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Advances in Hernia Care: Moving Towards Individualized Treatment

Recent advances in hernia surgery have allowed surgeons to accurately predict risk, diagnose hernias based on individual characteristics, and utilize new technology and techniques in the operating room. While outcomes have modestly improved, further progress is still needed, with emphasis on continued research, use of registries, education, and training. Hernia prevention strategies focusing on minimally invasive surgery and prophylactic mesh are also crucial. These advancements have led to the emergence of abdominal core health as a new subspecialty of general surgery.

Journal Article by Hope WW in Am Surg

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Same-Day Ileostomy Closure Discharge Reduces Costs without Compromising Outcomes

Post author By STITCHES Newsletter
Post date 07/04/2024
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract

Same-day discharge diverting loop ileostomy closure (SDD) demonstrated a significant reduction in median index episode hospitalization and 30-day post-operative costs compared to standard inpatient enhanced recovery protocol, saving $4,827 per patient. Complication rates, readmission, and reoperation rates were similar between groups. Implementing SDD for ileostomy closure offers substantial cost savings and potentially improves healthcare resource utilization, advocating for a shift towards same-day discharge protocols.

Journal Article by Ferrari D, Violante T (…) Larson DW et 4 al. in Ann Surg

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High Yield of Somatic Mutational Analysis in EUS-Guided Biopsy of Pancreatic Adenocarcinoma

Post author By STITCHES Newsletter
Post date 07/04/2024
Categories In General Surgery, HPB & Spleen

Somatic mutational analysis from EUS-guided biopsies of pancreatic adenocarcinoma showed a high yield and comparable impact to that of surgical resection. EUS sampling had a yield of 89.5%, with over a quarter carrying actionable mutations and one in six having treatment impacted by mutational analysis. This study highlights the potential and real impact of EUS sampling on treatment decisions for pancreatic adenocarcinoma patients.

Journal Article by Dong S, Agarunov E (…) Gonda T et 7 al. in Am J Gastroenterol

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Association of National Accreditation Program for Rectal Cancer Accreditation with Lower Morbidity and Mortality Rates after Surgery

Post author By STITCHES Newsletter
Post date 07/04/2024
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract

NAPRC-accredited hospitals have lower risk-adjusted in-hospital, 30-day, and 1-year mortality rates, as well as lower 30-day complication rates, compared to non-accredited hospitals among Medicare beneficiaries undergoing proctectomy for rectal cancer. Patients at accredited hospitals were more likely to receive minimally invasive procedures and had higher rates of sphincter preservation, pointing to higher quality surgical care in accredited institutions.

Journal Article by Harbaugh CM, Kunnath NJ (…) Ibrahim AM et 3 al. in J Am Coll Surg

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Comparing Gemcitabine Plus Nab-Paclitaxel and Gemcitabine Plus S-1 as Neoadjuvant Chemotherapy in Pancreatic Cancer Patients

Post author By STITCHES Newsletter
Post date 07/04/2024
Categories In General Surgery, HPB & Spleen

Patients with resectable/borderline-resectable pancreatic cancer underwent neoadjuvant chemotherapy with gemcitabine plus nab-paclitaxel or gemcitabine plus S-1. While there was no significant difference in 2-year progression-free survival rates between the two groups, the gemcitabine plus nab-paclitaxel regimen showed a longer median progression-free survival. Adverse events, completion rates, reduction in tumor marker levels, and lymph node metastasis were also more favorable in the gemcitabine plus nab-paclitaxel group.

Journal Article by Yamada D, Kobayashi S (…) Eguchi H et 14 al. in Ann Surg Oncol

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Understanding Patient Perspectives on Smartphone-Based Mobile Health Technology in Perioperative Care

Post author By STITCHES Newsletter
Post date 07/04/2024
Categories In Digital Surgery and Telemedicine, General Surgery

Patients value mobile health technology in perioperative care, but there is limited knowledge on their perceptions. A human-centered design approach is crucial for meaningful implementation. Recommendations from qualitative studies of surgeons and patients can help health care systems maximize mobile health technology for patient-centered surgical care.

Journal Article by Sinyard RD and Panda N in BMC Surg

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Correlation between emotional intelligence and burnout in general surgery residents

Post author By STITCHES Newsletter
Post date 07/04/2024
Categories In General Surgery, Perspectives, Opinions and Curiosities

Researchers found that higher emotional intelligence scores were associated with lower levels of burnout in general surgery residents. However, participation in patient-centered resident conferences did not significantly impact emotional intelligence or burnout levels. Further research is needed to better understand the relationship between emotional intelligence and burnout in surgical residents.

Journal Article by Standage H, Kelley K (…) Hoops H et 3 al. in Am J Surg

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Pouch Rediversion: Salvage Strategy for Failing Ileoanal Pouches

Post author By STITCHES Newsletter
Post date 07/04/2024
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract

Rediversion with an ileostomy was a safe, important first step in pouch salvage, with subsequent surgery for noninflammatory indications showing significantly higher pouch salvage rates than for inflammatory complications. Overall, 52% of patients underwent successful pouch salvage after rediversion, with a 5-year pouch survival rate of 94.5% for noninflammatory indications. Rediversion can be a helpful strategy in managing failing ileoanal pouches, providing valuable insights into post-salvage outcomes.

Journal Article by Uchino T, Lincango EP (…) Holubar SD et 11 al. in Inflamm Bowel Dis

© The Author(s) 2024. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
© The Author(s) 2024. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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Development of a more individualized treatment approach for hepatic adenoma

Post author By STITCHES Newsletter
Post date 07/04/2024
Categories In General Surgery, HPB & Spleen

Researchers reviewed the latest advancements in the diagnosis and management of hepatic adenomas. They classified it into 8 subtypes based on molecular pathology, each with unique characteristics and risks of malignant transformation. Larger adenomas over 5 cm have a higher risk of bleeding and malignancy and should generally be surgically removed. Magnetic resonance imaging is the preferred diagnostic tool, with up to 42% of cases presenting with hemorrhage. Future treatments may be tailored to individual molecular subtypes for improved outcomes.

Review by Aziz H, Underwood PW (…) Pawlik TM et 3 al. in J Gastrointest Surg

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Real-time AI-based cancer detection and tissue perfusion analysis using NIR technology

Post author By STITCHES Newsletter
Post date 07/04/2024
Categories In Digital Surgery and Telemedicine, General Surgery

Researchers propose a novel AI system for real-time cancer detection and tissue perfusion analysis during surgery using NIR technology. By applying interpretable AI methods to analyze fluorescence intensity curves generated from intra-operative NIR video streams, accurate tissue classification algorithms can be built with modest training sets. This system has the potential to enhance dynamic interpretation accuracy, improve cancer detection, and enable tissue perfusion classification for broader clinical applications.

Journal Article by Moynihan A, Boland P (…) Cahill R et 5 al. in Eur J Surg Oncol

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