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Surgical Strategies for Proximal Early Gastric Cancer: Dtr and Dft Shine

Surgeons need to know that proximal gastrectomy methods dtr and dft outperform tg and eg in key outcomes for early gastric cancer.

  • Reflux esophagitis rates were higher in eg compared to dft and dtr.
  • Anastomotic stenosis was less common with dtr than eg.
  • Dft achieved the highest 12-month hemoglobin levels; hospital stay was shorter compared to other methods.

Consider dtr and dft for improved patient outcomes and easier recovery in proximal early gastric cancer surgeries.

Meta-Analysis by Lee HJ, Kim JC (…) Yang HK et 6 al. in J Gastric Cancer

Copyright © 2025. Korean Gastric Cancer Association.

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Predict PHLF in HCC: New Nomogram Revolutionizes Surgery

A new nomogram predicts post-hepatectomy liver failure (PHLF) for hepatocellular carcinoma, improving patient outcomes.

  • Analyzed 654 patients, identifying 55 PHLF cases linked to seven key predictors: liver cirrhosis, total bilirubin, prothrombin time, albumin-bilirubin, fibrosis-4 index, ascites, and intraoperative blood loss.
  • Nomogram achieved an AUC of 0.880 for training and 0.879 for validation, indicating strong predictive accuracy.

Surgeons can now select patients with higher precision, reducing the risk of severe complications post-surgery.

Journal Article by Wang D, Ma Q (…) Zhang J et 4 al. in Front Med (Lausanne)

Copyright © 2025 Wang, Ma, Zhang, Hou, Zhang, Wu and Zhang.

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Effective Prehabilitation Reduces Complications in Colorectal Surgery

Multimodal prehabilitation significantly enhances outcomes for colorectal cancer patients undergoing surgery by lowering complications and improving recovery.

  • Multimodal prehabilitation cut postoperative complications by 53% (odds ratio: 0.47).
  • It also shortened hospital stays by an average of 1.17 days.

This integrated approach improves physical function, shown by a 27-meter increase in the 6-minute walk test pre-surgery, and reduces anxiety scores.

  • Benefits last with a 19-meter improvement sustained 4 weeks post-surgery.

Systematic Review by Li N, Liu X (…) Xie X et 2 al. in Front Med (Lausanne)

Copyright © 2025 Li, Liu, Wang, Song and Xie.

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Improved Survival Rates for Surgical Gastric Cancer Patients

Conditional relative survival after gastric cancer surgery shows promising results, suggesting better outcomes than previously thought.

  • Five-year conditional relative survival (CRS) rose from 87.2% at one year to 95.4% at five years post-surgery.
  • Stage III patients saw significant improvement, with CRS increasing from 53.2% at one year to 85.2% at five years.

Surgery remains a viable option for older patients, with those over 80 showing high survival rates similar to younger cohorts.

  • Total gastrectomy patients may require additional nutritional support due to lower CRS compared to distal gastrectomy.

Journal Article by Park H, Cho YS (…) Shin A et 5 al. in J Gastric Cancer

Copyright © 2025. Korean Gastric Cancer Association.

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Predicting Postoperative Leakage in Gastrectomy with AI

This study shows that deep learning can predict leakage during laparoscopic gastrectomy for gastric cancer, improving surgical outcomes.

  • Leakage rates were 1.3% at the duodenal stump and 4.3% at the esophagojejunal anastomoses.
  • The ResNet18 model achieved a recall of 84.7% for stump leakage and 80% for anastomosis leakage when trained on high-quality, single-image datasets with augmentation.

Using AI during surgery could facilitate timely interventions, enhancing patient safety and outcomes.

  • Key image features, both local and surrounding tissues, were critical for accurate predictions.

Journal Article by Park KB, Lee H (…) Seo H et 6 al. in J Gastric Cancer

Copyright © 2025. Korean Gastric Cancer Association.

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Structured Robotic Surgery Training Improves Outcomes in Cancer Patients

A structured training program significantly enhances surgical performance for robotic procedures.

  • 16 experienced surgeons trained in a four-stage curriculum, with only 8 achieving full certification.
  • Robotic procedures resulted in less blood loss (266.2 ml vs. 598.2 ml) despite longer operative times (304.9 min vs. 259.1 min).
  • No difference in lymph node yield or complication rates compared to traditional methods.

This model can be adapted for other institutions, ensuring safer transitions to robotic techniques in public health settings.

Randomized Controlled Trial by Abdalla RZ, Nahas WC, Cecconello I and Ribeiro U in J Robot Surg

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

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Prehabilitation Cuts Postoperative Risks in GI Surgery

Multimodal prehabilitation significantly reduces mortality and readmission rates in high-risk gastrointestinal surgery patients.

  • Participants had 30-day mortality at 32% of expected rates and readmission at 93% of expected rates.
  • Baseline dyspnea (47% in nonideal outcomes) and disseminated cancer are key risk factors linked to higher 30-day readmissions.

Surgeons should closely evaluate patients with dyspnea, as it represents a modifiable risk that may require targeted management beyond standard prehabilitation.

  • Open surgical approaches were associated with worse outcomes (82% in nonideal cases).

Journal Article by Goodnight B, Cook J (…) Sanford D et 2 al. in BMC Surg

Copyright © 2025 The Authors. Published by Elsevier Inc. All rights reserved.

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Minimally Invasive Surgery Cuts Complications in Small Bowel Tumors

Minimally invasive surgery for small bowel neuroendocrine tumors shows significant benefits over open resection.

  • MIS resulted in 54% lower odds of postoperative complications.
  • Patients had shorter hospital stays (4 vs. 6 days) and fewer infections: skin/soft tissue (2.1% vs. 6.8%), urinary tract (0.5% vs. 2.4%), sepsis (0.2% vs. 1.2%).

This approach enhances short-term outcomes and should be considered when oncologically appropriate.

Journal Article by Farooq MS, Roses RE, Karakousis GC and Etherington MS in J Gastrointest Surg

Copyright © 2025 The Authors. Published by Elsevier Inc. All rights reserved.

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ICG imaging elevates surgical outcomes in gastric cancer

Indocyanine green (ICG) guidance improves lymphadenectomy in gastric cancer post-neoadjuvant chemotherapy.

  • ICG increased lymph node retrieval by an average of nearly 9 nodes.
  • Patients with ICG guidance were 2.3 times more likely to retrieve 30 or more nodes compared to conventional methods.

ICG use showed no increase in complications, supporting its safe application in surgical practice for better outcomes.

  • Non-compliance rates were lower with ICG, enhancing surgical reliability.

Review by Fernandes MHF, Valério-Alves AP (…) Kassab P et 5 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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Cold Snare Biopsy Improves CRC Diagnosis Without Risks

Cold snare biopsy (CSB) significantly boosts diagnostic accuracy for suspected colorectal cancer compared to cold forceps biopsy (CFB), without increasing complication rates.

  • CSB achieved 100% diagnostic consistency; CFB was 90.5%.
  • Clinical outcomes were similar: bleeding rates were 3.9% for CSB vs. 4.6% for CFB.

Surgeons should consider CSB as the preferred method for obtaining biopsies in suspected CRC patients to enhance diagnostic certainty.

Journal Article by Wu J and Li X in Surg Laparosc Endosc Percutan Tech

Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.

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