Left gastric vein anatomy impacts the risk of pancreatic fistula after laparoscopic gastrectomy. Among 566 patients, 2.5% developed postoperative pancreatic fistula (POP). Type C vein anatomy (dorsal to the splenic artery) had a 17.9% POP rate, compared to just 1.7% for other types (p < 0.001). Consider robotic gastrectomy to reduce POP risk, especially in […]
Author: STITCHES Newsletter
Pocket-Creation Method Non-Inferior in Gastric ESD
The pocket-creation method for gastric tumors matches conventional techniques in safety and effectiveness, with fewer subsequent surgeries. Adverse event rates: 14.3% for pocket-creation vs. 12.9% for conventional. Significantly lower need for further surgery in pocket-creation group (2.9% vs. 12.9%, p=0.028). Consider using the pocket-creation method to reduce follow-up interventions while achieving comparable resection rates. Procedure […]
Enhanced Recovery Program Cuts Colorectal Surgery Stay
Quebec’s new enhanced recovery program significantly reduces hospital stays for colorectal surgery patients while maintaining safety. Median length of stay dropped from 4 to 3 days post-implementation (p<0.001). Complication rates remained stable, with a 5.5% reduction linked to greater adherence to protocols. Surgeons should prioritize ERAS adherence to optimize patient outcomes and streamline recovery processes. […]
Ventral Hernia Repair: Onlay Mesh Reduces Risks
Onlay mesh placement significantly lowers the risk of reoperation for recurrence and bowel obstruction after ventral hernia repair. Retromuscular mesh placement and IPOM both showed higher reoperation risks: HR 1.63 and HR 1.38, respectively, compared to onlay. The risk of bowel obstruction was also elevated, with HRs of 2.01 for retromuscular and 3.47 for IPOM. […]
Inguinal Hernia Repair: Stakeholders Disagree on Success Metrics
Different stakeholders prioritize diverse outcomes after inguinal hernia repair in older adults, impacting surgical practice. Veterans ranked postoperative urinary retention, physical function restoration within two months, and minimizing cognitive dysfunction as key success factors. Surgeons also emphasized returning to normal function in two months but added avoiding inguinodynia. Understanding these discrepancies can enhance patient-centered care […]
Innovative Technique Reduces Tension in Hiatal Hernia Repair
A modified technique using lateral relaxing incisions may improve outcomes in complex hiatal hernia repairs. Recurrence rates in redo patients were 12% and 18% in giant hernia cases. 84% of patients reported symptom improvement, including heartburn. This approach aims to enable tension-free repairs, particularly for those with high tension risks. Follow-up will assess long-term efficacy […]
Comparing ERCP Techniques in Billroth II Gastrectomy
Forward-viewing endoscopy with a cap shows similar efficacy to side-viewing duodenoscopy for ERCP in Billroth II patients. No significant differences in biliary cannulation or clinical success rates between the two techniques. Adverse event rates were comparable; however, post-ERCP pancreatitis rates were higher with the forward-viewing approach (14.5% vs 6.7%). Surgeons should interpret these findings cautiously […]
Improved Peritoneal Disease Detection in Advanced Gastric Cancer
Staging laparoscopy reveals peritoneal disease in over half of advanced gastric cancer patients, enhancing surgical decision-making. Peritoneal disease was found in 54.9% of patients undergoing staging laparoscopy, with positivity rates of 61.7% in type 4 lesions. The sensitivity and specificity of staging laparoscopy were 94.6% and 100%, respectively, demonstrating high diagnostic accuracy. The four-factor predictive […]
Plastic and Metal Stents Show No Survival Difference in Pancreatic Cancer
Stent choice for preoperative biliary drainage in pancreatic cancer does not affect long-term survival. Among 6,429 patients, overall and recurrence-free survival were similar for plastic (PS) and metal stents (MS) after pancreaticoduodenectomy, even in those receiving neoadjuvant therapy. No significant difference in postoperative complications between PS and MS. Choose stents based on drainage duration and […]
Prehabilitation Shows Promise in Abdominal Cancer Surgery
Multimodal prehabilitation may enhance baseline immune function in patients before abdominal cancer surgery, but its effect on postoperative immune outcomes appears limited. In a study of 130 patients (102 prehabilitation, 28 control), prehabilitation reduced pro-inflammatory cytokines and increased IL-10 levels. No significant immune function differences were noted on postoperative day 1 between groups. This suggests […]