The convergence of artificial intelligence and robotic surgery is redefining the management of genitourinary cancers by enhancing diagnostic accuracy, surgical precision, and training efficiency. This narrative review explores recent advancements in artificial intelligence applications across the cancer care continuum, with a focus on prostate, kidney, and bladder malignancies. Artificial intelligence tools, particularly those based on machine learning and deep learning, have demonstrated strong performance in analyzing imaging data, segmenting tumors, predicting pathological features, and supporting clinical decision-making. Intraoperatively, artificial intelligence enables skill assessment, personalized feedback, and real-time navigation by processing data from surgical videos and robotic system sensors. Augmented reality and intraoperative modeling further enhance visualization and margin control during complex procedures. The review also discusses emerging technologies such as single-port robotic platforms, which offer advantages in confined anatomical spaces and support less invasive approaches. Additionally, the growing field of telesurgery is addressed, highlighting its feasibility for complex urologic operations across vast distances. While many of these innovations are still in early stages of clinical validation, their integration into practice has the potential to improve oncologic and functional outcomes, expand access to expert care, and foster the development of next-generation surgical strategies in urologic oncology.
Syringomatous adenoma of the nipple (SAN) is a rare benign tumor of the breast that can become a clinical and diagnostic challenge, as it can be misdiagnosed as invasive carcinoma due to its infiltrative nature. The treatment of choice is wide resection with clear margins. There are limited published cases of SAN. We present a case of SAN in a 42-year-old female patient, with regard to clinical manifestations, histopathologic and surgical findings, and differential diagnosis from other entities. A literature review of histologically confirmed cases of SAN revealed a total of 61 cases, including ours.
Intracardiac echocardiography (ICE) is an imaging technique that provides real-time, detailed visualization of intracardiac structures during various interventional procedures performed in the electrophysiology laboratory. Over the past decades, ICE has evolved beyond simply assisting with transseptal puncture, becoming an auxiliary tool in numerous aspects of cardiac interventions. This scientific statement offers a comprehensive, systematic overview of current applications of ICE across different clinical scenarios. The existing evidence regarding the benefits of ICE is primarily derived from observational studies, which complicates the formulation of definitive advice for its clinical use. Thus, this document aims to serve as a practical roadmap, emphasizing the key benefits of the technique. The document covers fundamental principles of ICE imaging, standardized views, its role in transseptal puncture, ablation of supraventricular and ventricular arrhythmias, reduction of procedural radiation, early detection and management of periprocedural complications, identification of infective endocarditis, and the role of ICE for endomyocardial biopsy and left atrial appendage occlusion procedures.
OBJECTIVE:Antithrombotic therapy (AT) is crucial for preventing life-threatening thromboembolic events (TEEs). However, concerns about bleeding events (BEs) often lead to AT discontinuation before image-guided breast biopsy (iBB). This systematic review and meta-analysis assess the necessity and safety of AT suspension prior to iBB. METHODS:A systematic review was conducted using Embase and PubMed/MEDLINE databases through July 2024. Studies evaluating BEs in patients who had AT and were undergoing iBB were included. Case reports, surveys, and nonretrievable full texts were excluded. Data analysis was performed using Review Manager v5.4. The risk-of-bias assessment was based on the Risk Of Bias in Non-randomized Studies of Interventions tool. RESULTS:Of the 216 studies screened, 8 met the inclusion criteria, which comprised 1154 patients undergoing AT and 10 370 controls. Bleeding events occurred in 203 (17.9%) patients with AT and 1110 (10.7%) controls, yielding a pooled odds ratio of 1.89 (Z = 5.23; P < 0.001). Heterogeneity was moderate (I² = 34%). Variability existed in AT drugs, iBB techniques, and definitions of "clinically relevant BE." Only 3 (0.23%) BEs were considered "clinically relevant" in 1 study. CONCLUSION:Although current evidence is burdened by unstandardized reporting and data fragmentation, it supports the safety of performing iBB without suspending ongoing AT because local BEs, although slightly more frequent under AT, are predominantly minor and clinically irrelevant. Antithrombotic therapy continuation can improve diagnostic efficiency, minimize delays, limit patient anxiety, and reduce health care costs. Our quantitative findings support AT continuation in the context of iBB while providing a clinical rationale that addresses the TEE risks associated with AT interruption-an issue often underrepresented in prior literature.
AIMS:Left atrial appendage closure (LAAC) has emerged as an alternative to oral anticoagulation (OAC) for stroke prevention in atrial fibrillation (AF), but its long-term comparative efficacy remains uncertain. This systematic review and meta-analysis evaluated randomized controlled trials (RCTs) comparing LAAC with OAC in AF. METHODS AND RESULTS:MEDLINE, Embase, Scopus, and the Cochrane Database of Systematic Reviews were searched through 8 April 2026. Risk ratios (RR) with 95% confidence intervals (CI) were pooled using random-effects models. Certainty of evidence (CoE) was assessed using GRADE. Six RCTs involving 7004 participants were included (3681 assigned to LAAC and 3323 to OAC). Compared with OAC, LAAC resulted in a significantly higher risk of ischaemic stroke or systemic embolism (134 vs. 80 events; RR 1.41, 95% CI 1.07-1.86; moderate CoE). No significant differences were observed for any stroke or systemic embolism (RR 1.10, 95% CI 0.87-1.39; moderate CoE), all-cause mortality (RR 0.92, 95% CI 0.77-1.10; high CoE), cardiovascular mortality (RR 0.90, 95% CI 0.67-1.21; moderate CoE), non-cardiovascular mortality (RR 0.92, 95% CI 0.75-1.12; moderate CoE), major bleeding (RR 0.91, 95% CI 0.77-1.08; high CoE), or haemorrhagic stroke (RR 0.58, 95% CI 0.28-1.17; moderate CoE). LAAC reduced the risk of nonprocedural clinically relevant bleeding compared with OAC (RR 0.50, 95% CI 0.43-0.59; high CoE). CONCLUSION:In patients with AF, LAAC results in a higher risk of ischaemic stroke or systemic embolism than an OAC-based strategy. Compared with OAC, LAAC has no effect on major bleeding or mortality and does not reduce haemorrhagic stroke.
