👏👏👏Wen-Quan Wang, Yao-Lin Xu, Lin-Hui Tang, Jun-Yi He, Yu Li, Fei Liang, Yue-Ming Zhang, Wei Gan, Hua-Xiang Xu, Lei Zhang, Wen-Chuan Wu, Chen-Ye Shi, Yun Jin, Chong-Yi Jiang, Zheng Wang, Min He, Xu-An Wang, Yu-Dong Qiu, Liang Liu

A patented drainage device for external drainage was designed and the trial plans to enrol patients at moderate to high risk of postoperative pancreatic fistula (POPF) because retrospective data suggest that external drainage potentially reduces the incidence of POPF.

This article describes the protocol for a randomized clinical trial comparing the clinical benefit of external versus internal drainage techniques in pancreatoduodenectomy.

Iain K Moppett, Lawrence Mudford, John Norrie, Rupert M Pearse, Thomas Pinkney, Athanasios Saratzis, Robert Sayers, Cecilia Vindrola-Padros, Justin Waring

👏👏👏Jugdeep K Dhesi, Judith S L Partridge, Bridget C Strasser, Lindsay Bearne, Nathan Hall, Andrew Healey, John S M Houghton, Laura Magill, Bijan Modarai,

perioperative medicine services can be implemented at scale to cost-effectively improve clinical outcomes for older patients undergoing elective and emergency surgery. A predefined dissemination strategy has been co-designed with patients, clinical community of practice, and organizational bodies.

Perioperative Medicine for Older People Undergoing Surgery Scale Up (POPS-SUp) is a hybrid implementation–effectiveness interrupted time series study using mixed methodology to examine whether comprehensive geriatric assessment and optimization based

The number of older people undergoing surgery is increasing and age-related physiological decline, multimorbidity, frailty, and dementia predispose older people to postoperative complications and incomplete functional recovery, with resultant health and social care costs.

Marc G Besselink, Giovanni Marchegiani, Federico Storni, Alexander Dullenkopf, Fabian Hauswirth, Markus K Muller, Pietro Renzulli

👏👏👏Laura Pietrogiovanna, Pascal Probst, Eduard A van Bodegraven, Alberto Balduzzi, Jörg Kaiser, Thilo Hackert, Eva Kalkum, Philip C Müller, Sara Canovi, Pia Antony, Hendrik Strothmann,

The present meta-analysis therefore provides level 1a evidence in favour of a selective early drain removal policy in partial pancreatoduodenectomy and a no-drain policy in left pancreatectomy.

Early removal of drains in partial pancreatoduodenectomy was safe with the additional benefit of significantly reducing chyle leak. The omission of routine abdominal drainage in left pancreatectomy was found to be safe, resulting in fewer postoperative pancreatic fistulas and a shorter hospital stay

👏👏👏Thomas O Butler, Jessie A Elliott, Matthew G Davey, Patrick M Collins, Megan McNamara, Eoin O'Malley, Micheal J Brennan, Kevin Barry, Sami Abd Elwahab, Karl Sweeney, Carmel Malone, Ray McLaughlin, Aoife Lowery, Michael J Kerin

This study found that sarcopenia was not associated with poorer prognosis, but lower lean body mass was associated with reduced overall and invasive disease-free survival.

The association between sarcopenia and clinicopathological characteristics and prognostic outcomes among patients receiving neoadjuvant chemotherapy for breast cancer is unclear.

👏👏👏Evi Banken, Barbara M Geubels, Fleur E C Vande Kerckhove, Davy M J Creemers, Stijn H J Ketelaers, Joost Nederend, Heike M U Peulen, Irene E G van Hellemond, Harm J T Rutten, Jacobus W A Burger

It adds evidence for expanding organ-preserving strategies without compromising oncological outcomes in patients with locally advanced rectal cancer typically associated with a poorer prognosis.

This study supports the safety of a watch-and-wait approach in patients with high-risk rectal cancer with a complete response after total neoadjuvant therapy, highlighting low recurrence and favourable survival.