Use and outcomes of emergent laparoscopic resection for acute diverticulitis.

Background: The use and outcomes of laparoscopic sigmoid resection during emergency admissions for diverticulitis are unknown.

Methods: The Nationwide Inpatient Sample was queried for colorectal resections performed for diverticulitis during emergent hospital admissions (2003-2007). Univariate and multivariate analyses including patient, hospital, and outcome variables were performed.

Effect of surgical approach on 30-day mortality and morbidity after elective colectomy: a NSQIP study.

Purpose: The aim of this study was to evaluate the laparoscopic approach and pre- and postoperative conditions as predictors of 30-day mortality and morbidity in elective colectomy.

Methods: Elective colectomies were identified in the 2005-2008 American College of Surgeons National Surgical Quality Improvement Program database. Multivariate logistic regression was used to model 30-day mortality and morbidity following elective colectomy.

Utilization of laparoscopic colectomy in the United States before and after the clinical outcomes of surgical therapy study group trial.

Objective: To evaluate the utilization of laparoscopic colectomy (LC) in the United States before and after prospective data supported its use for the treatment of colon cancer.

Methods: The Nationwide Inpatient Sample 2001-2003 [before Clinical Outcomes of Surgical Therapy (COST)] and 2005-2007 (after COST) was queried for elective colectomies for both benign and malignant disease. The COST trial was published in 2004; therefore, 2004 data were excluded.

Specialized practice reduces inpatient mortality, length of stay, and cost in the care of colorectal patients.

Objective: This study aimed to determine whether specialized surgeon practice improves clinical outcomes for major inpatient adult colorectal resections.

Design: The Nationwide Inpatient Sample was queried for elective colorectal resections performed from 2001 through 2007. Specialization was determined by first identifying surgeons' procedures as either colorectal or noncolorectal.

Dramatic decreases in mortality from laparoscopic colon resections based on data from the Nationwide Inpatient Sample.

Objective: To determine the mortality rate and associated factors for laparoscopic and open colectomy as derived from the Nationwide Inpatient Sample database.

Design: Retrospective cohort.

Setting: Nationwide Inpatient Sample database.

Laparoscopic converted to open colectomy: predictors and outcomes from the Nationwide Inpatient Sample.

Background: Early in their learning curve, surgeons need to appropriately select patients to avoid conversion from laparoscopic to an open colectomy.

Methods: Using the Nationwide Inpatient Sample, laparoscopic and laparoscopic converted to open colectomies performed between 2002 and 2007 were compared. We evaluated patient and institutional characteristics to find significant predictors and outcomes of conversion.

Predicting malignant intraductal papillary mucinous neoplasm: a single-center review.

Background: The purpose of this study was to examine the characteristics of pancreatic intraductal papillary mucinous neoplasm (IPMN) in our institution and the selection for resection. Recent publications, including those from the International Consensus Guidelines and the Mayo Clinic, set forth criteria for resection. However, these criteria differ in the definition of main duct IPMN, which is an indication to resect.

Endoscopic ultrasound may be unnecessary in the preoperative evaluation of intraductal papillary mucinous neoplasm.

Objectives: Several imaging modalities are commonly performed during work-up of intraductal papillary mucinous neoplasm (IPMN), but guidelines do not suggest any one technique. The aim of this study was to evaluate tumour and duct measurements by computed tomography (CT) and endoscopic ultrasound (EUS) and their ability to predict high-grade dysplasia (HGD) and cancer within pancreatic IPMN.

Methods: Patients with IPMN who underwent preoperative CT and EUS between 2001 and 2009 were selected.

Laparoscopic proctectomy after neoadjuvant therapy: safety and long-term follow-up.

Purpose: The oncologic value of laparoscopic proctectomy for rectal adenocarcinoma is uncertain. Long-term data, particularly in tumors at higher risk of recurrence, is lacking. This study evaluated short- and long-term outcomes in patients who underwent laparoscopic proctectomy for locally advanced cancer (transmural and/or node positive) after neoadjuvant chemoradiotherapy (CRT).

Pylephlebitis: keep it in your differential diagnosis.

Pylephlebitis is thrombophlebitis of the portal vein or its tributaries. It is a rare diagnosis that carries a high mortality if not diagnosed and treated before the onset of sepsis. The authors describe a case of pylephlebitis in a patient who represented with sepsis after surgical treatment of perforated appendicitis.

Ethnicity influences lymph node resection in colon cancer.

The purpose of this study is to determine the association between ethnicity and lymph node retrieval after colon cancer resection. Using the Surveillance Epidemiology and End Results (SEER)-Medicare database, patients who underwent colon cancer resection from 2000-2003 were evaluated. Subjects were classified as having <12 (N = 20,605) or ≥12 (N = 12,358) lymph nodes examined.

Approach to management of intussusception in adults: a new paradigm in the computed tomography era.

Intussusception has been considered an operative indication in adults as a result of the risk of ischemia and the possibility of a malignant lead point. Computed tomographic (CT) scans can reveal unsuspected intussusception. All CT reports from July 1999 to December 2005 were scanned electronically for letter strings to include the keyword intussusception.