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Nanosecond pulsed electric field ablation is effective for HCC

The prospective multicenter trial demonstrated a 91.7% complete ablation rate for hepatocellular carcinoma (HCC) near critical structures, with a technical success rate of 99.5%. Smaller tumors (<2 cm) achieved higher ablation rates compared to larger tumors (90.1% vs. 71.7%). During a median follow-up of 33.5 months, local tumor progression rates were 9.8%, 13.8%, and 15.7% at 1, 2, and 3 years, respectively, with limited adverse events reported.

Journal Article by Xu M, Zhang W (…) Jiang T et 8 al. in Int J Surg

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

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AI Advances Enhance Hernia Surgery Outcomes

Artificial intelligence has the potential to significantly improve hernia surgery by enhancing surgical risk assessment and outcomes. The review highlights advancements from machine learning, natural language processing, computer vision, and robotics over the past two decades. Machine learning aids in prediction model development, while natural language processing improves human-computer interactions. Computer vision is critical for detecting views during surgeries, and robotics enhances precision in minimally invasive techniques. These innovations could revolutionize surgical practices and patient care in hernia surgery.

Review by Restrepo-Rodas G, Barajas-Gamboa JS (…) Guerron AD et 5 al. in Surg Innov

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Tumor burden score improves survival prediction in liver cancer.

A new classification for hepatocellular carcinoma enhances predictive accuracy for overall survival. In a study involving 1,766 patients, incorporating the tumor burden score (TBS) allowed reclassification into distinct categories, revealing improved five-year survival rates: the TBS-br model yielded rates of 70.8%, 58.3%, and 40.0% compared to the original boundary category’s 65.1%, 48.2%, and 46.4%. This research offers an advanced tool for clinicians assessing surgical candidacy in liver cancer patients.

Journal Article by Akabane M, Kawashima J (…) Pawlik TM et 21 al. in Ann Surg Open

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

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SmartPAN demonstrates safe and effective intraoperative pancreatic leakage visualization

In a first-in-human trial, SmartPAN hydrogel proved safe and easy to use for visualizing intraoperative pancreatic leakage during partial resections. Out of 29 patients receiving SmartPAN, 10 demonstrated positive leakage responses, with postoperative pancreatic fistula (POPF) occurring in 7 patients. Surgeons rated the device highly for its usability and expressed intent to use it frequently. No adverse effects were reported, indicating SmartPAN’s potential for improving surgical outcomes by enabling immediate leak detection and targeted intervention.

Journal Article by Pausch TM, Holze M (…) Hackert T et 10 al. in Ann Surg Open

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

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Multiservice machine learning models enhance surgical resource planning.

Multiservice machine learning models were developed to predict postsurgical length of stay (LOS) and discharge disposition at the time of case posting. An analysis of 63,574 patients showed the LOS model achieved an area under the curve (AUC) of 0.81. Incorporating relative value units and historical LOS improved prediction accuracy for both short and prolonged stays by up to 9%. These models aim to improve resource allocation and support timely discharge planning for elective surgeries.

Journal Article by Zaribafzadeh H, Howell TC (…) Buckland DM et 5 al. in Ann Surg Open

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

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Oligometastatic disease may benefit from aggressive multimodal therapy.

Oligometastatic patients with esophageal, gastro-esophageal junction, and gastric cancers experience improved outcomes with aggressive multimodal therapies. Research indicates that combining systemic therapy with surgical resection of primary tumors and metastases enhances prognosis. Notably, patients with oligometastatic cancer at the esophago-gastric junction showed potential for curative treatment. These findings suggest that current treatment paradigms should be updated to incorporate multimodal approaches, pending verification from ongoing prospective trials for future guideline inclusion.

Review by Goetze T, Chevallay M (…) Mönig SP et 3 al. in Innov Surg Sci

© 2024 the author(s), published by De Gruyter, Berlin/Boston.

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Immunotherapy expands treatment options for esophageal cancer.

Recent advancements in immunotherapy provide new treatment avenues for advanced esophageal cancer, particularly for squamous cell carcinoma and esophagogastric adenocarcinoma. Immune checkpoint inhibitors, such as nivolumab and pembrolizumab, are now approved in various treatment settings, including adjuvant therapy for patients post-surgery and first-line treatments combined with chemotherapy. These developments improve accessibility to effective therapies, regardless of PD-L1 status, marking a significant progress in personalized medicine for esophageal cancer treatment.

Review by Huber Y, Moehler M and Högner A in Innov Surg Sci

© 2024 the author(s), published by De Gruyter, Berlin/Boston.

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Machine learning effectively predicts optimal outcomes in liver surgery

A machine learning model successfully predicted textbook outcomes in liver surgery using preoperative data from over 2,000 patients. The top-performing xgboost model achieved an area under the curve of 0.73. Significant predictors included minimally invasive techniques and patient characteristics such as lower comorbidity scores. Furthermore, meeting textbook outcome criteria was associated with improved overall survival, indicating the model’s potential utility in guiding surgical decision-making and enhancing patient care.

Journal Article by Wang J, Ashraf Ganjouei A (…) Alseidi A et 15 al. in Ann Surg Open

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

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Estrogen receptor-α influences muscle fibrosis and hernia development

Estrogen receptor-α ablation has been shown to reverse muscle fibrosis and prevent inguinal hernias, conditions affecting about 50% of men by age 75. Using a humanized mouse model, findings reveal how esr1 drives fibroblast proliferation and extracellular matrix deposition linked to hernia formation. Furthermore, pharmacological inhibition of esr1 restored normal muscle architecture and reversed existing hernias. The research highlights potential non-surgical interventions for fibrotic diseases and hernias, providing hope for future medical treatments.

Journal Article by Potluri T, You T (…) Bulun SE et 7 al. in J Clin Invest

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Machine learning effectively predicts discharge against medical advice

A study evaluated machine learning algorithms to predict discharge against medical advice for 48,394 injured inpatients over five years. Among these individuals, 8.8% opted for discharge against medical advice. The light gradient boosting machine combined with edited nearest neighbors outperformed traditional logistic regression, achieving areas under the curve of 0.820 and 0.837 in internal and temporal validations, respectively. Key predictors included surgical grade, highlighting the model’s potential to improve patient management strategies.

Journal Article by Dai X, Liu S (…) Shi X et 6 al. in BMC Surg

Copyright © 2025 Elsevier Inc. All rights reserved.

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