A recent meta-analysis indicates that pathological complete response (pCR) following neoadjuvant chemoradiotherapy significantly improves long-term survival outcomes in patients with locally advanced esophageal cancer undergoing surgery. Findings from 38 included studies revealed a hazard ratio of 0.54 for overall survival and 0.51 for disease-free survival among those achieving pCR. Subgroup analyses showed even greater benefits […]
Author: STITCHES Newsletter
Nomogram effectively predicts anastomotic leakage in elderly patients.
A LASSO-based nomogram has been developed to predict anastomotic leakage (AL) in elderly patients undergoing laparoscopic gastrectomy. An analysis of 884 patients identified significant predictors, including age, ASA score, diabetes, intraoperative blood loss, and prognostic nutritional index. The nomogram demonstrated high predictive accuracy, achieving AUC values of 0.870 and 0.890 in training and validation cohorts, […]
Online Risk Models Aid in Identifying Surgical Candidates
Researchers developed online calculators to assess patients’ likelihood of benefiting from liver resection for intrahepatic cholangiocarcinoma. Among 889 patients studied, the 90-day mortality rate was 8.5%, with median overall survival at 24.1 months. Risk profiles categorized patients into three groups: favorable (90-day mortality 4.3%, survival 47 months), unfavorable (33.3% mortality, 11.9 months survival), and intermediate […]
Mastery of laparoscopic pancreaticoduodenectomy improves beyond initial learning curve
Cumulative sum analysis in laparoscopic pancreaticoduodenectomy showed that surgeon proficiency continues to evolve beyond the initial learning phase. In a review of 381 patients, significant improvements were noted across operative time, blood loss, length of stay, and postoperative complications over three defined phases. Notably, operative time and blood loss saw proficiency achieved after hundreds of […]
Prophylactic mesh reduces incisional hernia rates in surgeries
Prophylactic mesh reinforcement during elective abdominal surgeries significantly decreased the incidence of incisional hernias (IH) and the need for reoperations. In a meta-analysis of 15 randomized controlled trials involving 2,233 patients, mesh use demonstrated a notable reduction of IH at various follow-up points: 12 months (risk ratio 0.35), 24 months (0.28), and 36 months (0.62). […]
Non-penetrative fixation methods reduce hernia reoperation rates
A study involving 49,029 transabdominal pre-peritoneal hernia repairs revealed that non-penetrative fixation and self-fixating meshes significantly reduce reoperation rates for recurrence. Tack fixation, the most commonly used method, had the highest rate at 5.3% after five years. In contrast, glue fixation, self-fixating meshes, and no fixation showed much lower adjusted hazard ratios for reoperation: 0.25, […]
Suboptimal visualization in minimally invasive surgery costs billions yearly
A systematic review reveals that surgeons experience poor visualization in minimally invasive surgery (MIS) 40% of the time, leading to nearly 20% of surgical complications. Notably, lens cleaning costs average $312.53 per procedure, while visualization-related complications add $251 more per case. Together, these challenges contribute to over $2.2 billion in annual healthcare expenses in the […]
Prosthetic or bioprosthetic mesh in retromuscular plane minimizes hernias.
A recent meta-analysis involving 2,148 patients revealed that using prosthetic or bioprosthetic mesh in the retromuscular position significantly reduces the risk of incisional hernias following stoma closure. The study highlighted that both types of mesh led to lower hernia rates compared to non-use. However, no significant differences in surgical site infection rates were noted among […]
Radiomics-clinical model enhances prediction of difficult laparoscopic cholecystectomy
A novel predictive model combining preoperative CT radiomics and clinical data effectively identifies patients at risk for difficult laparoscopic cholecystectomy (DLC). An analysis of 2,055 cases revealed a top-performing model using random forest algorithms, achieving an AUC of 0.938 in the training cohort and 0.874 in validation. The model incorporates ten key features, including gallbladder […]
Limited training opportunities hinder robotic-assisted surgery skills among residents
A study highlighted significant gaps in robotic-assisted surgery (RAS) training among Dutch residents, despite 69.6% having some RAS experience. Only 14.2% operated as console surgeons, revealing limited hands-on training in 75.7% of hospitals. Most participants, 77.7%, expressed a desire for a national RAS curriculum. Qualitative analysis identified key themes, including training needs and the importance […]