A recent network meta-analysis evaluated prehabilitation strategies for patients undergoing digestive system cancer surgery. It involved 26 randomized controlled trials with 2042 patients, revealing significant benefits: a 1.12-day reduction in hospital stay and decreased postoperative complications by 29%. Exercise-based prehabilitation emerged as the top intervention, particularly for reducing complications and improving functional recovery, while multimodal […]
Author: STITCHES Newsletter
New machine learning models improve diagnosis of obstructive jaundice
A comprehensive study analyzing 5,726 patients with obstructive jaundice has identified key etiologies, revealing cholangiocarcinoma, pancreatic adenocarcinoma, and common bile duct stones as predominant causes. Despite traditional markers lacking accuracy, two machine learning models were successfully developed, achieving an area under the receiver operating characteristic curve (AUROC) of 0.862 for differentiating benign and malignant causes. […]
Advances in treating peritoneal oligometastasis in gastric cancer
Peritoneal metastasis from gastric cancer significantly impacts prognosis, but advancements in diagnostic and therapeutic strategies are transforming patient outcomes. A peritoneal cancer index (PCI) threshold of ≤6 identifies patients with oligometastasis who may benefit from aggressive therapies. Cytoreductive surgery coupled with hyperthermic intraperitoneal chemotherapy remains essential for curative intent. Emerging techniques like normothermic and pressurized […]
Augmented reality eliminates conversion rates in liver surgeries.
A retrospective analysis reveals augmented reality (AR) enhances tumour localisation in minimally invasive liver surgery (MILS), achieving a zero conversion rate for the AR group, compared to six conversions in the non-AR group. While AR increased operative times by 10%, it did not adversely affect resection margins or postoperative complications. The findings suggest AR’s potential […]
Mixed-reality feedback aids in assessing surgical training proficiency
A study evaluated visual attention and mental workload in novice surgeons using laparoscopic box trainers, revealing that eye-tracking metrics can effectively differentiate proficiency levels. Notably, trainees exhibited shorter fixation durations with pediatric trainers compared to adult ones, and their pupil diameters varied based on training starter modality. However, mixed-reality feedback did not significantly impact these […]
Trauma patients face significant delays despite access to care
A recent analysis of over 102,000 incident reports from Riyadh reveals a troubling prevalence of delays and undertriage among trauma patients. Although 66.8% of critically injured patients were transported to adequate trauma centers, 21.1% faced delays exceeding one hour, with some areas reaching up to 57.7%. Additionally, 28.7% were undertriaged to non-trauma centers. Implementing a […]
Postoperative delirium significantly increases risks for older adults.
A national study of over 5.5 million hospitalizations highlights that older adults undergoing major noncardiac surgery with postoperative delirium face markedly increased risks. Patients with delirium had 3.5 times higher odds of death or major complications, nearly 2.8 times the risk of dying within 30 days, and four times higher odds of nonhome discharges. Variations […]
Machine learning predicts prolonged surgery in laparoscopic cholecystectomy
A recent study revealed that machine learning can effectively predict prolonged operative times in fluorescent laparoscopic cholecystectomy, identifying 29% of patients at risk. Key predictive factors included type of cholecystitis, puncture ports, gallbladder adhesion, pre-surgery antibiotics, and gallbladder thickness. Using the light gradient boosting machine (LightGBM) model, researchers achieved an impressive AUC of 0.876, indicating […]
Scheduled imaging proves beneficial for identifying complications.
A multicenter trial found that scheduled repeat imaging within 48-72 hours significantly aids in identifying complications in patients with moderate to high-grade blunt liver and spleen injuries. Of the 2,341 liver injury and 2,143 spleen injury patients observed, 35.1% and 27.9% underwent repeat imaging, respectively. Complications were detected in 7.1% of liver and 7.5% of […]
Chyme reinfusion reduces complications after surgical reconstruction
A meta-analysis of five studies with 460 patients revealed that chyme reinfusion (CR) significantly lowers overall complications (odds ratio 0.25) and specifically ileus (odds ratio 0.35) and diarrhea (odds ratio 0.29) in patients undergoing reconstruction for high-output ostomies and enterocutaneous fistulas. Additionally, CR notably shortens hospital stays and reduces inflammatory markers like C-reactive protein and […]