Telemedicine has emerged as a transformative force in African surgical care, particularly in areas with scarce access to quality treatment. Despite challenges such as infrastructure deficits and personnel training, the implementation of telemedicine has demonstrated favorable outcomes. Increased adoption is evident in postsurgical care and doctor-patient consultations since the pandemic. While the potential for telesurgery […]
Author: STITCHES Newsletter
Laparoscopic pancreatoduodenectomy shows improved outcomes compared to open surgery
A network meta-analysis of seven randomized controlled trials involving 1,336 patients revealed that laparoscopic pancreatoduodenectomy (LPD) offers shorter hospital stays and reduced intraoperative blood loss compared to open pancreatoduodenectomy (OPD). However, LPD was associated with longer operative durations. In contrast, robotic pancreatoduodenectomy (RPD) showed no significant advantages over OPD. While LPD indicated potential better outcomes, […]
Nomograms effectively predict survival and recurrence in rectal cancer patients.
Nomograms developed from a multi-institutional study accurately forecast overall survival and recurrence for treatment-naïve rectal cancer patients post-surgery. Age predicted survival while venous invasion indicated recurrence. The model demonstrated strong discrimination, with Harrell’s c-index values of 0.77 for survival and 0.75 for recurrence in the internal validation cohort. Notably, adjuvant chemotherapy significantly enhanced 5-year survival […]
Perihilar resection increases risk of biliary leakage post-surgery
In a study analyzing data from 724 patients undergoing biliary anastomosis, researchers reported a 5.6% bile leak rate in distal malignant obstruction cases, while the rate increased to 14.6% in proximal malignant cases. Mortality varied significantly between anastomotic failure (26%) and no failure (2.6%). Advanced comorbidities and elevated preoperative bilirubin levels correlated with higher leak […]
Machine learning models effectively predict appendicitis in emergencies
This proof-of-concept study reveals that machine learning models can predict appendicitis in patients with acute abdominal pain more accurately than traditional methods. With AUROCs of 0.919 and 0.923 when including laboratory test results, the models outperformed the Alvarado scoring system (AUROC of 0.824) and matched or exceeded the performance of emergency department physicians. These findings […]
Muscle mass-to-fat ratio predicts outcomes in pancreatic cancer surgery
A study evaluating the muscle mass-to-fat ratio (mmfr) in pancreatic cancer patients revealed significant prognostic implications. Among 191 patients undergoing pancreaticoduodenectomy, those in the low-mmfr group faced shorter overall survival and higher incidences of postoperative pancreatic fistula compared to their high-mmfr counterparts. The optimal mmfr cutoff values were identified at 0.688 for males and 0.382 […]
Anterior gastropexy significantly reduces 1-year recurrence of hernia
Findings indicate that incorporating anterior gastropexy during minimally invasive paraesophageal hernia repair significantly lowers the 1-year recurrence rate. In a clinical trial involving 240 participants, the recurrence rate was 15% for those receiving anterior gastropexy compared to 36% for those without it, indicating a notable risk difference. While patient satisfaction and quality-of-life outcomes remained consistent […]
Deep learning model predicts early recurrence in gastric cancer
A deep learning model (DLRMLP) integrating clinical factors outperformed traditional methods in predicting early recurrence of locally advanced gastric cancer (LAGC) post-gastrectomy. In a study involving 620 patients, DLRMLP achieved an AUC of 0.891 compared to 0.797 with conventional models. This model effectively stratified early recurrence-free survival, disease-free survival, and overall survival (all p < […]
Robotic pancreaticoduodenectomy shows promising safety and feasibility
Analysis of 425 patients in Japan demonstrates that robotic pancreaticoduodenectomy (RPD) can be safely introduced, achieving a low conversion rate to open surgery (3.8%) and high minimally invasive surgery completion rate (91.1%). The median operative time was 617 minutes, with a median blood loss of 160 grams. While the complication rate was 20.5%, mortality rates […]
Laparoscopic repair reduces hernia recurrence and hospital stay
A comprehensive analysis of 20 studies involving 16,247 patients revealed laparoscopic mesh repair for ventral and incisional hernias significantly lowers hernia recurrence and postoperative complications compared to open repair techniques. Patients undergoing laparoscopic procedures also experienced shorter hospital stays. While retro-muscular repairs showed lower hernia recurrence compared to laparoscopic approaches, the difference was not statistically […]