Same-day discharge for bariatric surgery increased from 2.4% to 7.4% between 2016 and 2021. Black race, history of MI, renal insufficiency, DVT, and smoking were associated with higher complications. Roux-en-Y had a 72% higher risk than sleeve gastrectomy. While overall major complications were lower, there were significantly more deaths, cardiac arrests, and cases of dehydration […]
Author: STITCHES Newsletter
Optimal Management Strategy for Patients with Paraesophageal Hernia
Updated Markov model shows elective laparoscopic hernia repair increases life-years in individuals with paraesophageal hernia symptoms and Cameron lesions. Comorbid conditions impact life expectancy but do not change the preference for surgery over watchful waiting in most cases, except for the elderly without Cameron lesions. Individualized guidance for management of paraesophageal hernia patients can be […]
Comparing Liver Transplant and Liver Resection for Multifocal Hepatocellular Carcinoma
Liver transplant (LT) was associated with improved long-term survival compared to liver resection (LR) in patients with multifocal hepatocellular carcinoma (MHCC). Factors such as race, insurance status, and treatment facility influenced the likelihood of receiving LT. This study highlights the clinical and sociodemographic disparities between LT and LR patients, emphasizing the lower mortality risk associated […]
Analysis of Learning Curve in Robotic Hepatectomies
Analysis of 500 robotic hepatectomies revealed significant number of cases needed to achieve mastery in minor, major, and technically challenging resections. Surgeons can utilize this data to enhance patient safety and outcomes, providing valuable insights for those gaining experience in robotic hepatectomies. The findings highlight the importance of overcoming specific learning curves to achieve long-term […]
Improved Recurrence Surveillance with Personalized Circulating Tumor DNA Monitoring
Personalized circulating tumor DNA monitoring using a tumor-informed assay significantly improves recurrence surveillance and management in patients with colorectal liver metastases. Detectable ctDNA at specific time points post-surgery is associated with higher recurrence risk, serving as an independent prognostic marker. Longitudinal ctDNA analysis accurately predicts relapse, leading to increased secondary resection rates and improved outcomes. […]
Comparing Oxycodone and Sufentanil for Postoperative Pain Management
Patients undergoing laparoscopic gallbladder-preserving cholecystolithotomy were divided into oxycodone and sufentanil groups. Oxycodone group showed lower pain scores postoperatively, indicating better analgesic effects and reduced inflammatory responses compared to sufentanil group. This prospective randomized controlled trial highlights the superior postoperative analgesia induced by oxycodone in this patient population, as well as its potential to minimize […]
Impact of Resection Margin on Survival in Colorectal Liver Metastasis
Resection margin width significantly influences overall survival post liver resection for colorectal liver metastasis. A cohort study of 754 patients revealed poorer survival with margins of 0-0.9mm compared to ≥1mm, even in the era of modern chemotherapy. Narrow margins (
Comparison of D2 lymphadenectomy vs. D2 lymphadenectomy + complete mesogastric excision in gastric cancer
Adding complete mesogastric excision to D2 lymphadenectomy for gastric cancer improves 3-year disease-free survival without significant difference in overall survival rates. Recurrence rates were lower in the complete mesogastric excision group. This finding suggests potential benefits of the combined approach for better outcomes in advanced gastric cancer patients. Comparative Study by Xie D, Shen J […]
Arterial Divestment Techniques for Locally Advanced Pancreatic Cancer
Utilizing periarterial and sub-adventitial divestment alongside the triangle operation and RAMPS, researchers achieved R0 resection in locally advanced pancreatic body cancer without compromising oncologic outcomes. The technique, demonstrated in a multimedia article, provides an alternative to morbid arterial resection, ensuring optimal tumor clearance and preserving patient outcomes. Journal Article by Kumar NAN, Palod A, Usman […]
Enhancing HIPEC Efficacy with Bromelain in Appendiceal Cancer
Bromelain enhances cytotoxicity and mucolytic activity in appendiceal cancer tumors, reducing mucin production and increasing drug effectiveness in heated intraperitoneal chemotherapy (HIPEC) treatments. Combined with N-acetylcysteine, bromelain significantly reduces mucin levels and boosts cell death pathways like apoptosis and autophagy. These findings suggest a promising role for bromelain as a potent pretreatment agent in augmenting […]