Surgeons can leverage an innovative framework for integrating data-driven performance metrics into surgical training to improve education and patient outcomes. Interactive workshops with 54 participants from 13 countries identified priority methods: real-time feedback for technical skills and dashboards for non-technical skills. The framework allows supervising surgeons to access structured performance reports while protecting trainee data […]
Author: STITCHES Newsletter
Guidelines for Greener Operating Rooms in Canada
Surgeons can lower their environmental impact with new actionable guidelines for sustainable operating room practices. 21 recommendations are organized into four key areas: reduce waste, reuse items, recycle materials, and rethink practices. Focus on reducing pharmaceutical waste and unnecessary energy use can help cut greenhouse gas emissions from ORs. Adopting these strategies not only benefits […]
New biomarker predicts outcomes in esophageal cancer surgery
Low Cachexia Index (CXI) is a strong indicator of poorer survival in esophageal cancer patients undergoing surgery. Patients with low CXI had significantly worse overall survival (OS) and disease-free survival (DFS) compared to those with high CXI (both p < 0.001). Low CXI is also linked to older age, more severe comorbidities, and advanced tumor […]
Drain CRP Level on Postoperative Day 4 Predicts Pancreatic Fistulas
Drainage fluid C-reactive protein levels can help predict clinically relevant pancreatic fistulas post-pancreaticoduodenectomy. 15.1% of patients developed clinically relevant pancreatic fistulas. CRP levels in drainage fluid on postoperative day 4 ≥6.5 mg/dl have an odds ratio of 4.95 for predicting fistulas, with a negative predictive value of 95.6%. Consider using drain CRP measurements to enhance […]
Midterm Insights on Weight Loss in Bariatric Surgery
One-anastomosis gastric bypass leads to greater weight loss but carries higher gastrointestinal complication risks compared to sleeve gastrectomy. Patients had similar preoperative BMI: around 41 kg/m. One-anastomosis gastric bypass resulted in more significant weight loss but saw increased complications. Surgeons should weigh weight loss benefits against potential complications when choosing bariatric procedures. Journal Article by […]
Robotic Surgery Access Linked to Lower Open Rates
Access to robotic surgical systems reduces open surgery rates, particularly in disadvantaged areas. Higher social vulnerability correlates with increased open surgery rates: 18.3% in low-vulnerability vs. 32.7% in high-vulnerability areas. Areas without robotic systems have significantly higher open surgery rates: 42.9 vs. 19.4 per 100 procedures. Consider availability of robotic systems when assessing patient options […]
Understanding Celiac Axis Stenosis Predictors in Pancreatoduodenectomy
Surgeons can better anticipate interventions for celiac axis stenosis (CAS) during pancreatoduodenectomy by assessing key preoperative factors. Of 1,042 patients, 85 (8.2%) had CAS, but only 11 (1.1%) needed intervention. Four preoperative predictors emerged: stenosis diameter ≤2 mm, stenosis rate ≥70%, gastroduodenal-to-common hepatic artery ratio ≥1.0, collateral artery diameter ≥3 mm. Interventions were unnecessary when […]
Risk Calculator Didn’t Change Surgeons’ IPMN Decisions
A study found that a risk calculator had no significant impact on surgeons’ decisions regarding surveillance for low-risk pancreatic intraductal papillary mucinous neoplasms (IPMNs). Clinicians’ estimated likelihood of progression remained unchanged (88% vs. 89% for vignettes). Recommendation to continue surveillance did not significantly differ (57% vs. 41% across scenarios). Surgeons reported varying cancer risk thresholds, […]
Favorable Stoma-Free Survival in Rectal Cancer Surgery
Coloanal anastomosis offers an impressive 5-year stoma-free survival rate for patients with locally advanced rectal cancer. 5-year stoma-free survival rate is 88.9% at a median follow-up of 53 months. Factors that worsen survival: BMI ≥ 35 kg/m² (hazard ratio 3.80), handsewn anastomosis with mucosectomy (hazard ratio 5.58), and local recurrence (hazard ratio 6.51). Major postoperative […]
Predictors for Transversus Abdominis Release in Hernia Repair
Preoperative CT parameters can help determine the need for transversus abdominis release (TAR) during laparoscopic repair of midline hernias. TAR was necessary in 57% of patients, correlating with hernia width >5 cm and rectus-to-defect ratio (RDR) <2.35. Patients needing TAR had hernias averaging 6 cm compared to 4 cm in those who didn’t (p<0.0001). This […]