Additional procedures performed during elective colon surgery and their adverse impact on postoperative outcomes.

Background: The need for additional procedures during a segmental elective colectomy is considered to lead to increased postoperative morbidity, but there have been few data that have validated and quantified this risk.

Purpose: We hypothesized that patients having additional procedures performed during a segmental colectomy have worse outcomes compared to patients undergoing a colectomy alone.

Patients And Methods: All patients in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database who underwent an elective open or laparoscopic segmental colectomy during 2005-2009 and met the inclusion criteria were analyzed.

The novel use of intraoperative laser-induced fluorescence of indocyanine green tissue angiography for evaluation of the gastric conduit in esophageal reconstructive surgery.

Background: Esophagectomy with reconstruction using a gastric conduit is associated with a relatively high rate of anastomotic leakage. We used indocyanine green tissue angiography to evaluate the gastric conduit intraoperatively before gastroesophageal anastomosis to identify ischemia.

Methods: We performed an institutional review board-approved retrospective review of all esophagectomies performed from 2010 to the beginning of 2011.

One hundred and two consecutive robotic-assisted minimally invasive colectomies--an outcome and technical update.

Background: The objective of this study was to review 102 consecutive robotic colectomies at our institution. We evaluated the 8-year experience of one surgeon (DLC) in Peoria, IL using the da Vinci system.

Methods: An IRB-approved retrospective review was performed.

Complications associated with the Nuss procedure: continued evolution of the learning curve.

Background: We report unusual and/or significant complications encountered during and after the Nuss Procedure for pectus excavatum.

Methods: This was a retrospective review that was approved by the institutional review board, with parental consent.

Results: Seven patients had unique and/or significant complications as follows: (1) laceration of an internal mammary artery during bar placement requiring emergent minithoracotomy; (2) hemopericardium 10 weeks postoperatively after blunt chest trauma requiring exploration of the pericardium and clot evacuation; (3) almost complete recurrence of the pectus excavatum deformity immediately after bar removal; (4 and 5) immediate/early postoperative bar displacement requiring re-operation and placement of 2 bars each; and (6 and 7) almost complete neo-ossification of the Nuss bar, making removal challenging.