Improving physical fitness before surgery can significantly enhance recovery for patients undergoing oncologic procedures. 89% of studies emphasized the need for better cardiorespiratory fitness in prehabilitation programs. Most prehabilitation interventions (41%) were supervised and typically involved three sessions per week. Surgical outcomes such as complications were the primary focus, with 42% of studies reporting them […]
Author: STITCHES Newsletter
Automating Surgical Quality Data Shows High Accuracy
Using electronic health record (EHR) data for surgical quality improvement matches manual abstraction accuracy, easing the burden on resources. Strong agreement for race and ethnicity variables (kappa = 98.1%). Preoperative risk factors show lower agreement (median kappa = 28.6%), indicating caution in reliance on EHR for this domain. This shift could streamline data collection, enhancing […]
Overnight Total Thyroidectomy: Safe with High Patient Satisfaction
Surgeons can confidently implement overnight discharge after total thyroidectomy without increased complication risks. No differences in complications at 24 hours, 10 days, or 30 days between patients discharged on postoperative day 1 and those on day 3. 94.6% of patients discharged on day 1 reported high satisfaction with the rapid discharge protocol. Patient selection is […]
New Insights on Anatomic Landmarks in Endoscopic Thyroidectomy
Surgeons can improve outcomes in endoscopic thyroidectomy by leveraging newly defined surgical planes and landmarks. The dissecting triangle between strap muscles and thyroid lobe ensures 100% identification of inferior thyroid vessels and middle thyroid vein. The inferior and superior parathyroid glands were located accurately in 92.5% and 90% of cases, respectively. Understanding these zones aids […]
New block technique reduces pain in laparoscopic appendicectomy
Laparoscopic-assisted transversus abdominis plane (LTAP) block significantly improves postoperative pain management compared to port-site infiltration (PSI). LTAP group had lower VAS pain scores (-1.7) at 6 and 12 hours post-op (p < 0.001). Patients receiving LTAP required less oxycodone (0.8 vs. 1.2, p = 0.032). Consider implementing LTAP block into your analgesic protocols for better […]
Avoid Feeding Jejunostomy in Pancreatoduodenectomy
Feeding jejunostomy (FJT) after pancreatoduodenectomy increases complications and length of stay. Delayed gastric emptying occurred in 55% of FJT patients vs. 25% in nasojejunal tube (NJT) patients (p = 0.006). FJT led to a longer hospital stay: 11 days compared to 9 days for NJT (p = 0.007). Omit FJT to reduce postoperative complications without […]
Delirium in Surgery: High Rates, Big Impacts
Postoperative delirium is a common and serious complication affecting surgical patients, significantly influencing outcomes and care. Delirium occurred in 10.6% of screened patients; those affected were older and had higher comorbidity rates. Key predictors include dementia (37% vs 7.9% in non-delirium), urgent surgery (55% vs 26%), and each 10-min increase in surgery time raises delirium […]
Advancing HPB Surgical Techniques Show Improved Outcomes
Minimally invasive and robotic-assisted surgeries enhance recovery in hepatopancreatobiliary procedures. Patients who underwent robotic-assisted gastrectomy had shorter hospital stays and less intraoperative bleeding than those who had open surgeries. Operative times differed among procedures due to technical complexity and learning curves. Surgeons should consider robotic techniques for better postoperative recovery in select patients. Overall, advances […]
Endoscopic Dissection Transforms Early Upper GI Carcinoma Care
Endoscopic Submucosal Dissection (ESD) provides an advanced local treatment option for early upper gastrointestinal carcinomas, enabling complete tumor removal and improved patient outcomes. ESD allows for en bloc resection of early GI neoplasia, aiding in precise pathology and risk assessment. Key candidates for ESD include high-grade intraepithelial neoplasia and superficial early carcinomas without visible deep […]
Impact of Textbook Outcome on Biliary Tract Cancer Surgery
Achieving a textbook outcome (TO) significantly enhances overall survival in biliary tract cancer (BTC) post-hepatectomy. Patients who achieved TO had a 31% reduced hazard of mortality (HR 0.69, 95% CI 0.58-0.82). Thirteen predictors of TO were identified, including younger age (OR 1.61), lower ASA score (OR 1.83), and smaller tumor size (OR 1.08). Laparoscopic surgery […]