Carcinoma of the Colon (Colorectal Carcinoma)

const pptxgen = require("pptxgenjs");
const { execSync } = require("child_process");

// Fetch the colon diagram image
const images = JSON.parse(execSync(
  `node /home/daytona/skills/shared/scripts/fetch_images.js "https://cdn.orris.care/cdss_images/7de8c917a6f368adeac60eb1b0e87aa3e02dd9d40562d39396aa8bdea122668c.png"`
).toString());
const colonImg = images[0] && !images[0].error ? images[0].base64 : null;

// ─── PALETTE ───────────────────────────────────────────────────────
const DARK_BG   = "0D1F2D";   // deep navy – dominant
const MID_BG    = "152535";   // slightly lighter navy
const ACCENT1   = "E84855";   // surgical red
const ACCENT2   = "3ABEFF";   // clinical blue
const ACCENT3   = "F4A261";   // warm amber
const ACCENT4   = "2EC4B6";   // teal
const WHITE     = "FFFFFF";
const LIGHT     = "D6E4F0";
const GREY      = "8BA5BC";
const CARD_BG   = "1A3045";

const pres = new pptxgen();
pres.layout = "LAYOUT_WIDE";  // 13.3" × 7.5"
pres.title  = "Surgical Approaches for CRC by Location";
pres.author = "Orris Medical";

// ─── HELPER: section label bar ─────────────────────────────────────
function addTopBar(slide, color, label) {
  slide.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 13.3, h: 0.55, fill: { color } });
  slide.addText(label, {
    x: 0.3, y: 0, w: 12.7, h: 0.55,
    fontSize: 13, bold: true, color: WHITE, valign: "middle", margin: 0
  });
}

function addFooter(slide) {
  slide.addShape(pres.shapes.RECTANGLE, { x: 0, y: 7.22, w: 13.3, h: 0.28, fill: { color: "0A1620" } });
  slide.addText("Sources: Schwartz's Principles of Surgery 11th Ed. | Bailey & Love 28th Ed. | Yamada's Gastroenterology 7th Ed.", {
    x: 0.3, y: 7.22, w: 12.7, h: 0.28,
    fontSize: 7.5, color: GREY, valign: "middle", margin: 0
  });
}

function addSlideBg(slide) {
  slide.background = { color: DARK_BG };
}

// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
// SLIDE 1 – TITLE
// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
{
  const s = pres.addSlide();
  s.background = { color: DARK_BG };

  // Red accent block left
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 0.35, h: 7.5, fill: { color: ACCENT1 } });

  // Title
  s.addText("Surgical Approaches in", {
    x: 0.7, y: 1.5, w: 8.5, h: 0.9,
    fontSize: 36, bold: true, color: WHITE, fontFace: "Calibri"
  });
  s.addText("Colorectal Carcinoma", {
    x: 0.7, y: 2.35, w: 8.5, h: 0.9,
    fontSize: 36, bold: true, color: ACCENT1, fontFace: "Calibri"
  });
  s.addText("by Tumour Location", {
    x: 0.7, y: 3.2, w: 8.5, h: 0.7,
    fontSize: 28, bold: false, color: LIGHT, fontFace: "Calibri"
  });

  // Divider
  s.addShape(pres.shapes.RECTANGLE, { x: 0.7, y: 4.0, w: 5.5, h: 0.05, fill: { color: ACCENT2 } });

  // Subtitle info
  s.addText([
    { text: "Surgical principles  |  Extent of resection  |  Vascular ligation  |  Anastomosis", options: { color: GREY, fontSize: 13 } }
  ], { x: 0.7, y: 4.2, w: 9, h: 0.5 });

  // Colon image on right
  if (colonImg) {
    s.addImage({ data: colonImg, x: 9.2, y: 0.5, w: 3.8, h: 6.0 });
  }

  s.addText("Based on Schwartz's, Bailey & Love, and Yamada's Gastroenterology", {
    x: 0.7, y: 7.1, w: 9, h: 0.3, fontSize: 9, color: GREY
  });
}

// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
// SLIDE 2 – OVERVIEW: CRC LOCATIONS AND PROCEDURES (TABLE)
// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
{
  const s = pres.addSlide();
  addSlideBg(s);
  addTopBar(s, ACCENT1, "OVERVIEW  |  Tumour Location → Surgical Procedure");
  addFooter(s);

  // Table header
  const cols = [
    { label: "Tumour Location", w: 2.8, x: 0.15 },
    { label: "Operation", w: 2.9, x: 3.05 },
    { label: "Vessels Ligated", w: 3.3, x: 6.05 },
    { label: "Anastomosis", w: 3.6, x: 9.45 }
  ];
  const hdrY = 0.65;
  cols.forEach(c => {
    s.addShape(pres.shapes.RECTANGLE, { x: c.x, y: hdrY, w: c.w, h: 0.42, fill: { color: "1D3F5C" } });
    s.addText(c.label, {
      x: c.x + 0.08, y: hdrY, w: c.w - 0.1, h: 0.42,
      fontSize: 11, bold: true, color: ACCENT2, valign: "middle", margin: 0
    });
  });

  const rows = [
    ["Caecum / Terminal ileum",     "Ileocaecectomy",               "Ileocolic artery",                      "Ileum → ascending colon"],
    ["Caecum + Ascending colon",    "Right Hemicolectomy",          "Ileocolic + right colic arteries",      "Ileum → transverse colon"],
    ["Hepatic flexure / proximal transverse", "Extended Right Hemicolectomy", "Above + right branch of middle colic", "Ileum → mid transverse colon"],
    ["Mid/distal transverse colon", "Transverse Colectomy",         "Middle colic artery",                   "Ascending → descending colon"],
    ["Splenic flexure / distal transverse", "Extended Left Hemicolectomy", "Left colic + right br. middle colic", "Transverse → sigmoid colon"],
    ["Descending colon",            "Left Hemicolectomy",           "Left colic artery (IMA branch)",        "Transverse → sigmoid colon"],
    ["Sigmoid colon",               "Sigmoid Colectomy",            "Sigmoid branches of IMA",               "Descending colon → upper rectum"],
    ["Multiple / FAP / IBD",        "Total / Subtotal Colectomy",   "All colic vessels; preserve superior rectal", "Ileum → sigmoid or upper rectum"],
  ];

  rows.forEach((row, i) => {
    const rowY = 1.15 + i * 0.68;
    const bg = i % 2 === 0 ? CARD_BG : MID_BG;
    const rowData = [
      { val: row[0], x: 0.15, w: 2.8, color: WHITE, bold: true },
      { val: row[1], x: 3.05, w: 2.9, color: ACCENT3, bold: false },
      { val: row[2], x: 6.05, w: 3.3, color: LIGHT, bold: false },
      { val: row[3], x: 9.45, w: 3.6, color: ACCENT4, bold: false },
    ];
    rowData.forEach(cell => {
      s.addShape(pres.shapes.RECTANGLE, { x: cell.x, y: rowY, w: cell.w, h: 0.62, fill: { color: bg } });
      s.addText(cell.val, {
        x: cell.x + 0.1, y: rowY + 0.04, w: cell.w - 0.15, h: 0.58,
        fontSize: 10, bold: cell.bold, color: cell.color, valign: "middle", wrap: true, margin: 0
      });
    });
  });
}

// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
// SLIDE 3 – RIGHT COLON (with diagram)
// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
{
  const s = pres.addSlide();
  addSlideBg(s);
  addTopBar(s, ACCENT3, "RIGHT-SIDED CRC  |  Caecum · Ascending Colon · Hepatic Flexure");
  addFooter(s);

  // Colon diagram
  if (colonImg) {
    s.addImage({ data: colonImg, x: 7.3, y: 0.65, w: 5.6, h: 6.25 });
    // Overlay label for right hemicolectomy area
    s.addShape(pres.shapes.RECTANGLE, {
      x: 7.3, y: 6.55, w: 5.6, h: 0.35,
      fill: { color: "0A1620" }
    });
    s.addText("Fig: Resection types A→F (right hemicolectomy outlined)", {
      x: 7.35, y: 6.57, w: 5.5, h: 0.3,
      fontSize: 8, color: GREY, italic: true, margin: 0
    });
  }

  // Operation cards
  const ops = [
    {
      title: "Ileocaecectomy",
      loc: "Caecum / terminal ileum",
      vessels: "Ileocolic artery",
      anastomosis: "Ileum → ascending colon",
      nodes: "Requires ≥12 lymph nodes",
      color: ACCENT3
    },
    {
      title: "Right Hemicolectomy",
      loc: "Caecum + ascending colon",
      vessels: "Ileocolic + right colic arteries",
      anastomosis: "Ileum → transverse colon",
      nodes: "Standard for right colon CRC",
      color: ACCENT1
    },
    {
      title: "Extended Right Hemicolectomy",
      loc: "Hepatic flexure / proximal transverse",
      vessels: "Above + right br. middle colic artery",
      anastomosis: "Ileum → mid-transverse colon",
      nodes: "Splenic flexure mobilisation if needed",
      color: ACCENT2
    }
  ];

  ops.forEach((op, i) => {
    const cardY = 0.65 + i * 2.05;
    s.addShape(pres.shapes.RECTANGLE, { x: 0.15, y: cardY, w: 6.9, h: 1.9, fill: { color: CARD_BG }, shadow: { type: "outer", color: "000000", blur: 6, offset: 2, angle: 135, opacity: 0.2 } });
    // colour accent strip
    s.addShape(pres.shapes.RECTANGLE, { x: 0.15, y: cardY, w: 0.2, h: 1.9, fill: { color: op.color } });
    // title
    s.addText(op.title, { x: 0.5, y: cardY + 0.07, w: 6.5, h: 0.38, fontSize: 14, bold: true, color: op.color, margin: 0 });
    const details = [
      { text: "Location: ", options: { bold: true, color: LIGHT } },
      { text: op.loc + "\n", options: { color: LIGHT } },
      { text: "Vessels: ", options: { bold: true, color: GREY } },
      { text: op.vessels + "\n", options: { color: GREY } },
      { text: "Anastomosis: ", options: { bold: true, color: ACCENT4 } },
      { text: op.anastomosis + "\n", options: { color: ACCENT4 } },
      { text: "Note: ", options: { bold: true, color: ACCENT3 } },
      { text: op.nodes, options: { color: ACCENT3 } },
    ];
    s.addText(details, { x: 0.5, y: cardY + 0.48, w: 6.5, h: 1.32, fontSize: 10.5, valign: "top", margin: 0, wrap: true });
  });
}

// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
// SLIDE 4 – LEFT COLON
// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
{
  const s = pres.addSlide();
  addSlideBg(s);
  addTopBar(s, ACCENT2, "LEFT-SIDED CRC  |  Transverse · Splenic Flexure · Descending · Sigmoid");
  addFooter(s);

  if (colonImg) {
    s.addImage({ data: colonImg, x: 7.3, y: 0.65, w: 5.6, h: 6.25 });
    s.addShape(pres.shapes.RECTANGLE, { x: 7.3, y: 6.55, w: 5.6, h: 0.35, fill: { color: "0A1620" } });
    s.addText("Fig: Resection types G→K (left hemicolectomy, sigmoid)", {
      x: 7.35, y: 6.57, w: 5.5, h: 0.3, fontSize: 8, color: GREY, italic: true, margin: 0
    });
  }

  const ops = [
    {
      title: "Transverse Colectomy",
      loc: "Mid/distal transverse colon",
      vessels: "Middle colic artery",
      anastomosis: "Ascending colon → descending colon",
      note: "Hepatic + splenic flexure mobilisation required",
      color: ACCENT3
    },
    {
      title: "Left Hemicolectomy",
      loc: "Descending colon",
      vessels: "Left colic artery (IMA branch)",
      anastomosis: "Transverse colon → sigmoid colon",
      note: "Splenic flexure mobilised for tension-free anastomosis",
      color: ACCENT2
    },
    {
      title: "Sigmoid Colectomy",
      loc: "Sigmoid colon",
      vessels: "Sigmoid branches of inferior mesenteric artery",
      anastomosis: "Descending colon → upper rectum",
      note: "Full mobilisation of splenic flexure often needed",
      color: ACCENT4
    }
  ];

  ops.forEach((op, i) => {
    const cardY = 0.65 + i * 2.05;
    s.addShape(pres.shapes.RECTANGLE, { x: 0.15, y: cardY, w: 6.9, h: 1.9, fill: { color: CARD_BG }, shadow: { type: "outer", color: "000000", blur: 6, offset: 2, angle: 135, opacity: 0.2 } });
    s.addShape(pres.shapes.RECTANGLE, { x: 0.15, y: cardY, w: 0.2, h: 1.9, fill: { color: op.color } });
    s.addText(op.title, { x: 0.5, y: cardY + 0.07, w: 6.5, h: 0.38, fontSize: 14, bold: true, color: op.color, margin: 0 });
    const details = [
      { text: "Location: ", options: { bold: true, color: LIGHT } },
      { text: op.loc + "\n", options: { color: LIGHT } },
      { text: "Vessels: ", options: { bold: true, color: GREY } },
      { text: op.vessels + "\n", options: { color: GREY } },
      { text: "Anastomosis: ", options: { bold: true, color: ACCENT4 } },
      { text: op.anastomosis + "\n", options: { color: ACCENT4 } },
      { text: "Note: ", options: { bold: true, color: ACCENT3 } },
      { text: op.note, options: { color: ACCENT3 } },
    ];
    s.addText(details, { x: 0.5, y: cardY + 0.48, w: 6.5, h: 1.32, fontSize: 10.5, valign: "top", margin: 0, wrap: true });
  });
}

// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
// SLIDE 5 – RECTAL CANCER
// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
{
  const s = pres.addSlide();
  addSlideBg(s);
  addTopBar(s, ACCENT1, "RECTAL CANCER  |  Upper · Mid · Low Rectum");
  addFooter(s);

  // Key principle banner
  s.addShape(pres.shapes.RECTANGLE, { x: 0.15, y: 0.65, w: 13.0, h: 0.52, fill: { color: "1D3F5C" } });
  s.addText("Total Mesorectal Excision (TME) is the oncological cornerstone for all rectal cancer surgery — ensures complete removal of node-bearing mesorectum", {
    x: 0.3, y: 0.65, w: 12.7, h: 0.52,
    fontSize: 11, bold: true, color: ACCENT3, valign: "middle", margin: 0
  });

  const rops = [
    {
      title: "Local Excision / TEM",
      subtitle: "Transanal Endoscopic Microsurgery",
      loc: "T1 tumours, <3 cm, well-differentiated, no LVI/PNI",
      detail: "Transanal endoscopic approach\nNegative 2 mm margins required\n15% recurrence risk (higher in T2/T3)\nFollow-up colonoscopy at 3 months",
      color: ACCENT4
    },
    {
      title: "Anterior Resection (AR / LAR)",
      subtitle: "Low/Ultra-low Anterior Resection",
      loc: "Upper rectum (>12 cm) and mid rectum (5–12 cm) with sphincter preservation",
      detail: "Sphincter-sparing; maintains anal continence\nTotal mesorectal excision (TME)\nCircumferential resection margin (CRM) assessed by MRI\nColorectal or coloanal anastomosis",
      color: ACCENT2
    },
    {
      title: "Abdominoperineal Resection (APR)",
      subtitle: "Miles' Operation",
      loc: "Low rectum when negative distal margins cannot be achieved",
      detail: "Removes entire rectum, anal canal, and sphincter complex\nPermanent end colostomy\nIndicated when LAR not possible\nHigher morbidity; perineal wound complications",
      color: ACCENT1
    },
    {
      title: "Hartmann's Procedure",
      subtitle: "Emergency / High Risk",
      loc: "Obstructing / perforated left colon or rectal cancer; frail patients",
      detail: "Sigmoid / rectal resection without anastomosis\nEnd colostomy + Hartmann's pouch (rectal stump)\nReversal possible (2nd stage) in fit patients\nReduces anastomotic leak risk in emergency",
      color: ACCENT3
    }
  ];

  rops.forEach((op, i) => {
    const col = i % 2;
    const row = Math.floor(i / 2);
    const cx = 0.15 + col * 6.6;
    const cy = 1.3 + row * 2.95;
    s.addShape(pres.shapes.RECTANGLE, { x: cx, y: cy, w: 6.4, h: 2.75, fill: { color: CARD_BG }, shadow: { type: "outer", color: "000000", blur: 5, offset: 2, angle: 135, opacity: 0.2 } });
    s.addShape(pres.shapes.RECTANGLE, { x: cx, y: cy, w: 6.4, h: 0.55, fill: { color: op.color } });
    s.addText(op.title, { x: cx + 0.1, y: cy + 0.04, w: 6.2, h: 0.28, fontSize: 13, bold: true, color: WHITE, margin: 0 });
    s.addText(op.subtitle, { x: cx + 0.1, y: cy + 0.3, w: 6.2, h: 0.22, fontSize: 9, italic: true, color: "rgba(255,255,255,0.8)", margin: 0, color: "E0E0E0" });
    s.addText([
      { text: "Indication: ", options: { bold: true, color: ACCENT3 } },
      { text: op.loc + "\n", options: { color: LIGHT } },
    ], { x: cx + 0.1, y: cy + 0.6, w: 6.2, h: 0.45, fontSize: 10, wrap: true, margin: 0 });
    s.addText(op.detail, {
      x: cx + 0.1, y: cy + 1.05, w: 6.2, h: 1.6,
      fontSize: 10, color: GREY, wrap: true, valign: "top", margin: 0
    });
  });
}

// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
// SLIDE 6 – SPECIAL CASES (Total Colectomy, Laparoscopic vs Open)
// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
{
  const s = pres.addSlide();
  addSlideBg(s);
  addTopBar(s, ACCENT4, "SPECIAL CASES  |  Total Colectomy · Laparoscopic vs Open");
  addFooter(s);

  // LEFT COLUMN: Total / Subtotal Colectomy
  s.addShape(pres.shapes.RECTANGLE, { x: 0.15, y: 0.65, w: 6.3, h: 0.4, fill: { color: ACCENT4 } });
  s.addText("Total / Subtotal Colectomy", { x: 0.25, y: 0.65, w: 6.1, h: 0.4, fontSize: 13, bold: true, color: WHITE, valign: "middle", margin: 0 });

  const totalItems = [
    { head: "Indications", text: "FAP (attenuated or classic)\nLynch syndrome / IBD-related CRC\nSynchronous colon carcinomas\nFulminant colitis" },
    { head: "Vessels ligated", text: "All colic vessels (ileocolic, right colic, middle colic, left colic)\nSuperior rectal vessels preserved" },
    { head: "Anastomosis options", text: "Ileum → sigmoid (subtotal, ileosigmoid)\nIleum → upper rectum (total abdominal colectomy + IRA)\nEnd ileostomy + Hartmann's pouch if anastomosis contraindicated" },
    { head: "IPAA (Restorative Proctocolectomy)", text: "Entire colon + rectum removed; ileal pouch-anal anastomosis\nPreserves anal function\nPreferred for FAP; 50% risk of minor incontinence" },
  ];

  totalItems.forEach((item, i) => {
    const iy = 1.15 + i * 1.45;
    s.addShape(pres.shapes.RECTANGLE, { x: 0.15, y: iy, w: 6.3, h: 1.35, fill: { color: CARD_BG } });
    s.addText(item.head, { x: 0.3, y: iy + 0.04, w: 6.0, h: 0.3, fontSize: 11, bold: true, color: ACCENT4, margin: 0 });
    s.addText(item.text, { x: 0.3, y: iy + 0.35, w: 6.0, h: 0.9, fontSize: 9.5, color: LIGHT, wrap: true, valign: "top", margin: 0 });
  });

  // RIGHT COLUMN: Laparoscopic vs Open
  s.addShape(pres.shapes.RECTANGLE, { x: 6.85, y: 0.65, w: 6.3, h: 0.4, fill: { color: ACCENT2 } });
  s.addText("Laparoscopic vs Open Approach", { x: 6.95, y: 0.65, w: 6.1, h: 0.4, fontSize: 13, bold: true, color: WHITE, valign: "middle", margin: 0 });

  // comparison table
  const compRows = [
    ["Aspect",           "Laparoscopic",             "Open"],
    ["Recovery",         "Faster (shorter LOS)",     "Longer hospital stay"],
    ["Oncological outcome", "Equivalent to open",    "Equivalent"],
    ["Complications",    "Lower wound complications","Higher wound morbidity"],
    ["Conversion rate",  "5–10% (to open)",          "N/A"],
    ["Preferred when",   "Elective, non-perforated", "Adjacent organ invasion, perforation"],
    ["Standard?",        "Yes – elective CRC",       "Emergency / complex cases"],
  ];

  compRows.forEach((row, i) => {
    const ry = 1.15 + i * 0.77;
    const bg = i === 0 ? "1D3F5C" : (i % 2 === 0 ? CARD_BG : MID_BG);
    const textColor = i === 0 ? ACCENT2 : LIGHT;
    const boldFlag = i === 0;
    [row[0], row[1], row[2]].forEach((cell, ci) => {
      const cx2 = 6.85 + ci * 2.1;
      const cw  = ci === 0 ? 2.1 : 2.1;
      s.addShape(pres.shapes.RECTANGLE, { x: cx2, y: ry, w: cw, h: 0.7, fill: { color: bg } });
      s.addText(cell, { x: cx2 + 0.07, y: ry + 0.04, w: cw - 0.1, h: 0.62, fontSize: 9.5, bold: boldFlag, color: i === 0 ? ACCENT2 : (ci === 1 ? ACCENT4 : (ci === 2 ? ACCENT3 : LIGHT)), valign: "middle", wrap: true, margin: 0 });
    });
  });

  // Key quality metric note
  s.addShape(pres.shapes.RECTANGLE, { x: 6.85, y: 6.65, w: 6.3, h: 0.5, fill: { color: "1D3F5C" } });
  s.addText("Quality standard: Minimum 12 lymph nodes must be examined at resection (ACSS / ASCO / NCCN)", {
    x: 6.95, y: 6.65, w: 6.1, h: 0.5, fontSize: 10, bold: true, color: ACCENT3, valign: "middle", wrap: true, margin: 0
  });
}

// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
// SLIDE 7 – SURGICAL PRINCIPLES (GENERAL)
// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
{
  const s = pres.addSlide();
  addSlideBg(s);
  addTopBar(s, ACCENT3, "GENERAL SURGICAL PRINCIPLES  |  Applicable to All CRC Resections");
  addFooter(s);

  const principles = [
    { icon: "01", title: "Adequate Margins", body: "Wide resection of tumour with clear proximal and distal margins. No tumour at cut end ensures R0 resection.", color: ACCENT1 },
    { icon: "02", title: "En Bloc Lymphadenectomy", body: "Minimum 12 regional lymph nodes must be harvested and examined. More nodes = more accurate staging = better treatment selection.", color: ACCENT2 },
    { icon: "03", title: "High Vascular Ligation", body: "Vessels ligated at their origin to maximise lymph node yield along the vascular pedicle (central vascular ligation).", color: ACCENT3 },
    { icon: "04", title: "Total Mesorectal Excision (TME)", body: "Mandatory for rectal cancer. Sharp dissection in avascular plane surrounding the mesorectum. Reduces local recurrence from ~25% to <5%.", color: ACCENT4 },
    { icon: "05", title: "Tension-free Anastomosis", body: "Adequate mobilisation (e.g., splenic flexure) to prevent anastomotic leak. Stapled or hand-sewn depending on location and surgeon preference.", color: ACCENT1 },
    { icon: "06", title: "Endoscopic Options", body: "Carcinoma in polyp (T1, well-diff, no LVI): endoscopic resection ± ESD acceptable. 2 mm negative margins + follow-up colonoscopy at 3 months.", color: ACCENT2 },
  ];

  principles.forEach((p, i) => {
    const col = i % 3;
    const row = Math.floor(i / 3);
    const cx = 0.15 + col * 4.37;
    const cy = 0.65 + row * 3.1;
    s.addShape(pres.shapes.RECTANGLE, { x: cx, y: cy, w: 4.15, h: 2.95, fill: { color: CARD_BG }, shadow: { type: "outer", color: "000000", blur: 5, offset: 2, angle: 135, opacity: 0.18 } });
    // top colour bar
    s.addShape(pres.shapes.RECTANGLE, { x: cx, y: cy, w: 4.15, h: 0.12, fill: { color: p.color } });
    // number badge
    s.addShape(pres.shapes.ELLIPSE, { x: cx + 0.15, y: cy + 0.2, w: 0.48, h: 0.48, fill: { color: p.color } });
    s.addText(p.icon, { x: cx + 0.15, y: cy + 0.2, w: 0.48, h: 0.48, fontSize: 13, bold: true, color: WHITE, align: "center", valign: "middle", margin: 0 });
    // title
    s.addText(p.title, { x: cx + 0.75, y: cy + 0.22, w: 3.3, h: 0.48, fontSize: 13, bold: true, color: p.color, valign: "middle", margin: 0 });
    // body
    s.addText(p.body, { x: cx + 0.15, y: cy + 0.8, w: 3.85, h: 2.0, fontSize: 10.5, color: LIGHT, wrap: true, valign: "top", margin: 0 });
  });
}

// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
// SLIDE 8 – SUMMARY QUICK-REFERENCE
// ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
{
  const s = pres.addSlide();
  s.background = { color: DARK_BG };

  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 13.3, h: 0.55, fill: { color: ACCENT1 } });
  s.addText("QUICK REFERENCE  |  CRC Location → Operation at a Glance", {
    x: 0.3, y: 0, w: 12.7, h: 0.55, fontSize: 13, bold: true, color: WHITE, valign: "middle", margin: 0
  });

  // Visual horizontal flow
  const zones = [
    { label: "Caecum", op: "Ileocaecectomy", color: ACCENT1 },
    { label: "Ascending", op: "Right Hemi-colectomy", color: ACCENT1 },
    { label: "Hepatic Flexure", op: "Extended Right Hemi-colectomy", color: ACCENT3 },
    { label: "Transverse", op: "Transverse Colectomy", color: ACCENT3 },
    { label: "Splenic Flexure", op: "Extended Left Hemi-colectomy", color: ACCENT2 },
    { label: "Descending", op: "Left Hemi-colectomy", color: ACCENT2 },
    { label: "Sigmoid", op: "Sigmoid Colectomy", color: ACCENT4 },
    { label: "Rectum", op: "AR / APR + TME", color: ACCENT4 },
  ];

  zones.forEach((z, i) => {
    const bx = 0.15 + i * 1.62;
    // top location block
    s.addShape(pres.shapes.RECTANGLE, { x: bx, y: 0.65, w: 1.5, h: 0.52, fill: { color: z.color } });
    s.addText(z.label, { x: bx, y: 0.65, w: 1.5, h: 0.52, fontSize: 9.5, bold: true, color: WHITE, align: "center", valign: "middle", margin: 0 });
    // arrow down
    s.addText("▼", { x: bx, y: 1.2, w: 1.5, h: 0.3, fontSize: 12, color: z.color, align: "center", margin: 0 });
    // operation block
    s.addShape(pres.shapes.RECTANGLE, { x: bx, y: 1.5, w: 1.5, h: 0.95, fill: { color: CARD_BG } });
    s.addShape(pres.shapes.RECTANGLE, { x: bx, y: 1.5, w: 1.5, h: 0.08, fill: { color: z.color } });
    s.addText(z.op, { x: bx + 0.05, y: 1.58, w: 1.4, h: 0.85, fontSize: 9, color: WHITE, align: "center", valign: "middle", wrap: true, margin: 0 });
  });

  // Below: key rules
  s.addShape(pres.shapes.RECTANGLE, { x: 0.15, y: 2.6, w: 13.0, h: 0.05, fill: { color: ACCENT2 } });

  const rules = [
    { col: ACCENT1, title: "Right colon", text: "Typically presents with occult bleeding & anaemia\nRight hemicolectomy: standard approach" },
    { col: ACCENT3, title: "Transverse colon", text: "Less common; both flexures may need mobilisation\nExtended right or left hemicolectomy often preferred" },
    { col: ACCENT2, title: "Left colon", text: "Presents with change in bowel habit / obstruction\nSplenic flexure mobilisation for tension-free anastomosis" },
    { col: ACCENT4, title: "Rectum", text: "TME is mandatory\nT1: local excision; T2/T3: LAR or APR\nNeoadjuvant chemoradiotherapy for T3/T4 or N+" },
  ];

  rules.forEach((r, i) => {
    const rx = 0.15 + i * 3.3;
    s.addShape(pres.shapes.RECTANGLE, { x: rx, y: 2.75, w: 3.15, h: 3.8, fill: { color: CARD_BG } });
    s.addShape(pres.shapes.RECTANGLE, { x: rx, y: 2.75, w: 3.15, h: 0.42, fill: { color: r.col } });
    s.addText(r.title, { x: rx + 0.1, y: 2.75, w: 2.95, h: 0.42, fontSize: 13, bold: true, color: WHITE, valign: "middle", margin: 0 });
    s.addText(r.text, { x: rx + 0.1, y: 3.22, w: 2.95, h: 3.2, fontSize: 11, color: LIGHT, wrap: true, valign: "top", margin: 0 });
  });

  // Footer note
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 7.22, w: 13.3, h: 0.28, fill: { color: "0A1620" } });
  s.addText("Sources: Schwartz's Principles of Surgery 11th Ed. | Bailey & Love 28th Ed. | Yamada's Gastroenterology 7th Ed.", {
    x: 0.3, y: 7.22, w: 12.7, h: 0.28, fontSize: 7.5, color: GREY, valign: "middle", margin: 0
  });
}

// ─── WRITE FILE ────────────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/crc-surgery-ppt/CRC_Surgical_Approaches.pptx" })
  .then(() => console.log("DONE"))
  .catch(e => { console.error(e); process.exit(1); });

Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/crc-surgery-ppt/build.js'