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Association Between COVID-19 Diagnosis and Postoperative Outcomes in Bariatric Surgery Patients

Post author By STITCHES Newsletter
Post date 27/12/2023
Categories In General Surgery, Metabolic and Bariatric Surgery

Patients with a postoperative diagnosis of COVID-19 after bariatric surgery had worse outcomes, including a higher risk of anastomotic/staple line leak, postoperative pneumonia, and 30-day reoperation. However, patients who had COVID-19 before surgery had similar outcomes to those without COVID-19. The study suggests that it is safe to perform bariatric surgery on patients recently recovered from COVID-19.

Journal Article by Swanson J, Baker MS (…) Cohn T et 2 al. in Am J Surg

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Antimicrobial Prophylaxis with Ampicillin-Sulbactam Improves Short-term Outcomes after Esophagectomy

Post author By STITCHES Newsletter
Post date 26/12/2023
Categories In General Surgery, Upper Gastrointestinal Tract

Antimicrobial prophylaxis with ampicillin-sulbactam was found to be more effective compared to cefazolin in reducing surgical site infection, anastomotic leakage, and respiratory failure after esophagectomy. In a study involving 17,772 patients, the use of ampicillin-sulbactam was associated with significantly improved short-term postoperative outcomes, including reduced respiratory complications, length of stay, and total hospitalization costs. No significant differences in noninfectious complications were observed between the two groups.

Journal Article by Hirano Y, Konishi T (…) Kitagawa Y et 10 al. in Ann Surg

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Outpatient appendectomy for uncomplicated acute appendicitis: Safe, effective, and cost-saving

Post author By STITCHES Newsletter
Post date 26/12/2023
Categories In Appendix, Gallbladder and Surgical Emergencies, General Surgery

The PENDI-CSI Randomized Clinical Trial assessed the safety, efficacy, and cost-effectiveness of outpatient appendectomy for uncomplicated acute appendicitis. With 85.9% of patients discharged without admission, the study found that outpatient surgery is safe and effective. Predictors for admission included age over 31 years, hypertension, high anesthetic risk, previous abdominal surgery, postoperative pain, and fear. There were no differences in complications or readmissions between outpatient and inpatient surgery, and the perceived quality was similar. Outpatient appendectomy resulted in significant cost savings of €1,034.97 per patient.

Journal Article by Durán Muñoz-Cruzado V, Navarro Morales L (…) Padillo-Ruiz J et 3 al. in Ann Surg

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Delaying surgery until the morning shown to be non-inferior for acute appendicitis patients presenting at night

Post author By STITCHES Newsletter
Post date 26/12/2023
Categories In Appendix, Gallbladder and Surgical Emergencies, General Surgery

Delaying appendectomy until the following morning is non-inferior to immediate surgery in adults with acute appendicitis presenting at night, according to a randomized controlled trial. The study found that delaying surgery did not increase the risk of postoperative complications, meeting the noninferiority criteria. However, the mean time between the decision to operate and surgery was longer in the delayed group.

Journal Article by Patel SV, Zhang L (…) Vogt K et 5 al. in Ann Surg

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Post-ERCP Cholecystitis: Incidence and Outcomes from Multi-center Registry

Post author By STITCHES Newsletter
Post date 26/12/2023
Categories In General Surgery, HPB & Spleen, Surgical Endoscopy

The study aimed to describe the incidence, risk factors, and outcomes of post-ERCP cholecystitis using data from a multi-center registry. Among 4,428 patients, 17 cases of post-ERCP cholecystitis were identified, with an incidence of 0.38%. When using covered metal stenting, the incidence increased to 1.50%. Symptoms typically occurred around 5 days after ERCP. Management strategies included cholecystectomy, percutaneous cholecystostomy, and endoscopic stent removal/exchange. These findings provide valuable information on the risks associated with the procedure.

Journal Article by Khan R, Osman H (…) Forbes N et 19 al. in Gastrointest Endosc

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Safety and Efficacy of Percutaneous Jejunostomy Tube Placement Outperforms Surgical Methods

Post author By STITCHES Newsletter
Post date 26/12/2023
Categories In General Surgery, Surgical Endoscopy, Upper Gastrointestinal Tract

A retrospective analysis comparing direct percutaneous endoscopic jejunostomy (DPEJ) tube placement with laparoscopic (Lap-J) and open laparotomy (Open-J) surgical methods revealed similar procedural success rates and complication rates in all three approaches. However, patients who underwent DPEJ experienced significantly lower rates of tube dysfunction within 90 days compared to surgical groups, primarily due to reduced instances of tube clogging and dislodgement. DPEJ is a safe and effective alternative to surgical jejunostomy, providing eligible patients with improved outcomes and decreased complication rates.

Journal Article by Locke J, Norwood D (…) Peter S et 6 al. in Gastrointest Endosc

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Self-expanding metal stents for cholangiocarcinoma: higher clinical success rates but also higher stent-specific adverse events

Post author By STITCHES Newsletter
Post date 26/12/2023
Categories In General Surgery, HPB & Spleen

This retrospective study analyzes the optimal biliary stenting strategy for palliation in cholangiocarcinoma patients. It found that self-expanding metal stents (SEMS) and plastic stents (PS) within SEMS had higher clinical success rates but also higher stent-specific adverse events. Removing PS may facilitate percutaneous biliary drainage (PTBD). Double-pigtail stents had fewer complications compared to straight PS. Cases with balloon dilation and pus on endoscopic retrograde cholangiopancreatography benefited from earlier reintervention. A higher bismuth class, PS use, and PS within SEMS were associated with shorter mean time to repeat PTBD.

Journal Article by Al Nakshabandi A, Ali FS (…) Lee JH et 9 al. in Gastrointest Endosc

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Gasless Single-Incision Endoscopic Surgery for Lateral Neck Dissection in Papillary Thyroid Cancer: Scarless Cervical Appearence and Good Efficacy

Post author By STITCHES Newsletter
Post date 26/12/2023
Categories In Endocrine Surgery, General Surgery

Gasless single-incision endoscopic surgery via subclavicular approach (ESSA) is a safe and effective procedure for lateral neck dissection in patients with papillary thyroid cancer. Results showed that ESSA had comparable lymph node yield to video-assisted endoscopic surgery (VAES) and open surgery (OP), while also resulting in lower swallowing impairment scores and higher cosmetic satisfaction rates. ESSA may be a feasible choice for selected patients with papillary thyroid cancer who desire a scarless cervical appearance.

Journal Article by Zheng G, Ding W (…) Zheng H et 4 al. in Ann Surg Oncol

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Patients’ Preferences for Decision Counseling in Esophageal Cancer

Post author By STITCHES Newsletter
Post date 26/12/2023
Categories In General Surgery, Upper Gastrointestinal Tract

Patients with esophageal cancer were offered decision counseling (dc) either before or after neoadjuvant chemoradiotherapy (ncrt) to reflect on their treatment preferences. Interviews with patients revealed that those who received counseling before ncrt were satisfied with the timing, while some patients who received counseling after ncrt would have preferred it earlier. Overall, patients had positive experiences with dc. The study recommends introducing dc early and discussing with patients when they prefer to discuss treatment options more extensively during the decision-making process.

Journal Article by Hermus M, van der Zijden CJ (…) Kranenburg LW et 3 al. in Ann Surg Oncol

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Ex Vivo Expanded Allogeneic Mesenchymal Stem Cells Provide Durable Treatment for Fistulizing Crohn’s Disease

Post author By STITCHES Newsletter
Post date 26/12/2023
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract

The results of three phase Ib/IIa clinical trials show that treatment with ex vivo expanded allogeneic bone marrow-derived mesenchymal stem cells is safe and effective for severe perianal, rectovaginal, and peripouch fistulizing Crohn’s disease. At 6 months, 83.3% of perianal, 33.3% of rectovaginal, and 30.8% of pouch fistula treatment cohorts achieved combined clinical and radiographic healing. At 12 months, 67.7% of perianal, 37.5% of rectovaginal, and 46.2% of peripouch fistulizing Crohn’s disease patients maintained complete healing.

Journal Article by Lightner AL, Pineiro AO (…) Hull T et 5 al. in BMC Surg

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