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Preoperative Factors Dominate Surgery Choice for Small Bowel Obstruction

In small bowel obstruction cases, younger patients with fewer comorbidities are more likely to undergo laparoscopic surgery, which is linked to fewer complications and lower mortality compared to open surgery. Etiology plays a key role; adhesive obstructions favor laparoscopy while hernias prompt open procedures. Notable predictors of conversion from laparoscopic to open include abdominal malignancy and free fluid on CT scans. Optimal outcomes arise from preoperative assessments paired with adaptable intraoperative strategies.

Journal Article by Martinez-Casas I, Kaplan LJ (…) Bass GA et 6 al. in Surg Endosc

© 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Optimal Fibrinogen to Erythrocyte Ratio May Impact Surgical Outcomes

Enhancing the fibrinogen-to-erythrocyte suspension ratio could significantly reduce mortality and improve functional outcomes in major perioperative bleeding scenarios. The ADEFES study focuses on patients undergoing surgeries that entail substantial blood loss, evaluating the relationship between fibrinogen supplementation and critical recovery metrics. By scrutinizing the effect on both all-cause and bleeding-specific mortality alongside daily living scores, this multicenter observational study aims to fill a crucial gap in clinical guidance for blood product replacement during surgery.

Multicenter Study by Demir ZA, Kavak Akelma F (…) Aydın Güzey N et 10 al. in BMJ Open

© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.

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Innovative Therapies Aim to Transform Biliary Stricture Treatment

Biliary strictures, often resulting from various causes, disrupt bile flow and lead to significant complications. Traditional surgical methods are now complemented by advanced strategies, including molecular therapies targeting fibrosis pathways, gene-editing technologies, and tissue-engineered scaffolds. These approaches promise improved, safer treatment options tailored for precision medicine, addressing the complex pathology and enhancing outcomes for patients with biliary stricture.

Review by Peng B, Zhang J and Xiang Y in Front Med (Lausanne)

Copyright © 2025 Peng, Zhang and Xiang.

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Robotic-assisted liver surgeries outperform laparoscopic and open methods in complex cases

Minimally invasive liver surgeries demonstrate significant benefits over open resections, especially in advanced cases. Among 686 patients, robotic-assisted procedures reduced major complications to 8%, compared to 17% for laparoscopic and 23% for open surgeries. Both laparoscopic and robotic approaches showed lower blood loss and shorter hospital stays across various difficulty levels, emphasizing their safety and effectiveness. Tailoring surgical techniques to case complexity is crucial for optimal outcomes.

Journal Article by Abdelhadi S, El-Ahmar M (…) Sandra-Petrescu F et 7 al. in Surg Endosc

© 2025. The Author(s).

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Myopenia Predicts Poor Survival Outcomes After Radical Gastrectomy in Gastric Cancer Patients

Myopenia significantly reduces both overall and disease-free survival in gastric cancer patients post-radical gastrectomy. In a cohort of 943 patients, those with myopenia had a five-year overall survival rate of 45.5%, compared to 69.3% for those without. A new nomogram integrating myopenia risk assessments outperformed traditional staging systems, offering improved predictive accuracy for three- and five-year outcomes and allowing for better patient stratification.

Journal Article by Zheng CY, Huang XL (…) Lin W et 6 al. in Eur J Surg Oncol

Copyright © 2025. Published by Elsevier Ltd.

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Machine Learning Enhances Decision-Making in Hepatocellular Carcinoma Treatment

A machine learning model accurately predicts optimal treatment choices for hepatocellular carcinoma, comparing liver transplantation to surgical resection. The model stratifies patients into high- and low-risk groups, estimating potential survival improvements from tailored decisions. In a nationwide study of over 4,500 patients, machine learning outperformed traditional clinical decision-making approaches, suggesting enhanced outcomes. These findings underscore the model’s potential role in supplementing current treatment guidelines.

Journal Article by Kim HU, Han JW (…) You YK et 4 al. in JAMA Netw Open

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Robotic Hepatectomy Outcomes Improve with ERAS Protocol Implementation

Implementing the Enhanced Recovery After Surgery (ERAS) protocol significantly enhances perioperative outcomes in robotic hepatectomy. A study of 544 patients revealed reduced estimated blood loss—from 214.7 to 141.7 mL—and a drop in 90-day readmission rates from 22.6% to 13.4%. Notably, post-ERAS patients presented higher rates of coronary artery disease and hypertension, yet experienced better overall recovery metrics compared to their pre-ERAS counterparts.

Journal Article by Milivojev Covilo K, Pagano SJ (…) Sucandy I et 3 al. in Updates Surg

© 2025. Italian Society of Surgery (SIC).

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Key Operating Room Factors Elevate Surgical Site Infection Risks

A retrospective analysis of 479 general surgery patients revealed that 12.5% developed surgical site infections (SSIs). Independent risk factors for SSIs included elevated body mass index, diabetes mellitus, emergency surgeries, prolonged operative times, conventional operating room settings, changes in surgical personnel, and poor adherence to infection control measures like instrument sterilization and hand hygiene. Addressing these modifiable factors could inform future prevention strategies, but prospective studies are needed to confirm clinical impact.

Observational Study by Zhu S, Yang X, Zhang P and Chen C in Medicine (Baltimore)

Copyright © 2025 the Author(s). Published by Wolters Kluwer Health, Inc.

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Endosonography-guided Coloenterostomy Offers Major Survival Benefits in Palliative Care

Endosonography-guided coloenterostomy (CE) significantly enhances outcomes for patients with small-bowel ileus due to peritoneal carcinomatosis. In a cohort of 17 patients, CE achieved a 94% technical success rate, with most experiencing symptom relief and improved quality of life. Notably, overall survival spanned 86 days compared to 14 days with conventional gastrostomy. Moreover, over half had resumed systemic cancer treatment, signaling a shift in effective palliative strategies for advanced cancer management.

Journal Article by Weich A, Retzbach L (…) Meining A et 6 al. in Gastrointest Endosc

Copyright © 2025 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

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Lower Radiation Dose Linked to Better Survival in Esophageal Cancer

Patients with resected esophageal cancer receiving 41.4 Gy of neoadjuvant radiation saw improved overall survival compared to those treated with higher doses of 50-50.4 Gy. At a median follow-up of 61.6 months, median survival was 59.9 months for the lower dose vs. 45.5 months for the higher dose (p < 0.001). This advantage was particularly notable among patients with complete pathologic response, supporting a reevaluation of radiation dosing protocols.

Journal Article by Sutton TL, Patel RK (…) Wood SG et 6 al. in Ann Surg Oncol

© 2025. Society of Surgical Oncology.

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