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Mapping Surgical Evidence for GEP-NETs

Surgical management of gastro-entero-pancreatic neuroendocrine tumors is inconsistent, highlighting the need for clearer guidelines.

  • Only 4% of studies on surgery for GEP-NETs are prospective; 96.7% are retrospective.
  • Most research focuses on small pancreatic NETs and liver metastases, limiting broader applicability.

Surgeons should prioritize evidence from multi-institutional studies for better patient selection and outcomes.

  • Current literature primarily involves single-center analyses, diminishing evidence reliability.

Review by Meloche-Dumas L, Bleicher J (…) Hallet J et 6 al. in Ann Surg Oncol

© 2026. Society of Surgical Oncology.

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Delayed Recovery in Gastrectomy: Total vs. Other Procedures

Total gastrectomy patients experience slower recovery and greater symptom burden compared to other types of gastrectomy.

  • Recovery rates for total gastrectomy were 63% at one month and only 75% by six months, compared to 79% and 96% for other procedures.
  • Open total gastrectomy had a significantly lower odds ratio for recovery (0.28) compared to robotic distal gastrectomy.

Surgeons should consider these findings for better patient selection and surgical planning to optimize outcomes.

  • Total gastrectomy patients lost 15% of body weight by six months, but weight loss did not correlate with life enjoyment scores.

Journal Article by Takayama M, Tomita K (…) Ikoma N et 9 al. in Ann Surg Oncol

© 2026. The Author(s).

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Laparoscopic Cholecystectomy Outperforms Open and Robotic Methods

Laparoscopic cholecystectomy reduces mortality and complications compared to open surgery, especially in low- and middle-income settings.

  • Laparoscopic surgery cut mortality risk by 84% (RR 0.16) and complications by 54% (RR 0.46) versus open cholecystectomy.
  • Length of hospital stay decreased by an average of 4.08 days with laparoscopic techniques.

Robotic surgery did not show significant advantages over laparoscopic methods.

  • The mortality benefit from laparoscopic surgery was more pronounced in lower-income countries.

Review by Delpino FM, Tustumi F (…) Wolosker N et 5 al. in Am J Surg

Copyright © 2026 The Authors. Published by Elsevier Inc. All rights reserved.

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International Consensus on Managing Presacral Tumors

A unified expert consensus now clarifies the best practices for diagnosing and managing rare presacral tumors, essential for improving surgical outcomes.

  • High-resolution MRI is critical for risk stratification.
  • Image-guided biopsies are recommended for high-risk lesions that could change management.

Complete surgical resection is the primary goal, with approaches tailored to tumor characteristics, while minimally invasive techniques may be suitable in select cases.

  • Non-operative surveillance is endorsed for specific low-risk cystic lesions.

Journal Article by Perry WRG, Brown KGM (…) Dozois E et 18 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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Improving Survival Predictions in Colorectal Liver Metastases

This study assesses 11 clinical risk scores to enhance patient selection for liver resection in colorectal cancer.

  • Median overall survival after surgery was 26 months for 528 patients.
  • The Comprehensive Evaluation of Relapse Risk (CERR) score showed strong predictive performance with an area under the curve of 0.654 for 1-year survival and 0.62 for 5-year survival.
  • All risk scores, except one, effectively stratified patients by long-term survival.

Utilizing these scores can refine surgical decision-making and optimize patient outcomes in liver resections.

Journal Article by Schmidt F, Meister FA (…) Amygdalos I et 9 al. in Ann Surg Oncol

© 2026. The Author(s).

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Predicting Post-hepatectomy Liver Failure in HCC Patients

Understanding risk factors can guide surgical decisions for patients with hepatocellular carcinoma.

  • Post-hepatectomy liver failure (PHLF) occurred in 7% of patients, linked to a 30.8% major complication rate and 9.2% 90-day mortality.
  • PHLF patients had 5-year survival of 52.8%, compared to 78.8% in non-PHLF patients.

Identifying independent risk factors such as hepatitis B status and indocyanine green retention supports tailored surgical planning.

  • A predictive nomogram demonstrated strong performance (AUC 0.771), allowing for better preoperative risk assessment.

Journal Article by Jo HS, Kim NR (…) Kim DS et 2 al. in Ann Surg Oncol

© 2026. Society of Surgical Oncology.

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New Insights on Organ Preservation in Rectal Cancer

Organ preservation strategies in rectal cancer management are safe and effective.

  • 26% of patients underwent organ preservation, with higher rates in early-stage cases (51% vs. 18.1%).
  • Watch and wait was used for 78% of these patients, showing similar short-term outcomes to local excision.
  • At 2 years, overall survival exceeded 95% across the board, with no significant differences in disease-free or local recurrence-free survival.

Surgeons should consider these options to tailor treatment based on patient response, particularly in non-metastatic cases.

Journal Article by Noiret B, Manceau G (…) Denost Q et 27 al. in Dis Colon Rectum

Copyright © The ASCRS 2026.

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Surgical Resection Boosts Survival in Older Pancreatic Cancer Patients

Surgical resection significantly impacts survival in patients 65 and older with localized pancreatic cancer.

  • Five-year survival for surgical patients aged 65-74 is 25.6%, compared to just 2.0% for those without a surgery recommendation.
  • Surgical treatment reduces cancer-specific mortality with an adjusted hazard ratio of 0.26 versus those who do not receive surgery.

Surgeons should prioritize surgical options for suitable older patients to enhance outcomes.

  • Disparities in treatment uptake among sex and race underline the importance of tailored treatment decisions.

Journal Article by Ekenze SO, Charalampous CM and Pawlik TM in J Gastrointest Surg

Copyright © 2026 The Author(s). Published by Elsevier Inc. All rights reserved.

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Minimally Invasive vs. Open Surgery for Ampullary Cancer: No Difference

This study shows that minimally invasive pancreatoduodenectomy (mipd) and open pancreatoduodenectomy (opd) yield similar outcomes for ampullary adenocarcinoma, regardless of subtype.

  • R1 resection rates were comparable: aac-it (3.4% mipd vs. 6.9% opd) and aac-pb (9.8% mipd vs. 14.9% opd).
  • Five-year overall survival rates were similar: aac-it (56.8% mipd vs. 59.5% opd) and aac-pb (52.5% mipd vs. 44.4% opd).

Surgeons can choose between mipd and opd without compromising oncological outcomes.

Comparative Study by Uijterwijk BA, Moekotte A (…) Abu Hilal M et 27 al. in Ann Surg

Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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Laparoscopic transgastric necrosectomy may outperform endoscopic approach.

  • Study found similar 30-day readmission (23% vs 25%) and mortality rates (3% for both).
  • Median total debridement time was comparable (131 min for LTN vs 134 min for DEN), but complete debridement was achieved more often with DEN (3 times vs 1).
  • LTN reduced length of stay for patients with higher APACHE II scores (8 vs 10 days).

This suggests LTN could be the preferred choice for managing walled-off necrosis in select patients.

Comparative Study by Harrison JM, Day H (…) Visser BC et 13 al. in Ann Surg

Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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