Achievements in textbook outcomes (TO) for pancreatic surgery rose from 47% to 80.7% post-establishment of a specialized unit, indicating better surgical quality. Patients who met TO criteria showed notable overall survival rates at 1, 2, and 3 years: 86.9%, 55.7%, and 41%, compared to 62.7%, 40.3%, and 31.3% for those who did not (p=.013). Multivariate […]
Author: STITCHES Newsletter
Robotic surgery is poised to overtake laparoscopic techniques.
A significant trend toward robotic surgery is evident, especially in urologic procedures and complex surgeries such as hepatectomy and esophagectomy. Despite remaining relevant in colectomy, laparoscopic techniques are declining in most specialties. Open surgery continues to be prevalent, particularly in pancreatic and rectal operations. Projections indicate that by 2026, robotic surgery may surpass laparoscopic approaches […]
Sarcopenia predicts postoperative complications in colorectal cancer surgery
In a study of 387 patients undergoing laparoscopic radical resection for non-metastatic colorectal cancer, 40.31% were identified as sarcopenic. The overall postoperative complication rate reached 32.3%, with serious complications occurring in 12.1% of patients. Sarcopenic patients experienced significantly higher rates of total complications and serious issues, including anastomotic leakage and surgical site infections. Notably, sarcopenia […]
Eight treatments effectively reduce postoperative ileus.
An umbrella review of 24 meta-analyses revealed eight treatments that significantly alleviate postoperative ileus. Chewing gum, coffee, enhanced recovery after surgery (ERAS) protocols, acupuncture, opioid receptor antagonists, da-cheng-qi-tang, early enteral nutrition, and zusanli point injection therapy improved outcomes. Additionally, opioid receptor antagonists, early enteral nutrition, ERAS, and chewing gum notably shortened postoperative hospital stays. However, […]
Surgeons reach consensus on standardized theatre etiquette guidelines
A Delphi study involving 261 surgical professionals from 23 countries established a consensus on 29 statements of theatre etiquette, aimed at enhancing professional conduct and communication in operating environments. This initiative addresses the inconsistencies often seen in training newcomers to surgical teams, including medical students and resident trainees. The guidance developed is intended to serve […]
New Nomogram Enhances Prognostic Accuracy for Liver Cancer Patients
A novel prognostic nomogram was developed to assess cancer-specific survival (CSS) in patients with distant-metastatic hepatocellular carcinoma (dm-hcc). Using data from 651 patients, the model identified key predictors: alpha-fetoprotein levels, tumor grade, T stage, and treatment types. The nomogram achieved a c-index of 0.721 and 0.726 in training and validation sets, respectively, demonstrating strong predictive […]
Neoadjuvant chemotherapy enhances survival rates in colon cancer
Neoadjuvant chemotherapy (NAC) has demonstrated improved five-year overall survival (81.4% versus 77.8%) and disease-free survival (79.2% versus 73.7%) in patients with locally advanced colon cancer compared to upfront surgery followed by adjuvant chemotherapy. Researchers analyzed eight randomized controlled trials involving 3,038 patients, finding NAC to result in better surgical margin outcomes without increasing surgical risks. […]
Digital cholangioscopy is safer than surgery for Mirizzi syndrome
A multicenter study comparing digital single-operator cholangioscopy (DSOC) and surgery for Mirizzi syndrome reveals that despite lower technical success rates, DSOC significantly reduces overall and severe adverse events. Among 290 patients, those undergoing DSOC exhibited fewer complications and lower rates of conversion to open surgery and need for hepaticojejunostomy. These findings suggest that DSOC is […]
Prehabilitation strategies improve outcomes in digestive cancer surgery
A recent network meta-analysis involving 2042 patients indicates that prehabilitation significantly decreases hospital stay and postoperative complications while enhancing functional recovery. Exercise-based prehabilitation outperformed other strategies for minimizing complications and improving walking distance post-surgery. Multimodal approaches also excelled in improving quality of life and alleviating depressive symptoms before surgery. Gastric cancer patients showed marked benefits […]
Apixaban reduces VTE rates compared to enoxaparin in surgery
A study investigating postoperative venous thromboembolism (VTE) prophylaxis in colorectal surgery found that patients receiving apixaban had significantly lower rates of VTE (0.16%) compared to those on enoxaparin (1.29%), with a p-value of 0.023. Despite differences in patient demographics, such as age and operative complexity, the rates of postoperative bleeding were similar between both groups. […]