Laparoscopic cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is a safe and feasible procedure for selected patients with limited peritoneal disease. A retrospective analysis compared laparoscopic CRS-HIPEC to open CRS-HIPEC and found that laparoscopic procedures had lower estimated blood loss and overall morbidity rates. Grade III-IV complications, reintervention rates, and readmission rates were similar between […]
Author: STITCHES Newsletter
Management Strategies for Refractory Gastroesophageal Reflux Disease
Gastroesophageal reflux disease (GERD) is a common condition with increasing prevalence worldwide and a high economic burden. Despite proton pump inhibitor (PPI) therapy, a significant number of patients remain symptomatic. This review highlights the importance of differentiating between unproven GERD and refractory GERD, and provides a comprehensive overview of the diagnostic workup and personalized management […]
Customized bacteriophage therapy effectively cures chronic wounds and promotes healing
A randomized, placebo-controlled, double-blind clinical trial evaluated the efficacy and safety of bacteriophage therapy for chronic wounds. Customized bacteriophage cocktails were applied to wounds, resulting in 93.3% becoming sterile in 39 days, followed by complete healing within 90 days. In contrast, 83.3% of wounds treated with placebo remained colonized by bacteria without healing. The study […]
Robotic enucleation improves outcomes for tumors in the pancreatic head and uncinate process
A retrospective analysis compared short-term and long-term outcomes of robotic enucleation (ren) versus open enucleation (oen) for tumors in the pancreatic head and uncinate process. Of the 146 patients, 92 underwent ren with superior results in terms of shorter operative time, decreased blood loss, and lower postoperative pancreatic fistula rate. Bile leakage, major morbidity, mortality, […]
Optimal Pancreaticoduodenectomy Volume for Specialist Services
A systematic review and spline regression analysis of 33 cohort studies involving 198,377 patients were conducted to determine the minimum volume threshold required for a specialist pancreas service to achieve optimal outcomes. The results showed that 55 pancreaticoduodenectomies (PDs) per year were needed to achieve the lowest morbidity, while 43 PDs per year were required […]
Mindfulness-Based Interventions Improve Well-being and Performance in Surgeons
A scoping review of 24 studies on mindfulness-based interventions (MBIs) for surgeons found that MBIs are feasible in surgical contexts and can increase mindfulness, improve well-being (including burnout and psychological measures of stress), and enhance performance in terms of executive function, surgical skills, and communication skills. The conclusions are supported by psychometric measures, observations of […]
Prognostic Value of Circulating Tumor DNA in Localized Pancreatic Cancer
In a prospective study, researchers evaluated the prognostic value of circulating tumor DNA (ctDNA) using next-generation sequencing (NGS) in patients with localized pancreatic cancer (PDAC) undergoing neoadjuvant chemotherapy (NAC). They found that ctDNA detection was associated with higher CA19-9 levels and predicted worse progression-free survival. Moreover, the presence of KRAS ctDNA at diagnosis independently predicted […]
Surgical Sabermetrics Can Enhance Non-Technical Skills in the Operating Room
Researchers conducted a scoping review to evaluate the evidence for surgical sabermetrics, which refers to digital methods of assessing surgical non-technical skills. From a total of 19,229 articles, 81 studies met the inclusion criteria. These studies utilized 122 distinct objective, digital metrics to assess various non-technical skills, such as cognitive load, situation awareness, communication, teamwork, […]
Provider Perspectives on Cardiopulmonary Resuscitation for Frail Surgical Patients
Surgeons, anesthesiologists, and geriatricians hold differing views on cardiopulmonary resuscitation (CPR) for frail surgical patients. While judgment on CPR appropriateness depends on multiple factors including patient goals, comorbidities, and arrest cause, moral distress can arise from performing resuscitation in such patients. The study also highlights biases like ableism and ageism affecting clinicians’ perspectives and emphasizes […]
Judgement Errors and Patient Outcomes in Surgery
Researchers examined the impact of judgement errors on surgical patient care using data from a single institution’s national surgery quality improvement program. They found that 18% of surgical patients who experienced morbidity or mortality had an error in judgement during their hospitalization. Patients with specific preoperative variables, such as hepatobiliary procedures, insulin dependent diabetes, severe […]