Hydrogels are hydrophilic, soft polymer networks with high water content and mechanical properties that are tunable; they are also biocompatible. Therefore, as biomaterials, they are of interest to modern medicine. In this review, the main applications of hydrogels in essential clinical applications are discussed. Chemical, physical, or hybrid crosslinking of either synthetic or natural polymers allow for the precise control of hydrogels’ physicochemical properties and their specific characteristics for certain applications, such as stimuli-responsiveness, drug retention and release, and biodegradability. Hydrogels are employed in gynecology to regenerate the endometrium, treat infections, and prevent pregnancy. They show promise in cardiology in myocardial infarction therapy through injectable scaffolds, patches in the heart, and medication delivery. In rheumatoid arthritis, hydrogels act as drug delivery systems, lubricants, scaffolds, and immunomodulators, ensuring effective local treatment. They are being developed, among other applications, as antimicrobial coatings for stents and radiotherapy barriers for urology. Ophthalmology benefits from the use of hydrogels in contact lenses, corneal bandages, and vitreous implants. They are used as materials for chemoembolization, tumor models, and drug delivery devices in cancer therapy, with wafers of Gliadel presently used in clinics. Applications in abdominal surgery include hydrogel-coated meshes for hernia repair or Janus-type hydrogels to prevent adhesions and aid tissue repair. Results from clinical and preclinical studies illustrate hydrogels’ diversity, though problems remain with mechanical stability, long-term safety, and mass production. Hydrogels are, in general, next-generation biomaterials for regenerative medicine, individualized treatment, and new treatment protocols.

Over the course of nearly six decades since the inception of initial trials involving 5-FU in the treatment of mCRC (metastatic colorectal cancer), our progressive comprehension of the pathophysiology, genetics, and surgical techniques related to mCRC has paved the way for the introduction of novel therapeutic modalities. These advancements not only have augmented the overall survival but have also positively impacted the quality of life (QoL) for affected individuals. Despite the remarkable progress made in the last two decades in the development of chemotherapy, immunotherapy, and target therapies, mCRC remains an incurable disease, with a 5-year survival rate of 14%. In this comprehensive review, our primary goal is to present an overview of mCRC treatment methods following the latest guidelines provided by the National Comprehensive Cancer Network (NCCN), the American Society of Clinical Oncology (ASCO), and the American Society of Colon and Rectal Surgeons (ASCRS). Emphasis has been placed on outlining treatment approaches encompassing chemotherapy, immunotherapy, targeted therapy, and surgery's role in managing mCRC. Furthermore, our review delves into prospective avenues for developing new therapies, offering a glimpse into the future of alternative pathways that hold potential for advancing the field.

IntroductionPain is one of the most substantial factors responsible for lowering quality of life in patients with intestinal diseases. Its multifactorial pathogenesis makes intestinal pain difficult to manage with currently available medications, especially considering the risk of serious adverse effects and exacerbation of underlying disease.Areas coveredThe most commonly administered drugs in intestinal pain are medications forming the so-called analgesic ladder, which act directly on pain sensation: acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), and opioids in full range of activity strength. However, there are also many groups of supportive medications, which target intestinal pain indirectly and therefore, differs in applicability depending on underlying conditions and their pathophysiology, e.g. antispasmodics, antidepressants, probiotics, and biological anti-inflammatory drugs. In this review, we concentrated on possible analgesic options in patients suffering from irritable bowel syndrome (IBS), inflammatory bowel diseases (IBD), and colorectal cancer (CRC). Moreover, we examined future perspectives in treating abdominal pain with medications targeting transient receptor potential channels, the endocannabinoid system and other promising options, including new formulations of already known drugs and new peripherally restricted opioids.Expert opinionThere is constant need for improvement of intestinal analgesia and novel pharmacological approaches, from which interaction with TRP receptors is a particularly promising direction.

Purpose: The accessory spleen is quite a common abdominal anomaly. However, the traumatic accessory spleen rupture is an extremely rare condition requiring surgical intervention, even laparotomy. 9 cases of traumatic accessory spleen were found published between 1962 and 2022. The study aims to evaluate traumatic accessory spleen rupture cases regarding their causes, clinical course, and possible diagnosis without surgery and treatment. Methods: Desk research method using available online databases. Descriptive methods were employed to analyze the collected data. The results are summarized in the Table concerning gender, age, injury details, accessory spleen injury characteristics, treatment, and others such as previous splenectomy or primary spleen involvement in injury or accompanying abdominal injuries. Results: In total, there were 9 cases of traumatic accessory spleen, of which 2 were managed conservatively and the remaining 7 were treated operatively. All the patients survived. One-third of all included patients already had their primary spleen removed, which facilitated the diagnosis of traumatic rupture of an accessory spleen. The proper diagnosis of an accessory spleen rupture was concluded in 2 cases and confirmed in surgery. Conclusion: The recognition of the traumatic rupture of an accessory spleen before surgery is challenging but can be made easier if the patient underwent splenectomy before. The traumatic accessory spleen rupture does not coexist with an injury of a primary spleen.

Background: After curative-intent pancreatectomy for pancreatic ductal adenocarcinoma (PDAC), disease recurrence occurs almost invariably. Evidence guiding treatment of recurrence remains limited and may differ across single-site recurrence patterns. Methods: Scopus, MEDLINE, and the Cochrane Library were systematically searched for observational studies of adults with recurrent PDAC reporting liver-only, lung-only, or locoregional recurrence and post-recurrence treatments. Hazard ratio (HR) meta-analyses were performed to compare survival outcomes between treatment strategies for each recurrence location with additional descriptive survival summaries. Results: The inclusion criteria were met by 22 studies, with 17 included in the quantitative synthesis. Pattern-specific analyses favored selected local therapies. For liver-only recurrence, local therapy was associated with longer overall survival than chemotherapy alone (HR 0.26, 95% confidence interval [CI] 0.14–0.49), mainly due to surgical resection (HR 0.18; 95% CI 0.11–0.31). Ablation did not reach statistical significance. In lung-only recurrence, surgical resection was associated with longer survival than conventional management (HR 0.35; 95% CI 0.26–0.48). For locoregional recurrence, resection was associated with longer survival (HR 0.52; 95% CI 0.38–0.72). Stereotactic body radiotherapy outcomes from three small series were summarized descriptively. Conclusions: Pancreatic ductal adenocarcinoma recurrence outcomes differ significantly by recurrence pattern. Across liver-only, lung-only, and locoregional recurrence, selected patients undergoing local therapy had longer survival than those managed conventionally. Although current observational data do not confirm broad efficacy for specific methods, these results support recurrence pattern-specific prospective evaluation to define optimal site-tailored strategies.

Background: A wandering accessory spleen (WAS) is defined as an ectopic accessory spleen with a long vascular pedicle characterized by marked anatomical mobility. “Wandering” can be congenital or acquired due to splenomegaly or pregnancy. The study aimed to analyze the clinical course of WAS and its symptoms. Methods: The desk research method and statistical analysis were used to assess the outcome. Results: In total, 12 cases of WAS managed operatively, including 11 women and 1 man, have been found. The correct WAS diagnosis was established before surgery in 3 of the 12 patients. One individual did not exhibit any symptoms and underwent surgery to avoid WAS torsion and infarction. Abdominal pain was the most commonly reported symptom in 11 patients. No mortality has been reported. Conclusions: WAS is a rare anomaly. It can be symptomatic or produce a spectrum of symptoms, such as abdominal pain, and may resemble abdominal neoplasms. Torsion is the most common pathology in the WAS study group and is most common in young people.