Researchers explored the global landscape of robot-assisted minimally invasive gastrectomy (RAMIG) for gastric cancer in a 2020-2023 registry spanning 25 centers. In 759 cases, RAMIG showcased varying techniques and excellent outcomes. Anastomotic leakage rates after total and distal gastrectomy reflected high surgical quality. The study sets a RAMIG quality standard, offering an international reference for […]
Author: STITCHES Newsletter
New Subtypes in Intrahepatic Cholangiocarcinoma
Researchers classified intrahepatic cholangiocarcinoma (ICC) into perihilar and peripheral subtypes, revealing distinctive features and survival outcomes. Among 1264 patients, 84.3% were ICC-peripheral, while 15.7% were ICC-perihilar. The perihilar subtype exhibited aggressive characteristics and poorer survival than the peripheral subtype. Interestingly, ICC-perihilar behaved akin to bile duct carcinoma, while ICC-peripheral resembled primary liver malignancies. This novel […]
Screening Saves: Total Colonoscopy’s Crucial Role in Gastric Cancer Patients
In a study of 796 preoperative gastric cancer patients, 5.4% had synchronous colorectal cancer (SCRC). Endoscopic treatments were successful, and all SCRC patients underwent curative treatment, with no attributed deaths. Cumulative mortality rates showed 12.6% for gastric cancer-related deaths but none for SCRC. Screening total colonoscopy proved effective, suggesting its vital role. Cost-effectiveness analysis revealed […]
Histopathologic Insights into Median Arcuate Ligament Syndrome
In a breakthrough study, researchers introduced the first histopathologic grading system for Median Arcuate Ligament Syndrome (MALS). Examining specimens from 36 patients who underwent robotic MALS surgery, the team identified unique nerve and lipogranuloma findings. Histopathologic abnormalities correlated with postoperative improvement, supporting nerve compression and inflammation as key contributors to MALS pain. The study advocates […]
Shifting Tides: Embracing Total Neoadjuvant Therapy for Advanced Rectal Cancer
Examining trends from 2012 to 2020, researchers unveil that over 50% of 51,407 patients with locally advanced rectal cancer received total neoadjuvant chemoradiation (TNT). Factors like age and comorbidities influenced TNT rates, with stage III patients more likely to undergo it. Notably, TNT usage increased by 38% post-guideline inclusion in 2018. This study not only […]
Anastomosis Matters: Kono-S Offers Edge in Reducing Recurrence in Crohn’s Disease
Delving into Crohn’s disease post-ileocolic resection, this meta-analysis (17 studies, 2087 patients) compares anastomotic techniques. Endoscopic postoperative recurrence (epor) risk at ≥6 months was 37.2%. Kono-S anastomosis (17.7% cases) outshone conventional methods (81% cases), showing a lower epor incidence (24.7% vs. 42.6%). Results suggest Kono-S reduces epor risk, emphasizing its potential for challenging cases. While […]
Cracking the Code: Gastrojejunal Anastomosis Holds Clues to Weight Regain in Gastric Bypass Graduates
Researchers delved into the post-gastric bypass world, unraveling the mystery of weight regain (WR). Examining 34 Roux-en-Y gastric bypass alumni, they discovered a correlation between the gastojejunal anastomosis (GJA) diameter and WR. However, excluding outliers with GJA over 30 mm nullified the link. The study highlights the potential of visual GJA estimation and emphasizes that […]
Robotic Surgery Linked to Lower Postoperative Infections and Shorter Hospital Stays in Pancreatoduodenectomy
In a retrospective study spanning 2013 to 2022, researchers delved into healthcare-associated infections (HAIs) post-pancreatoduodenectomy (PD). Among 2632 patients, HAIs decreased over time, especially in open PD (OPD). Robotic PD (RPD) exhibited significantly fewer HAIs (5.8% vs. 9.6% in OPD). RPD correlated with reduced infections, shorter hospital stays, and higher costs. Notably, attention should be […]
Gallbladder Polyps: Size Matters in Predicting Cancer Risk
In this cohort study on 438 patients with gallbladder polyps (GPs), the risk of gallbladder cancer was 0.7% for all polyps, escalating to 5.9% for those ≥10 mm. GP size emerged as the sole predictor of malignancy (p = 0.0001), with a 21 mm cutoff indicating cancer risk. Patient’s age, symptoms, number of polyps, and […]
Big Data Shapes Future of Hepatopancreatobiliary Cancer Surgery
In the realm of surgical oncology, randomized controlled trials (RCTs) often face recruitment and standardization challenges. This study dives into hepatopancreatobiliary (HPB) cancer surgery, spotlighting the pivotal role of large databases. While RCTs provide crucial evidence, big data steps in where they fall short. Beyond justifying current practices, this research maps the future of HPB […]