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New Metric Improves Outcomes in Intrahepatic Cholangiocarcinoma

Surgeons should consider the margin-to-size ratio (MSR) as a key factor for patient outcomes in resectable intrahepatic cholangiocarcinoma (ICC).

  • Higher MSR significantly improves recurrence-free survival (RFS), with an HR of 0.59.
  • An MSR threshold of 0.142 predicts better 3-year RFS: 55.7% for high MSR vs. 45.2% for low MSR.

This approach may help tailor surgical margins based on individual tumor characteristics, enhancing patient outcomes.

Journal Article by Kawashima J, Sahara K (…) Pawlik TM 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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Effective outcomes for laparoscopic hiatal hernia repair with cTIF

Laparoscopic hiatal hernia repair combined with consecutive transoral incisionless fundoplication (cTIF) achieves high success rates in GERD patients.

  • 92% of patients achieved complete clinical success within 12 months.
  • Symptom improvement was reported by 90% and 84% normalized esophageal acid exposure.

Most patients (84%) stopped daily proton pump inhibitors, enhancing long-term management potential for surgeons.

  • Serious adverse events occurred in only 1.6% of cases, indicating the procedure’s safety.

Journal Article by Kolb JM, Canto MI (…) Nguyen NT et 9 al. in J Am Coll Surg

Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Surgeons.

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Surgeon Sleep and Patient Risk Linked to Major Events

Surgeons’ inconsistent sleep timing significantly impacts patient safety, with notable implications for surgical outcomes.

  • Social jet lag of 2 hours or more increases the risk of major adverse events by 36% compared to less than 1 hour.
  • Nearly 20% of surgeries (1410 out of 7117) led to major complications.

Surgeons who manage their sleep better may reduce patient risk and burnout, suggesting that addressing sleep habits should be part of preoperative protocols.

  • Midsleep time variability over 60 minutes did not correlate with adverse outcomes.

Journal Article by Pascal L, Polazzi S (…) Duclos A et 3 al. in JAMA Surg

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Documentation Gaps in Multidisciplinary Tumor Board Meetings

Tumor board documentation is inconsistent, impacting cancer patient care.

  • Only 51.7% of cases had adequate documentation, significantly varying by cancer type (5.5% for breast vs. 97.0% for colorectal).
  • Among documented cases, 44.7% of notes were unstructured, lacking important details like attendees’ specialties (29.3%) and clinical trial eligibility (15.8%).

Improving documentation standards could enhance the quality of multidisciplinary cancer care.

  • 55.7% of notes noted if patients were informed of recommendations, primarily by phone (71.8%).

Journal Article by Riner AN, Alobuia W (…) Cloyd JM et 5 al. in Ann Surg Oncol

© 2026. The Author(s).

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Colonic obstruction management redefined: SEMS trumps surgery.

Using self-expanding metal stents (SEMS) as bridge-to-surgery improved outcomes for obstructive left colon cancer.

  • One-year stoma rates were lower with SEMS (44.4%) compared to emergency surgery (73.4%).
  • Fewer readmissions (4.2% vs 15.9%) and faster chemotherapy initiation (76.1% vs 55.8%) were noted with SEMS.

Consider SEMS for selected patients to reduce stoma rates and enhance quality of life post-treatment.

  • Major morbidity and mortality rates were similar in both groups.

Journal Article by Giordano A, Mastronardi M (…) Podda M et 12 al. in Surg Endosc

© 2026. The Author(s).

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Robotic and Laparoscopic APR for Anal Cancer Show Lower Mortality

Minimally invasive surgery for anal cancer improves patient outcomes compared to open approaches.

  • Robotic APR showed lower 30-day mortality rates (1.2% vs 2.2% for open) and reduced 90-day mortality (3.2% vs 4.9% for open).
  • Laparoscopic APR also had lower mortality and similar survival rates to robotic APR, with a five-year survival of 54%.

Choosing robotic or laparoscopic techniques can lead to shorter hospital stays and fewer complications for selected patients.

  • Robotic APR reduced positive margin rates to 14.4% versus 17.8% for open surgery.

Journal Article by Barekatain K, Simon EF (…) Charles RA et 6 al. in Surg Endosc

© 2026. The Author(s).

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Neoadjuvant Serplulimab Improves Survival in PD-L1-Positive Gastric Cancer

Neoadjuvant serplulimab with chemotherapy enhances event-free survival in PD-L1-positive gastric cancer, making it a promising strategy for surgeons.

  • Median event-free survival was longer with serplulimab (not reached) compared to placebo (42 months) for patients with PD-L1 CPS ≥10 (HR 0.65, p=0.0082).
  • In the overall patient population, event-free survival was also improved (not reached vs. 35.9 months; HR 0.73, p=0.015).

Consider serplulimab for PD-L1-positive patients to potentially improve surgical outcomes while minimizing adverse events.

  • Grade 3+ treatment-related adverse events were lower in the serplulimab group (47%) versus placebo (59%).

Journal Article by Shen L, Zhang X (…) Ji J et 21 al. in Lancet

Copyright © 2026 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.

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Anastomotic Stenosis Risks in Pancreatoduodenectomy with Portal Vein Resection

Distal transection of the superior mesenteric vein significantly increases the risk of anastomotic stenosis during pancreaticoduodenectomy for cancer.

  • Non-tumorous stenosis rate was 40.9% for distal vs. 1.7% for proximal transection (p < 0.01).
  • Symptomatic complications like ascites and gastrointestinal bleeding were also higher in the distal group (15.9% vs. 1.2%, p < 0.01).

Surgeons should be cautious of the higher stenosis risk when performing distal transections in these patients.

  • Distal transection is a distinct technical risk factor, independent of resection length.

Journal Article by Ito R, Ono Y (…) Takahashi Y 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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Laparoscopic Exploration Crucial for Assessing Occult Metastasis in Gastric Cancer

Laparoscopic exploration is vital for detecting occult peritoneal metastasis (opm) in gastric cancer, significantly impacting patient outcomes.

  • 22.2% of 653 patients showed opm+ initially, linked to worse survival (15.9 months vs not reached).
  • Younger age, better ECOG status, primary gastric cancers, and specific CA72-4 levels were risk factors for opm+.
  • Re-evaluating opm status post-treatment revealed changes in 26.4% of patients, influencing survival rates.

Identifying opm early can guide treatment decisions and improve prognoses.

Journal Article by Yan X, Xie Q (…) Zhao L et 9 al. in Ann Surg Oncol

© 2026. Society of Surgical Oncology.

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Preoperative Anxiety and Depression Surge Risk in Colorectal Surgery

Patients with high anxiety and depression scores face greater postoperative complications after colorectal surgery.

  • 25% of patients experienced clinically relevant complications, with inflammatory bowel disease and active smoking identified as risk factors.
  • High hospital anxiety and depression scores increased the odds of complications (OR 1.07).

Surgeons should routinely screen for these psychological issues to improve patient outcomes.

  • Protective factor: high hemoglobin levels reduced complication risks (OR 0.81).

Journal Article by Kraft M, Maroli A (…) Espín-Basany E et 4 al. in BMC Surg

Copyright © 2026 Elsevier Inc. All rights reserved.

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