Background/Objectives: Emergency surgery for complicated colon cancer carries high morbidity and mortality, largely driven by systemic inflammation and organ dysfunction. This study aims to investigate the predictive value of preoperative inflammatory biomarkers for postoperative outcomes. Methods: We retrospectively analyzed 219 patients undergoing emergency surgery for complicated colon cancer. Patients were classified as uncomplicated (n = 164) or complicated (Clavien–Dindo ≥ IIIA; n = 55). Preoperative clinical data, comorbidity indices, laboratory values, and inflammatory markers: C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) were assessed. Logistic regression and ROC (Receiver Operating Characteristic) curves analyses identified predictors of Clavien Dindo complications graded as IIIA or higher, anastomotic leak (AL), and in-hospital mortality. Results: Most patients included in the study were males (75.02%), with a mean age of 69.63 (±11.54) years. Patients included in the complicated group had higher comorbidity burden, ASA (American Society of Anesthesiologists) grade, rates of diabetes, organ failure, and systemic inflammatory response. All inflammatory biomarkers were significantly elevated in the complicated group (p < 0.001). CRP (>62.8 mg/dL), NLR (>6.89), and PLR (>334.2) showed good discrimination for Clavien Dindo complications graded as IIIA or higher, with AUC (area under curve) ranging from 0.726 to 0.799. A multivariable model including Charlson Comorbidity Index (CCI), CRP, PLR, and diabetes predicted Clavien–Dindo ≥ IIIA complications with excellent accuracy (AUC 0.870). PLR, creatinine, and diabetes independently predicted AL (AUC 0.834). Mortality (20.5%) was strongly associated with peritonitis, CRP, and NLR (AUC 0.891). Conclusions: Preoperative inflammatory biomarkers, combined with comorbidity and renal function, reliably predict adverse outcomes after emergency colon cancer surgery. Multivariate models may be useful for early risk stratification and support individualized perioperative management.

Background: Acute malignant colorectal obstruction requires urgent management, traditionally by emergency resection or stoma formation. Colonic stenting as a bridge to surgery (BTS) has emerged as an alternative, but concerns persist regarding oncologic safety. This systematic review evaluates short-term and long-term outcomes of BTS with self-expanding metal stents (BTS-stent) compared with acute resection (AR). Methods: A systematic review was conducted on multiple databases. PubMed, Cochrane Library, and Google Scholar were searched for studies published between 2015 and 2025 reporting surgical management of obstructive colon cancer. Outcomes included perioperative morbidity and mortality, laparoscopic conversion, stoma formation, stent-related complications, and long-term overall survival (OS) and disease-free survival (DFS). Data were synthesized descriptively with reference to reported comparative effects and prior meta-analyses. Results: Fifteen studies published between 2015 and 2025 were included, encompassing 6999 patients (AR: 4944; BTS-stent: 1739; other BTS: 311). BTS was associated with higher rates of laparoscopic surgery (57% vs. 14%) and primary anastomosis, and significantly reduced stoma formation (27% vs. 60%). Postoperative morbidity and 30-day mortality were lower or comparable in BTS cohorts (4.9% vs. 7.8%). SEMS technical success ranged from 78 to 97%, with perforation rates of 0–15%, representing the main adverse event. Long-term outcomes were comparable between groups. Five-year OS ranged from 46 to 75% (BTS) and 46 to 74% (AR), with similar DFS. Subgroup data suggested possible worse outcomes in T4 tumors and improved results in selected stage III patients. Delayed surgery (>4 weeks) may improve survival, but increases complication risk. Conclusions: BTS with SEMS improves short-term outcomes without compromising long-term survival. Careful selection and avoidance of perforation are essential.

Background/Objectives: Diabetic macular edema (DME) are major causes of visual impairment worldwide, with vascular endothelial growth factor (VEGF) playing a central role in disease pathogenesis. Intravitreal anti-VEGF therapy is the current standard of care for center-involving DME. Methods: This narrative review summarizes and compares the pharmacological properties, clinical efficacy, safety, and real-world performance of aflibercept and brolucizumab in the treatment of DME, based on randomized controlled trials and observational studies published between 2014 and 2025. Results: Both agents demonstrate significant improvements in visual acuity and retinal anatomy. Brolucizumab has shown non-inferior visual outcomes and, in several studies, greater reductions in central retinal thickness with the potential for extended dosing intervals, suggesting reduced treatment burden. However, post-marketing data have identified an increased risk of intraocular inflammation, including retinal vasculitis and retinal vascular occlusion, associated with brolucizumab, which has influenced its clinical use. Conclusions: Both aflibercept and brolucizumab are effective anti-VEGF therapies for diabetic macular edema, but they differ in durability and safety considerations. Aflibercept remains a reliable first-line option for many patients, while brolucizumab may be considered in carefully selected cases where treatment burden is a priority. Individualized treatment selection based on clinical characteristics, patient preferences, and safety considerations is essential for optimizing long-term outcomes.

Background: Non-proliferative diabetic retinopathy (NPDR) is a common microvascular complication of type 2 diabetes mellitus (T2DM) associated with chronic inflammation, metabolic dysregulation, and multiple interacting systemic factors. This study evaluated the associations of inflammatory biomarkers, serum 25-hydroxyvitamin D [25(OH)D], electrolyte homeostasis, and lipid-derived indices with NPDR. Methods: In this cross-sectional study with prospective recruitment, 98 patients with T2DM were classified into NPDR (n = 55) and non-DR (n = 43) groups. Clinical characteristics, hematological inflammatory indices, serum interleukin-6 (IL-6), C-reactive protein (CRP), 25(OH)D, electrolyte concentrations, lipid profile, and derived biomarkers—including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune–inflammation index (SII), LDL-C/HDL-C ratio, and calculated serum osmolarity—were compared. Receiver operating characteristic (ROC) analysis and multivariable logistic regression were performed to assess discriminatory performance and independent associations with NPDR. Results: Patients with NPDR had significantly lower serum 25(OH)D concentrations than the non-DR group (16.6 ± 7.5 vs. 21.0 ± 5.2 ng/mL, p < 0.001). Serum IL-6 levels (4.2 ± 3.1 vs. 2.8 ± 1.4 pg/mL, p = 0.047), NLR (p = 0.043), LDL-C/HDL-C ratio (p = 0.031), and calculated serum osmolarity (p = 0.033) were significantly higher, whereas lymphocyte count and the lymphocyte-to-monocyte ratio were significantly lower. Among individual biomarkers, serum 25(OH)D showed the best discriminatory performance (AUC = 0.712). A multivariable model including insulin therapy, IL-6, serum 25(OH)D, and the LDL-C/HDL-C ratio demonstrated good discrimination (AUC = 0.813), with 81.8% sensitivity and 81.4% specificity. Bootstrap validation supported the stability of the model. Conclusions: NPDR was associated with lower serum 25(OH)D concentrations, systemic inflammation, and a less favorable LDL-C/HDL-C ratio. A multivariable model integrating inflammatory, metabolic, and nutritional biomarkers showed better discriminatory performance than individual biomarkers. The association between insulin therapy and NPDR likely reflects greater diabetes severity rather than a direct effect of insulin. These findings are exploratory, and prospective studies in larger independent cohorts are needed to determine whether these biomarkers improve risk stratification beyond established clinical factors.

Background and Objectives: In difficult clinical settings, laparoscopic cholecystectomy remains linked to higher conversion rates, prolonged operative time and an increased risk of bile duct injury. Near-infrared fluorescence cholangiography using indocyanine green (ICG) was developed as a real-time intraoperative imaging technique aimed at improving biliary anatomy visualization, reducing the need for cystic duct cannulation or use of ionizing radiation. We hypothesize that the variable performance of ICG fluorescence cholangiography might not be an intrinsic property of the technique, depending instead on the administration protocol, the specifications of the NIR devices and technical factors, patient characteristics, and the severity of the disease. The aim of the present narrative review with systematic search is to critically evaluate the available primary clinical evidence on the role of ICG fluorescence cholangiography as a tool in general and in difficult laparoscopic cholecystectomy, with special focus on biliary anatomy visualization, protocol heterogeneity, operative outcomes and evidence limitations. Materials and Methods: We conducted a systematic literature search in PubMed, Cochrane Library, and Web of Science to identify original studies published between 2015–2026 that evaluated ICG fluorescence during laparoscopic cholecystectomy. Afterwards, findings were synthesized narratively based on clinically relevant themes. Results: A total of 24 studies were included in the analysis. Several studies reported improved visualization of biliary anatomy using ICG fluorescence compared to conventional white-light imaging. Visualization improved with progression of dissection in Calot’s triangle. Potential clinical benefits suggested for technically difficult procedures (acute cholecystitis, severe inflammation, presence of adhesions, obese patients or distorted anatomy) remain uncertain, as these conditions also reduce fluorescence visibility. Some studies reported shorter times to biliary structure identification and achievement of the critical view of safety. Considerable heterogeneity persists regarding several variables: ICG dose and timing, the route of administration, and patient selection. Conclusions: Globally, the main benefits of ICG fluorescence cholangiography are the enhancement of biliary anatomy identification and the improvement of operative efficiency. Future randomized trials using standardized fluorescence protocols are needed to determine the optimal administration routes and doses of ICG and identify whether improved visualization translates into meaningful surgical and clinical improvements.