Meticulous closure of mesenteric defects during laparoscopic Roux-en-Y gastric bypass significantly reduces the risk of internal hernia, particularly at the jejunojejunostomy and Petersen defects. Improvements in closure techniques led to a notable decrease in internal hernia incidence over time, with the most effective method involving non-absorbable sutures and an additional purse-string suture. Clinicians should maintain […]
Author: STITCHES Newsletter
High Recurrence Rate and Poorer Disease-Free Survival Predictors after Pancreatectomy for Pancreatic Neuroendocrine Tumours
Patients with pancreatic neuroendocrine tumors face a 20% risk of disease recurrence or metastasis post-pancreatectomy, with prognostic factors like larger tumor size, high ki-67 index, perineural invasion, and node-positive disease significantly impacting disease-free survival. Non-functional tumors are more prevalent, with 2-year and 5-year disease-free survival rates at 82% and 76%, respectively. Identifying these predictors can […]
Minimally Invasive Surgery for Gastric GIST Resections
Minimally invasive surgery for gastric gastrointestinal stromal tumour (GIST) resections showed increased utilization and improved perioperative outcomes over time. Complication rates decreased, duration of admission and operating time shortened, while the composite measure of textbook outcome (TO) increased. Minimally invasive surgery was associated with fewer complications, shorter hospital stays, and higher TO rates, with low […]
Patients’ Preferences for Metabolic Bariatric Surgery
Patients with obesity overwhelmingly prefer metabolic bariatric surgery (MBS) options that offer significant weight loss without recurrence, no risk of complications, and minimal adverse effects. Two main patient groups emerged: those prioritizing weight loss and those prioritizing avoidance of complications. Attributes like out-of-pocket costs and resolution of medical conditions were deemed less critical. Understanding these […]
Skin-Only Closure Outperforms Bogota Bag in Achieving Fascial Closure
Skin-only closure (SC) showed significantly higher rates of primary fascial closure (PFC) compared to Bogota bag closure (BBC) in patients with peritonitis or abdominal trauma undergoing temporary abdominal closure (TAC). SC patients had lower rates of fascial dehiscence and wound infections. Multivariate analysis confirmed SC’s superiority in achieving PFC. Further studies are needed to confirm […]
Development of a Risk Score for Carcinoma Gallbladder in Patients with Suspicious Lesions
Among cancers, carcinoma gallbladder presents a poor prognosis. A study developed a risk score based on key clinical and imaging factors to predict malignancy in patients with suspicious gallbladder lesions. The model demonstrated a sensitivity of 78% and specificity of 70.4%, aiding in early identification and referral of high-risk patients. Prospective validation is warranted to […]
Improved Operating Room Communication through Standardized Handoff
Implementing a standardized handoff protocol for surgical technicians in the operating room significantly improved communication during staff changes. The pilot study showed a substantial increase in the completion of critical handoff elements, with 100% of observed cases including handoffs and addressing all elements 99.6% of the time. The use of a communication checklist acronym, SHRIMPS, […]
Strong Prognostic Indicator for Colorectal Cancer
Combining C-reactive protein-to-albumin ratio and comprehensive risk score is independently associated with better overall and recurrence-free survival in colorectal cancer patients across all disease stages. The combined score outperforms individual risk factors, offering a potent prognostic tool for patient management post-surgery, with potential implications for clinical practice. Journal Article by Kato Y, Shigeta K (…) […]
Minimally Invasive Liver Surgery on the Rise in France
Minimally invasive liver surgery (MILS) has doubled in incidence from 2013 to 2022, now representing 25.2% of liver resections in France. Major liver resections, primary, and secondary malignant tumors show the highest annual increases. University hospitals and high-volume centers are leading the adoption of MILS. Conversely, open liver surgery rates are decreasing across all indications […]
Continuous Vital Sign Monitoring Improves Early Complication Diagnosis
Patients undergoing major oncological abdominal surgery can benefit from continuous vital sign monitoring using wireless patches, which detected clinical deterioration earlier than nurse measurements. Among 227 patients, 22% experienced complications, with discrepancies in measurements largely due to respiratory rate. The sensium® patch identified elevated respiratory and heart rates earlier than nurses within the first postoperative […]