Multimodal preoperative educational interventions, including human-contact, written, and digital formats, enhance surgical outcomes by reducing hospital stays and analgesic use. Analysis of 40 studies with over 4,100 patients revealed significant drops in length of stay and postoperative pain. Notably, in-person education decreased hospitalization by over one day. Written and hybrid approaches effectively reduced pain management […]
Author: STITCHES Newsletter
Robotic cholecystectomy eradicates conversions to open surgery in high-risk patients
After adopting robotic surgery for benign gallbladder disease, conversion rates to open surgery dropped dramatically to zero. In a study of 636 patients, conversion rates declined from 14.6% in the pre-robotic era to 4.0% during the transition and reached 0% in the robotic period. While post-operative complications and hospital readmissions remained consistent across eras, this […]
Key Risk Factors Identified for Anastomotic Leakage and Gastroparesis Post-Gastrectomy
Hypoalbuminemia and significant intraoperative blood loss elevate anastomotic leakage risk after laparoscopic radical gastrectomy. Conversely, total gastrectomy offers protection against this complication. Among patients post-distal gastrectomy, smoking, pyloric obstruction, and Roux-en-Y anastomosis correlate with increased gastroparesis syndrome risk. This robust analysis of 3,779 patients clarifies factors influencing postoperative complications, challenging previous management paradigms for proximal […]
New Nomogram Accurately Predicts Survival in Hepatocellular Carcinoma with Vascular Invasion
A newly developed nomogram effectively predicts overall survival for hepatocellular carcinoma (HCC) patients with major vascular invasion. Analyzing data from 2,211 patients, key survival factors include tumor size, N stage, metastases, and treatment modalities. The model demonstrates robust predictive accuracy with c-index values around 0.72–0.73 across cohorts and high area under the curve (AUC) scores […]
Robotic Roux-en-Y Surgery Shows Technical Edge Without Added Risks
A meta-analysis of 38,647 gastric bypass patients across 27 countries reveals robotic Roux-en-Y gastric bypass (rrygb) requires longer surgical time but offers improved intraoperative safety compared to laparoscopic Roux-en-Y (lrygb). Despite a significant increase in robotic surgeries from 0.2% to 5.7% over 25 years, both techniques maintain similar mortality and complication rates. This comprehensive analysis […]
Neoadjuvant Chemotherapy Alone Lowers Surgical Risks in Rectal Cancer
Neoadjuvant chemotherapy without radiation significantly reduces anastomotic leaks, diverting ostomy use, and ostomy non-reversal in locally advanced rectal cancer patients. In a meta-analysis of four randomized controlled trials, chemotherapy was found equivalent or non-inferior to chemoradiation for oncologic outcomes. However, critical surgical outcomes remain inadequately reported, highlighting a need for standardized assessment in future studies. […]
High Adherence to Enhanced Recovery Pathway Cuts Mortality in Colorectal Cancer Surgery
Patients adhering to an enhanced recovery pathway (ERP) during colorectal cancer surgery saw a 31% reduction in overall mortality compared to those with low adherence. In a study involving 2,865 patients, those in the highest adherence quartile (≥80.8%) experienced a significant drop in death risk, underscoring the importance of robust ERP implementation for improved survival […]
Innovative EUS Techniques Transform Access for Biliary Interventions in Complex Anatomy
New endoscopic methods, EDGE and EDEE, revolutionize access to the biliary system for patients with surgically altered anatomy. These techniques facilitate minimally invasive procedures, significantly lowering morbidity rates while maintaining high success rates. By using lumen-apposing metal stents, they improve safety profiles and expand treatment options. This comprehensive review underscores the need for multicenter trials […]
Quality of Life Surges for Survivors After Emergency Abdominal Surgery
Quality of life after emergency abdominal surgery improves significantly for survivors over time. Initial post-operative EQ-5D-3L utility scores averaged just 0.21, but soared to 0.74 within three to eight months. Key early determinants include patient’s sex and preoperative risk levels, while longer-term outcomes are influenced by hospital stay duration and overall health status. Insights can […]
Optimal strategies for necrotizing pancreatitis: Early drainage and delayed surgery show promise
Early drainage with lavage and delayed step-up surgery demonstrate significant survival benefits in necrotizing pancreatitis, decreasing mortality and complications. In contrast, delayed video-assisted surgery leads to higher mortality rates. No significant differences between early and delayed intervention approaches were found. Tailoring treatment based on individual risk profiles is crucial as current evidence remains inconclusive, highlighting […]