Subgrading G2 pancreatic neuroendocrine tumors into 2A (Ki67 3% to < 10%) and 2B (10% to ≤ 20%) identifies distinct subsets with different metastasis rates and aggressiveness. G2B cases show significantly higher rates of liver/distant metastasis, lymph node metastasis, and histopathologic signs of aggressiveness compared to G2A. G2B tumors behave similarly to G3, suggesting they […]
Author: STITCHES Newsletter
Circulating Exosomal MicroRNA Panel Predicts Peritoneal Metastasis in Advanced Gastric Cancer
A circulating exosomal microRNA panel, robustly predicting peritoneal metastasis in advanced gastric cancer patients, was developed and validated with remarkable accuracy. The risk-stratification model, combined with currently used tumor markers, significantly outperformed conventional clinical factors in predicting metastasis. This novel liquid biopsy assay shows potential for improved patient selection and management, offering clinical impact in […]
Anatomical variations of the recurrent laryngeal nerve increase risk of vocal cord paralysis in thyroidectomy
Anatomical variations of the recurrent laryngeal nerve (RLN) during thyroidectomy, such as extralaryngeal branching and relation to the inferior thyroid artery (ITA), significantly increase the risk of vocal cord paralysis (VCP). This retrospective study on 1070 neck sides found that extralaryngeal branching nerves had higher VCP rates compared to nonbranching nerves. RLN crossing anteriorly or […]
Robot-assisted Ventral Hernia Repair: Cost-effective with Shorter Stay and Lower Complications
Robot-assisted ventral hernia repair is associated with decreased length of stay and lower complication rates compared with open repair, resulting in a more cost-effective procedure. In a retrospective cohort study, patients undergoing robot-assisted repair had a significantly shorter mean stay of 0.3 days, lower readmission rate of 4%, and lower total procedure cost of 1,094 […]
Laparoscopic segmentectomy using ICG fluorescent navigation shows superior outcomes
Laparoscopic segmentectomy using ICG fluorescence navigation with the negative staining method showed superior outcomes compared to open segmentectomy. Patients who underwent laparoscopic surgery experienced shorter operative times, reduced blood loss, and shorter hospital stays. Additionally, they had significantly fewer grade II and grade III or higher postoperative complications. These findings highlight the precision and safety […]
Higher Lymph Node Yield Improves Survival in Pancreatic Cancer Patients
Increased lymph node yield (LNY) of 22 or more nodes is linked to better overall survival (OS) and longer time to recurrence (TTR) in node-negative pancreatic ductal adenocarcinoma (PDAC) patients receiving neoadjuvant therapy (NAT). This association was observed in two separate patient cohorts, highlighting the importance of LNY in predicting oncologic outcomes and suggesting potential […]
Robotic Pancreatoduodenectomy: Experience Matters
Robotic pancreatoduodenectomy showed decreased complications and increased efficiency with experience, as seen in 150 consecutive patients. Morbidity was lower, mortality rates were comparable, and operative times significantly reduced in the latter half of cases. Higher lymph node resection and more partial portal vein resections were observed in experienced cases. These results emphasize the safety and […]
Robotic Cholecystectomy Proven Safe in UK Training Program
Study of 600 patients shows robotic cholecystectomy in UK training program has low bile duct injury, conversion to open surgery, and need for subtotal cholecystectomy. Majority female, discharged same day with low 30-day readmission rate. Key indications: biliary colic, cholecystitis, gallbladder polyps, pancreatitis. Median stay: 0 days. Findings support safe implementation of robotic cholecystectomy in […]
Improved outcomes seen with upper gastrointestinal specialist surgeons in emergency surgeries
Emergency upper gastrointestinal surgeries show better 30-day and in-hospital mortality outcomes when performed by specialists. A systematic review and meta-analysis of 24 articles found a significant decrease in mortality rates when UGI specialists were involved. Surgeons are advised to consider early subspecialist team involvement for improved patient outcomes. Journal Article by Barbaro A, Bunjo Z […]
Grading Esophageal Perforations Improves Outcome Predictions
Severely graded esophageal perforations (grades I-IV) impact patient survival differently, with grades II-IV showing lower overall survival rates. Factors such as duration of injury >24 hours, presence of mediastinitis, and esophageal necrosis are associated with unfavorable outcomes. Grading severity based on diagnostic CT scans, endoscopic, radiological, and clinical findings helps guide treatment decisions and may […]