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Aim: The present study aimed at identifying the pattern of patients with critical limb ischemia (CLI) compared with those with peripheral arterial occlusive disease (PAOD).

This paper presents the development of the hardware and software architecture of a sixdegrees of freedom (DOF) parallel robot (PARA-SILSROB) by illustrating all the stages undertaken to achieve the experimental model of the robot. Based on the experimental model, the control architecture is also presented, which is primarily based on a master–slave control system through which the surgeon controls the robot using the master console composed of commercial peripheral components (two 3D Space Mouse devices, computer, and keyboard) integrated with the solution developed in this study and presented in this paper. The robot was developed also according to the surgical protocol and surgeon's requirements, and for the functionality testing of the mechanical structure, two experimental stands were used. The first stand presented several surgical steps, such as manipulation, resection, and suture of experimental tissues (simulating real-life robot-assisted surgical maneuvers) using commercial instruments. The second stand presented a simulation of an esophagectomy for esophageal cancer and digestive reconstruction through a right intercostal approach. For this testing phase, the organs were created using 3D reconstruction, and their simplified models were 3D printed using PolyJet technology. Furthermore, the input trajectory generated using the master console was compared with the robot actuator's movements and the obtained results were used for validation of the proposed robot control system. [ABSTRACT FROM AUTHOR]

Pancreatic cancer is one of the most aggressive, heterogeneous, and fatal types of human cancer; therefore, more effective therapeutic drugs are urgently needed. Human epidermal growth factor receptor 2 (HER2) overexpression and amplification have been identified as a cornerstone in this pathology. The aim of this review is to identify HER2 membrane overexpression in relation to pancreatic cancer pathways that can be used in order to develop a targeted therapy. After searching the keywords, 174 articles were found during a time span of 10 years, between 2013 and 2023, but only twelve scientific papers were qualified for this investigation. The new era of biomolecular research found a significant relationship between HER2 overexpression and pancreatic cancer cells in 25–30% of cases. The variables are dependent on tumor-derived cells, with differences in receptor overexpression between PDAC (pancreatic ductal adenocarcinoma), BTC (biliary tract cancer), ampullary carcinoma, and PNETs (pancreatic neuroendocrine tumors). HER2 overexpression is frequently encountered in human pancreatic carcinoma cell lines, and the ERBB family is one of the targets in the near future of therapy, with good results in phase I, II, and III studies evaluating downregulation and tumor downstaging, respectively. [ABSTRACT FROM AUTHOR]

Simple Summary: Hepatocellular carcinoma (HCC) ranks as the third leading cause of cancer-related deaths worldwide, with liver resection being the most effective for curative intent. The hepatic venous pressure gradient (HVPG), transient elastography-liver stiffness measurement (TE-LSM), and TAC score are intricately connected with the postoperative evolution of cirrhosis. The primary objective of our study is to evaluate the predictive value of key parameters for surgical patients. The proposed predictors can better presume treatment outcomes in HCC and potentially allow an improvement in therapeutic strategy. Hepatocellular carcinoma (HCC) is the predominant form of primary liver cancer and the third contributor to malignancy-related deaths worldwide. The hepatic venous pressure gradient (HVPG), transient elastography-liver stiffness measurement (TE-LSM), and the association between TBS (tumor burden score), alpha-fetoprotein levels, and the Child–Pugh classification (TAC score) can serve as valuable prognostic indicators for these patients. Therefore, the main objective of our research was to analyze the prognostic value of the HVPG, TE-LSM, TBS, and TAC scores. An observational and survival study was conducted on 144 subjects. Our findings indicated that HVPG greater than 10 mmHg, AFP surpassing 400 ng/mL, an advanced C–P class, and low TAC score are independent predictors of overall survival. During the multivariate analysis, AFP serum levels and C–P class proved statistically significant. The present study revealed significant differences in overall survival between the two groups divided upon HVPG values and settled by the cutoff of 10 mmHg (p = 0.02). Moreover, by dividing the cohort into three groups based on the TAC score (very low, low, and moderate), statistically significant differences in overall survival were observed across the groups (p = 0.004). [ABSTRACT FROM AUTHOR]

Introduction. The introduction of robotic-guided procedures in surgical techniques has brought an increase in the accuracy and control of resections. Surgery has evolved as a technique since the development of laparoscopy, which has added to the visualisation of the peritoneal cavity from a different perspective. Multi-armed robot associated with real-time intraoperative imaging devices brings important manoeuvrability and dexterity improvements in certain surgical fields. Materials and Methods. The present study is designed to synthesise the development of imaging techniques with a focus on ultrasonography in robotic surgery in the last ten years regarding abdominal surgical interventions. Results. All studies involved abdominal surgery. Out of the seven studies, two were performed in clinical trials. The other five studies were performed on organs or simulators and attempted to develop a hybrid surgical technique using ultrasonography and robotic surgery. Most studies aim to surgically identify both blood vessels and nerve structures through this combined technique (surgery and imaging). Conclusions. Ultrasonography is often used in minimally invasive surgical techniques. This adds to the visualisation of blood vessels, the correct identification of tumour margins, and the location of surgical instruments in the tissue. The development of ultrasound technology from 2D to 3D and 4D has brought improvements in minimally invasive and robotic surgical techniques, and it should be further studied to bring surgery to a higher level. [ABSTRACT FROM AUTHOR]

Background & Aims: In the last years increasing scientific evidence drew attention on the potential effects of anesthetic drugs on postoperative outcome in cancer patients. Local anesthetics, especially lidocaine, have been intensively studied in relation with postoperative outcome in colorectal cancer patients. Our study objectives were to investigate the effects of perioperative intravenous lidocaine infusion on neutrophil-to-lymphocyte ratio and short-term postoperative outcome. Additionally, we also looked at 1 year outcome after intended radical colorectal cancer surgery. Methods: 150 patients scheduled for colorectal cancer surgery were randomized to receive sevoflurane anaesthesia with or without 48 hours lidocaine infusion. Results: 73 patients were included in the group A (sevoflurane) and 77 in the group B (sevoflurane with lidocaine). Lidocaine infusion did not modify neutrophil-to-lymphocyte ratio at 24 hours after surgery (p=0.58). Patients receiving intravenous lidocaine had significantly lower morphine consumption (p=0.04), faster mobilization time (p=0.001) and fewer days spent in the hospital (p=0.04). Moreover, at 1 year follow-up, patients in group B had a significant decreased rate of recurrences (p=0.03). There was no significant difference in 1 year survival (p=0.22). Conclusions: In our study, intravenous lidocaine infusion hastened the postoperative recovery of patients in terms of mobilization, hospital discharge and opioid consumption and reduced 1 year recurrence rate. Further studies on larger groups of patients are needed. [ABSTRACT FROM AUTHOR]

Background and Aim: Colorectal cancer is the third most common cancer worldwide both in men and women. The scope of this systematic review was to investigate if mobile applications exists and what are the benefits in the screening, diagnostic, pre-operative preparation, or post-operative follow-ups on the patients with colorectal cancer. Materials and Methods: We used the frame of PRISMA guideline. On September 1th, 2023, we systematically searched PubMed using the MeSH terms "Colorectal Neoplasms" and "Mobile Applications". No restrictions on the types of articles or publication date were imposed. Results: A total of 24 items were retained. The article's titles and abstracts were screened and 7 articles were removed due to the absence of the abstracts (n=2), the article described a prognostic scoring model (n=2), one was a systematic review, one was reviewing the use of SMS and one was a letter to the editor. Out of the 17 remaining articles, only 7 were available in full text and all were testing mobile applications. The scope of using the applications was to facilitate screening (n=3), recovery (n = 3) and monitor chemotoxicity (n=1). Conclusions: Mobile tools appear as an opportunity for rapid access and increased adherence to colorectal cancer screening guidelines. Mobile applications focused on patient recovery post colorectal cancer surgery need a more patient-centric approach. The mobile application built for monitoring chemotoxicity was deemed to address many of the limitations of identifying and quantifying chemotherapy toxicities. All in all, mobile applications may enhance existing clinical care and provide cost-effective real-time patient support, which may reduce the likelihood of hospital admission. [ABSTRACT FROM AUTHOR]

Transcutaneous electrical nerve stimulation (TENS) is a technique in which pulsed low-voltage electrical currents are delivered through electrodes applied on the intact skin surface of the painful area of the body, by using a special device in order to stimulate peripheral nerves including those for pain relief. This method is used to manage acute and chronic pain, conditions of nociceptive or neuropathic origin. All clinical trials with TENS for postoperative acute pain were included. Case reports, reviews, protocols, letters to the editor, animal experimental research, guidelines, and ongoing or uncompleted trials were excluded. Two hundred fifty-two articles involving postoperative pain and transcutaneous electric nerve stimulation were identified by applying the aforementioned search strategy which resulted in including 18 articles in the analysis. The number of patients assessed for eligibility in each article varies from a maximum of 800 to a minimum of 3. In 88.89% of the articles the frequency of the TENS applied in the patients was mentioned. In half of the research performed in the selected articles pain was evaluated with the visual analogue scale. Immediate postoperative active mobilization of the patient is a key point of shortening the convalescence period and hospitalisation, the one individual in cause being able to attend work and social activities as soon as possible therefore being able to discover non-invasive, simple to use methods that reduce pain overall and the consumption of pharmaceutical analgesics is mandatory. The TENS technique is a non-invasive, safe, complementary technique used in order to reduce acute postoperative pain and improve pulmonary function, especially deep breathing, facilitating active movement and recovery of the patient and significant morbidity reduction. [ABSTRACT FROM AUTHOR]

Background and Aim: The incidence of thyroid cancer has increased worldwide during the last decade, being one of the most common endocrine malignancies. Surgical resection, namely conventional thyroidectomy, remains at the frontline of therapy, Minimally invasive techniques gained popularity through the years. The purpose of this systematic review was to understand the most common techniques and to evaluate the outcomes of minimally invasive techniques. Materials and Methods: A literature search was conducted on 20 August 2023 using two MeSH terms: "Robotic Surgical Procedure" and "Thyroid Neoplasms" using PICOTS and PRISMA Statements. The results were narrowed to the articles available in full text. Results: A total of 31 items were retained. The article's titles and abstracts were screened and nine articles were removed as five articles were reviews, two articles were case repots, one was a letter to the editor and one was describing the impact of augmented reality. Remaining 22 articles to analyze the content. Conclusion: This study found that the most used minimally invasive thyroid surgical techniques are robotic transaxillary thyroidectomy and robotic thyroidectomy by bilateral axillo-breast approach. From the systematic review, it can be concluded that for selected patients (well-differentiated thyroid carcinoma), these modern techniques are not inferior to standard of care and are a safe alternative, with the advantage of avoiding a potentially disfiguring scar in the neck, when performed by surgeons who are familiar with and experienced in endoscopic and robotic techniques. [ABSTRACT FROM AUTHOR]

Aim: Primary liver tumors have an incidence of 20% regarding benign tumors respectively 5.7% of the overall incident cases of cancer. In any major hepatic injury, the surgical treatment has two main goals: hemostasis and excision of the affected liver segments. We aimed to systematic review the non-traumatic emergency liver resections, in order to raise concern about a rather rare, but difficult to treat hepatic pathology, which implies divergent therapeutical approach, and emergency liver surgery remains the first or backup option., Methods: A literature survey was performed guided by the words "liver resections", "major liver resections", "emergency liver resection". "hepatocellular carcinoma" using four databases: Pubmed, Scopus, Web of Science and Embase. All titles referred in English, published from 2000 until 2021, were checked for eligibility., Results: Six publications were considered relevant for major liver resections in emergency, from a total of 331 articles that were reviewed. Large hepatocellular carcinomas and adenomas were the most common types of tumors found at risk for spontaneous rupture. The patients with hemodynamic instability, reduced liver function and large tumors had lower long-term survival and disease-free survival. Major hepatectomy was indicated as a viable solution for prolonging survival rate, whenever the patient's general status permits it per primam., Conclusions: Emergency major liver resection for tumoral causes prolongs survival even if the cause is usually malignant. The tumor can be resected with negative resection margins, respecting the correct oncological requirements, both per primam or staged approach according to each case specifically., Key Words: Adenoma, Emergency, Hemorrhage, Hepatocellular Carcinoma, Liver Resection, Liver Tumors.