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Hand-sewn closure leads to higher complications in left pancreatectomy.

  • In a study of 2,183 patients, postoperative pancreatic fistula (POPF) occurred in 32.9% of hand-sewn closures versus 21.0% for stapler closures.
  • The reoperation rate was higher and hospital stays longer for hand-sewn patients.

Surgeons should consider stapler closure to reduce POPF risk and improve patient outcomes.

  • Findings were consistent across various pancreatic characteristics, reinforcing the need to evaluate closure techniques critically.

Comparative Study by Bonsdorff A, Wennerblom J (…) Sallinen V et 7 al. in J Am Coll Surg

Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Surgeons.

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Insurance Instability Tied to Employment Disruption in GI Cancer

Patients with gastrointestinal cancer face significant insurance instability that impacts surgery timelines and costs.

  • 9.8% of GI cancer patients changed insurance within a year post-diagnosis, compared to 8.8% of controls (adjusted HR 1.18).
  • Insurance instability led to delayed surgeries (adjusted rate ratio 1.15) and higher out-of-pocket costs ($3,675 vs $3,206).

Employment disruptions accounted for 97.2% of insurance instability, emphasizing the need for policies to ensure job and coverage security during cancer treatment.

  • Risk was highest for patients with HMO (HR 2.60) and comprehensive plans (HR 2.66).

Journal Article by Sarfraz A, Chatzipanagiotou OP (…) Pawlik TM et 7 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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Cost-Effective Strategies in Complicated Diverticulitis

Early colectomy is more cost-effective than interval colectomy for managing complicated diverticulitis with abscesses, leading to better outcomes for patients.

  • Early colectomy costs $8,852 less per patient and yields an incremental increase of 0.57 quality-adjusted life years (QALYs).
  • This approach was deemed cost-effective in 96% of scenarios analyzed.

Surgeons should consider early colectomy more often, but weigh patient preferences and quality of life when advising on management options.

  • Interval colectomy remains viable if drainage does not significantly impact a patient’s well-being.

Comparative Study by Esnaola GR, Schultz KS (…) Leeds IL et 3 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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Adhesion Barriers Cut Small-Bowel Obstruction After Ladd Procedure

Using adhesion barriers during the Ladd procedure reduces rehospitalization for small-bowel obstruction without raising midgut volvulus risk.

  • Reoperations for midgut volvulus: 3.5% with barrier vs. 2.7% without—no significant difference.
  • Rehospitalization for small-bowel obstruction: 2.6% with barrier vs. 6.3% without—a 3.6% reduction.

This suggests adhesion barriers can enhance patient outcomes after intestinal malrotation surgery.

  • No significant differences in mortality, surgical interventions, or rehospitalization costs were found.

Journal Article by Takamoto N, Aso S (…) Fujishiro J et 7 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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Small-bites technique reduces incisional hernia risk after laparotomy

A multicenter trial shows that small-bites fascial closure significantly lowers the incidence of incisional hernias compared to large bites after midline laparotomy.

  • Cumulative hernia incidence at 13 years: 34% (small bites) vs. 49% (large bites), hazard ratio 0.61.
  • Hernias over 20 mm: 17% in small-bites group vs. 34% in large-bites group, hazard ratio 0.36.

Using the small-bites technique can lead to better long-term outcomes for patients.

  • Smaller mean hernia size in small-bites group: 25 mm vs. 43 mm, p = 0.02.

Journal Article by van den Berg R, van Egmond S (…) Deerenberg EB et 15 al. in JAMA Surg

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Cost-Saving Strategy in Ileostomy Closure: Prophylactic Mesh

Using prophylactic biosynthetic mesh during ileostomy closure significantly reduces incisional hernia rates and healthcare costs.

  • Hernia incidence dropped to 8% with mesh vs. 24% without (p = .029).
  • Per-patient costs are €1,428.93 with mesh versus €2,290.00 without, saving €861.07.

Selective use in high-risk patients is recommended to optimize outcomes.

  • Cumulative savings could reach €1.32 million for hospitals and €0.89 million for society annually with 25% mesh adoption.

Journal Article by Rognoni C, Bracale U, Peltrini R and Tarricone R in BMC Surg

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

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Laparoscopic vs. Open Repair for Incisional Hernias: Key Insights

Laparoscopic repair of incisional hernias shows advantages but comes with serious risks.

  • No significant difference in recurrence rates between laparoscopic and open repairs.
  • Laparoscopic approach lowers wound drainage risks (RR = 0.07) and postoperative infections (RR = 0.31).
  • However, it nearly triples the risk of bowel injury (RR = 2.80).

Surgeons must weigh benefits against risks for optimal patient selection and outcomes.

Journal Article by Al-Qudimat AR, Zarour A (…) Bawadi H et 2 al. in World J Surg

© 2026 The Author(s). World Journal of Surgery published by John Wiley & Sons Ltd on behalf of International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).

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Patient Burden After Emergency Laparotomy Revealed

Emergency laparotomy patients face significant long-term quality of life challenges that surgeons must address in postoperative care.

  • 38.9% reported incisional hernias, and 34% expressed dissatisfaction with their body image.
  • 40.5% of employed respondents experienced job changes, including earlier retirement.
  • 11.3% had not resumed sexual activity post-surgery, highlighting delayed recovery.

Surgeons should implement tailored support systems focusing on mental health, dietary guidance, and physiotherapy to improve outcomes for these patients.

Journal Article by Silva LM, Mohammed SA (…) Cornish JA et 5 al. in World J Surg

© 2026 The Author(s). World Journal of Surgery published by John Wiley & Sons Ltd on behalf of International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).

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High Out-of-Pocket Surgical Costs in Ethiopia Impact Care Access

One in four surgical patients in Ethiopia faces catastrophic health expenditure, jeopardizing access to essential care.

  • 25% of surgical patients incurred costs exceeding 10% of their household income.
  • Major cost drivers: medications (37%), non-medical expenses like transportation (20%), and surgical fees (14%).

Understanding these financial risks can assist surgeons in patient counseling and help identify those at higher risk for financial distress.

  • Increased risk noted among unmarried individuals, smaller families, and patients requiring trauma-related surgeries.

Journal Article by Iverson KR, Kifle F (…) Beyene A et 9 al. in World J Surg

© 2026 International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).

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Reducing Postoperative Pulmonary Complications in Abdominal Surgery

Non-drug interventions can significantly lower the risk of postoperative pulmonary complications (PPCs) in abdominal surgery patients.

  • PPCs occurred in 11.7% of patients across 255 trials involving over 55,000 participants.
  • High-certainty evidence indicates that using low fractional inspired oxygen (FiO2) notably decreases PPC rates.

Surgeons should consider implementing these strategies to enhance patient outcomes and reduce hospital stays.

  • The findings support a hierarchy of effective interventions, aiding in surgical decision-making for patient selection.

Meta-Analysis by Huang C, Zhao X (…) Feng X et 15 al. in BMJ

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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