Systematic review and meta-analysis of hepatic artery-based therapies and systemic chemotherapy for unresectable colorectal liver metastases showed high overall survival rates for hepatic artery infusion and favorable outcomes compared to doublet chemotherapy in specific subgroups. Triplet chemotherapy had the best outcomes but with higher toxicity and inclusion of potentially resectable patients. The upcoming EA2222 pump […]
Author: STITCHES Newsletter
Frail Patients Gain Equal Quality of Life Benefits after Ventral Hernia Repair
Older patients undergoing elective ventral hernia repair were categorized based on frailty, with severely frail patients showing lower quality of life at baseline. Surprisingly, severely frail patients reported higher quality of life scores at 30 days and 6 months postoperatively compared to non-frail patients. Despite higher rates of surgical site complications, frail patients, when appropriately […]
Similar Outcomes of Robotic and Laparoscopic Pancreatoduodenectomy for Pancreatic Cancer
Robotic and laparoscopic approaches to minimally invasive pancreatoduodenectomy yield similar oncologic and surgical outcomes in pancreatic cancer patients, with a lower conversion rate to open surgery for the robotic cohort. The learning curve has a significant impact on outcomes, with higher-volume centers showing improved results, particularly in reducing 90-day mortality. Journal Article by Wehrle CJ, […]
Identification of Risk Factors for Postoperative Pancreatic Fistula after Post-pancreatectomy Acute Pancreatitis
Analysis of 817 patients after pancreaticoduodenectomy revealed that 19.5% developed postoperative pancreatic fistula (popf), with 45.9% being post-pancreatectomy acute pancreatitis (ppap)-associated popf. These patients had higher morbidity and distinct risk factors (blood loss, pancreatic texture) compared to non-ppap-associated popf. Non-ppap-associated popf was linked to age, gender, and pancreatic duct size. Regardless of risk scores, the […]
Creating Trauma Survivorship Centers: A Financial Win-Win
Establishing a Center for Trauma Survivorship (CTS) is not cost prohibitive, but a revenue generator for institutions. A post-and pre-cohort study found that CTS patients had more follow-up visits and surgeries, resulting in a $7,752 increase in net revenue per patient. The creation of dedicated centers improves patient outcomes and institution’s financial health. Journal Article […]
Effectiveness of Palliative Surgery in Providing Symptomatic Relief for Seriously Ill Patients
Palliative surgery aims to alleviate symptoms in seriously ill patients. Although common in surgical oncology, the durability of symptom improvement and quality of life post-surgery lacks high-quality evidence. Outdated studies with inconsistent definitions hinder decision-making. However, with effective communication and patient selection, palliative surgery can provide relief and reduce healthcare burdens for certain seriously ill […]
Modifier 22 in Medicare: Little Financial Benefit for Surgeons
Studies analyzed 625,316 surgical procedures and found that claims with modifier 22 had higher charges, payments, but were more likely to be denied. Overall mean payments varied, with some procedures showing higher payments with modifier 22. However, for most surgeries, little financial advantage was seen, suggesting surgeons have little incentive to use modifier 22 under […]
Combatting Stigma: Embracing Metabolic Bariatric Surgery
Metabolic bariatric surgery offers durable weight loss and medical improvement for obesity, contrary to misconceptions about obesity as a lack of willpower. Despite its effectiveness and safety, surgical treatment remains vastly underutilized due to societal stigma and patient misconceptions. Healthcare practitioners must combat these perceptions, advocating for surgery as a legitimate treatment for obesity alongside […]
Robotic surgery in foregut procedures
Comparing robotic and laparoscopic approaches in hiatal hernia repair and Heller myotomy, robotic surgery showed non-significantly shorter hospital stays, fewer conversions to open, and lower morbidity rates for hhr, while hm had significantly fewer esophageal perforations, reinterventions, and a non-significantly shorter stay. Both robotic procedures had longer operative times. Safety profiles and perioperative outcomes were […]
Low Rates of Colorectal Cancer Screening in First-Degree Relatives of Patients with Early-Onset Colorectal Cancer
First-degree relatives of patients with early-onset colorectal cancer have low rates of colorectal cancer screening, with only 44% undergoing screening despite guidelines recommending screening starting at age 40 or 10 years before the age of their relative’s diagnosis. Factors such as race, stage of disease, insurance coverage, and location were associated with lower screening rates, […]