Publications by authors named "Mark Zebley"
Background And Objectives: Venous thromboembolisms (VTEs) in patients who have undergone a colorectal cancer operation increases morbidity and mortality, lengthens recovery time, and are costly. The current common standard is a 28-day prophylactic regimen of 40 mg enoxaparin daily. This study aims to examine the variability in prophylaxis discharge prescriptions at one institution, report 30-day postoperative incidence of venous thromboembolisms and bleeding, and to offer a new protocol for VTE prophylaxis in postoperative patients.
View Article and Find Full Text PDFBackground: A comprehensive enhanced recovery pathway (ERP) was implemented in patients undergoing laparoscopic colectomy in an attempt to reduce postoperative opioid consumption. We hypothesized that improved local analgesia and increased use of non-opioid pain medication, combined with earlier feeding and ambulation, would allow for earlier return of bowel function and shorter postoperative length of stay (LOS).
Methods: We retrospectively reviewed 89 patients who underwent elective partial laparoscopic colectomy with our ERP fully integrated compared to a historical control group of 162 patients.
Background: Despite the high sensitivity of screening colonoscopy, polyps and cancers can still go undetected. With the polyp-to-cancer transformation cycle averaging 7-10 years, present guidelines recommend repeat colonoscopy within 10 years after negative screening. However, not all colorectal malignancies follow this decade-long progression.
View Article and Find Full Text PDFBackground: Laparoscopy to repair iatrogenic colonoscopic perforation of the colon has proven to be a safe, effective, and reproducible means to treat these potentially devastating emergencies. The use of the laparoscope provides exceptional diagnostic yield, and under the hand of a trained surgeon, produces excellent therapeutic results while minimizing recovery time for the patient.
Methods: We report the case of an 86-year-old man who underwent emergent laparoscopic repair of a postoperative anastomotic leak following sigmoid colectomy.
Background: There are few reports of long-term outcomes in elderly patients after open colectomy.
Objective: This study aimed to determine the in-hospital and 6-month outcomes and identify the variables associated with mortality after colectomy in patients ≥ 80 years of age.
Design: The charts of patients ≥ 80 years of age, who underwent open colectomy, were analyzed.
Objectives: To determine if laparoscopic colectomy is safer and more effective than open colectomy in patients older than 80 years of age.
Methods: An operating room database of all colectomies performed on patients >or=80 years, from January 2002 to September 2007, was analyzed retrospectively. Data reviewed included type of operation, type of resection, length of procedure, length of stay (LOS), estimated blood loss, American Society of Anesthesiologists (ASA) grade, diagnosis, complications, mortality rates, and discharge destination, with p-values <0.
Background: This study aimed to determine whether the number of diverticulitis or complicated diverticulitis episodes affects the conversion rate or postoperative complication rate in elective laparoscopic sigmoid colectomy.
Methods: In this study, 216 charts were reviewed for baseline characteristics, diverticulitis history, and intra- and postoperative complications. Analysis was performed with the Student's t-test, the chi-square test, and Fisher's exact tests.
Article Synopsis
- Laparoscopic and open resections for colon cancer are seen as equally effective, but previous studies indicated that conversion from laparoscopic to open surgery might lower survival rates.
- A study was conducted on 174 patients who had laparoscopic resections, with a median follow-up time of 51 months, to assess any survival differences based on conversion status.
- Results showed no significant differences in all-cause mortality or survival rates between patients who had successful laparoscopic surgeries and those who required conversion, suggesting that conversion may not adversely affect prognosis.
Objective: We analyzed the effect of neoadjuvant chemo radiation on feasibility and outcomes in rectal cancer patients undergoing laparoscopic resection of the rectum.
Methods: This was a retrospective analysis of a consecutive series of laparoscopic resections for rectal cancer from 1998 to 2004 (N=60).
Results: Eight patients received preoperative chemoradiation therapy (neoadjuvant group) for rectal cancer and 52 patients did not (primary surgical group).
Background And Objectives: A history of a prior abdominal operation is common among patients presenting for laparoscopic colorectal surgery, and its impact on conversion and complication rates has been insufficiently studied. This study compares the conversion rates of patients with and without a prior abdominal operation (PAO).
Methods: We analyzed 1000 consecutive laparoscopic colorectal resection cases.
Background: This study was undertaken to compare the technical success and outcomes of laparoscopic colectomy performed by resident surgeons (RS) and attending surgeons (AS).
Methods: A review of 451 consecutive laparoscopic colectomies performed by 2 surgeons either with or without a general surgery resident. Data reviewed included demographics, diagnoses, operative data, and outcomes.
We describe a case of idiopathic abdominal apoplexy secondary to a spontaneous mesocolic bleed. Preoperative computed tomography of the abdomen suggested a ruptured colonic mass at the splenic flexure. The diagnosis was made when exploratory laparotomy revealed hemoperitoneum and an extensive hematoma in the transverse mesocolon, with no apparent source.
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