Evidence-based perioperative blood management strategies significantly enhance patient outcomes by addressing anemia and minimizing blood loss. Early identification and correction of anemia lead to fewer transfusions, reduced complications, and improved patient safety. Both liberal and restrictive transfusion thresholds are evaluated, emphasizing the importance of tailored approaches based on patient conditions. Real-time clotting analysis techniques enable […]
Author: STITCHES Newsletter
Endoflip improves outcomes in achalasia treatment.
A systematic review and meta-analysis of 32 studies involving 2,681 patients found that the endoscopic functional luminal imaging probe (endoflip) significantly reduced the distensibility index (DI) following myotomy, with a mean difference of -3.72. Additionally, the Eckardt score, a measure of treatment effectiveness, decreased by an average of -5.21. These findings highlight endoflip’s role in […]
Endoscopist performance outweighs high-risk polyps in colorectal cancer risk
The study reveals that the risk of post-colonoscopy colorectal cancer (PCCRC) primarily hinges on endoscopist performance rather than the presence of high-risk polyps. An analysis of data from 239,217 individuals found no significant association between high-risk polyps and PCCRC risk. Instead, higher adenoma detection rates (ADR) and proximal serrated polyp detection rates (PSPDR) correlated with […]
A new system improves management of complex Crohn’s disease
A novel classification for ileocolic Crohn’s disease revealed that 56.8% of patients exhibit complex cases, linked to higher blood loss, prolonged hospital stays, and increased need for open surgery. Complex cases also experienced more emergencies and worse surgical outcomes compared to simpler forms. The classification system aims to enhance preoperative planning and communication among health […]
Machine-learning model accurately predicts gallbladder polyp malignancy
A novel machine-learning model, particularly the random forest algorithm, distinguishes between benign and malignant gallbladder polyps, utilizing clinical and ultrasound data from 1,050 patients. Key predictive factors identified include polyp size, age, fibrinogen levels, and presence of stones. The model achieved impressive performance metrics with area under the curve values ranging from 0.940 to 0.963 […]
Systemic indocyanine green lowers bilirubin levels post-liver surgery
A clinical trial involving 84 liver surgery patients revealed that systemic administration of indocyanine green (ICG) significantly reduced total bilirubin concentration in postoperative drainage fluid, compared to historical controls. On postoperative day three, the intervention group showed a mean difference of -1.11 mg/dl (p
Prehabilitation improves outcomes in gastrointestinal cancer surgeries
A systematic review reveals that multimodal prehabilitation programs significantly enhance functional capacity and reduce postoperative complications for patients undergoing major gastrointestinal cancer surgeries. These programs lead to shorter hospital stays and improved recovery, particularly in colorectal surgeries. However, the efficacy varies by cancer type, and while inpatient programs yield better results, they also incur higher […]
Feedback intervention boosts adherence to opioid prescribing guidelines
A study found that providing surgical clinicians with monthly feedback featuring peer comparisons and patient-reported outcomes significantly improved adherence to opioid prescribing guidelines from 57.2% to 71.8%. Following the intervention, adherence rates continued to rise, reaching 74.4% at follow-up. Notably, the greatest improvements occurred in orthopedic surgeries, such as knee, hip, and shoulder arthroplasties. Importantly, […]
A machine learning model predicts anastomotic leakage after surgery
An advanced interpretable machine learning model, based on the XGBoost algorithm, shows promising results in predicting anastomotic leakage (AL) following rectal cancer resection. Utilizing data from multiple centers, the model achieved an AUC of 0.984 in the test set, with high accuracy, sensitivity, and specificity. Serum calcium ion levels emerged as a critical predictor. This […]
AI model enhances diagnosis of anal injuries
A novel convolutional neural network (CNN) algorithm for endoanal ultrasound (EUS) efficiently distinguishes between benign anal injuries, notably achieving 100% accuracy for fissures. In assessing external and internal lacerations, the model demonstrated 82.5% sensitivity and 93.5% specificity, alongside 91.7% sensitivity and 85.9% specificity, respectively. This groundbreaking AI-assisted approach could significantly enhance diagnostic accuracy in proctology, […]