Author: STITCHES Newsletter

Sustainable surgical practices are achievable in resource-limited settings.

A case study on Kyabirwa Surgical Center in rural Uganda reveals that sustainable healthcare models can thrive in low-resource environments. From 2021 to 2023, only 0.4% of the center’s power and 25% of its water came from the town, yielding annual savings of over $6,121. The facility also effectively conserved 93% of collected rainwater and […]

Lymphocyte-C-Reactive Protein Ratio Predicts Outcomes in Liver Cancer Surgery

A study examining 715 patients undergoing liver resection for hepatocellular carcinoma and intrahepatic cholangiocarcinoma found that the lymphocyte-C-reactive protein ratio (LCR) could accurately predict postoperative complications, recurrence-free survival, and overall survival. An optimal LCR cutoff of 6100 was established, with lower levels associated with increased morbidity and worse survival outcomes. The findings, validated in an […]

RROM technique achieves low recurrence and minimal complications

The retro-rectus onlay mesh (RROM) technique for ventral hernia repair demonstrates notable long-term effectiveness. In a follow-up of over four years, a mere 0.38% recurrence rate was observed among 191 patients, alongside minimal complications, including four superficial infections. The method shows promise as a safe and cost-effective alternative to the standard intraperitoneal onlay mesh (IPOM) […]

Improved surgical quality significantly enhances pancreatic cancer survival

Achievements in textbook outcomes (TO) for pancreatic surgery rose from 47% to 80.7% post-establishment of a specialized unit, indicating better surgical quality. Patients who met TO criteria showed notable overall survival rates at 1, 2, and 3 years: 86.9%, 55.7%, and 41%, compared to 62.7%, 40.3%, and 31.3% for those who did not (p=.013). Multivariate […]

Robotic surgery is poised to overtake laparoscopic techniques.

A significant trend toward robotic surgery is evident, especially in urologic procedures and complex surgeries such as hepatectomy and esophagectomy. Despite remaining relevant in colectomy, laparoscopic techniques are declining in most specialties. Open surgery continues to be prevalent, particularly in pancreatic and rectal operations. Projections indicate that by 2026, robotic surgery may surpass laparoscopic approaches […]

Sarcopenia predicts postoperative complications in colorectal cancer surgery

In a study of 387 patients undergoing laparoscopic radical resection for non-metastatic colorectal cancer, 40.31% were identified as sarcopenic. The overall postoperative complication rate reached 32.3%, with serious complications occurring in 12.1% of patients. Sarcopenic patients experienced significantly higher rates of total complications and serious issues, including anastomotic leakage and surgical site infections. Notably, sarcopenia […]

Eight treatments effectively reduce postoperative ileus.

An umbrella review of 24 meta-analyses revealed eight treatments that significantly alleviate postoperative ileus. Chewing gum, coffee, enhanced recovery after surgery (ERAS) protocols, acupuncture, opioid receptor antagonists, da-cheng-qi-tang, early enteral nutrition, and zusanli point injection therapy improved outcomes. Additionally, opioid receptor antagonists, early enteral nutrition, ERAS, and chewing gum notably shortened postoperative hospital stays. However, […]

Surgeons reach consensus on standardized theatre etiquette guidelines

A Delphi study involving 261 surgical professionals from 23 countries established a consensus on 29 statements of theatre etiquette, aimed at enhancing professional conduct and communication in operating environments. This initiative addresses the inconsistencies often seen in training newcomers to surgical teams, including medical students and resident trainees. The guidance developed is intended to serve […]

New Nomogram Enhances Prognostic Accuracy for Liver Cancer Patients

A novel prognostic nomogram was developed to assess cancer-specific survival (CSS) in patients with distant-metastatic hepatocellular carcinoma (dm-hcc). Using data from 651 patients, the model identified key predictors: alpha-fetoprotein levels, tumor grade, T stage, and treatment types. The nomogram achieved a c-index of 0.721 and 0.726 in training and validation sets, respectively, demonstrating strong predictive […]

Neoadjuvant chemotherapy enhances survival rates in colon cancer

Neoadjuvant chemotherapy (NAC) has demonstrated improved five-year overall survival (81.4% versus 77.8%) and disease-free survival (79.2% versus 73.7%) in patients with locally advanced colon cancer compared to upfront surgery followed by adjuvant chemotherapy. Researchers analyzed eight randomized controlled trials involving 3,038 patients, finding NAC to result in better surgical margin outcomes without increasing surgical risks. […]