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Rendezvous treatment effectively resolves external pancreatic fistulas

Post author By STITCHES Newsletter
Post date 10/04/2025
Categories In General Surgery, HPB & Spleen, Surgical Endoscopy

Long-term follow-up of 40 patients treated for external pancreatic fistulas revealed a 100% closure rate after rendezvous internalization treatment, with an average closure time of 20 days. Complication rates were modest, including post-procedural acute pancreatitis (12.5%) and minor bleeding (7.5%). During a median follow-up of 53.5 months, 7.5% experienced fistula recurrence. Notably, new-onset diabetes mellitus affected half of the patients, indicating significant long-term effects despite treatment success.

Review by Chon HK, Kozarek RA, Fotoohi M and Irani SS in Surg Endosc

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Serious complications significantly impact surgeons’ mental health.

Post author By STITCHES Newsletter
Post date 10/04/2025
Categories In General Surgery, Metabolic and Bariatric Surgery

The study reveals that 41.3% of metabolic and bariatric surgeons experience diminished professional confidence due to serious complications, with 39.7% affected at home. Feelings of guilt, anxiety, and sleep disorders were reported by 53.7%, 53.7%, and 44.6% of respondents, respectively. Key barriers to seeking help include excessive workload, a macho culture, and poor communication. Notably, young and female surgeons face a greater psychological toll. Urgent institutional support solutions are deemed necessary.

Journal Article by Infantes P, Papini F (…) Paolino L et 4 al. in Obes Surg

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Desflurane anaesthesia linked to better respiratory outcomes post-oesophagectomy

Post author By STITCHES Newsletter
Post date 09/04/2025
Categories In General Surgery, Upper Gastrointestinal Tract

A retrospective study analyzed 21,080 patients undergoing oesophagectomy, revealing that desflurane anaesthesia resulted in lower rates of respiratory complications and ventilatory failure compared to sevoflurane and propofol. Patients receiving sevoflurane and propofol had significantly higher incidences of respiratory issues, with odds ratios of 1.13 and 1.43, respectively. Additionally, in-hospital mortality rates were lowest in the desflurane group at 1.6%. Multivariable analyses confirmed these associations, reinforcing desflurane’s advantages.

Comparative Study by Hirano Y, Konishi T (…) Kitagawa Y et 10 al. in Br J Surg

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TOS-1A thermobaric weapons inflict severe traumatic injuries

Post author By STITCHES Newsletter
Post date 09/04/2025
Categories In Appendix, Gallbladder and Surgical Emergencies, General Surgery

The study investigates the specific trauma caused by the TOS-1A thermobaric artillery during the Ukraine conflict. It found that injuries predominantly consisted of third- and fourth-degree burns, alongside significant respiratory damage and barotrauma. These injuries were more severe than those from conventional thermal sources. Findings underscore the urgent need for effective prevention strategies and specialized medical responses, as traditional protective measures are inadequate against such high-risk weaponry. Recommendations include enhanced evacuation protocols and burn care.

Journal Article by Epstein A, Humeniuk KV, Nagnibedyuk MV and Schwaitzberg SD in BMC Surg

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Extended colectomy outperforms segmental approach in ulcerative colitis neoplasia

Post author By STITCHES Newsletter
Post date 09/04/2025
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract

A nationwide study involving 879 patients revealed that extended colectomy significantly improves overall and disease-free survival rates for individuals with ulcerative colitis-associated neoplasia compared to segmental colectomy. Specifically, five-year disease-free survival rates for total proctocolectomy and subtotal colectomy were 87.8% and 83.9%, respectively, outperforming segmental colectomy at 72.0%. The research underscores the necessity of accurate diagnosis to differentiate between ulcerative colitis neoplasia and sporadic cancer for effective treatment planning.

Journal Article by Seishima R, Okabayashi K (…) Ishihara S et 5 al. in Dis Colon Rectum

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Tumour Biology Characteristics Score Predicts Outcome in HCC Patients

Post author By STITCHES Newsletter
Post date 09/04/2025
Categories In General Surgery, HPB & Spleen

A novel tumour biology characteristics score (TBCS), utilizing alpha-fetoprotein and PIVKA-II levels, significantly predicts recurrence-free survival (RFS) and overall survival (OS) in hepatocellular carcinoma (HCC) patients post-resection. Analysis of 695 patients revealed distinct survival outcomes across TBCS groups: 5-year RFS and OS were lowest in the high TBCS group (9.7% and 23.5%, respectively). TBCS serves as an independent prognostic factor, potentially guiding postoperative surveillance and interventions.

Journal Article by Wang MD, Wang BD (…) Yang T et 16 al. in J Gastrointest Surg

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Mobile app enhances colorectal cancer screening adherence

Post author By STITCHES Newsletter
Post date 09/04/2025
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract

A newly implemented mobile app for colorectal cancer (CRC) screening showed high adoption rates among healthcare professionals. With over 12,000 consultations recorded, the app facilitated appropriate recommendations, advising 50% of patients on using fecal occult blood tests instead of colonoscopies. Notably, the app supported the deferment of unnecessary follow-up colonoscopies, thereby aligning practice with updated guidelines. This approach could significantly lower the number of superfluous procedures while identifying high-risk patients needing intensive surveillance.

Journal Article by Casas MA, Schlottmann F (…) Pellisé M et 9 al. in BMC Gastroenterol

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Greater surgeon-staff familiarity leads to shorter operation times

Post author By STITCHES Newsletter
Post date 08/04/2025
Categories In General Surgery, Perspectives, Opinions and Curiosities

Elevated familiarity between surgeons and operating room staff correlates with reduced operation durations. An analysis of 257,645 operations revealed that teams with high familiarity achieved a 16% higher likelihood of completing procedures sooner than scheduled. Furthermore, cases led by familiar teams were found to be 8.7% shorter than those with low familiarity. These findings underscore the significance of surgeon-staff relationships in enhancing operational efficiency and quality of care in surgical settings.

Journal Article by Etzioni DA, Elliot M (…) Hasse C et 9 al. in Ann Surg

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Tumor response to neoadjuvant therapy predicts adjuvant chemotherapy benefits

Post author By STITCHES Newsletter
Post date 08/04/2025
Categories In General Surgery, Upper Gastrointestinal Tract

In an analysis of 1887 patients with gastro-oesophageal cancer, only those with a partial response to neoadjuvant FLOT chemotherapy showed significant improvements in disease-free survival (DFS) and overall survival (OS) when treated with adjuvant FLOT. Patients categorized as minimal responders or complete responders did not benefit from additional chemotherapy. This study suggests that assessing pathological response can optimize adjuvant treatment decisions, potentially reducing unnecessary chemotherapy exposure and its associated risks.

Multicenter Study by None None in Br J Surg

© The Author(s) 2025. Published by Oxford University Press on behalf of BJS Foundation Ltd. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.
© The Author(s) 2025. Published by Oxford University Press on behalf of BJS Foundation Ltd. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.

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Postoperative hepatic insufficiency still occurs in 12% of patients.

Post author By STITCHES Newsletter
Post date 08/04/2025
Categories In General Surgery, HPB & Spleen

Despite achieving the desired future liver remnant volume through portal vein embolization, 12% of patients still experienced postoperative hepatic insufficiency following major hepatectomy. Key risk factors identified include older age, performance status, preoperative biliary drainage, and specific diagnoses such as cholangiocarcinoma or gallbladder cancer. Notably, postoperative hepatic insufficiency significantly increased mortality rates from 3.5% to 45% and prolonged hospital stays from 7 to 16 days, highlighting the importance of considering additional predictors beyond volumetrics.

Journal Article by Li AY, Ahmad MU (…) Poultsides GA et 16 al. in BMC Surg

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