In a cohort of 769 hepatocellular carcinoma survivors, 21.6% experienced late recurrence post-treatment. Key findings showed that patients with late recurrence exhibited a higher fib-4 index (median 2.31) and a tendency toward microvascular invasion. Both factors were independently associated with worse recurrence-free survival (RFS). Patients identified as high-risk had a two-fold increase in recurrence hazard […]
Author: STITCHES Newsletter
Nonadherence to Antibiotic Guidelines Results in Waste and Costs
A retrospective analysis revealed that 92% of patients undergoing certain elective surgeries received unnecessary prophylactic antibiotics, despite guidelines recommending against their use. This nonadherence resulted in an estimated financial waste of US$3,279 and significant environmental impact, as 94% of the cases were classified as clean. Cefazolin was the most commonly administered antibiotic. The findings underscore […]
Modified approach slashes costs and carbon footprint in surgery
A modified step-up approach to elective laparoscopic cholecystectomy yielded notable reductions in surgical consumables, achieving a 51.9% decrease in weight, a 50.6% drop in carbon footprint, and a 43.1% cost reduction. Implemented without extending operating time or increasing complications, this strategy highlights an effective method of minimizing waste in surgical practices. Patients treated with this […]
Histopathological features predict pouch failure in ulcerative colitis patients
A study evaluating 417 patients who underwent ileal pouch-anal anastomosis found a 23% risk of pouch failure over 18 years. Key predictors included post-procedure Crohn’s disease and specific histologic features such as deep chronic inflammation and severe disease activity. Single-cell spatial transcriptomics identified immune cell infiltration and disrupted signaling pathways associated with pouch failure. These […]
Updated guidelines improve coagulation management in trauma care
A systematic review has led to updated clinical guidelines for inhospital coagulation management and fluid replacement therapy in patients with severe injuries. Key recommendations stress the importance of early interventions for trauma-induced coagulopathy and the use of viscoelastic assays to guide treatment. Notably, tranexamic acid should not be universally applied in emergency situations, as only […]
Endoscopic intermuscular dissection shows promise for rectal cancer
A study on endoscopic intermuscular dissection (EID) for deep submucosal invasive rectal cancer (d-smic) reports encouraging three-year outcomes. The procedure achieved a 94.1% en bloc resection and 82.5% R0 resection rates. In low-risk patients under active surveillance, locoregional recurrence rates were low (7%), while intermediate-risk had a 13% rate, all salvageable. Notably, there were no […]
Conversion surgery enhances survival in advanced gastric cancer patients
In a multicenter study of 232 patients with stage IV HER2-positive gastric cancer, conversion surgery following trastuzumab-based chemotherapy and immunotherapy yielded significantly improved outcomes. Patients who underwent the procedure experienced median progression-free survival of 37.7 months and overall survival of 50.9 months. In contrast, those who did not have surgery had progression-free survival of 10.8 […]
Deep learning model enhances 3D segmentation of pancreatic cancer
A newly developed deep learning auto-segmentation model effectively segments pancreatic cancer and surrounding structures to assist surgical planning. In a study involving 275 patients, the model achieved a Dice similarity coefficient of 75.4 in internal and 75.6 in external validation. High segmentation accuracy was noted in the pancreas parenchyma but lower in pancreatic cancer lesions. […]
Continuous glucose monitoring improves recovery in diabetic colorectal cancer patients
Enhanced recovery outcomes for colorectal cancer patients with type 2 diabetes markedly improved through continuous glucose monitoring (CGM). A study involving 181 patients revealed that those under CGM showed lower mean daily glucose levels (9.52 mmol/L) compared to conventional glucose monitoring (10.37 mmol/L) on postoperative day one. The technology significantly enhanced glycemic control and facilitated […]
Endoscopic techniques improve outcomes for biliary leak management
Endoscopic management has emerged as a key strategy for treating biliary leakages resulting from surgery or trauma. Researchers emphasize the importance of accurately classifying leaks to choose appropriate treatments, which range from conservative care to surgical intervention. Notably, endoscopic techniques, especially endoscopic retrograde cholangiopancreatography with sphincterotomy and stent placement, are now favored for accessible leaks, […]