Background/Objectives: Acute appendicitis (AA) is among the most common surgical emergencies. Differentiating between complicated (CAA) and uncomplicated (UAA) forms is essential for selecting the appropriate management—operative or non-operative—and for optimizing patient prioritization and outcomes. This study aimed to evaluate the diagnostic performance of emerging inflammatory indices in distinguishing these forms of AA. Methods: A total of 514 adult patients with surgically confirmed AA were retrospectively analyzed. Six immune-inflammatory indices—neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and pan-immune-inflammation value (PIV)—were calculated and compared with intraoperative and histopathological findings. Postoperative outcomes, including length of hospital stay (LOS) and hospitalization costs, were also evaluated. Results: All six indices were significantly higher in intraoperatively identified complicated cases (p < 0.0001). In histopathological analysis, five indices (NLR, MLR, SII, SIRI, and PIV) remained significantly elevated in patients with wall necrosis or perforation (p = 0.000–0.019), while PLR did not reach statistical significance. The indices showed fair diagnostic accuracy (AUC = 0.664–0.719, p < 0.0001). NLR and MLR were independent risk factors for CAA (p = 0.006 and p = 0.016), and MLR was also independently associated with complicated histopathological findings (p = 0.036). PIV independently predicted both increased LOS and higher hospitalization costs (p = 0.001 for each). Conclusions: These easily calculable inflammatory markers can serve as useful adjuncts for preoperative stratification of AA, supporting timely decision-making and contributing to more cost-effective emergency surgical care.

Background/Objectives: Cervical cancer primarily disseminates through the lymphatic system, with the metastatic involvement of pelvic and para-aortic lymph nodes significantly impacting prognosis and treatment decisions. Sentinel lymph node (SLN) mapping is critical in guiding surgical management. However, resource-limited settings often lack advanced detection tools like indocyanine green (ICG). This study evaluated the feasibility and effectiveness of SLN biopsy using alternative techniques in a high-risk population with a high prevalence of large tumours. Methods: This prospective, observational study included 42 patients with FIGO 2018 stage IA1–IIA1 cervical cancer treated between November 2019 and April 2024. SLN mapping was performed using methylene blue alone or combined with a technetium-99m radiotracer. Detection rates, sensitivity, and false-negative rates were analysed. Additional endpoints included tracer technique comparisons, SLN localization patterns, and factors influencing detection success. Results: SLNs were identified in 78.6% of cases, with bilateral detection in 57.1%. The combined technique yielded higher detection rates (93.3% overall, 80% bilateral) compared to methylene blue alone (70.4% overall, 40.7% bilateral, p < 0.05). The sensitivity and negative predictive values were 70% and 93.87%, respectively. Larger tumours (>4 cm), deep stromal invasion, and prior conization negatively impacted detection rates. False-negative SLNs were associated with larger tumours and positive lymphovascular space invasion. Conclusions: SLN biopsy is feasible in resource-limited settings, with improved detection rates using combined tracer techniques. However, sensitivity remains suboptimal due to a steep learning curve and challenges in high-risk patients. Until a high detection accuracy is achieved, SLN mapping should complement, rather than replace, pelvic lymphadenectomy in high-risk cases.

Background: Major morbidity and mortality remain important concerns after colorectal cancer (CRC) surgery. Cancer-related sarcopenia and heightened systemic inflammation may increase the risk of early postoperative major complications. Methods: In this retrospective single-center study, we analyzed 190 patients undergoing major CRC surgery. Skeletal muscle gauge (SMG) and the pan-immune-inflammation value (PIV) were assessed as preoperative risk markers, and 30-day major complications were evaluated. Results: Low SMG was strongly associated with major complications (OR 6.50, 95% CI 3.24–13.05; p < 0.001), and high PIV was also associated with increased risk (OR 3.51, 95% CI 1.77–6.99; p < 0.001). In multivariable analysis adjusting for age, surgical urgency, and procedure type, low SMG and emergency surgery remained independent predictors of 30-day major complications. The highest-risk phenotype (high PIV/low SMG; n = 23) had a major complication rate of 78.3% (18/23) (p < 0.001). A clinical model including age, urgency, and procedure type yielded an AUC of 0.739 (95% CI 0.661–0.816). Adding low SMG improved discrimination (AUC 0.784, 95% CI 0.711–0.857), with only a small additional increase after adding high PIV (AUC 0.791, 95% CI 0.717–0.864). Conclusions: Preoperative low SMG was independently associated with 30-day major complications after CRC surgery, while PIV provided complementary risk-stratification value. The combined high-PIV/low-SMG phenotype identified patients with particularly high postoperative risk.

Sciendo provides publishing services and solutions to academic and professional organizations and individual authors. We publish journals, books, conference proceedings and a variety of other publications.

Introductionː A strong connection between inflammation and obesity was repeatedly described, with the latter defined as a chronic low-degree systemic inflammatory state. This study analyzed the correlations between inflammatory blood indexes and both baseline anthropometric measurements and the weight–loss process after bariatric surgery. Methodsː An observational study was conducted on patients with obesity admitted for metabolic surgery in a private and a public hospital. The primary endpoints were to establish correlations between baseline inflammatory ratios i.e. neutrophil to lymphocyte (NLR), platelet to lymphocyte (PLR), monocyte to lymphocyte (MLR), monocyte to high-density lipoprotein cholesterol (MHR) ratios, systemic inflammatory index (SII) and anthropometric measurements. Secondary endpoints were to find out if these ratios measured at baseline are predictive factors for weight loss after bariatric surgery. Results: In the present study, we included 191 patients, mean age 39.1±10,7 and mean BMI 42,2±6,5 kg/m2. There was a positive correlation between MHR and all anthropometric measurements taken at baseline; a direct correlation was also found for MLR in regards to initial weight and waist circumference. No statistical correlations were found between the above-mentioned indexes and the weight loss process (measured as a percentage of excess weight loss - %EWL) at different follow-up timeframes. Conclusionsː Monocyte to high-density lipoprotein cholesterol ratio (MHR) was positively associated with baseline anthropo-metric measurements in patients with obesity. The above-mentioned inflammatory ratios did not correlate with the weight loss process after bariatric surgery, thus they should not be used as predictors of good postoperative results.