Recent advancements in surgical visualization and guidance, including fluorescence-guided surgery, contrast-enhanced ultrasound, and augmented reality, are shaping the future of general surgery. This narrative review explores cutting-edge technologies and their integration with artificial intelligence, promising enhanced intraoperative decision-making and surgical precision. While these innovations offer exciting prospects, further research and surgeon training in artificial intelligence […]
Author: STITCHES Newsletter
Higher burden and inequality in pancreatic cancer among older adults globally
Between 1990 and 2019, the number of pancreatic cancer deaths in older adults, age-standardized death rate, disability-adjusted life years, and age-standardized DALY rate increased globally. The burden is highest in southern Latin America and has grown fastest in the Caribbean. Males aged 65 to 74 years have a higher burden than females. Proportions of deaths […]
Can Endoscopic Gallbladder Stenting Prevent Recurrent Cholecystitis in Deferred Cholecystectomy?
Endoscopic gallbladder stenting significantly reduced the rate of recurrent cholecystitis at 3 months compared to patients who did not receive stenting. At 3-6 months, the stenting group also showed a lower, though not statistically significant, rate of recurring cholecystitis. The majority of recurrences in the non-stenting group occurred within 3 months, indicating that endoscopic stenting […]
Total neoadjuvant therapy increases risk of breached mesorectal excision but reduces disease progression in rectal cancer
Total neoadjuvant therapy for rectal cancer is associated with higher rates of breached total mesorectal excision compared to standard long-course chemoradiation, but no significant differences in surgical mortality or major complications. However, it significantly lowers the risk of disease progression to an unresectable stage during neoadjuvant treatment. Further research is needed to identify patients who […]
Risk of Anastomotic Leak Higher with Early Ileostomy Closure
Early closure of diverting loop ileostomy after proctectomy is associated with a higher risk of anastomotic leak, particularly when closure is done within 2 weeks of ileostomy formation. Factors such as diabetes mellitus, smoking, and early closure within 2 weeks are significantly associated with postoperative complications. Routine early ileostomy closure cannot be recommended based on […]
Comparable Long-term Survival Between Laparoscopic and Open Pancreaticoduodenectomy for Pancreatic Tumors
In a randomized clinical trial comparing laparoscopic and open pancreaticoduodenectomy for pancreatic or periampullary tumors, researchers found similar 3-year overall survival rates between the two groups. Quality of life, depression, and other outcomes also showed no significant differences. Laparoscopic pancreaticoduodenectomy, when performed by experienced surgeons, demonstrated comparable long-term outcomes to open surgery. Journal Article by […]
Robotic Pancreaticoduodenectomy Shows Lower Blood Loss and Higher Complication-Free Rates compared to Open Procedure
Researchers compared robotic pancreaticoduodenectomy (RPD) and open pancreaticoduodenectomy (OPD) outcomes in a high-volume center. RPD showed lower blood loss, higher rates of no complications, longer operative time, and fewer harvested lymph nodes in patients with ductal adenocarcinoma compared to OPD. No significant differences were found for major complications, reoperation rate, postoperative pancreatic fistula, or patients […]
Antibiotic Duration Unaffected by Biliary Stents in Pancreatoduodenectomy
Antibiotic duration did not impact infection rates in pancreatoduodenectomy patients with biliary stents. A retrospective cohort study found similar composite infection rates among patients receiving short, medium, or long-duration antibiotics, with no significant differences in other outcomes. Postoperative pancreatic fistula and male sex were associated with the primary outcome. The study suggests an opportunity to […]
Operative Management of Emergency General Surgery Conditions: Higher Costs Which Persist Over Time
Operative management of emergency general surgery conditions leads to higher in-hospital costs compared to nonoperative management, with costs remaining higher or equivalent through 180 days. Out-of-pocket costs are similar for both approaches. For hepatopancreaticobiliary conditions, costs for operative management start higher but become equivalent at 90 and 180 days. These findings have implications for decision-making […]
Ampicillin-Sulbactam Prophylaxis Benefits Esophagectomy
Antimicrobial prophylaxis with ampicillin-sulbactam was associated with significantly lower rates of surgical site infection, anastomotic leakage, and respiratory failure compared to cefazolin in esophagectomy patients. This choice of antibiotic also led to reduced respiratory complications, shorter hospital stays, and lower total hospitalization costs, with no increase in noninfectious complications. Propensity score matching and instrumental variable […]