Robotic surgery in esophagectomy for resectable esophageal cancer offers advantages such as reduced postoperative pain and pulmonary complications. A review of 113 studies shows that outcomes include a weighted mean postoperative pneumonia rate of 11%, anastomotic leak rate of 10%, and a 95% success rate in achieving a clear resection margin. There is a potential […]
Author: STITCHES Newsletter
Enucleation is Safe for Solid Pseudopapillary Tumor of the Pancreas
Patients who underwent enucleation (en) for solid pseudopapillary tumor of the pancreas had a shorter hospital stay and similar rates of 30-day and 90-day mortality compared to those who underwent partial pancreatectomy (pp) or pancreaticoduodenectomy (pd). Survival analysis showed no difference in overall survival between en and resection groups. Patients with lymph node metastases had […]
Do New Legal Thresholds Improve Postoperative Mortality in Digestive Cancer Surgery?
French nationwide study evaluated 61,169 high-risk digestive cancer surgeries. Postoperative mortality rates varied across types, with liver and pancreas surgeries showing benefits from the new criteria. Higher volume thresholds could further decrease mortality risks. Centralization policies and improved clinical pathways may enhance patient access to complex care in France. Journal Article by Thereaux J, Badic […]
Association of preoperative opioid use with post-discharge outcomes: Increased pain and worse clinical and patient-reported outcomes
Patients with preoperative opioid exposure experienced higher pain scores 30 days after surgery compared to opioid-naïve individuals. As opioid exposure increased, the probability of reporting moderate to severe pain also increased. Furthermore, clinical outcomes such as ED visits, readmissions, and reoperations within 30 days, as well as patient-reported outcomes like satisfaction, regret, and quality of […]
What hospital factors impact outcomes for gastrointestinal bleeding?
Among Medicare fee-for-service beneficiaries hospitalized for gastrointestinal bleeding, larger hospital size, greater case volume, increased staffing levels, and availability of advanced capabilities were associated with lower 30-day mortality. Patients treated at hospitals with multiple advanced specialized capabilities had a 22% reduction in mortality risk, compared to those without these services, although length of stay increased […]
Validity and Implementation of Entrustable Professional Activities in Surgery
Entrustable Professional Activities (EPAs) in general surgery show moderate validity evidence and practical recommendations for implementation, providing a more accurate assessment of residents’ competence compared to other methods. Challenges include obtaining faculty and resident buy-in for microassessments and feedback. EPAs represent a significant shift in evaluating general surgery residents, aligning with Competency-Based Education (CBE) progression. […]
Postoperative Recovery Patterns in Ambulatory Cancer Surgery Patients
Investigators analyzed data from 12,433 patients who underwent ambulatory cancer surgery and completed 110,936 surveys on symptom severity and interference. Pain severity was highest on postoperative days 1-3, but gradually improved, with moderate initial fatigue that rarely reached severe levels. Nausea was common, while vomiting and shortness of breath were less frequent. These findings provide […]
Improved Outcomes in Hepatocellular Carcinoma with Anatomic Liver Resection
Anatomic liver resection prioritizing portal territory margins for hepatocellular carcinoma (HCC) treatment offers improved surgical efficacy over traditional approaches. MPT-AR maximizes oncological and rehabilitation benefits, overcoming limitations of traditional AR and local liver resection while avoiding postoperative complications like liver failure. This innovation addresses challenges posed by HCC’s portal vein spread and cirrhosis-related liver function […]
Identification of Hepatic Lymphatic Drainage in Intrahepatic Cholangiocarcinoma using Laparoscopic Tracer Technique
Injecting indocyanine green into the Glisson pedicle in a patient with intrahepatic cholangiocarcinoma allowed accurate tracing of hepatic lymphatic drainage area during laparoscopic surgery. The technique enabled identification and dissection of regional lymph nodes, providing a potential method for precise lymph node mapping in liver cancer surgery. Journal Article by Wang X, Xie F (…) […]
Improving Surgical Care through Mobile Health Integration
Implementing mobile health in surgical practice can improve patient outcomes, satisfaction, and system performance by addressing issues of poor communication and care coordination. Experts developed an implementation guide using human-centered design techniques, focusing on identifying mobile health use in surgical practice, mapping the pathway to implementation, and measuring impact on patients and the surgical system. […]