Latest Surgery research

Top 10 this week

Week of 1 November 2026

1. 1

   Neoadjuvant short-course radiotherapy followed by camrelizumab and chemotherapy versus standard of care for locally advanced rectal cancer (UNION): a prespecified interim analysis of a multicentre, open-label, randomised, phase 3 trial

   The Lancet. Oncology · Q1 journal · RCT · Evidence level 1 (High) · 25 October 2026

   In a randomized trial of 231 patients in China, short-course radiation followed by camrelizumab and chemotherapy produced 91% 3-year event-free survival, compared with 77% with standard chemoradiotherapy and chemotherapy. Serious side effects were similar overall, but this prespecified interim analysis needs longer follow-up, and the regimen still needs comparison with current total neoadjuvant therapy strategies.

2. 2

   Laparoscopic Versus Open Liver Resection for Colorectal Liver Metastases : An Individual Participant Data Meta-analysis of Four Randomized Clinical Trials

   Annals of internal medicine · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 27 October 2026

   In pooled data from four randomized trials involving 761 patients with colorectal cancer liver metastases, complications occurred in 19% after laparoscopic resection versus 27% after open surgery. Overall and disease-free survival were similar after a median 93 months; among patients who received chemotherapy before surgery, complication rates were also similar.

3. 3

   Exercise Training During Neoadjuvant Treatment for Gastroesophageal Cancer and Tumor Surgery: A Randomized Clinical Trial

   JAMA network open · Q1 journal · RCT · Evidence level 1 (High) · 1 October 2026

   In this randomized trial of 202 patients, 9.9% assigned to twice-weekly exercise and 7.9% receiving usual care did not undergo surgery with curative intent after neoadjuvant treatment. Treatment discontinuation and postoperative complications also did not differ; 3-year survival was lower in the exercise group, a finding that needs further study.

4. 4

   Endoscopic Balloon Dilation Versus Endoscopic Stricturotomy for Short Crohn's Disease Strictures: The BEST-CD Randomized Trial

   Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · Q1 journal · RCT · Evidence level 1 (High) · 28 October 2026

   In a randomized trial of 106 adults, 24.5% treated with endoscopic stricturotomy needed reintervention within a year, compared with 49.1% after balloon dilation; clinical recurrence was also lower, 30.1% versus 54.7%. Adverse events were similar, but surgery rates did not differ significantly. The results favor stricturotomy in expert centers, though multicenter studies are needed to confirm them.

5. 5

   Individualized Cardiac Index-Guided Hemodynamic Therapy in High-Risk Patients Undergoing Elective Major Abdominal Surgery: The PELICAN Randomized Clinical Trial

   JAMA · Q1 journal · RCT · Evidence level 1 (High) · 19 October 2026

   In this randomized trial of 1,095 high-risk patients, the composite of kidney or heart injury, severe infection, cardiac arrest, or death occurred in 44% with individualized cardiac index-guided therapy and 47% with routine care, with no clear difference. None of the individual complications differed between groups, so targeting each patient's preoperative cardiac index did not improve early postoperative outcomes.

6. 6

   Negative-Pressure Wound Therapy for Surgical Site Infection Prevention After Elective Open Abdominal Surgery: A Risk-Stratified Systematic Review and Meta-Analysis of Randomized Controlled Trials

   The Journal of hospital infection · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 30 October 2026

   Across 15 randomized trials, infections occurred in 12.6% of patients given negative-pressure wound therapy, versus 19.5% with standard dressings - about 7 fewer infections per 100 patients. The low-certainty overall benefit was concentrated in high-risk patients and lower-income-country trials; high-income multicenter trials found no benefit, so routine use is not supported.

7. 7

   Minimally Invasive Versus Open CRS/HIPEC for Peritoneal Surface Malignancies: Postoperative Recovery and Long-Term Outcomes-A Systematic Review and Meta-Analysis

   Cancers · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 14 October 2026

   In 21 studies involving 1,184 patients, minimally invasive surgery with heated chemotherapy was linked to less blood loss, fewer transfusions and complications, and faster recovery than open surgery. Overall and cancer-free survival did not differ significantly, but most studies were retrospective and the findings support this approach only for appropriately selected patients treated by experienced teams.

8. 8

   Efficacy of indocyanine green (ICG) angiography in reducing postoperative complications in oesophagectomy: systematic review and meta-analysis

   The British journal of surgery · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 5 October 2026

   Across 23 studies involving 2,845 patients, indocyanine green imaging was associated with lower odds of anastomotic leak; the estimated number needed to treat was 13. Conduit necrosis was also less frequent, but mortality and reoperation did not differ. Evidence certainty was low or very low, and image interpretation remains operator-dependent.

9. 9

   The Effectiveness of Prehabilitation on Surgical Outcomes in Pancreatic Surgery: A Systematic Review and Meta-Analysis

   World journal of surgery · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 26 October 2026

   Across 12 studies involving 1,841 patients, prehabilitation was associated with 15% fewer overall complications and 23% fewer delayed gastric emptying events after pancreatic surgery. It did not significantly change hospital stay, major complications, deaths, readmissions or pancreatic fistula; most evidence was observational, and only two small randomized trials included 128 patients, so larger trials are needed to confirm the benefits.

10. 10

    Three-week ileostomy closure after colorectal surgery: a multicenter randomized trial of technical and postoperative outcomes

    Techniques in coloproctology · Q1 journal · RCT · Evidence level 1 (High) · 27 October 2026

    In a randomized trial of 224 patients with confirmed healing, closure at 3 weeks took 90 minutes on average, versus 130 minutes with delayed closure, and fewer patients needed extended adhesiolysis. Short-term complications and other postoperative outcomes were similar; 3.6% had a brief delay in chemotherapy. The results support early closure for carefully selected patients, but not without confirming anastomotic healing.

Paper of the day, last two weeks

• Robotic versus laparoscopic gastrectomy for gastric cancer: 5-year long-term results from a randomized controlled trial

  Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · Q1 journal · RCT · Evidence level 1 (High) · 4 November 2026

  In this randomized trial, 5-year relapse-free survival was 69% after laparoscopic surgery and 75% after robotic surgery; overall survival was 71% and 79%, respectively, with neither difference statistically significant. Subgroup analyses favored robotic surgery in men and after distal gastrectomy, but whether those signals represent a real benefit remains uncertain.

• Effect of pancreatic neck transection site on postoperative complications after laparoscopic pancreaticoduodenectomy: a multicenter randomized controlled trial

  Surgical endoscopy · Q1 journal · RCT · Evidence level 1 (High) · 5 November 2026

  In a randomized trial of 141 patients undergoing laparoscopic pancreaticoduodenectomy, extending the pancreatic neck cut reduced clinically relevant fistulas from 26% to 11%. Infectious complications also fell, while other perioperative complications did not differ significantly between groups. The results support this approach at experienced centers, but its value in broader practice remains to be established.

• A Single Daily Dose of Metronidazole is Non-Inferior to Three Daily Doses in Children With Perforated Appendicitis: A Real-World Randomized Trial

  World journal of surgery · Q1 journal · RCT · Evidence level 1 (High) · 2 November 2026

  In a randomized trial of 201 children who had open surgery, once-daily metronidazole with gentamicin was non-inferior to three daily doses for infection outcomes and treatment success; no severe antibiotic-related adverse events were recorded. The simpler regimen lowered metronidazole costs by an average of $1.71 per child, but the trial did not establish whether results apply beyond this setting.

• Delayed appendectomy as part of a nonoperative treatment strategy does not increase postoperative complications in children with simple appendicitis-A secondary analysis from a randomized controlled trial (Antibiotics Versus Primary Appendectomy in Children trial)

  Surgery · Q1 journal · RCT · Evidence level 1 (High) · 9 October 2026

  In children with simple appendicitis, complications occurred in 4 of 46 who had delayed surgery after initial nonoperative treatment, compared with 11 of 143 who had surgery first. The secondary analysis found no significant difference in complication rates or severity, but the small delayed-surgery group leaves uncertainty about how closely outcomes compare.

• Estimating the clinical benefit of metastases resection in liver-limited metastatic colorectal cancer: an IPD-based pooled analysis of nine randomized trials

  ESMO open · Q1 journal · RCT · Evidence level 1 (High) · 2 November 2026

  In a pooled analysis of 855 patients with liver-limited metastatic colorectal cancer, those who underwent liver resection spent only 26% of their follow-up on systemic therapy versus 47% for unresected patients, regardless of disease-free interval. Surgery also showed a trend toward longer overall survival in patients with high baseline tumor burden, suggesting a selective benefit.

• Negative Pressure Wound Therapy for Emergency Laparotomy: A Meta-Analysis With Trial Sequential Analysis

  The Journal of surgical research · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 30 October 2026

  Across eight trials involving 1,348 patients, negative-pressure wound therapy was linked to about half the risk of surgical site infection compared with standard dressings. But results varied, the largest trial found no benefit, and small-study effects weaken confidence; therapy was also linked to fewer seromas and wound separations, with no shorter hospital stay. The evidence supports selective, not routine, use.

• Operative Versus Non-Operative Management for Pancreatic Trauma: An Umbrella Review of Systematic Reviews and Meta-Analyses

  Journal of clinical medicine · Q1 journal · SR of cohorts · Evidence level 2 (Moderate) · 12 October 2026

  An umbrella review found nonoperative management succeeded in 87% of children with pancreatic trauma, with no clear mortality difference from surgery. It was linked to more pseudocysts but fewer fistulas; however, the reviews had high risk of bias and heavily overlapping pediatric data, so the strategies cannot be judged equivalent, especially for stable patients with duct injuries.

• Small-bite compared with large-bite closure of midline laparotomy: meta-analysis of short- and long-term outcomes with trial sequential analysis

  The British journal of surgery · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 5 October 2026

  Evidence informs laparotomy closure, hernia and SSI prevention

• Systematic review and meta-analysis of mesh versus suture repairs of small umbilical hernias (≤ 2 cm)

  Hernia : the journal of hernias and abdominal wall surgery · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 21 October 2026

  A review of studies found recurrence was about 54% lower after mesh than suture repair for umbilical hernias 2 cm or smaller. Mesh repairs were also linked to more bleeding and infections, while pain scores did not differ significantly. Varied study designs limit certainty, and randomized trials are needed to clarify long-term risks and patient experience.

Evidence summaries in Surgery

• Acute Appendicitis
• Acute Cholecystitis
• Appendicitis
• Necrotizing Fasciitis