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New guidelines standardize appendicitis management in Sweden

A comprehensive set of national guidelines for acute appendicitis management has been developed in Sweden, addressing significant practice variations. The guidelines, created by a working group of experts and informed by a national survey, provide evidence-based recommendations encompassing pathology, diagnosis, treatment, and special considerations for children and pregnant women. By consolidating the latest research and expert input, these guidelines aim to ensure uniform, safe, and cost-effective care for patients with appendicitis across the healthcare system.

Practice Guideline by Salö M, Tiselius C (…) Andersson RE et 3 al. in BJS Open

© The Author(s) 2025. Published by Oxford University Press on behalf of BJS Foundation Ltd.

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PANAMA Score differentiates survival benefits in pancreatic cancer patients

The PANAMA score effectively stratifies pancreatic cancer patients post-resection into low-, intermediate-, and high-risk categories, correlating with median overall survival rates of 48.5, 27.6, and 22.3 months, respectively. Adjuvant therapy demonstrated no survival benefit in low-risk patients, while significant improvements were seen in both intermediate (HR: 0.58) and high-risk groups (HR: 0.47). This validation underscores the score’s utility in guiding treatment decisions for patients following neoadjuvant FOLFIRINOX therapy.

Validation Study by Rompen IF, Stoop TF (…) Hank T et 42 al. in Ann Surg

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

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Da Vinci robotic surgery shows reduced complications compared to traditional methods

The systematic review analyzed 230 studies involving 3.9 million surgical cases, demonstrating that da Vinci robotic-assisted surgery (dv-ras) generally results in shorter hospital stays and fewer complications compared to laparoscopic and open procedures. Although operative time was longer for dv-ras, it led to fewer conversions, transfusions, postoperative complications, readmissions, and deaths. The findings highlight the potential benefits of dv-ras across various oncological surgeries and support its consideration by healthcare decision-makers.

Comparative Study by Ricciardi R, Seshadri-Kreaden U (…) Wright V et 5 al. in Ann Surg

Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.

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Optimal platelet count threshold established for colonoscopic polypectomy

A large-scale analysis identified a minimum platelet count of 90,000/μl as crucial for safe colonoscopic polypectomy, indicating that patients below this threshold face significantly heightened risks of both immediate and delayed postpolypectomy bleeding (ppb). Specifically, odds ratios indicated a 2.67-fold increase in immediate ppb and a 9.66-fold increase in delayed ppb among those with insufficient platelet levels. For high-risk procedures, a 100,000/μl threshold was recommended to mitigate risks effectively.

Journal Article by Hyun HK, Son NH (…) Kim TI et 7 al. in Am J Gastroenterol

Copyright © 2025 by The American College of Gastroenterology.

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Combination therapy significantly enhances outcomes in advanced hepatocellular carcinoma

The integration of transarterial chemoembolization (TACE) with tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) notably improves the objective response rate (RR = 1.81) and disease control rate (RR = 1.32) compared to TKIs and ICIs alone. Additionally, overall survival and progression-free survival are significantly prolonged, with hazard ratios of 0.55 and 0.73, respectively. While higher rates of pain and nausea/vomiting were observed, the therapy maintains an acceptable safety profile overall.

Comparative Study by Tian H and Wan C in World J Surg Oncol

© 2025. The Author(s).

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Increased adoption of intraoperative nerve monitoring in Italy

A nationwide survey revealed that 67.14% of Italian endocrine surgeons now routinely employ intraoperative nerve monitoring (IONM) during thyroid and parathyroid surgeries. This marks a significant increase since 2014, indicating improved surgical safety and reduced complication rates. Despite growing acceptance, challenges such as the variability in monitoring strategies and the occurrence of false results remain. The findings underscore the need for standardized protocols and enhanced training to maximize IONM’s benefits for patient outcomes.

Journal Article by Melcarne R, Docimo G (…) Boniardi M et 43 al. in Updates Surg

© 2025. The Author(s).

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Neoadjuvant therapy enhances survival in localized pancreatic cancer

In a cohort study of 251 patients with pancreatic ductal adenocarcinoma, neoadjuvant therapy followed by surgical resection significantly improved overall survival (39.87 months vs. 18.86 months) and recurrence-free survival (25.67 months vs. 12.83 months) compared to upfront surgery. Elevated carcinoembryonic antigen (CEA) levels were linked to worse survival outcomes, underscoring their prognostic significance. The results were confirmed in an independent cohort, highlighting the need for further prospective evaluation of patients with non-elevated carbohydrate antigen 19-9 levels.

Journal Article by Qiao G, Li X (…) Liang T et 10 al. in Ann Surg

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

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CPZ proves highly effective in distinguishing HCC from ICC

Carboxypeptidase z (cpz) demonstrates significant diagnostic potential for differentiating hepatocellular carcinoma (HCC) from intrahepatic cholangiocarcinoma (ICC). The study found cpz expressed in 90.8% of HCC cases, compared to 27.7% in ICC. Diagnostic accuracy was enhanced when cpz was combined with arginase-1 and hepatocyte paraffin antigen-1. Specifically, using all three markers yielded a sensitivity of 70.8% and specificity of 100%. Results suggest cpz may serve as a key adjunct in routine surgical pathology for HCC diagnosis.

Journal Article by Deng M, Luo R (…) Hou Y et 8 al. in Am J Surg Pathol

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

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Predictive factors for complicated acute appendicitis identified

A study of 1196 acute appendicitis patients revealed that 38.9% had complicated cases. Key predictive factors include male gender, age, duration of abdominal pain, temperature, abdominal tension, neutrophil count, and the presence of appendiceal fecaliths. The research developed a predictive nomogram that aids clinicians in distinguishing between complicated and uncomplicated cases, potentially improving surgical outcomes and postoperative care by enhancing decision-making based on patient characteristics.

Journal Article by Li R, Sun X (…) Zhao X et 3 al. in Am J Surg

Copyright © 2025 Elsevier Inc. All rights reserved.

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Standardized protocols reduce opioid use in surgical patients

Standardized electronic order sets significantly decreased inpatient opioid use for emergency general surgery patients from January 2019 to June 2023. The total morphine milligram equivalents (mme) per patient and average mme per opioid dose decreased notably, demonstrating sustained effects across administration routes. Additionally, lower mme medications were increasingly ordered, and multimodal regimens expanded, all while maintaining stable pain scores. This research suggests that effective opioid management can enhance surgical care for vulnerable populations.

Journal Article by Lucy AT, Sickels AD (…) Hashmi MZ et 5 al. in Am J Surg

Copyright © 2025. Published by Elsevier Inc.

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