Lymphovascular Invasion and Perineural Invasion Negatively Impact Overall Survival for Stage II Adenocarcinoma of the Colon.

Background: Lymphovascular invasion and perineural invasion are histopathological features associated with higher-risk colon cancer.

Objective: The purpose of this study was to quantify the impact of lymphovascular and perineural invasion on overall survival after diagnosis and to determine the protective effect of adjuvant chemotherapy for early adenocarcinoma with high-risk factors.

Design: This was a retrospective database review of the 2010-2014 National Cancer Database for colon cancer.

Minimally Invasive Surgery for Rectal Adenocarcinoma Shows Promising Outcomes Compared to Laparotomy, a National Cancer Database Observational Analysis.

Purpose/background: The surgical approach to adenocarcinoma of the rectum remains a controversial topic. Although current data focus on the noninferiority of minimally invasive surgery (MIS) for rectal cancer compared with laparotomy, conclusions are drawn from smaller sample sizes and may be underpowered. Methods/Interventions: The National Cancer Database (NCDB) from 2010 to 2014 was reviewed for all cases of invasive adenocarcinoma of the rectum (SEER Histology Codes 8140) who underwent surgical resection for malignancy.

Elective Stoma Reversal Has a Higher Incidence of Postoperative Clostridium Difficile Infection Compared With Elective Colectomy: An Analysis Using the American College of Surgeons National Surgical Quality Improvement Program and Targeted Colectomy Databases.

Background: Clostridium difficile infection is caused by the proliferation of a gram-positive anaerobic bacteria after medical or surgical intervention and can result in toxic complications, emergent surgery, and death.

Objective: This analysis evaluates the incidence of C difficile infection in elective restoration of intestinal continuity compared with elective colon resection.

Design: This was a retrospective database review of the 2015 American College of Surgeons National Surgical Quality Improvement Project and targeted colectomy database.

Estimating the risk of bowel ischemia requiring surgery in patients with tomographic evidence of pneumatosis intestinalis.

Background: Pneumatosis intestinalis (PI) presents a challenging dilemma for surgeons given its association with both benign and life threatening conditions. As such, the need for surgical intervention is oftentimes difficult to discern. We hypothesize that a clinical nomogram can be used to predict the need for surgical intervention in patients with PI.

Defining Surgical Site Infection in Colorectal Surgery: An Objective Analysis Using Serial Photographic Documentation.

Background: Surgical site infection is common following colorectal surgery, yet the incidence varies widely. CDC criteria include "diagnosis by attending physician," which can be subjective. Alternatively, the ASEPSIS score is an objective scoring system based on the presence of clinical findings.

Standardization of care: impact of an enhanced recovery protocol on length of stay, complications, and direct costs after colorectal surgery.

Background: Colorectal surgery is associated with considerable morbidity and prolonged length of stay (LOS). Recognizing the need for improvement, we implemented an enhanced recovery (ER) protocol for all patients undergoing elective colorectal surgery at an academic institution.

Study Design: A multidisciplinary team implemented an ER protocol based on: preoperative counseling with active patient participation, carbohydrate loading, multimodal analgesia with avoidance of intravenous opioids, intraoperative goal-directed fluid resuscitation, immediate postoperative feeding, and ambulation.