Purpose: Rapid weight loss that often occurs after laparoscopic sleeve gastrectomy (LSG) has been linked to an increased risk of gallstone formation. This study aimed to investigate whether ursodeoxycholic acid could be an effective alternative treatment for gallstone dissolution, potentially offering a nonsurgical option for patients requiring gallstone removal. Methods: This retrospective study analyzed 88 patients who underwent LSG and subsequently developed gallstones between 2017 and 2023. Fifty-one patients who received UDCA treatment were compared to 37 patients who did not receive UDCA. Demographic and clinical characteristics and gallstone dissolution rates were analyzed using SPSS v25.0. Results: Gallstones dissolved in 60% of patients who received UDCA treatment, and symptoms such as dyspepsia decreased. A stone diameter of less than 5 mm was associated with a higher treatment success rate. The number of hospitalizations and admissions due to gallstone symptoms has decreased. The side effects were mild and did not require treatment discontinuation. Conclusions: UDCA treatment is an effective option for the resolution of gallstones after LSG. However, surgery may be more appropriate for treating larger stones. The results of this study suggest that UDCA is an effective intervention for reducing gallstone-related complications following LSG.

To predict breast cancer molecular subtypes with neural networks based on magnetic resonance imaging apparent diffusion coefficient (ADC) radiomics and to detect the relation of lesion size with the stability of radiomics features. This retrospective study included 221 consecutive patients (224 lesions) with breast cancer imaged between January 2015 and January 2020. Three sample size configurations were identified based on tumor size (experiment 1: all cases, experiment 2: >1 cm³, and experiment 3: >2 cm³). The tumors were segmented by three observers based on diffusion-weighted imaging-registered ADC maps, and the volumetric agreement of these segmentations was evaluated using the Dice coefficient. Stability of radiomics features (n=851) was evaluated with intraclass correlation coefficient (ICC, >0.75) and coefficient of variation (CoV, <0.15). Feature selection was made with variance inflation factor (VIF, 0.75, and 37 remained stable in the first experiment, 49 in the second, and 59 in the third based on CoV and VIF analysis. High accuracy was demonstrated by the Luminal B, HER2-enriched, and triple-negative models in the first experiment (>80%), all models in the second experiment, and HER2-enriched and triple-negative models in the third experiment. A positive stability is indicated by an increased lesion size related to radiomics features. Neural networks may predict moleculer subtypes of breast cancers over 1 cm³ with high accuracy.

Background: Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are rare entities. Generally, they can be localized anywhere in the gastrointestinal or hepatobiliary tract. The purpose of our study is to evaluate the effect of tumor location on prognosis in patients with GEP-NET undergoing surgery. Our secondary objective is to examine other factors affecting the prognosis of patients with GEP-NET. Methods: We retrospectively analyzed data from 30 patients with GEP-NET who underwent surgery in the General Surgery Clinic between 2012 and 2022. The gNET group (n=18) included tumors located in the gastrointestinal tract, while the pNET group (n=12) included tumors located in the hepatopancreatobiliary system. Surgical, laboratory, radiological, and pathological findings of the patients, as well as follow-up outcomes were recorded and statistically analyzed. Results: In subgroup comparison, tumor size was found to be larger in the pNET group (P=0.002). The statistical analysis of recurrence (16.7% versus 33.3%) and mortality rates (16.7% versus 41.7%) between the subgroups (P=0.329 and P=0.210, respectively) did not reveal a significant difference. When all patients were evaluated, it was observed that advanced age, presence of carcinoma diagnosis, higher tumor grade, advanced TNM stage, larger tumor size, presence of lymphovascular or perineural invasion, elevated mitotic index, higher Ki-67 index, and having received adjuvant therapy increased the rates of recurrence and mortality. Conclusion: There was no statistically significant difference in survival outcomes between the GEP-NET groups located in the gastrointestinal tract and the hepatopancreatobiliary system.

Purpose: Real-world evidence comparing surgical techniques for symptomatic hemorrhoidal disease (HD) remains limited, despite the availability of multiple approaches. This study aimed to evaluate short-term, interim outcomes from a prospective, nationwide cohort study that compared the effectiveness of different operative techniques based on patient-reported outcome measures (PROMs) in patients with symptomatic HD.Methods: A prospective, nationwide cohort study was conducted at 20 tertiary care centers across Turkiye between July 2022 and July 2024. Adult patients aged 18 years or older with symptomatic HD (grades I–IV) who underwent surgery during this period were included. The choice of procedure was determined by the operating surgeon, and patients were categorized into excisional, fixative, and ablative groups according to the surgical approach used. The primary outcomes were changes in the Hemorrhoidal Disease Symptom Score, Short Health ScaleHD, visual analog scale for pain, and patient satisfaction, assessed from the preoperative period to postoperative day 7 and postoperative week 6.Results: The study included a total of 315 patients after excluding those who did not fulfil the inclusion criteria. Among them, 239 (78.9%) were male, with a mean age of 43.7±11.7 years. The distribution of patients across surgical groups was 207 (65.7%) in the excisional group, 30 (9.5%) in the fixative group, and 78 (24.8%) in the ablative group. All groups demonstrated significant improvements in PROM scores from preoperative to postoperative assessments. However, no statistically significant differences were observed between groups at any time point for PROM scores or for changes in PROM scores across consecutive evaluations (P≥0.05 for all comparisons). Urinary retention occurred more frequently, and hospital stays were longer in the fixative group (P=0.006 and P<0.001, respectively). The excisional group had a greater need for narcotic use and longer duration of use (P=0.003 and P<0.001, respectively).Conclusion: This real-world cohort study shows that all 3 surgical approaches are effective for HD, providing comparable short-term symptomatic relief and patient satisfaction. These techniques appear equally valid treatment options, and the choice of procedure may best be individualized based on patient-specific characteristics and surgeon preference.Trial registration: ClinicalTrials.gov identifier: NCT05429060