Researchers found that negative pressure wound therapy (NPWT) can significantly reduce surgical site infections (SSIs) after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). A study of 178 patients showed lower SSI rates with NPWT (5.6%) compared to standard surgical dressing (11.4%). Multivariate analysis confirmed that NPWT was associated with a significantly lower risk of […]
Author: STITCHES Newsletter
Challenges and Approaches in Treating Intraductal Papillary Neoplasms
Researchers discuss current strategies and challenges in diagnosing and treating intraductal papillary neoplasms (IPNs) of the bile duct and pancreatic duct, which are precursors to pancreatic cancer and cholangiocarcinoma. Modern imaging, biomarkers, and molecular tests are aiding in diagnosis, but treatment should be individualized based on risk assessment. Surgical intervention with chemotherapeutic agents is optimal […]
Optimizing Prediction Models for Pancreatic Fistula after Pancreatectomy
Postoperative pancreatic fistula (POPF) is a common complication following pancreatectomy, with over sixty prediction models existing primarily for pancreaticoduodenectomy. However, these models have shown suboptimal accuracy across diverse populations. Future research should focus on developing and validating prediction models for distal and central pancreatectomy, incorporating machine learning and personalized variables. Integration of novel imaging technologies […]
Over-the-Scope Clips Show Higher Success Rates for Bariatric Surgery Leaks
A meta-analysis of five studies found that the pooled proportion of successful closure with over-the-scope clips (OTSC) for leaks and fistulae following bariatric surgery was 81.1% (95% CI 67.3 to 91.7). Observational reports suggest that patients managed with OTSC had higher rates of defect healing compared to those treated with endoscopic suturing. Larger controlled studies […]
Factors influencing paraesophageal hernia recurrence after repair
This study analyzed paraesophageal hernia repairs to identify factors influencing postoperative symptom improvement and radiographic recurrence. Propensity score matching compared initial and reoperative repairs, showing lower symptom improvement rates in reoperations but similar rates of recurrence and complications. Most patients experienced symptom improvement, despite frequent radiographic recurrence, with hernia type, closure technique, fundoplication, and mesh […]
Factors influencing pursuit of academic surgery careers among general surgery residency graduates
17% of general surgery residency graduates pursued academic surgery careers. Factors associated with this choice included graduating from a top-20 program, working with a research mentor, holding an advanced degree, and publishing during residency. Only research productivity during residency predicted early career success. Programs should support trainees’ research efforts to cultivate academic surgeons effectively. Journal […]
Impact of Adjuvant Chemotherapy on Recurrence and Survival for Adenocarcinoma from Intraductal Papillary Mucinous Neoplasia
Adjuvant chemotherapy following resection for adenocarcinoma from intraductal papillary mucinous neoplasia did not show reduced recurrence rates or improved survival outcomes in a multicenter study. Various chemotherapy regimens were not associated with superior outcomes in any high-risk subgroup, indicating that chemotherapy may not influence recurrence patterns or overall survival in these patients over a median […]
Total Neoadjuvant Therapy in Pancreatic Cancer: Undefined and Inconsistent
Researchers examined the concept of total neoadjuvant therapy (TNT) for pancreatic ductal adenocarcinoma (PDAC), finding that the term “total” is not consistently defined. Although it has gained popularity for its promise of comprehensive preoperative treatment, the current understanding and protocols vary widely, with inconsistent therapy durations and approaches. Among 7 studies reviewed, the length of […]
Minimally Invasive Approach Improves Oncological Outcomes for High-Risk Ver Patients with Intrahepatic Cholangiocarcinoma
Minimally invasive surgery for intrahepatic cholangiocarcinoma in patients at high risk of early recurrence provides better disease-free and overall survival compared to open surgery. Laparoscopic approach leads to shorter surgery-adjuvant treatment interval and higher rates of adjuvant therapy initiation within 2 months post-surgery. This study highlights the oncological benefits of laparoscopy in high-risk VER patients. […]
Familial Obesity Linked to Reduced Long-Term Success After Sleeve Gastrectomy
Researchers examined the outcomes of sleeve gastrectomy (SG) in patients with familial aggregation of obesity (FAO) compared to those with sporadic obesity (SO). The study, involving 193 patients, found no significant differences in baseline characteristics or short-term postoperative weight loss between FAO and SO groups. However, by the two-year mark, patients with FAO had a […]