Surgery news.

A US national cohort study using the United Network for Organ Sharing database reported hepatitis B vaccination in 59.9% of liver transplant recipients. Vaccination rates varied by region and other clinical and demographic factors; the supplied abstract did not report sample size.

A multisociety guideline provides recommendations for perioperative cardiovascular evaluation and management in adults undergoing noncardiac surgery. The supplied abstract describes an update to the 2014 guideline, informed by a literature search conducted from August 2022 through March 2023.

A retrospective cohort study of 18,280 injured adults found that Black patients received prehospital airway interventions and intubation less often than White patients. Neighborhood disadvantage did not significantly explain the racial associations; inconsistencies in the supplied abstract warrant verification.

A phase 3 randomized trial enrolled 218 patients with resectable esophageal or esophagogastric junction adenocarcinoma; 202 underwent surgery. Robotic esophagectomy yielded more lymph nodes than conventional minimally invasive surgery, but postoperative complication rates were similar and 1-year survival did not differ.

A retrospective cohort study of 660 patients compared enucleation with pancreatoduodenectomy for benign or low-grade pancreatic head tumors. Enucleation was associated with more clinically relevant pancreatic fistulas but fewer major complications, shorter hospitalization, and better long-term quality of life.

Extended follow-up of the SWEDEGRAFT randomized trial found no significant reduction in death, myocardial infarction, or repeat revascularization with no-touch versus conventional vein harvesting for CABG. Among 900 analyzed patients, the composite outcome occurred in 19.8% versus 20.4%, respectively, over a median 6.46 years.

A BMJ target trial emulation study examined 697,145 knee replacement surgeries using National Joint Registry data. Robotic and conventional procedures showed no statistically significant differences in revision or intraoperative complication risks, although mean follow-up was 2.5 years and residual confounding remains possible.

A UK registry-based target trial emulation covering 666,283 total hip replacements found similar five-year implant survival with robotic and conventional surgery. Robotic procedures were associated with fewer malposition-related revisions, but residual confounding remains possible.

An Annals of Surgery review evaluates robotic-assisted minimally invasive esophagectomy using the IDEAL framework. It reports fewer complications and better patient-reported outcomes than open surgery in comparative trials, alongside registry benchmarks from 5,567 cases, but no demonstrated long-term survival difference.

An observational UNOS database study of 7,398 liver transplant recipients with hepatocellular carcinoma found complete pathologic response in 29.3%. Response was associated with better five-year survival, and rates were higher after yttrium-90 treatment or ablation than after transarterial chemoembolization.

An updated analysis of the phase III PIVOTAL trial, involving 256 patients with resectable stage III melanoma, reports sustained recurrence-free and distant metastasis-free survival benefits with neoadjuvant intralesional daromun versus upfront surgery. Median follow-up reached 36.8 months, with no new safety signals reported; updated effect estimates were not provided in the abstract.