IVC filter placement in trauma patients is declining but shows wide variation among hospitals, affecting patient outcomes. Among 2.3 million trauma patients, only 0.81% had IVC filters placed, down from 1.15% in 2017 to 0.59% in 2024 (p<0.001). 22.5% of centers had insertion rates ≥1%, highlighting significant interhospital differences. Higher IVC filter use did not […]
Author: STITCHES Newsletter
Understanding Recurrence Patterns in Intrahepatic Cholangiocarcinoma
Post-surgery tumor features impact recurrence patterns in intrahepatic cholangiocarcinoma, affecting long-term outcomes and follow-up strategies. Among 1,328 patients, 57.5% experienced recurrence; 23% had both intra- and extrahepatic recurrence. Three or more metastatic lymph nodes increased the chance of combined recurrence (adjusted odds ratio 3.47). Patients with combined recurrence had worse survival outcomes (hazard ratio 1.63) […]
High Accuracy in Simplified Triage for Military Trauma
A simplified triage system shows promise for prioritizing trauma care in combat settings, but surgeons must be aware of its overtriage rate. Undertriage for major trauma (ISS ≥16) was just 3.6% with a sensitivity of 96.4%. Overall undertriage was 8.5% for all injuries with an AIS score of 3 or greater, with a sensitivity of […]
Local Therapies Improve Survival in Recurrent Pancreatic Cancer
Surgeons should consider local therapies for recurrent pancreatic ductal adenocarcinoma as they show significant survival benefits. For liver-only recurrence, local therapy leads to longer survival than chemotherapy alone (HR 0.26). Surgical resection for lung-only recurrence offers better survival compared to conventional treatment (HR 0.35). Careful patient selection and tailored approaches could enhance outcomes in recurrence […]
Influence of Surgical Volume on Groin Hernia Repair Outcomes
Surgical unit volume has a minor influence on recurrence rates after open groin hernia repairs, which is crucial for optimizing patient outcomes. Reoperation rates for recurrence range from 1.9% to 2.8%, with medium-high volume units showing a significant increase (hazard ratio 1.14). Emergency repairs at low-volume units have a concerning increased reoperation risk (hazard ratio […]
Surgeons Face High Burnout and Mistreatment Rates
Burnout and mistreatment are alarmingly common among academic general surgery faculty, particularly affecting female surgeons, which could impact recruitment and retention. 34.9% report weekly burnout; 30.2% have thoughts of leaving their jobs. 66.2% report mistreatment, including 54.4% experiencing bullying and 46.3% facing discrimination. Targeting workplace conditions is essential to improve faculty well-being and reduce turnover. […]
Obesity poses no barrier to effective antireflux surgery outcomes.
In a study of 2,388 patients, those with BMI ≥35 had similar symptom improvement (GERD-HRQL scores: 10.7 vs. 10.1) and satisfaction rates (81.6% vs. 83.3%) post-operation compared to non-obese patients. Five-year anatomic integrity (75.8% vs. 78.2%) and revision rates (4.5% vs. 5.3%) were also comparable. However, obese patients had lower rates of pH normalization in […]
New Tool Flags High-Risk Patients for PE Post-Surgery
A new calculator improves pulmonary embolism (PE) risk assessment after surgery, potentially impacting thrombo-prophylaxis strategies. Among nearly 5 million surgeries, 0.35% (17,045) resulted in PE. Dynamic reassessment following unplanned readmissions could identify 24,320 patients over the 0.5% treatment threshold, revealing a PE rate of 2.92%. Surgeons can use this tool to inform extended thromboprophylaxis, reducing […]
Direct-to-Surgery for Stage II/III Rectal Cancer Yields Strong Results
For selected patients with stage II or III rectal cancer, a direct-to-surgery approach led to favorable 2-year oncologic outcomes. Local recurrence rate was just 1% among patients undergoing low anterior resection. Disease-free survival was 85%, and overall survival reached 99%. Surprisingly, only 8% of patients required post-operative radiation therapy. Preoperative MRI overstaged 51% of patients […]
Understanding Symptom Recovery After Pancreatectomy
Symptom recovery following pancreatectomy is crucial for optimizing patient outcomes. Overall recovery rates were 68.1% at one month, 78.6% at three months, and 86.9% at six months post-surgery. Top symptoms included pain, fatigue, sleep disturbance, drowsiness, and bloating; fatigue persisted the longest. Preventing postoperative complications is vital for improving recovery, regardless of surgical technique. Journal […]