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.

Background: One of the most common causes of lower back and radicular leg discomfort, especially in those between the ages of 30 and 50, is lumbar disc herniation (LDH). It frequently affects mobility and quality of life and is caused by disc debris squeezing spinal nerves. In order to treat LDH, this study contrasts the perioperative results, safety, and effectiveness of unilateral biportal endoscopic discectomy (UBED) and percutaneous endoscopic lumbar discectomy (PELD). Methods: PubMed, Embase, and Cochrane databases were systematically searched using relevant keywords from inception until July 2025. A total of nine studies were included after final screening. Outcomes were reported as Change in VAS Leg at 6 months, Change in VAS back at 6 months, Change in ODI at 6 months, Operating time, etc. Interstudy heterogeneity was assessed using I² and X² statistics (I²>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 included 9 observational studies with 845 patients, with 387 in the UBED group and 458 in the PELD group. Both procedures showed comparable improvement in leg pain (VAS Leg: MD = 0.16; 95% CI: − 0.06 to 0.38; p = 0.15), back pain (VAS Back: MD = 0.12; 95% CI: − 0.12 to 0.36; p = 0.32), and functional outcomes (ODI: MD = 2.63; 95% CI: − 10.14 to 15.39; p = 0.69). However, PELD was associated with shorter operative time (MD = 16.66 min; 95% CI: 7.48 to 25.83; p < 0.001), less intraoperative blood loss (MD = 33.99 mL; 95% CI: 17.32 to 50.65; p < 0.0001), and shorter hospital stay (MD = 1.80 days; 95% CI: 0.33 to 3.27; p = 0.02). Complication rates were statistically similar between groups (RR = 0.76; 95% CI: 0.30 to 1.96; p = 0.58). Conclusion: For Lumbar Disc Herniation, UBED and PELD offered similar clinical results. PELD, however, exhibits benefits in terms of recovery (shorter hospital stay), blood loss, and operating time. UBED is still useful for complicated herniations. Additional high-quality studies are required to validate long-term safety and effectiveness.

Background: Amiodarone and lidocaine are antiarrhythmic agents recommended for advanced cardiac life support in shockable ventricular arrhythmias during cardiac arrest, yet their comparative effectiveness in in-hospital (IHCA) and out-of-hospital cardiac arrest (OHCA) remains uncertain. Methods: From 930 records identified in PubMed, ScienceDirect, Embase, and Cochrane Library, 14 studies were included. Outcomes were analyzed using random-effects meta-analysis in R with IHCA and OHCA subgroup analyses. Bayesian meta-analysis using the bayesmeta package assessed result credibility. Results: Amiodarone did not improve return of spontaneous circulation (R0SC) compared with lidocaine (Risk ratio (RR) 0.96, p = 0.40). In IHCA, amiodarone was associated with lower survival to hospital discharge (RR 0.88, p < 0.0001), lower 24 h survival (RR 0.93, p < 0.0001), worse neurological recovery (RR 0.83, p < 0.0001), and longer arrest duration (Mean difference (MD) 7.46 min, p = 0.002). Termination of shockable rhythms favored lidocaine only after sensitivity analysis (RR 0.51, p = 0.02). In OHCA, amiodarone did not improve survival to discharge (RR 0.93, p = 0.44), while return of spontaneous circulation favored lidocaine after sensitivity analysis (RR 0.88, p = 0.002). No consistent benefit was observed across outcomes. Bayesian analysis showed overlapping credible intervals and low probabilities of benefit, indicating no clear superiority. Conclusions: No survival difference was observed between amiodarone and lidocaine arrest. Although lidocaine showed more favorable in-hospital outcomes, long-term survival was similar, suggesting agents may be selected based on availability and practice.

Background: Pulmonary hypertension (PH) is associated with increased pulmonary arterial pressure and impairment of right ventricular (RV) function. Reliable characterization of RV performance is important for prognosis, risk assessment, and therapeutic planning. Cardiac magnetic resonance (CMR) is considered the reference technique for quantifying RV volumes and function, but its expense and limited availability can restrict routine implementation. Echocardiography is more widely accessible; however, the extent to which individual echocardiographic indices correspond with CMR-derived RV ejection fraction (RVEF) remains incompletely defined. Objective: Our objective was to determine the correlation of RV fractional area change (RV-FAC), RV free-wall longitudinal strain (RV-FWLS), and RV global longitudinal strain (RV-GLS) with CMR-derived RVEF in individuals with PH. Methods: PubMed, Embase, ClinicalTrials.gov, Scopus, and the Cochrane Library were searched, yielding 404 records; six studies fulfilled the eligibility criteria. Studies were eligible when they enrolled patients with PH and provided extractable correlations between at least one prespecified echocardiographic measure and CMR-derived RVEF. Correlation coefficients were converted with Fisher’s z transformation, combined using common-effect and random-effects approaches, and then transformed back to correlation coefficients. Pooled mean RV-FAC was evaluated as a separate outcome. Between-study heterogeneity was quantified with I² and τ², with random-effects estimates emphasized for interpretation. Results: Each evaluated echocardiographic measure was positively correlated with CMR-derived RVEF. RV-FWLS had the largest pooled correlation and the greatest consistency (r = 0.79, 95% CI: 0.73–0.83; I² = 0.0%). The pooled correlation for RV-GLS was 0.75 (95% CI: 0.60–0.85; I² = 80.3%), while that for RV-FAC was 0.72 (95% CI: 0.61–0.80; I² = 61.8%). The random-effects pooled mean RV-FAC was 31.10% (95% CI: 26.77–35.43), with substantial heterogeneity (I² = 90.9%). Conclusions: RV-FWLS showed the highest numerical and most consistent association with CMR-derived RVEF, suggesting that it may serve as a useful non-invasive adjunct for RV assessment in PH, especially where CMR is not readily available. Larger studies using harmonized acquisition and analysis methods are required for confirmation.

Background: Atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF) usually coexist and are related to increased morbidity and mortality. Cardiovascular benefits have been demonstrated by drugs such as sodium-glucose cotransporter-2 inhibitors (SGLT2i) and GLP-1 receptor agonists including the dual GIP/GLP-1 receptor agonist tirzepatide (collectively, incretin-based therapies); however, their relative effectiveness in patients with concomitant AF and HFpEF remains undefined. Methods: We conducted a retrospective, propensity score-matched cohort study utilizing the TriNetX Global Collaborative Network. Adults with AF or atrial flutter with a diagnosis of HFpEF who initiated incretin-based therapies (GLP-1 receptor agonists or dual GLP-1/GIP receptor agonists) or SGLT2i were included; index medication was required to be initiated within 30 days of a qualifying AF/HFpEF diagnosis. 1:1 matching was performed based on baseline medications, demographics, and comorbidities. Co-primary outcomes were all-cause mortality, inpatient visits, and emergency department (ED) visits at 1 year. Secondary outcomes included myocardial infarction, ischemic stroke, acute kidney injury, transient ischemic attack, major adverse cardiovascular events (MACE; all-cause mortality/MI/stroke composite), and AF-related procedures. Agent-specific subgroup analyses were performed for semaglutide and tirzepatide separately. Sensitivity analyses were conducted at 6 months and 2 years. Results: 7624 patients were included in each cohort after matching (mean age: 70.8 years; 52% women). At 1 year, incretin-based therapy was associated with lower all-cause mortality (5.3% vs. 7.3%, HR 0.721, 95% CI 0.634–0.820; p < 0.001), fewer inpatient visits (30.0% vs. 37.4%, HR 0.743, 95% CI 0.702–0.787; p < 0.001), and no statistically significant difference in ED visits (27.0% vs. 28.0%; HR 0.946, 95% CI 0.888–1.007; p = 0.081) compared with SGLT2i. Incretin-based therapy was also associated with lower risk of MACE (HR 0.709), acute kidney injury (HR 0.751), myocardial infarction (HR 0.583), catheter ablation (HR 0.685), and electrical cardioversion (HR 0.472). No significant differences were observed in ischemic stroke or transient ischemic attack. These findings were broadly consistent at 6-month and 2-year follow-up, and directionally consistent in agent-specific subgroup analyses of semaglutide and tirzepatide. Conclusions: In this large propensity-matched cohort of patients with AF and HFpEF, initiation of incretin-based therapy (GLP-1 receptor agonists or dual GLP-1/GIP receptor agonists) was associated with lower all-cause mortality, fewer inpatient visits, and reduced cardiovascular events compared with SGLT2i. These findings, while subject to observational limitations, suggest potential benefits of incretin-based therapy in this high-risk population and support the need for prospective comparative trials.

Introduction: Atrial fibrillation (AF) is highly prevalent in heart failure (HF) and is linked to increased mortality and hospitalization in both preserved (HFpEF) and reduced ejection fraction (HFrEF). Catheter ablation (CA) has emerged as an effective rhythm-control strategy beyond medical therapy (MT), but phenotype-specific differences remain unclear. We compared the efficacy and safety of CA versus MT in AF with HFpEF or HFrEF. Methods: PubMed, Embase, Scopus, and Cochrane databases were searched through December 2025. Random-effects meta-analyses were conducted in R (version 4.5.3), reporting risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs). Results: Fifteen studies involving 27,130 patients (CA: 13,579; MT: 13,551) were included. Catheter ablation significantly reduced overall all-cause mortality (RR 0.44), with a significant benefit in HFpEF (RR 0.44), whereas the reduction in HFrEF did not reach statistical significance (RR 0.53, 95% CI 0.21–1.38). Cardiovascular mortality and cardiovascular hospitalization were also reduced overall, without significant differences between HF phenotypes. Stroke and atrial arrhythmia recurrence were not significantly reduced in the primary analyses, and favorable findings observed in sensitivity analyses were considered exploratory . Catheter ablation significantly improved LVEF in HFrEF but not in HFpEF, while effects on exercise capacity and biomarkers varied across outcomes and phenotypes. Adverse events were comparable between treatment strategies. Conclusion: Catheter ablation was associated with favorable clinical outcomes compared with medical therapy in AF with HF; however, the magnitude and statistical certainty of benefit varied across heart failure phenotypes and outcomes.