Publications by authors named "R E Billingham"
Background: Randomized controlled trials demonstrate the efficacy of arginine-enriched nutritional supplements (immunonutrition) in reducing complications after surgery. The effectiveness of preoperative immunonutrition has not been evaluated in a community setting.
Objective: This study aims to determine whether immunonutrition before elective colorectal surgery improves outcomes in the community at large.
Background: Randomized trials have found that alvimopan hastens return of bowel function and reduces length of stay (LOS) by 1 day among patients undergoing colorectal surgery. However, its effectiveness in routine clinical practice and its impact on hospital costs remain uncertain.
Study Design: We performed a retrospective cohort study of patients undergoing elective colorectal surgery in Washington state (2009 to 2013) using data from a clinical registry (Surgical Care and Outcomes Assessment Program) linked to a statewide hospital discharge database (Comprehensive Hospital Abstract Reporting System).
Screening, Surveillance, and Treatment of Anal Intraepithelial Neoplasia.
Clin Colon Rectal Surg
March 2016
Article Synopsis
- The incidence of anal intraepithelial neoplasia is rising, particularly among high-risk groups like MSM (men who have sex with men), HIV-positive individuals, and the immunosuppressed.
- The progression to invasive anal cancer from high-grade lesions is about 5%, but higher for high-risk patients, and while anal cytology is used for screening, it doesn’t reliably connect to actual disease presence.
- Treatment options range from nonoperative methods like topical medications to surgical procedures, but there are still high recurrence rates, emphasizing the need for vigilant surveillance, with no established optimal follow-up guidelines.
Objective: To determine the impact of elective colectomy on emergency diverticulitis surgery at the population level.
Background: Current recommendations suggest avoiding elective colon resection for uncomplicated diverticulitis because of uncertain effectiveness at reducing recurrence and emergency surgery. The influence of these recommendations on use of elective colectomy or rates of emergency surgery remains undetermined.