Competency, Proficiency, and Mastery: Learning Curves for Robotic Distal Pancreatectomy at 16 International Expert Centers.

Objective: The aim of this study was to evaluate the different phases of the learning curve for robotic distal pancreatectomy (RDP) in international expert centers.

Summary Background Data: RDP is an emerging minimally invasive approach; however, only limited, mostly single center data are available on its safe implementation, including the learning curve.

Methods: Consecutive patients undergoing elective RDP from 16 expert centers across three continents were included to assess the learning curve.

Poor Prognostic Factors in Long-Term Survivors of Resected Pancreatic Ductal Adenocarcinoma: An International, Multicenter Cohort Study.

Objective: To measure the rate of LTS in resected PDAC and determine the association between predictors of OS and LTS.

Summary Background Data: Long-term survival (>5 y, LTS) remains rare in pancreatic ductal adenocarcinoma (PDAC). Multiple predictors of overall survival (OS) are known but their association with LTS remains unclear.

Informing Decision-making for Transected Margin Reresection in Intraductal Papillary Mucinous Neoplasm-derived PDAC: An International Multicenter Study.

Objective: To assess the prognostic impact of margin status in patients with resected intraductal papillary mucinous neoplasms (IPMN)-derived pancreatic ductal adenocarcinoma (PDAC) and to inform future intraoperative decision-making on handling differing degrees of dysplasia on frozen section.

Summary Background Data: The ideal oncologic surgical outcome is a negative transection margin with normal pancreatic epithelium left behind. However, the prognostic significance of reresecting certain degrees of dysplasia or invasive cancer at the pancreatic neck margin during pancreatectomy for IPMN-derived PDAC is debatable.

Outcomes in intraductal papillary mucinous neoplasm-derived pancreatic cancer differ from PanIN-derived pancreatic cancer.

Background And Aim: Intraductal papillary mucinous neoplasm (IPMN)-derived pancreatic ductal adenocarcinoma (PDAC) management is generally extrapolated from pancreatic intraepithelial neoplasia (PanIN)-derived PDAC guidelines. However, these are biologically divergent, and heterogeneity further exists between tubular and colloid subtypes.

Methods: Consecutive upfront surgery patients with PanIN-derived and IPMN-derived PDAC were retrospectively identified from international centers (2000-2019).

Elective Direct Current Cardioversion of Atrial Fibrillation: Silent Brain Infarction and Health-Related Quality of Life.

Introduction: Atrial fibrillation (AF) increases the risk for stroke, dementia, and impaired health-related quality of life (HRQL). Elective direct current cardioversion (ECV) is often used to restore sinus rhythm but is associated with thromboembolism. While larger strokes usually produce symptoms, subclinical ones may go unrecognized and may cause cognitive and functional decline over time.

Prediction of Isolated Local Recurrence After Resection of Pancreatic Ductal Adenocarcinoma: A Nationwide Study.

Background: Distinguishing postoperative fibrosis from isolated local recurrence (ILR) after resection of pancreatic ductal adenocarcinoma (PDAC) is challenging. A prognostic model that helps to identify patients at risk of ILR can assist clinicians when evaluating patients' postoperative imaging. This nationwide study aimed to develop a clinically applicable prognostic model for ILR after PDAC resection.

Recurrent disease detection after resection of pancreatic ductal adenocarcinoma using a recurrence-focused surveillance strategy (RADAR-PANC): protocol of an international randomized controlled trial according to the Trials within Cohorts design.

Background: Disease recurrence remains one of the biggest concerns in patients after resection of pancreatic ductal adenocarcinoma (PDAC). Despite (neo)adjuvant systemic therapy, most patients experience local and/or distant PDAC recurrence within 2 years. High-level evidence regarding the benefits of recurrence-focused surveillance after PDAC resection is missing, and the impact of early detection and treatment of recurrence on survival and quality of life is unknown.

Serendipity in oto-rhino-laryngology.

Introduction: Serendipitous findings are findings that were initially unsought but nevertheless contribute to the development of the discipline. This article reviews eight serendipitous findings in oto-rhino-laryngology important to its advancement.

Method: The following serendipitous findings are discussed: the accidental discovery of the laryngeal mirror and indirect laryngoscopy by Garcia (1854), the invention of direct oesophagoscopy by Kußmaul (circa 1868), Czermák's (1863) development of diaphanoscopy, the unintentional emergence of bronchography from a clinical error made by Weingartner (1914), adenotomy by Meyer (1869), the discovery of the causes of unbalance related to the vestibular nerve by Flourens (1830), Bárány's (1914) finding that the semi-circular canal reflex is involved in equilibrium, and the relationship between gastroesophageal reflux and middle-ear infections by Poelmans and Feenstra (2002).

Vasculitis distribution and clinical characteristics in giant cell arteritis: a retrospective study using the new 2022 ACR/EULAR classification criteria.

Introduction: Giant cell arteritis (GCA) is the most common vasculitis of the elderly. In recent years, advanced imaging has to a certain extent replaced temporal artery biopsy (TAB) to aid diagnosis in many institutions and helped to identify three major phenotypes of GCA, namely, cranial GCA (c-GCA), large-vessel non-cranial GCA (LV-GCA), and a combination of these two patterns called mixed-GCA, which all show different clinical patterns. Recent 2022 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) classification criteria respect the changing conception and clinical practice during the last two decades.

Recurrent pericarditis.

Pericarditis is an important differential diagnosis in patients with chest pain. The two most common causes in the developed world are idiopathic pericarditis and inflammation following cardiac surgery or myocardial infarction. Recurrence of pericarditis affects up to 30 % of patients, half of whom experience multiple episodes, and approximately 10 % develop steroid-dependent and colchicine-refractory pericarditis.

A nationwide assessment of hepatocellular adenoma resection: Indications and pathological discordance.

Hepatocellular adenomas (HCAs) are benign liver tumors associated with bleeding or malignant transformation. Data on the indication for surgery are scarce. We analyzed indications and outcome of patients operated for HCAs < 50 mm compared to HCAs ≥ 50 mm.

Risk factors of low anterior resection syndrome after miniinvasive restorative rectal resection.

Introduction: Over the last decades outcomes for rectal cancer surgery have improved with increasing survival and lower recurrence rates. Nevertheless, functional disorders are still frequent. Low anterior resection with total mesorectal excision (TME) in patients with rectal cancer has improved oncological outcomes.

Fluorescent angiography in colorectal surgery, the influence of augmented reality in the operating room on the anastomotic leakage after low rectal resection.

Introduction: Near-infrared (NIR) fluorescence angiography (FA) is an augmented reality (AR) technique. When used in the operating room, it allows colorectal surgeons to visualize and evaluate intestinal blood flow in real time, identify lymph nodes, ureters, or peritoneal metastases. Evaluation of perfusion with FA in augmented reality mode has an impact on reducing the ALR (anastomotic leakage rate) in rectal resections.

Total mesorectal excision for rectal cancer - laparoscopic versus robotic approach.

Introduction: The primary goal of this study was to evaluate peroperative and early postoperative results of laparoscopic and robotic surgery for rectal cancer with total mesorectal excision (TME) and with primary anastomosis.

Methods: 404 patients were enrolled in the study, divided in two cohorts and compared retrospectively: a laparoscopic group (n=236) versus a robotic (TME + primary coloanal anastomosis) group (n=168). The evaluated cohorts were comparable in sex, age, BMI, ASA score, distal tumor margin from anal verge and neoadjuvant chemoradiotherapy.

Monitoring of the impact of road salting on spruce forest ecosystem in the vicinity of the highway D1 in the Bohemian-Moravian Highlands, Czech Republic.

Monitoring of pollution in the vicinity of roads connected to winter road maintenance is one of the important tools for optimising winter maintenance technology and reducing its environmental impact. The aim of this study was to determine the relationship between winter road maintenance and the increased concentration of sodium ion to characterise the harm caused by the de-icing agents on selected types of individual components grown in the Norway spruce ecosystem. The model area is located in the immediate vicinity of the D1 motorway connecting Prague and Brno (Czech Republic), at 103 km.

Safety and feasibility of rigid fixation by SternaLock Blu plates during the modified Ravitch procedure: a pilot study.

Background: Patients with anterior chest wall deformities unsuitable for minimally invasive repair are commonly treated by the modified Ravitch procedure. Although rigid plate fixation of the sternal osteotomy has previously shown to facilitate adequate sternal union, its use is troubled by an implant removal rate of up to 23% due to local complaints or complications associated with bulky plates. In contrast, the use of thinner and therefore biomechanically weaker plates may result in a higher incidence of non- or mal-union.