Advancements in massive transfusion protocols (MTPs) highlight the importance of balanced transfusion strategies, utilizing a 1:1:1 ratio of plasma, platelets, and red blood cells. This approach significantly enhances early hemorrhage control, though challenges persist with individual patient variability. Viscoelastic hemostatic assays facilitate personalized treatment by providing real-time clot assessments. Renewed interest in whole blood transfusions, […]
Author: STITCHES Newsletter
Robotic liver resection shows improved recurrence-free survival
A multicentric analysis involving 647 hepatocellular carcinoma patients revealed that robotic liver resection (RLR) offers significant advantages over laparoscopic liver resection (LLR). RLR showed wider surgical margins (10 mm vs 5 mm) and higher rates of R0 resection (98.9% vs 93.1%), alongside a lower conversion rate and shorter hospital stays. While overall survival rates were […]
Surgical care faces urgent need for reform and funding.
Global surgical care is at a critical juncture, with an unmet need for 160 million operations annually and 3.5 million deaths post-surgery each year. Despite inspiring engagement in policy through the Lancet Commission, progress toward achieving the 2030 targets remains insufficient, particularly in low- and middle-income countries. Chronic underfunding and workforce shortages have been exacerbated […]
Robotic surgery shows benefits for colon and rectal cancer patients
A retrospective analysis of over 52,000 patients revealed that robotic and laparoscopic surgeries significantly outperformed open surgery in achieving treatment goals (74.5% and 72.9% vs. 47.8%, p < 0.001) across all body mass index (BMI) categories. Robotic surgery also resulted in lower major morbidity rates compared to open surgery. Notably, rectal cancer patients with class […]
Lower Income Levels Linked to Poorer Surgical Outcomes
A meta-analysis involving over 24 million patients reveals that lower income and wealth levels significantly correlate with worse postoperative outcomes within 90 days of surgery. Those with Medicaid, Medicare, or uninsured status exhibited higher odds of complications, mortality, and readmission compared to privately insured individuals. Specifically, Medicaid patients faced a 1.85 times higher risk of […]
Intersphincteric resection with rectal eversion improves anal preservation
A novel surgical technique for low rectal cancer, intersphincteric resection combined with rectal eversion and total extra-abdominal resection (ISrer), shows promise in enhancing anal preservation rates without raising postoperative complications. In a study involving 74 patients, ISrer achieved a 94.3% anal preservation rate compared to 71.8% for conventional laparoscopic ISR, while maintaining a 100% R0 […]
Delayed treatment linked to age and insurance status in CRC patients
Analysis of over 3,100 patients revealed that 35.3% experienced delays in colorectal cancer (CRC) treatment. Key predictors included older age, with those aged 80 and above having an 81% higher likelihood of delay, as well as being on Medicaid or uninsured, which increased the odds by 54%. Additionally, patients with rectal tumors were three times […]
Coordinated policies are essential for improving surgical care access.
Rural Americans face significant challenges in accessing surgical care, with a 29% decline in general surgeon availability from 2001 to 2019 intensifying disparities. The article presents actionable policy recommendations to enhance surgical care access in rural areas. Key initiatives include bolstering the rural surgical workforce, improving medical education, sustaining hospital infrastructure, and expanding telehealth resources. […]
Emerging endoscopic techniques improve diagnosis and treatment of pancreatic cysts
Accurate diagnosis of pancreatic cystic lesions (PCLs) is critical to avoiding unnecessary surgeries. Despite existing guidelines, many patients with benign cysts still undergo major resections. New endoscopic methods, including advanced imaging and minimally invasive treatments, show promise for enhancing diagnostic precision and offering organ-sparing options. Techniques like endoscopic ultrasound (EUS) and novel therapeutics are well-tolerated […]
Multidisciplinary team meetings significantly impact pancreatic cancer care
Evidence from 36 studies reveals that multidisciplinary team meetings (MDMs) for pancreatic cancer significantly affect care decisions, influencing initial diagnoses in 3.4%-21.7% of cases and altering treatment plans in 18.2%-72.2%. These meetings improve clinical trial participation but incur substantial preparation time (16.5 hours weekly) and financial costs ($240 per case). Best practices suggest standardization and […]