Splenectomy shows variable success across indications in hematologic cancers. Overall 30-day complication rate was 49%, with 22% being severe. Success rate was 91.7% for bridge-to-transplant, but only 38.5% for transfusion independence in lymphoid patients. Surgeons should evaluate the indication for splenectomy carefully, as outcomes differ significantly based on underlying conditions. Myeloid patients had a higher […]
Author: STITCHES Newsletter
Early Foley Catheter Removal Safe After Colovesical Fistula Surgery
Early removal of Foley catheters post-segmental colectomy for diverticulitis shows promise in reducing complications. 90.8% of patients had catheters removed by postoperative day 2 or 3. No cases of bladder leaks, catheter reinsertion, or colovesical fistula recurrence were reported. Consider adopting early Foley removal as a routine practice to minimize urinary tract infection risks in […]
Survey Reveals Challenges for Junior Surgical Oncologists
Junior surgical oncologists face significant challenges in contract negotiation and compensation, affecting retention and workplace culture. 79% have a guaranteed salary for a median of 3 years, but most shift to productivity-based compensation. 25% are considering leaving their practice within a year; this jumps to nearly 80% if they feel their pay is unfair. Perceived […]
Postoperative complications raise long-term cardiovascular risk after gastrectomy.
21.4% of patients experienced complications within 30 days, leading to a cardiovascular disease (CVD) incidence rate of 12.1 per 1,000 person-years, compared to 7.0 per 1,000 in those without complications. Complications elevate the risk of CVD by 63%, especially pulmonary issues linked closely to heart failure. Surgeons should implement rigorous cardiovascular monitoring for patients with […]
AI Transforms Preoperative Risk Assessment in Surgery
Artificial intelligence can enhance risk assessment in surgery by analyzing complex datasets, improving outcomes for patients. Machine learning algorithms effectively predict postoperative mortality and major adverse cardiovascular events. Predicting technical complications like anastomotic leaks is more challenging with current data. Surgeons should view AI as a tool for informed decision-making, not a replacement for clinical […]
Transanal TME delivers strong outcomes for rectal cancer
Transanal total mesorectal excision (TATME) shows promising long-term results for patients with low rectal cancer. Three-year overall survival at 93.7%, disease-free survival at 84.6%. 97% of patients remained stoma-free at 3 years, enhancing quality of life. Consider TATME for resectable mid and low rectal tumors; ongoing monitoring of long-term outcomes remains essential. Significant late complications […]
Prehabilitation Alters Immune Response in Abdominal Cancer Surgery
Multimodal prehabilitation may not significantly impact postoperative immune function, but it leads to a less inflammatory state before surgery. 130 patients studied: 102 received prehabilitation, 28 usual care. Pro-inflammatory cytokine production decreased, while IL-10 levels increased after prehabilitation. Consider prehabilitation for optimizing patients pre-surgery, but be cautious of its limited postoperative immune benefits. No significant […]
Awareness of Sexual Misconduct in Surgery Varies Widely
Surgeons must recognize that perceptions of sexual misconduct in surgical environments differ drastically among colleagues, impacting workplace culture and safety. 742 surgeons reported conflicting experiences; some saw minimal issues while others described pervasive harassment and inaction. The lateral view x-ray theory suggests awareness of misconduct depends on one’s exposure and experiences—those less affected are often […]
Staging Laparoscopy Accurately Detects Peritoneal Disease in Advanced Gastric Cancer
Staging laparoscopy (SL) has high accuracy for identifying peritoneal disease (PD) in advanced gastric cancer, improving patient selection for treatment. SL detected PD in 54.9% of 761 treatment-naive patients, with an accuracy of 96.8%. Key predictors for PD include CA19-9 >37 u/ml and poorly differentiated histology. This predictive scoring system (0-6) can stratify PD risk, […]
Lymph node burden predicts recurrence patterns in cholangiocarcinoma
Tumor features after surgery for intrahepatic cholangiocarcinoma can inform recurrence risk and patient outcomes. Of 1,328 patients, 57.5% experienced recurrence: 381 had intrahepatic-only, 171 extrahepatic-only, and 165 combined recurrences. Having three or more metastatic lymph nodes increased the odds of combined recurrence by 3.47 times compared to intrahepatic-only (adjusted odds ratio). Patients with combined recurrence […]