Virtual Scale Endoscopy (VSE) significantly enhances accuracy in colorectal polyp size measurement, improving surgical decisions and patient outcomes. VSE improved measurement accuracy by 14.5% compared to visual assessment. Reduced total misclassifications from 73.6% to 54.3% with VSE. This suggests VSE could be crucial for better polypectomy and surveillance decisions. VSE also minimized overestimation rates from […]
Author: STITCHES Newsletter
Guidelines Favor taTME Over Laparoscopic Techniques for Rectal Cancer
taTME offers a preferred option for treating low- and selected mid-rectal cancers in appropriate surgical settings. Strong recommendation for taTME over laparoscopic TME (latme) for sphincter-preserving cases. High-risk patients, especially males with BMI > 30, may benefit most from this approach. Surgeons should consider expertise and high-volume centers when making treatment decisions. Shared decision-making with […]
Efficacy of Extended D2 Lymphadenectomy in Gastric Cancer
Extended D2 lymphadenectomy (D2+) improves outcomes in specific gastric cancer cases. Metastatic rates are 8% for stations 12b/12p and 13, and 7% for 14v, with therapeutic value indices (TVI) of 2.6, 2.4, and 3.9, respectively. Patients with duodenal invasion show significantly higher TVIs: 3.9 (12b/12p), 3.8 (13), and 9.0 (14v) compared to those without. Consider […]
Minimally Invasive Surgery Gains Ground in Pancreatic Cancer
Minimally invasive surgery (MIS) is being validated for pancreatic cancer, impacting how surgeons approach patient selection and procedures. 22 out of 28 statements on MIS received over 90% expert agreement, enhancing surgical guidance. The consensus includes recommendations for left pancreatectomy, pancreatoduodenectomy, and total pancreatectomy tailored for cancer. Surgeons can adopt these evidence-based practices to improve […]
Elra Improves Survival in Hepatic Echinococcosis with CTPV
Elra, or ex vivo liver resection and autotransplantation, offers a promising solution for patients with hepatic alveolar echinococcosis facing cavernous transformation of the portal vein. No intraoperative mortality in both treatment groups; 90-day mortality was 16.7%. Long-term survival for CTPV patients undergoing elra was 72.9%, compared to 29.6% for those treated conservatively. The data supports […]
New Criteria for Surgical Resection in Advanced Pancreatic Cancer
Surgeons can now better assess resectability in pancreatic cancer by focusing on specific vascular targets. Introducing a clear definition: “suitable target” vessels determine anatomic resectability, improving clarity in patient selection. Emphasizes the importance of 3D CT imaging and intraoperative assessment of vascular isolation for successful reconstruction. Adopting this approach enhances surgical eligibility evaluations and has […]
Watch-and-wait safe for rectal tumors beyond exam reach
Watch-and-wait management is viable for rectal cancers not palpable on exam, keeping patient outcomes comparable. 3-year local regrowth-free survival rates: 81.4% for palpable vs. 74.3% for nonpalpable tumors. 3-year disease-free survival rates: 80.8% for palpable vs. 74.3% for nonpalpable tumors. Surgeons can confidently consider watch-and-wait for these cases without compromising efficacy. Initial clinical responses don’t […]
New Guidelines for Splanchnic Venous Thrombosis Post-Splenectomy
Splanchnic venous thrombosis is a critical yet often overlooked risk after splenectomy in hematologic patients. Incidence is 11.4%, rising to 20.7% with routine imaging and 15.1% in single-center studies. Major risk factors include splenic size and weight; age, BMI, and platelet count were not significant. Patients with myeloproliferative neoplasms, lymphoma, and thalassemia face the highest […]
Uncut Roux-en-Y Outperforms Billroth in Gastrectomy Recovery
Uncut Roux-en-Y significantly reduces bile reflux and enhances quality of life post-distal gastrectomy for gastric cancer. Bile reflux incidence at 3 months: uncut R-Y (6.8%) vs. Billroth-II (77.6%) and Billroth II Braun (63.6%), p < 0.001. Results held at 12 months: 10.5% for uncut R-Y compared to 86% for Billroth-II and 67.9% for Billroth II […]
Enhancing Laparoscopic Cholecystectomy Safety with Ultrasound
Intraoperative ultrasound significantly improves safety during complex laparoscopic cholecystectomy. Intraoperative ultrasound reduced intraoperative iatrogenic rupture from 17.11% to 3.95% (p = 0.017). It improved differentiation between cystic duct stones and adhered structures. Integrating ultrasound with the modified gallbladder reporting and data system enhances decision-making, especially in higher-risk cases. The rate of atypical hyperplasia increased significantly […]