Outpatient observation for acute diverticulitis (Hinchey 1a) and no antibiotics resulted in lower recurrence rates and shorter hospital stays compared to inpatient treatment and antibiotics. Recurrence, hospital admissions, and mortality rates were similar between outpatient and inpatient management. Future studies are needed to confirm the effectiveness of observation-only and antibiotics-free approaches in managing uncomplicated acute […]
Author: STITCHES Newsletter
Impact of Routine Lymph Node Dissection on Intrahepatic Cholangiocarcinoma Patients
Therapeutic effects of routine lymph node dissection (LND) with liver resection for intrahepatic cholangiocarcinoma (ICC) were inconclusive. However, subgroup analyses revealed a potential benefit for ICC patients with low risk of bias, suggesting a positive impact on overall survival. More studies are needed to clarify the role of LND in this patient population. Review by […]
Ultrasound as an Adjunct in Management of Women with Right Iliac Fossa Pain
Pelvic ultrasound in women with right iliac fossa pain led to 42% pathology detection, with appendicitis diagnosis in 4.8%. Ultrasound had 78% specificity for appendicitis. Preoperative imaging reduced negative appendicectomy rates to 21.3%. Results advocate for ultrasound as a useful tool alongside clinical assessment in managing these patients. Journal Article by Standing HR, Boag KF […]
Options for Expiry Dates in Surgical Equipment
Hospitals are significant contributors to global warming, with operating theatres generating 70% of hospital waste. This study explores the assignment of use-by dates to surgical equipment and the potential for reusing or re-sterilizing expired items to reduce waste. While incineration is common, alternative disposal methods, like re-processing, are emerging. Further research is needed to ensure […]
Long-Term Oncologic Outcome of Duodenum-Preserving Pancreatic Head Resection
Duodenum-preserving pancreatic head resection for benign tumors, cystic neoplasms, and neuroendocrine tumors offers a cure with fewer complications compared to pancreatoduodenectomy. The meta-analysis showed lower mortality and reoperation rates with duodenum-preserving resection. It also demonstrated comparable rates of tumor recurrence between the two procedures. This suggests duodenum-preserving resection as a viable alternative to pancreatoduodenectomy for […]
National Guidelines for Diagnosis and Treatment of Hilar Cholangiocarcinoma
Consensus meeting of national experts led to national practice guidelines for hilar cholangiocarcinoma, highlighting the importance of a multidisciplinary approach for patient management. Diagnostic and staging workup includes imaging modalities and histopathologic confirmation may not always be necessary before resection. Surgical resection based on the Bismuth-Corlette classification remains the only curative option, with adjuvant chemotherapy […]
Effectiveness of Double-Nylon Purse-String Suture in Closing Postoperative Wounds after Gastric Submucosal Tumor Resection
Double-nylon purse-string sutures effectively close wounds post-endoscopic full-thickness resection (EFTR) of large (≥ 3 cm) gastric submucosal tumors (SMTs). In a retrospective analysis of 85 patients, all tumors were completely resected using EFTR, with no serious adverse events reported. This technique is valuable, especially for large EFTR wounds in SMTs, ensuring successful closure without laparoscopic […]
Standardizing Letters of Recommendation for Surgical Training Programs
Letters of recommendation are crucial for applicant selection in medical education. The shift to pass/fail USMLE scoring has increased their importance. Narratives may introduce bias and inflation. Standardized letters can address these issues. Interviews and focus groups informed the development of a new standardized letter for surgical residency applications. Researchers were also invited to revise […]
Addressing Health Disparities in Clinical Guidelines Development
SAGES implements updates to its guidelines development process to address health equity issues, aiming to minimize downstream health disparities. These updates ensure an evidence-based, standardized approach that considers health equity throughout the guideline development process, facilitating better patient counseling and research recommendations to mitigate disparities. By intentionally addressing disparities, SAGES aims to prevent the widening […]
Long-Term Weight Loss After Revisional Bariatric Surgery
This systematic review and meta-analysis of 28 observational studies involving 2213 patients revealed a mean total weight loss (%TWL) of 27.2% and a decrease in BMI of 10.2 kg/m² after revisional bariatric surgery. These findings underscore the effectiveness of revisional procedures in achieving sustained weight loss over medium to long-term follow-up periods (>2 years). Review […]