Background: The primary treatment for colorectal cancer, which is very prevalent, is surgery. Anastomotic leaking poses a significant risk following surgery. Intestinal perfusion can be objectively and instantly assessed with indocyanine green fluorescence imaging, which may lower leakage rates and enhance surgical results. Methods: PubMed, Embase, and Web of Science databases were systematically searched using relevant keywords from inception until 5th of March 2025. Eight studies were included after final screening. Outcomes were reported as overall anastomotic leakage, wound infection, paralytic ileus, mechanical ileus, and post-operative hospital stay. Interstudy heterogeneity was assessed using I ² and X ² statistics (I ² > 50% = significant heterogeneity). Statistical calculations were performed using Review Manager 5.4.1 (The Cochrane Collaboration, Copenhagen, Denmark), with a p-value of < 0.05 indicating statistical significance. Results: This meta-analysis includes 4047 patients from eight investigations (2026 indocyanine green (ICG) group, 2021 non-ICG group). Overall anastomotic leak risk was considerably decreased with ICG use (risk ratio (RR) = 0.66; 95% CI: 0.54–0.81; p < 0.0001) and showed no heterogeneity (I ² = 0%). There was no heterogeneity (I ² = 0%) in the Grade A leakage occurrence, which was considerably lower in the ICG group (RR = 0.34; 95% CI: 0.16–0.72; p = 0.005). With little heterogeneity (I ² = 8.6%), combined leakage grades also supported ICG use (RR = 0.54; 95% CI: 0.35–0.84; p = 0.006). ICG was associated with a substantial decrease in Clavien–Dindo Grade I complications (RR = 0.67; 95% CI: 0.49–0.92; p = 0.01) without heterogeneity (I ² = 0%). Initial postoperative hospital stays, mechanical ileus, paralytic ileus, and abdominal bleeding did not differ significantly. Although there was no heterogeneity (I ² = 0%), sensitivity analysis showed that the ICG group had a substantially longer postoperative stay (MD = 0.27; 95% CI 0.05–0.49; p = 0.02) and significantly fewer wound infections (RR = 0.17; 95% CI 0.04–0.76; p = 0.02). With noteworthy heterogeneity (I ² = 70%), the ICG group’s operating time was significantly longer (MD = 8.26 min; 95% CI 0.52–16.00; p = 0.04). Conclusion: Although indocyanine green fluorescence imaging may marginally lengthen the recovery period and duration of operation, it dramatically lowers anastomotic leakage and wound infections following colorectal surgery, enhancing results.

Introduction: Acute ischemic stroke (AIS) is the most common type of stroke, with increasing incidence and significant healthcare costs. Tenecteplase (TNK), a modified variant of tissue plasminogen activator (tPA), offers advantages such as a longer half‐life and single‐bolus administration. This meta‐analysis evaluates the safety and efficacy of TNK compared to non‐thrombolytic management in AIS to guide clinical decision‐making. Methodology: A comprehensive literature search across major databases identified randomized controlled trials (RCTs) comparing tenecteplase with non‐thrombolytic care in ischemic stroke. Data extraction and bias assessment were conducted independently, using RoB 2.0 and the GRADE framework. Meta‐analysis was performed using RevMan 5.4.1, applying random‐effects models and assessing heterogeneity with the I ² statistic. Results: This meta‐analysis included seven studies with 3266 patients and found no significant difference between tenecteplase and standard medical care in terms of the mRS score at 90 days (mean difference = −0.16, p = 0.58), functional independence (mRS 0–2 at 90 days) (odds ratio = 1.07, p = 0.51), and reperfusion (TICI 2b‐3 at 24 h) (odds ratio = 1.33, p = 0.39). However, tenecteplase was associated with significantly higher mRS 0–1 at 90 days (odds ratio = 1.22, p = 0.01), better recanalization at 24 h (odds ratio = 3.28, p = 0.04), and improved NIHSS scores at 7 days (mean difference = −0.71, p = 0.003). On the downside, tenecteplase showed a significantly higher incidence of symptomatic intracranial hemorrhage (SICH) within 36 h (odds ratio = 2.24, p = 0.04) and any ICH (odds ratio = 1.40, p = 0.04), with no significant differences in mortality at 90 days (odds ratio = 1.18, p = 0.33) or stroke recurrence (odds ratio = 1.23, p = 0.55) and Barthel Index Score (odds ratio = 1.09, p = 0.69) and quality of life. Serious adverse events were slightly higher in the tenecteplase group but did not reach statistical significance (odds ratio = 1.18, p = 0.23). Conclusion: Tenecteplase improves early neurological recovery and recanalization and provides excellent functional outcomes in acute ischemic stroke. However, it is associated with a higher risk of symptomatic and overall intracranial hemorrhage. Mortality, stroke recurrence, and overall functional independence remain unaffected.

Aortic valve stenosis in patients with chronic liver diseases, particularly liver cirrhosis and End-Stage Liver Disease, poses significant management challenges due to the interplay between cardiovascular and hepatic dysfunction. This systematic review and meta-analysis compared the safety and efficacy of Transcatheter Aortic Valve Replacement (TAVR) and Surgical Aortic Valve Replacement in this high-risk population. An extensive search of PubMed, Embase, and Web of Science (inception to January 5, 2025) identified 11 retrospective studies comprising 19,097 patients. Risk ratios for dichotomous outcomes and mean differences (MD) for continuous outcomes, each with 95% confidence intervals, were calculated using random-effects models. The analysis revealed that TAVR significantly reduced hospital mortality (RR 0.36, 95 % CI: 0.30-0.42; I² = 7.6 %), acute kidney injury (RR 0.51, 95 % CI: 0.33-0.78; I² = 57.2 %), bleeding (RR 0.33, 95 % CI: 0.28-0.39; I² = 0.0 %), stroke (RR 0.35, 95 % CI: 0.23-0.51; I² = 6.1 %), and blood transfusion (RR 0.48, 95 % CI: 0.40-0.57; I² = 7.6 %). TAVR was also associated with shorter hospital stays (MD -6.77 days, 95 % CI: -9.17 to -4.38; I² = 97.5 %). No significant differences were observed in vascular complications requiring surgery or hospital charges and post-operative infections. These findings suggest TAVR offers significant advantages over SAVR in reducing complications such as mortality, acute kidney injury, and bleeding in patients with liver disease. However, further randomized trials are necessary to confirm long-term outcomes and establish optimal treatment strategies for this high-risk population.

Objective: This meta-analysis aims to compare the clinical outcomes of the no-touch (NT) and conventional (CON) vein harvesting techniques in patients undergoing coronary artery bypass grafting (CABG). Methods: We conducted a systematic review and meta-analysis following the guidelines of the Cochrane Handbook and PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) statement. We searched PubMed, Embase and Web of Science for randomised controlled trials (RCTs) comparing NT and CON vein harvesting techniques in CABG patients. Data were extracted on primary outcomes (graft failure incidence per patient, graft occlusion incidence per patient and leg infection) and secondary outcomes (revascularisation, all-cause death, myocardial infarction). Statistical analysis was performed using Review Manager V.5.4, with risk ratios (RRs) calculated for binary outcomes. Results: Seven RCTs involving 4176 patients were included. The NT group showed a significantly lower risk of graft failure incidence per patient (RR=0.74, p=0.0001) and graft occlusion incidence per patient (RR=0.62, p=0.0002) compared with the CON group. However, the NT group had a higher risk of leg infection (RR=1.91, p<0.00001). No significant differences were observed between groups for revascularisation (p=0.46), all-cause death (p=0.87), or myocardial infarction (p=0.95). Conclusions: The no-touch vein harvesting technique is associated with reduced graft failure incidence per patient and graft occlusion incidence per patient compared with conventional harvesting techniques in CABG, though it increases the risk of leg infection. These findings suggest NT as a preferable technique for improving graft patency but highlight the need for caution regarding leg infection. PROSPERO registration number: CRD42025646500.