Lower preoperative CALLY index indicates worse survival and higher complications in cancer patients undergoing surgery. Each unit decrease in CALLY index increases the risk of overall survival failure by 91% (HR: 1.91, p < 0.001). Patients with low CALLY index had 88% higher recurrence risk (HR: 1.88, p < 0.001) and 151% higher cancer-specific mortality […]
Author: STITCHES Newsletter
Chlorhexidine Outperforms Povidone-Iodine in SSI Prevention
Chlorhexidine is more effective than povidone-iodine for preventing surgical site infections (SSIs), especially in clean-contaminated procedures. Chlorhexidine reduces overall SSI risk by 17% compared to povidone-iodine (risk ratio 0.83). It particularly lowers superficial incisional SSIs, with no significant effect on deep incisional or organ-space infections. Use chlorhexidine for skin preparation to enhance surgical outcomes. The […]
Kangduo Robot Outperforms Laparoscopy in Distal Pancreatectomy
Kangduo robotic distal pancreatectomy is more effective and cost-efficient than traditional laparoscopic surgery. Kangduo patients had lower blood loss and transfusion rates. Reduced operative time and conversion to open surgery rates were noted. This technique leads to similar recovery outcomes while cutting costs. Patients on the Kangduo system also showed a significant decrease in inflammatory […]
Laparoscopic Feeding Jejunostomy Outperforms Open Approach
Laparoscopic feeding jejunostomy (LFJ) offers a safer, less painful alternative to open feeding jejunostomy (OFJ) for patients with upper GI cancers. Major complications were similar (LFJ 10% vs. OFJ 17%, p = 0.472). LFJ had significantly fewer minor complications (26.6% vs. 89.6%, p < 0.001) and reduced post-operative pain. Patients with LFJ started feeds earlier […]
Outcomes from Adrenalectomy in Phaeochromocytoma Patients
Surgical approaches for large phaeochromocytomas matter: minimally invasive techniques reduce severe complications. Patients with tumours ≥ 6 cm faced significantly higher severe complication rates (11.2% vs. 4.8%; p < 0.001). Tumour size ≥ 6 cm is an independent predictor of complications (odds ratio 1.93; p < 0.001). Choosing laparoscopic or robotic adrenalectomy for large tumours […]
Histotripsy Shows Promise for Liver Tumor Control
Histotripsy, a novel noninvasive ultrasound technique, demonstrated effective tumor control in liver cancer treatments. 70% of patients treated with curative intent achieved nonviable tumors at 30 and 90 days. Complications were rare, with only 1% classified as significant. Targeting accuracy remains critical; improvements are expected as surgeons gain experience. 75% of treatments aimed for complete […]
Robotic Crush and Clip Technique Reduces Complications in Pancreatectomy
The crush and clip technique for pancreatic transection in robotic distal pancreatectomy shows promise for reducing complications. Postoperative pancreatic fistula rates were 13% for crush and clip vs. 26% for stapler (p=0.280). Significant advantage in thick pancreas cases: 6% vs. 47% for crush and clip vs. stapler (p=0.013). This technique eliminates major complications, with none […]
Improved Prognosis for Locally Advanced Rectal Cancer Patients
A new prognostic model combines tumor regression grading and yptnm staging to better predict outcomes in locally advanced rectal cancer after neoadjuvant therapy. The novel trg-yptnm model outperformed the traditional yptnm system in both training (1,046 patients) and validation (354 patients) cohorts. Trg and yptnm are independent prognostic factors, enhancing risk stratification for surgical candidates. […]
Preoperative CRP Levels Predict Difficult Laparoscopic Appendectomy
Elevated preoperative C-reactive protein levels can predict the complexity of laparoscopic appendectomy, aiding in better patient selection. A CRP cut-off of 220 mg/l indicates an 87% sensitivity and 90% specificity for predicting conversion to open surgery. The area under the ROC curve is 0.941, demonstrating strong diagnostic accuracy. This information can guide surgeons in deciding […]
Addressing Ageism in Surgery for Better Outcomes
Surgeons must confront ageism, which can delay vital procedures and worsen outcomes for older adults. Cognitive biases were highlighted in studies involving over 149,000 participants, revealing how they influence surgical decisions. Systemic inequities, such as transplant referral disparities, were noted across studies with over 24,000 participants, affecting resource allocation. Taking action against age-based discrimination can […]