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Impact of Anastomotic Leak Severity on Survival After Esophagectomy

Severity of esophageal anastomotic leak significantly affects long-term survival and complications in patients post-esophagectomy.

  • Out of 2905 patients, 425 (14.6%) developed an anastomotic leak, leading to nearly double the rate of pulmonary complications (46.8% vs. 26.7%; p<0.001).
  • Type III leaks (requiring surgical reintervention) were linked to increased 30-day and 90-day mortality (7.3% vs. 2.7% and 12.3% vs. 4%; p<0.001) and significantly reduced median overall survival (33.9 vs. 69.3 months; p<0.001).

Type III leaks represent a high-risk group, emphasizing the need for enhanced management strategies to mitigate these risks.

Journal Article by Giorgi L, Guidozzi N (…) Markar SR et 53 al. in Ann Surg

Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved.

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Global Budget Model for Rural Hospitals Shows No Impact on Cancer Surgery Outcomes

The introduction of a global budget model in Pennsylvania rural hospitals failed to improve short-term outcomes for cancer surgery patients.

  • Among over 17,000 cancer surgery admissions, the model did not change rates of 30-day or 90-day mortality, readmission, or other composite outcomes.
  • Results were consistent across multiple cancer types and patient cohorts.

Surgeons should consider that financial models like PARHM may not effectively enhance surgical care quality or outcomes in rural settings, prompting a reevaluation of strategies to improve surgical oncology results.

Journal Article by Whitman J, Roberts ET (…) Sabik LM et 6 al. in Ann Surg

Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved.

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Surgeon Workload High with Many Feeling Overburdened

A national survey reveals that the median scheduled workload for surgeons is over 68 hours per week, with 58% reporting this as excessive, which has implications for workforce planning and surgeon well-being.

  • Only 36.6% of surgeons found their workload manageable, highlighting a potential risk to patient safety and surgical outcomes.
  • Perceived burden correlates with cumulative workload, years in practice, female gender, and specific subspecialties like pediatric surgery (OR 5.19) and urology (OR 3.85).

Surgeons may need to reevaluate work-life balance and consider the implications of excessive workload on performance and mental health.

Journal Article by Sumra S, Margasahayam AS (…) Lebares CC et 13 al. in JAMA Surg

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Laparoscopic Liver Resection Outperforms Radiofrequency Ablation in Elderly

In elderly patients with solitary small hepatocellular carcinoma, laparoscopic liver resection leads to significantly better overall and disease-free survival compared to radiofrequency ablation, despite higher complication rates.

  • Median overall survival for resection was not reached vs. 67.5 months for ablation (5-year: 65.7% vs. 50.0%; p = 0.005).
  • Disease-free survival was also superior at 36.8 months for resection vs. 21.3 months for ablation (5-year: 40.2% vs. 34.3%; p < 0.001).

Consider laparoscopic liver resection as the first-line treatment for surgically fit elderly patients, while reserving ablation for those with higher surgical risks or smaller tumors.

Journal Article by Yang S, Feng J (…) Ming Z et 8 al. in BMC Surg

Copyright © 2026 Elsevier Inc. All rights reserved.

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Colovac Device Shows Promise for Ostomy Avoidance After LAR

The colovac anastomosis protection device may allow for effective fecal diversion following low anterior resection for rectal cancer, achieving ostomy avoidance without increasing major complications compared to standard diverting loop ileostomy.

  • By postoperative day 10, major complications were comparable: 4.1% in the colovac group versus 5.6% with diverting ostomy (p=0.167).
  • Effective fecal diversion was reported in 91.7% of patients with the colovac device, with device migration occurring in 14.3%.

This suggests that the colovac device could be a viable alternative to traditional ostomy in selected patients.

Journal Article by Sylla P, Lam K (…) Lefèvre JH et 13 al. in Ann Surg

Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved.

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Improved Cardiorespiratory Fitness with Rehabilitation After UGI Cancer Surgery

A randomized trial shows that a 12-week multidisciplinary rehabilitation program significantly enhances cardiorespiratory fitness in survivors of upper gastrointestinal cancer surgery compared to standard care.

  • Patients in the rehabilitation group saw a mean increase in VO₂peak of 1.5 ml/min/kg at post-intervention and 1.23 ml/min/kg at follow-up.
  • No significant differences were observed in other secondary outcomes like muscle strength or quality of life.

This evidence supports integrating targeted rehabilitation to enhance recovery in this patient population.

Journal Article by O’Neill LM, Smyth E (…) Guinan EM et 19 al. in Ann Surg

Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved.

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Guidelines for Managing Hereditary Colorectal Polyposis Syndromes

New guidelines emphasize timely risk assessment and genetic testing for hereditary colorectal polyposis syndromes to significantly reduce cancer risk.

  • Early identification through family history and genetic testing is crucial for patients at risk.
  • The guidelines offer clear recommendations for surgical and endoscopic interventions to mitigate cancer incidence.

Surgeons should integrate these recommendations into practice to structure patient management and follow-up, focusing on those with phenotypic expressions or familial risk.

Review by Mankaney G, Idos GE (…) Burke CA et 5 al. in Am J Gastroenterol

Copyright © 2026 by The American College of Gastroenterology.

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Duodenal Stump Leakage After Gastrectomy: Key Findings

Postoperative duodenal stump leakage occurs in 2.6% of gastric cancer patients and is associated with a 90-day mortality rate of 17.2%, emphasizing the need for preventive strategies.

  • 90-day mortality after duodenal stump leakage was significant, with 11 out of 64 patients dying (17.2%).
  • Prognostic factors for increased risk of leakage included preoperative weight loss, unreinforced duodenal stump, Billroth II reconstruction, and postoperative blood transfusion.

Surgeons should consider these factors in patient selection and surgical technique to mitigate risks associated with this complication.

Multicenter Study by Molteni M, Puccetti F (…) Rosati R et 25 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.
© 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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Endoscopic Grading of Gastric Intestinal Metaplasia Shows High Accuracy

Endoscopic grading of gastric intestinal metaplasia (EGGIM) effectively identifies extensive disease with high sensitivity and specificity, enhancing patient risk stratification for surveillance.

  • Pooled sensitivity of EGGIM is 90% and specificity is 92%, based on 1,143 patients across seven studies using narrow-band or blue light imaging.
  • The diagnostic odds ratio is 105.93, with an AUC of 0.96, indicating strong performance for identifying extensive gastric intestinal metaplasia.

These findings suggest that EGGIM could be integrated into endoscopic practice for real-time assessment, but further validation is needed.

Review by Luu MN, Trinh NA (…) Quach DT et 3 al. in Gastrointest Endosc

Copyright © 2026 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

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Intrathecal Morphine Offers Effective Pain Control Post-Pancreatectomy

A study shows that single-shot intrathecal morphine (ITM) is non-inferior to continuous wound infiltration (CWI) for pain management after open pancreatoduodenectomy, with a significant advantage in early pain control.

  • ITM resulted in lower mean coughing pain scores at 2 hours (5.7 vs. 6.1) and maintained better pain scores at 24 hours, leading to reduced need for fentanyl.
  • Despite comparable overall outcomes, ITM was associated with increased respiratory depression and pruritus in the early postoperative period.

Surgeons should consider ITM for enhanced early analgesia while remaining vigilant for its side effects.

Comparative Study by Yoon S, Kim T (…) Jang JY et 7 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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