Minimally invasive caudate lobectomy can lead to significant bleeding due to its proximity to the IVC, portal pedicle, and hepatic veins. Preoperative modeling and careful dissection techniques can help in safely managing the Spiegel/IVC interface during laparoscopic caudate resection, reducing the risk of thermal injury and ensuring successful outcomes. Journal Article by Salirrosas O, Harandi […]
Author: STITCHES Newsletter
Does palliative surgery improve outcomes in locally advanced pancreatic cancer?
Patients with locally advanced pancreatic cancer undergoing palliative surgery experienced slightly longer survival than those undergoing medical palliation, with hospital stays and readmission rates being significantly higher for the surgical group. Despite the marginal survival benefit, palliative surgery presents challenges in terms of hospitalization and risk of readmission. Journal Article by Kramer SP, Tonelli C […]
Development and Validation of a New Tool for Assessing Minimally Invasive Inguinal Hernia Repair Procedural Safety
Researchers developed and tested an 8-item procedure-specific assessment tool for minimally invasive inguinal hernia repair, showing good to excellent inter-rater reliability. Robotic procedures had higher reliability, and easier cases had higher agreement levels. The tool was designed and evaluated with expert input and real-world operative videos, with promising results for safety assessments in surgical training […]
Improving emotional support and clarity in surgical trainee remediation
Trainees perceived remediation as harrowing and isolating, with long-lasting emotional effects. They reported a lack of clarity on underperformance and subjective goals, and viewed remediation as a superficial ‘performance’ exercise. The study highlights the need for better emotional support and improved remediation plans to address deficits, with a focus on enhancing trainee/supervisor dynamics for improved […]
Incidence and Patterns of Hollow Viscus Perforation in Blunt Abdominal Trauma
Isolated hollow viscus (HV) perforations in blunt abdominal trauma (BAT) are rare but increasing in incidence. A retrospective study at a trauma center found that 6.04% of BAT patients undergoing emergency surgery had HV perforations, mostly involving grade II-III jejunum and grade I transverse colon. Despite a trend towards delayed diagnosis, a systematic approach based […]
Immediate Postoperative Mobilization Does Not Increase Overall Physical Activity After Colorectal Surgery
Immediate mobilization in the post-anesthesia care unit did not increase overall postoperative physical activity after elective colorectal surgery, as indicated by no significant differences in steps taken between the intervention group and standard care group during hospital stay. Other outcomes, including complications and compliance with ERAS protocol, were also similar between groups. Journal Article by […]
Does Fundoplication at the Time of Paraesophageal Hernia Repair Reduce Postoperative Reflux?
Patients who underwent paraesophageal hernia repair without fundoplication did not report different rates of postoperative symptoms compared to those who did. The study found that fundoplication at the time of hernia repair may not reduce postoperative reflux, despite being a standard practice for sliding-type hiatal hernias. This suggests that the additional procedure may not be […]
Tumor deposits negatively impact prognosis in colorectal cancers, new staging system proposed
Tumor deposits are a strong indicator of poor outcome in stage III colorectal cancers. A new staging system, considering tumor deposits, showed higher predictive values and better patient stratification for oncologic outcome compared to the current system. Tumor deposits were correlated with adverse prognostic indicators, confirming their negative impact on survival regardless of count. Revision […]
What Drives Good Outcomes in Older Patients with Colorectal Cancer Surgery?
Surgeon-led geriatric service and good quality surgery are key in achieving good outcomes in older colorectal cancer surgery patients. A 10-year review of 233 patients aged ≥75 years or frail showed low 30-day mortality (1.7%) and complications (12.0%), with a median length of stay of 7.0 days. Cumulative sum analysis demonstrated sustained improvement in outcomes, […]
Belonging in Surgery: Validated Instrument and Pilot Study
Researchers developed and validated an instrument to measure belonging in surgery among residents. The final instrument with 11 items showed a high internal consistency (Cronbach’s alpha = 0.90). Belonging in surgery was associated with race, graduating with one’s original intern cohort, and inversely correlated with resident stress levels. This validated instrument can be used to […]