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Social Factors Impact Post-Gastrectomy Outcomes in Cancer Patients

Social determinants significantly affect short-term outcomes after gastrectomy for gastric adenocarcinoma, highlighting disparities in care.

  • Black patients are 25% less likely and Hispanic patients are 29% less likely to experience extended hospital stays compared to white patients.
  • Higher education levels correlate with a 19% increased risk of extended stays and a 26% increased risk of readmissions.

Surgeons should consider social factors in patient selection and postoperative planning to improve outcomes.

  • Asian patients have 40% lower mortality rates compared to white patients.

Journal Article by Moten AS, Bailey C, Stanfill AG and Glazer ES in Am J Surg

Copyright © 2025 Elsevier Inc. All rights reserved.

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Bile Duct Injury Repair Insights: Delayed is Safer

Delayed repair for bile duct injuries (BDIs) following cholecystectomy significantly lowers reoperation and mortality rates.

  • Early repair increases reoperation rates by 3.31 times and stricture rates by 7.41 times compared to late repair.
  • Non-operative management leads to a staggering 16.60 higher reoperation rate than operative interventions.

Surgeons should prioritize delayed repair to improve patient outcomes after BDI.

  • Minimal invasive surgery shows similar outcomes to open repair.

Journal Article by Esparham A, Calabrese EC (…) El-Hayek K et 9 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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Early FAST Ultrasound Cuts Trauma Mortality in Low-Resource Settings

Using early FAST ultrasound drastically lowers mortality rates in severe trauma patients, proving essential in low-resource environments.

  • In-hospital mortality: 39.2% with FAST vs. 66.2% without (p=0.001).
  • Thirty-day mortality: 45.6% with FAST vs. 72.7% without (p=0.001).

Integrating FAST into trauma triage can enhance surgical outcomes significantly.

  • Reduced CT scans (82.5% with FAST vs. 96.1% without, p=0.006) and faster time to surgery (5.16 vs. 9.82 hours, p<0.001).

Randomized Controlled Trial by Kettani A, Moujtahid H (…) Faroudy M et 3 al. in Eur J Trauma Emerg Surg

© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

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Multimodal Advances Transforming Gastric Cancer Management

Recent updates in multimodal treatment are reshaping gastric cancer care, impacting surgical strategies and patient outcomes.

  • Laparoscopic and robotic gastrectomy are now standard in Asia, supported by major trials like JCOG0912 and K-LASS02.
  • The FLOT chemotherapy regimen is becoming the global standard, while SOX and XELOX gain traction in Asia.

Surgeons should consider integrating immunotherapy based on emerging trial results for select patients.

  • Ongoing trials are studying the role of conversion surgery in stage IV cases, highlighting the need for personalized multi-disciplinary approaches.

Review by Shoda K, Kawaguchi Y, Maruyama S and Ichikawa D in Ann Gastroenterol Surg

© 2025 The Author(s). Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterological Surgery.

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Efficacy of HIPEC After Laparoscopic Gastrectomy in Gastric Cancer

Laparoscopic gastrectomy plus hyperthermic intraperitoneal chemotherapy (HIPEC) improves outcomes for gastric cancer patients with positive peritoneal lavage cytology.

  • HIPEC-treated patients had significantly lower postoperative recurrence (66.7% vs. 90.9%) and visible metastasis (29.6% vs. 59.1%, p < 0.05).
  • 3-year overall survival for HIPEC patients was 51.8% versus 18.2% for non-HIPEC (p = 0.005).

Consider HIPEC for eligible patients to enhance survival and reduce recurrence rates.

  • Stage III cytology-negative patients had similar outcomes to HIPEC-treated patients (overall survival 56.4% vs. 51.8%, p = 0.39).

Journal Article by Lv C, Tong L (…) Cai L et 4 al. in Ann Surg Oncol

© 2025. Society of Surgical Oncology.

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Fluorescence Imaging with ICG Reduces Colorectal Leaks

Fluorescence imaging using indocyanine green significantly improves surgical outcomes in colorectal procedures.

  • It reduces anastomotic leak rates with an odds ratio of 0.58 (95% CI 0.44-0.75).
  • It enhances lymph node retrieval by an average of 6.32 nodes in gastrointestinal cancer surgeries (95% CI 4.43-8.22).

Intraoperative adjustments to transection points are feasible, improving surgical precision.

  • Evidence remains limited for other applications like thoracic duct identification and esophageal anastomoses.

Journal Article by Kapsampelis P, Calabrese EC (…) Keller DS et 15 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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Streamlined Robotic Training Cuts Time, Maintains Mastery

A refined robotic surgical training curriculum enhances skill acquisition while significantly lowering training time.

  • Mastery rates jumped from 83% to 100% with the new curriculum.
  • Mean console training time decreased from 7 hours to 5 hours and 42 minutes (p=0.005).

This efficient approach offers general surgery residents a more effective pathway to proficiency.

  • Median VR drill scores improved dramatically, with test scores up by over 400 points across both curricula.

Journal Article by Nunez-Rocha RE, Castillo-Flores S (…) Polanco PM et 7 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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New predictive models identify risks for liver tumor rupture

Understanding the risk factors for hepatocellular carcinoma (HCC) rupture can improve surgical outcomes.

  • Key risk factors include cirrhosis, protrusion ratio, and maximum tumor length.
  • The new capture nomogram achieved AUC values of 0.857, 0.824, and 0.840 across training, validation, and test groups, indicating high predictive accuracy.

Using these models can enhance early risk assessment and guide better management strategies for HCC patients, potentially reducing serious complications during surgery.

  • Random forest and deep learning models reached even higher AUCs of 0.870 and 0.872 in the test cohort.

Multicenter Study by Xia F, Liu Y (…) Zhu P et 30 al. in BJS Open

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

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One-stage surgery beats two-stage for unresectable liver metastases.

  • Median overall survival was 46.5 months for one-stage versus 34.0 months for two-stage (p = 0.043).
  • Complication rates were similar: 11% for one-stage and 13% for two-stage (p = 0.567).
  • Local treatment was more successful with one-stage surgery, achieving complete resection or ablation in 52 patients compared to 29 in the two-stage group (p < 0.001).

Consider one-stage approaches as a first option for eligible patients, with two-stage surgery reserved for more complex cases.

Comparative Study by Bond MJG, Bolhuis K (…) Swijnenburg RJ et 23 al. in BJS Open

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

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Laparoscopic Liver Resection in Segment 7 Shows Promise

Laparoscopic liver resection (LLR) for malignancies in segment 7 is a viable option, with potential short-term benefits.

  • LLR led to shorter hospital stays and a trend toward reduced blood loss compared to open liver resection (OLR).
  • Over 30 cases, the conversion rate to OLR decreased, indicating improved surgical safety with experience.

Surgeons can consider LLR as a safe alternative, especially as expertise builds, potentially enhancing patient outcomes.

Journal Article by Zhou H, Zheng H (…) Zhang W et 17 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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