Simultaneous resection of rectal and liver metastases is safe and linked to longer survival in high-risk patients. 92 patients showed no deaths; complications were seen in 15% with major issues like drainage (9%) and anastomotic dehiscence (3%). Median overall survival was 70 months, with recurrence-free survival at 10 months. Choose simultaneous resection judiciously; it can […]
Author: STITCHES Newsletter
Improved Outcomes with Robot-Assisted Pelvic Reconstruction
Robot-assisted pelvic reconstruction using rectus abdominis flaps shows promise for better surgical outcomes in pelvic cancer patients. Wound complications were significantly lower in robot-assisted surgeries compared to open approaches. One study noted a shorter length of hospital stay for robot-assisted patients. Surgeons may consider this technique to reduce complications and improve recovery times. Enhanced visualization […]
New Immune Signatures in MEN1-Related Tumors
Identifying immune signatures could refine patient selection and surgical outcomes for those with MEN1-related neuroendocrine tumors. Analyzed 42 MEN1 patients with duodenopancreatic neuroendocrine tumors (DPNETs); 14 had liver metastasis. Identified 1,117 immunoglobulin-bound proteins; 435 antigens enriched in DPNET patients, with 130 higher in those with liver metastasis. Surgeons may consider these findings for better risk […]
Navigating Hepatectomy: New Standards for Liver Remnant Volume
A study identifies critical thresholds for future liver remnant volume (FLRV) to reduce post-hepatectomy liver failure in cancer patients. FLRV of ≥30% in normal livers and ≥50% in impaired livers reduces the risk of severe morbidity. For every 10% increase in FLRV, the odds of severe liver failure-related complications decrease by nearly 40%. Focus on […]
Multimodal Prehabilitation Reduces Complications in Frail Elderly with Gastric Cancer
A multimodal prehabilitation program improves outcomes for older patients with frailty undergoing radical gastrectomy. Complications dropped significantly in the prehabilitation group (17.2% vs 28.7%; p=0.01). Minor complications were halved (10.7% vs 20.2%; p=0.01), and medical complications also decreased (8.3% vs 16.9%; p=0.02). Patients in the prehabilitation group improved their functional capacity before surgery with an […]
Wearable Acupoint Stimulation Beats Metoclopramide for PONV
A novel wearable device significantly outperforms metoclopramide in managing moderate to severe postoperative nausea and vomiting (PONV). The TEAS group achieved a 2-hour remission rate of 77.6% vs. 55.2% for controls (p < 0.001). 24-hour relapse rates were 12.2% for TEAS compared to 56.3% for metoclopramide (p < 0.001). This suggests wearable TEAS could enhance […]
Liver Fibrosis Increases Recurrence Risk in Colorectal Metastases
Background liver fibrosis intensifies the risk of intrahepatic recurrence after surgery for colorectal liver metastases, impacting surgical decision-making. Intrahepatic recurrence occurred in 36.3% of patients post-surgery, with 58.3% in the fibrosis group vs. 29.5% in the non-fibrosis group (p = 0.019). Each 1% increase in fibrotic area raised recurrence risk by 45% (hazard ratio 1.45; […]
Identifying Risks After Pancreatoduodenectomy
In-hospital mortality after pancreatoduodenectomy reveals critical timing for interventions impacting patient outcomes. 3.5% of patients (156 of 4474) died in the hospital, primarily from three complication clusters: postpancreatectomy-specific (51.9%), vascular (25.6%), and cardiopulmonary (17.9%). Complications emerge at different postoperative intervals: median 9 days for postpancreatectomy, 4.5 days for vascular, and 3 days for cardiopulmonary issues. […]
Reducing Water Waste at OR Scrub Sinks
Surgeons are wasting an estimated 337,596 liters of water annually during surgical scrubs, representing 34.2% of total usage. The median water wasted per wet scrub at timer-controlled sinks is 10 liters. Wet scrubs are performed in 25.9% of cases by attending surgeons and OR staff. Optimizing scrub practices could lead to significant water conservation without […]
CA 19-9 Testing Improves Survival in Resected Ampullary Cancer
Routine CA 19-9 surveillance detects recurrences early and enhances survival in resected ampullary cancer patients. Five-year overall survival stands at 56.4% in 572 patients, with 43.88% experiencing recurrences, predominantly distant. A serial rise in CA 19-9 is a strong predictor for recurrence, showing 71.05% sensitivity and 91.67% specificity. Detecting recurrences early through CA 19-9 testing […]