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Genetic profiling predicts chemotherapy response in colorectal liver metastasis

Post author By STITCHES Newsletter
Post date 19/05/2025
Categories In General Surgery, HPB & Spleen, Intestine and Lower Gastrointestinal Tract

A study involving 230 Chinese patients with colorectal liver metastasis identified significant predictors for chemotherapy response. Key factors included gender, the use of biological targeted agents (BTAs), and specific mutations in the KRAS gene and other rare genes. A predictive model achieved an area under the curve (AUC) of 0.73, indicating that around 75% of patients could bypass BTAs based on the model’s assessments. Approximately 32% of initially nonresponsive patients might benefit from including BTAs.

Journal Article by Wang LJ, Bao Q (…) Xing BC et 8 al. in Ann Surg Oncol

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Transoral septotomy and Z-POEM are both effective treatments.

Post author By STITCHES Newsletter
Post date 19/05/2025
Categories In General Surgery, Surgical Endoscopy, Upper Gastrointestinal Tract

A multicenter study found that transoral septotomy (TS) and Z-POEM treatments for Zenker diverticulum yield similarly high success rates of 96.2%. While TS requires a shorter operative time and has fewer intraoperative complications, both methods resulted in favorable outcomes and significant symptom relief after a median follow-up of 45 to 66 months. The study contributes valuable insights into optimizing treatment approaches for this condition, highlighting the effectiveness of both techniques.

Journal Article by Provenzano L, Siboni S (…) Salvador R et 7 al. in Surg Endosc

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KRAS status impacts surgical outcomes for colorectal liver metastases

Post author By STITCHES Newsletter
Post date 19/05/2025
Categories In General Surgery, HPB & Spleen, Intestine and Lower Gastrointestinal Tract

A study involving 220 patients revealed that KRAS mutations negatively affect long-term outcomes after thermal ablation (TA) and liver resection (LR) for colorectal liver metastases (CRLM). Among patients with mutated KRAS, factors like synchronous disease and the performance of multiple TAs significantly influenced disease-free survival. Furthermore, while TA was associated with liver-only recurrences in both mutated and wild-type tumors, the risk was notably higher in mutated cases, indicating a need to tailor surgical strategies based on KRAS status.

Journal Article by Giannone F, Sangiuolo F (…) Panaro F et 8 al. in World J Surg

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Nomogram effectively predicts lymph node metastasis in colon cancer

Post author By STITCHES Newsletter
Post date 19/05/2025
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract

An innovative online nomogram has been developed to predict the risk of lymph node metastasis (LNM) in colon cancer patients, enhancing treatment decision-making. Built on data from 412 patients, the model identified eight key independent predictors, demonstrating high discriminative ability with AUCs of 0.834 and 0.872 in training and validation cohorts, respectively. This tool presents significant clinical value, aligning predicted outcomes with actual results and offering insights for better patient management pre-surgery.

Validation Study by Deng L, Che L (…) Xu Q et 5 al. in BMC Gastroenterol

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Preoperative immune prognostic index predicts outcomes in esophageal cancer.

Post author By STITCHES Newsletter
Post date 19/05/2025
Categories In General Surgery, Upper Gastrointestinal Tract

The immune prognostic index (ipi) effectively predicts prognosis and the benefit of postoperative chemotherapy in esophageal squamous cell carcinoma (ESCC) patients following minimally invasive esophagectomy (MIE). Patients with a low ipi demonstrated significantly better 5-year overall survival (OS) and disease-free survival (DFS) compared to those with a high ipi. Notably, adjuvant chemotherapy in stage III patients with a high ipi was associated with improved OS and DFS, marking ipi as a valuable prognostic tool.

Journal Article by Huang J, Chen C (…) Chen SC et 6 al. in BMC Gastroenterol

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New guidelines aim to improve outcomes for HCC patients

Post author By STITCHES Newsletter
Post date 18/05/2025
Categories In General Surgery, HPB & Spleen

A consensus from Chinese experts has established eight recommendations for diagnosing and treating hepatocellular carcinoma (HCC) with microvascular invasion (MVI). These guidelines emphasize the use of MVI grading criteria and the EH-BH nomogram for improved accuracy in prediction and management. The goal is to enhance recurrence-free survival and overall survival rates among HCC patients facing MVI, addressing significant gaps in current knowledge and practice surrounding this critical aspect of HCC treatment.

Review by Sun J, Xia Y, Shen F and Cheng S in Hepatobiliary Surg Nutr

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Single-stage techniques improve outcomes in choledocholithiasis management

Post author By STITCHES Newsletter
Post date 18/05/2025
Categories In Appendix, Gallbladder and Surgical Emergencies, General Surgery, HPB & Spleen, Surgical Endoscopy

Management of choledocholithiasis has evolved towards single-stage techniques, which demonstrate significantly lower 30-day morbidity and shorter hospital stays compared to traditional two-stage laproendoscopic approaches. Intraoperative endoscopic rendezvous procedures show further enhanced patient outcomes by minimizing the risk of post-endoscopic pancreatitis. Additionally, laparoscopic common bile duct exploration offers superior stone clearance rates, reduced costs, and efficient hospital stays. However, barriers like training, equipment, and staffing hinder widespread adoption of these effective methods.

Review by Smith SM, Kelley JK, Zambito GM and Banks-Venegoni AL in Am Surg

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Intracorporeal anastomosis significantly reduces incisional hernia rates.

Post author By STITCHES Newsletter
Post date 18/05/2025
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract

A study of 192 patients undergoing laparoscopic right colectomy revealed that intracorporeal anastomosis is associated with a significantly lower incidence of incisional hernia compared to extracorporeal anastomosis. Notably, no incisional hernias occurred at the minilaparotomy site in the intracorporeal group, while 13.3% of extracorporeal patients developed one. The intracorporeal approach also correlated with a shorter hospital stay and a trend of lower postoperative ileus incidence, underscoring its potential advantages in surgical outcomes.

Journal Article by De Giulio E, Turri G (…) Pedrazzani C et 6 al. in Int J Colorectal Dis

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HIV status significantly influences surgical mortality risk during COVID-19

Post author By STITCHES Newsletter
Post date 18/05/2025
Categories In General Surgery, Perspectives, Opinions and Curiosities

A study in Johannesburg revealed that 25% of surgical mortalities during the COVID-19 pandemic tested positive for the virus, with a notable prevalence among HIV-positive patients. It found that smoking, chronic obstructive pulmonary disease (COPD), and hypertension markedly increased the odds of COVID-19 infection in surgical patients. Additionally, 55% of COVID-19-positive deaths were among HIV-positive individuals, particularly those not on antiretroviral treatment, highlighting significant preventability opportunities in this population.

Journal Article by Engelhardt S, Morley C (…) Luvhengo T et 4 al. in Ann Med Surg (Lond)

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Laparoscopic hiatal hernia repair enhances quality of life significantly

Post author By STITCHES Newsletter
Post date 18/05/2025
Categories In General Surgery, Hernia, Upper Gastrointestinal Tract

Health-related quality of life improves markedly for patients post-laparoscopic hiatal hernia repair with anterior 180° fundoplication. Over 12 months, physical functioning surged from 66.3 to 95.6, and bodily pain scores rose from 38.1 to 79.2 (p < 0.001). Notable enhancements in social functioning and mental health were also reported, with 72.5% of patients medication-free after one year. Recurrences affected physical and pain scores, but overall, this method proves effective for symptomatic hiatal hernias.

Journal Article by Siow SL and Ong ECW in Asian J Endosc Surg

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