Patients with high output chyle leaks post-esophagectomy benefited from early intervention, showing improved overall survival and shorter hospital stays. Non-operative and late interventional management were associated with increased mortality compared to prompt intervention. Early intervention reversed prognostic implications and led to outcomes similar to patients without chyle leaks. Journal Article by Deboever N, Correa AM […]
Author: STITCHES Newsletter
Cost-Effectiveness of Two Days vs. Five Days of Antibiotics for Complex Appendicitis
A study comparing costs for 2 days vs. 5 days of postoperative antibiotics after appendectomy for complex appendicitis found that two days resulted in a statistically significant cost reduction. The difference in overall societal costs was – €625 in favor of the 2-day group, largely due to reduced hospital stay. Restricting postoperative antibiotics to 2 […]
Effectiveness of Pancreatic Cancer Surveillance in High-Risk Individuals
Pancreatic cancer surveillance in high-risk individuals led to early diagnosis of pancreatic malignancies and premalignant lesions, with most cases found at baseline. Of the 156 participants with at least a 3-year follow-up or cancer-related events, 9 individuals had malignant or premalignant lesions, demonstrating the feasibility and safety of surveillance in a public healthcare system. Journal […]
Comparing Robot-assisted and Laparoscopic Pancreatoduodenectomy in a Pan-European Cohort
Robot-assisted and laparoscopic pancreatoduodenectomy showed similar major morbidity and mortality rates in a pan-European cohort. However, laparoscopic approach was associated with shorter operation time and lower rates of postoperative complications, while robot-assisted approach had lower conversion rates and higher lymph node retrieval. The study highlights the comparable outcomes of both techniques, each with its distinct […]
ABCD1 as a Highly Effective Diagnostic Marker for Solid Pseudopapillary Neoplasm of the Pancreas
ABCD1 is identified as a promising diagnostic marker for differentiating solid pseudopapillary neoplasm of the pancreas from other pancreatic neoplasms, including pancreatic neuroendocrine tumors, with exceptional efficacy in immunohistochemical staining. Through a large-scale patient cohort analysis, researchers found that ABCD1 shows high sensitivity (99.10%) and specificity (100%) in distinguishing SPN from other pancreatic tumors, demonstrating […]
Long-term Weight Maintenance and Nutritional Complications After Biliopancreatic Diversion
Biliopancreatic diversion for severe obesity leads to good and sustained weight maintenance up to 30 years with low perioperative risk. However, it is associated with a high long-term prevalence of nutritional complications, with 60% of patients experiencing nutritional issues at 20 years and 74% at 30 years. Despite these complications, weight loss and glycaemic control […]
Implications of Metabolic Bariatric Surgery Tourism
Metabolic bariatric surgery tourism presents barriers such as availability, accessibility, cost, eligibility, reputation, and stigma. Despite limited literature, the study highlights the need for further understanding motivational insights, healthcare system challenges, cost, and long-term outcomes. An audit to explore clinical relationships and guide policy-making is suggested to address the growing concerns of metabolic bariatric surgery […]
Disparities in Mentorship Impacting US Surgical Resident Education and Wellness
A survey of 6956 US surgical residents found that 66.8% reported meaningful mentorship, with non-white or hispanic residents less likely to report it. Senior residents were more likely to have meaningful mentorship. Residents with meaningful mentorship had higher rates of operative autonomy and lower rates of burnout, thoughts of attrition, and suicidality compared to those […]
Care Fragmentation in Hepatopancreatic Surgery: Impact on Postoperative Outcomes
High rates of fragmented practice in hepatopancreatic surgery were associated with increased odds of postoperative complications, extended length of stay, 90-day mortality, and lower likelihood of achieving a textbook outcome. This negative impact persisted regardless of surgeon volume and was more pronounced among female surgeons. Treatment by surgeons with higher fragmented practice also led to […]
Predicting Postoperative Outcomes in Perforated Peptic Ulcers: Charlson’s Index Versus PULP Score
Comparing Charlson’s Weighted Index of Comorbidity (WIC) and other predictive scores in patients with perforated peptic ulcers revealed WIC’s valuable predictability for mortality. Both WIC and the Peptic Ulcer Perforation (PULP) score effectively predicted high comprehensive complication index (CCI) in these patients. Factors such as age, sex, comorbidities, and ASA score >2 were associated with […]