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Journal Article by Norasi H, Hallbeck MS (…) Pak R et 3 al. in Surg Endosc

Robotic Surgery May Improve Surgeon Wellness and Reduce Work-Related Pain

Post author By STITCHES Newsletter
Post date 02/11/2023
Categories In General Surgery, Perspectives, Opinions and Curiosities

A survey of 79 surgeons in an academic hospital system compared workload, physical discomfort, and neuromusculoskeletal disorders (NMSDs) across four surgical modalities: endoscopic, laparoscopic, open, and robot-assisted (Da Vinci). Physical demand and mental workload were highest in open surgery. Robotic surgeons reported lower shoulder and finger discomfort and a significantly lower prevalence of NMSDs (7%) compared to other modalities (60-67%). These findings highlight the potential benefits of robotic surgery in improving surgeon well-being and reducing work-related pain.

Journal Article by Yi X, Zhang X, Li Q and Ouyang J in Surg Endosc

Transanal Surgery Shows Advantages Over Laparoscopy in Rectal Cancer

Post author By STITCHES Newsletter
Post date 02/11/2023
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract

This meta-analysis evaluated the outcomes of transanal total mesorectal excision (TaTME) versus laparoscopic TME (LaTME) for rectal cancer. Analyzing data from 22 studies comprising 5056 patients, including randomized controlled trials and prospective studies, revealed that TaTME had a lower conversion rate and better circumferential resection margin (CRM) outcomes than LaTME. There were no significant differences in several other parameters, making TaTME a promising choice for rectal cancer surgery, particularly due to its benefits in reducing conversion and improving CRM.

Journal Article by Somerset AE, Wood MH (…) Varban OA et 4 al. in Surg Endosc

Inequities in Bariatric Surgery Access for Medicaid Patients: A Program-Specific Divide

Post author By STITCHES Newsletter
Post date 02/11/2023
Categories In General Surgery, Metabolic and Bariatric Surgery

This study delves into bariatric surgery access for Medicaid patients and reveals stark disparities among programs. Involving a comprehensive data registry spanning 14 years and 43 programs, it highlights that the proportion of Medicaid cases varies significantly between institutions. Programs with more Medicaid patients treated individuals with greater disease severity but also faced longer wait times and higher complication rates. These findings underscore the need for standardizing insurance and implementing program-centered incentives to ensure equitable access to bariatric surgery, especially for those with lower socioeconomic status.

Journal Article by Thomaschewski M, Lipp M (…) Mittmann K et 4 al. in Surg Endosc

Persistent NIR Fluorescent Tattoos Improve Tumor Localization in Minimally Invasive Colorectal Surgery

Post author By STITCHES Newsletter
Post date 02/11/2023
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract, Surgical Endoscopy

This innovative study tackles the challenge of precisely locating tumors during minimally invasive colorectal surgery. Traditionally, blue dye has been used for preoperative marking, but it can lead to complications when spilled inside the body. The researchers introduced a new method using a near-infrared (NIR) fluorescent marker called AFS81x. In experiments on pigs, they successfully created NIR fluorescent tattoos in the colon, which remained clearly visible for at least 10 days. These persistent NIR tattoos promise to enhance tumor localization without hindering the recognition of surgical structures during laparoscopy.

Review by Kulasegaran S, Wang Y (…) Koea J et 3 al. in World J Surg

Defining Quality Performance Indicators for Oesophageal Cancer Surgery

Post author By STITCHES Newsletter
Post date 02/11/2023
Categories In General Surgery, Upper Gastrointestinal Tract

This systematic review explored existing quality performance indicators (QPIs) for the surgical management of oesophageal cancer (OC). Researchers collected data from articles, guidelines, and consensus reports. QPIs were categorized as process, outcome, or structural measures, covering aspects like multidisciplinary involvement, reoperation rates, and the role of surgical metrics. The findings provide a foundation for a quality initiative project focused on improving OC resection by objectively assessing and enhancing patient care.

read the whole article in World J Surg

Journal Article by Rompen IF, Levine J (…) Javed AA et 11 al. in Ann Surg

Pancreatic Cancer Recurrence: A Second Chance for Some

Post author By STITCHES Newsletter
Post date 01/11/2023
Categories In General Surgery, HPB & Spleen

Researchers examined the post-recurrence progression in patients with resected pancreatic ductal adenocarcinoma (PDAC) and the implications for treatment. Most PDAC patients experience recurrence within two years, with varying survival outcomes depending on the site of recurrence. Lung recurrence showed significantly longer post-recurrence survival. A subset of patients with local-only recurrence, especially those with specific markers for favorable tumor biology, had a chance for potential curative re-resections, highlighting the need for personalized treatment strategies in PDAC recurrence.

Journal Article by Fujikawa T, Hasegawa S (…) Obama K et 20 al. in Ann Surg

Continuing Aspirin Reduces Thromboembolic Risk in Gastroenterological Surgery

Post author By STITCHES Newsletter
Post date 01/11/2023
Categories In General Surgery, Perspectives, Opinions and Curiosities

Researchers conducted a multicenter study to assess the impact of continuing preoperative aspirin monotherapy in patients on antiplatelet therapy (APT) during gastroenterological surgery. The study revealed that patients who continued aspirin had significantly lower rates of thromboembolic complications compared to those who discontinued aspirin or were not on APT. These findings emphasize the importance of maintaining preoperative aspirin therapy to reduce the risk of thromboembolic consequences in elective gastroenterological surgery.

Journal Article by Abbasi A and Cifu AS in Ann Surg

Sham Surgery Trials: Potential Benefit for Patients

Post author By STITCHES Newsletter
Post date 01/11/2023
Categories In General Surgery, Perspectives, Opinions and Curiosities

Sham-controlled randomized trials, which involve sham surgical procedures, are essential for evaluating the risks and benefits of some surgeries. This study explores the ethics of sham surgery trials and argues that patients can benefit from participating. When the procedure under study is ineffective, patients who receive the sham procedure experience fewer harms than the full procedure entails. Even when the procedure is effective, the primary harm to sham participants is the delay in receiving the beneficial intervention. This perspective suggests rethinking the ethics of sham surgery trials.

Journal Article by Lucocq J, Hawkyard J (…) Pandanaboyana S et 53 al. in Ann Surg

Frequent Recurrence in Pancreatic Adenocarcinoma Arising from IPMN, with Treatment Improving Survival

Post author By STITCHES Newsletter
Post date 01/11/2023
Categories In General Surgery, HPB & Spleen

An international multicenter study analyzed 459 patients who underwent pancreatic resection for adenocarcinoma originating from intraductal papillary mucinous neoplasia (IPMN). Results showed that recurrence was common, with 45.5% experiencing it, including 23.2% with early recurrence within a year. Treatment of recurrence, such as adjuvant chemotherapy and other modalities, significantly improved overall survival, with a median survival of 27.0 months, compared to 14.6 months without treatment. The study highlights the need for vigilance in monitoring IPMN-related adenocarcinoma and considering treatment upon recurrence.