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Embrace or Hesitate? Public Opinion on International Surgeons

Surgeons should note that the public generally supports laws allowing internationally trained surgeons to practice in the U.S., but with significant reservations.

  • 85% of respondents backed state licensure laws for internationally trained surgeons.
  • 93% believe these laws will enhance access to care; 80% think they will improve diversity in the workforce.
  • 70% expressed concern over the ethics of international brain drain, while 73% questioned the equivalence of international training to U.S. standards.

Mandatory transparency on a surgeon’s training is crucial to gain patient trust.

  • 78% of respondents would hesitate to select an internationally trained surgeon for their care.

Journal Article by Bohler F, Noorani A (…) Chaiyasate K et 5 al. in JAMA Surg

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Late Anastomotic Leakage in Rectal Cancer Surgery: Key Insights

Late anastomotic leakage is a significant issue in rectal cancer surgery, affecting morbidity and long-term outcomes.

  • Overall anastomotic leakage occurred in 3.2% of patients, with late leakage at 48.3%.
  • 24.1% of late leak cases were diagnosed over a year post-surgery, often following diverting stoma formation.

Surgeons should consider enhanced surveillance for patients at higher risk, particularly those undergoing neoadjuvant chemoradiotherapy or robotic surgery.

  • Independent risk factors for late leakage include younger age, male sex, and high inferior mesenteric artery ligation.

Journal Article by Kim HK, Park IJ (…) Lim SB et 4 al. in Dis Colon Rectum

Copyright © The ASCRS 2026.

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Laparoscopic surgery yields similar outcomes for colorectal peritoneal metastases.

  • Survival rates are comparable: median overall survival is 37.3 months with laparoscopic versus 34.1 months with open surgery.
  • Postoperative complications are similar in both groups, but hospital stays are shorter for laparoscopic patients.
  • Patient selection is crucial; extraperitoneal metastasis significantly impacts survival outcomes.

Consider laparoscopic cytoreductive surgery for suitable patients to enhance recovery without compromising oncologic effectiveness.

Journal Article by Park SY, Kwak SG (…) Choi GS et 7 al. in Surg Endosc

© 2026. The Author(s).

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Exercise Boosts Recovery in Colorectal Cancer Survivors

Exercise significantly improves health-related quality of life (HRQoL) and mental health in colorectal cancer survivors.

  • Overall, exercise showed a notable increase in HRQoL (0.48) and reduced fatigue (-0.44), depression (-0.29), and anxiety (-0.29).
  • Supervised moderate-intensity exercise (3-5.9 METs), 30-60 minutes, 3-4 times weekly, maximizes benefits.

Incorporating structured exercise into post-treatment plans can enhance recovery and overall patient well-being.

  • Resistance training ranked highest for improving HRQoL (91.8%), while combined aerobic and resistance training was most effective for reducing symptoms (81.7%-82.4%).

Journal Article by Tang H, Zhang L (…) Chen J et 4 al. in J Gastrointest Surg

Copyright © 2026 Society for Surgery of the Alimentary Tract. Published by Elsevier Inc. All rights reserved.

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Early Feeding Safe After Esophagectomy for Cancer Patients

Early oral feeding after esophagectomy is safe and leads to better recovery outcomes.

  • No increase in anastomotic leakage (risk ratio 0.89) noted.
  • Early feeding significantly reduces pneumonia (risk ratio 0.66) and accelerates gastrointestinal recovery—first bowel movement and flatus occur about half a day earlier.
  • Hospital stays shortened by nearly two days (1.89 days) with associated lower costs.

Consider implementing early feeding protocols to enhance patient recovery while maintaining safety.

Review by Paudel N, Jha A (…) Awan NU et 9 al. in J Gastrointest Surg

Copyright © 2026 Society for Surgery of the Alimentary Tract. Published by Elsevier Inc. All rights reserved.

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Open Hemorrhoidectomy Outperforms Dearterialization in Efficacy

Open excisional hemorrhoidectomy (OEH) is superior to transanal hemorrhoidal dearterialization (THD) for grade III hemorrhoids despite more postoperative pain.

  • Clinical failure rate was 8% with OEH vs. 61% with THD (p < 0.001).
  • All reoperations (8) occurred in the THD group (p = 0.001).

Surgeons should weigh the higher pain and longer recovery of OEH against THD’s significantly worse outcomes.

  • Both treatments improved symptoms and quality of life, but OEH resulted in longer median return-to-work time (21 vs. 14 days; p = 0.010).

Comparative Study by Fernandez-Hurtado I, Pages-Valle N (…) Serra-Aracil X et 4 al. in Br J Surg

© The Author(s) 2026. Published by Oxford University Press on behalf of BJS Foundation Ltd. 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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Postoperative Undertriage Leads to Poorer Outcomes

Postoperative undertriage increases risk for high-acuity patients, prompting new goals of care.

  • Undertriaged patients had higher unplanned intubation rates (12.1% vs. 7.1%) and in-hospital mortality (7% vs. 1.1%).
  • New DNR status orders were issued for 7.2% of undertriaged patients compared to 2.8% in the ICU cohort.

Surgeons should reevaluate triage practices to mitigate these risks and improve patient outcomes.

  • Similar overall costs suggest no financial benefit in undertriaging.

Journal Article by Loftus TJ, Ruppert MM (…) Upchurch GR et 7 al. in J Am Coll Surg

Copyright © 2026 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Volume of Procedures, Not Total Trauma, Improves Outcomes

Higher procedural volume predicts better trauma care outcomes.

  • High-volume trauma centers (3.7% mortality) significantly outperform low-volume centers (5.4%) on mortality, p<0.001.
  • Major complication rates are also lower in high-volume centers (3.1%) compared to low-volume (8.1%), p<0.001.

Surgeons should focus on procedural volume for better patient outcomes.

  • Centers grouped by total trauma volume showed the opposite trends for mortality and complications, indicating a need to revise trauma center verification criteria.

Journal Article by Joseph B, Castillo-Diaz F (…) Magnotti LJ et 2 al. in J Am Coll Surg

Copyright © 2026 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Minimally invasive total gastrectomy matches open approach for cancer

Minimally invasive total gastrectomy (MITG) is as effective as open total gastrectomy (OTG) for locally advanced gastric cancer.

  • 5-year overall survival rates: MITG at 87.3% vs. OTG at 83.0% (p = 0.398)
  • Complication rates similar: MITG 10.6% vs. OTG 12.4% (p = 0.470)

Consider MITG for suitable patients, balancing its lower blood loss with longer operative times.

  • 5-year relapse-free survival: MITG at 72.5% vs. OTG at 71.0% (p = 0.895)

Journal Article by Kim KY, Hwang J (…) Hyung WJ et 4 al. in Ann Surg Oncol

© 2026. Society of Surgical Oncology.

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New technique enhances Pringle maneuver success in liver surgery

This study reveals a liver surface-guided method that significantly improves success rates for the Pringle maneuver in minimally invasive repeat liver resections.

  • Pringle taping success jumped from 33% to 91.4% with the new technique.
  • Median operative time was 331.5 minutes with only 70 ml blood loss and a short 8-day hospital stay.

This approach is especially beneficial for patients with prior open liver resections, enhancing surgical safety.

  • Complications (Clavien-Dindo grade ≥ III) were low at 5.6%, with no mortality reported.

Multicenter Study by Kawano Y, Murokawa T (…) Yoshida H et 18 al. in World J Gastroenterol

©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.

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