Preoperative ureteral stent placement during colorectal surgery did not lead to earlier detection of ureteral injury. Of 6481 patients, 15% had stents placed, with 0.4% experiencing a ureteral injury. Hematuria and UTI risk increased with stent use, but intraoperative identification of injury was not associated with stent placement. Iatrogenic ureteral injury was rare, contrasting with […]
Author: STITCHES Newsletter
Survival Outcomes Suggest Consideration of Additional Lymph Node Dissection for Incidentally Diagnosed Intrahepatic Cholangiocarcinoma Patients
Survival outcomes of incidental intrahepatic cholangiocarcinoma patients who did not undergo lymph node dissection were similar to those who underwent dissection in T1 stage, but poorer in T2 and T3+4 stages. Patients incidentally diagnosed with T2 or above T stage may benefit from additional lymph node dissection based on the study’s retrospective analysis of 284 […]
Factors influencing one-year mortality in elderly patients undergoing surgery for clinical T4 and locally recurrent rectal cancer
Higher one-year mortality rates were observed in elderly patients undergoing surgery for clinical T4 and locally recurrent rectal cancer. Factors associated with increased mortality included preoperative anemia, total pelvic exenteration, pulmonary complications, and higher grade complications. The main causes of death were failure to recover and disease recurrence. Tailoring treatment for these patients should consider […]
Self-Expanding Metallic Stenting Emerges as Safe Alternative for Left-Sided Colonic Obstruction
Emergency colonic resection has long been the standard treatment for left-sided malignant colonic obstruction, but self-expanding metallic stenting and decompressing stomas are emerging as viable alternatives. A systematic review and network meta-analysis of randomized controlled trials and propensity score matching studies found that stenting and stomas both significantly reduced permanent stoma rates, with stenting also […]
Middle Eastern Study Highlights Non-Operative Management of Epiploic Appendagitis
Epiploic appendagitis (EPA) is a rare, self-limiting acute abdominal disorder that is mostly treated non-operatively. A retrospective analysis of 156 cases in a Middle Eastern country showed that EPA primarily affects males with a mean age of 33 years. Computerized tomographic scans were the main diagnostic tool, with surgery required in only a few cases. […]
Resection Improves Survival in Patients with Local Recurrence of Esophageal Cancer
Patients with local recurrence of esophageal cancer following Ivor-Lewis esophagectomy have a significantly decreased overall survival. A retrospective study at a high-volume center showed that patients who underwent resection had better survival outcomes compared to those who did not. Chemoradiotherapy also showed promise in selected cases. Best supportive care was associated with shorter survival. These […]
Salvage Surgery Vital for Primary Ileal Pouch Leaks
Primary ileal pouch leaks after IPAA procedures are infrequent but challenging complications. Despite attempts at nonoperative management, success rates are limited. Salvage surgery has a high pouch retention rate, emphasizing its importance in leak management. A retrospective study at Cleveland Clinic over 27 years found that patients diagnosed with leaks after IPAA procedures had an […]
Significant Risk Factors for Nonalcoholic Fatty Liver Disease Post-Pancreatic Resection
After analyzing 26 studies with 4055 patients, the pooled incidence of nonalcoholic fatty liver disease after pancreatectomy was 29%. Female sex, pancreatic ductal adenocarcinoma, portal vein or superior mesenteric vein resection, dissection of nerve plexus around the superior mesenteric artery, and adjuvant chemotherapy were significantly associated with nonalcoholic fatty liver disease. Pancreatic enzyme replacement therapy […]
Disparities in Clinical Trial Enrollment among Patients with Gastrointestinal Cancer: Lower Rates among Minority-Serving Hospitals and Black Individuals
Among over 1 million patients with gastrointestinal cancer, only a small percentage were enrolled in clinical trials, with significantly lower enrollment rates among patients treated at minority-serving hospitals and black individuals. The odds of enrollment in a clinical trial were much lower for patients at minority-serving hospitals compared to non-minority-serving hospitals, and even after controlling […]
Impact of Sarcopenia on Perioperative Outcomes and Survival After Esophagectomy for Cancer
Patients with preoperative sarcopenia, identified using skeletal muscle index, had higher rates of major complications, including cardiac arrhythmia and mortality. They also had significantly lower overall survival and disease-free survival compared to non-sarcopenic patients. Sarcopenia was found to be an independent risk factor for lower survival on multivariate analysis. Sarcopenia is associated with increased risks […]