Background: This study aimed to analyze the relationship between the levels of tumor markers—specifically, carcinoembryonic antigen (CEA) and Ca19-9 antigen—determined in both serum (sCEA and sCa19-9) and intraoperative peritoneal washings (pCEA and pCa19-9) and the advanced stage of gastric cancer (including the occurrence of cancer cells in cytology from abdominal fluid). Methods: This study included 47 patients with histopathologically confirmed gastric cancer or gastroesophageal junction cancer who underwent surgical treatment. The material for the cytological examination and assessment of CEA and Ca19-9 concentrations in peritoneal fluid was collected intraoperatively. Later, blood was drawn to assess the CEA and Ca19-9 concentrations in blood serum. Results: There was a statistical correlation between a positive cytology result or the presence of peritoneal carcinomatosis and a positive result for the tumor markers obtained from abdominal washings. This correlation was not observed with marker levels obtained from blood serum. The pCEA marker was highly sensitive (93.3%) and specific (93.8%) for detecting cancer cells. The pCa19-9 marker was less effective in detecting cancer but matched pCEA in identifying the absence of cancer. No differences were observed in sCEA and sCA19-9 levels between patients who underwent neoadjuvant chemotherapy and those who did not receive this treatment. However, statistical analysis showed that this relationship did not apply to pCEA and pCa19-9 levels. Conclusions: Intraoperative determinations of tumor marker levels in peritoneal washings may be a predictive factor for a poor prognosis in patients with gastric cancer.

Background/Objectives: Colorectal cancer (CRC) frequently metastasizes to the peritoneum, significantly worsening patient prognosis. While serum tumor markers such as carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA 19-9) are routinely measured, their diagnostic or prognostic role in peritoneal fluid remains unclear. This study aimed to assess the relationship between CEA and CA 19-9 levels in both serum and peritoneal fluid, and the clinical stage of CRC, particularly focusing on the presence of peritoneal metastases and positive cytology. Methods: We retrospectively analyzed data from 89 patients with histologically confirmed CRC who underwent surgery between 2020 and 2023. All patients had preoperative assessment of CEA and CA 19-9 levels in serum and peritoneal fluid, along with cytological examination of peritoneal fluid samples. Patients were categorized based on the presence or absence of macroscopic peritoneal metastases and cytology results. Results: Elevated levels of CEA and CA 19-9 in peritoneal fluid were significantly associated with the presence of peritoneal metastases. A positive cytological finding also correlated with higher marker concentrations. Conclusions: CEA and CA 19-9 levels in peritoneal fluid strongly correlate with peritoneal dissemination in CRC. These markers may serve as additional predictive factors, aiding in early detection of peritoneal spread and improved risk stratification. Their assessment may be useful in guiding intraoperative and postoperative decision-making.

Purpose Emergency abdominal surgery carries a high risk of postoperative morbidity, yet prospective multicentre data on real-world abdominal wall closure practices remain limited. This interim analysis of the PROPHECY study aimed primarily to characterise current abdominal wall management and variation in practice across centres, and secondarily to describe early postoperative outcomes. Methods This prespecified interim analysis included adult patients undergoing emergency abdominal surgery in a prospective multicentre cohort across Poland (June–December 2025). Patients were grouped by operative access (laparotomy, laparoscopy, conversion). Closure practices and early outcomes, including surgical-site infection (SSI), fascial dehiscence, major postoperative morbidity (Clavien–Dindo ≥ III), in-hospital mortality, and length of stay, were assessed. Multivariable mixed-effects models with a random intercept for centre were used where applicable. Results Of 850 screened patients, 828 from 24 centres were included; 273 (33.0%) underwent laparotomy, 500 (60.4%) laparoscopy, and 55 (6.6%) conversion. Substantial variation between centres was observed in abdominal wall management, particularly in the use of short-stitch closure, subcutaneous drainage, and prophylactic negative-pressure wound therapy, whereas fascial closure of larger camera ports was nearly universal. Prophylactic mesh reinforcement was uncommon. SSI occurred in 9.3%, fascial dehiscence in 2.4%, major morbidity in 11.2%, and in-hospital mortality in 3.0%. Differences in early outcomes between operative approaches persisted in adjusted analyses but should be interpreted in the context of substantial differences in case-mix and potential residual confounding. Conclusion Emergency abdominal surgery is characterised by substantial variation in abdominal wall management across centres despite existing recommendations. This prospective real-world benchmark identifies areas of inconsistent practice and provides the clinical context for the planned 12-month assessment of incisional, port-site, and parastomal hernia outcomes in the PROPHECY cohort.

Introduction: Liver resection remains one of the fundamental treatment modalities for both malignant and benign hepatic diseases; however, it is still associated with a significant risk of intraoperative bleeding. Reducing blood loss and the need for transfusion is crucial for perioperative outcomes and long-term prognosis. The Coolingbis system, which utilizes a cooled monopolar radiofrequency electrode, represents a novel method of achieving hemostasis during hepatic parenchymal transection. Aim: The aim of this study was to evaluate the impact of the Coolingbis system on intraoperative blood loss, the need for blood product transfusions, and the perioperative course in patients undergoing liver resection. Materials and Methods: A retrospective analysis was conducted on 58 patients who underwent surgery for liver lesions between 2022 and 2024. The Coolingbis system was used in 25 patients, while conventional hemostatic techniques were applied in 33 patients. Intraoperative blood loss, operative time, transfusion rate, length of hospital stay, postoperative complications, and mortality were analyzed. Statistical analysis was performed using the Kruskal–Wallis test, the chi-square test, and Fisher’s exact test. Results: Intraoperative blood loss was significantly lower in the Coolingbis group compared with the conventional techniques group (338.0 450.1 mL vs 607.6 752.5 mL; p = 0.0062). Blood product transfusions were less frequent in the Coolingbis group (12.0% vs 24.2%; p = 0.0410). No significant differences were observed between the groups in terms of operative time or length of hospital stay. The rate of postoperative complications was lower in the Coolingbis group; however, the difference did not reach statistical significance. Age, sex, and BMI had no significant impact on intraoperative blood loss. Conclusions: The use of the Coolingbis system in liver resections is associated with a significant reduction in intraoperative blood loss and transfusion requirements, without an increased risk of complications. This technique may represent a valuable adjunct to conventional hemostatic methods in liver surgery.

Introduction: Gold standard treatment for locally advanced esophageal cancer is subtotal resection of the esophagus with resection of regional lymph nodes. Despite being performed in experienced and specialized centers, this procedure is associated with a high rate of complications. Complications such as anastomotic fistula and leakage can be life-threatening, primarily resulting from inadequate blood circulation in the anastomosis area. Aim: The aim of the study is to present the results of intraoperative indocyanine green (ICG) application in order to verify the adequate perfusion in esophagogastric anastomosis. Materials and methods: This is a single-center prospective analysis of 32 patients who underwent subtotal esophagectomy with regional lymph node resection for esophageal carcinoma. In all cases, intraoperative perfusion assessment using ICG fluorescence imaging (ICG-FI) was performed. Patient characteristics, comorbidities, and postoperative outcomes were analyzed, with treatment effects monitored for up to 1 year postoperatively. Results: Six patients required gastric conduit reduction due to poor blood perfusion visualized by intraoperative ICG-FI. Anastomotic leakage occurred in two cases, which were managed endoscopically with endo-vac therapy and esophageal stent placement. The remaining patients did not require additional surgical interventions during the postoperative course. Conclusions: The use of ICG dye in esophageal surgery appears to be a beneficial tool for objective assessment of perfusion that may be a valuable prediction factor in the postoperative course.