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https://www.readbyqxmd.com/read/29234938/impact-of-incisional-hernia-development-following-abdominal-operations-on-total-healthcare-cost
#1
Vamsi V Alli, Jianying Zhang, Dana A Telem
BACKGROUND: Introduction of the category III CPT code (0437T) for prophylactic mesh augmentation (PMA) highlights efforts to reduce incisional hernia (IH). PMA's value in the context of value-based care requires understanding both the cost of IH development and the savings from prevention. We hypothesized large healthcare costs with IH development. Appreciating which subsets of patients are at highest risk for IH, and the subsets who have the costliest care is essential in targeting interventions for hernia prevention...
December 12, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29234923/non-inferiority-multicenter-prospective-randomized-controlled-study-of-rectal-cancer-t2-t3s-superficial-n0-m0-undergoing-neoadjuvant-treatment-and-local-excision-tem-vs-total-mesorectal-excision-tme
#2
X Serra-Aracil, C Pericay, T Golda, L Mora, E Targarona, S Delgado, A Reina, F Vallribera, J M Enriquez-Navascues, S Serra-Pla, J C Garcia-Pacheco
PURPOSE: The standard treatment of rectal adenocarcinoma is total mesorectal excision (TME), in many cases requires a temporary or permanent stoma. TME is associated with high morbidity and genitourinary alterations. Transanal endoscopic microsurgery (TEM) allows access to tumors up to 20 cm from the anal verge, achieves minimal postoperative morbidity and mortality rates, and does not require an ostomy. The treatment of T2, N0, and M0 cancers remains controversial. Preoperative chemoradiotherapy (CRT) in association with TEM reduces local recurrence and increases survival...
December 12, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29225081/enteral-nutrition-and-quality-of-life-in-patients-undergoing-chemoradiotherapy-for-esophageal-carcinoma-a-comparison-of-nasogastric-tube-esophageal-stent-and-ostomy-tube-feeding
#3
Fang-Jung Yu, Hsiang-Yao Shih, Chien-Yi Wu, Yun-Shiuan Chuan, Jui-Ying Lee, Hsien-Pin Li, Pen-Tzu Fang, Dong-Lin Tsai, Shah-Hwa Chou, I-Chen Wu
BACKGROUND AND AIMS: This study prospectively recruited esophageal squamous-cell carcinoma patients who received esophageal stent, nasogastric tube (NG) or jejunostomy/gastrostomy feeding to compare the changes in nutritional status and quality of life during chemoradiation therapy (CRT). METHODS: In total, 81 patients were analyzed (stent 7, surgical ostomy 26, NG 19, oral intake 29). NG was inserted when despite medication dysphagia or pain worsened with oral feeding during CRT...
December 7, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29224706/prophylactic-placement-of-permanent-synthetic-mesh-at-the-time-of-ostomy-closure-prevents-formation-of-incisional-hernias
#4
Jeremy A Warren, Lucas R Beffa, Alfredo M Carbonell, Jennifer Cull, Brent Sinopoli, Joseph A Ewing, Cedrek McFadden, Jay Crockett, William S Cobb
BACKGROUND: Reversal of an enterostomy results in a high rate of incisional hernia at the ostomy site. Prophylactic mesh reinforcement of the fascial defect is typically not considered due to the contaminated nature of the case. We present the outcomes of a series of prophylactic mesh reinforcements with retromuscular, large-pore polypropylene at the time of enterostomy reversal. METHODS: Retrospective review of all ostomy reversals was performed. All cases with placement of synthetic mesh reinforcement were identified from a prospectively maintained, hernia database...
December 7, 2017: Surgery
https://www.readbyqxmd.com/read/29224507/three-anastomotic-techniques-following-laparoscopic-rectal-cancer-resection-our-experience-in-155-patients
#5
Mahtab Zanguie, Abbas Abdollahi, Roham Salek, Ali Jangjoo, Mehdi Jabbari Nooghabi, Hosein Shabahang, Hamed Golmohammadzadeh
PURPOSE: This study aimed to assess the impact of 3 anastomotic techniques after laparoscopic rectal cancer resection. METHODS: In a cross-sectional study, the data of 155 patients who underwent surgery for rectal cancer were retrieved. An anastomosis was created between the left colon and anal canal with 3 different methods: coloanal anastomosis with protective ileostomy (group A), coloanal anastomosis without ostomy (group B), and delayed coloanal anastomosis (group C)...
December 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/29189646/the-impact-of-early-involvement-in-a-postdischarge-support-program-for-ostomy-surgery-patients-on-preventable-healthcare-utilization
#6
Sirikan Rojanasarot
PURPOSE: To evaluate the impact of a postdischarge ostomy support program as an adjunct to nurse-led ostomy care on preventable healthcare utilization. DESIGN: A cross-sectional study. SUBJECTS AND SETTING: A postdischarge support program offered by an ostomy product's manufacturer provides persons living with an ostomy with patient-centered and easily accessible assistance. Individuals who underwent ostomy surgery within 18 months prior to the survey date were selected from an ostomy patient database maintained by the ostomy patient support program provider...
November 20, 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/29169441/patient-selection-and-counseling-for-urinary-diversion
#7
REVIEW
Elysia Sophia Spencer, Matthew D Lyons, Raj S Pruthi
Patient selection and preoperative counseling are critical aspects of determining which urinary diversion to perform and should be emphasized at each stage of preoperative planning. The surgeon must have a thorough understanding of the patient's disease process, functional and psycho-emotional status, and social support network so that they can set appropriate expectations. It is also crucial to have a multidisciplinary team of individuals who are experienced with all aspects of urinary diversion care, including ostomy nurses, nurse navigators, and urologic surgeons skilled at teaching and trouble-shooting self-catheterization for continent cutaneous diversion and orthotopic diversion in the setting of hypercontinence...
February 2018: Urologic Clinics of North America
https://www.readbyqxmd.com/read/29159278/comparative-evaluation-of-two-porcine-ex-vivo-models-for-training-in-endoscopic-ultrasound-guided-drainage-of-pancreatic-fluid-collections
#8
Frederick Moryoussef, Sarah Leblanc, Alice Bertucat, Arthur Laquiere, Emmanuel Coron, Luigi Mangialavori, Jean-Christophe Duchmann, Yann Le Baleur, Frederic Prat
Introduction:  EUS-guided cystoenterostomy (EUCE), a technique used for the drainage of pancreatic pseudocysts and peri-enteric collections, requires specific skills for which dedicated models are needed. Based on a compact EASIE model (Erlangen Active Simulator for Interventional Endoscopy), we developed two ex vivo porcine models of retrogastric cysts and evaluated learning performance within the frame of a structured training program. Material and methods:  The first model was made of porcine colon (i...
October 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/29154517/a-proposal-for-a-tailored-approach-to-diverting-ostomy-for-colorectal-anastomosis
#9
Lisa Manzenreiter, Georg Spaun, Michael Weitzendorfer, Rosalia Luketina, Stavros A Antoniou, Helwig Wundsam, Oliver O Koch, Klaus Emmanuel
BACKGROUND: The use of a protective stoma represents an important issue in colorectal surgery. Although evidence suggests that loop ileostomy may be superior, the optimal method for temporary decompression of colorectal anastomosis still remains controversial. Aim of this study was to make an evidence-based proposal for a tailored approach to the use of diverting colostomy or ileostomy. METHODS: A retrospective analysis of all patients subjected to creation and closure of a diverting loop colostomy or loop ileostomy between May 2007 and November 2014 in our institution was performed...
November 20, 2017: Minerva Chirurgica
https://www.readbyqxmd.com/read/29143906/surgery-for-diverticular-disease-results-in-a-higher-hernia-rate-compared-to-colorectal-cancer-a-population-based-study-from-ontario-canada
#10
E S Tang, D I Robertson, M Whitehead, J Xu, S F Hall
BACKGROUND: Incisional hernias are a well described complication of abdominal surgery. Previous studies identified malignancy and diverticular disease as risk factors. We compared incisional hernia rates between colon resection for colorectal cancer (CRC) and diverticular disease (DD). STUDY DESIGN: We performed a retrospective, population-based, matched cohort study. Provincial databases were linked through the Institute for Clinical Evaluative Sciences. These databases include all patients registered under the universal Ontario Health Insurance Plan...
November 16, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29143213/colorectal-surgery-fellowship-improves-in-hospital-mortality-after-colectomy-and-proctectomy-irrespective-of-hospital-and-surgeon-volume
#11
Julia T Saraidaridis, Daniel A Hashimoto, David C Chang, Liliana G Bordeianou, Hiroko Kunitake
BACKGROUND: General surgery residents are increasingly pursuing sub-specialty training in colorectal (CR) surgery. However, the majority of operations performed by CR surgeons are also performed by general surgeons. This study aimed to assess in-hospital mortality stratified by CR training status after adjusting for surgeon and hospital volume. METHODS: The Statewide Planning and Research Cooperative system database was used to identify all patients who underwent colectomy/proctectomy from January 1, 2000, to December 31, 2014, in the state of New York...
November 15, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29143090/pattern-of-lower-intestinal-ostomies-in-a-low-income-country-case-of-southeast-of-niger-republic
#12
Harissou Adamou, Oumarou Habou, Ibrahim Amadou Magagi, Ousseini Adakal, Amadou Magagi, Maazou Halidou, Rachid Sani
BACKGROUND: Intestinal ostomies are common surgical procedures performed in visceral surgery as part of management for several gastrointestinal diseases. This study aims to report the socio-demographic characteristics, indications and prognosis of intestinal ostomies in low-income country. METHODS: This was a 4-year retrospective study (January 2013 to December 2016) at Zinder National Hospital (Niger). All patients with a digestive ostomy on an ileum or colic segment were included in the study...
November 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29139176/costs-of-an-ostomy-self-management-training-program-for-cancer-survivors
#13
Mark C Hornbrook, Martha D Cobb, Nancy J Tallman, Janice Colwell, Ruth McCorkle, Elizabeth Ercolano, Marcia Grant, Virginia Sun, Christopher S Wendel, Judith H Hibbard, Robert S Krouse
OBJECTIVE: To measure incremental expenses to an oncologic surgical practice for delivering a community-based, ostomy nurse-led, small-group, behavior skills-training intervention to help bladder and colorectal cancer survivors understand and adjust to their ostomies and improve their health-related quality of life, as well as assist family caregivers to understand survivors' needs and provide appropriate supportive care. METHODS: The intervention was a five-session group behavior skills training in ostomy self-management following the principles of the Chronic Care Model...
November 14, 2017: Psycho-oncology
https://www.readbyqxmd.com/read/29117086/novel-pouching-techniques-for-the-neonate-with-fecal-ostomies
#14
Glenda Brunette
BACKGROUND: Neonatal ostomy management is challenging even under the best circumstances. When complex circumstances are encountered, creative pouching techniques must be employed. CASES: This article describes management of 5 neonates with problematic ostomies. CONCLUSION: Maintaining a neonatal pouch seal at times requires using modified adult pouching products; however, caution should always be used due to the fragility of this patient population...
November 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/29117082/the-lived-experiences-of-persons-hospitalized-for-construction-of-an-urgent-fecal-ostomy
#15
(no author information available yet)
No abstract text is available yet for this article.
November 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/29117081/the-lived-experiences-of-persons-hospitalized-for-construction-of-an-urgent-fecal-ostomy
#16
Per Herlufsen, Anne Brødsgaard
PURPOSE: The purpose of this study was to describe the lived experiences of hospital stays for patients undergoing urgent ostomy surgery. DESIGN: Qualitative, descriptive, phenomenological study. SUBJECTS AND SETTING: Six persons undergoing acute hospital admission and urgent ileostomy or colostomy surgery (either permanent or temporary) participated in the study. Participants were of Danish ethnicity and between the ages of 48 and 75 years...
November 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/29117080/evaluation-of-web-based-ostomy-patient-support-resources
#17
Joyce Pittman, Thom Nichols, Susan M Rawl
PURPOSE: To evaluate currently available, no-cost, Web-based patient support resources designed for those who have recently undergone ostomy surgery. DESIGN: Descriptive, correlational study using telephone survey. SAMPLE AND SETTING: The sample comprised 202 adults who had ostomy surgery within the previous 24 months in 1 of 5 hospitals within a large healthcare organization in the Midwestern United States. Two of the hospitals were academic teaching hospitals, and 3 were community hospitals...
November 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/29111787/performance-status-prognostic-scoring-and-parenteral-nutrition-requirements-predict-survival-in-patients-with-advanced-cancer-receiving-home-parenteral-nutrition
#18
Niamh Keane, Konstantinos C Fragkos, Pinal S Patel, Friderike Bertsch, Shameer J Mehta, Simona Di Caro, Farooq Rahman
We describe a cohort of Home Parenteral Nutrition (HPN) patients with advanced cancer in order to identify factors affecting prognosis. Demographic, anthropometric, biochemical and medical factors, Karnofsky Performance Status (KPS), Glasgow Prognostic Score (GPS), and PN requirements were recorded. Univariate and multivariate analyses were performed including Kaplan-Meier curves, Cox Regression, and correlation analyses. In total, 107 HPN patients (68 women, 39 men, mean age 57 yr) with advanced cancer were identified...
November 7, 2017: Nutrition and Cancer
https://www.readbyqxmd.com/read/29102276/effect-of-cd4-count-on-treatment-toxicity-and-tumor-recurrence-in-human-immunodeficiency-virus-positive-patients-with-anal-cancer
#19
Alex K Bryant, Ross Mudgway, Minh-Phuong Huynh-Le, Daniel R Simpson, Loren K Mell, Samir Gupta, Andrew B Sharabi, James D Murphy
PURPOSE: To study the effects of immunosuppression on treatment toxicity, long-term cancer recurrence risk, and survival among human immunodeficiency virus (HIV)-positive anal cancer patients. METHODS AND MATERIALS: From a nationwide retrospective cohort of veterans with anal cancer we identified 142 HIV-positive patients with stage I-III disease, diagnosed between 2000 and 2015 and treated with definitive-intent chemotherapy and radiation. We used regression models to study the impact of pretreatment CD4 counts and longitudinal posttreatment CD4 counts on outcomes including acute toxicity, long-term ostomy rates, cancer recurrence, cancer-specific survival, and overall survival...
September 22, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/29083464/initiating-exercise-interventions-to-promote-wellness-in-cancer-patients-and-survivors
#20
REVIEW
Anna L Schwartz, Hendrik Dirk de Heer, Jennifer W Bea
Exercise is associated with significant reductions in the recurrence and mortality rates of several common cancers. Cancer survivors who exercise can potentially benefit from reduced levels of fatigue, and improved quality of life, physical function, and body composition (ie, healthier ratios of lean body mass to fat mass). The amount of activity required to achieve protective effects is moderate (eg, walking 30 minutes per day at 2.5 miles per hour). However, many healthcare providers report a lack of awareness of the appropriate exercise recommendations across the phases of cancer survivorship, considerations regarding the timing of exercise interventions, and the ability to refer patients to exercise programs specifically aimed at cancer survivors...
October 15, 2017: Oncology (Williston Park, NY)
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