Current study identifies radial margin distance cutoffs that significantly impact survival outcomes in perihilar cholangiocarcinoma. Radical margin distance (rmd) of 0 mm correlates with a 5-year overall survival rate of only 21.8%, while ≥1.0 mm shows 78.5% survival. Recurrence rates are starkly different: 83.5% for rmd of 0 mm versus just 23.9% for rmd ≥1.0 […]
Author: STITCHES Newsletter
Optimizing Thyroid Cancer Diagnoses with EU-TIRADS
Using the EU-TIRADS ultrasound system improves identification of thyroid nodules needing surgery, minimizing unnecessary biopsies. A higher percentage of nodules classified as Bethesda IV-VI were found in the selective group (26%) vs. non-selective (13%), p=0.039. The malignancy rate was similar: 8% for selective vs. 5% for non-selective. Less need for cytology: 71% of patients in […]
Sphincter-Sparing Closure Cuts Bleeding in Endoscopic Papillectomy
A new pre-closure technique for endoscopic papillectomy significantly lowers delayed bleeding risk in duodenal papilla adenoma patients. Delayed bleeding rate was 0% with pre-closure vs. 17.95% without (p = 0.017). Immediate bleeding rate decreased from 66.67% to 37.93% (p = 0.027). This approach also shortens hospital stays: 6 days vs. 7 days (p = 0.048). […]
Next-Gen Sequencing Transforms Management of BD-IPMN
Next-generation sequencing significantly alters surgical decision-making for branch-duct intraductal papillary mucinous neoplasms, providing clarity when traditional guidelines fall short. Surgical plans shifted to surveillance in 43% of distal pancreatectomy and 61% of pancreatoduodenectomy scenarios when NGS was negative. Conversely, with positive NGS results, surveillance plans shifted to surgery 90% and 72% of the time, respectively. […]
Laparoscopic Total Gastrectomy Shows Promising Long-Term Outcomes
Laparoscopic-assisted total gastrectomy for resectable gastric cancer yields favorable long-term survival rates. Five-year overall survival is 62.5%, with a recurrence-free survival rate of 60.3%. Recurrence occurs in 40% of patients, primarily as distant metastases (61.4%). Understanding early and late recurrence, with a critical 12-month cutoff, can refine postoperative follow-up. An early recurrence prediction model outperforms […]
EUS-Guided Drainage for Symptomatic Gallstones Works
EUS-Guided Gallbladder Drainage shows strong promise for non-surgical patients with symptomatic cholelithiasis without cholecystitis. 100% technical success, with complete stone clearance achieved in all 23 patients. 87% achieved clearance in just one treatment; no procedure-related complications reported. Improving patient selection and outcomes may lead to broader acceptance of this technique in practice. Journal Article by […]
Ligation Level Doesn’t Impact Anastomotic Leakage in Rectal Cancer
Low vs. high ligation of the inferior mesenteric artery during rectal cancer surgery shows no significant difference in anastomotic leakage rates. Anastomotic leakage occurred in 4.9% (low ligation) vs. 6.0% (high ligation); no significant difference (p=0.68). 30-day postoperative morbidity was 14.0% for low ligation vs. 22.0% for high ligation (p=0.08). Surgeons can choose either ligation […]
YouTube Videos on Esophageal Cancer Vary in Quality
Surgeons should scrutinize YouTube content on esophageal cancer as video reliability is inconsistent, impacting patient education. Out of 78 analyzed videos, those from public institutions had the highest quality scores, significantly better than patient experience videos (p < 0.001). Viewer engagement levels showed no correlation with video quality; popularity doesn’t guarantee reliable information. Surgeons might […]
Externalized Pancreatic Stenting Reduces Fistula Rates in Robotic Surgery
Using an externalized pancreatic stent during robotic pancreaticoduodenectomy significantly lowers the risk of postoperative pancreatic fistula. In a study of 67 patients, overall POPF rate was 17.9%, with a majority classified as intermediate risk. This novel technique showed very low rates of fistula-related complications, making it a feasible option for surgeons. Surgeons should consider this […]
Global Surgeons Need More Support for Future Leaders
Surgeons involved in global surgery face significant barriers that impact engagement and outcomes. Early mentorship and community networks were vital for sustained commitment. Financial and institutional recognition obstacles hinder career development. To cultivate competent global surgery leaders, focus on improving training pathways and addressing funding challenges. Emphasizing humility and long-term impact is crucial for effective […]