Close margin of adverse histologic factors with a negative primary tumor margin is not associated with increased locoregional recurrence in colon cancer.

Purpose: Locoregional recurrence after resection of colon cancer is increased when primary tumor margin is positive (<1 ​mm). Data is limited regarding the risk of locoregional recurrence with close margin (<1 ​mm) of histologic factors, such as intravascular tumor, intranodal tumor, tumor deposits, or extranodal extension. We hypothesized that close margin of these factors doesn't affect locoregional recurrence.

Reprocessed bipolar energy for laparoscopic colectomy: Is it worth it?

Background: Reprocessed (re-sterilized) bipolar energy devices represent one effort to reduce operative costs.

Methods: Between January 2014 to October 2015, 76 patients underwent laparoscopic colectomy using a reprocessed bipolar energy device and were case-matched to 76 patients from a prospectively-maintained database from November 2012 to December 2013 when an identical, new device was used. Outcomes included reprocessed device safety, efficiency and hospital costs.

Comparison of anterior transgastric access techniques for natural orifice translumenal endoscopic surgery.

Background: The advancement of natural orifice translumenal endoscopic surgery (NOTES) into clinical practice is dependent on its safety, efficacy, and efficiency. Access is the obligatory first step in NOTES and serves as a surrogate to technical difficulties associated with this novel surgical approach. This study aimed to compare endoscopic transgastric access techniques in terms of safety, reproducibility, and efficiency.

A feasibility and dosimetric evaluation of endoscopic radiofrequency ablation for human colonic and rectal epithelium in a treat and resect trial.

Background: Endoscopic radiofrequency ablation (RFA) has been used effectively for ablation of foregut disorders and also may have a role in treating colonic pathology. This study aimed to assess the feasibility of delivering RFA to locations within the colon and to determine a range of safe treatment parameters.

Methods: Patients undergoing left hemicolectomy or proctocolectomy were evaluated.

Initial evaluation of a novel, prototype, forward-viewing echoendoscope in a porcine arterial bleeding model (with video).

Background: Real-time visualization of submucosal arterial flow at the base of an ulcer might improve endoscopic hemostasis by permitting more accurate assessment of the artery, precise targeting of therapy, and confirmation of vessel ablation.

Objective: To evaluate the utility of a novel, forward-viewing echoendoscope in identifying bleeding submucosal arteries, guiding hemostatic therapy, and confirming cessation of flow through treated vessels.

Design: In 7 pigs, a previously described porcine model for peptic ulcer hemorrhage was created by isolating the gastroepiploic and/or short gastric artery and tunneling it into the subserosal space at laparotomy.

Transgastric natural-orifice transluminal endoscopic surgery peritoneoscopy in humans: a pilot study in efficacy and gastrotomy site selection by using a hybrid technique.

Background: Diagnostic natural-orifice transluminal endoscopic surgery (NOTES) peritoneoscopy can easily be performed with standard endoscopic equipment in animal studies. The efficacy and optimal transgastric site for NOTES access in humans, however, has not been determined.

Objective: To characterize the efficacy of various anterior gastric access locations for diagnostic transgastric NOTES peritoneoscopy in humans.

Hydroperitoneum-facilitated EUS-guided peritoneal entry and closure of alternate access sites for NOTES.

Background: Access sites other than the anterior gastric wall may provide improved ergonomics for natural orifice transluminal endoscopic surgery (NOTES). Endoscopic ultrasound (EUS) guidance significantly reduces, but does not eliminate, risk of access through these alternate sites. This study evaluates the utility of hydroperitoneum as an adjunct to EUS-guided access and closure of alternate access sites for NOTES.

The diagnostic efficacy of natural orifice transluminal endoscopic surgery: is there a role in the intensive care unit?

Background: Evaluation of a potential source for abdominal sepsis in a critically ill patient can be challenging. With flexible endoscopy readily available in this setting, we sought to evaluate the diagnostic efficacy of a transgastric natural orifice transluminal endoscopic surgery (NOTES) peritoneoscopy vs. laparoscopic exploration in the identification of intra-abdominal pathology in a porcine model.

Peritoneal inflammatory response of natural orifice translumenal endoscopic surgery (NOTES) versus laparoscopy with carbon dioxide and air pneumoperitoneum.

Background: The immunologic and physiologic effects of natural orifice translumenal endoscopic surgery (NOTES) versus traditional surgical approaches are poorly understood. Previous investigations have shown that NOTES and laparoscopy share similar inflammatory cytokine profiles except for a possible late-phase tissue necrosis factor-alpha (TNF-alpha) depression with NOTES. The local peritoneal reaction and immunomodulatory influence of pneumoperitoneum agents in NOTES also are not known and may play an important role in altering the physiologic insult induced by NOTES.

Natural orifice proctectomy using a transanal endoscopic microsurgical technique in a porcine model.

Background: Transanal endoscopic microsurgery (TEM) has been used for several decades for excision of neoplastic lesions in the rectum. With the development of natural orifice translumenal endoscopic surgery (NOTES) techniques, the authors describe a new method of proctectomy using a combination of TEM and NOTES principles.

Methods: In a porcine model, a circumferential rectal sleeve resection was performed using TEM with flexible endoscopic assistance.

Endoscopic full-thickness resection of gastric lesions using a novel grasp-and-snare technique: evaluation in a porcine survival model.

Background: Endoscopic full-thickness resection (EFTR) is a less-invasive method of en bloc removal of gastrointestinal tumors. In a previous nonsurvival animal experiment, the feasibility of a novel grasp-and-snare EFTR technique using a prototype tissue-lifting device was demonstrated. The objective of this study was to evaluate the safety and outcomes of this EFTR method in a porcine survival model.

Effect of parathyroidectomy on anemia and erythropoietin dosing in end-stage renal disease patients with hyperparathyroidism.

Background: It has been suggested that parathyroidectomy for hyperparathyroidism (HPT) in end-stage renal disease (ESRD) may result in improvement in anemia and the response to erythropoiesis-stimulating drugs. This study examines the effect parathyroidectomy had on erythropoietin (EPO) dosing requirements and anemia in ESRD.

Methods: A retrospective review was conducted.

Inpatient mortality analysis of paraesophageal hernia repair in octogenarians.

Introduction: Paraesophageal hernia repair is often performed in an elderly population. Few studies have evaluated perioperative mortality in this group. We identified predictors of inpatient mortality using a nationally representative sample.

EUS in localizing safe alternate access sites for natural orifice transluminal endoscopic surgery: initial experience in a porcine model.

Background: Most natural orifice transluminal endoscopic surgery (NOTES) procedures have been performed through the anterior stomach wall, based on the established safety of PEG placement. This approach does not afford mechanically efficient access to all anatomic areas of interest.

Objective: To assess the utility of EUS in identifying safe alternate access sites for NOTES.