Surgeons need to know that NIH funding is growing, but surgeon engagement in research is shifting, risking patient outcomes. NIH surgery funding surged 53% to $539 million, while the number of grants remained stable. MD-only investigators fell from 48.9% to 40.8% of grants; MD-PhDs rose from 15.2% to 24.9%. The gap between credentialing and active […]
Author: STITCHES Newsletter
Esophagectomy vs Active Surveillance: Long-Term Outcomes for Esophageal Cancer
Active surveillance may be a viable option for select esophageal cancer patients achieving clinical complete response after neoadjuvant chemoradiation, but esophagectomy secures superior long-term survival. At 5 years, standard esophagectomy outperformed active surveillance with 1.74 vs 1.34 quality-adjusted life-years (QALYs) and 3.11 vs 2.41 life-years. Active surveillance showed short-term benefits, with a 2-year QALY gain […]
Novel Technique for LGA Reconstruction in Distal Pancreatectomy
Surgeons can now consider a new arterial reconstruction method for the left gastric artery (LGA) during distal pancreatectomy with celiac axis resection (DP-CAR). The common hepatic artery (CHA) can successfully supply the replaced left hepatic artery (RLHA), ensuring adequate blood flow. The procedure had an operative time of 215 minutes and only 35 ml of […]
Embrace or Hesitate? Public Opinion on International Surgeons
Surgeons should note that the public generally supports laws allowing internationally trained surgeons to practice in the U.S., but with significant reservations. 85% of respondents backed state licensure laws for internationally trained surgeons. 93% believe these laws will enhance access to care; 80% think they will improve diversity in the workforce. 70% expressed concern over […]
Late Anastomotic Leakage in Rectal Cancer Surgery: Key Insights
Late anastomotic leakage is a significant issue in rectal cancer surgery, affecting morbidity and long-term outcomes. Overall anastomotic leakage occurred in 3.2% of patients, with late leakage at 48.3%. 24.1% of late leak cases were diagnosed over a year post-surgery, often following diverting stoma formation. Surgeons should consider enhanced surveillance for patients at higher risk, […]
Laparoscopic surgery yields similar outcomes for colorectal peritoneal metastases.
Survival rates are comparable: median overall survival is 37.3 months with laparoscopic versus 34.1 months with open surgery. Postoperative complications are similar in both groups, but hospital stays are shorter for laparoscopic patients. Patient selection is crucial; extraperitoneal metastasis significantly impacts survival outcomes. Consider laparoscopic cytoreductive surgery for suitable patients to enhance recovery without compromising […]
Exercise Boosts Recovery in Colorectal Cancer Survivors
Exercise significantly improves health-related quality of life (HRQoL) and mental health in colorectal cancer survivors. Overall, exercise showed a notable increase in HRQoL (0.48) and reduced fatigue (-0.44), depression (-0.29), and anxiety (-0.29). Supervised moderate-intensity exercise (3-5.9 METs), 30-60 minutes, 3-4 times weekly, maximizes benefits. Incorporating structured exercise into post-treatment plans can enhance recovery and […]
Early Feeding Safe After Esophagectomy for Cancer Patients
Early oral feeding after esophagectomy is safe and leads to better recovery outcomes. No increase in anastomotic leakage (risk ratio 0.89) noted. Early feeding significantly reduces pneumonia (risk ratio 0.66) and accelerates gastrointestinal recovery—first bowel movement and flatus occur about half a day earlier. Hospital stays shortened by nearly two days (1.89 days) with associated […]
Open Hemorrhoidectomy Outperforms Dearterialization in Efficacy
Open excisional hemorrhoidectomy (OEH) is superior to transanal hemorrhoidal dearterialization (THD) for grade III hemorrhoids despite more postoperative pain. Clinical failure rate was 8% with OEH vs. 61% with THD (p < 0.001). All reoperations (8) occurred in the THD group (p = 0.001). Surgeons should weigh the higher pain and longer recovery of OEH […]
Postoperative Undertriage Leads to Poorer Outcomes
Postoperative undertriage increases risk for high-acuity patients, prompting new goals of care. Undertriaged patients had higher unplanned intubation rates (12.1% vs. 7.1%) and in-hospital mortality (7% vs. 1.1%). New DNR status orders were issued for 7.2% of undertriaged patients compared to 2.8% in the ICU cohort. Surgeons should reevaluate triage practices to mitigate these risks […]