Bariatric surgery significantly raises the risk of alcohol use disorder (AUD) and alcohol-related mortality, crucial for surgical decision-making. Gastric bypass (GBP) patients face a 5.07 times higher AUD risk, while vertical banded gastroplasty (VBG) and gastric banding patients are 2.28 and 2.34 times more likely to develop AUD, respectively. Alcohol-related mortality is 6.18 times higher […]
Author: STITCHES Newsletter
PANC Classification Improves Prognosis in Pancreatic Cancer
New insights on CA 19-9 dynamics can enhance treatment strategies for pancreatic cancer patients undergoing surgery. In a study with 283 patients, median overall survival was 56.3 months, and recurrence-free survival was 26.0 months. Patients categorized as type 1 (preoperative normalization) or type 2 (post-surgery normalization) had a significantly better prognosis (overall survival of 61.1 […]
Title: High Negative Appendectomy Rates in Overnight Admissions
Children with equivocal appendicitis are often unnecessarily admitted, leading to high rates of negative appendectomies. 54% of patients were admitted for observation after-hours, with 30% undergoing unnecessary appendectomies. An Alvarado score under 5 accurately ruled out appendicitis in all cases, yet 44% of these low-score patients were still admitted. Discharging children with low Alvarado scores […]
Tailored Chemotherapy for Gallbladder Cancer: A Better Approach
A prognostic model for gallbladder cancer can refine adjuvant chemotherapy decisions and improve patient outcomes. In a study of 2,252 patients, age, tumor grade, N stage, tumor size, and sex predicted overall survival more accurately than the TNM system. The 5-year overall survival rate was only 27.3%. High-risk patients saw improved survival with adjuvant chemotherapy, […]
Maximizing Efficiency in Robotic Cholecystectomy
A new service evaluation reveals that implementing high-intensity theatre (HIT) principles can double productivity for robotic cholecystectomy. Up to 10 robotic cholecystectomies can be performed in a single day, compared to 5 laparoscopic cases. Theatre utilization increased by 100%, optimizing patient throughput and revenue potential. This approach could significantly reduce elective surgery waiting lists while […]
Trisectionectomies Enhance Outcomes in Bismuth Type II-III Cholangiocarcinoma
Trisectionectomies significantly improve survival for patients with localized Bismuth-Corlette type II-III perihilar cholangiocarcinoma. Overall survival improved to 52.4 months with trisectionectomy vs. 31 months for extended hemihepatectomy (p < 0.001). R0 resection rates were higher with trisectionectomies (83.9% vs. 75.8%, p = 0.037). Consider trisectionectomies for appropriate patients to enhance oncological outcomes without increasing significant […]
Liver Resection for Colorectal Metastases Sets New Outcomes Benchmark
Liver resection remains a gold standard for colorectal liver metastases, providing critical data for patient selection and surgical outcomes. 90-day mortality rate is under 5% across most groups, signaling low operative risk. One-year overall survival exceeds 85% for most subgroups, but drops to 78% for patients with 10 or more metastases. Timely assessment of these […]
New model predicts early recurrence risk in pancreatic tumors
Surgeons can now identify non-functioning pancreatic neuroendocrine tumors at high risk for early recurrence preoperatively. Early recurrence occurred in 11% of patients, with a median disease-free survival of 16 months. Neoplastic venous thrombosis predicted a 71% chance of early recurrence; without it, patients with a KI-67 index ≥5% and tumor size ≥3 cm had a […]
New AI Model Detects Perineural Invasion in Colorectal Cancer
This machine learning model improves detection of perineural invasion (PNI) in colorectal cancer, crucial for surgical outcomes. LightGBM model achieved an AUC of 0.996 in training, 0.935 in testing, and 0.918 in external validation across 430 samples. PNI correlates with higher T stage, increased lymph node metastasis, and more lymphovascular invasion. Adopting this model could […]
New model predicts poor outcomes in liver surgery for HCC
Surgeons now have a validated model to identify patients at high risk for early non-curative recurrence after liver resection for hepatocellular carcinoma (HCC), crucial for tailoring postoperative care. Early non-curative recurrence significantly increases overall survival risk (hazard ratio 5.39). Median survival drops from 178.6 months to just 34.7 months in early recurrence cases (p < […]