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Improved Prognosis for Locally Advanced Rectal Cancer Patients

A new prognostic model combines tumor regression grading and yptnm staging to better predict outcomes in locally advanced rectal cancer after neoadjuvant therapy.

  • The novel trg-yptnm model outperformed the traditional yptnm system in both training (1,046 patients) and validation (354 patients) cohorts.
  • Trg and yptnm are independent prognostic factors, enhancing risk stratification for surgical candidates.

This model can guide surgical decision-making by better identifying patients at higher risk for poor outcomes.

  • Calibration and decision curve analysis confirmed its clinical utility.

Journal Article by Chen Y, Zheng J (…) Zhang R et 13 al. in Int J Surg

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

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Preoperative CRP Levels Predict Difficult Laparoscopic Appendectomy

Elevated preoperative C-reactive protein levels can predict the complexity of laparoscopic appendectomy, aiding in better patient selection.

  • A CRP cut-off of 220 mg/l indicates an 87% sensitivity and 90% specificity for predicting conversion to open surgery.
  • The area under the ROC curve is 0.941, demonstrating strong diagnostic accuracy.

This information can guide surgeons in deciding on surgical approaches and managing postoperative care more effectively.

  • Positive predictive value is 87%, with a negative predictive value of 93%.

Journal Article by Shahid S, Kazim E (…) Hamza SM et 3 al. in J Coll Physicians Surg Pak

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Addressing Ageism in Surgery for Better Outcomes

Surgeons must confront ageism, which can delay vital procedures and worsen outcomes for older adults.

  • Cognitive biases were highlighted in studies involving over 149,000 participants, revealing how they influence surgical decisions.
  • Systemic inequities, such as transplant referral disparities, were noted across studies with over 24,000 participants, affecting resource allocation.

Taking action against age-based discrimination can enhance patient care and equity in surgery.

  • Educational interventions, studied with over 20,000 participants, showed promise in reducing ageism in practice.

Journal Article by Cucchetti A, Berardi G, Ettorre GM and Ercolani G in Updates Surg

© 2025. Italian Society of Surgery (SIC).

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Laparoscopic Pancreatoduodenectomy Shortens Stay in African Hospital

  • Hospital stay: 8.1 days (LPD) vs 10.6 days (open), p=0.049.
  • Lower intraoperative blood loss and transfusion rates in the LPD group.

These findings affirm LPD as a feasible option in resource-limited settings, enhancing patient recovery without compromising oncological safety.

  • Comparable oncologic outcomes, including margin status and lymph node yield, suggest LPD’s effectiveness in cancer surgery.

Journal Article by Mostafa MS, Hamour D (…) Mohamed AAA et 5 al. in Surg Endosc

© 2025. The Author(s).

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Advancing Endoscopic Resection for Colorectal Lesions

A new saline-immersion technique shows promise for complex colorectal resections.

  • 181 lesions treated with an en bloc approach achieved an R0 resection rate of 92.3%.
  • Overall, 4.4% of patients experienced adverse events, with only four needing further intervention.

This technique enhances the safety profile of endoscopic procedures, supporting wider use in Western surgical practice.

  • 93.4% of procedures were performed under conscious sedation, making it a viable option for patient comfort.

Journal Article by Bosch EM, Kalopitas G (…) Despott EJ et 3 al. in J Gastroenterol Hepatol

© 2025 The Author(s). Journal of Gastroenterology and Hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

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Endoscopic Resection Worse for Poorly Differentiated Gastric Cancer

Surgical resection offers better survival outcomes for poorly differentiated early gastric cancer.

  • Surgical resection linked to better cancer-specific survival (CSS) and overall survival (OS) with hazard ratios of 0.61 and 0.56, respectively.
  • Statistically significant differences in CSS and OS observed after propensity score matching (p-values 0.034 and 0.033).

Surgeons should favor surgical resection to align with guidelines and ensure optimal patient outcomes.

Journal Article by Cai Y, Hu B, Gao Z and Dai Y in Eur J Gastroenterol Hepatol

Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.

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Surgery First Improves Outcomes in Primary Intestinal Lymphoma

Surgery first significantly enhances survival and safety in primary intestinal lymphoma compared to chemotherapy first.

  • 3-year and 5-year overall survival rates were higher in the surgery first group (p < 0.05).
  • Patients under 60, with stage I-II disease and low international prognostic index (IPI) scores, saw even greater survival benefits (p < 0.05).

You should prioritize surgery first for suitable patients to optimize outcomes and minimize complications.

  • Perioperative complications were notably lower in the surgery first group (2.86% vs. 36.17%, p < 0.001).

Journal Article by Li Y, Liu L (…) Li Z et 3 al. in Eur J Surg Oncol

Copyright © 2025. Published by Elsevier Ltd.

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New Insights on Fluid Management in Acute Pancreatitis

Dynamic fluid therapy strategies in acute pancreatitis can significantly impact patient mortality.

  • Identified five dynamic fluid therapy trajectories within the first 72 hours: low stable (7.3%), low-moderate sustained (10.8%), moderate stable (66.0%), moderate-high fluctuating (7.4%), and high sustained (8.6%).
  • Hazard ratios reveal increased in-hospital mortality: moderate-high fluctuating group (2.08) and high sustained group (2.91) compared to moderate stable.

Monitoring fluid therapy intensively could help tailor management and improve patient outcomes.

  • A 1 standard deviation increase in cumulative fluid therapy correlates with a 47% heightened mortality risk.

Journal Article by Wan J, Xiong S (…) Xia L et 6 al. in World J Emerg Surg

© 2025. The Author(s).

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Low-grade blunt liver injury rarely requires intervention

Adults with isolated low-grade blunt liver injury almost never need surgery, allowing for streamlined management strategies.

  • Only 1.33% of 4,498 patients required intervention.
  • Key risk factors for intervention included older age, tachycardia, and hypotension.

Young, stable patients may be discharged after brief observation, leading to more efficient use of resources.

  • Patients under 51 with stable hemodynamics have less than a 1% chance of needing intervention.

Journal Article by Dvorak JE, Tseng ES (…) Crandall ML et 2 al. in BMC Surg

Copyright © 2025 Elsevier Inc. All rights reserved.

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Corticosteroids Harm Postoperative Outcomes in Hepatopancreatobiliary Surgery

Corticosteroids do not improve postoperative outcomes after hepatopancreatobiliary surgery and may actually worsen results.

  • Administration linked to 116% increased odds of complications.
  • Patients who received corticosteroids had a 56% higher chance of extended hospital stays.
  • There’s a 26% rise in 90-day mortality among steroid recipients.

Avoid routine use of corticosteroids in this surgical context, as data shows potential harm rather than benefit.

Journal Article by Altaf A, Woldesenbet S (…) Pawlik TM et 6 al. in BMC Surg

Copyright © 2025 Elsevier Inc. All rights reserved.

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