Researchers report a successful case of a 90-year-old woman with a 6 cm gallstone causing sigmoid colon obstruction. Despite deferring colonoscopy due to gallstone size, urgent laparotomy for gallstone removal resulted in uneventful post-operative recovery and discharge on the 6th day. The study highlights the importance of multidisciplinary discussions between endoscopists and surgeons for optimal […]
Author: STITCHES Newsletter
Novel Prognostic Role of Tumor Microbiome in Intrahepatic Cholangiocarcinoma
Characterization of the tumor microbiome in intrahepatic cholangiocarcinoma revealed a higher diversity than in adjacent nontumoral liver tissues, with increased abundance of specific bacterial groups. Higher tumor microbial diversity was linked to lymph node metastasis and predicted shorter overall and recurrence-free survival. A risk score formulated from 11 selected bacteria could independently predict overall survival, […]
Reduced Gas Embolism with Low Pneumoperitoneum Pressure in Laparoscopic Liver Resection
Low pneumoperitoneum pressure reduces the incidence and duration of severe gas embolism during laparoscopic liver resection, leading to steadier hemodynamics, vital signs, and overall improved patient outcomes. Group L, with low pressure, showed significantly fewer cases of severe gas embolism, shorter duration of embolism episodes, and less physiological stress compared to Group S with standard […]
Non-Therapeutic Laparotomy in Locally Advanced Pancreatic Cancer has Limited Impact on Survival
Non-therapeutic laparotomy occurred in 28.2% of patients with locally advanced pancreatic cancer after induction (m)folfirinox, with no significant difference in overall survival or palliative therapy compared to those who did not undergo surgery. The 5-year overall survival rates were 11.4% for group a (laparotomy), 8.7% for group b (no surgery), and 24.7% for group c […]
Comparable Efficacy of Lumen Apposing Metal Stents vs. Balloon Dilation for Benign Colorectal Anastomotic Strictures
Lumen apposing metal stents (LAMS) appear to be as effective as endoscopic balloon dilation (EBD) for treating benign colorectal anastomotic strictures (BCAS), with a potential for requiring fewer procedures and being safer. Twenty-nine patients were involved, showing no significant differences in outcomes between LAMS and EBD, but a trend towards fewer procedures and adverse events […]
Understanding Functional Disorders in Ileal-Anal Pouch
Functional disorders in the ileal-anal pouch present a spectrum of symptoms, some expected and others related to surgical complications. Studies have attempted to define and measure normal pouch function, but few have addressed pouch physiology. The confusion surrounding pouch function highlights the need for a better understanding of expected changes in defecation physiology post-surgery. Identifying […]
Impact of Endoscopic Surgical Skill Qualification on Conversion to Laparotomy in Rectal Cancer Patients
Participation of ESQS-certified physicians was associated with lower risk of both indicated and technical conversion to laparotomy for rectal cancer patients undergoing laparoscopic surgery. Other factors influencing conversion included tumor diameter, combined resection of adjacent organs, and institution type. Referral to specialized centers, especially for high-risk patients, may improve outcomes. Journal Article by Goto K, […]
The Lethal Triad: Acute Cholecystitis, Obesity, and Steatohepatitis Increase Bile Duct Injury Risk
The study analyzed 387,501 laparoscopic cholecystectomy cases from the NSQIP registry and found that the presence of the lethal triad (acute cholecystitis, obesity, and steatohepatitis) significantly increased the risk of bile duct injury (BDI) by over 15-fold. Those with the triad had a BDI incidence rate of 1.49% compared to 0.09% in those without. This […]
Key Factors for Post-Operative VTE in Colorectal Surgery
Post-operative colorectal venous thromboembolism rates were 1.75%, with 53% of patients undergoing urgent/emergent surgeries and 60% receiving blood transfusions. Only 30% had high Caprini scores, while 66% had low preoperative albumin levels. The study highlights the importance of considering urgent surgeries, low albumin levels, and blood transfusions in enhancing VTE screening and prophylaxis for colorectal […]
Effectiveness of Cultural Competency Training in Surgical Settings
Health disparities in surgical settings are unjust and result in poor outcomes. Cultural competency training (CCT) for providers may address these disparities, but its cost-effectiveness is unclear. The effectiveness of CCT in improving health outcomes and whether it should be team-based are key considerations. Further research is needed to determine if CCT is a worthwhile […]