The findings highlight the need to balance functional outcomes with oncological benefits in future research.

👏👏👏Chun-Kai Liao, Yen-Lin Yu, Ya-Ting Kuo, Yu-Jen Hsu, Yih-Jong Chern, Yueh-Chen Lin, Pao-Shiu Hsieh, Jeng-Fu You, Jy-Ming Chiang

This meta-analysis of 65 studies involving 13 971 patients compared transanal with laparoscopic total mesorectal excision (TME) for rectal cancer. Transanal TME was associated with better surgical and oncological outcomes but a higher risk of major low anterior resection syndrome.

👏👏👏Arthur Morris, Sally A Roberts, Nikki Grae, Chris Frampton

This study analysed the surgical site infection (SSI) rate for clean operations where cefazolin prophylaxis was used. There were 66 292 procedures where the timing (in minutes) was known. There was a higher SSI risk when prophylaxis was given more than 51 minutes before incision.

👏👏👏Emma Hansson, Nicholas Moellhoff, Susanne Ahlstedt Karlsson, Alexandra Uusimäki, Ilkka Kaartinen, Lisbet Rosenkrantz Hölmich, Rado Zic, Ruth Waters, Mark Henley, Riccardo E Giunta, Anna Elanderon behalf of the ESPRAS European Quality Indicator Group

Spanning six quality domains and incorporating structure, process, and outcome measures, including patient-reported outcomes and patient-reported experiences, these quality indicators offer a comprehensive foundation for future benchmarking and quality improvement across Europe.

This study used a structured Delphi process involving experts and patient representatives from 21 European countries to develop a consensus-based set of 41 quality indicators for breast reconstruction.

👏👏👏Riadh Salem, Wing K Chou, Lorenzo Giorgi, Sivesh K Kamarajah, Sheraz R Markar

The overall quality of evidence was poor, with most studies non-randomized and at moderate risk of bias. Meta-regression identified industry involvement as a significant source of heterogeneity, highlighting the need for independent evaluation and cautious adoption.

This systematic review and meta-analysis of 90 studies (65 296 patients) found very low-certainty evidence suggesting possible benefits of robotic-assisted gastrectomy over conventional surgery.

👏👏👏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