taTME shows promising long-term outcomes for low rectal cancer patients, crucial for surgical practice. Three-year overall survival was 93.7%, with disease-free survival at 84.6%. Late complications in 32 patients, with 21 classified as severe; one required surgical revision. Surgery can prioritize sphincter preservation without compromising oncologic outcomes. 97% of patients were stoma-free at three years, […]
Author: STITCHES Newsletter
Synthetic Mesh Lowers Parastomal Hernia Recurrence
Using synthetic mesh for parastomal hernia repair reduces long-term recurrence risk compared to biologic mesh, which is crucial for surgical decision-making. Parastomal hernia recurrence rate at 5 years was 33.6% overall (37.5% for biologic vs. 29.4% for synthetic). Synthetic mesh showed a 45% reduction in recurrence risk (HR=0.65, p=0.028). Consider using synthetic mesh for better […]
Liver Transplant After Immunotherapy Shows Strong Outcomes
Transplanting liver patients who respond to atezolizumab-bevacizumab is promising for those with intermediate and advanced hepatocellular carcinoma. Recurrence-free survival is 90% and overall survival is 94% at two years post-transplant. Acute rejection rates are 25%, but remain manageable; 62.5% had complications within 90 days of transplant. Surgical teams should consider immunotherapy response when selecting candidates […]
Video Analysis Reveals Key Non-Technical Skills in Surgery
Silent video can predict surgeons’ non-technical skills, impacting training and outcomes. Analyzed 40 laparoscopic appendectomy videos with over 10,000 annotated actions. Mean cognitive rating was 5.6 out of 8, with a correlation between decision-making and situation awareness (r=0.8). This method paves the way for scalable assessments of surgical performance. Five key predictive factors identified include […]
Surgeon performance in shared decision-making varies widely
This study assessed shared decision-making among thousands of surgeons, revealing critical insights for improving patient outcomes. Only 1.2% of surgeons achieved top scores in shared decision-making, while 64% of patients felt their surgeons performed adequately. Male surgeons, those in cardiothoracic specialties, and surgeons with over 31 years of practice were linked to lower decision-making scores. […]
Enhanced Radiomics Predicts Pathological Response in HCC
Dynamic radiomic features from MRI can predict complete response in hepatocellular carcinoma (HCC) post-immune therapy, critical for surgical planning. A delta radiomic model achieved an AUC of 0.835 in predicting lesion-level complete response compared to 0.483 for baseline models. Combining radiomics with serum AFP response boosted predictive accuracy, yielding AUCs of 0.920 in the test […]
Long-term Atezolizumab-Bevacizumab Outcomes in HCC
Atezolizumab-bevacizumab shows promising long-term survival for patients with unresectable hepatocellular carcinoma. Median overall survival is 19.7 months with a 36-month survival rate of 30%. 36.8% experienced grade ≥3 adverse events; 14.1% had liver decompensation not related to tumor progression. Surgeons should consider multidisciplinary approaches, as 14.9% of patients underwent additional surgical or locoregional procedures post-treatment. […]
Surgical Sabermetrics Framework Enhances Training Outcomes
This study develops a practical implementation framework for integrating data-driven surgical metrics into training, improving assessment reliability and trainee outcomes. Engaged 54 trainees and trainers from 13 countries through workshops to inform framework development. Prioritized real-time feedback for technical skills and dashboards for non-technical skills to provide objective performance insights. Making surgical training more data-driven […]
Prognostic Model Predicts Wound Complications After Internal Hemipelvectomy
Surgeons can now preoperatively assess wound complication risk using a newly validated scoring model for internal hemipelvectomy. Wound complications requiring surgery occurred in 34% of patients overall, with rates of 7.4%, 40%, and 67% in low-, intermediate-, and high-risk groups in the training cohort. Similar results were observed in the validation cohort: 7.1%, 32%, and […]
Addressing Cancer Disparities in Surgical Oncology
Surgeons play a crucial role in tackling persistent cancer care disparities among marginalized populations. Marginalized groups experience higher cancer risks but often miss essential screenings and guidelines. Continued efforts are necessary to identify root causes and craft targeted interventions. Implementing these strategies can lead to more equitable oncologic outcomes for all patients. Collaboration with multidisciplinary […]