Pelvic exenteration (PE) substantially increases curative options for patients with locally advanced or recurrent rectal cancer. R0 resections are now achievable in over 60% of cases thanks to improved surgical techniques and interdisciplinary collaboration. Success hinges on strategic patient selection, imaging, and tailored reconstructions based on tumor extent. Although morbidity can be significant, mortality has […]
Author: STITCHES Newsletter
Inanimate Curriculum Enhances Surgical Skills and Reduces Stress in Residents
Integrating an inanimate training curriculum with virtual reality significantly boosts surgical residents’ technical skills and confidence. Over two weeks, 32 general surgery residents showed marked improvements, with modified objective structured assessment scores rising from 20.9 to 25.8 and task completion times dropping from 773 to 484 seconds. Residents reported feeling more relaxed and experienced lower […]
Timeouts in Surgery Slashing Mortality: A Crucial Safety Measure
Implementing surgical timeouts, drawn from aviation safety, significantly cuts mortality and complications in the operating room. Despite proven benefits, adherence remains inconsistent, with only half of clinicians satisfied with current practices. Challenges include high team turnover and checklist overload. Innovations like real-time feedback systems and integration with electronic medical records aim to enhance compliance and […]
Surgeons Back Preoperative Chemotherapy for Intrahepatic Cholangiocarcinoma Management
An international survey reveals that 91.6% of surgeons advocate for preoperative chemotherapy in initially unresectable intrahepatic cholangiocarcinoma (ICCA). Most cite tumor downstaging and selecting favorable cases for R0 resection as major benefits. Key concerns defining unresectability include insufficient future liver remnant volume and inability to achieve negative margins. As multidisciplinary discussions dominate decisions, establishing expert […]
Early stoma reversal significantly reduces complications and hospital stay
Timing of stoma reversal plays a critical role in patient outcomes. In a retrospective cohort study of 505 patients, those reversed within 18 months experienced significantly lower complication rates (7.9% vs. 35.1%) and shorter hospital stays (6 days vs. 7 days). Alarmingly, 28.9% underwent reversal, highlighting a gap in post-operative care. Factors such as male […]
New techniques expand endoscopic options for gastric subepithelial lesion resection
Innovations in endoscopic resection now enable the safe removal of larger and deeper gastric subepithelial lesions (SELs), previously suitable only for surgical intervention. This article outlines various endoscopic modalities and provides crucial technical tips. In a case series, successful en bloc resections were achieved in all patients with no adverse events, demonstrating the effectiveness of […]
AI Revolutionizes Endoscopy, Boosting Detection Rates and Workflow Efficiency
Artificial intelligence significantly enhances endoscopic precision, outperforming human detection rates, particularly in polyp identification. Systems like GI Genius demonstrate remarkable sensitivity and specificity, while convolutional neural networks facilitate real-time classification of lesions. Furthermore, AI streamlines workflows through automated reporting and training tools. Despite these advancements, successful implementation hinges on overcoming limitations like data quality and […]
Elevated CA19-9 Levels Signal Poor Prognosis in Very Early Intrahepatic Cholangiocarcinoma
Patients with very early intrahepatic cholangiocarcinoma (ICC) show significant long-term survival, with 1-, 3-, and 5-year overall survival rates at 92.3%, 72.6%, and 58.0%, respectively. However, elevated carbohydrate antigen 19-9 (CA19-9) levels correlate with worse overall and recurrence-free survival rates, indicating more aggressive tumor features. Such biomarkers could refine perioperative treatment strategies and identify patients […]
Surgical Resection After Systemic Therapy Shows Promising Outcomes in Liver Cancer
Surgical resection post-systemic therapy for hepatocellular carcinoma (HCC) yields encouraging long-term outcomes. In a cohort of 96 patients, median overall survival reached four years, with one-year survival rates at 86.1%. R0/R1 resection correlated with improved progression-free and overall survival, presenting a significant therapeutic advantage. Complications were manageable, with no 30-day mortalities and a 4.2% rate […]
Bariatric surgery significantly improves nonalcoholic fatty liver disease outcomes
One year post-bariatric surgery, 80% of patients showed a notable improvement in the nonalcoholic fatty liver disease (NAFLD) activity score. Nonalcoholic steatohepatitis (NASH) improved in 42.1% without worsening fibrosis, and 78.8% experienced fibrosis improvement. MRI-proton density fat fraction (MRI-PDFF) reliably detected liver fat remission in 72.2% to 90.4% of patients, while a significant decline in […]