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Prognostic Tool for Esophageal Cancer Predicts Survival

A new model accurately predicts 3-year mortality for patients with resected esophageal or gastroesophageal junction cancer, aiming to enhance surgical decision-making.

  • Internally validated with 2,124 Ontario patients, it shows an AUC of 0.77, indicating good predictive power.
  • Externally validated with 318 Manitoba patients, it maintains strong results, AUC of 0.73.

This tool may improve patient selection and treatment personalization, leading to better outcomes.

  • A web-based interface is being developed for real-world clinical use, enhancing shared decision-making.

Journal Article by Harrison LD, Gupta V (…) Mahar A et 12 al. in Ann Surg Oncol

© 2025. Society of Surgical Oncology.

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Effective Nonsurgical Strategy for Benign Biliary Strictures

Magnetic compression anastomosis offers a promising option for patients with completely obstructed benign biliary strictures unresponsive to standard therapies.

  • 92.9% overall success rate in 113 patients treated with MCA.
  • Only 14.3% experienced recurrence, with a median of 23.7 months after treatment.

Surgeons can consider MCA as a viable alternative, minimizing the need for surgical interventions.

  • Major complications were rare, with only one case of mild cholangitis.

Journal Article by Jang SI, Lee SY (…) Lee DK et 9 al. in Endoscopy

Thieme. All rights reserved.

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Predicting Anastomotic Leakage Risk After Gastric Cancer Surgery

A new machine learning model predicts anastomotic leakage risk post-gastrectomy, crucial for improving outcomes.

  • The model shows an AUC of 0.871 with a sensitivity of 71.2% and specificity of 87.3%.
  • Using CRP levels within three days post-surgery as a key predictor can boost negative predictive value to 98.9% at a higher sensitivity threshold.

Surgeons can use this model to identify at-risk patients early, guiding intervention strategies and potentially reducing complications.

  • Continued multicenter validation is needed for broader clinical application.

Journal Article by Ma W, Zhao S (…) Yu Y et 4 al. in Am Surg

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Minimally Invasive Esophagectomy Beats Open Surgery in Older Patients

Minimally invasive esophagectomy (MIE) significantly improves survival for older esophageal cancer patients compared to open esophagectomy (OE).

  • MIE offers a median overall survival of 60.17 months vs. 29.18 months for OE (HR=1.566, p=0.002).
  • Disease-free survival is also better with MIE (37.70 months vs. 25.20 months, HR=1.411, p=0.010).

MIE has similar major complication rates as OE, making it a preferable option for enhancing outcomes and recovery in older patients with esophageal squamous cell carcinoma.

Comparative Study by Li K, Lu S (…) Leng X et 7 al. in Langenbecks Arch Surg

© 2025. The Author(s).

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Predicting Bowel Resection Risk in Incarcerated Hernias

This study identifies key predictors for bowel resection in incarcerated abdominal wall hernias, which has crucial implications for surgical decision-making.

  • 12% of patients needed bowel resection due to strangulation.
  • Elevated white blood cell count, C-reactive protein, and lactate levels linked to a higher risk of resection.
  • Bowel obstruction and femoral hernia also significantly increase risk (OR 54.922 and OR 3.515, respectively).

Recognizing these factors can enhance patient selection and optimize preoperative assessments for improved outcomes.

Journal Article by Yilmaz S, Celik C (…) Somuncu E et 3 al. in ANZ J Surg

© 2025 Royal Australasian College of Surgeons.

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Rethinking Surgical Trials in Esophagogastric Cancer

Multicenter trials in esophagogastric cancer have not improved overall survival, raising urgent questions about trial design.

  • 27 trials were analyzed; only 10 aimed for survival superiority, none achieved significant benefits.
  • Common issues included limited surgeon credentialing and poor adherence monitoring.
  • Trials often lacked adequate power and internal piloting, with a 10% nonadherence potentially halving statistical power.

Surgeons should advocate for more rigorous quality assurance in trial design to enhance outcome validity.

Review by Das B, Mitra AT, Bossuyt P and Hanna GB in Ann Surg Oncol

© 2025. The Author(s).

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Low Ligation of IMA Enhances Survival in Rectosigmoid Surgery

Low ligation of the inferior mesenteric artery improves outcomes for rectal and sigmoid cancer patients.

  • Low ligation significantly boosts 5-year overall survival (HR 0.69, p = 0.026).
  • It reduces anastomotic leak rates (OR 0.71, p = 0.050) without affecting disease-free survival or lymph node yield.
  • No increase in overall complications, operative time, or blood loss was observed.

This supports low ligation as the preferred technique in rectosigmoid cancer surgery for better patient outcomes.

Review by Sassun R, Sileo A (…) Larson DW et 6 al. in Ann Surg Oncol

© 2025. Society of Surgical Oncology.

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Endoscopic Ultrasound Outperforms PTBD for Biliary Obstruction

Endoscopic ultrasound (EUS) is a cost-effective strategy for managing malignant distal biliary obstruction (MDBO) after failed ERCP, leading to better outcomes.

  • EUS-guided biliary drainage (EUS-GB) cost $14,520, yielding 0.38 QALYs and an incremental net monetary benefit (NMB) of $37,768.
  • EUS-guided choledochoduodenostomy (EUS-CBD) cost $17,694, providing 0.55 QALYs and an incremental NMB of $52,171.

EUS techniques show comparable outcomes to percutaneous options, offering advantages with potentially lower reintervention rates.

  • PTBD costs $14,988 but provides fewer QALYs and is deemed less effective.

Journal Article by Siranart N, Pajareya P and Steinway SN in Surg Endosc

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

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Innovative ultrasound technique enhances liver surgery outcomes

A novel ultrasound-guided technique to compress the middle hepatic vein allows for better detection of left-sided communicating veins, improving surgical options.

  • Left-sided communicating veins were detected in 71% of patients using this method.
  • Surgical strategies were modified in 57% of patients, enabling more parenchyma-sparing resections.

This technique could expand the criteria for liver resections and improve patient outcomes in cases involving the caval confluence.

  • Major complications occurred in only 5%, with no perioperative mortality.

Journal Article by Procopio F, Galvanin J (…) Torzilli G et 4 al. in Updates Surg

© 2025. Italian Society of Surgery (SIC).

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Transcutaneous Ultrasound Offers Hope for Vocal Cord Paralysis Diagnosis

Transcutaneous laryngeal ultrasound shows promise in detecting vocal cord paralysis after esophagectomy, crucial for surgical outcomes.

  • Pooled sensitivity of 79% and specificity of 95% highlight its potential as a diagnostic tool.
  • Vocal cord visualization achieved rates of 92.3%, with a 29% incidence of vocal cord paralysis post-surgery.

Consider this tool for assessing high-risk patients, but be aware of a notable 20% false-negative rate.

  • Further multicenter studies are essential to enhance detection protocols, especially in elderly patients.

Review by Luo X, Xiong J (…) Zhu Y et 7 al. in Esophagus

© 2025. The Author(s) under exclusive licence to The Japan Esophageal Society.

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