A study evaluated machine learning algorithms to predict discharge against medical advice for 48,394 injured inpatients over five years. Among these individuals, 8.8% opted for discharge against medical advice. The light gradient boosting machine combined with edited nearest neighbors outperformed traditional logistic regression, achieving areas under the curve of 0.820 and 0.837 in internal and […]
Author: STITCHES Newsletter
ETEP reduces post-operative pain compared to IPOM+ in hernia repair
Enhanced total extraperitoneal repair (ETEP) was compared with intraperitoneal onlay mesh repair-plus (IPOM+) for midline ventral hernia repair in a randomized trial involving 48 patients. Results indicated that ETEP had significantly longer operative times but resulted in notably lower pain scores at 6 and 24 hours, with fewer patients requiring rescue analgesia. Complications and recurrence […]
Conditional survival predictions enhance outcomes for pancreatic cancer patients
A study on pancreatic ductal adenocarcinoma reveals that conditional survival analysis based on kallikrein-related peptidase 7 (klk7) expression can significantly improve prognostic assessments. Results show that 1-, 2-, and 3-year conditional survival rates increased from 50.4% to 91.2%, while overall survival rates dropped from 81.9% to 38.6%. Patients surviving longer periods demonstrate improved future survival […]
Mindfulness interventions enhance surgeon well-being and performance
A scoping review assessed 24 studies on mindfulness-based interventions (MBIs) for surgeons, revealing that such programs are feasible and significantly improve mindfulness, reduce burnout, and enhance overall well-being. Notably, these interventions also boost executive function, surgical skills, and communication. Evidence was drawn from various study designs, including randomized control trials and qualitative research. Future research […]
Serum Transaminase Changes Predict Postoperative Complications in Liver Resection
Dynamic changes in serum AST and ALT levels after liver resection for hepatocellular carcinoma were shown to significantly impact postoperative morbidity. In a study involving 759 patients, an increase in the combined assessment of AST and ALT (caa) to ≥5 was strongly linked to higher complication rates, with an odds ratio of 1.63. The study […]
Spray coagulation mode enhances endoscopic dissection success
A multicenter trial revealed that spray coagulation mode endoscopic submucosal dissection (scm-esd) significantly improved completion rates for treating early gastric neoplasms without the use of hemostatic forceps, achieving 83.1% versus 13.8% for conventional forced coagulation mode (fcm-esd). Procedure time and adverse event rates were comparable between the two techniques. These findings suggest that scm-esd can […]
Achievement of textbook outcomes improves survival in HPB surgery
A systematic review and meta-analysis evaluated textbook outcomes (TOs) in hepatopancreaticobiliary (HPB) surgery across 27 studies involving 517,304 patients. It revealed a median TO achievement rate of 62% for hepatic procedures, 54% for biliary, and lower rates for pancreatic and liver transplantation surgeries. Importantly, achieving TOs was linked to an increased likelihood of 5-year overall […]
Blood tests enhance differentiation between liver cancer types
A study involving 165 patients diagnosed with hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) identified alpha-fetoprotein (AFP) and carbohydrate antigen 19-9 (CA19-9) as key tumor markers for accurate preoperative differentiation. Elevated white blood cell counts, neutrophil-to-lymphocyte ratios, and monocyte counts were linked to increased ICC risk, while higher lymphocyte-to-monocyte ratios indicated protection. The predictive model […]
Standardized approach established for Endoscopic Sleeve Gastroplasty
A global expert consensus defined standardized practices for Endoscopic Sleeve Gastroplasty (ESG) utilizing a modified Delphi method. Six experts, after three survey rounds, achieved 100% agreement on six cognitive skill statements and high consensus on 21 technical skill statements. Key procedural elements emphasized were starting at the incisura, using at least six sutures, and avoiding […]
Machine learning predicts surgical outcomes in cholangiocarcinoma patients
A machine learning model developed from 376 intrahepatic cholangiocarcinoma patients effectively predicts textbook outcomes. Key preoperative factors include Child-Pugh classification, ECOG score, hepatitis B status, and tumor size. The model achieved high accuracy during internal (AUC = 0.8825) and external validation (AUC = 0.8346). Survival analysis indicated that patients achieving textbook outcomes had disease-free survival […]