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Spleen Preservation Cuts Complications in Total Gastrectomy

Spleen-preserving gastrectomy lowers complication rates in proximal gastric cancer.

  • Reduced pancreatic fistula risk (RR 0.30; p < 0.000001)
  • Less blood loss (MD -172.47; p = 0.012396)

This approach supports safer patient outcomes when oncologic safety is prioritized.

  • Lower risk of anastomotic leak (RR 0.51; p = 0.006769) and intra-abdominal abscess (RR 0.40; p = 0.000160) further strengthen the case for spleen preservation.

Review by Menegat ALRS, Menegat BLRS (…) de Moraes FCA et 4 al. in J Gastrointest Cancer

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

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Laparoscopic hepatectomy excels for high-risk HCC patients

Laparoscopic hepatectomy achieves better outcomes for hepatocellular carcinoma patients with high-risk features, which matters for surgical selection and strategy.

  • Textbook outcome rate after laparoscopic surgery was 75.8% compared to 67.7% for open surgery (p=0.041).
  • Overall survival at 5 years was similar: laparoscopic 55.6% vs. open 55.5% (p=0.334).
  • Recurrence-free survival also showed no significant difference: laparoscopic 39.6% vs. open 36.4% (p=0.116).

Laparoscopic approach is viable for high-risk patients, offering better feasibility without compromising survival outcomes.

Journal Article by Qin L, Zhou Y (…) Li C et 8 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 scoring system predicts colorectal anastomotic leaks

A novel BADCAL score improves risk assessment for anastomotic leaks after colorectal surgery.

  • In a study of 109 patients, leaks occurred in 13 (11.9%).
  • The BADCAL score showed exceptional predictive ability with an AUC of 0.97; a score of ≤3 had a 100% negative predictive value.
  • High-risk scores (≥7) correlated with a 71.4% leak rate.

Use this score to enhance patient selection and monitoring post-surgery, but seek further validation for broader application.

  • Key predictors include CRP >60 mg/L, ASA grade ≥III, and blood loss >200 mL.

Journal Article by Sharma AK, Kumar S (…) Mandal M et 3 al. in J Gastrointest Surg

Copyright © 2025 Society for Surgery of the Alimentary Tract. Published by Elsevier Inc. All rights reserved.

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ERAS improves recovery in elderly patients with perforated ulcers

Enhanced recovery after surgery (ERAS) protocols accelerate recovery in elderly patients undergoing emergency surgery for perforated peptic ulcers.

  • ERAS patients achieved bowel movement in 1.21 days vs. 2.20 days (p=0.008) and mobilized faster (1.26 vs. 3.51 days, p<0.001).
  • Hospital stays were significantly shorter: 5.24 days vs. 7.03 days (p=0.001).

Implementing ERAS led to better pain control, lower opioid use (8.49 mg vs. 18.73 mg, p=0.001), and reduced nausea (22.4% vs. 41.8%, p=0.013) without increasing complications.

These findings support ERAS as a safe option for enhancing recovery in older emergency surgery patients, but results may vary for frailer individuals.

Comparative Study by Wael M, Shehab AS, El-Sayes I and Seif-Eldeen MIA in BMC Gastroenterol

© 2025. The Author(s).

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Ventral hernia repair outcomes hinge on proper closure metrics.

  • Overall anterior fascial closure rate post-transversus abdominis release was 93.9%.
  • Hernia widths of 15-20 cm and >20 cm significantly lower closure odds (0.39 and 0.05 respectively).
  • History of open abdomen and higher ASA classification also correlate with non-closure (0.33 and 0.39 respectively).

Proper patient selection and recognition of risk factors can enhance surgical outcomes and reduce infection rates post-repair.

  • Fascial non-closure directly increases wound morbidity and is linked to higher rates of one-year surgical site infections.

Journal Article by Remulla D, Woo KP (…) Miller BT et 10 al. in Hernia

© 2025. The Author(s).

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Geriatric Nutritional Risk Index Predicts Outcomes in Pancreatic Surgery

Preoperative nutritional status significantly impacts patient outcomes after pancreaticoduodenectomy.

  • Patients with a Geriatric Nutritional Risk Index (GNRI) < 82 had a 14.93% 30-day mortality and 26.87% 90-day mortality, starkly higher than those in better nutritional categories.
  • Major complication rates were 29.85%, with 20.9% requiring reoperation in the low GNRI group.

Improve surgical results by identifying and addressing malnutrition early in these high-risk patients.

  • The low GNRI group also faced higher ICU stays (adjusted odds ratio 3.98) and increased healthcare costs.

Journal Article by Huang SW, Kuo MC (…) Yin SM et 4 al. in Updates Surg

© 2025. Italian Society of Surgery (SIC).

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Survival Gains with FLOT in cT2cN0 Esophageal Cancer

FLOT chemotherapy significantly improves survival in patients with cT2cN0 adenocarcinoma of the esophagus compared to chemoradiotherapy.

  • Mean survival: 100.8 months for FLOT vs. 74.6 months for CROSS (p = 0.028).
  • Three-year survival rates: 87% for FLOT vs. 59% for CROSS.

Surgeons should prioritize FLOT treatment in multimodal approaches for these patients to enhance outcomes.

  • 23.3% of FLOT patients underwent gastrectomy versus 6.8% in the CROSS group (p = 0.007).

Journal Article by Wirsik NM, Schmidt T (…) Bruns CJ et 23 al. in Ann Surg Oncol

© 2025. The Author(s).

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Manual bowel repositioning cuts obstruction risk in colon surgery

Manually repositioning the small bowel and omentum reduces early postoperative small bowel obstruction (epsbo) after laparoscopic colorectal surgery.

  • epsbo rates fell from 4.5% to 1.4% after adopting the repositioning technique (p=0.003).
  • Omission of this technique increased epsbo risk threefold (odds ratio 3.09).

Incorporating this simple maneuver can enhance patient outcomes without extending surgery time or increasing complications.

  • Other risk factors included stoma creation (odds ratio 4.79) and intra-abdominal abscess (odds ratio 2.84).

Journal Article by Takeda M, Uemura M (…) Eguchi H et 10 al. in Surg Endosc

© 2025. The Author(s).

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Trauma Center Distribution Affects Patient Outcomes and Costs

Trauma center distribution matters: regions with more centers have better patient outcomes and lower economic costs related to injuries.

  • Higher density of trauma centers correlates with lower per capita costs for fatal injuries.
  • The northeast has the lowest burden of fatalities and years of potential life lost, while the south, with the fewest centers, faces the highest losses.

Optimizing trauma center allocation can significantly reduce costs and improve patient outcomes, especially in underserved areas.

  • The south loses the most state income tax revenue due to inadequate trauma center distribution.

Journal Article by Nasef H, Espat NN (…) Elkbuli A et 5 al. in J Surg Res

Copyright © 2025 Elsevier Inc. All rights reserved.

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Higher BMI Raises Postoperative Mortality in Pancreatic Surgery

Overweight and obese patients face significantly higher postoperative mortality rates after pancreatic resection, spotlighting the need for careful patient selection.

  • Overweight patients have a 52% increased risk of mortality (OR 1.52).
  • Obese patients experience a 66% increased risk (OR 1.66).

Surgeons should prioritize referring overweight and obese patients to high-volume hospitals, where surgery outcomes are more comparable to non-overweight individuals.

  • The findings are consistent across multiple studies, reinforcing the importance of surgical setting in managing these high-risk patients.

Review by Tai ZY, Li MY (…) Zhang CD et 2 al. in Eur J Surg Oncol

Copyright © 2025. Published by Elsevier Ltd.

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