Previous reviews suggest that prehabilitation may improve perioperative outcomes, but heterogeneity in cancer site, surgery, and study design limits direct applicability to gastrectomy. Recent randomized trials have expanded the evidence on prehabilitation before gastrectomy for gastric cancer. We assessed the perioperative and functional effects supported by this evidence, their certainty, and the extent to which current data can inform program design and implementation. We searched seven databases from inception to 17 June 2026 and screened the reference lists of eligible studies and relevant reviews. We limited the meta-analysis to randomized trials in gastric cancer and summarized separately one study that used predictable allocation based on odd and even admission order. We used random-effects models for six core outcomes, assessed risk of bias for each outcome, and rated certainty using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. The review was prospectively registered in PROSPERO (CRD420261344889). Six randomized trials involving 972 randomized participants formed the quantitative evidence base, while one quasi-randomized study was retained for structured narrative synthesis. The pooled estimates favored structured prehabilitation for 30-day overall postoperative complications (risk ratio 0.56, 95
Postoperative survival in gastric cancer (GC) surgery is increasingly measured by 90-day benchmarks, which reflect the complex perioperative cascade better than traditional 30-day metrics. Our primary objectives were to evaluate our institutional outcomes against international standards and to develop a preoperative risk-stratification tool (the MIS Gastric Score) capable of identifying patients at a high risk of developing major postoperative morbidity. We conducted an institutional cohort study involving 39 consecutive patients who underwent elective minimally invasive gastrectomy for GC between January 2022 and December 2025. This specialized series was analyzed as a foundational pilot dataset to establish the mathematical proof-of-concept and clinical feasibility of a novel preoperative risk-stratification tool before scaling up to a broad multicenter network. The primary endpoint was 90-day major morbidity, defined as a Clavien-Dindo score ≥ III. Independent risk factors were isolated using multivariate logistic regression analysis. The MIS Gastric Score was constructed by assigning weighted integers based on regression coefficients, and its performance was validated using Receiver Operating Characteristic (ROC) analysis and the Youden Index (J). Major postoperative morbidity occurred in 33.3
High-grade serous ovarian carcinoma (HGSOC) is the most common and aggressive subtype of epithelial ovarian cancer, accounting for the highest mortality among gynecologic malignancies. Neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) is a standard treatment for advanced HGSOC, yet responses to NACT vary significantly among patients. The Chemotherapy Response Score (CRS)—a histopathological assessment of treatment response—is clinically valuable, but reliable predictive biomarkers remain elusive. We retrospectively analyzed 159 HGSOC patients treated with NACT and subsequent IDS between 2013 and 2022. CRS was assigned to postoperative specimens as: CRS1 (no/minimal response), CRS2 (partial response), or CRS3 (complete/near-complete response). Immunohistochemistry (IHC) was used to evaluate ACTN4 and SARS2 protein expression in pre-NACT biopsy samples. Results showed that CRS3 patients had significantly longer progression-free survival (PFS) and overall survival (OS) than CRS1/2 patients (P < 0.001). High ACTN4 or SARS2 expression was associated with lower CRS3 rates (8
Spleen-preserving station No. 10 lymphadenectomy is technically demanding because the splenic hilar branches and pancreatic tail occupy a deep, confined field. We present a plane-first “Sandwich” sequence that organizes established anatomical planes and vessel-oriented maneuvers into a structured teaching workflow. A 50-year-old man (170 cm, 55 kg) with poorly differentiated gastric adenocarcinoma, staged cT3N+M0, received three cycles of neoadjuvant SOX plus camrelizumab. Endoscopy placed the esophagogastric junction at approximately 40 cm and the infiltrative lesion at 45–53 cm from the incisors. After multidisciplinary review and endoscopic carbon-nanoparticle marking, total gastrectomy was selected to secure an oncologically appropriate proximal margin. Station No. 10 dissection was an individualized decision based on the pretreatment tumor extent, posterior gastric-body involvement toward the greater-curvature side, radiographic nodal risk, planned total gastrectomy, and team experience. The upper and lower exposure planes were established before vessel-oriented removal of the intervening splenic hilar lymphoadipose layer. Operative time was 257 min, estimated blood loss was 100 mL, and no conversion, transfusion, pancreatic injury, splenic injury, or major vascular injury occurred. Permanent paraffin pathology showed residual moderately-to-poorly differentiated adenocarcinoma with negative margins, modified Ryan tumor regression score 2, and 2/41 metastatic lymph nodes (station No. 3, 1/2; station No. 5, 1/6; station No. 10, 0/3), yielding ypT3N1M0, post-neoadjuvant stage II. A postoperative pulmonary infectious episode requiring continued antibiotics and respiratory therapy was classified as Clavien–Dindo grade II. At approximately 51 months, the patient was alive with no reported recurrence. In this patient, the plane-first Sandwich sequence enabled completion of spleen-preserving No. 10 dissection with defined anatomical landmarks and completion criteria. Its principal contribution is a structured operative sequence and visual teaching framework for selected patients undergoing hilar lymphadenectomy. Not applicable.
To compare perioperative, oncological, and functional outcomes between intrafascial (IF) and extrafascial (EF) techniques in Retzius-sparing robot-assisted radical prostatectomy (RS-RARP) performed beyond the learning curve. This retrospective study analyzed 188 patients with localized prostate cancer (LPCa) who underwent RS-RARP between May 2021 and July 2023 at the urology departments of the Chinese PLA General Hospital. Patients were stratified into an IF group (n = 72) and an EF group (n = 116) based on the clinical T stage of the tumor and patient preference. All surgeries were performed by experienced surgeons (> 100 RS-RARP cases). Perioperative outcomes, positive surgical margin (PSM) rates, biochemical progression-free survival (bPFS), urinary continence (UC) recovery, and the EPIC-26 urinary incontinence and sexual scores were analyzed. No significant differences were observed in operative time, estimated blood loss, postoperative length of hospital stay, or complication rates (all P > 0.05). Regarding oncological outcomes, after multivariable adjustment, EF RS-RARP was associated with a lower hazard of biochemical recurrence (HR = 0.12, 95
