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Optimal haemostatic clip usage in laparoscopic cholecystectomy identified

Post author By STITCHES Newsletter
Post date 17/12/2024
Categories In Appendix, Gallbladder and Surgical Emergencies, General Surgery

A precise control pathway for haemostatic clip usage during laparoscopic cholecystectomy was established based on patient variations. Key factors affecting clip consumption included acute cholecystitis, anatomical variation, and severe adhesions. The study revealed that the optimal usage included no more than three clips in 17.3% of cases, four clips in 81.72%, and five or more in 0.98%. The findings support evidence-based management of medical consumables and suggest monitoring for evolving practices.

Observational Study by Yu X, Wang X (…) Zhao Y et 6 al. in BMJ Open

© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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End ileostomy technique reduces stoma outlet obstruction risk

Post author By STITCHES Newsletter
Post date 17/12/2024
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract

A novel end ileostomy surgical technique significantly decreased stoma outlet obstruction (SOO) rates in patients post-rectal resection. In a study of 78 patients, only 2.9% with end ileostomy experienced SOO compared to 25% with loop ileostomy, identifying the latter as an independent risk factor. This innovative approach presents a safer option for patients undergoing defunctioning ileostomy, potentially improving postoperative outcomes in rectal cancer treatment.

Journal Article by Fujii Y, Asai H (…) Takiguchi S et 7 al. in Surg Today

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Wade Programme successfully enhances surgical anatomy education

Post author By STITCHES Newsletter
Post date 17/12/2024
Categories In General Surgery, Perspectives, Opinions and Curiosities

A decade-long evaluation of the Wade Programme reveals its innovative educational framework effectively supports surgical anatomy training. After delivering 105 courses globally to 1,191 participants, feedback-rated satisfaction stood at 95%. The Wade educational approach, based on visualization, conceptual understanding, and practical application, received widespread acclaim as a groundbreaking method for teaching fundamental anatomical principles. This adaptable strategy benefits diverse courses, ensuring robust educational foundations from undergraduate studies to consultant practice.

Review by Jones RA, Mortimer JW (…) Sinclair DW et 3 al. in Curr Probl Surg

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Cost-effective silicone model enhances laparoscopic appendectomy training

Post author By STITCHES Newsletter
Post date 17/12/2024
Categories In Appendix, Gallbladder and Surgical Emergencies, General Surgery, Perspectives, Opinions and Curiosities

A novel silicone-based training model for laparoscopic appendectomy was developed, combining clinical and engineering insights. Iteratively refined through four stages and stakeholder consensus, the model closely mimics anatomical structures and provides realistic haptic feedback. At a cost of only €9.67, it is scalable for various laparoscopic box trainers. This approach facilitates residents’ skill acquisition in a safe environment, enabling them to practice necessary procedures effectively before encountering actual patients.

Journal Article by Roche AF, Diebold G (…) Condron CM et 5 al. in Front Surg

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EUS-guided biliary drainage techniques show high success rates

Post author By STITCHES Newsletter
Post date 17/12/2024
Categories In General Surgery, HPB & Spleen, Surgical Endoscopy

In a study of 191 endoscopic ultrasonography (EUS)-guided biliary drainage procedures, researchers achieved a technical success rate of 97.38% and a clinical success rate of 89.01%. Among the 191 patients, 16.75% experienced complications, including six fatal cases. These advanced techniques offer effective alternatives to traditional methods like ERCP for treating benign and malignant biliary strictures, thereby enhancing the quality of life for patients with unresectable biliopancreatic cancer.

Journal Article by Zieliński M, Jagielski M, Piątkowski J and Jackowski M in Pol Przegl Chir

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Tamsulosin Reduces Urinary Retention and Hospital Stay Post-Surgery

Post author By STITCHES Newsletter
Post date 16/12/2024
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract

Prophylactic use of tamsulosin significantly decreased urinary retention rates (4.7% vs. 9.2%) and reduced hospital stays (4.2 days vs. 5 days) in colorectal surgery patients. The study, which involved 2,072 patients, demonstrated that incorporating tamsulosin into the enhanced recovery after surgery (ERAS) protocol can enhance recovery outcomes. Propensity score matching ensured robust comparisons between the tamsulosin and control groups, highlighting the potential benefits of this medication for improving postoperative recovery.

Journal Article by Erozkan K, Belkovsky M (…) Gorgun E et 5 al. in Am J Surg

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Modified nutritional index predicts survival in elderly gastric cancer patients

Post author By STITCHES Newsletter
Post date 16/12/2024
Categories In General Surgery, Upper Gastrointestinal Tract

A novel modified nutritional index model (mcns) demonstrated high predictive value for long-term survival among elderly patients with advanced gastric cancer. Analyzing data from 555 patients, the study identified tumor size, pn, and the modified nutritional score (mconut) as independent prognostic factors, improving patient risk stratification. Notably, patients in the low-risk group benefiting from adjuvant chemotherapy exhibited significantly enhanced overall survival and recurrence-free survival, while the high-risk group showed no similar benefits.

Journal Article by Wu J, Huang ZN (…) Zheng CH et 8 al. in Eur J Surg Oncol

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A novel fluorescent probe targets pancreatic juice for surgical use

Post author By STITCHES Newsletter
Post date 16/12/2024
Categories In General Surgery, HPB & Spleen

Researchers identified a pancreatic juice-specific fluorescent probe, selectively targeting ectonucleotide pyrophosphatase/phosphodiesterase (enpp) 1, from a library of 411 enzyme-activatable fluorescent probes. The probe demonstrated high reactivity with pancreatic juice, providing the potential for visualizing pancreatic juice leakage during surgery. This advancement may assist surgeons in addressing leaking sites and evaluating the need for prophylactic abdominal drains, although further investigation into enpp1’s role in pancreatic juice is warranted.

Journal Article by Seki Y, Ishizawa T (…) Hasegawa K et 7 al. in HPB (Oxford)

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Hybrid ESD proves efficient for specific colorectal tumors

Post author By STITCHES Newsletter
Post date 16/12/2024
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract, Surgical Endoscopy

A multicenter study involving 890 patients evaluated hybrid endoscopic submucosal dissection (ESD) against conventional ESD for treating laterally spreading tumors (LSTs). Hybrid ESD demonstrated significantly reduced procedure times and hospitalization costs, particularly for lesions sized 10-30 mm. However, it yielded lower R0 resection rates and lifting sign positivity. For larger lesions, conventional ESD maintained better efficacy, despite higher costs. Overall, hybrid ESD emerged as an effective alternative for select patients, balancing efficiency and resection success.

Journal Article by Li H, Hong Y (…) Wei W et 11 al. in JGH Open

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New treatment guidelines enhance management of esophageal and gastric cancer.

Post author By STITCHES Newsletter
Post date 16/12/2024
Categories In General Surgery, Upper Gastrointestinal Tract

Comprehensive updates on the treatment of esophageal and gastric cancer emphasize the crucial role of perioperative systemic therapy. Neoadjuvant chemoradiotherapy followed by postoperative immunotherapy is standard for locally advanced squamous cell carcinoma, while perioperative FLOT chemotherapy shows superior outcomes for adenocarcinoma. Promising results are also noted for MSI-high tumor patients receiving neoadjuvant immunotherapy. The focus on prehabilitation and specialized care aims to lower the high cancer-specific mortality rates, which currently reach 70%.

Review by Lordick Obermannová R, Jedlička V (…) Kiss I et 6 al. in Rozhl Chir

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