Robotic-assisted surgery for the treatment of urologic cancers: recent advances.

Introduction: Recent advancements in single-port surgery, robotic platforms, 3D models and artificial intelligence have transformed surgical procedures, especially in urology. These innovations enhance precision, safety, and efficacy, reducing invasiveness and recovery times. The review focuses on the latest in robotic-assisted surgery for genitourinary cancers, highlighting the shift toward personalized, minimally invasive treatments.

Comparative Outcomes of En-Bloc Holmium Laser Enucleation of the Prostate and Transvesical Robot-Assisted Simple Prostatectomy for the Management of Benign Prostatic Hyperplasia: A Propensity-Matched Analysis.

Holmium laser enucleation of the prostate (HoLEP) and robot-assisted simple prostatectomy (RASP) have emerged as the two surgical treatments of medication-refractory benign prostatic hyperplasia (BPH). The comparative outcomes of en-bloc HoLEP with early apical release and RASP with modified Freyer's technique remain unexplored. Between 2018 and 2022, patients with medication-refractory BPH and prostate volume ≥80 g underwent HoLEP or RASP depending on clinical characteristics, patient choice, and surgeon preference.

Food Insecurity Is Common in Patients with Inflammatory Bowel Disease and Is Associated with Increased Ultra-Processed Food Intake.

Background/objectives: Food insecurity (FI) is defined as the lack of consistent access to enough food for an active and healthy life. FI affects over 30 million Americans and is associated with poor clinical outcomes and impaired quality of life and drives significant health inequities. Despite the rising prevalence of FI and the federal focus on improving access to healthy food, there is a paucity of research on FI in patients with inflammatory bowel disease (IBD).

Vibration Anesthesia During Invasive Procedures: A Meta-analysis.

Objective: Dermatologic office procedures involving needles including injection of local anesthetic both cutaneously and intraorally, botulinum toxin, fillers and keloids, as well as venipuncture and a plethora of other procedures can often cause pain that ranges from mild to severe. The technique of utilizing vibration frequently lessens pain. Vibration anesthesia is a non-invasive, inexpensive, virtually side-effect free, and well-established method of lessening pain during dermatologic procedures.

Advancements in Endovascular Treatment of Extracranial Carotid Artery Aneurysms.

Background: Traditionally, extracranial carotid artery aneurysms or pseudoaneurysms (ECCAs) have been managed through open surgical repair. Recent literature highlights the increasing success of endovascular techniques in treating ECCAs. Our study explores our center's experience with endovascular management of ECCAs, including the innovative use of transcarotid artery revascularization (TCAR) at a tertiary-care center.

Radiomultiomics: quantitative CT clusters of severe asthma associated with multiomics.

Background: Lung quantitative computed tomography (qCT) severe asthma clusters have been reported, but their replication and underlying disease mechanisms are unknown. We identified and replicated qCT clusters of severe asthma in two independent asthma cohorts and determined their association with molecular pathways, using radiomultiomics, integrating qCT, multiomics and machine learning/artificial intelligence.

Methods: We used consensus clustering on qCT measurements of airway and lung CT scans, performed in 105 severe asthmatic adults from the U-BIOPRED cohort.

Comprehensive feedback on user experiences with brain injury identification cards.

Purpose/objective: Brain injuries are often "invisible" injuries that can have lifelong consequences including changes in identity, functional independence, relationships, and reduced participation in daily activities. Survivors of brain injury experience stigma and challenges related to the misattribution of symptoms to other causes that are significant barriers to recovery and adjustment. Changes in policy and other large-scale interventions are cited as an underexplored, yet critical path to reducing the impact of brain injury.

Tumor Characteristics Associated With Preoperatively Detectable Tumor-Informed Circulating Tumor DNA in Patients With Renal Masses Suspicious for Renal Cell Carcinoma.

Purpose: Understanding the specific tumor characteristics associated with detectable circulating tumor DNA (ctDNA) in patients with renal cell carcinoma (RCC) is critical for informing future studies aiming to establish the clinical utility of such testing. We characterized the pathologic and clinical features associated with preoperatively detectable ctDNA in patients with renal masses suspicious for RCC.

Methods: Consecutive patients who underwent partial or radical nephrectomy for nonmetastatic suspected RCC (cT1b-T3) during 2022-2023 had prospectively collected tumor-informed ctDNA analyses conducted preoperatively and postoperatively.

Survival Outcomes by Race Following Surgical Treatment for Upper Tract Urothelial Carcinoma.

Objective: Discrepancies in survival outcomes of various genitourinary tract malignancies have been documented across different racial and ethnic groups. Here we sought to examine long-term survival outcomes of patients with upper tract urothelial carcinoma (UTUC) following radical nephroureterectomy (RNU) when stratified by race.

Methods: A multicenter retrospective analysis using the ROBUUST (ROBotic surgery for Upper tract Urothelial cancer Study) registry identified patients undergoing RNU for UTUC between 2015 and 2022 at 12 centers across the United States, Europe, and Asia.

The Common Expression of INSM1 in HPV-related Oropharyngeal Squamous Cell Carcinomas Is Not Associated With True Neuroendocrine Transformation or Aggressive Behavior.

INSM1 has rapidly emerged as a robust marker for neuroendocrine (NE) differentiation, prompting the use of INSM1 as a standalone marker for NE differentiation in various sites. INSM1 staining could be an especially practical tool for evaluating HPV-associated oropharyngeal squamous cell carcinoma (HPV-OPSCCs) because high-grade NE transformation may be exceedingly difficult to recognize on morphologic grounds alone, even though it portends highly aggressive clinical behavior. The purpose of this study was to determine the incidence of INSM1 expression in HPV-OPSCC and study its role in determining NE transformation and clinical aggressiveness.

Healthcare Worker Attitudes to Living Donation Prior to Planned Withdrawal of Care.

Background And Aims: This study assesses the attitudes of healthcare practitioners toward Living Donation Prior to Planned Withdrawal of Care (LD-PPW): the recovery of a living donor organ before withdrawal of life-sustaining measures in a patient who does not meet criteria for brain death, but for whom medical care toward meaningful recovery is deemed futile.

Methods: An electronic survey was administered to 1735 members of the American Society of Transplant Surgeons mailing list with 187 responses (10.8%).

Percutaneous LAAO and Pulsed-Field Isolation in a Canine Model: Feasibility and Safety Evaluation.

In this study, we investigated the feasibility, safety, and efficiency of using a novel device system to perform percutaneous left atrial appendage occlusion concomitant with left atrial appendage electrical isolation (LAAEI) via pulsed field ablation. In the acute phase, LAAEI was successful in 10 of 10 canines. At follow-up, full endothelialization was observed in 5 of 5 (100%) cases at 6 months.

The prognostic significance of circulating tumor DNA in patients with positive lymph node disease after robotic-assisted radical cystectomy: A contemporary analysis.

Background And Objective: Neoadjuvant therapy followed by radical cystectomy with lymphadenectomy remains the gold standard of treatment in patients with muscle-invasive bladder cancer. Pathologically positive lymph node (pN+) disease is known to convey a poor prognosis. Tumor-informed circulating tumor DNA (ctDNA) has emerged as a possible novel prognostic biomarker in the field.

Clinical Significance of Tumor Location for Ureteroscopic Tumor Grading in Upper Tract Urothelial Carcinoma.

Although previous literature shows tumor location as a prognostic factor in upper tract urothelial carcinoma (UTUC), there remains uninvestigated regarding the impact of tumor location on grade concordance and discrepancies between ureteroscopic (URS) biopsy and final radical nephroureterectomy (RNU) pathology. In this international study, we retrospectively reviewed the records of 1,498 patients with UTUC who underwent diagnostic URS with concomitant biopsy followed by RNU between 2005 and 2020. Tumor location was divided into four sections: the calyceal-pelvic system, proximal ureter, middle ureter, and distal ureter.

Robot-assisted nephroureterectomy: surgical and mid-term oncological outcomes in over 1100 patients (ROBUUST 2.0 collaborative group).

Objective: To analyse surgical, functional, and mid-term oncological outcomes of robot-assisted nephroureterectomy (RANU) in a contemporary large multi-institutional setting.

Patients And Methods: Data were retrieved from the ROBotic surgery for Upper tract Urothelial cancer STtudy (ROBUUST) 2.0 database, an international, multicentre registry encompassing data of patients with upper urinary tract urothelial carcinoma undergoing curative surgery between 2015 and 2022.

Predicting the impact of retinal vessel density on retinal vessel and tissue oxygenation using a theoretical model.

Vascular impairments, including compromised flow regulation, have been identified as significant contributors to glaucomatous disease. Recent studies have shown glaucoma patients with significantly reduced peripapillary, macular, and optic nerve head vessel densities occurring with early glaucomatous structural changes prior to detectable visual field loss. This study aims to quantify the potential impact of decreased vessel densities on retinal perfusion and oxygen metabolism.