Author: STITCHES Newsletter

Immunotherapy transforms surgical management of advanced liver cancer.

Immune checkpoint inhibitors are reshaping treatment for advanced hepatocellular carcinoma, establishing new standards and encouraging further research. A combination of atezolizumab and bevacizumab shows high response rates, prompting investigations into their roles in peri-operative settings and liver transplantation. However, there are concerns regarding immunosuppression and graft rejection, necessitating careful patient selection and management. Ongoing studies […]

Orthodontic rubber bands enhance colorectal ESD training efficiency

Orthodontic rubber band-assisted colorectal endoscopic submucosal dissection (ORB-ESD) significantly improved trainees’ procedure times, matching expert levels. The study found that ORB-ESD shortened colorectal ESD procedure duration (28.0 min) compared to conventional methods (41.0 min). Furthermore, resection speed, visual field exposure, and muscle injury rates were better in the ORB-ESD group compared to conventional trainees, suggesting […]

Gastrectomy at university hospitals reduces mortality in gastric cancer.

A nationwide study in Finland found that patients undergoing gastrectomy at university hospitals experience lower short-term and long-term mortality rates compared to those treated at nonuniversity hospitals. An analysis of 10,455 patients from 1987 to 2016 indicated that university hospital patients were younger and had more comorbidities. Notably, survival rates at university hospitals were higher […]

Darvadstrocel shows improved long-term effectiveness for complex perianal fistulas

A recent study indicates that darvadstrocel (DVS) outperformed standard of care (SOC) in treating complex perianal fistulas in Crohn’s disease, with patients experiencing shorter times to remission and longer intervals before relapse. Among 513 patients analyzed from both clinical trials and real-world data, a significantly higher proportion achieved clinical and patient-centric remission at 24 and […]

Surgical navigation enhances successful lymph node removal outcomes

Surgical navigation significantly improves successful retroperitoneal lymph-node dissection outcomes, achieving an 85% success rate compared to 50% in conventional methods. The trial, involving 69 participants, demonstrated that navigation aided surgeons in localizing targeted lymph nodes more effectively. Both complication rates were similar across both groups, and surgeons rated the navigation system favorably. These findings indicate […]

Self-gripping meshes reduce surgical time in hernia repair

In a comparative study of laparoscopic inguinal hernia repairs, self-gripping meshes (SGMs) demonstrated a significant reduction in surgical time (58.9 minutes) compared to fixation means for meshes (FMMs), which averaged 68.1 minutes (p = 0.0004). Additionally, while post-operative pain showed a trend towards reduction in the SGM group (p = 0.08), no recurrences were observed […]

Transaminase levels predict survival after liver cancer surgery

Changes in perioperative serum transaminase levels, specifically aspartate and alanine aminotransferase, were found to predict long-term survival following liver resection for hepatocellular carcinoma. A murine model demonstrated that hepatic ischemia/reperfusion injury led to increased tumor recurrence. Analyzing the ratio of aspartate to alanine aminotransferase on postoperative days one and three may help identify patients at […]

Multimodal prehabilitation enhances recovery in frail gastric cancer patients

Multimodal prehabilitation significantly improved physical capacity and reduced chronic inflammation in frail elderly patients undergoing gastric cancer surgery. The intervention, encompassing physical training, nutritional support, and psychosocial treatment over two weeks, resulted in a mean 6-min walk test change of +28 meters (p < 0.001). Notably, inflammation-related indicators improved, and proinflammatory cytokine release decreased, with […]

Sutureless harmonic scalpel reduces complications in thyroidectomy

A meta-analysis of 43 randomized controlled trials involving 10,361 patients reveals that the sutureless focus harmonic scalpel significantly lowers the risk of complications during thyroidectomy. The transient recurrent laryngeal nerve injury was reduced to 3.99% with the scalpel compared to 5.23% with the clamp-and-tie technique. Additionally, transient hypocalcemia rates were lower (11.3% vs. 15.4%). These […]

Interventions can combat low health literacy in surgical patients

Over one-third of surgical patients experience low health literacy, notably affecting older, rural, and Black populations. This condition leads to poor compliance with medical instructions, extended hospital stays, increased readmission rates, and higher healthcare costs. However, health literacy is modifiable, prompting opportunities for impactful interventions at patient, provider, and system levels. Researchers advocate for enhanced […]