Original research
Surgery
Original research relevant to this speciality, newest first.
- Early surgery is associated with better survival in asymptomatic severe primary mitral regurgitation
JAMA Network Open
Observational target-trial emulation, 802 patients. Surgery within six months was associated with lower mortality, HR 0.69; residual confounding remains possible. - Urine cell-free RNA shows promise for bladder cancer detection and treatment-response prediction
Nature Medicine
Diagnostic biomarker study, 683 urine samples. Localized cancer detection achieved 95% sensitivity at 90% specificity. Prospective clinical-utility validation is needed. - Major pathological response after neoadjuvant melanoma immunotherapy predicts excellent five-year survival
Nature Medicine
Pooled analysis, 1,038 patients. Five-year survival approached 98–99% among major responders to checkpoint inhibitors. Comparisons between treatment regimens were not randomized. - Robotic hip replacement shows no overall implant-survival advantage over conventional surgery
The BMJ
Registry target-trial emulation, 666,283 procedures. Matched five-year implant survival was 98.8% in both groups; malposition-related revisions were lower with robotics. - Robotic esophagectomy increases lymph-node yield without an established survival advantage
JAMA Surgery
Randomized trial, 218 patients. Median node yield: 36 versus 32. Complications were similar; one-year survival did not differ. - Supervised exercise improves persistent knee symptoms after ACL reconstruction
Annals of Internal Medicine
Randomized trial, 184 young adults. Modest additional improvement at four months; differences narrowed at twelve months, with no demonstrated cartilage benefit. - Hypotension prediction software shows no superiority over proactive blood-pressure management
Anesthesiology
Randomized trial, 100 surgical patients. No significant reduction in hypotension versus intervention at MAP ≤73 mmHg. The trial does not establish equivalence. - Lower intraoperative fluid use was not associated with more postoperative acute kidney injury.
JAMA Network Open
- Preoperative intravenous iron reduced transfusions and modestly improved recovery after cardiac surgery in patients with anaemia.
BMJ
- Platelets refrigerated for up to 21 days were noninferior to standard platelets for bleeding during cardiac surgery.
JAMA
- Intravenous anaesthesia did not improve days alive at home versus volatile anaesthesia after major noncardiac surgery.
JAMA
- A four-dose perioperative dapagliflozin regimen reduced acute kidney injury after elective cardiac surgery.
JAMA
- Aspirin alone was noninferior to rivaroxaban followed by aspirin after hip or knee replacement.
NEJM