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Early ERCP cuts mortality in acute cholangitis from CBD stones.

  • Urgent ERCP (within 24 hours) significantly reduced in-hospital mortality to 0.5% compared to 21% for non-urgent (adjusted OR 0.09; p=0.024).
  • Median hospital stay was shorter with urgent ERCP (5 days vs 8 days; p<0.001).

Surgeons should prioritize early ERCP for moderate to severe cases to improve outcomes.

  • Mortality benefits were pronounced in moderate and severe cholangitis but absent in mild cases.

Journal Article by Kongsakon R, Rugivarodom M (…) Pausawasdi N et 3 al. in Surg Endosc

© 2025. The Author(s).

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Innovative Block Lowers Opioid Use in Colorectal Surgery

A new incision-based precision multipoint rectus sheath block reduces opioid requirements in laparoscopic-assisted colorectal surgery, improving patient outcomes.

  • Patients receiving the new block had 25% less remifentanil usage (4.42 vs 5.92 μg/kg/h) during surgery (p=0.008).
  • Postoperative sufentanil use was also lower in the new block group, showing better pain management without complications.

Adopting this technique may enhance recovery and reduce reliance on opioids in your practice.

  • Intraoperative hemodynamic stability was improved in the precision block group.

Journal Article by Zhu S, Da X (…) Xu G et 4 al. in Postgrad Med J

© The Author(s) 2025. Published by Oxford University Press on behalf of the Fellowship of Postgraduate Medicine. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.

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Surgical Resection Improves Survival in T1 Esophageal Cancer

For T1 superficial esophageal cancer patients with non-curative endoscopic resection, additional surgical resection significantly enhances survival outcomes.

  • Overall survival rates at 5 years: 91.4% for surgical resection vs. 78.2% for non-surgical.
  • Recurrence-free survival rates at 5 years: 83.6% for surgical vs. 73.8% for non-surgical.

Surgical intervention is critical for improving long-term survival, especially in high-risk patients.

  • Disease-specific survival at 5 years: 97.8% for surgical vs. 91.1% for non-surgical.

Journal Article by Chen Y, Cao L (…) Deng K et 3 al. in Int J Surg

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

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Effective GERD Solution: Long-Term Gains from ARMS-L

Ligation-assisted antireflux mucosectomy (ARMS-L) shows promising long-term outcomes for patients with proton pump inhibitor (PPI)-dependent GERD.

  • 70.3% of patients achieved over 50% improvement in GERD symptoms after an average of 48 months.
  • Significant increases in lower esophageal sphincter pressure were noted: resting pressure rose from 6.3 to 6.6 mmHg, and residual pressure increased from 5.9 to 7.2 mmHg.
  • 70.9% of patients discontinued PPIs, indicating a potential shift in long-term management for GERD.

Prioritize ARMS-L in suitable patients to enhance symptom relief and reduce PPI reliance.

Journal Article by Zhu Y, Liu B (…) Liu X et 8 al. in United European Gastroenterol J

© 2025 The Author(s). United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.

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Robotic Assistance Enhances Endoscopic Submucosal Dissection

A new robotic system improves endoscopic submucosal dissection (ESD) efficiency and safety for gastrointestinal tumors.

  • En bloc resection rates are similar: 98.84% for the robotic group vs. 98.13% for conventional methods.
  • Robotic assistance cut dissection time significantly (p = 0.00435) and improved submucosal visualization while reducing muscular injury and operator workload.

This system acts as a “third hand,” enhancing surgical precision and workflow without compromising outcomes.

Randomized Controlled Trial by Fan K, Lv ML (…) Yang J et 6 al. in J Robot Surg

© 2025. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.

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Older Adults at Higher Risk Post-Hollow Viscus Injury

Older adults (65+) decompensate rapidly after blunt hollow viscus injuries, affecting surgical outcomes.

  • Mortality odds for older adults undergoing surgery are eight times higher than for younger adults.
  • Older adults wait nearly double the time to surgery compared to younger patients.

Delays over one hour from admission to surgery significantly increase mortality risk.

  • After 48 hours, older adults face a 13-point higher probability of death (16.20% vs. 3.28%).

Timely diagnosis and surgical intervention are critical to improving outcomes in elderly trauma patients.

Journal Article by Larson NJ, Dries DJ (…) Rogers FB et 4 al. in J Surg Res

Copyright © 2025 Elsevier Inc. All rights reserved.

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Optimal Lymphadenectomy Balances Immunotherapy in Gastric Cancer

A new study shows that the extent of lymph node dissection impacts immunotherapy efficacy in recurrent gastric cancer, emphasizing precise surgical strategies.

  • Patients with moderate lymph node dissection (16-30 nodes) achieved the best progression-free survival (8.0 months) compared to insufficient (≤15 nodes, 6.0 months) and excessive (>30 nodes, 7.0 months) resections.
  • Overall survival was highest in the moderate dissection group, with a median of 18.0 months versus 14.0 months for insufficient and 13.0 months for excessive dissections.

Surgeons should aim for balanced lymphadenectomy to enhance patient outcomes while maintaining antitumor immunity.

  • Multivariate analysis identified lymph node count as the sole independent predictor of survival outcomes.

Journal Article by Zhu D, Fang Z (…) Cheng X et 6 al. in Eur J Surg Oncol

Copyright © 2025 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

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Sequential Strategy Improves Survival in High-Risk Liver Metastases

A sequential approach combining neoadjuvant and adjuvant chemotherapy with surgery markedly boosts survival for high-risk colorectal liver metastasis patients.

  • Patients receiving neoadjuvant chemotherapy had a median progression-free survival of 1.1 years versus 0.6 years for surgery-first patients (p<0.001).
  • Overall survival was better in the neoadjuvant group: 5.2 years compared to 4.3 years (p=0.044).

Completing the entire treatment sequence correlates with the best outcomes.

  • Matched analysis confirmed these findings, indicating a clear benefit to neoadjuvant therapy before surgery.

Journal Article by Kobayashi K, Ono Y (…) Takahashi Y et 8 al. in Surg Today

© 2025. The Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd.

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Improved Survival After Liver Resection for HCC

Long-term survival rates for hepatocellular carcinoma patients significantly improved following liver resection over 20 years.

  • 5-year overall survival rates increased from 68.1% to 90.5% across three time periods (1996-2017).
  • Short-term outcomes enhanced, with 90-day mortality dropping to just 0.3% and major complications at 5.0%.

These advancements result from better surgical techniques and patient selection, allowing for safer and more effective surgeries for older patients and those with diverse HCC types.

  • Increased identification of non-B and non-C HCC cases and declining cirrhosis rates contribute to this trend.

Journal Article by Kim NR, Choi GH (…) Choi JS et 2 al. in Yonsei Med J

© Copyright: Yonsei University College of Medicine 2025.

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Successful Robotic Colorectal Surgeries with da Vinci Xi

Transitioning to the da Vinci Xi robotic platform for colorectal cancer surgery shows a significant improvement in outcomes.

  • 100% of colonic resections achieved a lymph node yield of 12 or more, surpassing the national average of 88.1%.
  • Only 3% conversion to open surgery, with a 1% anastomotic leak rate.

Robotic procedures also led to shorter hospital stays—just 7.1% had stays over 9 days versus 29% nationally.

  • Learning curves demonstrate surgeons with previous robotic experience gained proficiency faster, highlighting the need for structured training programs.

Journal Article by Massias S, Vadhwana B (…) Patel V et 5 al. in J Robot Surg

© 2025. The Author(s).

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