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Minimally invasive parathyroidectomy under local anesthesia is effective.

A systematic review of 23 studies involving 2,470 adults with primary hyperparathyroidism demonstrated the feasibility of minimally invasive parathyroidectomy under local anesthesia. Operative times averaged 43.86 minutes with a 95-97% success rate. Patients experienced a mean hospitalization of just 16.83 hours and relatively few complications. Preoperative and postoperative parathyroid hormone and calcium levels showed significant improvement, confirming this approach as a safe and efficient treatment method for well-localized cases.

Systematic Review by Palmieri L, Lucchini R, Angelucci D and Avenia N in Minerva Surg

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Neoadjuvant PD-1 blockade facilitates nonoperative management in early-stage tumors

In a phase 2 study involving 117 patients with early-stage mismatch repair-deficient solid tumors, neoadjuvant dostarlimab led to high rates of clinical complete responses. Specifically, all patients in cohort 1 with locally advanced rectal cancer opted for nonoperative management. Among cohort 2, 35 out of 54 also achieved a complete response. Remarkably, 92% of patients maintained recurrence-free survival at two years, with 95% experiencing only mild adverse events, highlighting the potential for organ preservation.

Journal Article by Cercek A, Foote MB (…) Diaz LA et 45 al. in N Engl J Med

Copyright © 2025 Massachusetts Medical Society.

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Opioids can be safely omitted after major surgeries.

A protocol to eliminate routine opioid prescriptions for patients after major intra-abdominal surgery resulted in a significant decrease in post-discharge opioid use. Only 17% of patients in the intervention group received opioids within thirty days compared to 46% in the control group (p<0.001). Despite equivalent inpatient opioid usage, the intervention group had a median discharge prescription of 0 mg compared to 10 mg for the control group. However, thirty-day readmission rates remained unchanged.

Journal Article by Ottaviano KE, Badar MM (…) Chismark AD et 5 al. in J Gastrointest Surg

Copyright © 2025. Published by Elsevier Inc.

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ChatGPT-4o is superior in aiding gastric cancer decisions

ChatGPT-4o significantly outperformed Gemini Advanced in generating treatment recommendations for advanced gastric cancer, as evidenced by a structured evaluation of responses to ten clinical questions. It provided superior recommendations in surgical suggestions and chemotherapy options during multidisciplinary team discussions. Additionally, it excelled in analyzing rare cases from PubMed, demonstrating increased accuracy and consistent evaluator agreement. These findings illustrate the potential of AI chatbots as supportive tools within clinical decision-making frameworks.

Journal Article by Li H, Huang J (…) Mao S et 5 al. in Eur J Surg Oncol

Copyright © 2025. Published by Elsevier Ltd.

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Complete closure reduces delayed postpolypectomy bleeding risk.

In a study analyzing 1,259 colorectal polyps from 1,025 patients, complete closure using titanium clips significantly reduced the incidence of delayed postpolypectomy bleeding (DPPB) to 3.6%. Factors influencing DPPB included male gender and polyp size, both immutable, while incomplete closure presented a higher risk. Logistic regression supported these findings, underscoring the importance of full closure after endoscopic mucosal resection, particularly for polyps 20 mm or smaller.

Journal Article by Li WF, Lai B (…) Xu BX et 7 al. in Therap Adv Gastroenterol

© The Author(s), 2025.

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Minimally invasive endoscopic interventions outperform traditional surgery for pancreatic fluid collections

A review highlights a shift toward minimally invasive endoscopic interventions for managing symptomatic pancreatic fluid collections linked to acute pancreatitis. Endoscopic transmural drainage and necrosectomy show comparable effectiveness to traditional surgery but with fewer adverse effects. Early intervention may be warranted in cases of suspected infection and organ dysfunction. Key findings support ongoing evolution and refinement in procedural techniques, aiming for better patient outcomes and effective treatment of complex pancreatic conditions.

Review by Rana R, Mahapatra SJ and Garg PK in Indian J Gastroenterol

© 2025. Indian Society of Gastroenterology.

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Operative management improves survival among frail patients.

An observational study of 49,169 patients revealed that operative management resulted in lower mortality rates overall (1.3% vs 2.5%, p<0.0001) and among most frailty categories, although not for the very frail (8.1% vs 12.1%, p=0.1). Furthermore, those undergoing surgery experienced more hospital-free days, especially notable in the very frail group. However, recovery was longer for frail patients, suggesting nonoperative management could be preferable for those severely frail presenting with certain conditions.

Journal Article by Mosher E, Nassereldine H (…) Hall DE et 24 al. in Ann Surg

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

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Interventional EUS improves biliary drainage success in patients

In a retrospective multicenter study of 432 patients with surgically altered anatomy, endoscopic biliary drainage (BD) achieved technical and clinical success rates of 80.3% and 79.9%, respectively. Adverse events were more common in those with Billroth-II reconstruction (14.4%). Notably, the last two years showed increased use of interventional EUS, leading to significantly better clinical outcomes (OR=7.87, p<0.001). Yet, overall success rates remain suboptimal across all surgical reconstruction types.

Journal Article by Mauro A, Vanella G (…) Anderloni A et 21 al. in Gastrointest Endosc

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

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Enhanced risk adjustment improves hospital benchmarking accuracy

A new methodology allows for risk adjustments using multiple CPT codes instead of just the principal code in hospital benchmarking. Analysis of 994,332 patient cases revealed that hospitals reporting more CPT codes generally had improved benchmarking outcomes across 13 of 14 measures. In contrast, hospitals using only the principal code had advantages when assessed solely on that basis. This approach creates a more balanced risk assessment, particularly important for hospitals performing multiple procedures.

Journal Article by Cohen ME, Liu Y, Hall BL and Ko CY in J Am Coll Surg

Copyright © 2025 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Enhanced recovery protocols improve outcomes in gastrointestinal surgery

In a systematic review of 27 studies involving 1,864 patients, clinicians found that enhanced recovery after surgery (ERAS) and fast-track surgery (FTS) markedly improved postoperative outcomes for acute gastrointestinal perforation. The ERAS/FTS group exhibited significantly reduced complications and inflammatory responses, along with earlier mobility and resumption of eating compared to traditional methods. Additionally, these protocols resulted in lower hospital costs and shorter stays, affirming their safety and efficacy in this critical perioperative setting.

Systematic Review by Wang C, Qiu W (…) Fang Y et 3 al. in Front Surg

© 2025 Wang, Qiu, Qu, Li, Xu and Fang.

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