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Wound complications common in Morel-Lavallee injuries

One in five patients undergoing surgery for Morel-Lavallee lesions face wound complications.

  • 20.1% of patients developed complications post-op, including skin necrosis (7.5%) and deep infections (6.7%).
  • The primary risk factor was being struck by a vehicle, with a 3.44 odds ratio for complications.

Understand these risks to better counsel patients on their potential outcomes.

  • Bicycle collisions also showed increased complication rates (14.8% vs. 1.9% in non-complications).

Journal Article by Nguyen PD, Grigorian A (…) Nahmias J et 44 al. in BMC Surg

Copyright © 2026 Elsevier Inc. All rights reserved.

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Routine Blood Cultures for Appendicitis Offer Limited Value

Bloodstream infections before appendectomy are rare and rarely impact outcomes.

  • Among 8,241 appendicitis patients, only 3.7% had positive blood cultures.
  • Most infections were expected organisms, primarily Bacteroides and E. coli.

Restricting blood cultures to unstable patients can reduce unnecessary tests and antibiotic use.

  • 33.3% of culture-positive patients received no antibiotics post-surgery, highlighting effective surgical management.

Journal Article by Bhatti UF, Barmparas G (…) Hennessy ML et 2 al. in BMC Surg

Copyright © 2026 Elsevier Inc. All rights reserved.

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Omitting Lateral Node Dissection in Rectal Cancer Safe

Lateral pelvic lymph node dissection in rectal cancer patients with responsive nodes after neoadjuvant therapy shows no survival benefit, impacting surgical strategies.

  • No significant differences in 5-year local recurrence rates (3.1% vs. 5.3%), disease-free survival (77.1% vs. 71.4%), or overall survival (87.0% vs. 86.9%) with or without dissection.
  • Dissection led to longer operative times (279.3 vs. 237.9 minutes) and higher early complication rates (27.0% vs. 19.6%).

This suggests focusing on patient selection may reduce surgical morbidity without compromising oncological outcomes.

Journal Article by Hwang SS, Park IJ (…) Kang SB et 21 al. in Ann Surg

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

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Endoscopic ultrasound-drained gallbladders safe in perforation

Surgeons can safely use endoscopic ultrasound-guided gallbladder drainage in patients with inoperable acute cholecystitis and Niemeier type II perforation.

  • Technical success was 100% in 14 patients treated with electrocautery-enhanced stents.
  • Clinical success reached 92.9% with only mild adverse events, and no severe complications after a median follow-up of 315 days.

Consider this approach in high-risk cases previously deemed inoperable, as it may improve patient outcomes.

Journal Article by Shin IS, Moon JH (…) Cho YD et 8 al. in Gastrointest Endosc

Copyright © 2026. Published by Elsevier Inc.

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Flexibility Stigma Complicates Family Life in Surgery Residencies

Surgeons should know that flexibility stigma hinders resident well-being and family formation.

  • 28 residents reported feeling pressured to avoid work-life accommodations to maintain their reputation.
  • Trainees often faced a “double bind,” balancing career expectations with parenting and personal health needs.

Addressing these cultural barriers within residency programs is crucial for supporting trainees and improving outcomes.

  • Structural changes in scheduling and policy communication can enhance the training environment for pregnant and parenting residents.

Journal Article by Lovejoy MC, Koelliker EL (…) Rangel EL et 6 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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Toupet vs. fundopexy: fewer reoperations with fundopexy

Fundoplication options show noteworthy differences in recurrence rates and patient outcomes.

  • Fewer symptomatic recurrences after fundopexy: 1.3% vs. 17.3% for toupet over 66 months.
  • Comparable rates of postoperative dilation for dysphagia: 21.3% for toupet, 13.3% for fundopexy.

Consider fundopexy for patients at risk of recurrence; randomized studies are needed to confirm these findings.

  • Similar complication rates and operative durations for both techniques, ensuring safety in practice.

Journal Article by Bui E, Erabelli N (…) Banki F et 3 al. in BMC Surg

Copyright © 2026 Elsevier Inc. All rights reserved.

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POEM and LHD show similar long-term outcomes for achalasia.

  • At 5 years, 87.3% of POEM and 90.1% of LHD patients had an Eckardt score ≤3.
  • POEM patients had a higher need for PPIs (45.6% vs 24.6%) and increased rates of esophagitis (34% vs 10.4%).

Surgeons should consider the higher GERD incidence with POEM when selecting treatment.

  • Symptomatic recurrence at 5 years was low in both groups: 9 in POEM, 12 in LHD.

Journal Article by Andrea C, Francesca M (…) Renato S et 8 al. in Surg Endosc

© 2026. The Author(s).

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Minimally Invasive vs. Open Pancreatoduodenectomy: Recovery Insights

Minimally invasive pancreatoduodenectomy (mipd) enhances recovery compared to open pancreatoduodenectomy (opd), especially in the month post-surgery.

  • On postoperative day 30, mipd patients averaged 659 more steps and 22 more active minutes daily than those in the opd group.
  • Mipd patients had a 9-millisecond higher heart rate variability, indicating less physiological stress.

These early recovery benefits may influence surgical decision-making for resectable neoplasms in the pancreatic region.

  • Benefits in physical activity persisted up to 5 weeks, suggesting improved postoperative care protocols with mipd.

Journal Article by Bruna CL, Emmen AMLH (…) Abu Hilal M et 28 al. in JAMA Surg

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Surgeon Attrition: A Growing Concern for Surgical Care

Surgeon attrition is threatening surgical services, particularly in key specialties.

  • Nearly 10% of surgeons exited active practice in 8 years, peaking at 2.5% in 2019.
  • Oral and maxillofacial surgery (25.1%), obstetrics and gynecology (23.2%), and plastic surgery (19.3%) showed the highest attrition rates.

Surgeons with 10-14 years of experience faced more than double the risk of leaving practice compared to those with 5-9 years.

  • Female surgeons showed no difference in attrition rates compared to males.

Prioritizing retention strategies is crucial to ensure continued access to surgical care.

Journal Article by Elemosho A, Chatzipanagiotou OP (…) Pawlik TM 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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Muscle Loss Impacts Survival in Advanced Esophageal Cancer

Excessive muscle loss during neoadjuvant therapy significantly predicts survival outcomes in locally advanced esophageal squamous cell carcinoma.

  • Among 421 patients, 5-year overall survival was 60%, with 26.6% experiencing muscle loss during the initial treatment.
  • Muscle loss at two points during therapy was linked to a higher risk of mortality (stage A HR 1.78; stage B HR 1.83).

Maintaining muscle mass post-therapy correlates with better survival rates, indicating the need for nutritional strategies during treatment.

  • Patients without initial muscle loss who retained muscle in stage B had a 51% lower risk of death (HR 0.49).

Journal Article by Huang G, Zhu J (…) Wang Q et 5 al. in Ann Surg Oncol

© 2026. Society of Surgical Oncology.

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