For the 2026 proposal procedure, numerous modifications to the ICD-10-GM and OPS classification were initiated and implemented through the Health Economics Section of the German Society for General and Visceral Surgery at the Federal Institute for Drugs and Medical Devices (Bundesinstitut für Arzneimittel und Medizinprodukte). The aim is to achieve a more precise and performance-adequate representation of surgical procedures within the G‑DRG system. Within ICD-10-GM, perianal malignancies were further differentiated, including the introduction of a new specific code for malignant melanoma of the perianal skin.In the OPS classification, the designation of bilateral procedures with the marker "B" will be discontinued in favor of separate side-specific coding. A new code has also been introduced for the intraoperative identification of parathyroid glands using autofluorescence.Revision surgery of the stomach has been expanded by introducing a new category for other revision procedures. In addition, the coding of surgical treatment for diaphragmatic hernias has been fundamentally restructured and will now differentiate between primary and recurrent procedures as well as surgical approaches, allowing a more accurate representation of clinical practice in this field. In hemifundoplication, closure of the hiatus must now be coded separately in a systematic manner.For incisional hernias, a renewed proposal will be submitted to the Federal Institute for Drugs and Medical Devices for the 2027 proposal procedure to introduce differentiated coding of W1-W3 defect sizes. This request is based on our recently published study demonstrating a significantly higher complication rate starting from W2 incisional hernias, suggesting that these cases are clinically unsuitable for management within a hybrid DRG framework. The transversus abdominis release (TAR) technique will now be considered equivalent to component separation procedures in OPS coding.Furthermore, colon resections and atypical liver resections will be coded in greater detail, particularly with regard to reconstruction type, conversion of surgical approach, and the number of resected lesions.

Small round cell tumors (SRCT) affecting soft tissue and bone are a distinct category of malignancies. These lesions frequently exhibit similar clinical and radiologic features, may harbor overlapping histologic and immunophenotypic features, and generally have distinct prognostic outcomes. Therefore, in some instances, the diagnosis and accurate subclassification require molecular confirmation. We aimed to provide a comprehensive overview of the morphologic, immunohistochemical, and molecular features of SRCTs of soft tissue and bone in pediatric and young adult patients, with an emphasis on both commonly encountered tumors and rare, recently described entities, accompanied by illustrative material from our TruSight platform. The literature data were mined from the PubMed/Medline, Scopus, and Cochrane databases covering the period from January 1, 2014, to December 31, 2024, and the authors' personal experience with diagnostic cases at their institutions. We reviewed tumors that include sarcoma with EWSR1-non-ETS fusion, CIC-rearranged sarcoma, BCOR-rearranged sarcoma, Ewing sarcoma, alveolar rhabdomyosarcoma, desmoplastic small round cell tumor, high-grade/round cell myxoid liposarcoma, poorly differentiated synovial sarcoma, small-cell type osteosarcoma, mesenchymal chondrosarcoma, and extraskeletal myxoid chondrosarcoma. Immunohistochemistry plays a crucial role in interpreting a specific diagnosis or narrowing the differential diagnosis of SRCTs. Molecular genetic investigations are essential, particularly in cases exhibiting atypical or overlapping histologic and immunohistological features.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a prevalent, yet underrecognized condition with serious, but preventable, complications. The American Association for the Study of Liver Diseases, American Association of Clinical Endocrinology (2022), and American Diabetes Association (2025) recommend MASLD screening for patients with type 2 diabetes, including using the Fibrosis-4 (FIB-4) index for noninvasive risk stratification of those needing further evaluation. Primary care physicians are key to early diagnosis but may be unfamiliar with updated guidelines.