A meta-analysis of seven studies involving 760 patients demonstrates that surgical intervention for hemorrhoids significantly surpasses conservative methods in achieving complete symptom resolution (odds ratio = 2.96, p < 0.001) and reducing pain scores (standard mean difference = -0.93, p = 0.02). Though both treatment options showed similar postoperative complications, surgery provided faster recovery, particularly […]
Author: STITCHES Newsletter
Hydrogels may reduce esophageal stricture risk post-ESD.
Innovative hydrogel interventions show promise in significantly reducing stricture rates following endoscopic submucosal dissection for early esophageal cancer. Current methods have limited effectiveness and safety concerns, but hydrogels offer biocompatibility and enhanced therapeutic delivery. They promote epithelial regeneration and reduce fibrosis, potentially improving long-term outcomes. This review highlights the transformative potential of hydrogels in clinical […]
Etomidate-opioids show promising sedation balance for endoscopy
A systematic review and network meta-analysis of 152 trials involving 26,527 patients reveals no pharmacological regimen superior to propofol-opioids for sedation success in gastrointestinal endoscopy. However, etomidate-opioids ranked highest for sedation success, bradycardia, and recovery time, significantly reducing hypoxia risk compared to propofol-opioids. Esketamine-remimazolam exhibited superior hemodynamic stability and faster alertness but lower sedation success. […]
Mosapride accelerates recovery of gastrointestinal motility post-surgery
Mosapride significantly enhances gastrointestinal recovery following elective colorectal cancer surgery. In a randomized controlled trial involving 44 patients, those receiving mosapride experienced their first bowel movement in an average of 26 hours compared to 50 hours for the control group (p=0.004). Similarly, the time to passage of flatus was reduced from 70 hours to 40 […]
New guidelines prioritize systemic therapy for colorectal cancer with peritoneal metastases
Consensus guidelines for managing colorectal cancer with peritoneal metastases emphasize early referral to specialized centers. A national panel achieved over 90% consensus on clinical pathways, favoring systemic therapy over upfront surgery in synchronous cases. In metachronous cases, risk stratification was updated. Although the overall evidence remains low, the guidelines represent significant progress in addressing optimal […]
Wound protectors reduce postoperative complications in pancreatic surgery.
In evaluating 20,960 pancreaticoduodenectomy patients, the use of wound protectors (WPs) significantly decreased serious complications and surgical site infections (SSIs). Among the cohort, 29.4% used WPs, which were linked to an increased operative time but shortened hospital stays. Notably, WP use correlated with a 20% lower rate of serious complications and a 43% reduction in […]
Perioperative probiotics may significantly lower infection rates after surgery
A meta-analysis of 28 randomized controlled trials with 2,686 participants revealed that perioperative probiotics and synbiotics are linked to a significant reduction in total postoperative infection rates after elective colorectal surgery. Specifically, the use of these interventions correlated with nearly a 50% decrease in infections within 30 days post-surgery (relative risk 0.55, p < 0.001). […]
Laparoscopic technique enhances outcomes for necrotizing pancreatitis patients
Laparoscopic retroperitoneal necrosectomy (LRN) significantly improved outcomes for 120 patients with infected necrotizing pancreatitis. Postoperative complications occurred in 34.2%, with a mere 8.3% experiencing surgery-related mortality. Key factors linked to complications included ICU length of stay and extrapancreatic infections. Patients showed marked recovery, with decreased SOFA scores and CT severity indices post-surgery, indicating effectiveness. Notably, […]
Ethylene oxide sterilization proves superior for contaminated endoscopes
A study evaluated the efficacy of two reprocessing methods for endoscopes used in pancreatic encapsulated necrosis with multidrug-resistant infections. The pass rate for endoscopes sterilized with ethylene oxide reached 100%, significantly higher than the 61.54% for those using peracetic acid. Microbiological cultures revealed common multidrug-resistant bacteria, including Pseudomonas aeruginosa. The findings underscore the necessity of […]
Improving adherence to antithrombotic management in endoscopy
A review highlights that inconsistent adherence to guidelines for peri-endoscopic management of antithrombotic agents poses significant challenges. Identified barriers include insufficient education, delayed updates, and unclear responsibilities. Strategies proposed for improvement encompass enhanced education for healthcare providers and patients, digital clinical decision tools, unified management teams, and international collaboration. These initiatives aim to reduce discrepancies […]