Klinikum Lippe

Background: Artificial intelligence is emerging as a promising tool in surgical oncology, with growing evidence suggesting potential applications in diagnostic support, intraoperative guidance, and perioperative risk assessment. In gastric cancer surgery, emerging applications range from AI-assisted endoscopic detection to data-driven perioperative risk prediction, while some technological developments, particularly in robotic autonomy, derive from broader surgical or experimental models that may inform future gastric procedures. Methods: A narrative review was conducted following established methodological standards, including the Scale for the Assessment of Narrative Review Articles (SANRA) and the Search-Appraisal-Synthesis-Analysis (SALSA) framework. English-language studies indexed in PubMed, Scopus, Embase, and Web of Science up to October 2025 were included. Evidence was synthesized thematically across five domains: AI-assisted anatomical recognition and lymphadenectomy support, autonomous robotic systems, early cancer detection, perioperative predictive and frailty models, and ethical and regulatory considerations. Results: AI-based computer vision and deep learning algorithms have demonstrated promising capabilities for real-time anatomical recognition, surgical phase classification, and intraoperative guidance, although evidence of direct patient-level benefit remains limited. In diagnostic settings, AI-assisted endoscopy and Raman spectroscopy have been shown to improve early lesion detection and reduce dependence on operator experience. Predictive models, including MySurgeryRisk and AI-driven frailty assessments, may support individualized prehabilitation planning and perioperative risk stratification. Persistent limitations include small and heterogeneous datasets, insufficient external validation, and unresolved concerns related to data privacy, algorithmic interpretability, and medico-legal responsibility. Conclusions: Artificial intelligence is progressively emerging as a promising tool in gastric cancer surgery, integrating automation, advanced analytics, and human clinical reasoning. Its safe and ethical adoption requires robust validation, transparent governance, and continuous surgeon oversight. When developed within human-centered and ethically grounded frameworks, AI can augment, rather than replace, surgical expertise, potentially advancing precision, safety, and equity in oncologic care.

The rapid evolution of genomic technologies is poised to transform patient care during the next decade, integrating precision medicine with artificial intelligence (AI) to enhance diagnostic accuracy, therapeutic decision making, and personalized healthcare strategies. This review explores key advancements in genomics, including whole-genome sequencing, single-cell genomics, pharmacogenomics, and gene-editing technologies, and their potential impact on clinical practice. AI is emerging as a critical tool in genomic data interpretation, improving disease risk prediction, patient stratification, and drug-response assessments. The synergy between AI and genomics is fostering novel insights into complex diseases such as cancer, cardiovascular conditions, and neurodegenerative disorders. In addition, epigenomics and liquid biopsies are expanding early disease detection capabilities, allowing for minimally invasive diagnostics and real-time treatment monitoring. Despite these promising developments, challenges remain in accessibility, cost, and ethical considerations, particularly regarding genomic data privacy and algorithmic bias. This review highlights ongoing global initiatives, such as the UK Biobank and the 100,000 Genomes Project, as models for integrating genomic data into mainstream health care. Furthermore, the widespread adoption of gene-editing techniques such as CRISPR holds potential for curative interventions in hereditary diseases. By 2030, genomics will likely be embedded in routine clinical practice, shifting medicine toward a predictive, preventive, and personalized model. Equitable access and ethical governance must be prioritized to ensure the responsible implementation of these transformative technologies, however. This review underscores the need for interdisciplinary collaboration to maximize the clinical and societal benefits of genomic innovation.

Laparoscopic gastrectomy (LG) has emerged as a cornerstone in the surgical management of gastric cancer, particularly in its early stages. Compared to conventional open surgery, LG offers numerous advantages, including reduced postoperative pain, shorter hospital stays, faster recovery, and improved cosmetic outcomes, contributing to its widespread use [1]. Despite these advancements, the presence of comorbidities continues to pose significant challenges to achieving optimal outcomes in patients undergoing LG.

BackgroundConspicuous color patterns are traditionally believed to advertise the toxicity of prey to potential predators. However, many aposematic species show drastic variation in coloration, indicating the possibility of other functions of coloration such as intraspecific communication. To study these other functions, we can investigate the influence of intrinsic (e.g., sex) and external factors (e.g., climate) on color variation. We used the aposematic European fire salamander (Salamandra salamandra) to study drivers of variation in the yellow-to-black ratio of the dorsal coloration based on citizen science data available in a new online database.ResultsOur results suggest a widespread sexual dichromatism in fire salamanders in Germany with males displaying a larger yellow-to-black ratio, i.e. are more yellow, than females. This dichromatism persisted even after correcting for a sex-difference in body shape that accounts for some of the variation in the yellow-to-black ratio. Among six investigated putative drivers of this color variation, the proportion of the aposematic yellow coloration increased with latitude but showed no association with other environmental variables such as temperature or the productivity of the habitat.ConclusionsIntegrating citizen science data in this study enabled a comparison of fire salamander populations across large parts of their distribution and highlights widespread sexual dichromatism. Future studies should further investigate potential mechanisms of mate choice in fire salamanders and other selective forces on coloration such as differential predation pressure between both sexes or the role in crypsis. Lastly, multi-national studies supported by citizen science data could fully unravel the extent of color variation in this species.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12862-025-02461-0.

Successful periodontal therapy may yield poor esthetic outcomes, impacting patient satisfaction, and while adhesive ceramic veneers demonstrate success in esthetically compromised cases, their effectiveness in periodontally compromised patients' satisfaction remains unexplored. Therefore, this retrospective study assesses patient-reported quality of life and satisfaction in periodontally healthy and stable patients with anterior ceramic veneer restorations. Patients, both periodontally healthy and stable, who received anterior veneer restorations at least 5 years ago, participated in the study. Satisfaction data, Oral Health Impact Profile (OHIP-G14), and Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) scores were collected, and groups were categorized based on periodontal diagnosis (healthy, stage I/II, stage III/IV). Veneers were evaluated using pink esthetic score (PES) and white esthetic score (WES) criteria. Analysis of 68 patients and 312 veneers with an average 8-year follow-up revealed high satisfaction with anterior veneer restorations. The study indicates that veneers positively impact oral health-related quality of life (OHRQoL) for patients with and without severe attachment loss, with mild periodontitis potentially enhancing satisfaction. The PES score is lower in patients with severe periodontitis (mean ± SD: 7.33 ± 1.78, p < 0.01). The results emphasize the positive impact on functionality and esthetic quality, suggesting that veneer restorations in the anterior region are a beneficial treatment option for improving OHRQoL, independent from attachment loss due to periodontitis. Veneer restorations significantly improve patient satisfaction and oral health-related quality of life (OHRQoL), even in patients with a history of periodontitis. This suggests veneers are a viable esthetic solution regardless of previous periodontal attachment loss. While patients with severe periodontitis may exhibit lower pink esthetic scores (PES), the white esthetic outcome (WES) and overall patient satisfaction remain high. This underlines the importance of managing expectations regarding soft tissue esthetics without compromising the perceived success of the treatment. Anterior ceramic veneers should be considered a reliable treatment option for esthetic rehabilitation in both periodontally healthy and previously compromised patients, when periodontal stability is achieved. Periodontal disease can compromise both the function and appearance of anterior teeth, and even after successful treatment, patients may remain dissatisfied with esthetic outcomes. This study evaluated whether anterior ceramic veneers could improve patient-reported outcomes, particularly oral health-related quality of life (OHRQoL), in individuals with varying degrees of periodontal health. A cohort of 68 patients, including periodontally healthy and stable patients with a history of stage I-IV periodontitis, was retrospectively assessed at least 5 years after receiving anterior ceramic veneers. Using validated questionnaires and clinical esthetic scores, the study found consistently high levels of patient satisfaction across all groups. Notably, patients with mild periodontitis reported the highest satisfaction, and even those with advanced attachment loss experienced improved OHRQoL. While the pink esthetic score (PES) was lower in patients with severe periodontitis, the white esthetic score (WES) showed no significant differences between groups. These findings suggest that anterior ceramic veneers are a reliable and effective restorative option for enhancing both esthetics and psychosocial outcomes, regardless of periodontal history, and may play an important role in comprehensive rehabilitative care for patients with previous periodontal disease.