Surgeons should consider the margin-to-size ratio (MSR) as a key factor for patient outcomes in resectable intrahepatic cholangiocarcinoma (ICC). Higher MSR significantly improves recurrence-free survival (RFS), with an HR of 0.59. An MSR threshold of 0.142 predicts better 3-year RFS: 55.7% for high MSR vs. 45.2% for low MSR. This approach may help tailor surgical […]
Author: STITCHES Newsletter
Effective outcomes for laparoscopic hiatal hernia repair with cTIF
Laparoscopic hiatal hernia repair combined with consecutive transoral incisionless fundoplication (cTIF) achieves high success rates in GERD patients. 92% of patients achieved complete clinical success within 12 months. Symptom improvement was reported by 90% and 84% normalized esophageal acid exposure. Most patients (84%) stopped daily proton pump inhibitors, enhancing long-term management potential for surgeons. Serious […]
Surgeon Sleep and Patient Risk Linked to Major Events
Surgeons’ inconsistent sleep timing significantly impacts patient safety, with notable implications for surgical outcomes. Social jet lag of 2 hours or more increases the risk of major adverse events by 36% compared to less than 1 hour. Nearly 20% of surgeries (1410 out of 7117) led to major complications. Surgeons who manage their sleep better […]
Documentation Gaps in Multidisciplinary Tumor Board Meetings
Tumor board documentation is inconsistent, impacting cancer patient care. Only 51.7% of cases had adequate documentation, significantly varying by cancer type (5.5% for breast vs. 97.0% for colorectal). Among documented cases, 44.7% of notes were unstructured, lacking important details like attendees’ specialties (29.3%) and clinical trial eligibility (15.8%). Improving documentation standards could enhance the quality […]
Colonic obstruction management redefined: SEMS trumps surgery.
Using self-expanding metal stents (SEMS) as bridge-to-surgery improved outcomes for obstructive left colon cancer. One-year stoma rates were lower with SEMS (44.4%) compared to emergency surgery (73.4%). Fewer readmissions (4.2% vs 15.9%) and faster chemotherapy initiation (76.1% vs 55.8%) were noted with SEMS. Consider SEMS for selected patients to reduce stoma rates and enhance quality […]
Robotic and Laparoscopic APR for Anal Cancer Show Lower Mortality
Minimally invasive surgery for anal cancer improves patient outcomes compared to open approaches. Robotic APR showed lower 30-day mortality rates (1.2% vs 2.2% for open) and reduced 90-day mortality (3.2% vs 4.9% for open). Laparoscopic APR also had lower mortality and similar survival rates to robotic APR, with a five-year survival of 54%. Choosing robotic […]
Neoadjuvant Serplulimab Improves Survival in PD-L1-Positive Gastric Cancer
Neoadjuvant serplulimab with chemotherapy enhances event-free survival in PD-L1-positive gastric cancer, making it a promising strategy for surgeons. Median event-free survival was longer with serplulimab (not reached) compared to placebo (42 months) for patients with PD-L1 CPS ≥10 (HR 0.65, p=0.0082). In the overall patient population, event-free survival was also improved (not reached vs. 35.9 […]
Anastomotic Stenosis Risks in Pancreatoduodenectomy with Portal Vein Resection
Distal transection of the superior mesenteric vein significantly increases the risk of anastomotic stenosis during pancreaticoduodenectomy for cancer. Non-tumorous stenosis rate was 40.9% for distal vs. 1.7% for proximal transection (p < 0.01). Symptomatic complications like ascites and gastrointestinal bleeding were also higher in the distal group (15.9% vs. 1.2%, p < 0.01). Surgeons should […]
Laparoscopic Exploration Crucial for Assessing Occult Metastasis in Gastric Cancer
Laparoscopic exploration is vital for detecting occult peritoneal metastasis (opm) in gastric cancer, significantly impacting patient outcomes. 22.2% of 653 patients showed opm+ initially, linked to worse survival (15.9 months vs not reached). Younger age, better ECOG status, primary gastric cancers, and specific CA72-4 levels were risk factors for opm+. Re-evaluating opm status post-treatment revealed […]
Preoperative Anxiety and Depression Surge Risk in Colorectal Surgery
Patients with high anxiety and depression scores face greater postoperative complications after colorectal surgery. 25% of patients experienced clinically relevant complications, with inflammatory bowel disease and active smoking identified as risk factors. High hospital anxiety and depression scores increased the odds of complications (OR 1.07). Surgeons should routinely screen for these psychological issues to improve […]