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ETEP reduces post-operative pain compared to IPOM+ in hernia repair

Enhanced total extraperitoneal repair (ETEP) was compared with intraperitoneal onlay mesh repair-plus (IPOM+) for midline ventral hernia repair in a randomized trial involving 48 patients. Results indicated that ETEP had significantly longer operative times but resulted in notably lower pain scores at 6 and 24 hours, with fewer patients requiring rescue analgesia. Complications and recurrence rates remained similar for both techniques, underscoring ETEP’s potential as an effective alternative despite its longer procedure duration.

Journal Article by Singh S, Agrawal H (…) Gupta N et 2 al. in J Minim Access Surg

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Conditional survival predictions enhance outcomes for pancreatic cancer patients

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

A study on pancreatic ductal adenocarcinoma reveals that conditional survival analysis based on kallikrein-related peptidase 7 (klk7) expression can significantly improve prognostic assessments. Results show that 1-, 2-, and 3-year conditional survival rates increased from 50.4% to 91.2%, while overall survival rates dropped from 81.9% to 38.6%. Patients surviving longer periods demonstrate improved future survival expectations, indicating that adverse factors like klk7’s impact diminishes over time.

Journal Article by Zheng BW, Yang XY, Zheng J and Yao RC in Medicine (Baltimore)

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Mindfulness interventions enhance surgeon well-being and performance

Post author By STITCHES Newsletter
Post date 03/04/2025
Categories In General Surgery, Perspectives, Opinions and Curiosities

A scoping review assessed 24 studies on mindfulness-based interventions (MBIs) for surgeons, revealing that such programs are feasible and significantly improve mindfulness, reduce burnout, and enhance overall well-being. Notably, these interventions also boost executive function, surgical skills, and communication. Evidence was drawn from various study designs, including randomized control trials and qualitative research. Future research aims to broaden the application of MBIs across diverse healthcare settings, tailoring interventions to meet specific needs.

Review by Coopersmith AS, Shroff YV (…) Lebares CC et 4 al. in Ann Surg

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Serum Transaminase Changes Predict Postoperative Complications in Liver Resection

Post author By STITCHES Newsletter
Post date 03/04/2025
Categories In General Surgery, HPB & Spleen

Dynamic changes in serum AST and ALT levels after liver resection for hepatocellular carcinoma were shown to significantly impact postoperative morbidity. In a study involving 759 patients, an increase in the combined assessment of AST and ALT (caa) to ≥5 was strongly linked to higher complication rates, with an odds ratio of 1.63. The study emphasizes that routine lab tests can effectively identify patients at risk for adverse postoperative outcomes.

Multicenter Study by Wang F, Lu J (…) Pawlik TM et 19 al. in Ann Surg

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Spray coagulation mode enhances endoscopic dissection success

Post author By STITCHES Newsletter
Post date 03/04/2025
Categories In General Surgery, Surgical Endoscopy, Upper Gastrointestinal Tract

A multicenter trial revealed that spray coagulation mode endoscopic submucosal dissection (scm-esd) significantly improved completion rates for treating early gastric neoplasms without the use of hemostatic forceps, achieving 83.1% versus 13.8% for conventional forced coagulation mode (fcm-esd). Procedure time and adverse event rates were comparable between the two techniques. These findings suggest that scm-esd can streamline the endoscopic dissection process, potentially reducing costs and device exchanges.

Journal Article by Esaki M, Sumida Y (…) Ogawa Y et 28 al. in Am J Gastroenterol

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Achievement of textbook outcomes improves survival in HPB surgery

Post author By STITCHES Newsletter
Post date 03/04/2025
Categories In General Surgery, HPB & Spleen

A systematic review and meta-analysis evaluated textbook outcomes (TOs) in hepatopancreaticobiliary (HPB) surgery across 27 studies involving 517,304 patients. It revealed a median TO achievement rate of 62% for hepatic procedures, 54% for biliary, and lower rates for pancreatic and liver transplantation surgeries. Importantly, achieving TOs was linked to an increased likelihood of 5-year overall survival (OR 1.22) and disease-free survival (OR 1.26), emphasizing the importance of defining TO criteria consistently.

Review by Dawood ZS, Khalil M (…) Pawlik TM et 3 al. in J Gastrointest Surg

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Blood tests enhance differentiation between liver cancer types

Post author By STITCHES Newsletter
Post date 03/04/2025
Categories In General Surgery, HPB & Spleen

A study involving 165 patients diagnosed with hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) identified alpha-fetoprotein (AFP) and carbohydrate antigen 19-9 (CA19-9) as key tumor markers for accurate preoperative differentiation. Elevated white blood cell counts, neutrophil-to-lymphocyte ratios, and monocyte counts were linked to increased ICC risk, while higher lymphocyte-to-monocyte ratios indicated protection. The predictive model achieved an area under the curve of 0.791, improving diagnostic strategies for personalized treatment in primary liver cancer.

Journal Article by Shi W, Jin W (…) Hu S et 2 al. in Medicine (Baltimore)

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Standardized approach established for Endoscopic Sleeve Gastroplasty

Post author By STITCHES Newsletter
Post date 02/04/2025
Categories In General Surgery, Metabolic and Bariatric Surgery, Surgical Endoscopy

A global expert consensus defined standardized practices for Endoscopic Sleeve Gastroplasty (ESG) utilizing a modified Delphi method. Six experts, after three survey rounds, achieved 100% agreement on six cognitive skill statements and high consensus on 21 technical skill statements. Key procedural elements emphasized were starting at the incisura, using at least six sutures, and avoiding the fundus. This consensus creates important guidelines for ensuring the safe and effective delivery of ESG procedures.

Journal Article by Jirapinyo P, Advani R (…) Thompson C et 8 al. in Gastrointest Endosc

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Machine learning predicts surgical outcomes in cholangiocarcinoma patients

Post author By STITCHES Newsletter
Post date 02/04/2025
Categories In Digital Surgery and Telemedicine, General Surgery, HPB & Spleen

A machine learning model developed from 376 intrahepatic cholangiocarcinoma patients effectively predicts textbook outcomes. Key preoperative factors include Child-Pugh classification, ECOG score, hepatitis B status, and tumor size. The model achieved high accuracy during internal (AUC = 0.8825) and external validation (AUC = 0.8346). Survival analysis indicated that patients achieving textbook outcomes had disease-free survival rates of 64.2%, 56.8%, and 43.4% at one, two, and three years, respectively.

Validation Study by Huang TF, Luo C (…) Zeng YY et 9 al. in World J Gastroenterol

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Trauma care systems need improvement in conflict-vulnerable regions.

Post author By STITCHES Newsletter
Post date 02/04/2025
Categories In Appendix, Gallbladder and Surgical Emergencies, General Surgery

A growing demand for effective trauma care in conflict-affected areas necessitates urgent enhancements to local health systems. Current humanitarian efforts are insufficient to cope with increased civilian injuries due to armed conflicts. Advocates urge assessing trauma care readiness in regions at risk and fostering partnerships to bolster local capacity. Recommendations include identifying vulnerable areas, evaluating existing trauma care systems, and enhancing training for health care providers to better prepare for future surges in casualties.

Journal Article by Garber K, Dicker R (…) Gaarder C et 5 al. in BMC Surg

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