Publications by authors named "Robert E Mitchell"
Porcine acellular dermis-assisted breast reconstruction: influence of adjuvant radiotherapy on complications and outcomes.
Plast Reconstr Surg Glob Open
November 2013
Background: Implant-based reconstruction is the most frequently performed breast reconstruction procedure. A persistent issue with this approach is optimizing outcomes in the setting of radiotherapy. Experimental evidence suggests that acellular dermal matrix use may provide a protective benefit, but clinical evidence is lacking.
View Article and Find Full Text PDFObjective: Resident work-hour restrictions and a reduction in general surgery training have impacted urologic training. We sought to assess the educational needs of urology residents after preurology training in general surgery to compare self-reported outcomes to those of supervising faculty and to determine which aspects of preurology training have an impact on those needs.
Design: A survey was distributed electronically to urology residents and faculty of Accreditation Council for Graduate Medical Education (ACGME) residency programs.
Schistosomiasis is a parasitic disease caused by flatworms that live in snail-infested fresh water. It is endemic to 74 countries and affects some 200 million people worldwide, causing an estimated 200,000 deaths annually [1]. Schistosomiasis can affect the gastrointestinal tract and liver (S.
View Article and Find Full Text PDFVascular access for hemodialysis by arteriovenous fistula (AVF) is broadly recommended. Vein depth in many obese patients makes cannulation of an otherwise successful AVF difficult or impossible. We reviewed the case of an obese patient where liposuction was used to remove adipose tissue resulting in a superficial and easily accessed AVF.
View Article and Find Full Text PDFObjective: To determine the impact of hospital variables on immediate surgical outcomes for patients treated with radical prostatectomy (RP) in academic centres.
Patients And Methods: The University HealthSystem Consortium (UHC) Clinical Data Base was queried for data corresponding to patients who had RP at one of 130 academic medical centres nationwide between 2003 and the second quarter of 2007 (48,086). RP case volume (1-99, 100-499 and >500), total discharges (1-49,999, 50,000-99,999 >100,000), and geographical region (five categories) were determined and categorized for each academic centre.
Background: We sought to determine the impact of radical nephrectomy case volume, hospital size, and geographic region on immediate surgical outcomes for patients undergoing radical nephrectomy in academic centers across the country.
Methods: The University HealthSystem Consortium (UHC) Clinical Data Base was queried for data corresponding to patients who underwent radical nephrectomy at 1 of 134 academic medical centers nationwide between 2003 and quarter 2 of 2007 (n = 42,988). Radical nephrectomy case volume (1-99, 100-499, and 500 +), total discharges (1-49,999, 50,000-99,999, 100,000 +), and geographic region (5 categories) were determined for each academic center.
Purpose Of Review: Despite the well documented stage migration in prostate cancer, a substantial number of men still present to urologists with locally advanced or metastatic disease.
Recent Findings: The beneficial role of prostatectomy has been affirmed in several studies examining its therapeutic impact in locally advanced, nonmetastatic prostate cancer. Adjuvant therapy with radiation or hormones appears to increase prostate-specific antigen relapse-free survival.
Objectives: To describe the changes in the Gleason grading system over time and evaluate how a shift in Gleason grading has affected the overall predictive accuracy of the system in predicting biochemical disease-free survival after radical prostatectomy.
Methods: The Columbia University Urologic Oncology Database was reviewed, and 1515 patients who met the inclusion criteria were identified who had undergone radical prostatectomy from 1988 to 2004. The patients were divided into two time cohorts (1988 to 1997 and 1998 to 2004).
Purpose: Multiple investigators have argued that PSA may no longer be an accurate marker of prostate cancer biology. We determined whether the impact of PSA in predicting biochemical failure after radical prostatectomy has changed since the beginning of the PSA era.
Materials And Methods: A total of 1,246 patients were identified from the Columbia University Comprehensive Urological Oncology Database who underwent radical prostatectomy by 1 of 3 surgeons between 1988 and 2003.
Objectives: To examine how the biochemical outcomes after radical prostatectomy (RP) have changed in the prostate-specific antigen (PSA) era when controlling for the effects of other prognostic variables. Since the beginning of the PSA era, the presentation, treatment, and therapeutic outcomes of prostate cancer have evolved.
Methods: We reviewed the Columbia University Comprehensive Urologic Oncology Database and identified 1319 patients who had undergone RP without adjuvant therapy, performed by three surgeons, between 1988 and 2003 (minimal follow-up of 12 months).
Objectives: To determine whether the type of surgery (partial nephrectomy [PN] versus radical nephrectomy [RN]) has any effect on cancer outcome for renal cortical tumors 4 cm or larger. PN outcomes for large renal cortical tumors have been shown to be worse than outcomes for smaller tumors, but the upper limit of tumor diameter amenable to PN remains controversial.
Methods: We identified 33 patients from the Columbia University Comprehensive Urologic Oncology Database who underwent PN between 1988 and 2004 for renal cortical tumors 4 cm or larger.