Associations of neurodevelopmental traits and adverse childhood experiences with problem gambling: A nationwide cross-sectional study.

Gastric cancer remains a major global health burden and is the fifth leading cause of cancer-related morbidity and mortality . GLOBOCAN 2022 estimates nearly 1 million new cases and more than 650,000 deaths annually , . Incidence varies markedly by geography, with a 15- to 20-fold difference between high- and low-incidence regions . The highest rates occur in Asia, South America, and Eastern Europe, whereas Western Europe, Australia, and North America report the lowest . China alone contributes almost 50% of newly diagnosed non-cardia gastric cancers with an incidence of 25.41 per 100,000 people reported in 2022 . Although long-term trends suggest declining incidence and mortality , early-onset disease is increasing, particularly among individuals born between 1980 and 1994, whose incidence is approximately double that of cohorts born in the 1950s . Surgical resection is the cornerstone of curative treatment, and laparoscopic approaches now predominate. In China, a nationwide cohort from 53 leading hospitals across 27 provinces reported that among 90,292 surgically treated patients, the proportion undergoing laparoscopy exceeded that of laparotomy (49.51% vs. 47.67%) . In Korea, the proportion of laparoscopic gastrectomy rose from 6.6% in 2004 to 70.8% in 2023 . Japan has seen a steady 3%–5% annual increase over the past decade . However, laparoscopic gastrectomy is technically demanding, with a relatively long learning curve . The Dutch Upper Gastrointestinal Cancer Audit reported postoperative complications as high as 28.5% after laparoscopic gastrectomy . Nearly half (48%) of preventable in-hospital adverse events arise intraoperatively . Visual navigation systems that provide real-time spatial relationships between instruments and anatomy, a Global Positioning System (GPS) for the body, can enhance precision, safety, and efficiency . Unlike solid-organ procedures that can leverage preoperative computed tomography-based models, operations on hollow organs such as the stomach are challenged by dynamic deformation due to traction and insufflation, limiting the utility of static preoperative models. Consequently, given the complex vascular and visceral anatomy surrounding the stomach, real-time, intraoperative recognition is essential for laparoscopic gastrectomy.