30-Second Takeaway
- Supervised multimodal prehabilitation meaningfully reduces complications and preserves function in frail older gastrectomy patients, even on ERAS pathways.
- Updated WSES Jerusalem guidelines endorse risk-stratified imaging and selective nonoperative management for uncomplicated appendicitis, while reaffirming laparoscopy as standard.
- Simple anatomic rules and cachexia or malnutrition screening help stratify risk and target perioperative support in GI cancer surgery.
- Early rib fracture fixation and structured geriatric co-management substantially shorten length of stay and reduce pulmonary and cardiac complications in older adults.
- Technology-enabled (p)rehabilitation offers a scalable option to shorten hospitalization and improve patient-reported outcomes after major cancer surgery.
Week ending January 31, 2026
Perioperative risk optimization, prehabilitation, and targeted decision tools for older and complex surgical patients
Supervised multimodal prehabilitation lowers complications in frail older gastrectomy patients on ERAS
In this 15-centre RCT, 347 frail patients aged 65–85 undergoing radical gastrectomy received ERAS with or without supervised multimodal prehabilitation. Prehabilitation for at least 2 weeks reduced 30-day complications compared with ERAS alone (17.2% vs 28.7%), mainly fewer minor and medical complications. Functional capacity improved preoperatively (6-minute walk +24 m from baseline) and remained above baseline 4 weeks postoperatively. Secondary outcomes, including low-grade inflammation, ICU stay, ventilation time, and hospital stay, generally favoured the prehabilitation group.
2025 WSES Jerusalem guidelines refine risk-stratified management of acute appendicitis
The 2025 WSES Jerusalem Guidelines synthesise evidence into 35 GRADE-based recommendations for diagnosing and treating acute appendicitis across key populations. They recommend clinical risk scores plus imaging to improve diagnostic accuracy and lower negative appendectomy rates. Selected patients with uncomplicated appendicitis may receive nonoperative antibiotic management, with population-specific guidance and mandated follow-up. Guidelines endorse laparoscopic appendectomy as standard, allow surgery delay up to 24 hours, and restrict postoperative antibiotics for complicated disease to short courses.
CLAEG prospective cohort supports prioritising abdominal lymphadenectomy for AEG
This multicentre prospective registry analysed 2044 radical resections for oesophagogastric junction adenocarcinoma across 44 high-volume centres. Lymph node metastases were far more frequent in abdominal stations than mediastinal nodes, highlighting abdominal lymphadenectomy as the priority field. Total gastrectomy yielded lower postoperative complication rates than proximal gastrectomy and enabled more extensive lymphadenectomy. Laparoscopic resection was associated with faster recovery and comparable complication rates to open surgery, with no perioperative mortality reported.
References
Numbered in order of appearance. Click any reference to view details.
Additional Reads
Optional additional studies from this edition.