Laparoscopic Nissen fundoplication shows strong long-term effectiveness for GERD with high patient satisfaction over 10 years. Heartburn prevalence dropped from 94% to 34% post-surgery. Overall patient satisfaction reached 87%, with 87% willing to repeat the procedure. Consider LNF for candidates seeking durable symptom relief, keeping in mind potential for gas-bloating and dysphagia in over half […]
Author: STITCHES Newsletter
Predicting Recurrence in Lymph Node-Negative Pancreatic Tumors
A new risk score for lymph node-negative pancreatic neuroendocrine tumors helps identify patients at risk for recurrence and guides postoperative surveillance. Recurrence rate for lymph node-negative patients was 10.6%, occurring at a median of 32.4 months post-surgery. Risk factors included male sex (2.2x), tumor size ≥3 cm (2.64x), grade 2 or higher (3.70x), and lymphovascular […]
Disparities Impact Pancreatic Cancer Outcomes
Multimodal treatment disparities in pancreatic cancer significantly affect patient survival and care. 8,466 patients analyzed; nonmetastatic cases had higher therapy rates than metastatic. Non-Hispanic black patients experienced longer delays to treatment compared to non-Hispanic whites. Uninsured and Medicaid patients showed the highest odds of not receiving therapy in metastatic cases. Primary resection strongly predicts improved […]
Predicting Pancreatic Fistula Risk with Elastography
Pre-operative shear wave elastography can effectively predict the risk of post-operative pancreatic fistula (POPF) after partial pancreatectomy, impacting surgical decision-making. In a study of 305 patients, lower elastography measurements correlated with a higher risk of POPF. An integrated prediction model using elastography, BMI, and pancreatic duct dilation accurately assessed POPF risk with AUC values over […]
Conversion Resection Improves Outcomes in Intermediate-Stage HCC
Preoperative conversion therapy significantly enhances surgical outcomes for intermediate-stage hepatocellular carcinoma. 23.2% of patients in the conversion resection group achieved a complete pathological response. Microvascular invasion rates were lower in the conversion group (17.9% vs. 58.6% in direct resection). Consider conversion therapy to improve pathology and survival before resection in select patients. 51.8% of the […]
Outcomes for Retroperitoneal Sarcoma Patients Improve Significantly
Recent management of primary retroperitoneal sarcomas shows improved survival rates over time. 5-year overall survival increased from 61.7% (2002-2011) to 78.8% (2012-2021). Distant metastases rates decreased in the recent cohort (HR 1.50). These findings influence patient selection and highlight the need to adopt newer treatment strategies to enhance outcomes. 30-month post-recurrence survival rose dramatically from […]
AI Enhances Predictions for Oesophagectomy Outcomes
Using explainable AI, we can significantly improve predictions for 90-day mortality and anastomotic leakage after oesophagectomy. The 90-day mortality rate was 6.0%, with anastomotic leakage at 12.4%. Explainable AI achieved an AUC of 0.95 for predicting mortality, compared to 0.88 for traditional methods. This technology allows for personalized risk assessments, improving decision-making for surgical candidates. […]
Revisiting Resection Criteria for Hepatocellular Carcinoma
Tumor markers may improve patient selection for liver resection in HCC. In a study of 803 patients, 32.3% of resectable tumors had high tumor markers (AFP > 500 ng/ml or DCP > 1000 mau/ml). TM-high patients had a median survival of 120.7 months, significantly lower than non-TM-high patients at 160.8 months (p = 0.008). Incorporating […]
New Prognostic Model for Pancreatic Cancer Outcomes
A novel risk model using stress granule-related gene signatures (sgrgs) shows promise for improving prognostic accuracy in pancreatic ductal adenocarcinoma (PDAC). Four key sgrgs (lama3, itga6, col17a1, top2a) were identified as significant predictors of PDAC prognosis. A nomogram combining age, N stage, and risk score demonstrated strong predictive capacity. Understanding these markers can enhance patient […]
Colorectal Cancer Burden Rising in East Asia: Key Trends and Projections
Colorectal cancer (CRC) incidence and mortality are sharply increasing in East Asia, necessitating targeted surgical interventions and screening. South Korea leads with a 5.29% annual increase in CRC incidence, followed by China at 4.11%. Projections indicate a continued rise in China by 2050, while South Korea’s incidence stabilizes and Japan’s growth slows. Males, particularly in […]