Preoperative low-energy diets may reduce complications for overweight patients undergoing non-bariatric surgery. Patients lost an average of 4.5 kg during a 3-week low-energy diet. Pooled analysis shows a 19% relative risk reduction in postoperative morbidity with low-energy diets. Further validation through a larger trial is needed to enhance recruitment and follow-up. Adherence to the diet […]
Author: STITCHES Newsletter
Biliary Stent Choice for Bile Leak After Fenestrated Cholecystectomy
Different types of biliary stents show no significant impact on healing bile leaks after fenestrated cholecystectomy. 93.8% of patients healed with 10F stents, similar to other types, showing no advantage for larger or covered stents. Median time to follow-up ERCP for leak resolution was 59 days across the cohort of 145 patients. Surgeons can confidently […]
Wearables Enhance Surgical Recovery Insights
Increasing postoperative steps may significantly reduce hospital stay and complications for surgical patients. Each additional 1,000 steps/day post-surgery is linked to a 6% shorter length of stay. This increase is associated with a 17% lower chance of 30-day complications and a 18% drop in 90-day readmissions. Focus on monitoring step count post-surgery rather than relying […]
Glycated Hemoglobin Predicts Risks in Colorectal Surgery
Glycemic control via preoperative glycated hemoglobin levels can enhance risk assessment for postoperative complications in elective colorectal surgery. Patients with poorly controlled diabetes had a 23% increased risk of any complication and a 20% higher risk of serious complications compared to those without diabetes. Well-controlled diabetes did not significantly change the risk for any complication […]
Advances in Conversion Surgery Improve Outcomes for Pancreatic Cancer
Conversion surgery for unresectable pancreatic cancer with liver metastasis can significantly improve survival for select patients. In a study of 90 patients, overall survival after conversion surgery was 39.7 months, with earlier treatment yielding 53.1 months from initial diagnosis. Preoperative normalization of CA 19-9 and negative lymph node metastasis were key factors linked to better […]
Early Mobilisation After Abdominal Surgery Improves Recovery
Early mobilisation within 24 hours post-abdominal surgery significantly enhances patient recovery. Engaging patients in standing or walking boosts physiological recovery and outcomes. Key prerequisites include stable hemodynamics, effective pain relief, and cognitive readiness. Implementing early mobilisation can standardize recovery protocols and improve surgical outcomes. Well-staffed healthcare teams are crucial for successful early mobilisation efforts. Systematic […]
Improving Surgical Safety with Report Cards and Assessments
Using surgical report cards linked to quality improvement efforts can enhance patient outcomes. Review identified 19 studies showing report cards lead to improved surgical outcomes when tied to quality improvement initiatives. One in four controlled studies saw a statistically significant reduction in mortality. Integrating report cards with actionable improvements is essential for better results. Most […]
Model Reveals Absorption Challenges in Short Bowel Syndrome
A new gut model shows how surgical interventions impact nutrient absorption in short bowel syndrome (SBS), crucial for surgical planning. Neonates experience a significant drop in glucose absorption even with slight bowel dilation, peaking at 1.1x diameter. Adolescent and child absorption remains stable until 1.5x diameter, with absorption rates at 54% for adolescents, 98% for […]
GLP-1 Receptor Agonists Reduce High Stoma Output by 50%
New research shows glucagon-like peptide-1 receptor agonists (GLP-1 RAs) significantly lower stoma output, offering a promising option for managing high output stomas. Three studies found GLP-1 RAs led to up to a 50% reduction in stoma output. Patients showed improved nutritional status and decreased dependence on parenteral nutrition. Mild gastrointestinal side effects, mainly nausea, were […]
MRI Enhances Liver Metastasis Detection in Pancreatic Cancer
MRI improves liver metastasis detection in pancreatic cancer, crucial for surgical decision-making. MRI identified additional liver metastases in 2-23% of CT-negative patients and 12-45% of those with indeterminate CT findings. The impact on time to surgery was inconsistent, with delays averaging a 5.7-day increase, but cases varied widely. Surgeons should consider integrating MRI in pre-operative […]