Delayed gastric emptying (DGE) is a major complication after pancreatic surgery, impacting recovery and hospital stays. The overall DGE grade B/C rate was 11.9%, with 12.7% after pancreatoduodenectomy and 4.2% after left pancreatectomy. No effective treatments for DGE were found, but 12 strategies showed promise in reducing rates, notably minimally invasive left pancreatectomy. Minimally invasive […]
Author: STITCHES Newsletter
Laparoscopic Resection Rectopexy Outperforms Delorme’s for Rectal Prolapse
Laparoscopic resection rectopexy significantly reduces recurrence rates in full-thickness rectal prolapse compared to Delorme’s procedure. Recurrence rates within 24 months: 8.2% for laparoscopic resection vs. 42.8% for Delorme’s. Laparoscopic surgery had a median time to recurrence of 17.8 months, compared to 8.2 months for Delorme’s. Choose laparoscopic resection for better long-term outcomes and improved quality […]
Neoadjuvant Therapy Improves Outcomes in Intrahepatic Cholangiocarcinoma
Neoadjuvant chemotherapy followed by surgery significantly improves survival and reduces recurrence in patients with potentially resectable intrahepatic cholangiocarcinoma. Median overall survival was 52.9 months for neoadjuvant therapy versus 37.0 months for upfront surgery. Recurrence risk was lower at 57.7% compared to 65.7%, and the time to relapse extended to 16.5 months from 10.7 months. This […]
Gallstone Disease and Lifestyle Factors: A New Approach
Higher lifestyle health scores may reduce gallstone disease risk. A standard deviation increase in Life’s Essential 8 (le8) decreases gallstone odds by 29%. Life’s Crucial 9 (lc9), which includes mental health, reduces odds by 31% and shows better predictive power than le8. Consider integrating lifestyle assessments into patient evaluations to lower gallstone disease risk. lc9 […]
Gastric Cancer Treatment Shift: Prioritizing Patient Outcomes
Gastric cancer with peritoneal metastases is rising, especially in younger patients, highlighting the urgent need for better outcomes. Novel therapies like normothermic intraperitoneal and systemic chemotherapy have shown overall survival benefits. Patient-reported outcomes remain underreported in major trials, with critical insights missed from studies like Dragon-01. Incorporating tailored patient-reported measures into clinical trials is essential […]
Effective Weight Loss Device for Type 2 Diabetes and Obesity
An endoscopically placed bypass liner significantly improves glycemic control and weight loss in patients with poorly controlled type 2 diabetes and obesity. HbA1c reduction at 12 months was -1.10% for the bypass group versus -0.28% for sham (p=0.0004). Patients in the bypass group experienced a 7.7% total weight loss compared to 2.1% in the sham […]
New treatment shows promise for refractory GERD patients
Anti-reflux mucosal ablation significantly benefits patients with reflux-predominant GERD unresponsive to PPI therapy. 71.4% of patients receiving mucosal ablation reported at least a 50% improvement in quality of life after 6 months, compared to just 3.6% in the sham group (p<0.001). Significant reductions in heartburn, regurgitation, and reflux episodes were observed, with 35.7% of patients […]
Endoscopic Submucosal Dissection Effective for Rectal Neoplasms
Endoscopic submucosal dissection (ESD) shows promise for safely resecting rectal neoplasms near the dentate line, improving surgical options. En bloc resection rates reached 93.7% and R0 resection rates were at 85.4% in 255 patients. Overall adverse events occurred in just 8.7%, with manageable complications like bleeding (5.1%). This technique could replace traditional transanal methods, but […]
Emerging Techniques for GERD: Long-Term Efficacy Insights
Novel minimally invasive procedures for gastroesophageal reflux disease show promising outcomes, impacting patient selection and surgical approaches. Esophyx and Linx provide long-lasting symptom relief, with sustained quality of life improvements for chronic GERD patients. Stretta shows clinically significant long-term effects on proton pump inhibitor usage and pH monitoring but has limited follow-up data. Surgeons should […]
Predicting Liver Failure After Hepatectomy: Key Early Indicators
Early liver function tests can help surgeons identify patients at risk for post-hepatectomy liver failure (PHLF), improving outcomes. In a study of 445 patients, 8.5% developed PHLF. On postoperative day 3, bilirubin ≥1.8 mg/dl (sensitivity 93.3%) and INR ≥1.18 (sensitivity 80.6%) strongly predicted PHLF. Relying on current guidelines starting at day 5 could delay important […]