Recent updates in multimodal treatment are reshaping gastric cancer care, impacting surgical strategies and patient outcomes. Laparoscopic and robotic gastrectomy are now standard in Asia, supported by major trials like JCOG0912 and K-LASS02. The FLOT chemotherapy regimen is becoming the global standard, while SOX and XELOX gain traction in Asia. Surgeons should consider integrating immunotherapy […]
Author: STITCHES Newsletter
Efficacy of HIPEC After Laparoscopic Gastrectomy in Gastric Cancer
Laparoscopic gastrectomy plus hyperthermic intraperitoneal chemotherapy (HIPEC) improves outcomes for gastric cancer patients with positive peritoneal lavage cytology. HIPEC-treated patients had significantly lower postoperative recurrence (66.7% vs. 90.9%) and visible metastasis (29.6% vs. 59.1%, p < 0.05). 3-year overall survival for HIPEC patients was 51.8% versus 18.2% for non-HIPEC (p = 0.005). Consider HIPEC for […]
Fluorescence Imaging with ICG Reduces Colorectal Leaks
Fluorescence imaging using indocyanine green significantly improves surgical outcomes in colorectal procedures. It reduces anastomotic leak rates with an odds ratio of 0.58 (95% CI 0.44-0.75). It enhances lymph node retrieval by an average of 6.32 nodes in gastrointestinal cancer surgeries (95% CI 4.43-8.22). Intraoperative adjustments to transection points are feasible, improving surgical precision. Evidence […]
Streamlined Robotic Training Cuts Time, Maintains Mastery
A refined robotic surgical training curriculum enhances skill acquisition while significantly lowering training time. Mastery rates jumped from 83% to 100% with the new curriculum. Mean console training time decreased from 7 hours to 5 hours and 42 minutes (p=0.005). This efficient approach offers general surgery residents a more effective pathway to proficiency. Median VR […]
New predictive models identify risks for liver tumor rupture
Understanding the risk factors for hepatocellular carcinoma (HCC) rupture can improve surgical outcomes. Key risk factors include cirrhosis, protrusion ratio, and maximum tumor length. The new capture nomogram achieved AUC values of 0.857, 0.824, and 0.840 across training, validation, and test groups, indicating high predictive accuracy. Using these models can enhance early risk assessment and […]
One-stage surgery beats two-stage for unresectable liver metastases.
Median overall survival was 46.5 months for one-stage versus 34.0 months for two-stage (p = 0.043). Complication rates were similar: 11% for one-stage and 13% for two-stage (p = 0.567). Local treatment was more successful with one-stage surgery, achieving complete resection or ablation in 52 patients compared to 29 in the two-stage group (p < […]
Laparoscopic Liver Resection in Segment 7 Shows Promise
Laparoscopic liver resection (LLR) for malignancies in segment 7 is a viable option, with potential short-term benefits. LLR led to shorter hospital stays and a trend toward reduced blood loss compared to open liver resection (OLR). Over 30 cases, the conversion rate to OLR decreased, indicating improved surgical safety with experience. Surgeons can consider LLR […]
New Tool to Predict Parastomal Hernia Post-Colostomy
A newly developed nomogram predicts the risk of parastomal hernia in patients undergoing permanent colostomy for rectal cancer, crucial for improving patient outcomes. In a study of 430 patients, 30.9% developed parastomal hernia. Key risk factors include age ≥ 65 years (odds ratio 2.51) and BMI ≥ 25 kg/m² (odds ratio not specified). This tool […]
New CT Model Predicts Chemotherapy Response in Stomach Cancer
A dual-energy CT radiomics model can better predict neoadjuvant chemotherapy response in locally advanced gastric cancer, impacting surgical decision-making. The dual-energy CT model achieved an AUC of 0.806 versus 0.729 with conventional CT in the training dataset (p = 0.041). High-risk patients identified by the dual-energy CT model had nearly double the overall survival and […]
New Prognostic Tool for Acute Pancreatitis Outcomes
A novel Neutrophil-C-Reactive Protein Index (NCI) can enhance risk stratification for severe acute pancreatitis and in-hospital mortality, crucial in resource-limited settings. Optimal NCI cut-off values are ≥1877 for severe pancreatitis and ≥3180 for mortality. NCI predictions for severe pancreatitis had AUCs of 0.853 to 0.897 across different patient cohorts, outperforming other biomarkers. This tool leverages […]