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Triple therapy enhances survival in advanced hepatocellular carcinoma.

Post author By STITCHES Newsletter
Post date 13/03/2025
Categories In General Surgery, HPB & Spleen

In high-risk advanced hepatocellular carcinoma patients, triple therapy involving FOLFOX-based hepatic arterial infusion, tyrosine kinase inhibitors, and PD-1 inhibitors significantly improved median overall survival to 24.6 months compared to 11.9 months with dual therapy (HR=0.43, p<0.001). Progression-free survival also favored triple therapy at 10 months versus 7.7 months (HR=0.68, p=0.002). Additionally, more patients converted to non-high-risk status after triple therapy, indicating its potential as a first-line treatment.

Multicenter Study by Zuo M, Zheng G (…) Fan W et 4 al. in Int J Surg

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New model predicts postpancreatectomy hemorrhage risk accurately

Post author By STITCHES Newsletter
Post date 13/03/2025
Categories In General Surgery, HPB & Spleen

A novel predictive model using lasso-logistic regression has been developed to assess the risk of postpancreatectomy hemorrhage. Analyzing data from over 9,600 patients, the model identifies nine independent risk factors, including preoperative BMI and ASA scores. Its predictive accuracy reached an area under the ROC curve of 0.87 during external validation, outperforming previous models significantly. This advancement aims to enhance surgical safety and improve patient outcomes following pancreatectomy procedures.

Validation Study by Duan Y, Du Y (…) Wang C et 5 al. in Int J Surg

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Delaying surgery post-COVID-19 improves patient outcomes.

Post author By STITCHES Newsletter
Post date 13/03/2025
Categories In General Surgery, Perspectives, Opinions and Curiosities

A study involving 4,953 patients revealed that delaying surgery for at least two weeks post-COVID-19 infection can significantly lower the risks of short-term complications and mortality. Patients who postponed their procedures for over seven weeks experienced enhanced long-term functional recovery, as indicated by reduced disability rates at both six and twelve months. These findings underline the importance of timing in surgical interventions for individuals recovering from COVID-19, particularly amid the omicron variant.

Journal Article by Che L, Yu J (…) Huang Y et 6 al. in Int J Surg

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Advances in managing gastric cancer with peritoneal metastasis

Post author By STITCHES Newsletter
Post date 12/03/2025
Categories In Cytoreductive Surgery & Peritoneum, General Surgery, Upper Gastrointestinal Tract

Recent insights into gastric cancer with peritoneal metastasis (gcpm) reveal dismal outcomes, underscoring the need for improved management strategies. A growing body of clinical trials investigates the efficacy of cytoreductive surgery (crs) combined with hyperthermic intraperitoneal chemotherapy (hipec), recognized in new national guidelines. Enhanced understanding of gcpm’s mechanisms and novel therapeutic targets could lead to breakthroughs in overcoming treatment resistance. This review synthesizes advancements and current guidelines, addressing the ongoing challenges in gcpm management.

Review by Lewis KA, Diggs LP and Badgwell BD in Ann Surg Oncol

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Surgeons benefit from 360-degree feedback on non-technical skills

Post author By STITCHES Newsletter
Post date 12/03/2025
Categories In General Surgery, Perspectives, Opinions and Curiosities

Feedback from 88 academic surgeons through the intraoperative 360-degree evaluation (i360) primarily highlighted crucial non-technical skills such as leadership and communication. Analysis revealed that 84.3% of comments were related to non-technical skills, with key themes including mentorship, professionalism, teamwork, and situation awareness. Leadership themes accounted for 53.1% of feedback, whereas decision-making and situation awareness were also acknowledged. This evaluation demonstrates the value of perioperative staff insights in enhancing surgical performance.

Journal Article by Soelling SJ, Cummins E (…) Smink DS et 5 al. in Am J Surg

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Standardized training for colorectal liver metastases established

Post author By STITCHES Newsletter
Post date 12/03/2025
Categories In General Surgery, HPB & Spleen, Intestine and Lower Gastrointestinal Tract

A new structured guide addressing colorectal liver metastases (CRLM) fills a vital gap in surgical oncology education. By updating the European Society of Surgical Oncology’s curriculum, it provides essential information on epidemiology, staging, and treatment strategies. Researchers conducted a thorough literature review, focusing on recent guidelines and studies, to support hepatobiliary surgeons and oncologists. This resource aims to standardize educational approaches and facilitate preparation for European board examinations in surgical oncology.

Review by Carrion-Alvarez L, Primavesi F (…) Stättner S et 6 al. in Eur J Surg Oncol

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New tool enhances risk prediction for liver surgery complications

Post author By STITCHES Newsletter
Post date 12/03/2025
Categories In General Surgery, HPB & Spleen

A dynamic tool utilizing albumin-bilirubin (ALBI) scores and fibrosis-4 (FIB-4) index trends improves risk stratification for patients undergoing hepatocellular carcinoma resection. K-means clustering revealed three patient groups with varying complication risks. Those in the lowest ALBI cluster had a 76% reduced odds of severe complications compared to the highest-risk group. A novel predictive model achieved an AUC of 0.71, outperforming traditional methods, facilitating better patient safety in surgical outcomes.

Journal Article by Akabane M, Kawashima J (…) Pawlik TM et 19 al. in Eur J Surg Oncol

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Acute pancreatitis incidence and mortality remain significant in England

Post author By STITCHES Newsletter
Post date 12/03/2025
Categories In Appendix, Gallbladder and Surgical Emergencies, General Surgery, HPB & Spleen

An analysis of 260,009 acute pancreatitis patients in England from 2013 to 2023 reveals an incidence rate rising by 2.6% annually, with 456 cases per million. In-hospital mortality stands at 4.5%, while the 10-year survival rate reaches 63.9%. Factors influencing better long-term outcomes include biliary etiologies, younger age, and the absence of intensive care unit admission. A significant 30.2% of patients experience readmission after a median follow-up of 45 months.

Journal Article by Lucocq J, Barbour F (…) Pandanaboyana S et 3 al. in HPB (Oxford)

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EUS-FNB significantly enhances diagnosis of autoimmune pancreatitis

Post author By STITCHES Newsletter
Post date 11/03/2025
Categories In General Surgery, HPB & Spleen, Surgical Endoscopy

A prospective multicenter study evaluated the effectiveness of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) in diagnosing autoimmune pancreatitis (AIP) using the International Consensus Diagnostic Criteria (ICDC). Results showed that EUS-FNB improved diagnostic levels in 92.3% of suspected AIP patients, with a diagnostic accuracy of 94.2%. The histological analysis differentiated subtype AIP, achieving a compatibility rate of 73.1% for type 1 and 50% for type 2. Two mild pancreatitis cases were reported post-procedure.

Journal Article by Conti Bellocchi MC, Crinò SF (…) Frulloni L et 10 al. in Gastrointest Endosc

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Preventive interventions significantly reduce postoperative delirium risk

Post author By STITCHES Newsletter
Post date 11/03/2025
Categories In General Surgery, Perspectives, Opinions and Curiosities

Preventive strategies have been shown to lower the risk of postoperative delirium (POD) by 49% after intraabdominal surgery, according to a systematic review and meta-analysis of 16 randomized controlled trials involving 4,060 participants. The findings underscore the necessity for standardized screening and intervention protocols to enhance surgical outcomes, particularly among high-risk patients. This highlights the critical importance of developing effective prevention strategies in light of the rising incidence of POD in an aging population.

Review by Jensen J, Thorhauge K (…) Burcharth J et 2 al. in Am J Surg

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