Outcomes of stereotactic ablative radiotherapy or surgery for early-stage lung cancer in patients with interstitial lung disease.

Puncture path planning for thermal ablation surgery of hyperparathyroidism based on multi-objective constraints

Uterine fibroids are a common indication for image-guided, uterus-preserving therapies such as focused ultrasound ablation surgery (FUAS), yet substantial interpatient variability in treatment difficulty limits reproducible analysis. Here, we present a curated multimodal dataset comprising structured clinical variables, continuous multisequence magnetic resonance imaging (MRI), procedural parameters, and quantitatively defined treatment outcome indicators from patients undergoing FUAS for uterine fibroids. The dataset integrates heterogeneous data modalities within a standardized and anonymized framework to support reproducible research and downstream reuse. To facilitate technical validation, we further provide a reference multimodal prediction pipeline that integrates dynamic MRI sequences with structured clinical data to estimate treatment difficulty and derive a rule-based FUAS recommendation label. Using this baseline implementation, the dataset supports joint regression and classification tasks, achieving a mean absolute percentage error of 0.265 and an area under the receiver operating characteristic curve of 0.931 on an independent test set. This openly available dataset provides a valuable resource for benchmarking and for multimodal data fusion research related to FUAS treatment of uterine fibroids.

Preoperative CT provides a detailed anatomical basis for navigation in sinus surgery, guiding surgeons through intricate nasal structures while providing 3D awareness of critical anatomy. However, this static representation lacks the capacity to adapt to intraoperative tissue ablation. Efforts toward endoscope-based navigation reconstruct anatomy from visual cues alone, often without incorporating the CT prior that anchors surgical context. We propose a method to ground both CT and endoscope in a unified representation that bridges pre- and intraoperative domains, enabling dynamic updates of the surgical scene. We initialize the CT as a volumetric signed distance field (SDF), reformulating the update process with non-projective SDFs and accumulating camera-space observations with dense depth estimated from endoscopic video. These volumes are reconciled to produce intraoperative SDFs for updated surface mesh extraction. We validated our method on three multi-step cadaveric sinus datasets with paired preoperative CT and intraoperative endoscopic video of a simulated sinus surgery. We extract intraoperative meshes at each surgical step and compare to ground-truth intraoperative CT. Our vision-guided update method demonstrates improved surface alignment of the intraoperative representations throughout surgical progression, achieving submillimeter geometric accuracy. We show that integrating CT priors with intraoperative vision enables anatomically consistent updates to patient-specific models. This method provides a foundation for CT-consistent endoscopic reconstruction, and future work aimed at integrating camera localization toward a fully realized vision-guided surgical navigation system.

Outcomes of Free-Flap Reconstructive Microsurgery in Frail Head and Neck Patients.

This video describes in detail our current technique for laparoscopic port placement in infants when using retroperitoneoscopy. More than 60 ablative and reconstructive renal surgeries have been performed since 2017 using this retroperitoneoscopic approach in infants weighing less than 10 Kg, with no conversions or complications linked to access or port placement. It is our impression that retroperitoneoscopy is very similar in smaller children, and might have some advantages such as shorter distance between entry point and target organ and more flexible abdominal wall. This video shows a combination of 5 mm and 3 mm ports, allowing use of all current types of energy devices, clip appliers and single use scissors, and also excellent vision during initial dissection. This approach has been used in our university centers for nephrectomies, hemi-nephrectomies, pyeloplaties and uretero-ureterostomies.

To evaluate management strategies, complication rates and outcomes of para-aural abscessation (PAA) following total ear canal ablation with lateral bulla osteotomy (TECA-LBO) in dogs, focusing on the difference of medical versus surgical treatment and associated neurological outcomes. Retrospective multicentre case series. Thirty-six dogs presenting with PAA post-TECA-LBO between 2010 and 2022. Data were collected on signalment, presenting signs, surgical procedure, microbiological findings, management strategies and long-term outcomes. Neurological deficits, both pre- and post-treatment, were documented. Outcomes were classified as excellent, improved or poor based on clinical resolution and complications. PAA occurred at a median of 197.5 days after TECA-LBO (range, 7-1652 days). Brachycephalic breeds were overrepresented (15/36). Medical management resolved PAA in 30% (6/20) of cases compared to 73.3% (22/30 cases) resolution with surgery. Neurological complications following surgical management of PAA were common (13/30 cases), with resolution occurring in only seven cases. Culture results at incident surgery and at the time of PAA matched in only 13 cases and 50% of positive cultures revealed multidrug-resistant bacteria. In this case series, surgical management yielded higher resolution rates compared to medical treatment but carried significant risks of permanent neurological deficits. Findings emphasise the importance of complete epithelial removal during the original surgery and culture-guided antimicrobial therapy. Surgical treatment of PAA carries a high risk of permanent neurological injury, with facial neuropathy being the most common.

Pulmonary vein isolation (PVI) has become the cornerstone of atrial fibrillation (AF) treatment. Nevertheless, the efficacy of radiofrequency ablation remains limited by a substantial rate of recurrence. The selection of anesthesia, the surgeon's operative experience and medical expertise, as well as the ablation surgery strategy, all have an impact on the recurrence after atrial fibrillation surgery. Our research aims to explore a novel method for predicting atrial fibrillation (AF) recurrence. This study enrolled 148 patients with atrial fibrillation (AF) undergoing first-time radiofrequency ablation. Based on the data from the AIFV system (an artificial intelligence-based ablation quality analysis system that generates structured Vistag scores from CARTO3 mapping data), patients were divided into two groups: the high-score group(Vistag analysis scores ≥ V5) and the low-score group(scores < V5). Baseline characteristics, intraoperative parameters, and AIFV system-related data were collected. Multivariate logistic regression analysis was performed to identify factors associated with atrial fibrillation (AF) recurrence. Among the 148 enrolled patients, 84 were categorized into the high-score group and 64 into the low-score group. Patients in the low-score group had significantly higher Left Ventricular End-Diastolic Volume (LVEDV), Left Ventricular Ejection Fraction (LVEF), and Left Ventricular End-Systolic Volume (LVESV), as well as a higher prevalence of diabetes (29.5% vs. 9.5%, p = 0.002). During a minimum follow-up of 365days, 11 patients (13.1%) in the high-score group experienced recurrence of atrial arrhythmia, compared to 19 patients (29.7%) in the low-score group. Kaplan-Meier analysis revealed a significantly higher atrial arrhythmia-free survival rate in the high-score group (log-rank test, P = 0.012). Multivariate logistic regression analysis revealed that being in the high-score group was an independent protective factor against AF recurrence (OR = 0.383, 95% CI 0.160-0.912, P = 0.030). The AIFV system was used to evaluate six procedural parameters in each atrial fibrillation procedure, which could play a crucial role in predicting the recurrence of atrial fibrillation.

This study aimed to compare the safety and effectiveness of cone-beam CT (CBCT)-guided thermal ablation vs video-assisted thoracic surgery (VATS) in patients with stage I-IIIA non-small-cell lung cancer (NSCLC). A total of 43 NSCLC patients underwent CBCT-guided thermal ablation, and 899 patients received VATS. After 1:1 propensity score matching (PSM), 32 patients were included in each cohort. Overall survival (OS), disease-free survival (DFS), recurrence rates, length of hospital stay, and complications were analyzed. The mean OS was 3.02 ± 1.31 years in the ablation group and 4.79 ± 2.87 years in the VATS group ( P = 0.08). The mean DFS was 2.30 ± 1.55 years and 4.34 ± 2.98 years, respectively ( P = 0.021). Local and distant recurrence occurred in five (15.6%) and seven (21.9%) patients in the ablation group, and in six (18.8%) and seven (21.9%) patients in the VATS group, with no significant difference in overall recurrence ( P = 0.595). The hospital stay was significantly shorter in the ablation group (3.67 ± 2.04 days) than in the VATS group (8.21 ± 3.68 days, P < 0.0001). The incidences of pneumothorax (P = 0.430), infection ( P = 0.086), pneumonia ( P = 0.554), and fever ( P = 0.230) were comparable between groups. CBCT-guided thermal ablation is a safe and effective treatment option for patients with stage I-IIIA NSCLC.

This study investigated sensory recovery of microvascular free flaps in the oral cavity with functional magnetic resonance imaging to assess activation in the primary sensory cortex (S1). The study included 20 patients with sensory recovery at the flap site in the tongue or floor of mouth after ablative cancer surgery that involved unilateral resection of the lingual nerve and reconstruction with a radial free forearm flap, anterolateral thigh flap, or lower leg perforator flap without nerve readaptation between 2012 and 2019. Control nonflap and contralateral flap sites were electrically stimulated with a patient-specific, sensation-inducing voltage for 10 minutes with 30-second on/off intervals. During this process, functional magnetic resonance imaging was conducted simultaneously to assess the signal area and level in S1. The stimulation voltage was higher at the flap site than at the control nonflap site (6.0 versus 3.0 V; P < 0.001). The signal area activated upon stimulation of the flap and control nonflap site was located in the cortical area representing the lingual nerve. The signal level in S1 upon stimulation of the flap site was similar to that upon stimulation of the control nonflap site (3.2 versus 3.5 T; P = 0.751). Activation of the cortical area representing the lingual nerve upon stimulation of the flap site implies that sensory recovery of microvascular free flaps in the tongue and floor of mouth region involves nerve ingrowth from the remaining lingual nerve into the flap tissue.

Aim: To evaluate the cost-utility of pulsed field ablation (PFA) compared with radiofrequency ablation (RFA) and cryoablation, respectively, in Chinese patients with paroxysmal atrial fibrillation. Materials &methods: Patients with paroxysmal atrial fibrillation at different levels of atrial arrhythmia burden (<0.1%, 0.1-9.9%, ≥10%) may experience various atrial arrhythmia burden states after undergoing ablation. A decision tree model was developed to simulate this process from a healthcare perspective, where patients could undergo a repeat ablation or experience a nonfatal stroke. Transition probabilities, clinical outcome and quality of life data were obtained from published sources and confirmed by expert physicians. Cost data were estimated from a survey of clinicians at tertiary hospitals, based on actual clinical practices. The uncertainty of results was explored through one-way sensitivity analysis and probabilistic sensitivity analysis by Monte Carlo simulation. The secondary outcome, return on investment, was calculated from hospital administrator perspective, as net revenue divided by total cost of certain ablation type. Results: PFA demonstrated favorable cost-effectiveness compared with both RFA and cryoablation under the three-times China's per capita GDP threshold. When compared with RFA, PFA yielded an incremental 0.016 quality-adjusted life years (QALYs)(0.859 vs 0.842) with an incremental cost-effectiveness ratioof ¥37,000 per QALY gained. This cost-effectiveness was primarily driven by savings of ¥1558 in weighted repeat ablation surgery costs and ¥506 in long-term medication costs for anti-arhythmic and anticoagulants. When compared with cryoablation, PFA resulted in an incremental 0.006 QALYs (0.859 vs 0.852) with an incremental cost-effectiveness ratio of ¥231,167 per QALY gained, mainly attributed to savings of ¥1300 in repeat ablation surgery costs and ¥133 in long-term medication costs. As a secondary outcome, PFA yielded a return on investment of 0.313. Conclusion: PFA was likely to be more cost effective than both radiofrequency ablation and cryoablation in China. The study suggests that PFA represents a high-value intervention that aligns superior clinical outcomes with favorable hospital financial sustainability, supporting its prioritized adoption in the management of atrial fibrillation in China.

Stereotactic ablation surgery for treatment-resistant obsessive-compulsive disorder: Technical evolution, clinical application, and future prospects.

Ten years after transoral endoscopic thyroidectomy vestibular approach (TOETVA): Why did we abandon the transoral route?

Objective: To investigate optimal long-term medication regimens combined with focused ultrasound ablation surgery (FUAS) for alleviating dysmenorrhea in patients with extrinsic adenomyosis. Methods: A retrospective research enrolled patients with extrinsic adenomyosis diagnosed by pelvic magnetic resonance imaging and presenting with significant dysmenorrhea symptoms, who underwent FUAS treatment at Qingdao Women and Children's Hospital from December 2019 to December 2023. Patients were divided into two groups based on postoperative treatment regimens: FUAS+gonadotrophin-releasing hormone agonist (GnRH-a)+levonorgestrel-releasing intrauterine system (LNG-IUS) group (Group LNG-IUS) and FUAS+GnRH-a+dienogest group (Group DNG). Clinical characteristics, imaging data, and treatment outcomes of the patients were retrospectively analyzed. Patients were followed up for 12 to 60 months to compare symptom improvement, recurrence rates, and adverse events among different treatment modalities. Results: (1) Clinical data: a total of 87 patients were included, with a mean age of (39.0±5.2) years, a median dysmenorrhea score of 8 and a median course of disease of 5 years. Group LNG-IUS comprised 53 patients with an average age of (40.2±5.2) years and a median dysmenorrhea score of 7 (including 34 cases of severe pain and 17 cases of moderate pain), among whom 24 patients (45.3%, 24/53) had deep infiltrating endometriosis (DIE). Group DNG had 34 patients with an average age of (37.1±4.5) years and a median dysmenorrhea score of 8 (including 21 cases of severe pain and 11 cases of moderate pain), among whom 25 patients (73.5%, 25/34) had DIE. (2) FUAS treatment information: in Group LNG-IUS, the average operation time was (82±29) minutes, with a median irradiation time of 570 s and an average ablation rate of (60.4±22.6)%. In Group DNG, the average operation time was (80±35) minutes, with a median irradiation time of 518 s and an average ablation rate of (58.7±17.8)%. No significant differences were observed in FUAS treatment parameters between the two groups (all P>0.05). (3) Follow-up: dysmenorrhea scores of both groups were significantly lower post treatment (all P<0.001). Different postoperative treatment regimens affected treatment outcomes (P=0.018). Long-term follow-up showed a significant difference in treatment effectiveness between the two groups (P<0.05). Uterine volume had significantly decreased in both groups compared to before treatment (all P<0.001). (4) Adverse events: adverse events during FUAS procedure were all classified as Society of Interventional Radiology (SIR) A-B, and drug-related adverse events were all grade 1-2, with no serious adverse events occurring in either group. Conclusions: Adjuvant therapy with GnRH-a and LNG-IUS or sequential dienogest after FUAS could effectively relieve dysmenorrhea in extrinsic adenomyosis patients, achieving favorable medium- and long-term therapeutic effects. The choice of medication regimen could be based on the patients' condition and personal preference. For patients with coexisting DIE, after contraindications are ruled out, sequential dienogest after FUAS combined with GnRH-a is a viable option.

Whilst guidelines recommend routine frailty screening for elderly patients with head and neck cancer (HNC), no consensus exists on the preferred tool to predict postoperative morbidity. The aim of this study was to assess the predictive capacity of three validated frailty screening tools for postoperative complications in patients undergoing major ablative and reconstructive head and neck surgery. A prospective cohort of 50 patients aged ≥ 70 years undergoing major ablative and reconstructive HNC surgery was recruited from a single institution in Sydney, Australia. Patients completed three frailty assessment tools pre-operatively: the Clinical Frailty Scale (CFS), Modified Frailty Index-5 (mFI-5) and Modified Frailty Index-11 (mFI-11). Postoperative complications were recorded using the Clavien-Dindo Classification (CDC) and the Comprehensive Complication Index (CCI). Logistic regression and ROC analysis were used to assess predictive performance. The CFS increased the odds of severe (CDC ≥ 3) complications five-fold (OR 5.16, 95% CI 1.12, 23.69; AUC 0.70; cut-off 5). Age ≥ 86 years was also a significant predictor of severe complications (OR = 9.00, 95% CI: 1.79, 45.19, p = 0.008, AUC = 0.71), though limited by prevalence. The mFI-5 and mFI-11 demonstrated limited predictive utility for severe complications (AUC = 0.30 and 0.58, respectively). CFS provided the greatest accuracy in predicting severe complications after free-flap surgery, with high specificity and negative predictive value. Age ≥ 86 years also confers high risk. Incorporating CFS into preoperative pathways may guide surgical decision-making and perioperative interventions to improve patient outcomes.

Postoperative weight gain is a recognized complication of deep brain stimulation, but whether ablative surgery produces target-dependent weight effects remains unknown. We investigated whether pallidothalamic tractotomy (PTT) causes greater weight gain than pallidotomy and explored spatial associations. We retrospectively analyzed 79 patients with focal, segmental, or generalized dystonia who underwent unilateral PTT (n = 41) or globus pallidus internus (GPi) lesioning (n = 38). Multivariable linear regression quantified the effect of target on weight and body mass index (BMI) changes, adjusting for age, sex, side, preoperative BMI, follow-up duration, and Burke-Fahn-Marsden dystonia rating scale (BFMDRS) improvement. In a subset with postoperative magnetic resonance imaging (MRI), lesion overlap (N) maps and voxel-wise mean BMI-change maps were generated to explore anatomical associations. PTT resulted in greater postoperative weight gain than GPi lesioning (+6.7 ± 7.5 kg vs. +1.1 ± 4.7 kg), with ≥10 kg gain in 29.3% versus 5.3% of patients. After covariate adjustment, PTT remained independently associated with greater weight gain (adjusted difference + 5.18 kg; 95% confidence interval [CI] +13 to +8.23) and BMI increase (+1.92 kg/m2; 95% CI +0.85 to +2.99). Lesion mapping localized PTT lesions to Forel's field H1. Weight-gain hotspots mapped medial to the inferior border of the subthalamic nucleus, whereas GPi maps showed no consistent intranuclear hotspot. PTT was associated with greater postoperative weight gain than pallidotomy, independent of covariates. These findings suggest that lesion target influences postoperative body-weight regulation, highlighting the potential risk of lesions extending into the caudal subthalamic region. © 2026 International Parkinson and Movement Disorder Society.

Dysphagia following oral cancer ablative surgery with free flap reconstruction significantly impairs quality of life, yet personalized rehabilitation approaches remain understudied. This randomized controlled trial compared a personalized swallowing rehabilitation program with standard care in these patients. This single-center randomized controlled trial enrolled 300 patients with oral squamous cell carcinoma who underwent tumor resection with free flap reconstruction between January 2022 and December 2025 at Shanghai Fengcheng Hospital. Patients were randomly assigned (1:1) to receive either a personalized swallowing rehabilitation program (n=150) incorporating neuromuscular electrical stimulation, surface electromyography biofeedback, tongue pressure resistance training, and individualized exercise protocols, or standard care (n=150) consisting of conventional swallowing exercises. The primary outcome was the Functional Oral Intake Scale (FOIS) score at 6 months. Secondary outcomes included MD Anderson Dysphagia Inventory (MDADI) scores, aspiration rates, time to oral feeding recovery, feeding tube dependency, and aspiration pneumonia incidence, assessed at 1, 3, and 6 months postoperatively. At 6 months, the personalized rehabilitation group demonstrated significantly higher FOIS scores compared with standard care (median, 7 [interquartile range (IQR), 6-7] vs 6 [IQR, 5-6]; Hodges-Lehmann median difference, 1.00; 95% CI, 1.00-1.00; P < 0.001; effect size r = 0.366). The intervention group showed superior MDADI composite scores (median, 75.57 [IQR, 65.99-86.06] vs 65.80 [IQR, 56.30-74.40]; P < 0.001), lower aspiration rates (12.0% vs 21.3%; relative risk, 0.56; P = 0.044), shorter time to oral feeding recovery (median, 15.84 vs 19.80 days; P < 0.001), and reduced feeding tube dependency at 6 months (8.7% vs 28.7%; P < 0.001). Subgroup analyses demonstrated consistent benefits across tumor sites, clinical stages, and reconstruction types, though the effect was attenuated in patients receiving adjuvant chemoradiotherapy (P = 0.201). The mean adherence rate in the intervention group was 78.96% ± 13.34%. A personalized swallowing rehabilitation program significantly improves functional swallowing outcomes, reduces aspiration risk, and enhances swallowing-related quality of life compared with standard care in oral cancer patients following surgical resection with free flap reconstruction. These findings support the integration of individualized, multimodal rehabilitation strategies into routine postoperative management.

The maxilla is an important component of the midfacial skeleton from both an aesthetic and functional view point. In addition to cosmetic impairment, surgical procedures in this region have substantial ramifications for speaking, swallowing and mastication, all of which may lead to psychological anguish for the patient. This necessitates rehabilitation with an obturator prosthesis or surgical reconstruction. The temporalis muscle flap has considerable potential for reconstructing various maxillofacial area abnormalities. It appears to be one of the finest solutions among all other regional flaps due to its consistent blood supply, appropriate mass and anatomical proximity to the maxillary defect. Temporalis myofascial flap is valuable due to the proximity of flap to oral cavity, palate. This is a reliable flap which has less donor site morbidity and functionally and aesthetically accepted. Ten (10) patients who fulfilled the criteria were selected by purposive sampling. Observational study had done. Study was conducted in Oral and Maxillofacial Surgery Department, Dhaka Dental College Hospital, Bangladesh from July 2022 to June 2023. Out of 10 patients 4 (40%) patients were below or equal to 50 years and 6(60.0%) patients were above 50 years. Among all patients, 6(60.0%) patients were female and 4(40.0%) were male. Among all 40.0% had lesion in both buccal and alveolar mucosa, 40.0% had lesion in buccal, alveolar and palatal mucosa and 20.0% had lesion in palatal mucosa. TNM stage-2 were 80.0% and 20.0% TNM stage-3. Post operative radiotherapy and metastatic cases were not considered in this study. Post operative mouth opening was adequate and facial nerve was patent among all patients. Temporal hollowing was present in all patients. Flap was viable in all patients. All patients showed symmetrical face, normal malar prominence whereas one patient showed bulky cheek. Temporalis myofascial flap is a thin, adaptable flap which can be the first line choice of maxillary reconstruction after ablative surgery.

Direct closure of the posterior tibial artery flap donor site defect with an open envelope incision: a prospective non-randomized clinical study.

Analysis of influencing factors for tympanic dysfunction associated with adenoid hypertrophy in children and outcomes after adenoidectomy.