Adopting AI-powered scribes can streamline electronic health record tasks for surgical practices and enhance patient volume. Clinicians using AI scribes spent 13.4 fewer minutes on EHRs weekly and reduced documentation time by 16 minutes. On average, they saw 0.49 more patients per week. Surgeons may benefit from integrating AI tools to improve efficiency and patient […]
Author: STITCHES Newsletter
No Long-Term Outcome Difference in Gallbladder Cancer Resection
Surgeons can expect similar long-term outcomes when choosing between segment 4b/5 and wedge resection for gallbladder adenocarcinoma. 163 patients underwent randomized surgeries; segment 4b/5 took longer (318 min vs. 287 min) and had higher blood loss (265 ml vs. 223 ml). No differences in morbidity, mortality, or R0 resection rates were observed. At 27 months […]
New Biliary Drainage Technique for Altered Anatomy Shows Promise
A novel endoscopic approach improves biliary drainage outcomes for patients with altered anatomy. Technical success rate: 87.3%, clinical success: 93.8%. Adverse event rate: 20%, with 30.6% persistent fistula rate within 3 months. Consider this technique for patients with complex anatomy, especially when multiple biliary interventions are needed. Most common indication: benign strictures (58.2%). Multicenter Study […]
Improved Outcomes with Elective Paraesophageal Hernia Repairs
Elective repairs of paraesophageal hernias lead to significantly better outcomes than urgent or emergent procedures. Elective surgeries had a textbook outcome rate of 88.1%, compared to 58.2% for urgent and 46.7% for emergent (p < 0.001). Elective repairs used laparoscopic or robotic techniques 96.3% of the time, versus only 40% for emergent cases (p < […]
Cost Insights on Alpha Blockade for Pheochromocytoma Surgery
Selective alpha blockers lower medication expenses but yield similar surgical outcomes for pheochromocytoma. Median preoperative medication cost was $19.73 for selective vs. $1,033.70 for nonselective (p < 0.001). Total admission costs were nearly identical: $31,104.47 for selective vs. $31,471.90 for nonselective (p = 0.428). Choosing selective blockers may optimize preoperative costs without compromising patient care. […]
Imaging Predicts Complications After Pancreatic Surgery
Evaluating liver toxicity from oxaliplatin-based neoadjuvant therapy (NAT) can enhance surgical decision-making for pancreatic ductal adenocarcinoma. Significant increases in splenic volume and hepatic parenchyma variability were observed post-chemotherapy (p < 0.001). Low liver attenuation and heterogeneous enhancement pre-surgery were linked to severe postoperative complications (p < 0.001). This study underscores the importance of preoperative imaging […]
Improved Liver Retraction in Robotic Hepatectomy
A new technique for liver retraction during robotic surgery minimizes trauma and enhances surgical precision. Implemented in 26 robotic hepatectomies, the Clip-Pulley Maneuver (CPM) proved to be complication-free. No major events (Clavien-Dindo grade III or higher) were reported, and the diaphragm remained intact in all cases. This method allows real-time adjustments for optimal retraction without […]
Impact of Enhanced Recovery on Liver Surgery Outcomes
High compliance with enhanced recovery programs does not significantly improve survival after liver surgery. Among 1,860 patients, only 24.4% achieved high compliance. Twelve-month overall survival rates were similar: 96% for high compliance vs. 92% for low compliance (p = 0.11). Long-term mortality risks included metastatic disease and prolonged operative times. Only patients with colorectal liver […]
Total Neoadjuvant Therapy Hurts Survival in Rectal Cancer
Patients with rectal cancer who undergo total neoadjuvant therapy have significantly worse survival rates after liver surgery. Median overall survival is 48.7 months for total neoadjuvant therapy patients vs 99.5 months for those who didn’t (p = .01). Total neoadjuvant therapy is an independent predictor of decreased overall survival (hazard ratio 0.41). Watch for higher […]
Predictive Model for Perineural Invasion in Colorectal Cancer
A new predictive score identifies patients at risk for perineural invasion (PNI) in colorectal cancer, impacting surgical management and outcomes. PNI was found in 13.1% of patients; it predicts a 5-year overall survival of 54% versus 76.4% without PNI. Key predictors include age, male sex, race, tumor location, histology, and elevated carcinoembryonic antigen (CEA) levels. […]