Surgery for constipation in patients with prior spinal cord injury: the Department of Veterans Affairs experience.

Objective: Patients with spinal cord injury (SCI) typically have difficulty with constipation. Some undergo surgery for bowel management. We predicted that SCI patients would have higher mortality and/or morbidity rates following such surgery than neurally intact patients receiving the same procedures.

Proctectomy for rectal cancer in patients with prior spinal cord injury.

Introduction: Limited published information is available concerning the clinical course of spinal cord injured (SCI) patients who later develop rectal cancer and undergo proctectomy. We hypothesized that such patients would have poorer outcomes than comparable neurally-intact patients.

Methods: We conducted a retrospective study of all SCI veterans receiving care at all Department of Veterans Affairs (DVA) Medical Centers who subsequently underwent proctectomy for rectal cancer during fiscal years 1993-2002.

Risk factors for adverse outcomes following surgery for small bowel obstruction.

Objective: To construct risk indices predicting adverse outcomes following surgery for small bowel obstruction (SBO).

Methods: The VA National Surgical Quality Improvement Program contains prospectively collected data on more than 1 million patients. Patients undergoing adhesiolysis only or small bowel resection for SBO from 1991 to 2002 were selected.

Patient surveillance after curative-intent surgery for rectal cancer.

The follow-up of patients with rectal cancer after potentially curative resection has significant financial and clinical implications for patients and society. The ideal regimen for monitoring patients is unknown. We evaluated the self-reported practice patterns of a large, diverse group of experts.

Follow-up of colorectal cancer patients after resection with curative intent-the GILDA trial.

Purpose: Surgery remains the primary treatment of colorectal cancer. Data are lacking to delineate the optimal surveillance strategy following resection. A large-scale multi-center European study is underway to address this issue (Gruppo Italiano di Lavoro per la Diagnosi Anticipata-GILDA).

Morbidity and mortality of gastrectomy for cancer in Department of Veterans Affairs Medical Centers.

Background: The purpose of this study was to define risk factors that predict 30-day morbidity and mortality after gastrectomy for cancer in Veterans Affairs (VA) Medical Centers.

Methods: The VA National Surgical Quality Improvement Program prospectively collected data on 708 patients undergoing gastrectomy for cancer in 123 participating VA medical centers from 1991 to 1998. Independent variables included 68 preoperative patient characteristics and 12 intraoperative variables; the dependent variables were 21 defined adverse outcomes and death.