Background: Emergency laparotomy (EL) is accompanied by high post‐operative morbidity and mortality which varies significantly between countries and populations. The aim of this study is to report outcomes of emergency laparotomy in Greece and to compare them with the results of the National Emergency Laparotomy Audit (NELA).Methods: This is a multicentre prospective cohort study undertaken between 01.2019 and 05.2020 including consecutive patients subjected to EL in 11 Greek hospitals. EL was defined according to NELA criteria. Demographics, clinical variables, and post‐operative outcomes were prospectively registered in an online database. Multivariable logistic regression analysis was used to identify independent predictors of post‐operative mortality.Results: There were 633 patients, 53.9% males, ASA class III/IV 43.6%, older than 65 years 58.6%. The most common operations were small bowel resection (20.5%), peptic ulcer repair (12.0%), adhesiolysis (11.8%) and Hartmann's procedure (11.5%). 30‐day post‐operative mortality reached 16.3% and serious complications occurred in 10.9%. Factors associated with post‐operative mortality were increasing age and ASA class, dependent functional status, ascites, severe sepsis, septic shock, and diabetes. HELAS cohort showed similarities with NELA patients in terms of demographics and preoperative risk. Post‐operative utilisation of ICU was significantly lower in the Greek cohort (25.8% vs 56.8%) whereas 30‐day post‐operative mortality was significantly higher (16.3% vs 8.7%).Conclusion: In this study, Greek patients experienced markedly worse mortality after emergency laparotomy compared with their British counterparts. This can be at least partly explained by underutilisation of critical care by surgical patients who are at high risk for death.

Background/Objectives: Survival rates for esophageal cancer patients have markedly improved. Inevitably, attention has been drawn to functional and quality-of-life problems. The aim of the current study was to investigate the prevalence of dumping syndrome in patients following esophageal resection and its correlation with postoperative quality of life. Methods: This cross-sectional study involved disease-free patients who underwent a potentially curative resection for esophageal or gastroesophageal junction carcinoma between January 2019 and January 2024 in a single academic institution. Patients were asked to fill in two questionnaires: the Dumping Syndrome Rating Scale (DSRS) and the QLQ-OG25. A Composite Dumping Syndrome Index (CDSI) was calculated by adding the summary severity and frequency scores for each patient. Results: During the study period, 42 patients underwent esophagectomy for malignant esophageal or junctional tumors. In total, 14 eligible patients responded to the questionnaires at a mean time of 19.7 (±20.8) months following their operation. Three patients (21%) reported having at least quite severe problems related to at least two dumping symptoms. Six patients (43%) reported that they avoid certain foods in order to alleviate related problems. A high CDSI score was associated with significantly increased OG25 scores for dysphagia, eating restriction, odynophagia, pain and discomfort, and reflux (p < 0.05). Conclusions: Early dumping syndrome can occur in a significant proportion of patients following esophagectomy and may adversely affect quality of life.

Background and Objectives: Posthepatectomy liver failure (PHLF) remains a major cause of morbidity and mortality for patients undergoing major liver resections. Recent research highlights the expanding role of machine learning (ML), a crucial subfield of artificial intelligence (AI), in optimizing risk stratification. The aim of the current study was to review, elaborate on and critically analyze the available literature regarding the use of ML-driven risk prediction models for posthepatectomy liver failure. Materials and Methods: A systematic search was conducted in the PubMed/MEDLINE, Scopus and Web of Science databases. Fifteen studies that trained and validated ML models for prediction of PHLF were further included and analyzed. Results: The available literature supports the value of ML-derived models for PHLF prediction. Perioperative clinical, laboratory and imaging features have been combined in a variety of different algorithms to provided interpretable and accurate models for identifying patients at risk of PHLF. The ML-based algorithms have consistently demonstrated high area under the curve and sensitivity values, surpassing traditionally used risk scores in predictive performance. Limitations include the small sample sizes, heterogeneity in populations included, lack of external validation and a reported poor ability to distinguish between true positive and false positive cases in several studies. Conclusions: Despite the constraints, ML-driven tools, in combination with traditional scoring systems and clinical insight, may enable early and accurate PHLF risk detection, personalized surgical planning and optimization of postoperative outcomes in liver surgery.

Introduction: Despite the widespread use of minimally invasive techniques, open left thoracoabdominal esophagectomy (LTE) can offer excellent visualization and adaptability. The current study aimed to present and evaluate the outcomes related to an open LTE in esophageal malignancy treatment. Methods: A retrospective cohort analysis of data collected from two institutions was performed, including patients with distal esophageal or junctional tumors who underwent open LTE between November 2018 and December 2023. Results: Twenty-two patients were included (16 males; mean age 62.8 years). Postoperative complications occurred in eight patients (36%), with pulmonary complications being the most prevalent (seven patients; 32%). One patient experienced a clinical anastomotic leak. No reoperations or escalation to a higher level of care were required. In-hospital and 30-day mortality were zero. Tumor cells were found at the surgical margins in six patients (27%). The mean lymph node yield was 27. During the follow-up period, there were nine deaths and 11 cases of disease recurrence. Isolated locoregional recurrence was seen in five patients (23%). The one-year and two-year overall survival rates were 79% and 47%, respectively. Conclusion: In selected cases, open LTE remains a valid and safe operation with acceptable morbidity and oncological efficacy.