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Endovascular management improves outcomes in acute mesenteric ischaemia

A scoping review of 39 studies on acute mesenteric ischaemia indicated that endovascular interventions significantly improved patient outcomes. Notably, they showed lower 30-day mortality rates compared to open surgery, ranging from 0% to 53.8% versus 21% to 81%. Additionally, patients receiving endovascular treatment experienced shorter hospital and ICU stays. However, delays in diagnosis, averaging between 13.9 to 48 hours, remain a concern, emphasizing the need for timely diagnosis and multidisciplinary approaches for optimal patient management.

Review by Costello L, Duggan WP (…) Kavanagh DO et 2 al. in Dig Surg

S. Karger AG, Basel.

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Pathological complete response enhances survival in esophageal cancer.

A recent meta-analysis indicates that pathological complete response (pCR) following neoadjuvant chemoradiotherapy significantly improves long-term survival outcomes in patients with locally advanced esophageal cancer undergoing surgery. Findings from 38 included studies revealed a hazard ratio of 0.54 for overall survival and 0.51 for disease-free survival among those achieving pCR. Subgroup analyses showed even greater benefits based on histology, suggesting pCR could serve as a valuable surrogate endpoint for evaluating treatment efficacy.

Meta-Analysis by Sun J, Sun C (…) Shen J et 5 al. in BMC Surg

© 2025. The Author(s).

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Nomogram effectively predicts anastomotic leakage in elderly patients.

A LASSO-based nomogram has been developed to predict anastomotic leakage (AL) in elderly patients undergoing laparoscopic gastrectomy. An analysis of 884 patients identified significant predictors, including age, ASA score, diabetes, intraoperative blood loss, and prognostic nutritional index. The nomogram demonstrated high predictive accuracy, achieving AUC values of 0.870 and 0.890 in training and validation cohorts, respectively. This tool allows for early identification of AL risk, potentially guiding preventive measures in surgical practice.

Journal Article by Yang N and Deng Y in J Gastrointest Oncol

Copyright © 2025 AME Publishing Company. All rights reserved.

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Online Risk Models Aid in Identifying Surgical Candidates

Researchers developed online calculators to assess patients’ likelihood of benefiting from liver resection for intrahepatic cholangiocarcinoma. Among 889 patients studied, the 90-day mortality rate was 8.5%, with median overall survival at 24.1 months. Risk profiles categorized patients into three groups: favorable (90-day mortality 4.3%, survival 47 months), unfavorable (33.3% mortality, 11.9 months survival), and intermediate (15.1% mortality, 29.9 months survival). The models promote tailored decision-making in clinical settings.

Journal Article by Altaf A, Khalil M (…) Pawlik TM et 19 al. in BMC Surg

Copyright © 2025 Elsevier Inc. All rights reserved.

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Mastery of laparoscopic pancreaticoduodenectomy improves beyond initial learning curve

Cumulative sum analysis in laparoscopic pancreaticoduodenectomy showed that surgeon proficiency continues to evolve beyond the initial learning phase. In a review of 381 patients, significant improvements were noted across operative time, blood loss, length of stay, and postoperative complications over three defined phases. Notably, operative time and blood loss saw proficiency achieved after hundreds of cases, while a peak in conversions from laparoscopic to open surgery occurred during the transition from the second to the third phase.

Journal Article by McKean JA, Hamilton JS (…) Hughes SJ et 6 al. in BMC Surg

Copyright © 2025 Elsevier Inc. All rights reserved.

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Prophylactic mesh reduces incisional hernia rates in surgeries

Prophylactic mesh reinforcement during elective abdominal surgeries significantly decreased the incidence of incisional hernias (IH) and the need for reoperations. In a meta-analysis of 15 randomized controlled trials involving 2,233 patients, mesh use demonstrated a notable reduction of IH at various follow-up points: 12 months (risk ratio 0.35), 24 months (0.28), and 36 months (0.62). However, this technique was linked to higher risks of seroma and wound infections, especially with the sublay approach.

Review by Abbas AW, Abo-Elsoad MF (…) Elghadban H et 6 al. in Hernia

© 2025. The Author(s).

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Non-penetrative fixation methods reduce hernia reoperation rates

A study involving 49,029 transabdominal pre-peritoneal hernia repairs revealed that non-penetrative fixation and self-fixating meshes significantly reduce reoperation rates for recurrence. Tack fixation, the most commonly used method, had the highest rate at 5.3% after five years. In contrast, glue fixation, self-fixating meshes, and no fixation showed much lower adjusted hazard ratios for reoperation: 0.25, 0.21, and 0.51, respectively. The study highlights the influence of mesh type on recurrence risks.

Comparative Study by Mortensen A, Bodilsen A and Friis-Andersen H in Hernia

© 2025. The Author(s).

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Suboptimal visualization in minimally invasive surgery costs billions yearly

A systematic review reveals that surgeons experience poor visualization in minimally invasive surgery (MIS) 40% of the time, leading to nearly 20% of surgical complications. Notably, lens cleaning costs average $312.53 per procedure, while visualization-related complications add $251 more per case. Together, these challenges contribute to over $2.2 billion in annual healthcare expenses in the U.S. Improving visualization through standardized protocols and advanced technologies is essential for enhancing surgical outcomes and reducing costs.

Review by Dhingra J, Beinart N (…) Uecker JM et 5 al. in JSLS

© 2025 by SLS, Society of Laparoscopic & Robotic Surgeons.

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Prosthetic or bioprosthetic mesh in retromuscular plane minimizes hernias.

A recent meta-analysis involving 2,148 patients revealed that using prosthetic or bioprosthetic mesh in the retromuscular position significantly reduces the risk of incisional hernias following stoma closure. The study highlighted that both types of mesh led to lower hernia rates compared to non-use. However, no significant differences in surgical site infection rates were noted among various mesh types or placement sites. These findings provide clarity on effective prophylactic strategies post-stoma closure.

Review by Ramírez-Giraldo C, Santamaría-Forero S (…) Isaza-Restrepo A et 5 al. in Hernia

© 2025. The Author(s).

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Radiomics-clinical model enhances prediction of difficult laparoscopic cholecystectomy

A novel predictive model combining preoperative CT radiomics and clinical data effectively identifies patients at risk for difficult laparoscopic cholecystectomy (DLC). An analysis of 2,055 cases revealed a top-performing model using random forest algorithms, achieving an AUC of 0.938 in the training cohort and 0.874 in validation. The model incorporates ten key features, including gallbladder wall thickness and inflammatory markers, outshining previous models and supporting safer surgical strategies tailored to individual patient needs.

Journal Article by Sun RT, Li CL (…) Qu C et 10 al. in World J Emerg Surg

© 2025. The Author(s).

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