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High fib-4 index and microvascular invasion predict late recurrence.

In a cohort of 769 hepatocellular carcinoma survivors, 21.6% experienced late recurrence post-treatment. Key findings showed that patients with late recurrence exhibited a higher fib-4 index (median 2.31) and a tendency toward microvascular invasion. Both factors were independently associated with worse recurrence-free survival (RFS). Patients identified as high-risk had a two-fold increase in recurrence hazard at five years. These distinct risk patterns suggest a need for personalized postoperative surveillance to enhance early detection of recurrence.

Journal Article by Akabane M, Kawashima J (…) Pawlik TM et 19 al. in J Gastrointest Surg

Copyright © 2025 Society for Surgery of the Alimentary Tract. Published by Elsevier Inc. All rights reserved.

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Nonadherence to Antibiotic Guidelines Results in Waste and Costs

A retrospective analysis revealed that 92% of patients undergoing certain elective surgeries received unnecessary prophylactic antibiotics, despite guidelines recommending against their use. This nonadherence resulted in an estimated financial waste of US$3,279 and significant environmental impact, as 94% of the cases were classified as clean. Cefazolin was the most commonly administered antibiotic. The findings underscore the need for improved antibiotic stewardship in surgical practices to mitigate both economic and ecological burdens.

Journal Article by Sandigo-Saballos I, Montero S (…) Chen KT et 2 al. in Am Surg

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Modified approach slashes costs and carbon footprint in surgery

A modified step-up approach to elective laparoscopic cholecystectomy yielded notable reductions in surgical consumables, achieving a 51.9% decrease in weight, a 50.6% drop in carbon footprint, and a 43.1% cost reduction. Implemented without extending operating time or increasing complications, this strategy highlights an effective method of minimizing waste in surgical practices. Patients treated with this approach experienced similar safety and outcomes compared to those undergoing the traditional method within a prior 12-month period.

Journal Article by Gangakhedkar S, Chen S (…) McCahill O et 3 al. in ANZ J Surg

© 2025 Royal Australasian College of Surgeons.

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Histopathological features predict pouch failure in ulcerative colitis patients

A study evaluating 417 patients who underwent ileal pouch-anal anastomosis found a 23% risk of pouch failure over 18 years. Key predictors included post-procedure Crohn’s disease and specific histologic features such as deep chronic inflammation and severe disease activity. Single-cell spatial transcriptomics identified immune cell infiltration and disrupted signaling pathways associated with pouch failure. These insights support the importance of histologic and molecular analyses to identify high-risk patients and enhance surgical outcomes.

Journal Article by Olivas AD, Mou Ngai PC (…) Weber CR et 11 al. in Cell Mol Gastroenterol Hepatol

Copyright © 2025 The Authors. Published by Elsevier Inc. All rights reserved.

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Updated guidelines improve coagulation management in trauma care

A systematic review has led to updated clinical guidelines for inhospital coagulation management and fluid replacement therapy in patients with severe injuries. Key recommendations stress the importance of early interventions for trauma-induced coagulopathy and the use of viscoelastic assays to guide treatment. Notably, tranexamic acid should not be universally applied in emergency situations, as only 20% of trauma patients display hyperfibrinolysis. The updated guidelines are derived from the evidence of fifty-nine new studies, improving consensus in clinical practice.

Systematic Review by Lier H, Goossen K (…) Hilbert-Carius P et 4 al. in Eur J Trauma Emerg Surg

© 2025. The Author(s).

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Endoscopic intermuscular dissection shows promise for rectal cancer

A study on endoscopic intermuscular dissection (EID) for deep submucosal invasive rectal cancer (d-smic) reports encouraging three-year outcomes. The procedure achieved a 94.1% en bloc resection and 82.5% R0 resection rates. In low-risk patients under active surveillance, locoregional recurrence rates were low (7%), while intermediate-risk had a 13% rate, all salvageable. Notably, there were no distant recurrences or cancer-specific deaths across all groups, suggesting EID may reduce the need for radical surgeries.

Journal Article by van der Schee L, Albers SC (…) Moons LMG et 10 al. in Gut

© Author(s) (or their employer(s)) 2025. No commercial re-use. See rights and permissions. Published by BMJ Group.

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Conversion surgery enhances survival in advanced gastric cancer patients

In a multicenter study of 232 patients with stage IV HER2-positive gastric cancer, conversion surgery following trastuzumab-based chemotherapy and immunotherapy yielded significantly improved outcomes. Patients who underwent the procedure experienced median progression-free survival of 37.7 months and overall survival of 50.9 months. In contrast, those who did not have surgery had progression-free survival of 10.8 months and overall survival of 22.0 months. These findings support the efficacy of surgical intervention for select patients.

Journal Article by Liang H, Liang C (…) Zhao L et 6 al. in Ann Surg Oncol

© 2025. Society of Surgical Oncology.

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Deep learning model enhances 3D segmentation of pancreatic cancer

A newly developed deep learning auto-segmentation model effectively segments pancreatic cancer and surrounding structures to assist surgical planning. In a study involving 275 patients, the model achieved a Dice similarity coefficient of 75.4 in internal and 75.6 in external validation. High segmentation accuracy was noted in the pancreas parenchyma but lower in pancreatic cancer lesions. Notably, cancer detection improved with larger tumor sizes, indicating potential for significant clinical applications in preoperative assessment.

Journal Article by Rhu J, Oh N (…) Min JH et 6 al. in Int J Surg

Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc.

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Continuous glucose monitoring improves recovery in diabetic colorectal cancer patients

Enhanced recovery outcomes for colorectal cancer patients with type 2 diabetes markedly improved through continuous glucose monitoring (CGM). A study involving 181 patients revealed that those under CGM showed lower mean daily glucose levels (9.52 mmol/L) compared to conventional glucose monitoring (10.37 mmol/L) on postoperative day one. The technology significantly enhanced glycemic control and facilitated quicker recovery, wound healing, and early detection of hyperglycemia. These promising results endorse CGM’s integration in surgical management for this patient population.

Journal Article by Wang Q, Zhou Y (…) Li H et 5 al. in Front Med (Lausanne)

Copyright © 2025 Wang, Zhou, Wang, Ou, Wu, Chen, Li and Li.

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Endoscopic techniques improve outcomes for biliary leak management

Endoscopic management has emerged as a key strategy for treating biliary leakages resulting from surgery or trauma. Researchers emphasize the importance of accurately classifying leaks to choose appropriate treatments, which range from conservative care to surgical intervention. Notably, endoscopic techniques, especially endoscopic retrograde cholangiopancreatography with sphincterotomy and stent placement, are now favored for accessible leaks, improving patient outcomes even in complex cases. Overall, tailored approaches significantly enhance recovery and prevent severe complications.

Review by Ellrichmann M, Bösenkötter J, Schoch S and Conrad CC in Visc Med

© 2025 S. Karger AG, Basel.

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