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Elevated preoperative tumor markers affect survival in cancer patients

Post author By STITCHES Newsletter
Post date 21/03/2025
Categories In Cytoreductive Surgery & Peritoneum, General Surgery, Intestine and Lower Gastrointestinal Tract

Elevated preoperative levels of carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), and cancer antigen 125 (CA125) in colorectal cancer patients with peritoneal metastases significantly influence overall survival. In a study of 204 patients, the presence of high CA19-9 and CA125 was linked to poorer outcomes, with hazard ratios of 2.7 and 2.2, respectively. Histopathological features also indicated negative survival impact, underscoring the necessity of these markers for better patient selection for cytoreductive surgery.

Review by Ghabra S, Chang D and Sugarbaker PH in Eur J Surg Oncol

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Autologous flap-supported stomas improve patient outcomes significantly

Post author By STITCHES Newsletter
Post date 21/03/2025
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract

A comparative study of autologous flap-supported loop stomas revealed significant benefits over traditional rod-supported loop stomas. The intervention group showed lower short-term complication rates, particularly in peristomal dermatitis and stoma leakage, alongside reduced stoma appliance replacement frequency and costs. Additionally, operating times and blood loss during closure surgery were also lower for the intervention group. Long-term complications did not differ significantly between the two groups, indicating autologous flaps offer enhanced safety and feasibility.

Journal Article by Li WB, Zhang Y (…) An J et 3 al. in Surg Laparosc Endosc Percutan Tech

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Perioperative pathways in emergency laparotomy lack detailed reporting.

Post author By STITCHES Newsletter
Post date 21/03/2025
Categories In Appendix, Gallbladder and Surgical Emergencies, General Surgery

Identifying 26 unique perioperative pathways in emergency laparotomy, the review highlights a significant variability in interventions among 44,055 patients. Most studies were at moderate risk of bias, and 66.6% failed to report TIDIER framework items, indicating inadequate reporting practices. Outcomes measured primarily focused on morbidity, mortality, and hospital length of stay, with 250 outcomes reported. The findings stress the need for improved transparency in intervention reporting to enhance postoperative care and outcomes in high-risk surgical patients.

Review by Harji DP, Griffiths B (…) Brown JM et 3 al. in World J Emerg Surg

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Chemoresist signature predicts survival in pancreatic cancer patients

Post author By STITCHES Newsletter
Post date 20/03/2025
Categories In General Surgery, HPB & Spleen

A novel predictive and prognostic signature, named chemoresist, was developed to assess the outcomes of patients with pancreatic ductal adenocarcinoma (PDAC) post-surgery and adjuvant chemotherapy. In a multicohort analysis, significant survival differences were noted between high and low chemoresist patients, with median overall survival reaching 42 months in low chemoresist groups, compared to just 17 months in high groups. This signature outperformed traditional TNM staging and identified patients likely to benefit from chemotherapy.

Multicenter Study by Huang L, Han Q (…) Shi Y et 3 al. in Ann Surg

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Omitting abdominal drains improves outcomes after left pancreatectomy

Post author By STITCHES Newsletter
Post date 20/03/2025
Categories In General Surgery, HPB & Spleen

A systematic review and meta-analysis involving 15,817 patients revealed that avoiding routine abdominal drainage following left pancreatectomy significantly reduces major morbidity, postoperative pancreatic fistula rates, readmissions, and surgical site infections. The no-drain group experienced a 23% reduction in major complications and substantially lower rates of fistulas and infections. Additionally, patients without drains had shorter hospital stays, suggesting that non-drain strategies may enhance postoperative recovery and outcomes after the procedure.

Comparative Study by Fatima M, Ahmed A (…) Aziz H et 4 al. in Ann Surg

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Evidence-based nursing improves recovery in older gastrointestinal surgery patients

Post author By STITCHES Newsletter
Post date 20/03/2025
Categories In General Surgery, Perspectives, Opinions and Curiosities

An evidence-based enhanced recovery after surgery (ERAS) protocol has significantly improved outcomes for older adults undergoing gastrointestinal surgery. In a trial involving 392 patients, those receiving the new nursing model exhibited lower heart rates, stable blood parameters, and reduced postoperative complications compared to a control group. Key benefits included shorter recovery times, lower anxiety scores, and fewer infections. Precision nursing interventions addressing stress responses proved crucial in enhancing overall patient recovery.

Clinical Trial by Yuan CD, Zhou BZ (…) Hu ZZ et 2 al. in World J Gastroenterol

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Colonic J-Pouch Reconstruction Improves Quality of Life Post-Surgery

Post author By STITCHES Newsletter
Post date 20/03/2025
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract

A prospective cohort study involving 66 patients with ultra-low rectal cancer revealed that colonic j-pouch reconstruction significantly enhances bowel function and quality of life compared to direct anastomosis. At all postoperative intervals (1, 3, and 6 months), patients who received the j-pouch exhibited superior LARS and FIQL scores. Both approaches showed similar postoperative complication rates, suggesting that while both techniques are viable, the colonic j-pouch offers marked benefits in postoperative recovery and daily living.

Journal Article by Zhu JH, Zhang FM (…) Liu ZC et 5 al. in BMC Surg

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Early recurrence significantly worsens survival in HCC patients.

Post author By STITCHES Newsletter
Post date 20/03/2025
Categories In General Surgery, HPB & Spleen

A multicenter study involving 2828 patients with hepatocellular carcinoma (HCC) and microvascular invasion revealed that early recurrence (ER) occurs more frequently within the first year after hepatectomy, leading to poorer outcomes than late recurrence (LR). Median overall survival was 20.2 months for ER compared to 52.6 months for LR. Regular postoperative surveillance significantly improved overall survival (37.1 months) and post-recurrence survival (21.2 months) compared to irregular surveillance, emphasizing the need for consistent monitoring.

Journal Article by Zhang XP, Zhang TC (…) Liu R et 32 al. in Hepatol Int

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Individualized strategies improve survival in metastatic rectal cancer

Post author By STITCHES Newsletter
Post date 19/03/2025
Categories In General Surgery, HPB & Spleen, Intestine and Lower Gastrointestinal Tract

An extent-based tailored strategy for managing rectal cancer with synchronous resectable liver metastases achieved an 82% complete resection rate in a study involving 83 patients. Over a median follow-up of 43 months, the median overall survival reached 58 months, with one- and three-year survival rates at 94% and 73%, respectively. Multivariate analysis highlighted complete resection as the sole prognostic factor for improved survival, indicating the effectiveness of individualized treatment approaches in this patient population.

Journal Article by Abdalla S, Bibani H (…) Benoist S et 7 al. in BMC Surg

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Operative patients experience lower mortality despite more complications.

Post author By STITCHES Newsletter
Post date 19/03/2025
Categories In Appendix, Gallbladder and Surgical Emergencies, General Surgery

A study of 32,280 emergency general surgery patients revealed that surgical intervention led to lower risk-adjusted inpatient mortality rates compared to nonoperative management, despite the surgical group experiencing higher complication odds and longer hospital stays. Younger patients and those without preexisting conditions were more likely to undergo surgery, while a higher percentage of uninsured individuals were found in the nonoperated group. These findings underscore the need for improved surgical access and risk stratification in developing countries.

Journal Article by Abdul Rahim K, Mahmood SBZ (…) Haider A et 6 al. in World J Surg

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