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Colectomy

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https://www.readbyqxmd.com/read/28649796/lymph-node-yield-in-right-colectomies-for-cancer-a-comparison-of-open-laparoscopic-and-robotic-approaches
#1
Maria Widmar, Metin Keskin, Paul Strombom, Pedro Beltran, Oliver S Chow, J Joshua Smith, Garrett M Nash, Jinru Shia, David Russell, Julio Garcia-Aguilar
AIM: Studies have demonstrated a relationship between lymph node (LN) yield and survival after colectomy for cancer. The impact of surgical technique on lymph node yield has not been well explored. METHOD: This is a retrospective study of right colectomies (RC) for cancer at a single institution from 2012-2014. Exclusion criteria were previous colectomy, emergent and palliative operations. All data were collected by chart review. Primary outcomes were LN yield and the lymph node to length of surgical specimen (LN-LSS) ratio...
June 26, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28647046/assessment-of-emergency-general-surgery-care-based-on-formally-developed-quality-indicators
#2
Angela Ingraham, Avery Nathens, Andrew Peitzman, Allison Bode, Gina Dorlac, Warren Dorlac, Preston Miller, Mahsa Sadeghi, Deena D Wasserman, Karl Bilimoria
BACKGROUND: Emergency general surgery outcomes vary widely across the United States. The utilization of quality indicators can reduce variation and assist providers in administering care aligned with established recommendations. Previous quality indicators have not focused on emergency general surgery patients. We identified indicators of high-quality emergency general surgery care and assessed patient- and hospital-level compliance with these indicators. METHODS: We utilized a modified Delphi technique (RAND Appropriateness Methodology) to develop quality indicators...
June 21, 2017: Surgery
https://www.readbyqxmd.com/read/28643308/-anatomical-strategies-of-henle-trunk-in-laparoscopic-right-hemi-colectomy-for-right-colon-cancer
#3
Bo Feng, Xialin Yan, Sen Zhang, Pei Xue, Zirui He, Minhua Zheng
The advancement of laparoscopic surgery serves as a trigger for better understanding of the vascular structure at the inferior border of the pancreas, especially Henle trunk. Henle trunk was first found as convergence to superior mesenteric vein (SMV) conjoined by sub-right colon vein (SRCV) and right gastroepiploic vein (RGEV), but decades later, anterior superior pancreatic duodenal vein (ASPDV) was described as another conjoint vein of Henle trunk. These tributaries are the basic elements of Henle trunk in early years' study...
June 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28641191/early-anastomotic-stricture-occurring-after-colectomy-that-responded-well-to-transanal-decompression-and-local-steroid-therapy-a-case-report
#4
Masanori Hayashi, Atsushi Ikeda, Mitsuo Yokota, Hiroyuki Sako, Hiroshi Uchida, Ken Ikeda, Seijiro Okusawa
INTRODUCTION: Anastomotic strictures occurring after colectomy are a most challenging postoperative complication for gastroenterological surgeons. Reports documenting anastomotic strictures developing in the early postoperative phase are scant, and no established treatment is available. PRESENTATION OF CASE: A 78-year-old man who had undergone a laparoscopic left hemicolectomy for lower colon cancer presented on postoperative day 12 because of abdominal pain and no bowel movement...
June 16, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28638838/kaposi-sarcoma-mimicking-acute-flare-of-ulcerative-colitis
#5
Vivek Kumar, Parita Soni, Mohit Garg, Madina Abduraimova, Jonathan Harris
Besides an AIDS-defining illness, Kaposi sarcoma (KS) is also seen in individuals on long-term immunosuppressant therapy. We report KS in a 70-year-old immunocompetent man, which initially mimicked acute flare of ulcerative colitis (UC). He was hospitalized multiple times for complaints of watery diarrhea and tenesmus. Despite treatment with mesalamine, short courses of methylprednisolone, and one dose of infliximab, his symptoms improved only partially. He underwent colonoscopy, which revealed mild active colitis and a mass in the ascending colon...
April 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28638234/ischemic-or-toxic-injury-a-challenging-diagnosis-and-treatment-of-drug-induced-stenosis-of-the-sigmoid-colon
#6
Zong-Ming Zhang, Xiang-Chun Lin, Li Ma, An-Qin Jin, Fang-Cai Lin, Zhuo Liu, Li-Min Liu, Chong Zhang, Na Zhang, Li-Juan Huo, Xue-Liang Jiang, Feng Kang, Hong-Jun Qin, Qiu-Yang Li, Hong-Wei Yu, Hai Deng, Ming-Wen Zhu, Zi-Xu Liu, Bai-Jiang Wan, Hai-Yan Yang, Jia-Hong Liao, Xu Luo, You-Wei Li, Wen-Ping Wei, Meng-Meng Song, Yue Zhao, Xue-Ying Shi, Zhao-Hui Lu
A 48-year-old woman was admitted with 15-mo history of abdominal pain, diarrhea and hematochezia, and 5-mo history of defecation difficulty. She had been successively admitted to nine hospitals, with an initial diagnosis of inflammatory bowel disease with stenotic sigmoid colon. Findings from computed tomography virtual colonoscopy, radiography with meglumine diatrizoate, endoscopic balloon dilatation, metallic stent implantation and later overall colonoscopy, coupled with the newfound knowledge of compound Qingdai pill-taking, led to a subsequent diagnosis of ischemic or toxic bowel disease with sigmoid colon stenosis...
June 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28637590/evaluation-of-readmissions-due-to-surgical-site-infections-a-potential-target-for-quality-improvement
#7
Romil Shah, Emily Pavey, Mila Ju, Ryan Merkow, Ravi Rajaram, Michael W Wandling, Mark E Cohen, Allison Dahlke, Anthony Yang, Karl Bilimoria
INTRODUCTION: Readmissions have become a focus of pay-for-performance programs. Surgical site infections (SSI) are the reason for most readmissions. Readmissions for SSI could be a unique target for quality improvement. METHODS: Readmission risk for SSI were evaluated for patients undergoing colectomies from 2013 to 2014. Hazard models were developed to examine factors associated with and hospital-level variation in risk-adjusted rates of readmission for SSI. RESULTS: Among 59,088 patients at 525 hospitals, the rate of readmissions for SSI ranged from 1...
June 8, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28637562/ibd-a-growing-and-vulnerable-cohort-of-hospitalized-patients-with-clostridium-difficile-infection
#8
Allan Mabardy, Justin McCarty, Alan Hackford, Haisar Dao
The most recent nationwide data show a rising incidence of Clostridium difficile infection in hospitalized patients with ulcerative colitis (UC). We describe recent national trends with regard to incidence, mortality, and the rate of total colectomy. The Nationwide Inpatient Sample database identified patients admitted to hospitals in the United States with diagnoses of C. difficile and inflammatory bowel disease (IBD) during the study years 2007 to 2013. We analyzed incidence of C. difficile, mortality, and colectomy rates...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28637557/nomogram-derived-prediction-of-postoperative-ileus-after-colectomy-an-assessment-from-nationwide-procedure-targeted-cohort
#9
Ahmet Rencuzogullari, Cigdem Benlice, Meagan Costedio, Feza H Remzi, Emre Gorgun
Postoperative ileus (POI) is a clinical burden to health-care system. This study aims to evaluate the incidence and predictors of POI in patients undergoing colectomy and create a nomogram by using recently released procedure-targeted nationwide database. Patients who underwent elective colectomy in 2012 and 2013 were identified from American College of Surgeons National Surgical Quality Improvement Program using the new procedure-targeted database. Demographics, comorbidities, and 30-day postoperative outcomes were evaluated...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28636471/laparoscopic-colectomy-in-a-district-hospital-the-single-surgeon-can-be-safe
#10
A A Aikoye, A Khushal, C Parkin, T Bates
BACKGROUND: Several outcome measures have been identified for colorectal surgery and published in the literature. This study sought to compare outcomes of high volume laparoscopic colectomy by a single surgeon in a district hospital with outcomes from tertiary referral centres. METHODS: This was a retrospective review of elective laparoscopic colectomy by a single laparoscopic general surgeon in a district hospital over a 51-month period using a prospectively maintained database...
February 7, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28632890/minimally-invasive-surgery-and-its-impact-on-30-day-postoperative-complications-unplanned-readmissions-and-mortality
#11
A Sood, C P Meyer, F Abdollah, J D Sammon, M Sun, S R Lipsitz, M Hollis, J S Weissman, M Menon, Q-D Trinh
BACKGROUND: A critical appraisal of the benefits of minimally invasive surgery (MIS) is needed, but is lacking. This study examined the associations between MIS and 30-day postoperative outcomes including complications graded according to the Clavien-Dindo classification, unplanned readmissions, hospital stay and mortality for five common surgical procedures. METHODS: Patients undergoing appendicectomy, colectomy, inguinal hernia repair, hysterectomy and prostatectomy were identified in the American College of Surgeons National Surgical Quality Improvement Program database...
June 20, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28631086/nearly-a-third-of-high-grade-dysplasia-and-colorectal-cancer-is-undetected-in-patients-with-inflammatory-bowel-disease
#12
Swathi Eluri, Alyssa M Parian, Berkeley N Limketkai, Christina Y Ha, Steven R Brant, Sharon Dudley-Brown, Jonathan E Efron, Sandy G Fang, Susan L Gearhart, Michael R Marohn, Stephen J Meltzer, Safar Bashar, Brindusa Truta, Elizabeth A Montgomery, Mark G Lazarev
BACKGROUND: It is unclear whether intensive surveillance protocols have resulted in a decreased incidence of colorectal cancer (CRC) in inflammatory bowel disease (IBD). AIMS: To determine the prevalence and characteristics of IBD associated high-grade dysplasia (HGD) or CRC that was undetected on prior colonoscopy. METHODS: This is a single-center, retrospective study from 1994 to 2013. All participants had a confirmed IBD diagnosis and underwent a colectomy with either HGD or CRC found in the colectomy specimen...
June 19, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28629609/outcomes-after-laparoscopic-or-robotic-colectomy-and-open-colectomy-when-compared-by-operative-duration-for-the-procedure
#13
Sunu Philip, Nancy Jackson, Vijay Mittal
Laparoscopic colectomy is associated with important early postoperative advantages. These procedures can however increase total operative duration. Our hypothesis is that increased operative duration is associated with post-operative complications that may outweigh the benefits of a minimally invasive approach. We analyzed data from the Michigan Surgical Quality Collaborative (MSQC)R. This is a statewide database of patients who have undergone colon or rectal resections. Colorectal procedures were divided into four groups by surgical approach: open, laparoscopic, robotic and laparoscopic and robotic procedures converted to open...
June 16, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28626383/an-alternative-approach-to-the-terminal-management-of-ogilvie-syndrome
#14
Daniel Galban, Joshua J Baiel
Ogilvie syndrome is defined as colonic pseudo-obstruction due to nonmechanical causes. Mortality of nearly 50% is associated with perforation of the distended, pseudo-obstructed colon. While conservative medical therapy has proven to be beneficial in a majority of cases, >3% of patients have significant distention or perforation of the colon that warrants surgical resection. The case of a 48-year-old male with progressive abdominal discomfort and distention 12 days following knee replacement surgery is presented...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28625817/natural-history-of-adult-ulcerative-colitis-in-population-based-cohorts-a-systematic-review
#15
Mathurin Fumery, Siddharth Singh, Parambir S Dulai, Corinne Gower-Rousseau, Laurent Peyrin-Biroulet, William J Sandborn
INTRODUCTION: A comprehensive knowledge of the natural history of UC helps understand disease evolution, identify poor prognostic markers and impact of treatment strategies and facilitates shared decision-making. We systematically reviewed the natural history of UC in adult population-based cohort studies with long-term follow-up. MATERIALS AND METHODS: Through a systematic literature review of MEDLINE through March 31, 2016, we identified 60 studies performed in 17 population-based inception cohorts reporting the long-term course and outcomes of adult-onset UC (n=15,316 UC patients)...
June 15, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28624035/racial-disparities-in-length-of-stay-persist-even-with-no-postoperative-complications
#16
Matthew D Giglia, Aerin DeRussy, Melanie S Morris, Joshua S Richman, Mary T Hawn, Selwyn M Vickers, Sara J Knight, Daniel I Chu
BACKGROUND: To determine the contribution of race to postoperative length-of-stay in elective colorectal surgery without complications. METHODS: The 2012-2013 National Surgical Quality Improvement Program Colectomy-Targeted Database was queried for patients undergoing elective colorectal surgery without complications. After stratifying by race, univariate/bivariate comparisons were made. On adjusted comparison, predictors of postoperative length-of-stay were identified along with incident rate ratios and Least Squares Means for predicted length-of-stays...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28622448/ileocecal-valve-syndrome-after-surgery-in-adult-patients-myth-or-reality
#17
S Palmisano, M Silvestri, M Troian, P Germani, F Giudici, N de Manzini
AIM: The onset of symptoms after ileocecal valve (ICV) removal may be perceived as an unwanted effect of surgery and induce patients to bring unnecessary litigation against surgeons. The aim of our study is to assess the real impact on the quality of life of patients whose ICV was surgically removed, using three validated questionnaires. METHOD: In patients who had their ICV removed surgically, the Gastrointestinal Quality of life (GIQLI) questionnaire and those used by the European Organization for research and Treatment of Cancer (EORTC) were administered pre and post surgery...
June 16, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28619265/comparison-of-surgical-incision-complete-closure-versus-leaving-skin-open-in-wound-class-iv-in-emergent-colon-surgery
#18
Anand Dayama, Catherine A Fontecha, Shahin Foroutan, Jonathan Lu, Sumit Kumar, Nathaniel M Matolo
INTRODUCTION: Our aim was to compare the effect of techniques of wound closure in the emergent colon surgery with wound class IV. METHODS: Using 2014 the colectomy targeted ACS-NSQIP dataset; we identified patients undergoing emergent colectomy with wound class IV. Comparison of surgical incision complete closure versus leaving the skin open and multivariate logistic regression analyses was performed. RESULTS: Of 1792 patients undergoing emergent colectomy with wound class IV, the complete closure cohort had 1376 patients and the incision skin open cohort had 416 patients...
June 3, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28618062/examining-maintenance-care-following-infliximab-salvage-therapy-for-acute-severe-ulcerative-colitis
#19
Dean Seah, Matthew C Choy, Alexandra Gorelik, William R Connell, Miles P Sparrow, Daniel van Langenberg, Geoffrey Hebbard, Gregory Moore, Peter De Cruz
BACKGROUND AND AIMS: Data supporting the optimal maintenance drug therapy & strategy to monitor ongoing response following successful infliximab (IFX) induction, for acute severe ulcerative colitis (ASUC), are limited. We aimed to evaluate maintenance & monitoring strategies employed in patients post IFX induction therapy. METHODS: Patients in 6 Australian tertiary centres treated with IFX for steroid-refractory ASUC between April 2014 & May 2015 were identified via hospital IBD & pharmacy databases...
June 15, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28617029/medium-to-long-term-efficacy-and-safety-of-oral-tacrolimus-in-moderate-to-severe-steroid-refractory-ulcerative-colitis
#20
Raúl Vicente Olmedo Martín, Víctor Amo Trillo, Rocío González Grande, Miguel Jiménez Pérez
BACKGROUND: Oral tacrolimus is an effective drug that induces clinical remission in patients with moderate to severe ulcerative colitis refractory to steroids. However, there is little data with regard to its medium to long-term efficacy and safety. The aim of this study was to assess the medium to long-term efficacy and safety of oral tacrolimus in this challenging clinical situation. METHODS: This was a retrospective observational review of the clinical charts of 34 patients with moderate to severe ulcerative colitis refractory to steroids treated with oral tacrolimus at our hospital (July 2001-July 2016)...
June 15, 2017: Revista Española de Enfermedades Digestivas
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