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Triclosan-Containing Sutures Reduce Surgical Site Infections

A recent systematic review and meta-analysis of 31 studies involving 17,968 participants demonstrated that triclosan-containing sutures substantially lower the incidence of surgical site infections compared to non-triclosan sutures, achieving a relative risk of 0.75 (95% CI, 0.65-0.86). Despite moderate certainty due to heterogeneity, the trial sequential analysis indicated that additional studies are unlikely to alter these findings. This evidence reinforces the clinical guideline recommendation for using triclosan sutures in surgical procedures.

Meta-Analysis by Jalalzadeh H, Timmer AS (…) Boermeester MA et 12 al. in JAMA Netw Open

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Preoperative smoking cessation reduces postoperative complications in cancer surgery

This systematic review and meta-analysis involving 39,499 participants reveals that smokers who stopped smoking at least four weeks prior to cancer surgery experience significantly fewer complications. Those who smoked within four weeks before surgery faced 31% higher odds of complications, while those who never smoked had even greater risks, showing an odds ratio of 2.83. Interestingly, short-term smoking cessation (within two weeks) did not show significant difference in complications, highlighting the need for further investigation on optimal cessation periods.

Meta-Analysis by Wong C, Mohamad Asfia SKB (…) McCaffrey N et 7 al. in JAMA Netw Open

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Supraumbilical port reduces postoperative pain in gallbladder surgery

Laparoscopic cholecystectomy via the supraumbilical port significantly decreased postoperative pain compared to the subxiphoid port. In a study of 253 patients, the supraumbilical group reported lower worst pain ratings (4.24 vs. 4.91) and milder pain on the third day (3.35 vs. 3.75). Pain affected general activity, mood, walking ability, and enjoyment of life more severely in the subxiphoid group. This technique did not compromise surgical times or increase complication risks.

Comparative Study by Ye X, Niu X (…) You Z et 7 al. in Int J Surg

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

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MUST emerges as the most valid nutritional screening tool

A multicentre study involving 1,649 patients assessed malnutrition risk in major abdominal surgeries. The Subjective Global Assessment (SGA) identified 34.1% as malnourished, while various tools showed significant variability in assessments. The Malnutrition Universal Screening Tool (MUST) and Mini Nutrition Assessment Short Form (MNA-SF) exhibited the best diagnostic capabilities. MUST demonstrated strong construct and prognostic validity, proving to be the most accurate nutritional screening tool for postoperative patients, emphasizing its utility in surgical care.

Multicenter Study by Petra G, Kritsotakis EI (…) Lasithiotakis K et 10 al. in Br J Surg

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

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Endoscopic techniques may enhance palliative care for pancreatic cancer

Significant advancements in endoscopic techniques for managing malignant biliary and gastric outlet obstruction in pancreatic cancer patients provide promising alternatives to traditional surgical bypass. Emerging evidence suggests that endoscopic ultrasound-guided methods, including biliary drainage and gastroenterostomy, may outperform conventional approaches, addressing symptom relief more effectively. These developments highlight the necessity for improved palliative strategies as over 80% of cases present with advanced disease, reinforcing the need for innovative solutions tailored to enhance patient quality of life.

Review by Wu P, Chen K and He J in Ann Gastroenterol Surg

© 2024 The Author(s). Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterological Surgery.

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Hepatectomy outcomes vary significantly by resectability criteria

The study analyzed treatment outcomes for hepatocellular carcinoma (HCC) related to newly established oncological resectability criteria. Results showed median survival times were 107.2 months for resectable (R) patients, 44.4 months for BR1, and only 18.4 months for BR2 patients. The data indicate that these criteria effectively stratify prognosis post-hepatectomy, with poor outcomes for BR2 patients suggesting the necessity for multidisciplinary treatment approaches.

Journal Article by Komatsu S, Yano Y (…) Fukumoto T et 7 al. in Ann Gastroenterol Surg

© 2024 The Author(s). Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterological Surgery.

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Stapling anastomosis is increasingly preferred for colectomy.

Analysis of 232,155 colectomy cases revealed that stapling anastomosis (SA) is favored over hand-sewn anastomosis (HA), with usage rising from 80% in 2015 to 85% in 2021. The study, using propensity score matching, indicated a higher reoperation risk in the HA group (1.27%) compared to the SA group (0.93%; risk ratio 1.36). Conversely, SA was associated with an increased need for endoscopic intestinal hemostasis (0.20% vs 0.04%).

Journal Article by Ebinuma S, Kunisawa S (…) Imanaka Y et 5 al. in Ann Gastroenterol Surg

© 2024 The Author(s). Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterological Surgery.

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Older patients face higher risks in minimally invasive surgeries

A multicenter study of 7,303 patients revealed that octogenarians undergoing laparoscopic or robot-assisted colorectal surgeries exhibit significantly higher postoperative complication rates compared to younger counterparts. Specifically, patients aged 80 and above had increased comorbidities and elevated ASA and ECOG-PS scores, indicating greater surgical risks. Findings suggest that minimizing operation time and controlling blood loss are essential, particularly for rectal cancer patients in this age group, to enhance safety outcomes in elder surgical care.

Journal Article by Yamamoto T, Hida K (…) Obama K et 8 al. in Ann Gastroenterol Surg

© 2024 The Author(s). Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterological Surgery.

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Food insecurity is linked to worse surgical outcomes.

Food insecurity in surgical trauma patients correlates with significantly higher complication rates (41.4% vs. 12.5%) and longer hospital stays (median of 13 days vs. 5 days). Among 848 patients, 21% reported food insecurity prior to surgery, with those becoming food insecure postoperatively also facing greater risks of complications at three months. These findings underscore the critical need for routine screening and targeted interventions to address food access issues, thereby improving surgical outcomes.

Journal Article by Ehsan AN, Jones A (…) Ranganathan K et 12 al. in JAMA Surg

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Improving Hepatocellular Carcinoma Management in Sub-Saharan Africa

The 2024 IHPBA Legacy Initiative targets hepatocellular carcinoma (HCC) in sub-Saharan Africa, addressing significant healthcare challenges due to high incidence rates and inadequate infrastructure. It focuses on enhancing management pathways and access to care through a multidisciplinary approach, including prevention, early diagnosis, and treatment strategies. Key efforts involve expanding healthcare resources, implementing screening programs, and advocating for policy reforms in collaboration with regional partners. These actions aim to improve HCC outcomes and alleviate the disease burden in the region.

Editorial by Jonas E, Smith M (…) Wendy Spearman C et 2 al. in HPB (Oxford)

Copyright © 2025 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

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