Publications by authors named "Joseph C Carmichael"

: Intestinal Behçet's disease (iBD) often requires surgical intervention, with a significant proportion of patients needing reoperation. This study aimed to investigate the risk factors associated with reoperation in patients with iBD who underwent initial bowel resection and to evaluate the perioperative and long-term outcomes in these patients. : This was a retrospective case-control study analyzing patients who underwent their initial bowel resection due to iBD between 2005-2021 at a tertiary referral hospital.

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Purpose: Although advancements in medical treatments have been made, approximately half of patients with intestinal Crohn's disease (CD) require intestinal resections during their lifetime. It is well-known that the nutritional status of CD patients can impact postoperative morbidity. The objective of this study was to evaluate the clinical significance of prognostic nutritional index (PNI) in patients with intestinal CD who underwent primary bowel resection.

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  • The study aims to analyze the characteristics of rectal cancer survivors participating in SWOG S1820, which tests an intervention (AIMS-RC) for managing bowel dysfunction after treatment.* -
  • Participants were selected based on specific criteria including their treatment history and age, with outcomes focusing on bowel function, quality of life, and symptom management motivations.* -
  • The research successfully recruited 117 participants over 29 months, revealing that most had made dietary changes post-surgery and experienced significant bowel problems, highlighting the need for better management strategies.*
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Background: Colectomies and proctectomies are commonly performed by both general surgeons (GS) and colorectal surgeons (CRS). The aim of our study was to examine the outcomes of elective colectomy, urgent colectomy, and elective proctectomy according to surgeon training.

Study Design: Data were obtained from the Vizient database for adults who underwent elective colectomy, urgent colectomy, and elective proctectomy from 2020 to 2022.

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Background: Survivors of rectal cancer experience persistent bowel dysfunction after treatments. Dietary interventions may be an effective approach for symptom management and posttreatment diet quality. SWOG S1820 was a pilot randomized trial of the Altering Intake, Managing Symptoms in Rectal Cancer (AIMS-RC) intervention for bowel dysfunction in survivors of rectal cancer.

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  • Management of lateral abdominal wall hernias, including flank hernias, poses a surgical challenge and has various treatment options that are debated.
  • Flank hernias can develop from surgical issues more often than from trauma, which is rare.
  • The article discusses a specific case where a traumatic flank hernia reoccurred after initial repair, ultimately being treated with an anchored suture repair and a polyester mesh reinforcement.
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  • - The OPRA trial studied the long-term outcomes of different treatment sequences for stage II/III rectal cancer, comparing induction chemotherapy followed by chemoradiation (INCT-CRT) with chemoradiation followed by consolidation chemotherapy (CRT-CNCT) to evaluate organ preservation and oncologic results.
  • - After a median follow-up of 5.1 years with 324 patients, the 5-year disease-free survival (DFS) rates were similar for both treatment groups, while TME-free survival was significantly higher in the CRT-CNCT group (54% vs. 39%).
  • - The study found that most tumor regrowth occurred within the first 2 years for patients who opted for the watch-and-w
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Introduction: Rigid proctosigmoidoscopy (RP) and flexible sigmoidoscopy (FS) are two modalities commonly used for intraoperative evaluation of colorectal anastomoses. This study seeks to determine whether there is an association between the endoscopic modality used to evaluate colorectal anastomoses and the rate of anastomotic leak (AL), organ space infection, and overall infectious complication.

Methods: The 2012-2018 American College of Surgeons National Surgical Quality Improvement Program database was queried for patients undergoing colorectal anastomoses.

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After potentially curative treatment, colorectal cancer (CRC) patients remain at high risk for recurrence, second primary CRC, and high-risk adenomas. In combination with existing data, our previous findings provide a rationale for reducing tissue polyamines as tertiary prevention in non-metastatic CRC patients. The goal of this study was to demonstrate rectal tissue polyamine reduction in optimally treated stage I-III CRC patients after intervention with daily oral aspirin + dietary arginine restriction.

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Article Synopsis
  • A clinical trial was conducted to evaluate the effectiveness of a watch-and-wait strategy in preserving organs for patients with locally advanced rectal cancer after total neoadjuvant therapy, involving 324 patients.
  • Both groups receiving different treatment sequences (induction chemotherapy followed by chemoradiotherapy vs. chemoradiotherapy followed by consolidation chemotherapy) showed a similar 3-year disease-free survival (DFS) rate of about 76%.
  • Results indicated that approximately half of the patients could avoid total mesorectal excision (TME) while maintaining survival rates comparable to historical data, suggesting organ preservation is a viable option.
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Background: Fecal incontinence affects 7% to 12% of the US adult population, causing social, financial, and quality of life burdens.

Objective: The primary aim of this study was to evaluate the efficacy and safety of nonanimal stabilized hyaluronic acid/dextranomer through 36 months as a condition of postmarket approval application.

Design: This was a prospective, single-arm, multicenter, observational Food and Drug Administration-mandated postapproval clinical study.

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Background: The optimal timing of adjuvant chemotherapy (AC) in non-metastatic colon cancer is poorly defined. Delays in AC result in decreased survival. Effective cytotoxic treatments should be considered during the perioperative phase of care.

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Contrast enema is the gold standard technique for evaluating a pelvic anastomosis (PA) prior to ileostomy closure. With the increasing use of flexible endoscopic modalities, the need for contrast studies may be unnecessary. The objective of this study is to compare flexible endoscopy and contrast studies for anastomotic inspection prior to defunctioning stoma reversal.

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Obesity is associated with risk of colorectal adenoma (CRA) and colorectal cancer. The signaling pathway activated by metformin (LKB1/AMPK/mTOR) is implicated in tumor suppression in Apc mice via metformin-induced reduction in polyp burden, increased ratio of pAMPK/AMPK, decreased pmTOR/mTOR ratio, and decreased pS6/S6 ratio in polyps. We hypothesized that metformin would affect colorectal tissue S6 among obese patients with recent history of CRA.

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Objective: The aim of this study is to examine the effect of postoperative chemotherapy on survival in patients with stage II or III rectal adenocarcinoma who undergo neoadjuvant chemoradiation (CRT) and surgical resection.

Methods: A retrospective review of the National Cancer Database (NCDB) from 2006 to 2013 was performed. Cases were analyzed based on pathologic complete response (pCR) status and use of adjuvant therapy.

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Ileocolic resection is the most common operation performed for Crohn's disease patients with terminal ileum involvement. We sought to evaluate the outcomes in Crohn's disease patients who underwent open ileocolic resection (OIC) and laparoscopic ileocolic resection (LIC) by using the ACS-NSQIP database from 2006 to 2015. Of 5670 patients, 48.

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Right-side diverticulitis (RSD) is an uncommon disease in Western countries. We conducted a case-matched comparison of surgically managed right-side and left-side diverticulitis (LSD) from the Southern California Kaiser Permanente database (2007-2014). Of 995 patients undergoing emergent surgery for diverticulitis, 33 RSD (3.

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Background: Laparoscopic ileostomy closure with intracorporeal anastomosis offers potential advantages over open reversal with extracorporeal anastomosis, including earlier return of bowel function and reduced postoperative pain. In this study, we aim to compare the outcome and cost of laparoscopic ileostomy reversal (utilizing either intracorporeal or extracorporeal anastomosis) with open ileostomy reversal.

Methods: A retrospective review of sequential patients undergoing elective loop ileostomy reversal between 2013 and 2016 at a single, high-volume institution was performed.

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Background: The primary objective of this study was to retrospectively compare short-term outcomes of intracorporeal versus extracorporeal anastomosis for minimally invasive laparoscopic and robotic-assisted right colectomies for benign and malignant disease. Recent studies suggest potential short-term outcomes advantages for the intracorporeal anastomosis technique.

Methods: This is a multicenter retrospective propensity score-matched comparison of intracorporeal and extracorporeal anastomosis techniques for laparoscopic and robotic-assisted right colectomy between January 11, 2010, and July 21, 2016.

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Importance: Surgical and medical device manufacturers have a cooperative relationship with clinicians. When evaluating published works, one should assess the integrity and academic credentials of the authors, who serve as putative experts. A relationship with a relevant manufacturer may increase the potential risk for bias in relevant studies.

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Objective: To consider fertility options in women with advanced cervical cancer.

Design: Case report.

Setting: Large tertiary care center.

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