Transanal total mesorectal excision (TATME) shows promising long-term results for patients with low rectal cancer. Three-year overall survival at 93.7%, disease-free survival at 84.6%. 97% of patients remained stoma-free at 3 years, enhancing quality of life. Consider TATME for resectable mid and low rectal tumors; ongoing monitoring of long-term outcomes remains essential. Significant late complications […]
Author: STITCHES Newsletter
Prehabilitation Alters Immune Response in Abdominal Cancer Surgery
Multimodal prehabilitation may not significantly impact postoperative immune function, but it leads to a less inflammatory state before surgery. 130 patients studied: 102 received prehabilitation, 28 usual care. Pro-inflammatory cytokine production decreased, while IL-10 levels increased after prehabilitation. Consider prehabilitation for optimizing patients pre-surgery, but be cautious of its limited postoperative immune benefits. No significant […]
Awareness of Sexual Misconduct in Surgery Varies Widely
Surgeons must recognize that perceptions of sexual misconduct in surgical environments differ drastically among colleagues, impacting workplace culture and safety. 742 surgeons reported conflicting experiences; some saw minimal issues while others described pervasive harassment and inaction. The lateral view x-ray theory suggests awareness of misconduct depends on one’s exposure and experiences—those less affected are often […]
Staging Laparoscopy Accurately Detects Peritoneal Disease in Advanced Gastric Cancer
Staging laparoscopy (SL) has high accuracy for identifying peritoneal disease (PD) in advanced gastric cancer, improving patient selection for treatment. SL detected PD in 54.9% of 761 treatment-naive patients, with an accuracy of 96.8%. Key predictors for PD include CA19-9 >37 u/ml and poorly differentiated histology. This predictive scoring system (0-6) can stratify PD risk, […]
Lymph node burden predicts recurrence patterns in cholangiocarcinoma
Tumor features after surgery for intrahepatic cholangiocarcinoma can inform recurrence risk and patient outcomes. Of 1,328 patients, 57.5% experienced recurrence: 381 had intrahepatic-only, 171 extrahepatic-only, and 165 combined recurrences. Having three or more metastatic lymph nodes increased the odds of combined recurrence by 3.47 times compared to intrahepatic-only (adjusted odds ratio). Patients with combined recurrence […]
Neoadjuvant Therapy Improves Survival After Intrahepatic Cholangiocarcinoma Resection
Neoadjuvant therapy may significantly enhance post-recurrence survival in patients with intrahepatic cholangiocarcinoma. Patients receiving neoadjuvant therapy had a median post-recurrence survival of 31.9 months compared to 16.4 months for those who did not (p = 0.006). Neoadjuvant therapy was an independent predictor of survival (hazard ratio, 0.506; p = 0.008). Consider integrating neoadjuvant therapy in […]
Examining Age Impacts Survival in Intrahepatic Cholangiocarcinoma
Younger patients with intrahepatic cholangiocarcinoma (IHC) show significantly better outcomes when unresectable compared to older patients, which may influence surgical decision-making. The median overall survival for the entire cohort was 23 months, with younger patients having longer overall survival when unresectable (p = 0.008). In the surgical group, older patients had better recurrence-free survival (27 […]
Surgeons See 10-Year Survival in Resection of Liver Metastases
Resection of solitary colorectal liver metastases leads to excellent long-term survival, but outcomes depend on lymph node status and tumor size. Median overall survival is 10 years; 52% remain recurrence-free at 3 years. Salvage therapy for 51% of recurrences boosts overall survival significantly (5.89 years vs. 2.24 years; p<0.001). Patients with more than three positive […]
Angioembolization Equals Survival to Surgery in Liver Trauma
Angioembolization offers equivalent survival rates compared to surgery for penetrating liver trauma but leads to longer hospital stays. Mortality rates were similar: 2.0% for angioembolization vs 4.8% for surgery (p = .069). Hospital stay averages: 17.3 days for angioembolization vs 11.7 days for surgery (p < .001). Identifying patients who are at higher risk for […]
Biologic vs. synthetic mesh in hernia repair: no clear winner
Surgeons should weigh the trade-offs of biologic versus synthetic mesh in inguinal hernia repair, as this meta-analysis shows no significant advantage. No significant difference in hernia recurrence between biologic and synthetic mesh (risk ratio 2.45, p = .08). Biologic mesh led to higher seroma risk (risk ratio 1.58, p = .02) but lower chronic pain […]