- Clinical significance of intraoperative dissection time and machine learning-based prediction in laparoscopic distal gastrectomy for gastric cancer. [Journal Article]
- CONCLUSIONS: For patients undergoing laparoscopic radical gastrectomy for distal gastric cancer, an intraoperative dissection time of 133 min was identified as a critical threshold, beyond which there was a higher incidence of complications. Although there were differences in prognosis, intraoperative dissection time was not an independent risk factor. Among the evaluated models, the random forest model showed the most stable predictive performance and may offer additional value for the preoperative evaluation of patients at risk of prolonged intraoperative dissection time.
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- Laparoscopic adhesiolysis for small bowel obstruction in patients with abdominal surgical history: what makes it technically challenging? [Journal Article]
- CONCLUSIONS: LA completion demonstrates overall advantages even in patients with prior abdominal surgery; however, in technically demanding cases with prolonged operative times or the need for conversion, complication rates approximate those of OA, warranting prudent case selection.
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- Laparoscopic-guided transversus abdominis plane block with low-pressure versus standard-pressure pneumoperitoneum versus port site infiltration with standard-pressure pneumoperitoneum for postoperative pain management in laparoscopic cholecystectomy: randomized controlled trial. [Journal Article]
- CONCLUSIONS: TAP-based strategies were associated with lower early postoperative pain and reduced rescue analgesic requirements than S-PS. L-TAP suggested additional analgesic benefit over S-TAP, although differences in local anesthetic dose, volume, and timing limit attribution to individual components.
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- Thoracoscopic versus endoscopic resection for esophageal leiomyoma: a propensity score-matched retrospective cohort study. [Journal Article]
- CONCLUSIONS: Endoscopic resection was associated with faster postoperative recovery in patients with esophageal leiomyoma, whereas thoracic surgery remained important for larger tumors and complex lesions. These findings support a size- and location-oriented treatment strategy rather than a universal preference for either approach.
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- Operating under pressure: a scoping review of the effects of climate change on general surgery. [Journal Article]
- CONCLUSIONS: High-level evidence regarding climate change's impact on general surgery remains limited. Emerging evidence suggests that extreme weather events and temperature fluctuations may increase demand for surgical services, disrupt timely access to treatment, and worsen postoperative outcomes. These effects may further strain healthcare systems and resources, requiring targeted mitigation and future research in this important evolving field.
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- Bayesian network meta-analysis comparing efficacy of surgical gastrojejunostomy, endoscopic stenting, and EUS-guided gastroenterostomy for malignant gastric outlet obstruction. [Review]
- CONCLUSIONS: EUS-GE was associated with a favorable balance of efficacy, durability, and recovery and may represent a promising minimally invasive alternative in centers with appropriate expertise. ES provides rapid recovery but is associated with more frequent reintervention, whereas S-GJ remains an established option. Additional direct randomized comparisons are needed to define the optimal palliative strategy.
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- Prior abdominal surgery characteristics predict adhesion phenotype and adhesiolysis in robotic colorectal cancer resection while preserving short-term outcomes. [Journal Article]
- CONCLUSIONS: Specific PAS characteristics, rather than PAS presence alone, were associated with technically relevant adhesions and adhesiolysis in robotic CRC resection. Despite increased technical burden, short-term outcomes remained comparable, supporting a more individualized interpretation of prior surgical history in robotic colorectal surgery.
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- Incidence of parastomal hernia after open versus minimally invasive surgery: a comparative systematic review. [Journal Article]
- CONCLUSIONS: Minimally invasive intestinal resection may be associated with a higher incidence of PSH than open surgery, but the certainty of the evidence is very low. Subcutaneous prolapse is seldom recognised as a distinct form of stoma herniation. Clear differentiation is essential, as these conditions differ in their underlying mechanisms and management.
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- Association between technical difficulty and patient prognosis after transanal total mesorectal excision for middle and low rectal cancer: a multicenter cohort study. [Journal Article]
- CONCLUSIONS: Technical difficulty in TaTME was mainly reflected by prolonged operative time and was not significantly associated with increased local recurrence or reduced 3-year DFS/OS. Early surveillance for systemic recurrence remains important.
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- The patient perspective in benign foregut surgery guidelines: bridging evidence, values, and clinical decision-making. [Journal Article]
- CONCLUSIONS: Direct patient involvement remains uncommon and concentrated in recommendation development rather than the entirety of guideline development. Foregut-related surgical societies should combine patient-preference evidence with transparently reported patient partnership from priority setting through implementation and updating.
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- Six-month comparative outcomes of endoscopic sleeve gastroplasty versus laparoscopic sleeve gastrectomy: an MBSAQIP analysis. [Journal Article]
- CONCLUSIONS: When compared to ESG at 6 months, LSG provides an improvement in total body weight loss, has a reduced operative time, and is associated with dramatic metabolic comorbidity improvement including a reduction in resolution of medication and insulin-dependent diabetes. No clinically meaningful comorbidity resolution was seen in patients receiving ESG compared to LSG at 6 months although this cohort was less comorbid at baseline.
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- Comparison of medium-weight vs heavy-weight mesh in minimally invasive extraperitoneal ventral hernia repairs. [Journal Article]
- CONCLUSIONS: MW and HW mesh demonstrate comparable early and mid-term outcomes following MIS extraperitoneal VHR. Further prospective study and long-term follow-up are necessary as these techniques proliferate.
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- Endoscopic ultrasound-guided gallbladder drainage versus choledochoduodenostomy for distal malignant biliary obstruction. [Journal Article]
- CONCLUSIONS: In selected patients with DMBO after failed ERCP, EUS-GBD provides efficacy and safety comparable to EUS-CD and represents a feasible rescue option when choledochoduodenostomy is technically challenging or not feasible.
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- Efficacy, safety, and cost of immediate versus on-demand endoscopic necrosectomy in infected necrotizing pancreatitis: a systematic review and meta-analysis. [Review]
- CONCLUSIONS: Immediate endoscopic necrosectomy did not demonstrate a consistent clinical advantage over an on-demand approach. Low- to very-low-certainty evidence suggests little or no difference in clinical efficacy or safety outcomes, while very-low-certainty evidence suggests that immediate necrosectomy may increase the proportion of patients undergoing necrosectomy. However, the magnitude and clinical significance of this effect remain uncertain. These findings should be interpreted cautiously given the limited number of randomized trials, modest sample sizes, and low or very low certainty of evidence for several outcomes.
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- Proprietary platform artificial intelligence-based segmentation of surgical videos facilitates review and rating of operative recordings. [Journal Article]
- CONCLUSIONS: AI-based auto-segmentation is an attractive tool for assessment of surgical performance, as it significantly expedites the editing process to prepare footage for review by subject matter experts. To which extent this approach will be applicable outside highly standardized surgical interventions must be further studied.
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