Between 2019 and 2023, surgical opioid stewardship in 15 hospitals resulted in a notable decline in preoperative opioid use from 17% to 10%, coupled with an increase in intraoperative blocks from 21% to 27%. Data from 18,325 patients indicated that opioid avoidance strategies were effectively maintained for 68-70% of patients, while discharge opioid prescriptions remained […]
Author: STITCHES Newsletter
ERAS protocols significantly improve outcomes in colorectal surgery
The implementation of enhanced recovery after surgery (ERAS) protocols across four institutions led to substantial improvements in elective colorectal surgery outcomes. Complications such as superficial surgical site infections dropped from 7.5% to 2.5%, while overall 30-day complications decreased by 35%. Additionally, median hospital stays shortened from five to four days, and readmission rates fell from […]
AI Models Accurately Predict Lymph Node Metastasis in Colorectal Cancer
Artificial intelligence models demonstrated significant predictive capability for lymph node metastasis (LNM) in patients with T1 colorectal cancer, outperforming guideline-recommended metrics. Among 1,386 analyzed patients, 12.5% exhibited LNM, with AUROC values of models including regularized logistic regression classifier (0.673) and catboost classifier (0.679) surpassing the expected 0.525. These findings suggest AI integration could enhance surgical […]
Machine learning model predicts liver metastasis in rectal cancer
A new radiomics model utilizing multiparametric MRI and machine learning demonstrates the potential to accurately predict metachronous liver metastasis (MLM) in rectal cancer patients. In a study involving 301 patients, the random forest model outperformed traditional methods, achieving an area under the curve (AUC) of 0.919 in training and 0.901 in validation. The model integrates […]
AI and robotics enhance surgical precision and outcomes.
AI and robotic technologies are transforming surgical practices by enhancing precision, reducing errors, and improving patient outcomes. The systematic review synthesizes recent studies across various specialties, showcasing breakthroughs in imaging, data analysis, and automated instruments. Results indicate significant advancements in decision-making and personalized treatment strategies. However, challenges such as costs, ethical issues, and training requirements […]
Colectomy indication influences postoperative outcomes significantly.
A comprehensive analysis of over 280,000 colectomy patients revealed that the underlying disease etiology significantly affects postoperative outcomes. Unadjusted rates showed patients with infectious causes exhibited the highest mortality (2.6%) and morbidity (27.6%). After adjusting for risk factors, those with inflammatory bowel disease (IBD) had 30% higher odds of morbidity compared to both colon cancer […]
Opioid prescription reductions seen post-hepatectomy
Non-hepatectomy opioid reduction efforts significantly decreased opioid prescriptions after hepatectomy. An analysis of 2,005 patients revealed over 50% reductions in both intraoperative and inpatient median oral morphine equivalents, alongside a 73% decline in discharge opioids. Clinically, pain scores remained low, showing no compromise in patient comfort. Additionally, the percentage of patients discharged without opioids rose […]
SAGES establishes a systematic approach to updating guidelines
The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has developed a standardized procedure for regularly updating clinical practice guidelines. This evidence-based approach aims to maintain the relevance and quality of recommendations for physicians and patients. By establishing a systematic framework for reviewing existing guidelines, SAGES highlights the importance of ongoing evaluation to ensure that […]
AI Model Enhances Prediction of Perineural Invasion in Pancreatic Cancer
An advanced AI model utilizing computed tomography can predict extrapancreatic perineural invasion (epni) in pancreatic ductal adenocarcinoma (PDAC) patients. Analyzing data from 1,065 patients, the model achieved an area under the curve of 0.87 to 0.83 across different validation sets. Furthermore, survival analysis confirmed significantly better outcomes for patients predicted to be epni-negative. With its […]
Multidisciplinary approach enhances outcomes in complex cholangiocarcinoma surgery
A case study demonstrated the effectiveness of a multidisciplinary approach in managing perihilar cholangiocarcinoma, involving neoadjuvant therapy and interventional radiology. Neoadjuvant chemotherapy significantly reduced the tumor size, facilitating an r0 surgical resection. Additionally, interventional radiology played a critical role in addressing postoperative complications, including a life-threatening pulmonary embolism, through techniques like percutaneous pharmaco-mechanical thrombectomy. This […]