Active surveillance after neoadjuvant chemoradiotherapy provides similar survival to surgery while significantly enhancing quality of life for patients with locally advanced oesophageal cancer. Active surveillance patients reported significantly better scores for dysphagia, dyspnoea, fatigue, and physical functioning at 6 months (Cohen’s d of -1.09, -0.63, -0.70, and 0.77, all p ≤ 0.001). Dysphagia improvements were […]
Author: STITCHES Newsletter
Intrathoracic Side-Overlap Anastomosis Reduces Pain and Reflux
Intrathoracic side-overlap esophagogastrostomy (SOE) shows promise as a viable alternative to circular stapled (CSE) technique in esophagectomy for Siewert type I/II adenocarcinoma. SOE leads to significantly lower postoperative pain scores: 3.49 vs. 4.04 on day one (p=0.002). Severe gastroesophageal reflux is lower with SOE (14.5%) compared to CSE (34.0%) (p=0.019). Dysphagia symptoms are reduced with […]
10-Year Outcomes: Distal vs. Standard Roux-en-Y Bypass
Distal Roux-en-Y gastric bypass results in greater long-term weight loss but carries higher risks of nutritional deficiencies. Mean BMI reduction after standard RYGB was 12.0 kg/m2 vs. 14.7 kg/m2 for distal RYGB, a significant difference of 2.7 kg/m2. Total weight loss percentage was 23.0% for standard vs. 28.2% for distal, a difference of 5.3% (p […]
Predicting Opioid Needs After Surgery
Machine learning can help personalize opioid-sparing strategies for outpatient surgeries. In a study of 223 patients, 42% required opioids, using a median of 4 doses post-surgery. The machine learning model identified key risk factors like active cancer and age, achieving an AUC of 0.674, with 70% sensitivity and 68% specificity. Adoption of this model could […]
Limited knowledge of CoC Standards in surgical trainees
Surgical trainees show significant gaps in understanding critical cancer surgery standards, impacting surgical outcomes. Only 30% of trainees received formal training on CoC operative standards. Correct response rates were just 30% for CoC standards versus 50% for core cancer principles. Incorporating education on these standards is crucial for improving surgical quality and documentation practices. 71% […]
Next-gen Cadaver Model Enhances Laparoscopic Training
A new embalming method offers superior realism for laparoscopic surgery training. Residents and experts rated laparoscopic procedures positively, especially TEP, with scores of “good” to “very good.” Novices rated lifelike tissue manipulation significantly higher than experts (p < 0.001). This model may improve surgical education, leading to better outcomes for patients. Tissue quality and color […]
Impact of Preoperative Cannabis Use on Gastroparesis Surgery
Preoperative cannabis use leads to worse outcomes after surgery for gastroparesis, indicating patient selection is crucial. Cannabis users had a higher reintervention rate within 90 days (9.3% vs 1.2%) and more inpatient admissions (32.4% vs 23.7%). Over 5 years, they faced higher hospital admission rates (59.3% vs 41.0%) and showed less outpatient engagement (54.6% attended […]
New PPM Classification to Improve Pancreatic Surgery Outcomes
A standardized classification for postpancreatectomy mortality (PPM) can enhance surgical outcomes and patient safety. PPM defined as death within 90 days, attributable to surgical complications, offers clarity for reporting. Three categories identified: PPM 1 (15-30%, technical complications), PPM 2 (45-65%, mainly pancreatic fistulas), and PPM 3 (10-25%, cardiopulmonary issues). This new framework promises to guide […]
Diagnostic insights for colorectal laterally spreading tumors
Magnifying endoscopy offers limited guidance for treating non-granular laterally spreading tumors (lst-ng), crucial for surgical decisions. Pseudodepressed lesions show significantly higher rates of high-grade dysplasia (78.1% vs. 31.2%) and T1 carcinoma (34.4% vs. 2%). All T1b carcinomas were found in pseudodepressed lesions, emphasizing the need for en bloc resection. Surgeons should prioritize technical feasibility for […]
AI in Surgery: Bridging Expectation and Reality
Surgeons face significant gaps between their expectations of AI interventions and the actual outcomes in the operating room, highlighting challenges in implementation. 57% of surgeons were neutral on the AI’s usefulness; only 37% had a positive outlook. Key concerns included the need for extensive training, difficulties accessing data, and limited predictive capabilities for complications. Minimizing […]