Biliary Dyskinesia and Hyperkinesis.

Biliary dyskinesia refers to a group of functional and motility disorders of the biliary system in patients presenting with typical biliary pain, but without any visible structural abnormalities on standard imaging. The Rome IV Criteria establishes diagnostic criteria for functional gallbladder disorder (gallbladder dyskinesia and biliary hyperkinesia), functional biliary sphincter of Oddi disorder (biliary dyskinesia), and pancreatic sphincter of Oddi disorder. Many diagnostic adjuncts such as hepatobiliary scintigraphy and sphincter of Oddi manometry exist, although these results are supportive and not necessarily diagnostic for biliary dyskinesia.

Second primary malignancies in women with breast cancer.

Background: Increased screening and treatment advancements have resulted in improved survival rates in women with breast cancer (BC). However, recent data suggests these women have elevated risk of developing a second primary malignancy (SPM) compared to the general population. Limited data exists on factors associated with BC patients developing a SPM.

Impact of primary tumor resection in the management of metastatic well-differentiated neuroendocrine tumors of the small bowel and pancreas.

Patients with gastroenteropancreatic (GEP) neuroendocrine tumors (NET) often present with advanced disease. Primary tumor resection (PTR) in the setting of unresectable metastatic disease is controversial. Most studies evaluating the impact of PTR on overall survival (OS) have been performed using large population-based databases, with limited treatment related data.

Enhancing Lymph Node Yield in Gastric Cancer Resection: Impact of Back Table Dissection on Number of Lymph Node Examined.

Introduction: During gastric cancer resection, back table dissection (BTD) involves examination and separation of lymph node (LN) packets from the surgical specimen based on LN stations, which are sent to pathology as separately labeled specimens. With potential impact on clinical outcomes, we aimed to explore how BTD affects number of LNs examined.

Methods: A retrospective review of a gastric cancer database was performed, including all cases of gastrectomy with D2 lymphadenectomy from January 2009 to March 2022.

Contemporary Cancer Program Practice Profile Report Compliance Rates for Gastric Cancer: A National Cancer Database Analysis.

Background: The Commission on Cancer (CoC) established quality measures to be reported in National Cancer Database (NCDB) Quality Reporting Tools. Compliance is provided to accredited cancer programs as Cancer Program Practice Profile Reports (CP3R). At the time of this study, the quality metric for gastric cancer (GC) was removal and pathologic examination of 15 regional lymph nodes for resected GC (G15RLN).

Role of ROR2 in promoting gastric cancer metastasis by enhancing c-JUN-mediated MMP3 transcription.

Background: Receptor tyrosine kinase-like orphan receptor 2 (ROR2) is a transmembrane receptor that has a complex role in cancer, acting either to promote or inhibit tumor progression in different tumor types. The effect of ROR2 on gastric cancer is unclear.

Methods: Immunohistochemistry was used to investigate the role of ROR2 in the prognosis of gastric cancer.

30-Day Postoperative Outcomes in Patients With Limited Mobility - A Propensity Score-Matched Comparative Analysis.

Introduction: There is limited data correlating preoperative mobility limitations with clinical outcomes in bariatric patients. This study uses propensity score matching (PSM) to compare 30-day outcomes between patients with preoperative limited mobility (LM) versus patients without (non-LM).

Methods: Using the 2016-2018 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database, patients undergoing primary laparoscopic sleeve gastrectomy or gastric bypass were identified.

Operative approach and case volume are associated with negative resection margins for adrenocortical carcinoma.

Background: Surgical resection with negative margins is the treatment of choice for adrenocortical carcinoma (ACC). This study was undertaken to determine factors associated with negative resection margins.

Methods: National Cancer Database was queried from 2010 to 2016 to identify patients with AJCC/ENSAT Stage I-III ACC who underwent adrenalectomy.

The Efficacy of Collaborative Authoring of Video Scene Descriptions.

The majority of online video contents remain inaccessible to people with visual impairments due to the lack of audio descriptions to depict the video scenes. Content creators have traditionally relied on professionals to author audio descriptions, but their service is costly and not readily-available. We investigate the feasibility of creating more cost-effective audio descriptions that are also of high quality by involving novices.

Routine Versus Selective Liver Biopsy During Bariatric Surgery: Postoperative Outcomes and Preoperative Predictors of NASH.

Background: Nonalcoholic steatohepatitis (NASH) is common in patients with obesity. Liver biopsy (LB) can be routinely or selectively performed during bariatric surgery to identify patients with NASH.

Methods: Patients undergoing bariatric surgery between 2016 and 2020 at our institution were identified.

Adrenocortical Carcinoma: The Value of Lymphadenectomy.

Background: Adrenocortical carcinoma (ACC) staging does not account for the number of positive nodes. The prognostic value of quantitative metastatic nodal burden is unknown.

Methods: The National Cancer Database was retrospectively queried from 2004-2016 to identify patients with Stage I-III ACC undergoing adrenalectomy.

Disparities and survival in newly diagnosed gastric cancer in Hispanic patients in the United States: a propensity score matched analysis.

Background: The burden of gastric cancer involving Hispanic patients in the United States is growing as both the population and the incidence of gastric cancer in this group increases. This burden is compounded by presentation with advanced disease and socioeconomic challenges shaping cancer care. We sought to describe the demographics, socioeconomic factors, treatment, and survival experience of Hispanic patients with gastric adenocarcinoma.

Factors Associated with Non-Operative Management of Resectable Adrenocortical Carcinoma.

Introduction: Surgery is the initial treatment of choice for patients with resectable adrenocortical carcinoma (ACC). We sought to determine factors associated with non-operative management of resectable ACC.

Methods: 2004-2016 National Cancer Database (NCDB) was queried to identify patients with AJCC/ENSAT Stage I-III ACC.

Changes in utilization of axillary dissection in women with invasive breast cancer and sentinel node metastasis after the ACOSOG Z0011 trial.

The American College of Surgeons Oncology Group Z0011 (ACOSOG Z0011) trial demonstrated no survival advantage for women with clinical T1-T2 invasive breast cancer with 1-2 positive sentinel lymph nodes (SLN) who received whole-breast radiation, and no further axillary surgery when compared to women who did undergo axillary lymph node dissection (ALND). We used the National Cancer Database (NCDB) to study changes in utilization of ALND after the publication of this trial. NCDB was queried for female patients from 2012 to 2015 who met Z0011 criteria.

Surgical Supply Cost Awareness Is Associated With Lower Costs: A Single-Center Experience.

Surgeons are often unfamiliar with the costs of surgical instrumentation and supplies. We hypothesized that surgeon cost feedback would be associated with a reduction in cost. A multidisciplinary team evaluated surgical supply costs for laparoscopic appendectomies of 7 surgeons (surgeons A-G) at a single-center academic institution.

Treatment at Academic Centers Increases Likelihood of Reconstruction After Mastectomy for Breast Cancer Patients.

Background: Mastectomy rates continue to increase in women diagnosed with breast cancer (BC). There are limited data regarding reconstruction rates at academic centers (AC) versus community hospitals (CH). We aim to determine the effect of facility type on reconstruction rates.

Patterns in the Use of Axillary Operations for Patients with Node-Positive Breast Cancer After Neoadjuvant Chemotherapy: A National Cancer Database (NCDB) Analysis.

Background: The American College of Surgeons Oncology Group (ACOSOG) Z1071 and Sentinel Neoadjuvant (SENTINA) trials of sentinel node biopsy for node-positive breast cancer treated with neoadjuvant chemotherapy (NAC) demonstrated false-negative rates that varied on the basis of surgical technique. This study evaluated trends in axillary operations before and after publication of these trials.

Methods: This study analyzed patients from National Cancer Database (NCDB) with clinical T0 through T4, N1 and N2, M0 breast cancer who received NAC from 1 January 2012 to 31 December 2015 and sentinel lymph node biopsy (SNB) or axillary lymph node dissection (ALND).

Variability in Critical Care-Related Charge Markups in Medicare Patients.

Charge markups for health care are variable and inflated several times beyond cost. Using the 2015 Medicare Provider Fee-For-Service Utilization and Payment Data file, we identified providers who billed for critical care hours and related procedures, including CPR, EKG interpretation, central line placement, arterial line placement, chest tube/thoracentesis, and emergent endotracheal intubation. Markup ratios (MRs), defined as the amount charged divided by the amount allowable, were calculated and compared; 42.

Imaging utilization affects negative appendectomy rates in appendicitis: An ACS-NSQIP study.

Background: Negative appendectomy rates (NAR) historically ranged from 15 to 25%, but have decreased recently.

Methods: Using the 2016 ACS-NSQIP database, we identified patients who underwent appendectomies for appendicitis. Patients with and without appendicitis on pathology were compared.