Most patients drop out of hernia watchful waiting within a few years, and the young fastest

The edition in brief

In a single-centre cohort of 400 patients on a watchful-waiting protocol for asymptomatic or minimally symptomatic inguinal hernia, 60% had dropped out of scheduled surveillance by the end of follow-up. Discontinuation was 92.9% in patients under 30, 63.6% at 30-50 and 56.4% over 50. No emergency repairs were found among those still followed or those contacted, but most who left could not be reached. A four-centre European randomised trial of 202 patients with oesophageal or junctional adenocarcinoma found robot-assisted oesophagectomy removed more lymph nodes than conventional minimally invasive oesophagectomy (median 36 vs 32), with similar complications and 1-year survival; node count is a surrogate. A French national target-trial emulation of 1,872 patients with synchronous rectal cancer liver metastases found combined and staged resection had similar severe complications (adjusted OR 0.82, 0.58-1.16) and survival (HR 0.88, 0.65-1.19); major hepatectomy raised complication risk. A 60-patient open-label trial found immunonutrition did not lower morbidity compared with standard supplements before colorectal cancer surgery.