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Preoperative fitness impacts esophagectomy outcomes

Prehabilitation focusing on nutrition and fitness can significantly influence postoperative recovery in esophageal cancer patients.

  • Higher preoperative BMI linked to more overall complications (p = .029).
  • Better exercise capacity and muscle function correlated with fewer pulmonary complications (p < .045) and improved functional capacity (p < .032).

Addressing fatigue preoperatively is crucial, as it relates to better patient outcomes.

  • Less fatigue pre-surgery associated with improved quality of life and less postoperative fatigue (p ≤ .001).

Journal Article by Reijneveld EAE, Dronkers JJ (…) Veenhof C et 8 al. in J Gastrointest Surg

Copyright © 2026 The Authors. Published by Elsevier Inc. All rights reserved.

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Hepatic Artery Infusion Pump Shows Promise in Colorectal Liver Metastases

A small fraction of unresectable colorectal liver metastasis patients qualify for liver transplant, but HAIP chemotherapy can improve outcomes.

  • Only 4.8% of patients in the study were liver transplant-eligible.
  • After HAIP, the median overall survival was 61 months, with a 5-year survival rate of 53%.

This suggests that HAIP may aid in patient selection for surgical interventions.

  • 78% of patients converted to resection after a median of 5 HAIP cycles.

Journal Article by Chandra P, Preston W (…) Kingham TP et 12 al. in Ann Surg

Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved.

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EUS-Guided Biopsy for Pancreatic Cysts: Key Outcomes and Risks

EUS-guided through-the-needle biopsy (EUS-TTNB) offers valuable diagnostic insights for pancreatic cysts but carries significant risks that surgeons must navigate.

  • Diagnostic adequacy is high at 80.3%, with changes in management seen in 16.3% of cases.
  • Adverse events (AEs) occurred in 20.9% of procedures, predominantly acute pancreatitis (15%).
  • Intraductal papillary mucinous neoplasm (IPMN) significantly raises AE risk (OR 2.24).

Surgeons should use a risk stratification model to enhance patient selection and mitigate complications.

  • Risk categories: low (11.9% AE), moderate (20.6% AE), high (37.0% AE for patients with IPMN).

Journal Article by Lee HS, Song TJ (…) Seo DW et 3 al. in Gastrointest Endosc

Copyright © 2026 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

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Smaller Staplers Safe in Esophagojejunostomy Outcomes

Using smaller circular staplers in esophagojejunostomy does not harm patients’ quality of life post-surgery.

  • No differences were found in quality-of-life scores between patients using small vs. large staplers.
  • Anastomotic lumen diameter had no impact on quality-of-life outcomes.

Surgeons can confidently select smaller staplers when anatomical constraints arise without compromising patient recovery.

  • Findings challenge the notion that larger stapler sizes are essential for better postoperative outcomes.

Journal Article by Yazdi SAM, Chinisaz F (…) Sahebi L et 2 al. in Ann Surg Oncol

© 2026. Society of Surgical Oncology.

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Laparoscopic Surgery Reduces Complications for Strangulated SBO

Laparoscopic surgery may significantly lower postoperative complications in patients with strangulated small bowel obstruction (SSBO).

  • Complications (Clavien-Dindo grade ≥ II) were 7.4% with laparoscopy versus 29.6% for open surgery (p = 0.036).
  • Conversion to open surgery occurred in 25.6% of laparoscopic cases, primarily in those with prior laparotomies or gastrointestinal surgeries.

Surgeons should consider laparoscopic approaches but assess patient history carefully to anticipate the need for conversion.

Journal Article by Kobayashi T, Suda R (…) Kawachi S et 15 al. in World J Surg

© 2026 International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).

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Navigating Challenges in Emergency Surgery for Older Adults

Surgeons need to recognize unique diagnostic hurdles when treating older adults in emergency general surgery, as these can lead to worse outcomes.

  • Key challenges identified include atypical presentations, multiple comorbidities, and age-related complications.
  • Emphasis on non-diagnostic factors like functional health, patient preferences, and family involvement must not be overlooked.

Tailoring strategies, like using surgical risk calculators and multidisciplinary teams, could enhance diagnostic accuracy.

  • Practitioners highlighted barriers to implementing these tools, signaling a need for quality improvement in surgical care for this demographic.

Journal Article by Liu JK, Peters XD (…) Ko CY et 3 al. in World J Surg

© 2026 International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).

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ESD outperforms TEM for early rectal tumors in cost-effectiveness.

  • ESD showed a significant net monetary benefit of €1,797 for complete resection at one year.
  • The en-bloc excision rate was higher with ESD (99%) compared to TEM (92.5%).

Choosing ESD could enhance surgical outcomes while managing costs effectively.

  • Disease-free survival was better with ESD at 94.3%, versus 84.6% for TEM.

Journal Article by Beyer-Berjot L, Delettrez C (…) Lepilliez V et 33 al. in Gastroenterology

Copyright © 2026 AGA Institute. Published by Elsevier Inc. All rights reserved.

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New Machine Learning Model Enhances Open Surgery Skill Assessment

Surgeons can now assess open surgical skills more accurately with a novel machine learning model.

  • Achieved an 80.1% mean F1 score, surpassing previous assessment methods.
  • Novice classification accuracy reached 90.1%, while proficient levels scored 86.3%.

Consider using this model for objective skill evaluation in training to ensure higher surgical quality and patient safety.

  • The model predicts skill levels in just 10.2 seconds per video, streamlining assessments.

Journal Article by Alipour A, Balian J (…) Benharash P et 4 al. in BMC Surg

Copyright © 2026 The Author(s). Published by Elsevier Inc. All rights reserved.

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Robotic Pancreatoduodenectomy Implementation Shows Promise

A new robotic pancreatoduodenectomy program demonstrates safe implementation with improved outcomes.

  • 79.5% of post-implementation surgeries were robotic with a conversion rate of 19.4%.
  • Median length of stay decreased from 8 days to 5 days (p < .0001), while maintaining similar complication and mortality rates.

Surgeons can consider a liberal patient selection approach without sacrificing patient safety or recovery time.

  • Fewer pancreatic fistulas were noted post-implementation (-12.3%, p = .02).

Journal Article by Fong ZV, Stucky CC (…) Wasif N et 9 al. in BMC Surg

Copyright © 2025 The Author(s). Published by Elsevier Inc. All rights reserved.

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Sustainable Choices Slash Costs in Colorectal Surgery

Shifting to reusable instruments in colorectal surgeries can save money and help the environment.

  • Total savings across 65 laparoscopic resections: £14,239.03.
  • Reusable harmonic devices offered savings of £24.7k-£28.5k and were cost-effective across various scenarios.

Prioritize reusable textiles, which consistently outperformed disposables.

  • Reusable ports showed no cost savings and should be evaluated against current pricing before implementation.

Journal Article by Aseem R, Lodhia S, Rockall T and Jackson D in BMC Surg

Copyright © 2025 Elsevier Inc. All rights reserved.

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