Researchers conducted a population-based study to determine if the publication of the STOP-IT randomized controlled trial influenced antibiotic prescribing for patients with complicated intraabdominal infection (CIAI). The study analyzed data from four hospitals in Calgary, Canada, between July 2012 and December 2018. The results showed that antibiotic duration for appendix or biliary tract sources of […]
Author: STITCHES Newsletter
No significant difference in patient outcomes between trainee-led and consultant-led emergency laparotomy
Based on a population dataset analysis, this study compared the outcomes of trainee-led emergency laparotomy surgeries with consultant-led surgeries. The study included 111,583 patients and found that mortality rates at discharge were equivalent between the two groups after adjusting for various factors. Trainee-led operations reported fewer cases of significant blood loss, and the length of […]
Colorectal Surgery Postdischarge App: Enhancing Satisfaction, Impact on 30-Day Readmission Limited
A randomized controlled trial evaluated the effectiveness of a postdischarge mobile app in reducing 30-day readmissions and improving patient-reported outcomes after elective colorectal surgery. The app did not significantly reduce readmissions or emergency room visits, but it led to significant improvements in patient satisfaction, well-being, and reduced anxiety levels. While the app may not reduce […]
Total Neoadjuvant Therapy for Rectal Cancer: Impact on Surgical Outcomes and Pathology
In a meta-analysis of 11 randomized controlled trials involving 3,185 rectal cancer patients, researchers compared total neoadjuvant therapy (TNT) to standard long course chemoradiotherapy (LCRT). TNT did not significantly differ in mortality or major complications but increased the risk of breached total mesorectal excision (TME). However, TNT showed a lower risk of disease progression during […]
Perioperative Chemotherapy Improves Overall Survival in Synchronous Colorectal Liver Metastases
Analyzing 72,376 patients with colorectal liver metastases (CRLM) from the National Cancer Database, researchers found that liver-only CRLM patients undergoing perioperative chemotherapy had a superior median overall survival (OS) of 44.7 months. Resection of both primary and metastatic sites also correlated with better OS (38.9 months) compared to metastatic site alone (30.2 months) or primary […]
Predictive Scoring Model Identifies Risks for Unplanned ICU Readmission in Surgical Patients
Analyzing 1,112 surgical ICU patients, researchers identified congestive heart failure, high SOFA-hepatic score, carbapenem use, and pre-discharge factors (inadequate glycemic control, positive fluid balance, low PaO2/FiO2 ratio, and total parenteral nutrition) as predictors for unplanned ICU readmission. The developed scoring model showed good discrimination, with an AUC of 0.74. Patients with scores ≥4 points had […]
Laparoscopy Safely Manages Anterior Abdominal Stab Wounds
In a retrospective study spanning 25 years, researchers evaluated laparoscopic surgery’s role in diagnosing and treating anterior abdominal stab wounds (AASWs). Among 142 surgical patients, laparoscopy (62.7%) proved safe, with only 2 cases of overlooked injuries. For stable patients without significant injuries, laparoscopy demonstrated advantages, including reduced blood loss and shorter hospital stays compared to […]
Predicting Portal Vein System Thrombosis: A Nomogram Using Preoperative Portal Vein Velocity after Splenectomy with Esophagogastric Devascularization
In cirrhotic patients with portal hypertension undergoing splenectomy with esophagogastric devascularization (SED), portal vein system thrombosis (PVST) is a serious concern. This study involving 562 patients revealed that low preoperative portal vein velocity (PVV) was the strongest independent risk factor for PVST. Patients with PVV ≤ 16.5 cm/s had a significantly higher incidence of PVST. […]
Validating Basic Robotic Surgical Skills: A Proficiency Test for the Versius Surgical Robot Using a Virtual Reality Simulator
In assessing competency for the Versius surgical robot, researchers developed a virtual reality simulator-based test. Participants, categorized by experience, underwent exercises on the Versius trainer. Discriminatory analysis revealed parameters distinguishing novices and experienced surgeons but not intermediates. Test-retest reliability analysis showed moderate reliability for selected parameters. Non-compensatory pass/fail levels were defined, indicating novices’ failure and […]
Deep Neuromuscular Blockade Mitigates Working Space Issues in Low-Pressure Pneumoperitoneum during Laparoscopic Cholecystectomy
In a non-inferiority RCT comparing low-pressure pneumoperitoneum (LPP) with deep neuromuscular blockade (NMB) to standard pressure pneumoperitoneum (SPP) with moderate NMB for laparoscopic cholecystectomy, researchers found similar surgeon satisfaction scores between groups. This suggests that LPP with deep NMB is not inferior to SPP with moderate NMB, indicating a potential approach to address working space […]