Endoscopic ultrasound-guided tissue acquisition (EUS-TA) demonstrated high diagnostic yields in biliary lesions, achieving 96.3% sensitivity and 100% specificity. Of 71 cases, 54 were diagnosed as malignant, marking a 76.1% malignancy rate. When combined with endoscopic retrograde cholangiography (ERC), EUS-TA increased overall diagnostic accuracy from 82.5% to 94.2%, identifying 30 additional malignant cases. The procedure’s adverse […]
Author: STITCHES Newsletter
Radiologic-pathologic discordance significantly impacts HCC survival rates
In a nationwide cohort study, researchers found that discrepancies between radiologic findings and pathological evaluations in hepatocellular carcinoma patients undergoing resection are linked to worse survival outcomes. Specifically, discordance in more than two factors notably increased the hazard ratio to 3.251. Factors like lymph node metastasis and vascular invasion were also significant independent predictors of […]
Sarcopenia and frailty predict poor outcomes after emergency surgery
A study involving 101 patients over 55 years undergoing emergency laparotomy revealed that sarcopenia, myosteatosis, and frailty are critical in predicting adverse outcomes. Notably, low grip strength and positive sarc-f questionnaire scores significantly associated with increased rehabilitation admission risk and likelihood of not returning home. Frailty was linked to fewer days alive outside the hospital […]
EUS-guided drainage proves effective for complicated diverticulitis
EUS-guided pelvic abscess drainage (EUS-PAD) using lumen-apposing metal stents demonstrates high efficacy and safety in managing complicated acute diverticulitis. In a study involving 53 patients, the procedure achieved a technical success rate of 92.5% and a clinical success rate of 88.7%. Adverse events were minimal, occurring in 3.8% of cases, with no procedure-related mortalities. EUS-PAD […]
Next-generation sequencing enhances management of pancreatic cysts
Incorporating next-generation sequencing (NGS) into the management of pancreatic cysts improved diagnostic precision and surgical decision-making. In a retrospective study of 441 patients, NGS revealed high-risk mutations in 55.3% of those with unclear cyst types, guiding management changes for 26.1% of patients. Specifically, NGS demonstrated a sensitivity of 72.7% and specificity of 97.8% in predicting […]
Bariatric surgery enhances survival and is cost-effective for cirrhosis patients.
Bariatric surgery significantly improves survival outcomes among patients with obesity and cirrhosis, showing observed survival of 9.09 years compared to 8.23 years for lifestyle interventions. The incremental cost-effectiveness ratios were $18,679 for sleeve gastrectomy and $44,704 for gastric bypass in cirrhosis cohorts, proving cost-effective when compared to a $100,000 willingness-to-pay threshold for quality-adjusted life years. […]
Women and racial minorities face higher mortality in necrotizing fasciitis
Analysis of nearly 119,000 necrotizing fasciitis patients revealed women and certain racial minorities faced significantly higher in-hospital mortality than white counterparts. Women were 18% more likely to die, while Asian and Hispanic patients also showed increased mortality risks. Additionally, these groups experienced longer hospital stays and substantially higher costs, with Asian patients averaging $17,596 more […]
Whole-body CT becomes vital for diagnosing severe injuries.
A systematic review identified imaging strategies for patients with multiple or severe injuries, highlighting the importance of whole-body computed tomography (WBCT). Among 21 studies involving over 55,000 patients, extended focused assessment with sonography for trauma was recommended alongside WBCT as essential diagnostic tools. Modifications were made to existing recommendations, achieving strong consensus among experts regarding […]
Faecal immunochemical test screening matches colonoscopy in safety
A pragmatic trial involving 57,404 individuals revealed that faecal immunochemical test (FIT) screening is non-inferior to colonoscopy in reducing colorectal cancer mortality over 10 years. Participation rates were higher for FIT at 39.9% compared to colonoscopy’s 31.8%. The colorectal cancer mortality risk was nearly identical between the two groups, suggesting that a FIT-based screening program […]
Adverse events during colorectal ESD increase with age.
A nationwide study in Japan reveals that the risk of adverse events (AEs) during colorectal endoscopic submucosal dissection (ESD) escalates significantly in older adults, particularly those aged 85 and above. Among 143,925 patients, AEs were recorded at 5.3% for ages 60-64, rising to 9.2% for those over 90. The analysis highlighted significant post-operative bleeding as […]