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New model predicts poor outcomes in liver surgery for HCC

Surgeons now have a validated model to identify patients at high risk for early non-curative recurrence after liver resection for hepatocellular carcinoma (HCC), crucial for tailoring postoperative care.

  • Early non-curative recurrence significantly increases overall survival risk (hazard ratio 5.39).
  • Median survival drops from 178.6 months to just 34.7 months in early recurrence cases (p < 0.001).

Implementing this model can refine patient monitoring and improve long-term outcomes after HCC surgery.

  • Key predictive factors include elevated alpha-fetoprotein, larger tumor size, multiple tumors, portal invasion, and serosal invasion.

Journal Article by Shibamoto J, Moriguchi M (…) Sugiura T et 8 al. in Int J Surg

Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc.

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ICG Navigation Outperforms Conventional Technique for Hepatic Hemangioma

Using indocyanine green (ICG) fluorescence navigation in laparoscopic hepatectomy leads to better outcomes for hepatic hemangioma patients.

  • Median blood loss: 100 ml (ICG) vs 200 ml (conventional), p < 0.001.
  • Hospital stays shortened: 5.9 days (ICG) vs 7.1 days (conventional), p < 0.001.

For patients with an Iwate score above 9, ICG significantly reduced operative time (158 min vs 224 min, p < 0.001) and hepatic inflow occlusions.

Consider ICG navigation to enhance surgical precision and patient recovery.

Journal Article by Yu ZN, Li L (…) Zhang M et 7 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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Liposomal Bupivacaine Beats Ropivacaine for Hemorrhoid Surgery

Liposomal bupivacaine provides superior pain relief compared to ropivacaine for patients post-hemorrhoidectomy.

  • Patients receiving liposomal bupivacaine had consistently lower resting pain scores (median 0-2.0 vs 2.0-4.0, p<0.001).
  • The need for rescue analgesics dropped significantly in the liposomal group (43.9% vs 83.3%, p<0.001).

Consider using liposomal bupivacaine to enhance postoperative comfort and reduce opioid usage.

  • Lower defecation pain scores were also reported (median 3.0 vs 5.0, p<0.001).

Comparative Study by Huang H, Wei S (…) Lu K et 9 al. in BMJ Open

© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.

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Extended thromboprophylaxis cuts VTE rates in colorectal surgery

Extended thromboprophylaxis significantly reduces venous thromboembolism (VTE) risk after colorectal surgery without increasing bleeding complications.

  • VTE rates were reduced to 0.56% with low molecular weight heparin (LMWH) and 0.22% with direct oral anticoagulants (DOAC), compared to no extended treatment.
  • No major bleeding events differed between LMWH and DOAC groups at 90 days.

For high-risk patients, implementing extended thromboprophylaxis for at least 28 days can enhance postoperative outcomes.

Review by Choi JDW, Huynh N (…) Toh JWT et 8 al. in Int J Colorectal Dis

© 2025. Crown.

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Surgical Resection Boosts Survival in HCC After Triple Therapy

Surgical resection significantly improves survival for hepatocellular carcinoma patients who reach complete response following triple therapy.

  • One-, two-, and three-year survival rates post-surgery were 96.0%, 90.8%, and 90.8%, compared to 91.3%, 85.8%, and 73.1% for nonsurgical management.
  • Patients who underwent surgery saw 70.9% achieve pathological complete response; however, the overall complication rate was 24.2%.

Surgical resection should be strongly considered for these patients to enhance outcomes.

Journal Article by Zhang X, Feng X (…) Wang H et 5 al. in Liver Cancer

© 2025 The Author(s). Published by S. Karger AG, Basel.

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Next-gen camera control for cholecystectomy using mixed reality

A new head-mounted mixed reality platform could revolutionize cholecystectomy by improving camera control.

  • Verbal instructions for camera assistants dropped from 15.3 to 0.2 per procedure.
  • Mean operative time decreased from 74.8 to 66.0 minutes.

This technology not only boosts efficiency but also enhances visualization and reliability in surgery.

  • Camera movements were reduced by over 70%, leading to nearly 25% less intraoperative blood loss.

Journal Article by Sun X, Xin J (…) Yi B et 2 al. in J Robot Surg

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

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New CAD System Rivals Endoscopist Techniques for CRC

A computer-aided diagnosis system is showing promise for predicting deeply invasive colorectal cancer but still lags behind established methods.

  • The CAD system achieved an overall diagnostic accuracy of 61.3%, with high confidence cases showing 95.3% accuracy.
  • Compared to magnifying narrow-band imaging (m-NBI) and magnifying chromoendoscopy (mCE), the CAD system’s performance was inferior (p = 0.011 and p = 0.014, respectively).

For surgeons, integrating high-confidence CAD data may enhance decision-making, but reliance on traditional methods remains crucial for low-confidence cases.

  • m-NBI and mCE demonstrated superior sensitivity (74.2% and 83.9% respectively) and were more reliable overall.

Journal Article by Matsumura T, Fujie M (…) Kato J et 10 al. in Surg Endosc

© 2025. The Author(s).

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Predictive nomogram reduces futile surgery in gallbladder cancer

Surgeons can now better identify patients who may not benefit from surgery for gallbladder cancer.

  • 11.1% of patients experienced ‘futile surgery’ with a median survival of only 8.9 months.
  • Those who received successful surgical intervention had a median survival of 88.7 months (p < 0.001).

Incorporating this nomogram into preoperative decision-making may significantly reduce unnecessary procedures.

  • Key predictors include elevated CA 19-9 levels, borderline resectable status, and the need for extended resections.

Journal Article by Varty GP, Patkar S (…) Goel M et 14 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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Optimal Timing for Surgery in Small Bowel Obstruction

Early surgical intervention in small bowel obstruction can significantly reduce mortality and improve outcomes.

  • Surgery within 24 hours cut mortality risk by 47% (risk ratio 0.53).
  • Analysis included 47 studies with 12,486 patients, providing robust data on outcomes.

Implementing earlier interventions could be critical for improving patient survival and minimizing complications.

  • Delaying surgery past 24 hours may increase bowel resection rates and complications.

Review by Kanani F, Messer N (…) Zoabi N et 2 al. in Am Surg

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New Drainage Device Improves Healing in SSI After Abdominal Surgery

A simplified negative pressure drainage device shows better outcomes than standard care for surgical site infections after abdominal surgery.

  • Superior wound healing with p < 0.001 versus standard care.
  • Significantly shorter healing times and reduced dressing changes.
  • Lower wound care costs and shorter antibiotic use and hospital stays.

This device offers a promising, cost-effective alternative for managing SSIs, enhancing patient care and satisfaction.

Journal Article by Liu B, Liu J (…) Sun Y et 3 al. in Int J Surg

Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc.

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