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Lower Fistula Risk with Robotic Pancreatoduodenectomy

Robotic pancreatoduodenectomy (RPD) significantly lowers the risk of clinically relevant pancreatic fistula compared to open pancreatoduodenectomy (OPD).

  • RPD reduced the incidence of clinically relevant pancreatic fistula by 40% (odds ratio 0.60, 95% CI 0.51-0.67).
  • Over 24,000 patients were analyzed, with 5,000 undergoing RPD and 19,600 OPD.

Surgeons should consider RPD in suitable patients at high-volume centers to minimize complications.

Review by Marchese T, Valle V (…) Ielpo B et 4 al. in Surg Endosc

© 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Impact of Tumor Progression on Hepatectomy Outcomes in NETLM

Preoperative tumor progression significantly predicts early mortality in patients undergoing cytoreductive hepatectomy for neuroendocrine tumor liver metastases.

  • 47% of short-term survivors had preoperative progression compared to 16.6% of long-term survivors (p < 0.001).
  • Patients with pancreatic neuroendocrine tumors and progression faced a median overall survival of just 1.8 years (p = 0.042).

Incorporating tumor progression metrics into preoperative evaluations can refine surgical decision-making and improve patient outcomes.

  • Tumor growth over 20% and weekly growth over 1.04% were strongly linked to early mortality (p < 0.001).

Journal Article by Podrascanin V, Ammann M (…) Starlinger PP et 10 al. in Eur J Surg Oncol

Copyright © 2025 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

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Preoperative Weight Loss Lowers Complications in Colorectal Cancer Surgery

A preoperative weight loss program significantly improves outcomes for colorectal cancer patients with excess weight.

  • 61% of patients in the diet intervention lost 5% or more of their weight, compared to just 9% in usual care (odds ratio 16.8).
  • Average weight loss in the intervention group was 6.1 kg, 4.3 kg more than controls.

Patient retention was 100%, with no safety concerns reported.

  • Weight loss correlates with improved postoperative outcomes: losing 3.2% or more cuts complications by 50%.

Multicenter Study by Koutoukidis DA, Jebb SA (…) Buczacki SJA et 19 al. in JAMA Netw Open

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TACE Plus Systemic Therapy Improves HCC Survival with Thrombus

Combining transarterial chemoembolization (TACE) with systemic therapy significantly enhances outcomes for hepatocellular carcinoma patients with hepatic vein or inferior vena cava tumor thrombus.

  • Median overall survival was 20.9 months with TACE vs. 14.3 months without (HR=0.65).
  • Progression-free survival also favored TACE, at 10.7 months compared to 7.3 months (HR=0.67).

Adding TACE improves the objective response rate significantly, suggesting it should be considered in first-line treatment.

  • 45.3% response rate with TACE vs. 28.8% without (p<0.001).

Journal Article by Lin LW, Chen Q (…) Zhu HD et 15 al. in Int J Surg

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

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Robotic Surgery Outperforms Laparoscopic for Rectal Cancer

Robotic surgery shows better long-term outcomes for middle and low rectal cancer compared to laparoscopic techniques.

  • 3-year disease-free survival rate: 86.7% for robotics vs. 83.3% for laparoscopy (p=0.017).
  • Lower 3-year locoregional recurrence (2.2% vs. 4.7%, p=0.001) and postoperative complications (14.3% vs. 19.5%, p<0.001) with robotic surgery.

This suggests robotic techniques may enhance surgical decision-making and patient outcomes in rectal cancer interventions.

  • Abdominoperineal resection rate was lower at 7.5% vs. 12.4% (p<0.001).

Journal Article by Wang K, Guo T (…) Feng Q et 6 al. in Int J Surg

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

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CALLY Index Predicts Outcomes in Cancer Surgery

Lower preoperative CALLY index indicates worse survival and higher complications in cancer patients undergoing surgery.

  • Each unit decrease in CALLY index increases the risk of overall survival failure by 91% (HR: 1.91, p < 0.001).
  • Patients with low CALLY index had 88% higher recurrence risk (HR: 1.88, p < 0.001) and 151% higher cancer-specific mortality (HR: 2.51, p < 0.001).
  • Major postoperative complications are nearly double with low CALLY levels (OR: 2.07, p = 0.005).

Integrating CALLY index into preoperative assessments may refine risk stratification and improve surgical outcomes.

Journal Article by Zhang L, Wang K (…) Wang W et 6 al. in Int J Surg

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

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Chlorhexidine Outperforms Povidone-Iodine in SSI Prevention

Chlorhexidine is more effective than povidone-iodine for preventing surgical site infections (SSIs), especially in clean-contaminated procedures.

  • Chlorhexidine reduces overall SSI risk by 17% compared to povidone-iodine (risk ratio 0.83).
  • It particularly lowers superficial incisional SSIs, with no significant effect on deep incisional or organ-space infections.

Use chlorhexidine for skin preparation to enhance surgical outcomes.

  • The analysis included 32 high-quality trials and nearly 30,000 patients.

Systematic Review by Yang S, Li Z (…) Wang C et 3 al. in Front Med (Lausanne)

Copyright © 2025 Yang, Li, Wu, Sun, He and Wang.

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Kangduo Robot Outperforms Laparoscopy in Distal Pancreatectomy

Kangduo robotic distal pancreatectomy is more effective and cost-efficient than traditional laparoscopic surgery.

  • Kangduo patients had lower blood loss and transfusion rates.
  • Reduced operative time and conversion to open surgery rates were noted.

This technique leads to similar recovery outcomes while cutting costs.

  • Patients on the Kangduo system also showed a significant decrease in inflammatory markers.

Journal Article by Luo W, Weng G (…) Zhang T et 5 al. in J Robot Surg

© 2025. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.

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Laparoscopic Feeding Jejunostomy Outperforms Open Approach

Laparoscopic feeding jejunostomy (LFJ) offers a safer, less painful alternative to open feeding jejunostomy (OFJ) for patients with upper GI cancers.

  • Major complications were similar (LFJ 10% vs. OFJ 17%, p = 0.472).
  • LFJ had significantly fewer minor complications (26.6% vs. 89.6%, p < 0.001) and reduced post-operative pain.
  • Patients with LFJ started feeds earlier and had shorter hospital stays.

Consider LFJ for suitable candidates to improve recovery times despite a longer surgery duration.

Journal Article by Rajasekar S, Kumbhar US (…) Raja K et 3 al. in J Minim Access Surg

Copyright © 2025 Journal of Minimal Access Surgery.

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Outcomes from Adrenalectomy in Phaeochromocytoma Patients

Surgical approaches for large phaeochromocytomas matter: minimally invasive techniques reduce severe complications.

  • Patients with tumours ≥ 6 cm faced significantly higher severe complication rates (11.2% vs. 4.8%; p < 0.001).
  • Tumour size ≥ 6 cm is an independent predictor of complications (odds ratio 1.93; p < 0.001).

Choosing laparoscopic or robotic adrenalectomy for large tumours can lower morbidity compared to open surgery.

  • Minimally invasive surgery was linked to lower complications (laparoscopic OR 0.33; robotic OR 0.40).

Multicenter Study by McLennan S, Verhoeff K (…) Sutcliffe RP et 84 al. in BJS Open

© The Author(s) 2025. Published by Oxford University Press on behalf of BJS Foundation Ltd.

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