Surgeons need to know that a five-year collaboration in Ethiopia significantly improved trauma care capacity at Hawassa University Hospital. Trauma care scores rose in provider knowledge, infrastructure, supplies, and hospital processes. Clinical gains for specific injuries were limited, pointing to room for improvement. Investing in human resources remains critical, as this area saw no improvement […]
Author: STITCHES Newsletter
Increasing Use of Robotic Cholecystectomy for Obese Patients
Robotic cholecystectomy is on the rise, especially among obese patients, but it does not improve postoperative outcomes compared to laparoscopic surgery. Robotic surgery utilization increased significantly from 23.1% in 2020 to 55.8% in 2024 for patients with BMI ≥ 50 kg/m². Obese patients (BMI 35-49.9 kg/m²) were 15% more likely to have robotic surgery; those […]
Terminology Confusion in Pancreatic Surgery: A Call to Action
Surgeons need to know that recent trends show increasing use of imprecise terms for pancreatic head resections, which can impact clinical understanding. Between 2004 and 2023, “pancreaticoduodenectomy” dominated 65.7% of titles, with “pancreatoduodenectomy” at 27.9%. Other variants, including “duodenopancreatectomy,” saw significant decline in use. Inconsistencies affect education and literature indexing, urging a push for standardized […]
Major Pathologic Response Improves Outcomes in Pancreatic Cancer
Achieving a major pathologic response (mpr) after preoperative treatment for pancreatic ductal adenocarcinoma significantly impacts survival rates. Mpr was noted in just 11.5% of patients, but those who achieved it had a median overall survival of 71.5 months, compared to 40.9 months for non-mpr patients. Recurrence-free survival also improved, with mpr patients experiencing 55.5 months […]
Pulmonary metastases after pancreatic cancer surgery tied to better survival
Patients with isolated pulmonary metastases post-resection of pancreatic ductal adenocarcinoma (PDAC) have improved overall survival compared to other metastatic sites. Of 343 patients studied, 21% had lung metastases with a median overall survival of 30 months, compared to 13 months for liver and 20 months for other sites. Recurrences occurred in 85% of patients within […]
Long-term Outcomes of Endoscopic Submucosal Dissection in T1 CRC
Endoscopic submucosal dissection (ESD) offers compelling insights into managing T1 colorectal cancer (CRC), shaping surgical strategies. Of 383 T1 CRC patients, 3.6% had recurrences and 1.8% died in the high-risk group; none occurred in low-risk patients. In high-risk cases, local recurrence was 6.8% without surgery versus 0% with surgery (p < .001). Consider ESD alone […]
Rationalizing Surgical Trays Cuts Costs and Emissions
Rationalizing surgical trays for elective procedures can save money and reduce environmental impact. 39% reduction in tools for rectal procedures, from 53 to 16 items. Open hernia repair trays reduced from 53 to 43 items and from 75 to 60 items. Annual savings estimated at £16,863 and reduced carbon emissions by 42.6 kgCO2. This approach […]
Endoscopic Therapy in Chronic Pancreatitis: Key Insights
Targeted endoscopic approaches offer symptom relief in chronic pancreatitis but surgery is preferred for long-term outcomes. Endoscopy is effective for small pancreatic duct stones; larger stones require extracorporeal shock wave lithotripsy or pancreatoscopy. Main pancreatic duct strictures should be treated with dilation and single large-caliber plastic stents; avoid fully covered metal stents due to higher […]
Postoperative Complications Raise Risks in Colon Cancer Surgery
Patients with stage I-III colon cancer face higher locoregional recurrence and lower survival rates when complications occur. 28% of patients had postoperative complications; 4.9% developed anastomotic leakage needing re-intervention. The 5-year locoregional recurrence rate was 13.5% for those with any complications versus 6.8% for those without. Anastomotic leakage is the only complication independently linked to […]
Total Neoadjuvant Therapy Has Similar Outcomes for Rectal Cancer
Total neoadjuvant therapy does not change the selection criteria for lateral pelvic lymph node dissection in rectal cancer. 25% of patients undergoing lateral pelvic lymph node dissection had pathologically positive nodes. Key risk factors for positive nodes include CT4b stage (odds ratio 2.60) and multiple enlarged lymph node stations (odds ratio 3.82). Three-year local recurrence-free […]