Switching to a global budget revenue model can enhance surgical outcomes for cancer procedures. Textbook outcomes improved from 72.8% to 76.1% in GBR hospitals versus a slight change from 70.2% to 70.5% in controls, showing a 2.9 percentage point gain (p=0.02). Complication rates fell by 1.5 percentage points, and prolonged stays decreased by 1.8 percentage […]
Author: STITCHES Newsletter
Robotic Liver Surgery Complexity Scores Validated
Surgeons now have a new, validated tool to assess the complexity of robotic liver surgery, improving patient selection and outcomes. The International RoboLiver Difficulty Scoring System outperformed the Southampton model with an AUC of 0.719, indicating better prediction of intraoperative complications. Key predictors of prolonged operative time include neoadjuvant chemotherapy, lesion size >50 mm, and […]
Diabetes Status Matters for Surgical Risk Assessment
Elective surgeries may carry different risks based on patients’ glycemic status rather than just diabetes diagnosis. In a study of over 2 million hospitalizations, 9.16% of patients with diabetes and hyperglycemia had major adverse events, compared to 5.31% without diabetes. Patients with diabetes without hyperglycemia had a modest increased risk (5.85%) with a number needed […]
Delayed Closure in Colorectal Surgery May Not Cut Infections
Delayed primary closure with intrawound irrigation doesn’t reduce surgical site infections after colorectal perforation. Superficial and deep SSI rates: 25% for delayed closure vs. 50% for primary closure. ICU and hospital stays were longer for delayed primary closure. Surgeons should weigh the benefits of reduced infection risk against potential longer recovery times. Findings need confirmation […]
Pelvic MRI is unreliable post-neoadjuvant therapy for rectal cancer.
40% of patients with a complete clinical response (CCR) endoscopically had residual disease on MRI. After a mean follow-up of 4.8 years, 30% had disease regrowth, with no significant difference in rates based on MRI results (33% vs. 27.8%). Surgeons should be cautious in relying solely on MRI for treatment decisions following total neoadjuvant therapy, […]
Robotic Pancreatoduodenectomy in Octogenarians Offers Advantages
Robotic pancreatoduodenectomy in patients 80 and older shows significant benefits over open surgery. Operative time was longer for robotic (441 min) vs. open (375 min), but with less blood loss (266 ml vs. 565 ml). Postoperative complications were lower with robotic surgery (52.2% vs. 70.6% for open, p = .013) as well as rates of […]
Surgeons Improve Antibiotic Use with Education
Surgeons can significantly enhance antimicrobial prescribing practices through targeted education, tackling the critical issue of antibiotic misuse. Educational interventions led to better antibiotic selection, timing, and duration. Review included 17 studies, primarily from high-income, tertiary hospitals, emphasizing pre-post design effectiveness. These findings underscore the importance of implementing educational strategies to strengthen antimicrobial stewardship in surgical […]
Mentorship Programs Increase Diversity in Surgery
Surgical subspecialties are striving for greater diversity through targeted mentorship for underrepresented minorities. Only 18 of 255 studies highlighted programs for URIM students, mainly at medical school (11) and high school (3) levels. Outreach can effectively boost interest in surgery among URIM individuals, though vascular surgery lacks any dedicated programs. Increasing mentorship initiatives across all […]
Redefining Surgical Education with a Virtual Journal Club
A novel journal club enhances resident training and engagement in trauma surgery. Residents improved critical appraisal skills and public speaking abilities. Faculty valued direct interactions with study authors on methodology and clinical relevance. This low-resource model fosters meaningful discussions without the logistical burdens of in-person events. Participating experts gained visibility and scholarly dissemination with minimal […]
Enhancing Liver Surgery Training: Outcomes from a Leading Fellowship
Dedicated hepatobiliary fellowship programs sharply boost surgical confidence and competence, crucial for today’s complex liver surgeries. Fellows showed a confidence jump from 2.5 to 9 out of 10 in performing right hemihepatectomies after training. Median surgical volume included 65 liver resections, with minimally invasive exposure rising from 10 to over 20 cases in five years. […]