Surgical unit volume has a minor influence on recurrence rates after open groin hernia repairs, which is crucial for optimizing patient outcomes. Reoperation rates for recurrence range from 1.9% to 2.8%, with medium-high volume units showing a significant increase (hazard ratio 1.14). Emergency repairs at low-volume units have a concerning increased reoperation risk (hazard ratio […]
Author: STITCHES Newsletter
Surgeons Face High Burnout and Mistreatment Rates
Burnout and mistreatment are alarmingly common among academic general surgery faculty, particularly affecting female surgeons, which could impact recruitment and retention. 34.9% report weekly burnout; 30.2% have thoughts of leaving their jobs. 66.2% report mistreatment, including 54.4% experiencing bullying and 46.3% facing discrimination. Targeting workplace conditions is essential to improve faculty well-being and reduce turnover. […]
Obesity poses no barrier to effective antireflux surgery outcomes.
In a study of 2,388 patients, those with BMI ≥35 had similar symptom improvement (GERD-HRQL scores: 10.7 vs. 10.1) and satisfaction rates (81.6% vs. 83.3%) post-operation compared to non-obese patients. Five-year anatomic integrity (75.8% vs. 78.2%) and revision rates (4.5% vs. 5.3%) were also comparable. However, obese patients had lower rates of pH normalization in […]
New Tool Flags High-Risk Patients for PE Post-Surgery
A new calculator improves pulmonary embolism (PE) risk assessment after surgery, potentially impacting thrombo-prophylaxis strategies. Among nearly 5 million surgeries, 0.35% (17,045) resulted in PE. Dynamic reassessment following unplanned readmissions could identify 24,320 patients over the 0.5% treatment threshold, revealing a PE rate of 2.92%. Surgeons can use this tool to inform extended thromboprophylaxis, reducing […]
Direct-to-Surgery for Stage II/III Rectal Cancer Yields Strong Results
For selected patients with stage II or III rectal cancer, a direct-to-surgery approach led to favorable 2-year oncologic outcomes. Local recurrence rate was just 1% among patients undergoing low anterior resection. Disease-free survival was 85%, and overall survival reached 99%. Surprisingly, only 8% of patients required post-operative radiation therapy. Preoperative MRI overstaged 51% of patients […]
Understanding Symptom Recovery After Pancreatectomy
Symptom recovery following pancreatectomy is crucial for optimizing patient outcomes. Overall recovery rates were 68.1% at one month, 78.6% at three months, and 86.9% at six months post-surgery. Top symptoms included pain, fatigue, sleep disturbance, drowsiness, and bloating; fatigue persisted the longest. Preventing postoperative complications is vital for improving recovery, regardless of surgical technique. Journal […]
End-to-Side Anastomosis Reduces Crohn’s Disease Recurrence
End-to-side ileocolonic anastomosis is a low-risk option that can improve outcomes for Crohn’s disease patients after ileocecectomy. The end-to-side configuration showed lower blood loss and shorter operative times compared to other methods. Multivariable analysis revealed that elective surgery and end-to-side anastomosis correlated with a lower recurrence rate over a 32-month follow-up. This technique is safe […]
Obesity Increases Conversion Rates in Colorectal Surgery
Higher BMI significantly raises the risk of converting from minimally invasive to open surgery for colorectal procedures. Laparoscopic surgery rates were 36.4% in Nova Scotia versus 49.3% in the national cohort, with conversion rates of 23.1% and 19.3%, respectively. BMI was a strong predictor of conversion: odds ratio of 2.54 for Nova Scotia and 1.61 […]
Minimally Invasive Surgery Safe for pT4 Colon Cancer Patients
Minimally invasive surgery (MIS) shows promise for pT4 colon cancer without compromising long-term oncologic outcomes. In a study of 1,850 patients, those undergoing MIS had 2.4 times fewer major complications compared to open surgery. After 42 months of follow-up, overall recurrence rates were similar for both groups, with better disease-free survival (DFS) and overall survival […]
Higher Risk of Postoperative Ileus in Robotic Rectal Surgery
Robotic rectal resection shows a higher rate of primary postoperative ileus (POI) compared to laparoscopic surgery. Primary POI occurred in 25.4% of robotic patients versus 8.5% in laparoscopic patients (p=0.007). Intraoperative fluid balance was significantly higher in robotic surgery (36.0 vs. 29.2 ml/kg, p=0.0025) along with longer anesthesia time (403 vs. 346 min, p<0.001). Focus […]