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Access Boost for Surgical Oncology via APP-First Model

A new care delivery model for gastrointestinal malignancies significantly enhances patient access and treatment initiation.

  • APPs increased initial patient evaluations from 25.5% to 61.2% post-implementation.
  • Patients were more likely to proceed to surgery after their first visit, rising from 11.4% to 14.3%.

Implementing this model can streamline workflows and improve patient readiness for treatment.

  • Overall, new patient volume increased by 36.9%, reinforcing the value of incorporating APPs into surgical teams.

Letter by Stefanou AJ, Hendrick L (…) Anaya DA et 4 al. in Ann Surg Oncol

© 2025. Society of Surgical Oncology.

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Fewer Endocrine Complications with Completion Pancreatectomy

Completion pancreatectomy reduces severe endocrine complications compared to total pancreatectomy.

  • Total pancreatectomy patients face a 2.9-fold increase in endocrine issues during the first year post-surgery.
  • Risk of hypoglycemia is 3.0 times higher, while diabetic ketoacidosis risk is 9.3 times greater in total pancreatectomy patients.

Surgeons should consider completion pancreatectomy for better endocrine outcomes and enhance patient monitoring and education.

  • Analysis showed earlier and more frequent hypoglycemic events in total pancreatectomy patients.

Journal Article by Chang ML, Kraft M (…) Nevler A et 4 al. in BMC Surg

Copyright © 2025 The Author(s). Published by Elsevier Inc. All rights reserved.

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Intracorporeal Anostomosis Reduces Hernia Rates in Right Colectomy

Intracorporeal anastomosis during minimally invasive right colectomy leads to fewer incisional hernias compared to extracorporeal methods.

  • Extraction site hernia rate at 2 years: 10.1% (extracorporeal) vs. 1.9% (intracorporeal), p=0.013.
  • No conversions to open surgery in the intracorporeal group; 4.7% in extracorporeal, p<0.0001.
  • Intracorporeal methods resulted in shorter hospital stays (3 vs. 4 days, p<0.0001) and faster recovery.

Surgeons should consider prioritizing intracorporeal techniques for better patient outcomes and reduced complication rates.

Journal Article by Cleary RK, Silviera M (…) Pigazzi A et 16 al. in Surg Endosc

© 2025. The Author(s).

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New Decision Tool Reduces CT Scans in Minor Trauma

A clinical decision instrument can safely cut abdominopelvic CT usage in minor blunt trauma patients, minimizing unnecessary procedures.

  • Among 894 patients, only 9.9% had clinically significant injuries.
  • The tool identified five key predictors for injury, recommending imaging for 53.3% of patients.
  • Sensitivity was high at 96.6%, with a negative predictive value of 99.3%.

Implementing this instrument may reduce radiation risks and healthcare costs while maintaining patient safety.

Journal Article by Shopen N, Lahav Z (…) Cohen N et 5 al. in Eur J Trauma Emerg Surg

© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

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New Standard Technique for Gallbladder Bed Detachment

Butterfly traction shows promise as a standardized method for gallbladder bed detachment in laparoscopic cholecystectomy, enhancing surgical outcomes.

  • Bile contamination from perforations was reduced to 4% with butterfly traction, compared to 17% in nonstandardized methods (p=0.030).
  • Blood loss was also significantly lower in the butterfly traction group (0 g vs. 1 g, p=0.003).
  • Notably effective in complex cases, with less blood loss and fewer perforations.

Consider adopting butterfly traction to improve patient safety and outcomes, especially for less experienced surgeons.

Journal Article by Noguchi D, Ito T (…) Mizuno S et 7 al. in Asian J Endosc Surg

© 2025 The Author(s). Asian Journal of Endoscopic Surgery published by Asia Endosurgery Task Force and Japan Society of Endoscopic Surgery and John Wiley & Sons Australia, Ltd.

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Prognostic Tool for Esophageal Cancer Predicts Survival

A new model accurately predicts 3-year mortality for patients with resected esophageal or gastroesophageal junction cancer, aiming to enhance surgical decision-making.

  • Internally validated with 2,124 Ontario patients, it shows an AUC of 0.77, indicating good predictive power.
  • Externally validated with 318 Manitoba patients, it maintains strong results, AUC of 0.73.

This tool may improve patient selection and treatment personalization, leading to better outcomes.

  • A web-based interface is being developed for real-world clinical use, enhancing shared decision-making.

Journal Article by Harrison LD, Gupta V (…) Mahar A et 12 al. in Ann Surg Oncol

© 2025. Society of Surgical Oncology.

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Effective Nonsurgical Strategy for Benign Biliary Strictures

Magnetic compression anastomosis offers a promising option for patients with completely obstructed benign biliary strictures unresponsive to standard therapies.

  • 92.9% overall success rate in 113 patients treated with MCA.
  • Only 14.3% experienced recurrence, with a median of 23.7 months after treatment.

Surgeons can consider MCA as a viable alternative, minimizing the need for surgical interventions.

  • Major complications were rare, with only one case of mild cholangitis.

Journal Article by Jang SI, Lee SY (…) Lee DK et 9 al. in Endoscopy

Thieme. All rights reserved.

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Predicting Anastomotic Leakage Risk After Gastric Cancer Surgery

A new machine learning model predicts anastomotic leakage risk post-gastrectomy, crucial for improving outcomes.

  • The model shows an AUC of 0.871 with a sensitivity of 71.2% and specificity of 87.3%.
  • Using CRP levels within three days post-surgery as a key predictor can boost negative predictive value to 98.9% at a higher sensitivity threshold.

Surgeons can use this model to identify at-risk patients early, guiding intervention strategies and potentially reducing complications.

  • Continued multicenter validation is needed for broader clinical application.

Journal Article by Ma W, Zhao S (…) Yu Y et 4 al. in Am Surg

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Minimally Invasive Esophagectomy Beats Open Surgery in Older Patients

Minimally invasive esophagectomy (MIE) significantly improves survival for older esophageal cancer patients compared to open esophagectomy (OE).

  • MIE offers a median overall survival of 60.17 months vs. 29.18 months for OE (HR=1.566, p=0.002).
  • Disease-free survival is also better with MIE (37.70 months vs. 25.20 months, HR=1.411, p=0.010).

MIE has similar major complication rates as OE, making it a preferable option for enhancing outcomes and recovery in older patients with esophageal squamous cell carcinoma.

Comparative Study by Li K, Lu S (…) Leng X et 7 al. in Langenbecks Arch Surg

© 2025. The Author(s).

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Predicting Bowel Resection Risk in Incarcerated Hernias

This study identifies key predictors for bowel resection in incarcerated abdominal wall hernias, which has crucial implications for surgical decision-making.

  • 12% of patients needed bowel resection due to strangulation.
  • Elevated white blood cell count, C-reactive protein, and lactate levels linked to a higher risk of resection.
  • Bowel obstruction and femoral hernia also significantly increase risk (OR 54.922 and OR 3.515, respectively).

Recognizing these factors can enhance patient selection and optimize preoperative assessments for improved outcomes.

Journal Article by Yilmaz S, Celik C (…) Somuncu E et 3 al. in ANZ J Surg

© 2025 Royal Australasian College of Surgeons.

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