Contemporary Comparative Effectiveness Research (CER) often lacks explicit specification of clinically significant differences in study outcomes, as revealed in a systematic review of 307 studies from prominent medical journals. Only 8.5% of studies specified clinical significance, with 2.3% recommending changes in clinical decision-making based on statistical significance alone. Authors frequently defined clinical significance using validated […]
Author: STITCHES Newsletter
ICG-Guided Lymphadenectomy in LAGC: RCT Results
Indocyanine Green (ICG)-guided lymph node (LN) dissection during laparoscopic radical gastrectomy significantly improves the quality of lymphadenectomy in locally advanced gastric cancer (LAGC) patients post-neoadjuvant chemotherapy (NAC). A randomized controlled trial with 236 patients demonstrates that ICG increases LN retrieval and decreases non-compliance rates, particularly in cases without baseline measurable LNs and in those with […]
PORSHA for Paraesophageal Hernias: Phase 2a Results
Posterior Rectus Sheath Hiatal Flap Augmentation (PORSHA) exhibits promise as a surgical innovation for large and recurrent paraesophageal hernias. In a study of 27 cases, PORSHA, after technical modifications, demonstrated safety and success in repairing type III, IV, and recurrent paraesophageal hernias. At an 11-month follow-up, there were no radiologic recurrences, abdominal eventrations, or hernias […]
Pediatric Pancreatic Surgery: Safe, Effective, and Centralized
Pediatric pancreatic surgery, analyzed in a 73-patient study, demonstrated safety and effectiveness. Distal pancreatectomy was the most common procedure, addressing indications like chronic pancreatitis, tumors, and trauma. Postoperative morbidity occurred in 34.2%, with no 90-day mortality. The 5-year overall survival was 90.5%, emphasizing the feasibility of pediatric pancreatic surgery. Centralization in specialized pancreatic centers ensures […]
Crucial Role of EUS in LT Workup for Unresectable pCCA
EUS plays a crucial role in the liver transplantation (LT) workup for patients with unresectable perihilar cholangiocarcinoma (pCCA). In a nationwide study, EUS identified malignant nonregional lymph nodes (LNs) in 4% of patients potentially eligible for LT. Surgical staging confirmed malignancy in 14% of patients with nonregional LNs. The study emphasizes the limited but clinically […]
Patient Engagement Technologies in Colorectal Surgery: Improving Outcomes Through Interaction
Patients engaging with patient engagement technologies (PETs) during colorectal surgery showed improved outcomes. In a retrospective study, 89.1% activated PETs, completing surveys and health-checks. Those engaging more frequently experienced shorter lengths of stay, lower readmission rates, and fewer post-operative complications. Notably, patients who completed more post-discharge health-checks had a lower complication rate, emphasizing the positive […]
TSLG versus LTH for Siewert Type II AEG: Advantages and Efficacy
Transthoracic single-port-assisted laparoscopic gastrectomy (TSLG) demonstrates technical safety and feasibility in comparison to laparoscopic transhiatal approach (LTH) for Siewert type II adenocarcinoma of the esophagogastric junction. In a retrospective study, TSLG showed advantages, including increased harvested lymph nodes, reduced lower mediastinal lymph nodes, and longer proximal margins. The R0 gastrectomy rate was higher in the […]
Single Anastomosis Duodeno-Ileal Bypass (SADI-S) Shows Comparable Outcomes in Primary and Two-Stage Approaches
Comparing outcomes of primary single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) to two-stage SADI-S after sleeve gastrectomy (SG), a Canadian bariatric study with 179 laparoscopically treated patients (2016–2020) revealed both approaches as efficient in achieving weight loss and comorbidity reduction at short and mid-term follow-ups. Preoperative criteria are crucial for surgeon decision-making between primary […]
Procedure-Specific Risk of Postoperative Nausea
In a cross-sectional study analyzing data from 152 German and Austrian hospitals, researchers determined procedure-specific, risk-adjusted probabilities of postoperative nausea for 72 types of operations. The adjusted absolute risk ranged from 6.2% to 36.2%, with laparoscopic bariatric operations having the highest risk. Factors such as male sex, antiemetic prophylaxis, regional anesthesia, and preoperative opioids influenced […]
Short-Term Expectant Management of Small Bile Duct Stones in Cholecystectomy
In cholecystectomy patients with small common bile duct stones (≤5 mm) identified by intraoperative ultrasound, a short-term expectant management approach, avoiding immediate duct clearance, proved safe. Among 51 patients, 46 underwent expectant management, with 89.1% not requiring postoperative interventions. Over 3 years, none presented with residual stones, and hospital length of stay was significantly reduced. […]