Current Issue : April-June Volume : 2026 Issue Number : 2 Articles : 5 Articles
The integration of artificial intelligence (AI) is rapidly transforming the field of breast reconstruction, with applications spanning surgical planning, complication prediction, patient-reported outcome assessment, esthetic evaluation, and patient education. A comprehensive narrative review was performed to evaluate the integration of AI technologies in breast reconstruction, encompassing preoperative planning, intraoperative use, and postoperative care. Emerging evidence highlights AI’s growing utility across these domains. Machine learning algorithms can predict postoperative complications and patient-reported outcomes by leveraging clinical, surgical, and patient-specific factors. Neural networks provide objective assessments of breast esthetics following reconstruction, while large language models enhance patient education by guiding consultation questions and reinforcing in-clinic discussions with accessible medical information. As these tools continue to advance, their adoption in everyday practice is becoming increasingly relevant. Staying current with AI applications is essential for plastic surgeons, as AI is not only reshaping breast reconstruction today, but is also poised to become an integral component of routine clinical care....
To develop and validate a predictive model for assessing the risk of short-term mortality in patients with invasive fungal diseases (IFDs) following cardiac surgery. This retrospective study analyzed clinical data from patients diagnosed with postoperative IFDs in the cardiac surgical intensive care unit (ICU) of Qilu Hospital of Shandong University (QLH), between January 2020 and December 2023. A total of 98 patients were included and divided into a non-survival group (n = 42) and a survival group (n = 56) based on 28-day mortality. Demographic, clinical, and postoperative parameters were collected. The Least Absolute Shrinkage and Selection Operator (LASSO) regression was used for variable selection, and selected variables were then entered into multivariate logistic regression to identify independent risk factors. A nomogram was developed, and its predictive performance was evaluated using the receiver operating characteristic (ROC) curve, decision curve analysis (DCA), and clinical impact curve (CIC). Multivariate logistic regression, following variable selection by LASSO, identified a history of smoking, an elevated SOFA score, mean arterial pressure (MAP) below 70 mmHg, and tachyarrhythmia as independent risk factors for short-term mortality in this cohort (p < 0.05). The prediction model demonstrated excellent discrimination, with an area under the ROC curve (AUC) of 0.886 (95% CI: 0.816–0.957). The calibration curve showed good agreement between predicted and observed outcomes, with a mean absolute error of 0.023. Decision curve analysis indicated a net clinical benefit across a threshold probability range of 0.1 to 0.87. The clinical impact curve confirmed a high concordance between predicted mortality and actual outcomes. A history of smoking, an elevated SOFA score, MAP below 70 mmHg, and tachyarrhythmia independently predict short-term mortality in patients with IFDs after cardiac surgery. Therefore, the nomogram constructed from these factors provides an accurate and clinically applicable tool for risk stratification....
Background/Objectives: Despite growing awareness of mitral annular disjunction’s (MAD) clinical significance, robust data regarding the outcomes of surgical interventions on MAD remain sparse. This meta-analysis aims to systematically evaluate the current evidence on the efficacy and safety of mitral valve (MV) surgery in patients with MAD. Methods: A systematic review was conducted from inception until May 2025 for studies comparing patients undergoing MV surgery with and without MAD and was registered in PROSPERO: CRD42025649821. Results: Patients with MAD were generally younger (59.3 ± 5.0 vs. 63.4 ± 2.2 years, standardized mean difference: −0.3073), had fewer comorbidities but more complex valve lesions (41.0% vs. 13.7%, risk difference: 0.2627) compared to those without MAD. MV replacement was performed less frequently in the MAD group than in the No-MAD group (risk ratio, RR: 0.690 [95% confidence interval, CI: 0.508; 0.937], p = 0.017), probably related to the significant difference in age between the two groups. The MAD cohort demonstrated a higher incidence of ventricular arrhythmia both after surgery (RR: 7.255 [95%CI: 1.231; 42.763], p = 0.029) and during follow-up (incidence rate ratio, IRR: 2.750 [95%CI: 1.372; 5.512], p = 0.004). Although the MAD group experienced more arrhythmic events over time, this did not translate into a significant difference in overall mortality compared to patients without MAD (IRR: 0.573 [95%CI: 0.072; 4.555], p = 0.599). Conclusions: This meta-analysis revealed significant baseline differences between the populations. Our findings suggest that patients with MAD remained at significantly higher risk for both postoperative and long-term arrhythmias. These results highlight the need for close arrhythmic surveillance in this population....
Background and Objectives: To evaluate factors affecting aneurysm rupture, present our surgical experience with intracranial aneurysms, specifically using the picket-fence clipping technique for giant aneurysms, and highlight the complementary roles of sodium fluorescein (Na-Fl) and indocyanine green (ICG) videoangiography in enhancing surgical precision and patient outcomes. Materials and Methods: We retrospectively analyzed 47 patients who underwent microsurgical clipping of intracranial aneurysms with intraoperative Na-Fl and ICG videoangiography between September 2015 and February 2024. We assessed relationships between patient comorbidities, family history of subarachnoid hemorrhage (SAH), smoking history, aneurysm location and size, and SAH occurrence. Concordance between intraoperative videoangiography and postoperative digital subtraction angiography (DSA) for detecting residual aneurysms was also evaluated. Results: Of the 47 patients (31 female, 16 male; mean age 51.78 ± 11.16 years), 11 (23.4%) presented with SAH. The most common aneurysm location was the middle cerebral artery (MCA) (68.1%). Hypertension and smoking history were significantly higher in the hemorrhage group (p < 0.05). Aneurysm size and anterior communicating artery (AComA) location were also significantly associated with hemorrhage (p < 0.05). Aneurysm size demonstrated significant discriminative power for hemorrhage [AUC: 0.884 (0.827–0.941)], with a cutoff of 7.1 mm yielding 90.9% sensitivity and 94.4% specificity. Five giant MCA aneurysms were treated with the picket-fence technique, with intraoperative ICG and Na-Fl confirming parent artery patency and complete aneurysm occlusion, subsequently confirmed by postoperative DSA. Small remnants were detected in 2 cases (4.26%) on postoperative DSA, both in distal ACA aneurysms, which were also detected by intraoperative videoangiography. Conclusions: Hypertension, smoking history, aneurysm size, and location were important predictors of aneurysm rupture. Intraoperative ICG and Na-Fl videoangiography provide real-time, high-resolution visualization crucial for complex intracranial aneurysm surgery, including the picket-fence technique for giant aneurysms. Their complementary use enhances surgical safety, guides intraoperative decision-making, and contributes to improved outcomes in challenging cases....
Background/Objectives: Management of prehepatic portal hypertension involves endoscopic and medical therapies with subsequent shunting if symptoms persist. Lately, surgical shunts, particularly the Meso-Rex shunt, are increasingly considered early in the disease course, offering benefits such as minimized hyperammonemia, improved somatic growth, and preservation of liver function. Our study evaluates post-operative outcomes after different surgical procedures in children with prehepatic portal hypertension. Methods: This single-centre retrospective case series included six children undergoing surgical shunting for prehepatic portal hypertension over a 5-year period. Medical records before and after surgery, followed for an average of 4.0 years, were analyzed. Results: Five patients underwent a Meso-Rex bypass, while one patient underwent a mesorenal shunt procedure. All cases showed clinically significant regression of esophageal varices six months postsurgery. Thrombocyte as well as leukocyte count significantly increased in five out of six patients during the long-term follow-up. Currently, five out of six surgically formed shunts (83%) continue to function normally. Conclusions: Our study supports early surgical intervention for improved long-term outcomes in managing portal hypertension, reducing complications like hypersplenism and variceal bleeding. Early consideration and ongoing monitoring are crucial for long-term success in children with portal hypertension....
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