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New Classification System for Surgical Site Outcomes

A new classification system called DISH (Dehiscence, Infection, Seroma, Haematoma) standardizes the reporting of surgical site outcomes, enhancing clinical management and research.

  • DISH categorizes outcomes by five grades of intervention (0-4) and four grades of presentation (a-d), providing a detailed snapshot of surgical site status.
  • This system exhibited high reliability, with inter-rater agreement at 0.93 (95% CI 0.91-0.96), indicating strong consensus across specialty experts.

Implementing DISH could improve surveillance and auditing of surgical site complications, leading to better patient management and outcome tracking.

Journal Article by Bond-Smith G, Boermeester MA (…) Chen AF et 2 al. in Br J Surg

© The Author(s) 2026. Published by Oxford University Press on behalf of BJS Foundation Ltd.

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Pancreaticobiliary Maljunction Linked to Recurrence in Gallbladder Cancer

Patients with pancreaticobiliary maljunction (PBM) have significantly worse recurrence-free survival following surgical resection for gallbladder carcinoma without hepaticojejunostomy.

  • PBM is associated with a 2.10-fold increased risk of recurrence (95% CI 1.13-3.89, p=0.019) compared to non-PBM patients in the study population.
  • Overall survival in palliative settings is also adversely impacted, with a hazard ratio of 3.10 (95% CI 1.57-6.11, p<0.001).

Surgeons should consider closer postoperative surveillance for patients with PBM following gallbladder cancer surgery.

Journal Article by Wang A, Cao J (…) Chen Y et 7 al. in Ann Surg Oncol

© 2026. Society of Surgical Oncology.

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Streamlined Robotic Pancreatoduodenectomy Technique Improves Workflow

A counterclockwise, step-by-step approach for robotic pancreatoduodenectomy enhances surgical workflow and appears to reduce operative complications.

  • Mean console time was 279 minutes across 150 procedures, with no conversions to open surgery.
  • Major complications occurred in 13.3% of patients, with a postoperative pancreatic fistula rate of 6.7% and delayed gastric emptying in 23.3%.
  • The 30- and 90-day mortality rates were low at 1.3% and 3.3%, respectively.

Adopting this standardized technique could lead to better surgical efficiency and outcomes in complex pancreatic operations.

Journal Article by Morelli L, Comandatore A (…) Furbetta N et 9 al. in Ann Surg Oncol

© 2026. Society of Surgical Oncology.

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Biological Mesh for Pelvic Reconstruction Not Cost-Effective

Using biological mesh for pelvic floor reconstruction after extralevator abdominoperineal resection in low rectal cancer patients does not provide a cost-effective solution despite slightly reducing perineal complications.

  • Pelvic reconstruction with biological mesh increased costs (€57,991) versus primary closure (€56,232) without significant improvement in long-term patient outcomes or quality of life.
  • The study’s conclusions suggest routine use of biological mesh is not justified from a cost-effectiveness standpoint.

Surgeons should carefully consider the financial and clinical implications of using biological mesh in this context.

Video-Audio Media by van den Berg R, Musters GD (…) Tanis PJ et 15 al. in Dis Colon Rectum

Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, LLC. on behalf of the American Society of Colon and Rectal Surgeons.

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Endoscopic Therapy for Cystic Duct Remnant Stones Shows High Success

ERCP is a highly effective and safe option for managing symptomatic cystic duct remnant stones in post-cholecystectomy patients, reducing the need for surgical excision.

  • Technical success was achieved in 95% of cases (20/21), with clinical success at 91% (19/21).
  • Balloon sweep alone cleared stones in 43% of patients, with cholangioscopy and electrohydraulic lithotripsy frequently required for larger or impacted stones.

Surgeons should consider ERCP as a first-line approach for this indication, as it may minimize invasive interventions.

Journal Article by Arif Y, Tielleman T (…) Issa D et 10 al. in Gastrointest Endosc

Copyright © 2026. Published by Elsevier Inc.

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Prophylactic HIPEC Improves Survival in Advanced Colorectal Cancer

Prophylactic hyperthermic intraperitoneal chemotherapy (HIPEC) significantly enhances peritoneal metastasis-free survival and disease-free survival in patients with locally advanced colorectal cancer, though overall survival rates and complication rates remain unchanged.

  • One-year peritoneal metastasis-free survival improved by 48% (HR 0.521), 3-year disease-free survival improved by 67% (HR 0.333), and 5-year disease-free survival improved by 29% (HR 0.714) with prophylactic HIPEC vs. controls.
  • No significant differences in overall survival or postoperative complications were observed.

Consider discussing prophylactic HIPEC with patients at high risk for peritoneal metastasis, as it may improve disease-free outcomes.

Journal Article by Chen YC, Chang SC (…) Chen WT et 3 al. in Ann Surg Oncol

© 2026. Society of Surgical Oncology.

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Survey Shows Surgeons Hesitant on Cell Salvage in Liver Cancer

Surgeons are familiar with intraoperative cell salvage (ICS) but use it sparingly during liver resections for cancer due to concerns about tumor cell contamination, indicating a need for more robust oncological outcome data.

  • 26 hepatopancreatobiliary surgeons reported moderate to high familiarity with ICS (23/26) and occasional use (23/26), but only 10 used it during liver cancer operations.
  • Most cited oncologic safety as a barrier, and 20/26 expressed that long-term outcome data would boost their confidence in using ICS.

Surgeons are willing to participate in trials to assess ICS safety, highlighting a potential path forward in its adoption if safety concerns are addressed.

Journal Article by Ivankovic V, Vanterpool Z (…) Martel G et 2 al. in Ann Surg Oncol

© 2026. Society of Surgical Oncology.

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Artery-First Approach for Distal Pancreatectomy Shows Zero Mortality

Utilizing an artery-first approach for distal pancreatectomy with celiac axis resection can effectively manage blood loss and maintain low mortality in pancreatic cancer surgery.

  • In a study of 14 patients, R0 resection was achieved in all cases, with a 90-day mortality rate of 0%.
  • The median operation time was 469 minutes, and median blood loss was 286.5 ml, although two patients experienced significant hemorrhage due to inflow control loss.

While this technique shows promise, surgeons must maintain careful control of arterial clamping to minimize complications.

Journal Article by Aso K, Ito R (…) Saiura A et 10 al. in Ann Surg Oncol

© 2026. Society of Surgical Oncology.

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Improved Outcomes for Locally Recurrent Rectal Cancer Surgery

Curative surgery for locally recurrent rectal cancer (LRRC) is yielding better long-term outcomes, with a significant increase in the R0 resection rate and overall survival.

  • The R0 resection rate increased from 59% to 78% from 2000 to 2023 (p < 0.001).
  • Overall survival significantly improved in the recent cohort (2018-2023) with a hazard ratio of 0.75, indicating a 25% reduced risk of death (p = 0.030).

This trend suggests that advancements in treatment methods and patient selection may enhance results for LRRC surgery, making the importance of meticulous surgical planning and perioperative care even more critical.

Journal Article by Vande Kerckhove FEC, Creemers DMJ (…) Burger JWA et 17 al. in Ann Surg Oncol

© 2026. The Author(s).

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Robot-assisted Esophagectomy: Managing Intraoperative Adverse Events

Intraoperative adverse events (IAEs) during robot-assisted minimally invasive esophagectomy (RAMIE) can occur in about 8.6% of cases, but most are managed robotically without conversion to open surgery.

  • 41 patients experienced IAEs, with bleeding being the most common (69.6% of events).
  • Major IAEs (4.2% of cases) led to significantly increased blood loss (average 1211 ml vs. 296 ml), higher conversion rates (15.0% vs. 1.3%), and longer operative times (478.6 vs. 413.3 min).

Despite the occurrence of these events, there was no significant increase in postoperative complications, hospital stays, or mortality, suggesting that robotic assistance may effectively facilitate management of IAEs.

Journal Article by Badaloni F, Zeyara A (…) Ruurda JP et 5 al. in Ann Surg

Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, LLC.

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