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Novel Prognostic Role of Tumor Microbiome in Intrahepatic Cholangiocarcinoma

Post author By STITCHES Newsletter
Post date 21/03/2024
Categories In General Surgery, HPB & Spleen

Characterization of the tumor microbiome in intrahepatic cholangiocarcinoma revealed a higher diversity than in adjacent nontumoral liver tissues, with increased abundance of specific bacterial groups. Higher tumor microbial diversity was linked to lymph node metastasis and predicted shorter overall and recurrence-free survival. A risk score formulated from 11 selected bacteria could independently predict overall survival, suggesting the tumor microbiome’s potential as a prognostic indicator in intrahepatic cholangiocarcinoma.

Journal Article by Xin HY, Zou JX (…) Zhou SL et 11 al. in J Gastroenterol

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Reduced Gas Embolism with Low Pneumoperitoneum Pressure in Laparoscopic Liver Resection

Post author By STITCHES Newsletter
Post date 20/03/2024
Categories In General Surgery, HPB & Spleen

Low pneumoperitoneum pressure reduces the incidence and duration of severe gas embolism during laparoscopic liver resection, leading to steadier hemodynamics, vital signs, and overall improved patient outcomes. Group L, with low pressure, showed significantly fewer cases of severe gas embolism, shorter duration of embolism episodes, and less physiological stress compared to Group S with standard pressure.

Journal Article by Luo W, Jin D (…) Zhong J et 12 al. in Ann Surg

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Non-Therapeutic Laparotomy in Locally Advanced Pancreatic Cancer has Limited Impact on Survival

Post author By STITCHES Newsletter
Post date 20/03/2024
Categories In General Surgery, HPB & Spleen

Non-therapeutic laparotomy occurred in 28.2% of patients with locally advanced pancreatic cancer after induction (m)folfirinox, with no significant difference in overall survival or palliative therapy compared to those who did not undergo surgery. The 5-year overall survival rates were 11.4% for group a (laparotomy), 8.7% for group b (no surgery), and 24.7% for group c (resection). Non-therapeutic laparotomy did not reduce overall survival when compared to no surgery, suggesting minimal impact on oncological outcomes.

Journal Article by Theijse RT, Stoop TF (…) Besselink MG et 8 al. in Br J Surg

© The Author(s) 2024. Published by Oxford University Press on behalf of BJS Foundation Ltd.

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Comparable Efficacy of Lumen Apposing Metal Stents vs. Balloon Dilation for Benign Colorectal Anastomotic Strictures

Post author By STITCHES Newsletter
Post date 20/03/2024
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract, Surgical Endoscopy

Lumen apposing metal stents (LAMS) appear to be as effective as endoscopic balloon dilation (EBD) for treating benign colorectal anastomotic strictures (BCAS), with a potential for requiring fewer procedures and being safer. Twenty-nine patients were involved, showing no significant differences in outcomes between LAMS and EBD, but a trend towards fewer procedures and adverse events with LAMS.

Journal Article by Kankotia RJ, Kwon RS (…) Machicado JD et 5 al. in Gastrointest Endosc

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Understanding Functional Disorders in Ileal-Anal Pouch

Post author By STITCHES Newsletter
Post date 20/03/2024
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract

Functional disorders in the ileal-anal pouch present a spectrum of symptoms, some expected and others related to surgical complications. Studies have attempted to define and measure normal pouch function, but few have addressed pouch physiology. The confusion surrounding pouch function highlights the need for a better understanding of expected changes in defecation physiology post-surgery. Identifying the cause of pouch-related symptoms is crucial for appropriate management.

Journal Article by Church J in Dis Colon Rectum

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Impact of Endoscopic Surgical Skill Qualification on Conversion to Laparotomy in Rectal Cancer Patients

Post author By STITCHES Newsletter
Post date 20/03/2024
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract, Surgical Endoscopy

Participation of ESQS-certified physicians was associated with lower risk of both indicated and technical conversion to laparotomy for rectal cancer patients undergoing laparoscopic surgery. Other factors influencing conversion included tumor diameter, combined resection of adjacent organs, and institution type. Referral to specialized centers, especially for high-risk patients, may improve outcomes.

Journal Article by Goto K, Watanabe J (…) Naitoh T et 9 al. in Surg Endosc

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The Lethal Triad: Acute Cholecystitis, Obesity, and Steatohepatitis Increase Bile Duct Injury Risk

Post author By STITCHES Newsletter
Post date 20/03/2024
Categories In Appendix, Gallbladder and Surgical Emergencies, General Surgery

The study analyzed 387,501 laparoscopic cholecystectomy cases from the NSQIP registry and found that the presence of the lethal triad (acute cholecystitis, obesity, and steatohepatitis) significantly increased the risk of bile duct injury (BDI) by over 15-fold. Those with the triad had a BDI incidence rate of 1.49% compared to 0.09% in those without. This prognostic measure can better guide patient counseling and potentially impact treatment decisions.

Journal Article by Gutierrez JV, Chen DD, Yheulon CG and Mangieri CW in Surg Endosc

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Key Factors for Post-Operative VTE in Colorectal Surgery

Post author By STITCHES Newsletter
Post date 20/03/2024
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract

Post-operative colorectal venous thromboembolism rates were 1.75%, with 53% of patients undergoing urgent/emergent surgeries and 60% receiving blood transfusions. Only 30% had high Caprini scores, while 66% had low preoperative albumin levels. The study highlights the importance of considering urgent surgeries, low albumin levels, and blood transfusions in enhancing VTE screening and prophylaxis for colorectal surgery patients.

Journal Article by Almanzar A, Dahmani SL (…) Berkey S et 4 al. in Am J Surg

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Effectiveness of Cultural Competency Training in Surgical Settings

Post author By STITCHES Newsletter
Post date 20/03/2024
Categories In General Surgery, Perspectives, Opinions and Curiosities

Health disparities in surgical settings are unjust and result in poor outcomes. Cultural competency training (CCT) for providers may address these disparities, but its cost-effectiveness is unclear. The effectiveness of CCT in improving health outcomes and whether it should be team-based are key considerations. Further research is needed to determine if CCT is a worthwhile investment in reducing health disparities in surgical care settings.

Journal Article by Mora R and Maze M in Br Med Bull

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General Surgery Residents Overwhelmingly Support Mandatory Wellness Curriculum Six Years Later

Post author By STITCHES Newsletter
Post date 20/03/2024
Categories In General Surgery, Perspectives, Opinions and Curiosities

Following the approval of a resident-created physician wellness program in 2016, a recent survey of 25 general surgery residents showed unanimous support for ongoing development and mandatory participation in the wellness curriculum. The majority preferred quarterly “wellness half-days” as a mandatory component, citing reasons such as ease of explanation to faculty, guilt around leaving shifts, and the need to prioritize self-care. Complaints from other team members regarding resident wellness have increased, indicating room for improvement.

Journal Article by Haider A, Sullivan J (…) Greenbaum A et 3 al. in J Surg Res

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