The Upstate New York Surgical Quality Improvement Opioid Reduction Project.

Over 5 million Americans currently abuse prescription opioids. Patients' first exposure to opioids is often after surgery. Few opioid guidelines account for the challenges to health care institutions that serve wide catchment areas.

The accumulation of ERAS (enhanced recovery after surgery) components reduces post-colectomy length of stay at small and low volume hospitals.

In small hospitals, where the majority of colectomy surgery is performed in the United States, adopting more individual ERAS components improves outcomes. The accumulation of individual ERAS components influences outcome more than an "ERAS designation" and this can be used by small hospitals to improve outcomes.

Independent predictors of mortality for patients with traumatic renal injury.

Purpose: To investigate the parameters of renal trauma, including emergent intervention type, that predict the mortality of patients with traumatic renal injury.

Methods: A retrospective database analysis was performed on patients who sustained a traumatic renal parenchymal injury identified by the 2017 National Trauma Data Bank. Data were analyzed to identify differences in hospital length of stay, ER and hospital disposition, and mortality based on patient age, gender, race, Injury Severity Score, renal injury grade, and need for emergent intervention (angioembolization versus open surgery).

The Impact of Anticoagulation on Trauma Outcomes : An National Trauma Data Bank Study.

Background: Increased prevalence of patients on anticoagulants and the advent of new therapies raise concern over how these patients fare if they sustain a traumatic injury. We investigated the role of prehospitalization anticoagulation therapy in trauma-related mortality and postacute disposition.

Methods: A retrospective analysis was performed on patients who sustained traumatic injury identified in the 2017 National Trauma Data Bank (NTDB).

Appendiceal Carcinoid Tumors: Is There a Survival Advantage to Colectomy over Appendectomy?

Background: Guidelines recommend colectomy for appendiceal carcinoid tumors larger than 2 cm, but physicians debate whether colectomy would be beneficial in treating smaller tumors. We sought to determine when colectomy confers a survival advantage over appendectomy.

Methods: Appendiceal carcinoid patients in the US Surveillance, Epidemiology, and End Results (SEER) database (1988-2011) were stratified by age group, gender, TNM stage, tumor grade, and race.

Survival trends in patients with tracheal carcinoma from 1973 to 2011.

Purpose: The prognosis for primary tracheal cancer is dismal. We investigated whether there has been improvement in survival in tracheal cancer patients and how treatment modality affected overall and cancer-specific survival.

Materials And Methods: Using the Surveillance, Epidemiology, and End Results database, 1144 patients with tracheal cancer were identified between 1973 and 2011.

Effect of median household income on surgical approach and survival in renal cell carcinoma.

Purpose: We sought to determine whether median household income (MHI) independently predicts surgical approach (partial vs. radical nephrectomy) and survival in patients with renal cell carcinoma.

Methods: The U.

Trends in lymph node excision and impact of positive lymph node ratio in patients with colectomy for primary colon adenocarcinoma: Population based study 1988 to 2011.

Background: Studies suggest increased lymph node excision in patients with colon cancer portends improved survival. Guidelines recommend excising 12 or more lymph nodes during colectomy. There is an inverse correlation between the positive lymph node ratio and survival in patients of these patients.

Readmissions After Colectomy: The Upstate New York Surgical Quality Initiative Experience.

Background: Hospital readmissions remain a major medical and financial concern to the healthcare system and have become an area of interest in health outcomes performance metrics. There is a pressing need to identify process measures that may help reduce readmissions.

Objective: Our aim was to assess the patient characteristics and surgical factors associated with 30-day readmissions for colorectal surgery in Upstate New York.

Renal Ganglioneuroma Presenting as an Apparent Renal Artery Aneurysm.

We present a case of a 30-year-old woman with a suspected contained rupture of a renal artery aneurysm which was managed with staged embolization and nephrectomy. Pathology demonstrated that the collection around the presumed aneurysmal rupture was an associated ganglioneuroma.

Trends in Testicular Cancer Survival: A Large Population-based Analysis.

Objective: To determine whether discrepancies in testicular cancer outcomes between Caucasians and non-Caucasians are changing over time. Although testicular cancer is more common in Caucasians, studies have shown that other races have worse outcomes.

Materials And Methods: Using the Surveillance, Epidemiology, and End Results registry, we identified 29,803 patients diagnosed with histologically confirmed testicular cancer between 1983 and 2011.

Cancer control of partial nephrectomy for high-risk localized renal cell carcinoma: population-based and single-institutional analysis.

Purpose: Cancer control of partial nephrectomy for high-risk localized renal cell carcinoma is unclear. To assess whether PN provides adequate cancer control in high-risk disease (HRD), survival outcomes were compared in both a population-based cohort and an institutional cohort.

Methods: Surveillance, Epidemiology, and End Results database and a prospectively maintained institutional database were queried for patients with RCC who underwent PN or RN for a localized tumor ≤7 cm and were found to have high-grade and/or high-stage disease (HRD).

Histopathology of surgically treated renal cell carcinoma: survival differences by subtype and stage.

Purpose: Previous studies of the impact of renal cell carcinoma histopathology on survival are conflicting and generally limited to institutional analyses. Thus, we determined the role of renal cell carcinoma histopathology on the stage specific survival rate in a large population based cohort.

Materials And Methods: We used the 2000 to 2005 National Cancer Institute SEER (Surveillance, Epidemiology and End Results) database to identify 17,605 patients who underwent surgery for renal cell carcinoma and met study inclusion criteria.

Safety and outcomes of surgical treatment of renal cell carcinoma in the elderly.

Introduction: Treatment of the elderly patient with a small renal mass is becoming a common conundrum with scant data available to support treatment decisions. Goals were to assess risk of surgical treatment for renal cell carcinoma (RCC) in the elderly as compared to their younger counterparts.

Materials And Methods: A prospectively maintained database consisting of all renal tumors between August 2004 and November 2009 was utilized.

The role of socioeconomic status in renal cell carcinoma.

Gender, race, income level, and socioeconomic status (SES) are factors in the decision to diagnose and treat patients with localized and advanced renal cell carcinoma (RCC). These variables affect both health care delivery at the provider level as well as health care receipt and decision-making at the patient level. The purpose of this article is to review current literature regarding the role of socioeconomic status and patient demographics on the risk of developing, diagnosing, and treating RCC.

Is there a role for partial nephrectomy in patients with metastatic renal cell carcinoma?

Objectives: The incidence of metastatic disease in patients with renal cell carcinoma (RCC) correlates with tumor size. We sought to determine the incidence of metastatic disease by tumor size, and the utilization and impact of nephron-sparing surgery on survival in those with metastatic disease.

Materials And Methods: Utilizing the Surveillance, Epidemiology, and End Results (SEER) database, we identified 56,011 patients between 1988 and 2005 diagnosed with RCC.

Renal cell carcinoma in octogenarians: nephron sparing surgery should remain the standard of care.

Purpose: Data regarding clinical outcomes in elderly patients with renal cell carcinoma are scarce. We determined management, and overall and cancer specific survival in elderly patients with renal cell carcinoma.

Materials And Methods: Using the Surveillance, Epidemiology, and End Results database we identified 59,944 patients who underwent partial or radical nephrectomy for renal cell carcinoma between 1988 and 2005.

Is patient outcome compromised during the initial experience with robot-assisted radical cystectomy? Results of 164 consecutive cases.

Objective: • Robot-assisted radical cystectomy (RARC) remains controversial in terms of oncologic outcomes, especially during the initial experience. The purpose of this study was to evaluate the impact of initial experience of robotic cystectomy programs on oncologic outcomes and overall survival.

Patients And Methods: • Utilizing a prospectively maintained, single institution robotic cystectomy database, we identified 164 consecutive patients who underwent RARC since November 2005.

Defining morbidity of robot-assisted radical cystectomy using a standardized reporting methodology.

Background: Adverse event reporting is highly variable and nonstandardized in urologic literature, especially for robot-assisted radical cystectomy (RARC).

Objective: We sought to better characterize complications in patients after RARC using a standardized reporting methodology.

Design, Setting, And Participants: Using a prospectively maintained, single-institution database, we identified 156 consecutive patients who underwent RARC with at least 90 d of follow-up.

Men of higher socioeconomic status have improved outcomes after radical prostatectomy for localized prostate cancer.

Objective: We sought to evaluate the impact of socioeconomic status (SES) on the likelihood of undergoing radical prostatectomy (RP) or external beam radiation therapy (XRT) and the ensuing effect on cancer-specific survival (CSS) after treatment for men with low-risk prostate cancer.

Methods: Using the California Cancer Registry database, we identified 123,953 men diagnosed with localized, Gleason ≤7 prostate cancer from 1996 to 2005. Patients were separated into quintiles based on socioeconomic status and were stratified by race, age, year of diagnosis, and treatment.

Does previous robot-assisted radical prostatectomy experience affect outcomes at robot-assisted radical cystectomy? Results from the International Robotic Cystectomy Consortium.

Objectives: To evaluate the effect of previous robot-assisted radical prostatectomy (RARP) case volume on the outcomes of robot-assisted radical cystectomy. Little is known regarding the effect of previous robotic surgical experience on the implementation and execution of robot-assisted radical cystectomy.

Methods: Using the International Robotic Cystectomy Consortium database, 496 patients were identified who had undergone robot-assisted radical cystectomy by 21 surgeons at 14 institutions from 2003 to 2009.

Prospective clinical trial of preoperative sunitinib in patients with renal cell carcinoma.

Purpose: Sunitinib is an approved treatment for metastatic renal cell carcinoma. We performed a prospective clinical trial to evaluate the safety and clinical response to sunitinib administered before nephrectomy in patients with localized or metastatic clear cell renal cell carcinoma.

Materials And Methods: Patients with biopsy proven clear cell renal cell carcinoma were enrolled in the study and treated with 37.