Background/Aims: Cholecystectomy for gallbladder (GB) polyps is performed primarily based on preoperative images. This study examined the accuracy of surgical indications commonly used in clinical practice for detecting neoplastic polyps and investigated further clues for predicting neoplastic polyps. Methods: This retrospective study included 385 patients who underwent a cholecystectomy for GB polyps. The predictive performances of seven surgical indications were compared by fitting the receiver operating characteristic curves. Logistic regression analysis was used to identify the candidate variables associated with predicting neoplastic polyps. Results: Neoplastic polyps were identified in 18.9% (n=62) of the 385 patients assessed. The neoplastic group contained more females than males, larger polyps, more frequent solitary lesions, and lower platelet counts than the non-neoplastic group. Current surgical indications revealed an unsatisfactory prediction for neoplastic polyps. The optimal cutoff polyp size for neoplastic polyps by ultrasound (US) was larger than by computed tomography (CT) (12 mm vs. 10 mm). The proportion of pathologic neoplastic polyps was higher when both US and CT images were used than that predicted using a single test. Logistic regression analysis revealed larger polyps, increasing age, female sex, and lower platelet count to be associated with neoplastic polyps. Conclusions The current indications for cholecystectomy in GB polyps have a low predictive value for neoplastic lesions that can lead to overtreatment. Combining the polyp size from US and CT images may reduce unnecessary surgery. In addition, knowledge of the patient's age, sex, and platelet count could help make more selective surgical decisions for neoplastic polyps.

Methods: The UBE approach targeted the ventral part of the superior articular process in the transforaminal UBE setup, specifically for upper lumbar disc herniation, with an approach angle of approximately 30º on the axial plane. Intraoperative navigation was employed to improve puncture accuracy for this relatively unfamiliar surgical technique. Navigation-assisted transforaminal UBE lumbar discectomy was performed on four patients presenting with back or leg discomfort due to disc herniation at the L1–L2 or L2–L3 levels. Results: All patients experienced symptom relief and were discharged on postoperative day 2. Conclusions Transforaminal UBE lumbar discectomy is a viable therapeutic option for upper lumbar paracentral disc herniation, which is typically associated with poor prognosis. Integrating navigation integration into this novel approach enhances precision and safety.

Methods: The UBE approach targeted the ventral part of the superior articular process in the transforaminal UBE setup, specifically for upper lumbar disc herniation, with an approach angle of approximately 30º on the axial plane. Intraoperative navigation was employed to improve puncture accuracy for this relatively unfamiliar surgical technique. Navigation-assisted transforaminal UBE lumbar discectomy was performed on four patients presenting with back or leg discomfort due to disc herniation at the L1–L2 or L2–L3 levels. Results: All patients experienced symptom relief and were discharged on postoperative day 2. Conclusions Transforaminal UBE lumbar discectomy is a viable therapeutic option for upper lumbar paracentral disc herniation, which is typically associated with poor prognosis. Integrating navigation integration into this novel approach enhances precision and safety.

Background/Aims: Cholecystectomy for gallbladder (GB) polyps is performed primarily based on preoperative images. This study examined the accuracy of surgical indications commonly used in clinical practice for detecting neoplastic polyps and investigated further clues for predicting neoplastic polyps. Methods: This retrospective study included 385 patients who underwent a cholecystectomy for GB polyps. The predictive performances of seven surgical indications were compared by fitting the receiver operating characteristic curves. Logistic regression analysis was used to identify the candidate variables associated with predicting neoplastic polyps. Results: Neoplastic polyps were identified in 18.9% (n=62) of the 385 patients assessed. The neoplastic group contained more females than males, larger polyps, more frequent solitary lesions, and lower platelet counts than the non-neoplastic group. Current surgical indications revealed an unsatisfactory prediction for neoplastic polyps. The optimal cutoff polyp size for neoplastic polyps by ultrasound (US) was larger than by computed tomography (CT) (12 mm vs. 10 mm). The proportion of pathologic neoplastic polyps was higher when both US and CT images were used than that predicted using a single test. Logistic regression analysis revealed larger polyps, increasing age, female sex, and lower platelet count to be associated with neoplastic polyps. Conclusions The current indications for cholecystectomy in GB polyps have a low predictive value for neoplastic lesions that can lead to overtreatment. Combining the polyp size from US and CT images may reduce unnecessary surgery. In addition, knowledge of the patient's age, sex, and platelet count could help make more selective surgical decisions for neoplastic polyps.

Background/Aims: Cholecystectomy for gallbladder (GB) polyps is performed primarily based on preoperative images. This study examined the accuracy of surgical indications commonly used in clinical practice for detecting neoplastic polyps and investigated further clues for predicting neoplastic polyps. Methods: This retrospective study included 385 patients who underwent a cholecystectomy for GB polyps. The predictive performances of seven surgical indications were compared by fitting the receiver operating characteristic curves. Logistic regression analysis was used to identify the candidate variables associated with predicting neoplastic polyps. Results: Neoplastic polyps were identified in 18.9% (n=62) of the 385 patients assessed. The neoplastic group contained more females than males, larger polyps, more frequent solitary lesions, and lower platelet counts than the non-neoplastic group. Current surgical indications revealed an unsatisfactory prediction for neoplastic polyps. The optimal cutoff polyp size for neoplastic polyps by ultrasound (US) was larger than by computed tomography (CT) (12 mm vs. 10 mm). The proportion of pathologic neoplastic polyps was higher when both US and CT images were used than that predicted using a single test. Logistic regression analysis revealed larger polyps, increasing age, female sex, and lower platelet count to be associated with neoplastic polyps. Conclusions The current indications for cholecystectomy in GB polyps have a low predictive value for neoplastic lesions that can lead to overtreatment. Combining the polyp size from US and CT images may reduce unnecessary surgery. In addition, knowledge of the patient's age, sex, and platelet count could help make more selective surgical decisions for neoplastic polyps.

Background/Aims: Cholecystectomy for gallbladder (GB) polyps is performed primarily based on preoperative images. This study examined the accuracy of surgical indications commonly used in clinical practice for detecting neoplastic polyps and investigated further clues for predicting neoplastic polyps. Methods: This retrospective study included 385 patients who underwent a cholecystectomy for GB polyps. The predictive performances of seven surgical indications were compared by fitting the receiver operating characteristic curves. Logistic regression analysis was used to identify the candidate variables associated with predicting neoplastic polyps. Results: Neoplastic polyps were identified in 18.9% (n=62) of the 385 patients assessed. The neoplastic group contained more females than males, larger polyps, more frequent solitary lesions, and lower platelet counts than the non-neoplastic group. Current surgical indications revealed an unsatisfactory prediction for neoplastic polyps. The optimal cutoff polyp size for neoplastic polyps by ultrasound (US) was larger than by computed tomography (CT) (12 mm vs. 10 mm). The proportion of pathologic neoplastic polyps was higher when both US and CT images were used than that predicted using a single test. Logistic regression analysis revealed larger polyps, increasing age, female sex, and lower platelet count to be associated with neoplastic polyps. Conclusions The current indications for cholecystectomy in GB polyps have a low predictive value for neoplastic lesions that can lead to overtreatment. Combining the polyp size from US and CT images may reduce unnecessary surgery. In addition, knowledge of the patient's age, sex, and platelet count could help make more selective surgical decisions for neoplastic polyps.

Background/Aims: Cholecystectomy for gallbladder (GB) polyps is performed primarily based on preoperative images. This study examined the accuracy of surgical indications commonly used in clinical practice for detecting neoplastic polyps and investigated further clues for predicting neoplastic polyps. Methods: This retrospective study included 385 patients who underwent a cholecystectomy for GB polyps. The predictive performances of seven surgical indications were compared by fitting the receiver operating characteristic curves. Logistic regression analysis was used to identify the candidate variables associated with predicting neoplastic polyps. Results: Neoplastic polyps were identified in 18.9% (n=62) of the 385 patients assessed. The neoplastic group contained more females than males, larger polyps, more frequent solitary lesions, and lower platelet counts than the non-neoplastic group. Current surgical indications revealed an unsatisfactory prediction for neoplastic polyps. The optimal cutoff polyp size for neoplastic polyps by ultrasound (US) was larger than by computed tomography (CT) (12 mm vs. 10 mm). The proportion of pathologic neoplastic polyps was higher when both US and CT images were used than that predicted using a single test. Logistic regression analysis revealed larger polyps, increasing age, female sex, and lower platelet count to be associated with neoplastic polyps. Conclusions The current indications for cholecystectomy in GB polyps have a low predictive value for neoplastic lesions that can lead to overtreatment. Combining the polyp size from US and CT images may reduce unnecessary surgery. In addition, knowledge of the patient's age, sex, and platelet count could help make more selective surgical decisions for neoplastic polyps.

Methods: The UBE approach targeted the ventral part of the superior articular process in the transforaminal UBE setup, specifically for upper lumbar disc herniation, with an approach angle of approximately 30º on the axial plane. Intraoperative navigation was employed to improve puncture accuracy for this relatively unfamiliar surgical technique. Navigation-assisted transforaminal UBE lumbar discectomy was performed on four patients presenting with back or leg discomfort due to disc herniation at the L1–L2 or L2–L3 levels. Results: All patients experienced symptom relief and were discharged on postoperative day 2. Conclusions Transforaminal UBE lumbar discectomy is a viable therapeutic option for upper lumbar paracentral disc herniation, which is typically associated with poor prognosis. Integrating navigation integration into this novel approach enhances precision and safety.

Background: Oral sulfate tablets (OSTs) are bowel preparation agents that combine oral sulfate solution and simethicone. This study compared the efficacy, tolerability, and safety of OST compared to 2 L-polyethylene glycol plus ascorbic acid (2 L-PEG/ASC). Methods: This prospective, randomized, controlled, single-blinded, multicenter, noninferiority trial enrolled 211 healthy adults who underwent colonoscopy between May 2020 and September 2022 at 13 university hospitals. The bowel cleansing rate was assessed using the Boston Bowel Preparation Scale (BBPS) and Harefield Cleansing Scale (HCS), and the preparation agents were administered in split regimens. Results: The total BBPS score (8.2 ± 1.5 vs. 7.8 ± 1.4, p = 0.040) and the high-quality bowel cleansing rates in the right colon (73.2% vs. 50.5), transverse colon (80.6% vs. 68.0%), and left colon (81.5% vs. 67.0%) on the BBPS were significantly higher in the OST group than in the 2 L-PEG/ASC group. However, the rates of successful cleansing according to BBPS (90.7% vs. 91.2%) and HCS (96.3% vs. 94.2%) did not significantly differ between the two groups.The taste, ease, and amount of consumption of the preparation agent; and willingness to repeat colonoscopy with the same agent (89.8% vs. 78.6%, P = 0.026) were significantly better in the OST group compared to the 2 L-PEG/ASC group. Adverse events and clinically significant laboratory changes were not significantly different between the two groups. Conclusion The OST was not inferior to 2 L-PEG/ASC in terms of bowel cleansing efficacy and showed better tolerability when used for bowel preparation for colonoscopy.

Background: Oral sulfate tablets (OSTs) are bowel preparation agents that combine oral sulfate solution and simethicone. This study compared the efficacy, tolerability, and safety of OST compared to 2 L-polyethylene glycol plus ascorbic acid (2 L-PEG/ASC). Methods: This prospective, randomized, controlled, single-blinded, multicenter, noninferiority trial enrolled 211 healthy adults who underwent colonoscopy between May 2020 and September 2022 at 13 university hospitals. The bowel cleansing rate was assessed using the Boston Bowel Preparation Scale (BBPS) and Harefield Cleansing Scale (HCS), and the preparation agents were administered in split regimens. Results: The total BBPS score (8.2 ± 1.5 vs. 7.8 ± 1.4, p = 0.040) and the high-quality bowel cleansing rates in the right colon (73.2% vs. 50.5), transverse colon (80.6% vs. 68.0%), and left colon (81.5% vs. 67.0%) on the BBPS were significantly higher in the OST group than in the 2 L-PEG/ASC group. However, the rates of successful cleansing according to BBPS (90.7% vs. 91.2%) and HCS (96.3% vs. 94.2%) did not significantly differ between the two groups.The taste, ease, and amount of consumption of the preparation agent; and willingness to repeat colonoscopy with the same agent (89.8% vs. 78.6%, P = 0.026) were significantly better in the OST group compared to the 2 L-PEG/ASC group. Adverse events and clinically significant laboratory changes were not significantly different between the two groups. Conclusion The OST was not inferior to 2 L-PEG/ASC in terms of bowel cleansing efficacy and showed better tolerability when used for bowel preparation for colonoscopy.