In a Delphi survey involving 43 global obesity experts, unanimous consensus (≥70% agreement) was achieved on 15 essential definitions and reporting standards in metabolic bariatric surgery (MBS). Notable agreement (95/121 statements) covered preferred surgical procedures like Roux-en-Y gastric bypass and sleeve gastrectomy. Moderate consensus existed for specific procedures, but none for intra-gastric balloons. Agreement extended […]
Author: STITCHES Newsletter
Combined Hepatic Resection and Ablation Ensure Safety and Long-Term Survival in Extensive Colorectal Liver Metastases
Examining 161 patients with colorectal liver metastases (CRLM), researchers investigated the safety and efficacy of simultaneous hepatic resection (HR) and ablation. With 77.6% having bilobar disease and 57.1% having ≥5 tumors, the combined procedure demonstrated acceptable safety and durable long-term survival (median 38.2 months, 5-year OS 33.2%). Simultaneous colon resection increased complications. Importantly, patients with […]
Pelvic Exenterations and Cytoreductions Safely Combined for T4 Rectal Cancers with Peritoneal Metastasis
Investigating the combination of pelvic exenterations and cytoreductions in T4 rectal cancers with peritoneal metastasis, a study on 39 patients (median age 35) revealed safety in terms of morbidity (18% major complications). Although achieving CC-0 in 97.4%, hyperthermic intraperitoneal chemotherapy was administered to 15 patients. Despite safety, overall and recurrence-free survival remained modest at 17 […]
Adjuvant Chemotherapy’s Limited Benefit in Node-Negative Pancreatic Cancer
In a Danish cohort study emulating a randomized controlled trial, researchers assessed adjuvant chemotherapy’s impact on node-negative (PN0) and node-positive (PN+) pancreatic cancer survival after surgery. Among PN0 patients, adjuvant therapy showed no significant 2-year survival difference (-2.2%). For PN+ individuals, a 9.9% improvement in 2-year survival was noted. Median overall survival was 24.9 months […]
AI Text-to-Image Generators Reinforce Bias: Underrepresentation of Diversity in Surgeon Depictions
Examining three popular AI text-to-image generators, the study assessed the demographic accuracy of surgeon representations. It found these models overwhelmingly portrayed surgeons as white and male, reinforcing societal biases. Trainees, especially non-white and female, were underrepresented. While one model reflected attending surgeons accurately, all underestimated trainee diversity. The study emphasizes the need for safeguards and […]
Optimal Surgical Approach for Small Bowel Neuroendocrine Tumors
In addressing the surge in small bowel neuroendocrine tumors (SB-NETs), this study underscores surgery’s pivotal role. Emphasizing multifocal assessment and mesenteric-sparing strategies, it delineates eight systematic steps for surgical planning. While stressing the necessity of achieving oncological control, some controversies persist, notably regarding resection in the presence of liver metastasis. The study encourages SB-NET resection […]
Outcomes of Esophagectomy in Elderly Patients with Esophageal Cancer
Analyzing 120 elderly esophageal cancer patients (Stage I-IV), the study revealed a 5-year overall survival rate of 45.2%. Lower body mass index, reduced pre-albumin levels, advanced tumor stage, postoperative pulmonary issues, and specific treatments significantly influenced outcomes. Despite a median 31-month follow-up, esophagectomy proved safe and feasible for elderly patients, emphasizing the importance of preventing […]
Optimal Timing for Gastric Cancer Surgery: Impact on Lymph Node Upstaging and Survival
Analyzing clinically node-negative gastric cancer patients, the study investigated the influence of time from diagnosis to surgery. Among 1824 patients, those with a longer interval (≥ 8 weeks) experienced less lymph node upstaging. Although overall survival differences appeared in Kaplan-Meier curves, multivariable analysis didn’t associate timing with survival. The findings suggest extended intervals don’t predict […]
Optimizing Surgical Approach in Synchronous Colorectal Liver Metastases
Analyzing data from 976 patients with synchronous colorectal liver metastases, researchers compared simultaneous and staged resections. Simultaneous resection, beneficial for low to moderate tumor burden and node-negative right-sided primary tumors, showed increased complications in high tumor burden cases. Staged resection demonstrated better outcomes for patients with node-positive left-sided primaries and higher tumor burden scores. Tailoring […]
Innovative Imaging for Anastomotic Site Assessment in Esophagectomy
In a prospective study on esophageal cancer patients undergoing thoracic esophagectomy, researchers compared tissue oxygen saturation and indocyanine green measurements. Tissue oxygen saturation imaging proved valuable in identifying the anastomotic site, overcoming limitations of indocyanine green. In 57 patients, decreased tissue oxygen saturation at the conduit tip correlated with congestion and an increased risk of […]