A narrative review highlights the absence of a universally accepted definition and grading system for anastomotic leaks (AL) in hepato-pancreato-biliary procedures. Variability in reported incidence complicates understanding and managing complications such as postoperative pancreatic fistula and bile leaks. The review emphasizes the substantial human and economic costs associated with AL, including increased morbidity, mortality, and […]
Author: STITCHES Newsletter
Surgeons’ dual roles face unprecedented decline
The decline of surgeon-scientists has reached critical levels, with their unique contributions to research and patient care in jeopardy. A systematic review and global survey revealed gaps in applying existing countermeasures to address this issue. Key reasons identified include a profit-driven focus in hospitals and a flawed selection process for academic excellence. Researchers propose a […]
Standardization of Surgical Complication Reporting Promoted
A recent study evaluated the use of the Clavien-Dindo Classification (CDC) and Comprehensive Complication Index (CCI) in assessing postoperative morbidity across randomized controlled trials (RCTs). Although reliance on these metrics is growing, only one-third of RCTs adequately utilized the complete spectrum of CDC grades. The findings were enriched by input from 163 surgeons on complex […]
Primary tumor resection significantly enhances survival in liver metastases
Analyzing data from 21,928 patients, researchers determined that primary tumor resection (PTR) improves overall and cancer-specific survival rates for patients with colorectal, pancreatic, and breast cancer liver metastases. Significant factors influencing survival benefits from PTR included age and tumor characteristics for colorectal patients, while chemotherapy affected pancreatic cancer outcomes. Additionally, a predictive model was developed […]
Enhanced Recovery Program Improves Outcomes in Bariatric Surgery
Implementation of the Enhanced Recovery After Surgery (ERAS) program in bariatric procedures significantly reduced hospital stay, costs, and unplanned readmissions. A study comparing pre-ERAS and post-ERAS cohorts revealed a median length of stay decrease by one day and an average cost reduction of $2,230. Additionally, the post-ERAS group exhibited a 52% lower risk of 30-day […]
Mural nodules and intraluminal air predict neuroendocrine tumors.
Mural nodules protruding into the lumen and intraluminal air serve as significant predictors of neuroendocrine tumors in patients with acute appendicitis. In a study involving 1,150 patients, those with neuroendocrine tumors exhibited a mural nodule prevalence of 53.3% sensitivity and 95.8% specificity, while intraluminal air showed 53.3% sensitivity and 76.7% specificity. Incorporating these imaging indicators […]
Risk scoring model effectively predicts peritoneal recurrence in gastric cancer
The study identified key risk factors for peritoneal recurrence (PR) in gastric cancer, involving 622 patients post-gastrectomy. Among these, 64 experienced PR with significantly poorer survival rates compared to those with recurrence in other sites. A newly developed risk-scoring model, based on eight variables, demonstrated 81% accuracy in predicting PR. Notably, 82.8% of patients with […]
Spontaneous portosystemic shunts predict post-hepatectomy liver failure
Analysis of pre-operative CT scans indicated that spontaneous portosystemic shunts (SPSs) were present in 17.4% of patients undergoing liver resection for hepatocellular carcinoma. Among 425 patients, post-hepatectomy liver failure (PHLF) occurred in 6.4%, with 4% experiencing grades B/C. Multivariable analysis revealed SPS as an independent risk factor for all-grades PHLF (OR 6.83) and clinically significant […]
Roux-en-Y gastric bypass outperforms sleeve gastrectomy in long-term hypertension remission
A systematic review of 11 randomized controlled trials involving 2,323 patients indicates that both sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) show comparable hypertension remission within the first four years post-surgery. However, RYGB demonstrated a significantly greater effectiveness in achieving remission at five years or more, with a relative risk of 1.39. These findings […]
Robotic training effectiveness varies by prior surgical experience
In an evaluation of robotic surgical training, participants—including experienced robotic surgeons, laparoscopic surgeons, and novices—demonstrated varying skill levels across first-touch tasks. Robotic surgeons outperformed both laparoscopic surgeons and novices in pegboard and camera operations. It was observed that prior experience notably influenced first-touch skills, while overall surgical experience affected suturing performance. These findings emphasize the […]