Billroth I reconstruction shows clear advantages over Roux-en-Y in laparoscopic distal gastrectomy for early efficiency and outcomes. Operative time: 216.6 min for Billroth I vs 251.7 min for Roux-en-Y (p = .016) Blood loss: 33 ml for Billroth I vs 105 ml for Roux-en-Y (p = .003) Hospital stay: 6.7 days for Billroth I vs […]
Author: STITCHES Newsletter
Gastrointestinal cancers present sharp disparities in working-age populations across BRICS-plus countries.
In 2021, China reported over 17 million disability-adjusted life years (DALYs) for gastrointestinal cancers, leading among BRICS-plus nations. Colorectal, esophageal, stomach, and liver cancers make up over 70% of the burden, with significant reductions noted for esophageal and stomach cancers in most countries. Men generally face a higher incidence, except for gallbladder cancers, which disproportionately […]
Adherence to BCLC Guidelines Boosts Survival in HCC
Real-world adherence to BCLC treatment guidelines in hepatocellular carcinoma significantly impacts patient survival. Overall adherence was only 47.8%, with the best rates (93.5%) in stage D and the lowest (23.1%) in stage C. Patients following BCLC recommendations lived longer: 722 days versus 535 days for non-adherents. Improving adherence, especially in early and advanced stages, is […]
Hybrid EMR-Hot Avulsion Reduces Recurrence in Early Gastric Cancer
Hybrid EMR-hot avulsion significantly lowers cancer recurrence rates after endoscopic submucosal dissection for early gastric cancer. Recurrence rate with EMR-ha was just 11.5% (3/26) vs. 44% (11/25) for hot avulsion and 36.6% (15/41) for APC. Median disease-free survival post-recurrence treatment was 34.5 months, with 84.6% of patients achieving complete resection via re-ESD. Consider adopting hybrid […]
Limit Post-Op Antibiotics in Uncomplicated Appendicitis
Using postoperative antibiotics for uncomplicated appendicitis is unnecessary and may increase risks. Preoperative antibiotics lead to shorter hospital stays and fewer complications. Postoperative antibiotics raise the risk of Clostridium difficile infections and surgical site infections. Patients given only preoperative antibiotics had better outcomes than those receiving postoperative doses. Surgeons should revise protocols to limit antibiotic […]
Multifocal Cholangiocarcinoma: Rethinking Prognosis
Surgeons need to reconsider the staging of multifocal intrahepatic cholangiocarcinoma as all cases should be classified as AJCC stage III, impacting surgical decision-making. Patients with multifocal tumors showed worse overall survival (26.1 vs. 60.0 months) and disease-free survival (9.8 vs. 25.0 months) compared to solitary tumors of stage II. Genomic profiling revealed that both satellite […]
MELD Score Assesses Risks in Appendectomy Patients
The MELD score predicts postoperative complications in acute appendicitis, aiding surgical decision-making. Analyzing 121,207 patients, 30-day mortality was just 0.5% (567 cases). MELD 3.0 significantly outperformed previous versions in predicting outcomes, with a risk cutoff of 11 indicating higher complication rates. This score enhances patient selection and risk assessment for appendectomy, whether laparoscopic or open. […]
Innovative Training Could Address Global Surgeon Shortage
A shift to tech-driven, competency-based surgical education is critical for resolving the surgeon shortage. Telementoring and simulation training can enhance skill acquisition significantly. Online platforms support scalable learning and faculty development. Implementing these strategies could improve surgical outcomes in underserved areas. Collaboration through global networks promotes resource sharing and retention. Review by Kewalramani D and […]
Improved Liver Segmentation Enhances Surgical Planning
Surgeons can refine liver surgery strategies with a new patient-specific segmentation method focused on vascular structures. This new hepatic and portal vein-based classification (hpvc) showed better anatomical alignment than conventional methods, particularly for complex liver segments 5 and 8. Surgeons rated hpvc higher in accuracy for surgical planning and anatomical adherence compared to traditional classifications […]
Outpatient Cholecystectomy Shows Solid Outcomes with New Technique
Transcylindrical cholecystectomy is a promising, safe approach for outpatient treatment of cholelithiasis. 1626 patients with an average age of 59 saw low complication rates: only 0.9% conversion and 5.5% unplanned admissions. 78% reported good to excellent physical condition within 24 hours post-op. This method, particularly under various anesthetic options, can enhance patient selection and care […]