Root cause analysis of mortality after esophagectomy revealed that more than half of deaths were potentially preventable. Factors such as inappropriate indications, patient characteristics, unexpected intraoperative findings, and delays in diagnosing complications were associated with preventable deaths. Following national guidelines and centralizing care may reduce mortality in these cases. Journal Article by Levenson G, Coutrot […]
Author: STITCHES Newsletter
Smaller Gastrojejunostomy Diameters Linked to Enhanced Weight Loss in Laparoscopic Gastric Bypass
Researchers reviewed the impact of gastrojejunostomy (GJ) anastomosis diameter on weight loss outcomes after laparoscopic Roux-en-Y gastric bypass (RYGB). In the systematic review, including six studies with varying GJ diameters and follow-up durations of 1-5 years, smaller GJ diameters generally led to greater short-to-medium-term weight loss. However, complications like stenosis increased with smaller diameters beyond […]
Prognostic Value of Preoperative CALLY Index in Gastric Cancer Patients
The preoperative CALLY index is a valuable prognostic marker for gastric cancer patients, correlating with clinicopathological factors, overall and disease-free survival, and postoperative complications. A low preoperative CALLY index was significantly associated with advanced disease stages and independently predicted poorer outcomes. This index shows promise for guiding perioperative and oncological management in this patient population. […]
Feasibility and Safety of Highly Complex Liver Resections
Highly complex liver resections (HCLR) can be performed with an acceptable complication profile, similar to major non-HCLR procedures. However, HCLR is associated with increased rates of biliary complications, readmissions, and reoperations. No postoperative 90-day mortality was observed in the HCLR group. Tertiary hepato-pancreato-biliary centers should be considered for cases of questionable resectability. Journal Article by […]
Management of Infected Collections in Acute Pancreatitis: To Drain or Not Drain?
Recent literature advocates for delaying catheter drainage in acute pancreatitis, but critically ill patients with severe disease and infected peri-pancreatic collections may still benefit from drainage procedures. A retrospective review of 72 patients showed high rates of ICU admission, respiratory and renal failure, and in-hospital mortality. Until more research is done, drainage should continue to […]
Laparoscopic Liver Resection VS Radiofrequency Ablation for Small Hepatocellular Carcinoma
Patients with small hepatocellular carcinoma showed similar overall and recurrence-free survival rates whether treated with laparoscopic liver resection or radiofrequency ablation. This randomized clinical trial suggests that percutaneous radiofrequency ablation may offer comparable therapeutic effects to laparoscopic liver resection for this patient population. Journal Article by Song J, Cao L (…) Zheng S et 4 […]
Low Morbidity and High Survival with Surgical Microwave Ablation for Colorectal Liver Metastasis
Researchers conducted a retrospective review of 394 microwave ablation (MWA) procedures on 328 patients with colorectal liver metastasis. The study found a low morbidity rate, with Clavien-Dindo grade III or IV complications occurring in 3.6% of patients, all of whom had concomitant procedures. Incomplete ablation and local recurrence rates were 1.5% and 6.3% per tumor, […]
Regional Metastasis Worsens Survival in Nonfunctional Pancreatic Neuroendocrine Tumors
Lymph node metastasis (LNM) in nonfunctional pancreatic neuroendocrine tumors (NF-PNET) has a negative impact on disease-free survival (DFS) and overall survival (OS). In a systematic review of 52 studies involving 24,608 PNET cases, reported LNM rates for NF-PNET ranged from 7% to 64%, with higher rates in tumors >2 cm. Additionally, 66% of the studies […]
CA19-9 and DUPAN-2 Combination Identifies Early-Stage Pancreatic Adenocarcinoma
Patients with pancreatic ductal adenocarcinoma (PDAC) and normal levels of CA19-9 and DUPAN-2 are more likely to have resectable and early-stage cancer. In a study of 521 patients, those with normal CA19-9 and DUPAN-2 had a significantly higher proportion of resectable PDAC (71.5%) and a 5-year survival rate of 66.0%, much better than other groups […]
Minimally Invasive Surgery Conversion Provides Survival Benefit in Colon Cancer
Conversion from minimally invasive surgery to open surgery in colon cancer patients resulted in higher overall survival compared to upfront laparotomy. This survival advantage was particularly notable in patients over 65 years old, those with significant comorbidities, and individuals with left-sided tumors. Minimally invasive surgery should be favored in the absence of contraindications for patients […]