Standardizing process in acute biliary disease, researchers identified modifiable factors impacting patients’ time to theater, intraoperative time, and time to discharge. Implementing a perioperative management protocol based on imaging selection, operative grade identification, and drain placement could lead to significant cost savings and improved patient outcomes. Journal Article by Tranter-Entwistle I, Eglinton T and Connor […]
Author: STITCHES Newsletter
Effectiveness of Hyperthermic Intraperitoneal Chemotherapy in Gastric Cancer
A meta-analysis of 16 randomized controlled trials with 1,641 patients assessed the efficacy of hyperthermic intraperitoneal chemotherapy (HIPEC) for treating and preventing peritoneal carcinomatosis in advanced gastric cancer. Surgery plus HIPEC improved overall survival in both prophylactic (HR 0.56) and therapeutic (HR 0.57) settings, with a 3-year mortality rate of 32% for the prophylactic HIPEC […]
Association Between Social Vulnerability and Outpatient Management of Symptomatic Cholelithiasis
Patients with symptomatic cholelithiasis from vulnerable regions are more likely to fail outpatient management, leading to recurrent ED visits. Socially vulnerable status, especially in terms of socioeconomic and minority groups, significantly increases the odds of management failure. Timely follow-up and elective cholecystectomy can help reduce overutilization of ED resources for these patients. Journal Article by […]
Long-term Efficacy of Imatinib Combined with Hepatic Resection for GIST Liver Metastases
Imatinib combined with hepatic resection significantly improves overall survival in patients with gastrointestinal stromal tumor liver metastases compared to imatinib monotherapy. Achieving no evidence of disease status through surgical intervention leads to prolonged overall survival, liver-specific progression-free survival, and progression-free survival. Age ≤60 years and combination therapy were independently associated with better outcomes. Journal Article […]
Computed Tomography Radiogenomics: Predicting Molecular Subtypes in Gastric Stromal Tumors
A combined model integrating clinical and contrast-enhanced computed tomography (CE-CT) features accurately predicts specific genetic mutations in gastrointestinal stromal tumors (GISTs). Researchers developed three models from data from 231 GIST patients, with the best model achieving high accuracy in predicting molecular subtypes. In the training cohort, the area under the curve (AUC) values indicated significant […]
Effect of Compression Time on Postoperative Complications in Stapled Hemorrhoidopexy
Longer compression time (2 minutes) before stapler firing in staple hemorrhoidopexy resulted in decreased postoperative bleeding compared to typical compression time (30 seconds). Typical compression time was associated with higher rates of bleeding, additional procedures, and fecal urgency. No significant differences were found in dehiscence and stenosis rates between the groups. Journal Article by Yoo […]
Factors Influencing Variation in Postoperative Opioid Prescribing
Prescribing variation after surgery is largely influenced by prescriber-level factors, with a significant proportion of unwarranted variation in opioid quantities identified. Unwarranted covariates associated with higher opioid quantities include race, insurance status, smoking history, discharge times, and prescriber type. Targeting prescribers through education and training may effectively reduce excessive postoperative opioid prescribing practices. Journal Article […]
Benefit of Surgical Cytoreduction for Patients with Small Intestinal Neuroendocrine Tumors Metastatic to the Liver and Peritoneum
Complete cytoreduction can significantly improve survival and relieve symptoms in patients with small intestinal neuroendocrine tumors metastatic to the liver and peritoneum. Despite initial controversies, achieving complete cytoreduction yielded comparable outcomes in patients with isolated liver metastases and those with liver and peritoneal metastases. Aggressive surgical cytoreduction should be considered even in the presence of […]
Whole Blood Hemostatic Resuscitation in Geriatric Trauma: Impact on Mortality
A nationwide study examined the impact of whole blood (WB) hemostatic resuscitation on geriatric trauma patients with severe hemorrhagic shock. Among 1,194 patients identified, 141 (12%) received WB in addition to component therapy (CT). Multivariable analysis revealed that WB use was associated with reduced 24-hour mortality (odds ratio 0.62, 95% CI 0.41-0.94, p = 0.024) […]
Management of Recurrent Laryngeal Nerve Infiltrated by Thyroid Carcinoma
Novel intraoperative phonosurgical management significantly improved voice quality post-surgery in patients with thyroid carcinoma infiltrating the recurrent laryngeal nerve. Resection and arytenoid adduction for medullary thyroid cancer, resection and ansa cervicalis-to-rln anastomosis for well-differentiated thyroid cancer with preoperative paralysis, and rln preservation for patients with normal vocal fold mobility showed promising outcomes. Journal Article by […]