Patients treated for firearm injuries at non-violence intervention programs (VIPs) miss critical support services, affecting outcomes. Two-thirds of patients were at VIP facilities, but 81.5% did not receive VIP services. Assault-related injuries were the strongest predictor of VIP service use (OR 3.00; p=0.002). High-risk patients at non-VIP facilities are older and less likely to receive […]
Author: STITCHES Newsletter
Patterns of Recurrence After Esophageal Cancer Surgery
Half of esophageal cancer patients face recurrence after surgery, with significant implications for patient management. Of 1,310 patients with recurrence, 37.3% had it at multiple distant sites, while 14.4% experienced isolated local recurrence. Liver-only recurrence was detected significantly earlier (median 9 months) and had the poorest survival (7.4 months post-recurrence). Surgeons should tailor postoperative surveillance […]
Neoadjuvant Chemo Fails to Improve Outcomes in Colorectal Metastases
Neoadjuvant chemotherapy before CRS/HIPEC for metachronous colorectal peritoneal metastases offers no survival benefit and increases complication risks. Patients receiving neoadjuvant chemotherapy had a complication rate of 25% versus 12.7% for those undergoing upfront surgery. Length of hospital stay increased to 12 days with neoadjuvant treatment compared to 10 days without. Surgeons should weigh these risks […]
Robotic en bloc resection for pancreatic cancer is safe.
A robotic approach combined distal splenopancreatectomy and left nephrectomy in a complex case with renal infiltration from pancreatic adenocarcinoma. The procedure achieved negative margins and involved a multidisciplinary team to minimize conversion risk and enhance oncological outcomes. The patient was discharged on postoperative day 6, indicating a favorable recovery. Pathology revealed T4 cancer with two […]
Effectiveness of Anti-Adhesion Agents in Surgery
Anti-adhesion agents significantly reduce adhesive intestinal obstruction rates in intra-abdominal surgery, impacting surgical outcomes and costs. Incidence of adhesive intestinal obstruction was 12.4% in patients using anti-adhesion agents, versus 18.5% in non-users. Patients receiving these agents had higher quality-adjusted life years (1.992 QALYs) and lower average costs ($3,794, saving $1,330). Consider broader use of anti-adhesion […]
Robotic and laparoscopic cholecystectomy yield similar outcomes.
In a study of 592 patients, no significant differences were found in intraoperative complications or secondary outcomes between robotic and laparoscopic cholecystectomy across all severity grades of acute cholecystitis. Laparoscopic surgery had a longer postoperative hospital stay for grade II-V cholecystitis patients (2 days vs. 1 day, p = .048), but it wasn’t an independent […]
High Satisfaction in Mentor-Mentee Surgical Programs
Mentee-mentor matching in surgical training shows strong satisfaction, but evidence is weak. A pooled satisfaction rate of 92% from 144 mentees indicates effective pairing. Shared clinical or research interests were the main matching criterion, used by 83% of programs. Surgeons should consider enhancing selection processes and meeting structures to bolster mentorship effectiveness. Areas needing improvement […]
Multivisceral Resection for Pancreatic Cancer: Comparable Outcomes
Multivisceral resection (MVR) for pancreatic ductal adenocarcinoma shows similar short-term outcomes to standard resection, but poorer long-term survival rates among selected patients. 2-year overall survival rate for MVR is 33.3% vs. 49.9% for standard resection (p=0.006). 2-year disease-free survival rate is 11.3% for MVR vs. 25.9% for standard resection (p=0.018). Surgeons should consider MVR for […]
Surgical availability impacts patient care decisions in urgent cases.
Nearly 30% of patients seek non-local care for urgent/emergent surgery. Counties with the lowest hospital treatment rates performed 15% fewer surgeries per admission. Surgical outcomes may hinge more on local practices than workforce numbers. Regions with low surgery rates saw a 17% increase in non-local urgent care utilization. Journal Article by Abid M, Holmes GM […]
Fragmented Care Impacts Pancreatic Cancer Outcomes
Fragmented care for pancreatic cancer patients at high-volume centers leads to delays in chemotherapy but not worse surgical outcomes. One-third of patients (n = 124) received fragmented care, often living farther from the center. Delayed chemotherapy initiation occurred in 17.6% of fragmented care patients compared to 5.6% of those receiving care solely at the center. […]