultaneously, the increasing surgical radicality and higher oncological safety with wide resection margins is inevitably associated with larger and, due to radiation, more complex tissue defects in the perineal and sacral parts of the pelvic floor.