A systematic review of seven randomized controlled trials involving 720 patients indicates that intracorporeal anastomosis in laparoscopic right hemicolectomy does not significantly increase the risk of anastomotic leakage compared to the extracorporeal technique. However, it is associated with lower rates of postoperative ileus and surgical site infections, along with quicker recovery of bowel function and […]
Author: STITCHES Newsletter
Major morbidity and mortality linked to complications post-surgery
Among 2,186 patients undergoing major liver resection for perihilar cholangiocarcinoma, a failure to rescue (FTR) rate of 24% was identified in those with severe complications. Key factors associated with FTR included age, higher ASA classification, jaundice at presentation, right-sided resections, and low annual hospital surgical volume. Notably, liver failure significantly increased the odds of FTR […]
Effective resuscitation strategies improve outcomes for trauma patients
Timely and balanced resuscitation strategies are crucial for optimizing outcomes in unstable injured surgical patients. A review of 55 studies highlights the significance of controlled fluid and blood product administration, permissive hypotension during hemorrhagic shock, and damage control surgery. By emphasizing evidence-based practices and educational frameworks, this study enhances the understanding of trauma resuscitation among […]
Liraglutide effectively addresses weight regain post-bariatric surgery
A randomized, placebo-controlled trial demonstrated that liraglutide 3.0 mg significantly combats weight regain after Roux-en-Y gastric bypass, with 76% of subjects achieving at least a 5% total body weight loss compared to 17% in the placebo group. Notably, 21% of liraglutide recipients exceeded their postoperative nadir weight. Throughout the study, nonserious adverse events were reported […]
Tumor-stroma percentage predicts survival in gastric cancer patients
A predictive model utilizing tumor-stroma percentage (tsp) in gastric cancer (gc) demonstrated its significance as an adverse prognostic factor for overall survival (OS). Among 872 gc patients, tsp-visual showed a hazard ratio of 2.042, indicating a correlation with advanced pathological staging. The developed nomogram effectively identified patients at risk for poor prognosis, while a novel […]
Robotic surgery enhances early discharge and reduces complications.
In a study of 282,490 patients undergoing elective colectomy, robotic surgery emerged as the strongest predictor of early discharge (15.3%), surpassing both laparoscopic and open techniques. Patients discharged early exhibited significantly lower rates of 30-day readmissions (5.84% vs. 10.37%), bounceback readmissions (3.56% vs. 5.75%), and overall complications (5.65% vs. 18.63%). These findings underscore the advantages […]
Cancer patients face higher mortality and complications from acute cholecystitis
Analysis of 8,673 patients revealed that those with active malignancies experienced significantly elevated 30-day mortality, with an odds ratio of 5.85. Furthermore, cancer patients had greater rates of infectious complications, including sepsis and pneumonia. The cancer cohort was also more likely to receive nonoperative management. These disparities in clinical outcomes and treatment processes underscore the […]
Most prescribed opioids for surgery are unused by patients
A significant portion of opioids prescribed post-elective colorectal surgery remains unused, with 63% of pills going unconsumed. In a study of 344 patients, the median prescribed amount was 13 pills, yet many reported using none. Factors like younger age, higher preoperative anxiety, and the number of pills prescribed correlated with increased consumption. These findings suggest […]
Short-Course TNT Outperforms Long-Course Treatment in Rectal Cancer
A multi-institutional review of 857 patients demonstrated that short-course total neoadjuvant therapy (sc TNT) significantly increases complete response (CR) rates in rectal cancer compared to long-course chemoradiation (lCRT). Specifically, CR rates were 34.1% for sc TNT versus 20.3% for lCRT. Notably, patients completing 5-6 months of consolidation chemotherapy had a CR rate of 42.9%. Despite […]
Consensus guidelines established for peri-operative care in obese patients
A modified Delphi process yielded 94 consensus statements on optimising peri-operative care for patients with obesity undergoing non-bariatric surgery. Key pre-operative strategies include access to prehabilitation and risk stratification tools, while intra-operative focus centres on the roles of anaesthetists and surgeons, minimally invasive techniques, and infection prevention. Post-operative care emphasises analgesia, nutritional support, and physiotherapy. […]