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Long-term outcomes for upfront pancreatectomy with venous resection in pancreatic cancer

Post author By STITCHES Newsletter
Post date 22/11/2025
Categories In General Surgery, HPB & Spleen

Upfront pancreatectomy with venous resection shows promising outcomes in select pancreatic cancer patients.

30-day mortality is low at 1.2%, while 90-day mortality is 3.7%.
Median overall survival is 19.8 months, with 1-, 2-, and 3-year survival rates of 71.4%, 40.8%, and 23.2%.
Key predictors of decreased survival include older age (>65 years), high preoperative CA19-9, and poor tumor differentiation.

Adjuvant chemotherapy significantly enhances survival outcomes, emphasizing its role in postoperative care.

Journal Article by Lin J, Liu M (…) Jiang K et 13 al. in Int J Surg

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Impact of Valsalva Maneuver Duration on HIFU Liver Ablation

Post author By STITCHES Newsletter
Post date 22/11/2025
Categories In General Surgery, HPB & Spleen

Long durations of the Valsalva maneuver during high-intensity focused ultrasound liver ablation significantly worsen brain function outcomes.

Burst suppression rates soared to 66.7% with >5.2-minute Valsalva episodes, compared to 2.0% in the control group (p < 0.001).
Emergence agitation was notably higher in the long Valsalva group at 64.7%, versus only 2.0% in controls (p < 0.001).

Consider limiting Valsalva maneuver episodes to ≤5.2 minutes to improve recovery quality and minimize complications.

The long Valsalva group also had the lowest quality of recovery scores (106 vs 110 in control).

Journal Article by Zhu Q, Ran R (…) Shu S et 7 al. in Int J Surg

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Chronic Pain After Surgery: 15 Key Risk Factors Identified

Post author By STITCHES Newsletter
Post date 22/11/2025
Categories In General Surgery, Perspectives, Opinions and Curiosities

Surgical patients face significant risk factors for chronic post-surgical pain (CPSP) that can inform preoperative assessments.

21 risk factors linked to increased CPSP risk were identified; 15 factors had a significant association (p < 0.001).
Key contributors include age, obesity, low income, smoking, insufficient sleep, and pre-existing health conditions.

Targeting these factors can enhance pain management strategies and optimize patient selection for surgery.

High-sodium diets and certain hematological indicators also elevate CPSP risk (p < 0.05).

Journal Article by Batuer T, Hu Y (…) Liu J et 15 al. in Int J Surg

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CRP Levels Predict Safe Early Discharge After Colorectal Surgery

Post author By STITCHES Newsletter
Post date 22/11/2025
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract

Postoperative C-reactive protein (CRP) can reduce reoperation rates by guiding safe early discharge following colectomies.

CRP measured on day three post-surgery has a sensitivity of 77.8% and specificity of 84.0% for detecting anastomotic leakage.
A CRP threshold of less than 15.0 mg/dl indicates a 96.1% negative predictive value for low leakage risk, enabling quicker patient discharge.

Utilizing CRP levels can help streamline patient recovery while maintaining safety in surgical practice.

Journal Article by Marques TM, Rovaris EM (…) Aguiar S et 8 al. in Rev Col Bras Cir

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Hand-Assisted Laparoscopic Surgery Outperforms Open Surgery in Proctectomy

Post author By STITCHES Newsletter
Post date 21/11/2025
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract

Hand-assisted laparoscopic surgery (HALS) leads to fewer complications than converting laparoscopic procedures to open surgery (LCOS) in proctectomy patients.

Patients undergoing LCOS had a 20.85% transfusion rate vs. 5.99% for HALS (p < 0.001).
Postoperative renal insufficiency occurred in 17.06% of LCOS patients vs. 7.12% of HALS patients (p < 0.001).

Considering HALS in complex cases may improve outcomes and avoid unnecessary conversions.

Mortality was 1.90% in the LCOS group compared to 0.37% in the HALS group (p = 0.018).

Journal Article by Hyon SS, Elsawwah JK (…) Nemeth ZH et 3 al. in Surg Laparosc Endosc Percutan Tech

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Improved Survival Prediction in Colorectal Cancer Surgery

Post author By STITCHES Newsletter
Post date 21/11/2025
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract

An integrated nutritional and immune-inflammation score significantly predicts disease-free survival in colorectal cancer patients post-surgery.

The new n-sii and n-siri scores achieved area under the curve values of 0.829 and 0.850, outperforming traditional indices.
Patients with a score of 2 face double the risk of progression (HR: 2.442 for n-sii; 2.527 for n-siri) and a reduced disease-free survival of just 31.19 months.

Optimizing patient selection with these scores may enhance surgical outcomes and aid in post-operative management.

Journal Article by Xu L, Huang L (…) Liu Y et 3 al. in J Gastrointest Oncol

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Nicotine’s Toxic Impact on Chronic Wounds

Nicotine hinders healing for chronic wounds, complicating patient recovery.

Identified 160 targets linking nicotine to chronic wound failure.
Core inflammatory factors like TNF and IL-6 disrupted healing pathways.

Surgeons should consider nicotine’s role when assessing wound recovery potential in smokers.

Strong binding affinity of nicotine to key targets TNF (-5.6 kcal/mol) and IL-6 (-5.0 kcal/mol) was confirmed.

Journal Article by Guo G, Xu Y (…) Jiang Y et 2 al. in Int J Low Extrem Wounds

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Global Strategies to Widen Robotic Surgery Access

Post author By STITCHES Newsletter
Post date 21/11/2025
Categories In General Surgery, Perspectives, Opinions and Curiosities

Robotic surgery is advancing rapidly, but access remains limited in low-resource settings.

The U.S. houses about 60% of robotic installations, leading in both resources and research.
Barriers include high costs, inadequate training, and regulatory issues, hindering wider adoption.
Facilitators like public-private partnerships and tailored training can improve access and outcomes.

Surgeons should advocate for innovative strategies to enhance robotic surgery’s equity and effectiveness globally.

Journal Article by Tustumi F, Bolm L (…) Khan S et 17 al. in Arq Bras Cir Dig

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New Classification System Improves Biliary Stricture Outcomes

Post author By STITCHES Newsletter
Post date 21/11/2025
Categories In General Surgery, Surgical Endoscopy, Transplant Surgery

Researchers developed a new classification for biliary strictures after liver transplantation, enhancing treatment choices and outcomes.

Patients were classified into three types: type I (43.8%), type II (32.3%), and type III (24.0%).
Type I patients using fully covered metal stents had fewer procedures and lower costs compared to plastic stents (p=0.02 and p=0.04).
Stent-free success rates were highest for type I (69.0%) and lowest for type III (34.7%, p=0.03).

This classification aids surgeons in selecting the most effective treatment strategies, particularly for complex cases.

Journal Article by Xu Z, Liu D (…) Zhang L et 10 al. in Transl Gastroenterol Hepatol

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