Ileostomy reversal restores bowel continuity and quality of life. This is usually performed within 3 to 6 months following the initial procedure but is often delayed in regional centres due to limited surgical capacity and resource constraints. This study evaluated outcomes and predictors of morbidity for ileostomy reversals in an Australian regional centre. A retrospective review was performed for all ileostomy reversals undertaken between April 2020 and April 2025. Data included demographics, perioperative characteristics, time to reversal, booking interval, length of stay (LOS), and 30-day outcomes. Primary endpoint was the postoperative complication rate; secondary outcomes were length of stay, readmission, and mortality. Univariable comparisons used χ2, Fisher’s exact, and non-parametric tests. Multivariable logistic regression identified independent predictors of morbidity. A total of 112 patients underwent reversal; median age was 63.5 years and 75.9
Lichtenstein mesh repair is the gold standard for inguinal hernia, but mesh-related complications have renewed interest in tissue-based alternatives. This long-term retrospective cohort study compared Desarda’s non-mesh technique with Lichtenstein’s mesh repair for elective uncomplicated inguinal hernia with 5‑year follow-up. We reviewed 200 patients (> 14 years) who underwent elective inguinal hernia repair between August 2018 and August 2020 at a university hospital in Egypt. Patients were divided into Desarda repair (n = 100) and Lichtenstein mesh repair (n = 100). Hernias were classified according to the European Hernia Society (EHS) classification (medial, M; lateral, L; and femoral, F components), including defect size. The primary outcome was 5‑year recurrence. Secondary outcomes included operative time, postoperative complications, return to normal activities, and long-term chronic pain. Follow-up was completed in August 2025. Operative time was significantly shorter in the Desarda group (45.2 ± 8.3 vs. 58.7 ± 11.4 min; p < 0.001). No significant differences were observed in postoperative complications (seroma 3
Colorectal cancer (CRC) in older adults represents an increasing clinical challenge. Outcomes are influenced not only by tumor characteristics and chronological age, but also by comorbidity, frailty, physiological reserve, emergency presentation, and postoperative complications. This review examines current strategies aimed at optimizing surgical management in this heterogeneous population. A narrative review of the literature was conducted, focusing on comprehensive geriatric assessment, prehabilitation, minimally invasive surgery, emergency surgery, and management of postoperative complications. Preliminary institutional experience following the implementation of a geriatric co-management program is also presented for illustrative purposes. Current evidence supports individualized treatment based on patient vulnerability and disease characteristics rather than chronological age alone. Comprehensive geriatric assessment may help to identify frailty and potentially modifiable deficits and guide multidisciplinary interventions throughout the perioperative period. Prehabilitation and minimally invasive surgery may reduce the physiological burden of treatment in selected patients. Emergency presentation remains associated with particularly poor outcomes. Postoperative complications are especially relevant because older patients may experience substantially greater mortality once a complication occurs, emphasizing the importance of prevention, early recognition, and prompt management. Surgical management of older patients with CRC should be individualized and multidisciplinary. Comprehensive geriatric assessment, prehabilitation, minimally invasive surgery, appropriate management of emergency presentations, and proactive prevention and management of postoperative complications represent complementary strategies for optimizing care.
This study aimed to evaluate whether indocyanine green (ICG) fluorescence navigation is independently associated with lymph node yield during open total gastrectomy with systematic D2 lymphadenectomy after adjustment for baseline clinical covariates. This single-center retrospective–prospective comparative study included 102 patients undergoing open total gastrectomy, D2 lymphadenectomy, and Roux-en‑Y reconstruction. A historical non-ICG cohort operated between 2016 and 2020 (n = 76) was compared with a prospective ICG cohort operated between 2023 and 2025 (n = 26). Indocyanine green (0.625 mg/ml) was injected endoscopically 12–24 h before surgery into four quadrants around the tumor. Multivariable linear regression with heteroscedasticity-consistent (HC3) standard errors adjusted for age, sex, body mass index (BMI), ASA class, neoadjuvant chemotherapy, and clinical T stage. Mean lymph node yield was higher in the ICG cohort (26.8 ± 4.9 vs. 18.1 ± 5.2; p < 0.001). After multivariable adjustment, ICG navigation remained independently associated with a higher lymph node yield (adjusted β = 8.79 nodes; 95
Gallbladder cancer (GBC) is a highly aggressive malignancy with a poor prognosis and varied global incidence. Despite surgical resection being the primary treatment, optimal approaches remain heterogeneous and debated due to limited high-quality evidence. This study aims to validate current surgical recommendations in a European real-world cohort. We retrospectively analyzed data from 150 GBC patients who underwent surgery at the University Hospital of Essen, Germany (2008–2023). Patient and tumor characteristics (UICC/TNM stage, incidental diagnosis, surgical approach), perioperative outcomes (mortality, morbidity, length of hospital stay), and overall survival (OS) were recorded. Congruence with established surgical recommendations was assessed, and its impact on OS analyzed using multivariate regression. Our cohort, predominantly female (60
