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Antibiotics provide a safe alternative to surgery for appendicitis

Post author By STITCHES Newsletter
Post date 28/01/2025
Categories In Appendix, Gallbladder and Surgical Emergencies, General Surgery

Antibiotic treatment is a viable alternative to appendicectomy for adults with imaging-confirmed acute appendicitis, as evidenced by a one-year complication rate of 5.4% for antibiotics compared to 8.3% for surgery. Approximately 66% of patients treated with antibiotics avoided surgery within the first year. However, patients with appendicolith experienced higher complications with antibiotics, prompting a substantial proportion to require subsequent appendicectomy. These findings emphasize the importance of shared decision-making in treatment selection.

Journal Article by Scheijmans JCG, Haijanen J (…) Boermeester MA et 18 al. in Lancet Gastroenterol Hepatol

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Minimally invasive surgery shows better outcomes for colonic diverticular disease

Post author By STITCHES Newsletter
Post date 28/01/2025
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract

Analysis of data from 1.25 million hospitalizations in Germany reveals a trend towards minimally invasive surgery for colonic diverticular disease, with rates rising from 34.6% to 52.9% for complicated cases and from 67.8% to 86.2% for uncomplicated cases between 2019 and 2023. Open surgery was significantly linked to higher in-hospital mortality and complications (odds ratio: 7.41), along with longer hospital stays, underscoring the benefits of minimally invasive techniques.

Comparative Study by Kolbe EW, Buciunas M (…) Kostev K et 4 al. in Tech Coloproctol

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Updated gastric cancer guidelines enhance multidisciplinary treatment approaches

Post author By STITCHES Newsletter
Post date 28/01/2025
Categories In General Surgery, Upper Gastrointestinal Tract

The 2024 Korean Practice Guidelines for Gastric Cancer present significant updates, particularly in systemic treatment, following a thorough review by an interdisciplinary team. Six key questions were revised, and seven statements developed based on extensive systematic reviews and recent research. The updated guidelines aim to enhance the quality of care, with recommendations categorized by evidence level and clinical applicability. Clinicians are supported through a structured approach to screening, diagnosis, and treatment strategies for gastric cancer.

Review by Kim IH, Kang SJ (…) Han HS et 30 al. in J Gastric Cancer

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Function-Preserving Gastrectomy Improves Quality of Life

Post author By STITCHES Newsletter
Post date 28/01/2025
Categories In General Surgery, Upper Gastrointestinal Tract

Function-preserving gastrectomy (FPG) techniques, such as pylorus-preserving and proximal gastrectomy, effectively balance oncological safety while enhancing patients’ quality of life (QoL) following early gastric cancer treatment. These methods yield comparable oncological outcomes to traditional surgery and promote better nutritional recovery with fewer gastrointestinal issues. However, the adoption of FPG remains impacted by its technical complexity and need for specialized surgical skills. A global push for standardized QoL assessments and collaborative research is necessary to validate findings and enhance implementation.

Review by Kim J and Lee HJ in J Gastric Cancer

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Preserving the inferior mesenteric artery improves defecatory function

Post author By STITCHES Newsletter
Post date 27/01/2025
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract

A study found that preserving the inferior mesenteric artery during laparoscopic colorectal resection for diverticular disease significantly reduced the incidence and severity of defecatory disorders. With 219 patients evaluated, those who had the artery preserved reported improved quality of life and stable defecatory function over time, even six years post-surgery. These findings suggest that arterial preservation minimizes colonic denervation, enhancing patient outcomes in terms of daily activities and overall well-being.

Journal Article by Mari FS, Chiarini L (…) Brescia A et 5 al. in Surg Endosc

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Lymph node size on preoperative CT predicts colon cancer metastasis.

Post author By STITCHES Newsletter
Post date 27/01/2025
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract

Measuring lymph node size via preoperative CT significantly predicts pathological lymph node metastasis in colon cancer. Researchers established optimal cutoff values of 6.5 mm for maximum long diameter and 5.5 mm for short diameter, with AUCs of 0.7794 and 0.7755, respectively. Importantly, cutoff values varied by tumor location—higher in the right-sided colon (7.7 mm and 5.9 mm) than in the left (5.8 mm and 5.2 mm)—suggesting tailored diagnostic approaches are necessary.

Journal Article by Kawazoe T, Nakanishi R (…) Yoshizumi T et 5 al. in BMC Gastroenterol

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AI analysis of pancreatic tissue predicts postoperative complications

Post author By STITCHES Newsletter
Post date 27/01/2025
Categories In General Surgery, HPB & Spleen

A study involving 134 patients from the RECOPANC trial found that AI-assisted analysis of pancreatic tissue composition can reliably predict postoperative pancreatic fistula (POPF) risk. The strongest determinant identified was the relative fibrotic tissue area, which outperformed conventional surgical assessments of pancreatic texture. These findings highlight the potential of digital pathology to improve risk stratification and outcomes in pancreatic surgery, marking a significant advance in understanding postoperative complications associated with pancreatic resections.

Journal Article by Màlyi A, Bronsert P (…) Timme S et 8 al. in HPB (Oxford)

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New prognostic model enhances survival predictions for esophageal carcinoma

Post author By STITCHES Newsletter
Post date 27/01/2025
Categories In General Surgery, Upper Gastrointestinal Tract

The study developed a novel prognostic model for overall survival in esophageal carcinoma (EC) patients, incorporating nine significant predictors, including body mass index and treatment modalities. Tested on 3,127 patients, the model achieved a c-index of 0.715 in training and 0.711 in validation cohorts. Area under the curve scores for 1, 3, and 5-year survival predicted accuracy exceeded 0.75, confirming the model’s effectiveness in guiding personalized treatment approaches.

Journal Article by Yu SS, Zheng X (…) Lei HK et 4 al. in World J Gastrointest Oncol

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Laparoscopic repair outperforms traditional methods for gastric ulcers.

Post author By STITCHES Newsletter
Post date 27/01/2025
Categories In Appendix, Gallbladder and Surgical Emergencies, General Surgery, Upper Gastrointestinal Tract

The study reveals that laparoscopic omental patch repair (LOPR) offers significant advantages for treating Helicobacter pylori-associated gastric ulcers with perforations. Patients undergoing LOPR demonstrated reduced operative time, less intraoperative blood loss, and quicker postoperative recovery compared to those receiving the Graham patch technique. Additionally, LOPR resulted in lower rates of postoperative complications and recurrence. Overall, LOPR emerged as a superior therapeutic option, addressing key performance metrics in surgical outcomes.

Comparative Study by Pan J, Shen M and Peng S in Ann Ital Chir

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Preoperative opioid use significantly decreased during the study.

Post author By STITCHES Newsletter
Post date 26/01/2025
Categories In General Surgery, Perspectives, Opinions and Curiosities

Between 2019 and 2023, surgical opioid stewardship in 15 hospitals resulted in a notable decline in preoperative opioid use from 17% to 10%, coupled with an increase in intraoperative blocks from 21% to 27%. Data from 18,325 patients indicated that opioid avoidance strategies were effectively maintained for 68-70% of patients, while discharge opioid prescriptions remained stable at 81%. The initiative adapted successfully to challenges from the COVID-19 pandemic, showcasing its long-term sustainability and effectiveness.

Journal Article by Podder SK, Koeneman S (…) Pitt HA et 7 al. in J Am Coll Surg

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