Colorectal cancer in young adults.

The incidence of colorectal cancer in young adults (CRCYAs) is increasing globally, and it is now the third leading cause of cancer death among young adults under 50 years old. The rising incidence is attributed to various emerging risk factors such as genetics, lifestyle factors, and microbiome profiles. Delayed diagnosis and more advanced disease presentation contribute to worse outcomes.

Update on the management of sigmoid diverticulitis.

Diverticular disease and diverticulitis are the most common non-cancerous pathology of the colon. It has traditionally been considered a disease of the elderly and associated with cultural and dietary habits. There has been a growing evolution in our understanding and the treatment guidelines for this disease.

Impact of Neoadjuvant Systemic Therapy on Pancreatic Fistula Rates Following Pancreatectomy: a Population-Based Propensity-Matched Analysis.

Introduction: Postoperative pancreatic fistula (POPF) drives morbidity and mortality following pancreatectomy. Use of neoadjuvant chemotherapy (NAC) has recently increased in the treatment of potentially resectable pancreatic ductal adenocarcinoma (PDAC). This study examined the effect of NAC on POPF rates and postoperative outcomes in PDAC.

Randomized Clinical Trial of Epidural Compared with Conventional Analgesia after Minimally Invasive Colorectal Surgery.

Background: The effectiveness of thoracic epidural analgesia (EA) vs conventional IV analgesia (IA) after minimally invasive surgery is still unproven. We designed a randomized controlled trial comparing EA with IA after minimally invasive colorectal surgery.

Study Design: A total of 87 patients who underwent minimally invasive colorectal procedures at a single institution between 2011 and 2014 were enrolled.

A Nationwide Analysis of Kidney Autotransplantation.

There are limited data regarding outcomes of patients underwent kidney autotransplantation. This study aims to investigate outcomes of such patients. The nationwide inpatient sample database was used to identify patients underwent kidney autotransplantation during 2002 to 2012.

Body Mass Index Significantly Impacts Outcomes of Colorectal Surgery.

There are limited data regarding the association between body mass index (BMI) and colorectal surgery outcomes. We sought to evaluate the effect of BMI on short-term surgical outcomes in colon and rectal surgery patients in the United States. The American College of Surgeons National Surgery Quality Improvement Project database was used to identify all patients who underwent colon or rectal resection from 2005 to 2013.

Racial Disparities in Access and Outcomes of Cholecystectomy in the United States.

Disparities in access to health care between white and minority patients are well described. We aimed to analyze the trends and outcomes of cholecystectomy based on racial classification. The Nationwide Inpatient Sample database was reviewed for all patients undergoing cholecystectomy from 2009 to 2012.

Implications of preoperative hypoalbuminemia in colorectal surgery.

Serum albumin has traditionally been used as a quantitative measure of a patient's nutritional status because of its availability and low cost. While malnutrition has a clear definition within both the American and European Societies for Parenteral and Enteral Nutrition clinical guidelines, individual surgeons often determine nutritional status anecdotally. Preoperative albumin level has been shown to be the best predictor of mortality after colorectal cancer surgery.

Outcomes of colon resection in patients with metastatic colon cancer.

Background: Patients with advanced colorectal cancer have a high incidence of postoperative complications. We sought to identify outcomes of patients who underwent resection for colon cancer by cancer stage.

Methods: The National Surgical Quality Improvement Program database was used to evaluate all patients who underwent colon resection with a diagnosis of colon cancer from 2012 to 2014.

Post-Hospital Discharge Venous Thromboembolism in Colorectal Surgery.

Background: There are limited data regarding the criteria for prophylactic treatment of venous thromboembolism (VTE) after hospital discharge. We sought to identify risk factors of post-hospital discharge VTE events following colorectal surgery.

Methods: The NSQIP database was utilized to examine patients developed VTE after hospital discharge following colorectal surgery during 2005-2013.

Laparoscopic right hemicolectomy: short- and long-term outcomes of intracorporeal versus extracorporeal anastomosis.

Background: The use of laparoscopy for right hemicolectomy has gained popularity allowing the option of a totally laparoscopic intracorporeal anastomosis (IA) for intestinal reconstruction. This technique may alleviate some of the technical limitations that a surgeon faces with a laparoscopic-assisted extracorporeal anastomosis (EA).

Methods: A retrospective chart review of 195 consecutive patients who underwent laparoscopic right hemicolectomy by four colorectal surgeons at three institutions from March 2005 to June 2014 was performed.

Predictive Factors of Ventilator Dependency after Colon and Rectal Surgery.

There is limited data analyzing ventilator dependency by operative diagnoses and types of the procedures performed in colorectal surgery. We sought to identify predictive factors of ventilator dependency in colorectal surgery and investigate complication rates across various colorectal procedures. The National Surgical Quality Improvement Program database was used to examine the clinical data of patients with ventilator dependency for more than 48 hours after colorectal resection during 2005-2013.

Unplanned readmission after appendectomy.

Background: Unplanned readmission of patients who undergo appendectomy is a relatively frequent occurrence. Our aim was to report the most common reasons and the predictors of unplanned readmission after appendectomy.

Methods: The National Surgical Quality Improvement Program database was used to examine the clinical data of patients undergoing emergent and/or urgent appendectomy during 2012 to 2013.

Contemporary management of anastomotic leak after colon surgery: assessing the need for reoperation.

Background: We sought to investigate contemporary management of anastomosis leakage (AL) after colonic anastomosis.

Methods: The American College of Surgeons National Surgical Quality Improvement Program database 2012 to 2013 was used to identify patients with AL. Multivariate regression analysis was performed to find predictors of the need for surgical intervention in management of AL.

Comparison of open, laparoscopic, and robotic approaches for total abdominal colectomy.

Background: The utilization of minimally invasive surgery is increasing in colorectal surgery. We sought to compare the outcomes of patients who underwent elective open, laparoscopic, and robotic total abdominal colectomy.

Methods: The NIS database was used to examine the clinical data of patients who underwent an elective total colectomy procedure during 2009-2012.

Impact of chronic steroid use on outcomes of colorectal surgery.

Background: Steroid use has been recognized as a factor which has various effects on multiple organs. We aim to investigate the association between chronic steroid use and postoperative complications after colorectal surgery.

Methods: The National Surgical Quality Improvement Program database was used to examine the clinical data of patients undergoing colorectal resection during 2005 to 2013.

Surgical site infection impact of pelvic exenteration procedure.

Background: We sought to investigate morbidity and infectious complications following pelvic exenteration (PEx) and compare infectious complications of patients undergoing PEx and conventional rectal resections.

Methods: The NSQIP database was utilized to examine the clinical data of patients undergoing elective rectal resections during 2005-2013. Multivariate regression analysis was used to compare postoperative complications of patients who underwent PEx and proctectomy procedure.

Wound Disruption Following Colorectal Operations.

Objectives: Postoperative wound disruption is associated with high morbidity and mortality. We sought to identify the risk factors and outcomes of wound disruption following colorectal resection.

Methods: The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was used to examine the clinical data of patients who underwent colorectal resection from 2005 to 2013.

Preoperative Leukocytosis in Colorectal Cancer Patients.

Background: Preoperative asymptomatic leukocytosis has been reported as a factor that affects morbidity of surgical patients. We sought to identify the relationship between asymptomatic preoperative leukocytosis and postoperative complications in elective colorectal cancer surgery.

Study Design: The NSQIP database was used to examine the clinical data of patients who had preoperative leukocytosis (white blood cell count more than 11,000/μL) and colorectal cancer resection from 2005 to 2013.

Colorectal surgery in Parkinson's disease--outcomes and predictors of mortality.

Purpose: Although diseases of the lower gastrointestinal tract are common in patients with Parkinson's disease, there is a paucity of data regarding postoperative outcomes after colorectal surgery.

Methods: The Nationwide Inpatient Sample database (2007-2011) was utilized to analyze outcomes in patients with Parkinson's disease (PD) undergoing colorectal surgery. Main outcomes were risk-adjusted inpatient morbidity, mortality, hospital charge, and length of hospital stay.

Risk factors for prolonged ileus following colon surgery.

Background: Prolonged ileus is one of the most common postoperative complications after colorectal surgery. We sought to investigate the predictors of prolonged ileus following elective colon resections procedures.

Methods: The national participant user files of NSQIP databases were utilized to examine the clinical outcomes of patients undergoing elective colon resection during 2012-2013.

Outcome of preoperative weight loss in colorectal surgery.

Background: There are limited data regarding the outcomes of patients with preoperative weight loss. We sought to identify complications associated with preoperative weight loss in colorectal surgery.

Methods: The National Surgical Quality Improvement Program database was used to examine the clinical data of patients undergoing colorectal resection from 2005 to 2012 who had unintentional preoperative weight loss (more than 10% in 6 months of surgery).

Nationwide analysis of outcomes of bowel preparation in colon surgery.

Background: There are limited data comparing the outcomes of preoperative oral antibiotic bowel preparation (OBP) and mechanical bowel preparation (MBP) in colorectal surgery. We sought to identify the relationship between preoperative bowel preparations (BP) and postoperative complications in colon cancer surgery.

Study Design: The NSQIP database was used to examine the clinical data of colon cancer patients undergoing scheduled colon resection during 2012 to 2013.

Even modest hypoalbuminemia affects outcomes of colorectal surgery patients.

Background: A small decrease in the serum albumin from the normal level is a common condition in preoperative laboratory tests of colorectal surgery patients; however, there is limited data examining these patients. We sought to identify outcomes of such patients.

Methods: The National Surgical Quality Improvement Program database was used to evaluate all patients who had modest levels of hypoalbuminemia (3 ≤ serum albumin < 3.

Diverting ileostomy in colorectal surgery: when is it necessary?

Purpose: The role of fecal diversion using a loop ileostomy in patients undergoing rectal resection and anastomosis is controversial. There has been conflicting evidence on the perceived benefit vs. the morbidity of a defunctioning stoma.