Abstract This study aimed to compare the safety of outpatient thyroidectomy (OPT) versus inpatient thyroidectomy (IPT). Several databases were systematically searched for clinical trials and cohort studies. Thirty‐one studies were included. The pooled results showed that OPT was associated with lower observed rates of overall complications (RR = 0.55 [95% CI = 0.39–0.78], p < .001), including hematoma (RR = 0.62 [95% CI = 0.50–0.76], p < .001), transient vocal cord dysfunction (VCD) (RR = 0.55 [95% CI = 0.31–0.95], p = .032), permanent VCD (RR = 0.26 [95% CI = 0.13–0.53], p < .001), transient hypocalcemia (RR = 0.49 [95% CI = 0.35–0.70], p < .001), persistent hypocalcemia (RR = 0.41 [95% CI = 0.24–0.68], p < .001), hospital readmission (RR = 0.70 [95% CI = 0.59–0.83], p < .001), reoperation (RR = 0.45 [95% CI = 0.32–0.63], p < .001) and mortality (RR = 0.25 [95% CI = 0.15–0.42], p < .001). However, these findings likely reflect the selection of lower‐risk patients for OPT rather than a direct causal benefit of the surgical setting itself. OPT in well‐selected patients appears safe. Most of the included studies exhibited considerable baseline differences between the OPT and IPT groups, which potentially affect the outcomes. Conducting high‐quality clinical trials is warranted to confirm the safety of OPT.

Abstract Introduction Lung cancer is one of the most commonly encountered cancers, with about 85% of cases classified as non‐small cell lung cancer (NSCLC). Video‐assisted thoracoscopic surgery (VATS) has certain limitations such as rigid instrument movement and poor hand‐eye coordination. On the other hand, robotic‐assisted thoracic surgery (RATS) has emerged, offering potential advantages such as a wider range of instrument manoeuvrability. However, the comparative outcomes between the two remain debated. This review aims to evaluate the outcomes of RATS compared with VATS in patients with NSCLC. Method This systematic review and meta‐analysis was conducted following the Cochrane Handbook for Systematic Reviews of Interventions 6.2 and the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) checklist. The search was performed on PubMed, Cochrane, Science Direct and Scopus starting from 22 September 2024. Results A total of eight studies involving 1580 NSCLC patients were included in this research. RATS demonstrated a higher number of dissected lymph node stations (mean difference [MD] 1. 34, CI 0.87–1.82, p < .00001, I 2 = 87%) and better 3‐year disease‐free survival compared with VATS (MD 2.19, CI 1.21–3.95, p = .009, I 2 = 47%). Subgroup analyses, including only randomized controlled trials (RCTs) or studies focusing exclusively on lobectomy, showed that RATS outperformed VATS in the number of dissected lymph node stations ( p < .05). Conclusion RATS is non‐inferior to VATS and demonstrates superiority in the number of dissected lymph node stations in all analyses.

Abstract BackgroundThermal ablation is effective for early‐stage hepatocellular carcinoma (HCC). It can induce a host immune response through dynamic changes in serum cytokines. It is unknown whether this host immune response correlates with tumour recurrence. This prospective study aims to investigate the dynamic changes of serum cytokines after thermal ablation of HCC and its clinical significance.MethodsSixty patients with HCC treated by thermal ablation were recruited. The dynamic changes of 39 serum cytokines were measured. The primary outcome was 2‐year disease‐free survival. Univariate and multivariate analyses were performed to identify the prognostic factors for disease‐free survival.ResultsSix cytokines [interleukin (IL)‐1, IL‐6, IL‐10, epidermal growth factor (EGF), eotaxin, transforming growth factor (TGF)‐α] demonstrated significant dynamic changes after thermal ablation. The overall tumour recurrence rate was positively correlated with the dynamic changes in serum IL‐6 and IL‐10 levels. The 2‐year disease‐free survival was 49.7%. Serum bilirubin (≥25 μmol/L) and dynamic change of serum IL‐10 (≥22 IU/mL) levels were the significant independent prognostic factors for disease‐free survival.ConclusionThere are significant dynamic changes in serum cytokines after thermal ablation. High serum bilirubin and upregulation of serum IL‐10 levels are independent poor prognostic factors for tumour recurrence after thermal ablation.

Abstract ObjectiveTo explore the potential and accuracy of the generative dialogue artificial intelligence tool GPT‐4.0 in answering questions related to paediatric emergency appendicitis.MethodsA cross‐sectional observational study design was used. We collected 134 appendicitis‐related questions from authoritative websites, such as Mayo Medical and APSA, covering all aspects of appendicitis, including simple and complex questions. These questions were answered by GPT‐4.0, and then evaluated by three paediatric surgical experts using a quality score ranging from 0 to 5. The answers were generated by GPT‐4.0 and then similarly evaluated by three experts for accuracy.ResultsWe found that GPT‐4.0 could achieve a high accuracy rate on simple questions with a quality score of 4.65 (standard deviation 0.51). For complex questions, the average score was 3.77 (standard deviation 0.68), and there was a significant difference between the two (P < .05). On clinical questions, the accuracy score of GPT‐4.0 was 4.00 (standard deviation 0.21). When answering actual questions from families of children with appendicitis, the accuracy score was 4.12 (standard deviation 0.59). Its accuracy lies between simple questions and complex questions, and it can basically meet the accuracy requirements of clinical questions. It's worth noting that GPT‐4.0 demonstrated empathy in answering some questions, which might further enhance patient satisfaction.ConclusionGPT‐4.0 showed its potential and accuracy in handling paediatric appendicitis questions, especially in simple and clinical questions. However, improvements are still needed in handling complex questions and updating information. Despite the limitations, this model is expected to improve the quality of medical services and enhance patient satisfaction.

Abstract BackgroundSurvivors of gunshot injuries are at high risk of developing infections at the injury site. However, data on gunshot wound infections and their associated burdens are limited. This study aims to determine the prevalence of gunshot wound infections and identify the risk factors associated with them in a tertiary hospital located in the eastern part of the Democratic Republic of the Congo.Materials and MethodsThis retrospective observational study was conducted at the Provincial General Reference Hospital of Bukavu in the Democratic Republic of the Congo, reviewing data from patients hospitalised between January 1, 2019, and December 31, 2020.ResultsA total of 549 patients were included in the study, with wound infections occurring in 26.6% of cases. Multivariate logistic regression analysis identified fractures (adjusted odds ratio [aOR] = 1.81; 95% confidence interval [CI] 1.12–2.92; P = .0146), nerve damage (aOR = 2.65; 95% CI 1.70–4.14; P < .0001), trunk injuries (aOR = 5.64; 95% CI 2.61–12.16; P < .0001), lower extremity injuries (aOR = 2.71; 95% CI 1.39–5.28; P = .0034), and multiple injuries (>2; aOR = 2.35; 95% CI 1.05–5.25; P = .0378) as independent predictors of gunshot wound infection.ConclusionThe main factors predisposing gunshot wounds to infection, identified in this study, require thorough evaluation and urgent management. In cases of abdominal gunshot trauma, fractures, and vascular or nerve lesions, management procedures are aimed at reducing the infection burden.