Following the approval of a resident-created physician wellness program in 2016, a recent survey of 25 general surgery residents showed unanimous support for ongoing development and mandatory participation in the wellness curriculum. The majority preferred quarterly “wellness half-days” as a mandatory component, citing reasons such as ease of explanation to faculty, guilt around leaving shifts, […]
Author: STITCHES Newsletter
Predictors of Perioperative Complications in Open Biliary Bypass for Malignant Biliary Obstruction
Patients undergoing open biliary bypass for malignant biliary obstruction face significant perioperative risks. A multicenter study identified preoperative cholangitis, longer surgery duration, and elevated serum bilirubin levels as predictors of complications. Hazard ratios revealed 2.49 times higher risk with cholangitis, 2.47 times higher risk with longer surgery, and a 14% increase in risk per 1 […]
Improved Esophageal Cancer Response Assessment with Early Contrast-Enhanced MRI
Early contrast-enhanced MR imaging showed higher accuracy in detecting complete tumor response in esophageal squamous cell carcinoma post-neoadjuvant therapy compared to T2WI+DWI. ECE-MRI had an AUC of 0.85 for diagnosing ypt1-4, significantly better than T2WI+DWI. Performance improved with increasing tumor stage, with higher AUCs in ypt1 and ypt2 tumors. ECE-MRI visual evaluation is promising for […]
Comparable Efficacy of Lumen-Apposing Metal Stents and Plastic Stents for Walled-Off Necrosis Drainage: PROMETHEUS Study
This multicenter, randomized trial compared lumen-apposing metal stents (LAMS) and double-pigtail plastic stents (DPS) for walled-off necrosis drainage. Results showed similar short and long-term clinical success rates between both groups. LAMS had a shorter procedure duration, similar hospital stay, and safety profile compared to DPS, with a lower incidence of de novo fever. Overall, the […]
Virtual Reality with Head-Mounted Display Improves Decision-Making in Hepatic Surgery Training.
A study compared virtual reality with head-mounted display (VR-HMD), on-screen 3D visualization, and 2D computed tomography for hepatic surgery training. Results showed higher accuracy and faster responses in the VR-HMD and 3D groups compared to the 2D group. Both VR-HMD and 3D were equally effective, indicating VR-HMD’s usefulness in determining liver anatomy and tumor involvement […]
Safe and Effective Robot-Assisted Gastric Resection: 5-Year Clinical Outcome
Robot-assisted endoscopic full-thickness gastric resection with regional lymph node dissection using a 3D near-infrared video system resulted in no metastasis or mortality in patients with early gastric cancer over a 5-year follow-up period. This approach may be a safe and effective method for radical gastrectomy in such patients, highlighting the potential benefits of this technique […]
Small Bowel Obstruction Recurrence Score (SBORS) Predicts Risk of Recurrence in Patients with History of Intra-abdominal Surgery.
Researchers conducted a study in Taiwan to assess the risk of recurrent small bowel obstruction (SBO) after non-operative management in patients with a history of intra-abdominal surgery. They developed a scoring system, the Small Bowel Obstruction Recurrence Score (SBORS), which successfully predicted 6-month recurrence of SBO after non-surgical management. Patients with scores >2 had higher […]
Comparison of Laparoscopic and Open Pancreatectomy for Solid Pseudopapillary Neoplasms
Outcome and survival were similar between laparoscopic and open pancreatectomy for solid pseudopapillary neoplasms in 102 patients. Laparoscopic approach was associated with lower blood loss, shorter surgery duration, fewer complications, and smaller tumor size for specific procedures. Recurrence rates were low and unrelated to the surgical approach. Laparoscopic pancreatectomy is safe and effective but should […]
Key ERAS Recommendations Predict Surgical Outcomes in Multi-Institutional US Study
Compliance to the Enhanced Recovery after Surgery (ERAS) protocol significantly impacts surgical outcomes in the United States, with certain recommendations showing more predictive value than others. Early Foley catheter removal, limited nasogastric tube use, oral carbohydrates, and patient education are associated with improved recovery and reduced complications in specific surgeries. Future research should validate these […]
Identification of Predictive Factors for Clinically Relevant Postoperative Pancreatic Fistula
Researchers identified that a combination of inflammatory parameters and drainage fluid culture results on postoperative day 3 can accurately predict the risk of clinically relevant postoperative pancreatic fistula (CR-POPF) after pancreatectomy. Factors such as drainage fluid amylase level ≥722 IU/L, culture positivity, and neutrophil count ≥5473/mm significantly influence the onset of CR-POPF. A predictive model […]