Robotic pancreatoduodenectomy in patients 80 and older shows significant benefits over open surgery. Operative time was longer for robotic (441 min) vs. open (375 min), but with less blood loss (266 ml vs. 565 ml). Postoperative complications were lower with robotic surgery (52.2% vs. 70.6% for open, p = .013) as well as rates of […]
Author: STITCHES Newsletter
Surgeons Improve Antibiotic Use with Education
Surgeons can significantly enhance antimicrobial prescribing practices through targeted education, tackling the critical issue of antibiotic misuse. Educational interventions led to better antibiotic selection, timing, and duration. Review included 17 studies, primarily from high-income, tertiary hospitals, emphasizing pre-post design effectiveness. These findings underscore the importance of implementing educational strategies to strengthen antimicrobial stewardship in surgical […]
Mentorship Programs Increase Diversity in Surgery
Surgical subspecialties are striving for greater diversity through targeted mentorship for underrepresented minorities. Only 18 of 255 studies highlighted programs for URIM students, mainly at medical school (11) and high school (3) levels. Outreach can effectively boost interest in surgery among URIM individuals, though vascular surgery lacks any dedicated programs. Increasing mentorship initiatives across all […]
Redefining Surgical Education with a Virtual Journal Club
A novel journal club enhances resident training and engagement in trauma surgery. Residents improved critical appraisal skills and public speaking abilities. Faculty valued direct interactions with study authors on methodology and clinical relevance. This low-resource model fosters meaningful discussions without the logistical burdens of in-person events. Participating experts gained visibility and scholarly dissemination with minimal […]
Enhancing Liver Surgery Training: Outcomes from a Leading Fellowship
Dedicated hepatobiliary fellowship programs sharply boost surgical confidence and competence, crucial for today’s complex liver surgeries. Fellows showed a confidence jump from 2.5 to 9 out of 10 in performing right hemihepatectomies after training. Median surgical volume included 65 liver resections, with minimally invasive exposure rising from 10 to over 20 cases in five years. […]
Global Consensus on Managing Gastric Cancer Peritoneal Metastasis
Experts established clear guidelines for handling gastric cancer with peritoneal metastasis, crucial for improving patient outcomes. Consensus reached on 13 statements regarding diagnosis and treatment, with 75-100% agreement among 42 experts. A broader expert group, including medical oncologists, showed 12 of 13 statements agreed upon but struggled with systemic treatment consensus (52%). These guidelines aim […]
Hand-sewn closure leads to higher complications in left pancreatectomy.
In a study of 2,183 patients, postoperative pancreatic fistula (POPF) occurred in 32.9% of hand-sewn closures versus 21.0% for stapler closures. The reoperation rate was higher and hospital stays longer for hand-sewn patients. Surgeons should consider stapler closure to reduce POPF risk and improve patient outcomes. Findings were consistent across various pancreatic characteristics, reinforcing the […]
Insurance Instability Tied to Employment Disruption in GI Cancer
Patients with gastrointestinal cancer face significant insurance instability that impacts surgery timelines and costs. 9.8% of GI cancer patients changed insurance within a year post-diagnosis, compared to 8.8% of controls (adjusted HR 1.18). Insurance instability led to delayed surgeries (adjusted rate ratio 1.15) and higher out-of-pocket costs ($3,675 vs $3,206). Employment disruptions accounted for 97.2% […]
Cost-Effective Strategies in Complicated Diverticulitis
Early colectomy is more cost-effective than interval colectomy for managing complicated diverticulitis with abscesses, leading to better outcomes for patients. Early colectomy costs $8,852 less per patient and yields an incremental increase of 0.57 quality-adjusted life years (QALYs). This approach was deemed cost-effective in 96% of scenarios analyzed. Surgeons should consider early colectomy more often, […]
Adhesion Barriers Cut Small-Bowel Obstruction After Ladd Procedure
Using adhesion barriers during the Ladd procedure reduces rehospitalization for small-bowel obstruction without raising midgut volvulus risk. Reoperations for midgut volvulus: 3.5% with barrier vs. 2.7% without—no significant difference. Rehospitalization for small-bowel obstruction: 2.6% with barrier vs. 6.3% without—a 3.6% reduction. This suggests adhesion barriers can enhance patient outcomes after intestinal malrotation surgery. No significant […]