Short MRI protocols demonstrate suitability for surveillance of intraductal papillary mucinous neoplasms (IPMNs). In a retrospective study, protocols with T1-weighted, T2-weighted, MRCP, and DWI sequences show high concordance with clinical decisions for IPMN management. Inter-observer agreement is substantial across different protocols. Short MRI protocols offer efficient surveillance methods for IPMN, facilitating timely and accurate patient […]
Author: STITCHES Newsletter
Comparing Circular Staplers for Colorectal Anastomosis
A systematic review and meta-analysis compared two-row, three-row, and powered circular staplers for colorectal anastomosis. Powered staplers showed significantly lower risk of leakage and anastomotic bleeding, while three-row staplers only reduced leakage risk. Subgroup analysis did not reveal significant differences between the groups. An important finding was the superior risk reduction in leakage with powered […]
Identification of Mesenteric Entry Site as Weak Point in Gastrointestinal Anastomoses
Biomechanical analysis of gastrointestinal anastomoses reveals the mesenteric entry site as a potential weak point, exhibiting significantly higher rates of leakage and bursting compared to other sections. The study underscores the importance of refining surgical techniques to optimize outcomes, particularly in addressing complications like anastomotic leakage, which are associated with increased morbidity and mortality in […]
Disappointing Results of SMART Technique for Parastomal Hernia Repair
The study assesses the Modified Stapled Mesh Stoma Reinforcement Technique (mSMART) for parastomal hernia repair, revealing a high recurrence rate of 57.1% during follow-up. Despite low rates of surgical site occurrence and infection, disappointing outcomes indicate the need for alternative approaches in addressing parastomal hernias to improve patient outcomes and reduce recurrence. Journal Article by […]
Practice Patterns of Non-certified Surgeons Treating Medicare Patients
Non-certified surgeons treating Medicare patients show unique practice patterns, handling more non-white patients, those with lower socioeconomic status, and operating frequently in rural and critical-access hospitals. They’re less likely to be fellowship-trained and more likely to be foreign medical graduates. Non-certified surgeons perform a higher proportion of emergency admissions. However, there were no differences in […]
Feasibility and Safety of Hepatic Arterial Infusion Pump Chemotherapy for Colorectal Liver Metastases
Feasible and safe, hepatic arterial infusion pump chemotherapy combined with systemic chemotherapy (HAIP-SYS) for colorectal liver metastases (CRLMs) showed promising results in a phase II study in the Netherlands. With a completion rate of 90% for two cycles, it demonstrated favorable disease control rates at first radiological evaluation and six months post-treatment. Although some patients […]
Higher Rates of Late ERCP Post-Cholecystectomy Associated with Adverse Outcomes
Despite an increase in non-invasive biliary imaging, the rate of late-ERCP post-cholecystectomy has significantly risen, with high rates of adverse events including pancreatitis, hospitalization, and new chronic opioid use. Factors linked to late-ERCP included gut-brain interaction disorders, liver disease, and use of specific medications. Late-ERCPs are associated with disproportionately worse outcomes, suggesting the need for […]
Laparoscopic Liver Resection Shows Comparable Outcomes to Open Liver Resection for High Tumour Burden Colorectal Liver Metastases
Laparoscopic liver resection (LLR) matches open liver resection (OLR) in outcomes for ≥ 3 colorectal liver metastases (CRLM), showing similar morbidity, mortality, and survival rates. LLR offers shorter hospital stays, advocating its consideration for selected patients with high tumour burden disease. This study, analyzing 277 patients, demonstrates comparable major hepatectomy rates between LLR and OLR. Although OLR […]
Overweight and Thin Rectus Abdominis are Risk Factors for Stoma Prolapse After Laparoscopic Loop Colostomy
Being overweight (BMI ≥ 25) and a thin rectus abdominis penetration (
Understanding Upper Gastrointestinal and Hepatopancreaticobiliary Surgery in New Zealand
New Zealand is a low-volume center for upper gastrointestinal surgery, with most complex procedures concentrated in national cancer centers. There is evidence of regionalization, where larger centers perform procedures more frequently. Palliative procedures are more widely performed, but indigenous Māori are less likely to be treated in designated cancer centers. The challenge lies in optimizing […]