Surgically resected early-onset pancreatic cancer shows worse outcomes and aggressive molecular features compared to late-onset cases. Patients under 50 had a median disease-free survival of 10.9 months versus 14.2 months for those 50 and older (p = 0.011). More young patients received adjuvant chemotherapy, yet their disease-free survival was shorter at 12.6 months vs. 16.0 […]
Author: STITCHES Newsletter
Rare Pancreaticoduodenectomy in Situs Inversus Done Safely
Pancreaticoduodenectomy is feasible in patients with complete situs inversus, ensuring oncologic principles are upheld. Complete R0 resection achieved in a 68-year-old with pancreatic adenocarcinoma. Complicated course included grade II adverse events with a 16-day hospital stay. Surgeons should prioritize meticulous preoperative planning and adapt intraoperatively to unique anatomical variations. Final pathology revealed high-stage disease with […]
Protocol CT Scans Improve Detection in Pancreatic Fistula Patients
Early protocol CT scans in high-risk patients after pancreatoduodenectomy increase detection of complications but don’t improve overall outcomes. In a prospective cohort, 76.7% of asymptomatic patients received CT scans by day 4 versus day 8 in historical controls. Abnormal findings were noted in 73.9% of scans, leading to timely intervention in 6 patients. Despite increased […]
Postdischarge risks in nonoperative diverticulitis care
Nonoperative management of complicated diverticulitis significantly increases readmission risks. 33.9% of nonoperatively managed patients were readmitted due to recurrence, compared to just 4.8% of those who underwent surgery. Nonoperatively managed patients had 9-fold higher odds of readmission and were 3 times more likely to need surgery upon readmission. Surgeons should carefully consider the need for […]
Adjuvant Radiation Therapy Boosts Survival in Early Anal Cancer
Patients with T1-2 N0 anal squamous cell carcinoma benefit significantly from adjuvant radiation therapy after local excision. Five-year overall survival rates were 82.8% with radiation versus 74.9% without (p < .001). The benefit was especially marked in those with positive surgical margins (79.9% vs 67.2%; p = .003) and in women ≥65 years (85.8% vs […]
NAPRC Accreditation Increases Rectal Cancer Patient Volume
Accreditation for rectal cancer is linked to higher patient volumes and early-stage procedures. Naprc-accredited hospitals saw an annual increase of 4.3 rectal cancer patients per institution. Accreditation boosted stage I procedure volume, with a gain of 1.01 procedures (p=0.05). Improving accreditation may support institutional growth without sacrificing care quality. Care fragmentation remained unchanged, indicating continuity […]
Enhanced Dissection Technique in Robotic Pancreaticoduodenectomy
A new standardized robotic dissection technique for the celiac axis and hepatic artery shows promise for safer, more precise pancreatic surgery. Successfully performed level 1 to level 3 dissection with no intraoperative arterial injury. Utilized advanced imaging for stable magnified visualization, improving safety during intricate dissections. This approach supports consistent oncological principles in robotic procedures. […]
Understanding Prognosis for Esophageal Basaloid Carcinoma
A study of 803 patients shows esophageal basaloid squamous cell carcinoma (EBSCC) has a similar overall survival to conventional esophageal squamous cell carcinoma (ESCC) post-surgery, despite unique challenges. Only 4.1% of patients had EBSCC; neoadjuvant chemotherapy response was poor—0% pathologic response > grade 2 vs. 27.8% for ESCC. Recurrence rates: 33.3% for EBSCC vs. 28.3% […]
Rare Gallbladder Neoplasm: High Dysplasia Rates Found
Intracholecystic papillary neoplasms (ICPNs) are infrequent but significant preinvasive lesions associated with high-grade dysplasia and carcinoma. The pooled incidence of ICPNs is 1.5% in cholecystectomy cases. High-grade dysplasia occurs in 35.4% of ICPN lesions; 26.9% have concurrent adenocarcinoma. Lymph node metastases found in 18% of invasive cases, with 5-year survival rates varying from 46.7% to […]
Surgeons Should Rethink Approach for Anal SCC Surgery
Local excision offers better survival than abdominoperineal resection for anal squamous cell carcinoma post-chemoradiotherapy. 5-year overall survival: 75% for local excision vs. 46.1% for abdominoperineal resection (p < .001). Local excision had lower 90-day mortality (0.9% vs. 5.1%, p < .001) and lower 30-day readmission rates (1.5% vs. 7.7%, p < .001). Despite more positive […]