Implementation of enhanced recovery after surgery (ERAS) protocols at 15 Ontario hospitals resulted in a significant 1.05-day reduction in length of stay (13.7%) for colorectal surgeries. Notably, left-sided colorectal surgeries saw an even greater decrease of 1.17 days (15.6%). This reduction remained consistent over time and was more pronounced after adjusting for various predictors. The […]
Author: STITCHES Newsletter
Stool-based surveillance reduces colonoscopies after polypectomy
Stool-based surveillance strategies may safely decrease colonoscopy demand by 15-41% following polypectomy, according to the MOCCAS study. Conducted on 3,453 individuals, the study demonstrated that multitarget stool DNA tests and fecal immunochemical tests (FIT) were effective alternatives, especially for those at lower risk. Long-term simulations indicated that while multitarget stool DNA testing incurred higher costs, […]
Endoscopic Vacuum Therapy effectively treats Boerhaave’s syndrome.
A multicenter analysis demonstrates that Endoscopic Vacuum Therapy (EVT) has a high success rate for treating Boerhaave’s syndrome, yielding an 80% treatment success in 25 patients. Mortality rates were significantly lower for EVT patients (8.0%) compared to those undergoing other methods (25.0%). Moreover, treatment success with EVT was statistically superior to non-EVT approaches (43.8%). These […]
Omission of drains reduces complications and hospital stays in surgery
Patients undergoing minimally invasive distal pancreatectomy without abdominal drains experienced significantly lower rates of postoperative pancreatic fistula (3.4% vs. 27.6%) and abdominal collections (3.4% vs. 31.0%), along with a shorter hospital stay (5 days vs. 9 days). These findings suggest that not using drains during this type of surgery may enhance recovery without increasing severe […]
Multidisciplinary case conference enhances management of benign hepatopancreatobiliary disease
A study reviewing 56 cases presented at the novel benign liver and pancreas rounds highlights the effectiveness of a multidisciplinary case conference in managing benign hepatopancreatobiliary diseases. The discussions resulted in a change or adjustment in the proposed management plan for 82% of cases, with 71% of these recommendations being implemented. Most cases addressed pancreatic […]
Endoscopic submucosal dissection proves more effective than EMR
A systematic review and meta-analysis involving 9,352 patients reveals that endoscopic submucosal dissection (ESD) outperforms endoscopic mucosal resection (EMR) in effectively treating early Barrett’s neoplasia. ESD achieved significantly higher en-bloc resection rates (odds ratio 25.96) but was associated with greater incidence of adverse events. The findings highlight the need for careful consideration of the balance […]
Early esophago-gastric adenocarcinoma linked to high lymph node metastasis risk
A multicenter study involving 1,601 patients revealed a 13.5% incidence of lymph node metastasis (lnm) in early esophago-gastric adenocarcinoma. Factors such as tumor depth and lymphovascular invasion showed initial associations with lnm but lacked significance in multivariable analyses. Notably, surgery following endoscopic resection significantly improved survival rates, highlighting the potential need for reevaluation of predictive […]
Postoperative insulin resistance worsens recovery after gastrectomy.
A cohort study involving 60 gastric cancer patients revealed that postoperative insulin resistance significantly worsens short-term recovery after radical gastrectomy. Key findings indicated increased insulin resistance and inflammation, along with decreased nutritional markers. The gut microbiome showed notable changes, including reduced bifidobacterium and butyrate levels. Negative correlations were found between insulin resistance and beneficial gut […]
Gender gap persists in surgical specialties with low female representation
A comprehensive analysis of over 1.1 million physicians reveals only 16.7% of surgeons are female, highlighting significant ongoing gender disparities in surgery. While there is a gradual increase in female representation, specialty-specific trends show that women are less likely to enter cardiac surgery compared to colorectal surgery. Variations related to practice setting and graduation year […]
GAME-SCORE predicts chemotherapy response in colorectal liver metastases
GAME-SCORE demonstrates predictive value for pathological and radiological responses to neoadjuvant chemotherapy in colorectal liver metastases. High-risk GAME-SCORE patients exhibited significantly lower pathological response rates (82.6%) and increased radiological progression (10%) compared to low (3.8%) and moderate (3.5%) risk groups. Furthermore, multivariable analysis identified high-risk GAME-SCORE as an independent predictor of pathological response, alongside factors […]