Opioid prescribing in emergency general surgery varies significantly across hospitals, with discrepancies of 1.5 to 3.7 times in morphine equivalents. While most discharges follow elective guidelines (75%-96%), compliance drops sharply for colectomy, with only 4% adherence compared to 25% for appendectomy. Increased comorbidity and ASA classification correlate with non-guideline prescriptions, highlighting an urgent need for […]
Author: STITCHES Newsletter
Urban Prehospital Whole Blood Program Shows Promising Survival Rates in Trauma Patients
An urban prehospital whole blood (ph-wb) program effectively treated 375 trauma patients, administering 588 units of whole blood. Patients experienced significant improvements in systolic blood pressure, averaging a rise of 28 mmHg, while pulse decreased by 19 bpm before reaching the emergency department. Notably, 83% survived 24 hours and 80.8% were alive after 30 days. […]
Nearly 25% of Rectal Cancer Patients Face Parastomal Hernia After Surgery
In a cohort of 836 rectal cancer patients, 24.8% developed parastomal hernias (PSH) within 85 months following abdominoperineal resection. Key risk factors included female sex, age over 60, and a BMI of 24 or higher. The study also introduces a nomogram for predicting PSH risk, enabling clinicians to personalize prevention strategies such as stoma positioning […]
Laparoscopic Surgery Reduces Mortality and Complications for Peptic Ulcers
Laparoscopic treatment of perforated peptic ulcers significantly cuts mortality and postoperative complications compared to open surgery. A network meta-analysis of 16 studies with 1,259 patients revealed lower odds of death (OR 0.36) and fewer wound infections (OR 0.15) and ileus (OR 0.33) with laparoscopic methods. While alternative strategies lacked sufficient evidence, this analysis confirms laparoscopic […]
Robotic Techniques Slash Recovery Times in Colorectal Surgery
Patients undergoing robotic natural orifice transluminal extraction colectomy (r-notec) and robotic no-incision colectomy (r-nic) experienced significantly shorter hospital stays compared to traditional robotic colectomy. The r-notec/r-nic group averaged just 2.0 days in the hospital versus 3.4 days for conventional patients. Both methods maintained comparable safety profiles, with lower complication rates and reduced opioid use. These […]
Innovative Ex Vivo Surgery and Autotransplantation Successfully Treats IVC Leiomyosarcoma
Surgeons successfully performed an ex vivo liver resection and autotransplantation in a patient with extensive inferior vena cava leiomyosarcoma. The operation included en bloc tumor removal, extensive vascular reconstruction, and involvement of open-heart surgery techniques. After a 13-hour procedure and significant blood loss, the patient was discharged after a month and remains disease-free 16 months […]
Minimally Invasive Surgery Cuts Complications and Mortality in Pancreatic Cancer Patients
Minimally invasive distal pancreatectomy (MIDP) markedly reduces hospital stays, infections, and 90-day mortality compared to open distal pancreatectomy (ODP) in pancreatic ductal adenocarcinoma patients. Analyzing data from 20 studies involving 9,339 patients, MIDP also leads to significantly lower blood loss and transfusions. Despite showing better clinical outcomes, further randomized clinical trials are necessary to solidify […]
Innovative Patch Technique Enhances Venous Reconstruction in Pancreatoduodenectomy
A new patch reconstruction technique for venous resection during pancreatoduodenectomy offers significant advantages. It preserves essential venous collaterals while maintaining oncologic radicality, minimizing risks of torsion or stenosis typically seen with segmental resection. This versatile approach is effective for both open and robotic surgeries, addressing various tumor infiltrations without compromising surgical outcomes. The technique emphasizes […]
Positive lymph node status predicts very early recurrence in pancreatic cancer
Positive lymph node status dramatically increases the risk of very early recurrence—defined as recurrence within three months—after neoadjuvant therapy and curative resection for pancreatic ductal adenocarcinoma. In a cohort of 305 patients, 9.1% experienced this rapid recurrence, which severely impacts overall survival (6 months vs. 40 months). This finding suggests that patients with positive lymph […]
New Surgical Score Predicts Postoperative Complications After Liver Cancer Surgery
A novel surgical burden score (SBS), factoring in adjusted blood loss and operative time, significantly forecasts postoperative complications in hepatocellular carcinoma (HCC) surgery. Among 801 patients analyzed, complications were noted in 39.1%, with severe cases at 11%. The SBS model surpassed existing models, achieving area under the curve (AUC) scores of 0.73 for training and […]