In the quest for superior hernia care, researchers explored designated hernia centers (DHCs). Analyzing over 14,000 ventral hernia repairs (VHRs) from 261 sites, they found no clear advantage to DHCs. Surprisingly, non-designated hernia centers (NDHCs) displayed fewer 30-day complications and lower one-year hernia recurrence rates. The message? Current hernia center labels might not guarantee better […]
Author: STITCHES Newsletter
Irreversible Nerve Damage: The Pre-op Pain Predictor for Chronic Post-op Pain in Inguinal Hernia Patients
Inguinal hernia patients with pre-op pain face potential irreversible nerve damage, signaling a road to chronic post-op pain (CPIP). Studying 40 patients who underwent hernia repair, researchers found intraneural fibrosis within the ilioinguinal nerve in all pre-op pain cases. The fibrosis degree correlated positively with pain duration. This unveils a crucial link between pre-op pain […]
Subtotal vs. Total Adrenalectomy in Bilateral Pheochromocytoma – Less Insufficiency, More Recurrence?
In the world of adrenal gland dilemmas, researchers delve into the showdown between total adrenalectomy and its hip sibling, subtotal adrenalectomy, for bilateral pheochromocytoma. Analyzing 10 studies with 1202 patients, they uncover that subtotal adrenalectomy, while saving from adrenal insufficiency, packs a punch with a higher recurrence rate (14.1% vs. 2.6%) and lower post-surgery steroid […]
Navigating Neoadjuvant Therapies for Esophageal Cancer
In the exploration of treatments for advanced esophageal squamous cell carcinoma (ESCC), researchers compared outcomes of neoadjuvant chemotherapy (NCT), neoadjuvant chemoradiotherapy (NCRT), and neoadjuvant immunochemotherapy (NICT). NCRT and NICT groups exhibited superior pathological responses, with higher pathologic complete response rates (29.9% and 23.6%, respectively) compared to NCT (8.1%). NCRT significantly reduced lymph node metastasis in […]
Intraperitoneal Paclitaxel Shows Promise: Effective and Tolerable Combo for Gastric Cancer with Peritoneal Metastasis
In a phase II study, researchers explored the efficacy of intraperitoneal paclitaxel combined with S-1 and cisplatin for gastric cancer with peritoneal metastasis. Among 53 patients, the treatment achieved a 73.6% 1-year overall survival rate, meeting the primary endpoint. The median survival time was 19.4 months, and the 1-year progression-free survival rate reached 49.6%. While […]
Insights from Percutaneous Transesophageal Gastro-Tubing in Japan
In a comprehensive study of 3,684 patients undergoing percutaneous transesophageal gastro-tubing (PTEG) in Japan, researchers found a mere 1.3% complication rate. PTEG served diverse purposes, with 1,455 cases for decompression and 2,193 for feeding. Notably, complications led to minimal invasive treatments, predominantly red blood cell transfusions and tube replacements. This real-world analysis not only sheds […]
Impact and Strategies for Unplanned Conversions in Robotic Pancreaticoduodenectomy
In the robotic frontier of pancreaticoduodenectomy, a study of 400 patients revealed a 10.5% unplanned conversion rate. Men, especially, faced this detour, often due to vascular surprises or bleeding challenges. While conversions meant shorter surgeries, they spiked blood loss and complications, with higher mortality rates. Thankfully, conversion rates decreased over time, suggesting growing surgeon proficiency. […]
Beyond CT Scans: Nomogram Outshines in Predicting Lymph Node Metastasis in Colorectal Cancer
In a game-changing move for superficial colorectal cancer, researchers crafted a user-friendly nomogram for personalized lymph node metastasis (LNM) prediction after endoscopic surgery. Analyzing 608 cases, the nomogram trumped traditional CT scans, showcasing superior predictive power, as validated by ROC, DCA, and clinical impact curves. By spotlighting age, tumor features, and lipid levels, this tool […]
Seeing Green: Assessing Indocyanine’s Impact in Surgery Through Meta-Review
Exploring the surge in indocyanine green’s (ICG) role in surgeries, this meta-review of 116 studies uncovered varying ICG applications, from bariatric to urologic procedures. Despite benefits in anastomotic leak prevention, especially in colorectal surgery, and limited advantages in sentinel node detection, the study cautions on methodological shortcomings. Most meta-analyses scored low quality per AMSTAR 2, […]
A Mental Fitness Pilot for Academic Surgeons
In a pioneering initiative, academic surgeons underwent a six-week Positive Intelligence (PQ) training program, aiming to uplift mental fitness and well-being. Results from 15 participants showed significant PQ score improvements (59 to 65), endorsing the program’s impact. High users reported ongoing benefits, fostering a supportive community. While sleep and well-being metrics didn’t significantly shift, the […]