Using silver and DACC dressings significantly lowers surgical site infections (SSIs), which can improve recovery times and reduce costs. Silver dressings reduce SSI risk by 22% (RR 0.78; moderate certainty). DACC dressings halve the risk of SSI (RR 0.49; moderate certainty). Mupirocin dressings show no significant impact on SSIs. Consider adopting silver or DACC dressings […]
Author: STITCHES Newsletter
Long-term outcomes after endoscopic resection for esophageal cancer show low recurrence risk.
In a study of 540 patients with pt1a-muscularis mucosa esophageal squamous cell carcinoma, 485 were monitored without intervention. The 5-year cumulative recurrence rates were low at 4.9% for observation, 2.2% for chemoradiotherapy, and 10.0% for surgery. Given the data, observation may be a viable strategy for these patients. Overall survival rates were high, reaching 100% […]
Delayed Diagnosis of Anastomotic Leak Increases Mortality Risk
Delayed diagnosis of anastomotic leak is linked to higher failure to rescue rates after colon resection, which can profoundly impact surgical outcomes. Patients with delayed organ space surgical site infection (31.1%) had a failure to rescue (FTR) rate of 7.8% versus 2.2% for early diagnoses. Mean length of stay was longer for delayed diagnoses (22.6 […]
Global Cancer Surgery Access Requires Urgent Attention
Access to safe and timely cancer surgery is critical but lacking, especially in low- and middle-income countries. Over 80% of patients with solid tumors will require at least one surgical intervention. Low- and middle-income countries will face rising cancer burdens, intensifying demand for surgery. Surgeons must be aware of these disparities to adapt treatment strategies. […]
High-risk lymph node mapping improves outcomes in esophageal cancer
Mapping lymph node metastases in T1-2 esophageal squamous cell carcinoma offers insights that could enhance surgical strategies. High-risk stations 2, 7, 8, 16, and 17 show metastasis rates of 6.47% to 11.37%, significantly impacting prognosis. Patients with high-risk metastasis have a nearly double risk of poor outcomes (hazard ratio 1.986, p < .001). Identifying these […]
New Antibiotic Standard May Transform Pancreatoduodenectomy Outcomes
Broad-spectrum penicillin-based antibiotics significantly improve outcomes after pancreatoduodenectomy compared to standard care options. Surgical site infections dropped by 47% (OR 0.53), and postoperative pancreatic fistula rates decreased by 38% (OR 0.62). Patients had shorter hospital stays, averaging 2 days less (MD -2.02). Implementing broad-spectrum antibiotics could redefine surgical management and reduce complication rates, especially for […]
Liver Transplant vs. ALPPS: Survival Similarities Uncovered
Liver transplantation (LT) and associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) yield comparable survival outcomes for colorectal liver metastases (CRLM). Median overall survival after ALPPS was 76 months vs. 72.7 months for LT. After adjusting for biases, ALPPS showed a higher risk of death (HR=1.40), but no significant difference in survival […]
Flexible Endoscopy Surpasses Rigid Endoscopy for Zenker Repair
Flexible endoscopy achieves better outcomes than rigid endoscopy for Zenker diverticulum repair, making it a strong first-line option. Clinical success rates: flexible endoscopy 84.6% vs. rigid endoscopy 55.6% (p = 0.032); comparable to open surgery 88.9% (p = 0.712). Adverse event rates are lowest for flexible endoscopy at 4.5%, with a trend towards fewer complications […]
Stenosis Risk High After Circumferential Colorectal Dissection
Post-resection stenosis significantly impacts surgical outcomes for colorectal lesions treated with endoscopic submucosal dissection when over 90% of the circumference is involved. Stenosis rates reached 34.2%, higher for rectal lesions (38.2%) compared to colonic (11.6%). Complete resection was achieved in 85.1% of cases, with oncological resection rates of 80.3%. Effective endoscopic treatments resolved all stenosis […]
New Model Predicts Surgical Risks in Emergencies
A new tabular foundation model outperforms traditional methods in predicting surgical risks for emergency patients, improving decision-making. In a study of 7,281 emergency surgery patients, the model demonstrated a mortality prediction accuracy of 0.89 and a morbidity accuracy of 0.82. It achieved better calibration scores (0.04 for mortality and 0.15 for morbidity) than logistic regression […]