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Long-term Outcomes of Nonoperative Management for Appendicitis

Nonoperative management of acute appendicitis has high rates of later surgery and hospital visits, which surgeons should consider in patient selection.

  • 33% of patients experienced a subsequent event (hospital visit or surgery) within 1 year, rising to 36% at 5 years.
  • At 5 years, 16% had appendicitis-related hospital readmissions, 12% needed emergency surgery, and 21% underwent scheduled appendectomy.

Surgeons should weigh the risks of future interventions when opting for nonoperative management in appendicitis cases.

  • For uncomplicated cases, 28% had interventions at 1 year and 32% by 5 years.

Journal Article by Telesnicki T, Nantais J (…) Gomez D et 2 al. in Ann Surg

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

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Predicting SMA Margin Status in Pancreatic Cancer Patients

A new computer vision algorithm shows promise in predicting superior mesenteric artery margin status for pancreatic ductal adenocarcinoma, which could reshape surgical decision-making.

  • The algorithm achieved a sensitivity of 0.43 and an accuracy of 0.85, outperforming expert radiologists and surgeons (0.23 and 0.76, respectively).
  • Specificity was high across all evaluations, with both the algorithm and radiologists scoring 0.94.

This tool may enhance preoperative assessments, helping surgeons better select patients for potentially curative resection.

Journal Article by Wang J, Ashraf Ganjouei A (…) Alseidi A et 15 al. in Ann Surg

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

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Higher EGS Rates in Cancer Patients Demand Surgical Strategy Shifts

Cancer patients face a significantly higher risk of emergency general surgery (EGS) conditions shortly after diagnosis, impacting surgical decision-making.

  • Within the first year post-diagnosis, 4.8% of cancer patients develop EGS conditions versus 3.2% of noncancer patients.
  • Patients with lung cancer show the highest incidence at 6.8%, followed by breast cancer at 4.0%.
  • Despite these higher rates, cancer patients are 1.6 times less likely to undergo surgery compared to noncancer peers.

This underscores the need for tailored surgical strategies and careful monitoring in cancer populations.

Journal Article by Jolissaint JS, Lobaugh SM (…) Wei AC et 4 al. in Ann Surg

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

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Study Reveals Gaps in Innovative Bariatric Surgery Oversight

Surgeons should be alert to significant issues in the implementation of non-standard metabolic bariatric surgeries.

  • 57 studies analyzed involved 10,754 patients; median from first operation to publication was 5 years.
  • Only 11% had prospective trial registration; 26% reported outcomes at 3 years or more.

These findings point to systemic failures in monitoring experimental procedures, emphasizing the need for stronger regulations to safeguard patient safety and ensure solid evidence for new surgical techniques.

Journal Article by Papadia FS, De Cian O, Di Lorenzo N and Cohen RV in Br J Surg

© The Author(s) 2026. Published by Oxford University Press on behalf of BJS Foundation Ltd.
© The Author(s) 2026. Published by Oxford University Press on behalf of BJS Foundation Ltd.

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Advancements in Achalasia Treatment Enhance Outcomes

New strategies in achalasia management are improving surgical and endoscopic outcomes for better patient care.

  • Minimally invasive techniques like robotic myotomy and POEM have significant advantages over traditional methods.
  • Treatment can now be tailored based on manometric subtype, esophageal structure, and patient health, increasing success rates.

Surgeons should prioritize individualized treatment plans to enhance patient quality of life and manage complications effectively.

  • Ongoing innovations and longer follow-up are crucial for refining these treatment protocols.

Journal Article by Conner A, Wills MV (…) Lee Y et 7 al. in Br J Surg

© The Author(s) 2026. Published by Oxford University Press on behalf of BJS Foundation Ltd.

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Enhancing Trauma Care Capacity in Ethiopia

Surgeons need to know that a five-year collaboration in Ethiopia significantly improved trauma care capacity at Hawassa University Hospital.

  • Trauma care scores rose in provider knowledge, infrastructure, supplies, and hospital processes.
  • Clinical gains for specific injuries were limited, pointing to room for improvement.

Investing in human resources remains critical, as this area saw no improvement and is still the weakest domain.

  • Effective prehospital systems play a vital role in enhancing trauma outcomes in low-resource settings.

Journal Article by Alexander KJ, Lee M (…) Rodas EB et 8 al. in J Am Coll Surg

Copyright © 2025 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Increasing Use of Robotic Cholecystectomy for Obese Patients

Robotic cholecystectomy is on the rise, especially among obese patients, but it does not improve postoperative outcomes compared to laparoscopic surgery.

  • Robotic surgery utilization increased significantly from 23.1% in 2020 to 55.8% in 2024 for patients with BMI ≥ 50 kg/m².
  • Obese patients (BMI 35-49.9 kg/m²) were 15% more likely to have robotic surgery; those with BMI ≥ 50 kg/m² were 34% more likely.
  • No difference in complication rates was observed between robotic and laparoscopic approaches across BMI groups.

Consider offering robotic cholecystectomy to obese patients, knowing it may address technical challenges without changing outcome profiles.

Comparative Study by VanWinkle CK, Howard R (…) Jackson HT et 4 al. in J Am Coll Surg

Copyright © 2025 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Terminology Confusion in Pancreatic Surgery: A Call to Action

Surgeons need to know that recent trends show increasing use of imprecise terms for pancreatic head resections, which can impact clinical understanding.

  • Between 2004 and 2023, “pancreaticoduodenectomy” dominated 65.7% of titles, with “pancreatoduodenectomy” at 27.9%.
  • Other variants, including “duodenopancreatectomy,” saw significant decline in use.

Inconsistencies affect education and literature indexing, urging a push for standardized terminology in surgical practices and documentation.

  • Emphasizing etymological accuracy is vital for clear communication and improved patient outcomes.

Journal Article by Perim V, Fonseca A (…) Rose JB et 3 al. in Ann Surg Oncol

© 2026. Society of Surgical Oncology.

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Major Pathologic Response Improves Outcomes in Pancreatic Cancer

Achieving a major pathologic response (mpr) after preoperative treatment for pancreatic ductal adenocarcinoma significantly impacts survival rates.

  • Mpr was noted in just 11.5% of patients, but those who achieved it had a median overall survival of 71.5 months, compared to 40.9 months for non-mpr patients.
  • Recurrence-free survival also improved, with mpr patients experiencing 55.5 months versus 15.2 months in the non-mpr group.

Understanding and predicting mpr can help tailor postoperative management, as adjuvant chemotherapy was not an independent prognostic factor for mpr patients.

  • Factors predicting mpr include chemoradiotherapy, preoperative treatment duration of 6 months or more, and normal carbohydrate antigen 19-9 levels post-treatment.

Journal Article by Yamane K, Nagai K (…) Hatano E et 25 al. in Ann Surg

Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, Inc.

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Pulmonary metastases after pancreatic cancer surgery tied to better survival

Patients with isolated pulmonary metastases post-resection of pancreatic ductal adenocarcinoma (PDAC) have improved overall survival compared to other metastatic sites.

  • Of 343 patients studied, 21% had lung metastases with a median overall survival of 30 months, compared to 13 months for liver and 20 months for other sites.
  • Recurrences occurred in 85% of patients within 3 years, with liver metastases linked to the highest mortality risk.

Consider targeted therapies for patients with pulmonary metastases as they show promising outcomes.

  • Overall, mortality risk was 7-fold higher for lung metastases, 12-fold for others, and 23-fold for liver involvement.

Journal Article by D’Souza M, Andrée M (…) Holmberg M et 2 al. in Ann Surg Oncol

© 2026. The Author(s).

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