Evaluation of Pelvic Anastomosis by Endoscopic and Contrast Studies Prior to Ileostomy Closure: Are Both Necessary? A Single Institution Review.

Contrast enema is the gold standard technique for evaluating a pelvic anastomosis (PA) prior to ileostomy closure. With the increasing use of flexible endoscopic modalities, the need for contrast studies may be unnecessary. The objective of this study is to compare flexible endoscopy and contrast studies for anastomotic inspection prior to defunctioning stoma reversal.

Ileocolic Resection for Crohn's Disease: A Minimally Invasive Approach Claims Its Place.

Ileocolic resection is the most common operation performed for Crohn's disease patients with terminal ileum involvement. We sought to evaluate the outcomes in Crohn's disease patients who underwent open ileocolic resection (OIC) and laparoscopic ileocolic resection (LIC) by using the ACS-NSQIP database from 2006 to 2015. Of 5670 patients, 48.

An endoscopic mucosal grading system is predictive of leak in stapled rectal anastomoses.

Background: Anastomotic leak is a devastating postoperative complication following rectal anastomoses associated with significant clinical and oncological implications. As a result, there is a need for novel intraoperative methods that will help predict anastomotic leak.

Methods: From 2011 to 2014, patient undergoing rectal anastomoses by colorectal surgeons at our institution underwent prospective application of intraoperative flexible endoscopy with mucosal grading.

Respiratory complications after colonic procedures in chronic obstructive pulmonary disease: does laparoscopy offer a benefit?

Background: Patients with severe chronic obstructive pulmonary disease (COPD) are at a higher risk for postoperative respiratory complications. Despite the benefits of a minimally invasive approach, laparoscopic pneumoperitoneum can substantially reduce functional residual capacity and raise alveolar dead space, potentially increasing the risk of respiratory failure which may be poorly tolerated by COPD patients. This raises controversy as to whether open techniques should be preferentially employed in this population.

Randomized Clinical Trial of Epidural Compared with Conventional Analgesia after Minimally Invasive Colorectal Surgery.

Background: The effectiveness of thoracic epidural analgesia (EA) vs conventional IV analgesia (IA) after minimally invasive surgery is still unproven. We designed a randomized controlled trial comparing EA with IA after minimally invasive colorectal surgery.

Study Design: A total of 87 patients who underwent minimally invasive colorectal procedures at a single institution between 2011 and 2014 were enrolled.

Defining the Role of Minimally Invasive Proctectomy for Locally Advanced Rectal Adenocarcinoma.

Objective: National examination of open proctectomy (OP), laparoscopic proctectomy (LP), and robotic proctectomy (RP) in pathological outcomes and overall survival (OS).

Background: Surgical management for rectal adenocarcinoma is evolving towards utilization of LP and RP. However, the oncological impacts of a minimally invasive approach to rectal cancer have yet to be defined.

Incidence, Risk Factors, and Trends of Motor Peripheral Nerve Injury After Colorectal Surgery: Analysis of the National Surgical Quality Improvement Program Database.

Background: Motor peripheral nerve injury is a rare but serious event after colorectal surgery, and a nationwide study of this complication is lacking.

Objective: The purpose of this study was to report the incidence, trends, and risk factors of motor peripheral nerve injury during colorectal surgery.

Design: The National Surgical Quality Improvement Program database was surveyed for motor peripheral nerve injury complicating colorectal procedures.

Body Mass Index Significantly Impacts Outcomes of Colorectal Surgery.

There are limited data regarding the association between body mass index (BMI) and colorectal surgery outcomes. We sought to evaluate the effect of BMI on short-term surgical outcomes in colon and rectal surgery patients in the United States. The American College of Surgeons National Surgery Quality Improvement Project database was used to identify all patients who underwent colon or rectal resection from 2005 to 2013.

Colorectal Surgery in Patients with HIV and AIDS: Trends and Outcomes over a 10-Year Period in the USA.

Background: HIV has become a chronic disease, which may render this population more prone to developing the colorectal pathologies that typically affect older Americans.

Methods: A retrospective review of the Nationwide Inpatient Sample was performed to identify patients who underwent colon and rectal surgery from 2001 to 2010. Multivariate analysis was used to evaluate outcomes among the general population, patients with HIV, and patients with AIDS.

Laparoscopic right hemicolectomy: short- and long-term outcomes of intracorporeal versus extracorporeal anastomosis.

Background: The use of laparoscopy for right hemicolectomy has gained popularity allowing the option of a totally laparoscopic intracorporeal anastomosis (IA) for intestinal reconstruction. This technique may alleviate some of the technical limitations that a surgeon faces with a laparoscopic-assisted extracorporeal anastomosis (EA).

Methods: A retrospective chart review of 195 consecutive patients who underwent laparoscopic right hemicolectomy by four colorectal surgeons at three institutions from March 2005 to June 2014 was performed.

Early Outcome of Treatment of Chronic Mesenteric Ischemia.

There are limited data regarding long-term outcomes of chronic mesenteric ischemia (CMI) of the intestine. We sought to identify treatment outcomes of CMI. The NIS database was used to identify patients admitted for the diagnosis of CMI between 2002 and 2012.

Predictive Factors of Ventilator Dependency after Colon and Rectal Surgery.

There is limited data analyzing ventilator dependency by operative diagnoses and types of the procedures performed in colorectal surgery. We sought to identify predictive factors of ventilator dependency in colorectal surgery and investigate complication rates across various colorectal procedures. The National Surgical Quality Improvement Program database was used to examine the clinical data of patients with ventilator dependency for more than 48 hours after colorectal resection during 2005-2013.

Outcomes of Bowel Resection in Patients with Crohn's Disease.

There is limited data regarding outcomes of bowel resection in patients with Crohn's disease. We sought to investigate complications of such patients after bowel resection. The Nationwide Inpatient Sample databases were used to examine the clinical data of Crohn's patients who underwent bowel resection during 2002 to 2012.

Impact of chronic steroid use on outcomes of colorectal surgery.

Background: Steroid use has been recognized as a factor which has various effects on multiple organs. We aim to investigate the association between chronic steroid use and postoperative complications after colorectal surgery.

Methods: The National Surgical Quality Improvement Program database was used to examine the clinical data of patients undergoing colorectal resection during 2005 to 2013.

Preoperative Leukocytosis in Colorectal Cancer Patients.

Background: Preoperative asymptomatic leukocytosis has been reported as a factor that affects morbidity of surgical patients. We sought to identify the relationship between asymptomatic preoperative leukocytosis and postoperative complications in elective colorectal cancer surgery.

Study Design: The NSQIP database was used to examine the clinical data of patients who had preoperative leukocytosis (white blood cell count more than 11,000/μL) and colorectal cancer resection from 2005 to 2013.

Outcome of preoperative weight loss in colorectal surgery.

Background: There are limited data regarding the outcomes of patients with preoperative weight loss. We sought to identify complications associated with preoperative weight loss in colorectal surgery.

Methods: The National Surgical Quality Improvement Program database was used to examine the clinical data of patients undergoing colorectal resection from 2005 to 2012 who had unintentional preoperative weight loss (more than 10% in 6 months of surgery).

Nationwide analysis of outcomes of bowel preparation in colon surgery.

Background: There are limited data comparing the outcomes of preoperative oral antibiotic bowel preparation (OBP) and mechanical bowel preparation (MBP) in colorectal surgery. We sought to identify the relationship between preoperative bowel preparations (BP) and postoperative complications in colon cancer surgery.

Study Design: The NSQIP database was used to examine the clinical data of colon cancer patients undergoing scheduled colon resection during 2012 to 2013.

Even modest hypoalbuminemia affects outcomes of colorectal surgery patients.

Background: A small decrease in the serum albumin from the normal level is a common condition in preoperative laboratory tests of colorectal surgery patients; however, there is limited data examining these patients. We sought to identify outcomes of such patients.

Methods: The National Surgical Quality Improvement Program database was used to evaluate all patients who had modest levels of hypoalbuminemia (3 ≤ serum albumin < 3.

Risk factors of postoperative myocardial infarction after colorectal surgeries.

There are limited data regarding the specific risk factors of postoperative myocardial infarction (MI) in patients undergoing colorectal resectional surgery. We sought to identify risk factors of acute MI after colorectal resection operations. The National Inpatient Sample database was used to identify patients who had postoperative MI after colorectal resection operations between 2002 and 2010.

Outcomes of conversion of laparoscopic colorectal surgery to open surgery.

Objectives: There is limited data regarding the outcomes of patients who undergo conversion to open surgery during a laparoscopic operation in colorectal resection. We sought to identify the outcomes of such patients.

Methods: The NIS (National Inpatient Sample) database was used to identify patients who had conversion from laparoscopic to open colorectal surgery during the 2009 to 2012 period.

Effects of ascites on outcomes of colorectal surgery in congestive heart failure patients.

Background: There are limited data regarding the effects of ascites on outcome of patients undergoing colorectal resection. We sought to identify complications related to ascites.

Methods: The National Surgical Quality Improvement Program database was used to evaluate congestive heart failure (CHF) patients who had ascites before colorectal resection between 2005 and 2012.

Preoperative dehydration increases risk of postoperative acute renal failure in colon and rectal surgery.

Objectives: There is limited data regarding the effects of preoperative dehydration on postoperative renal function. We sought to identify associations between hydration status before operation and postoperative acute renal failure (ARF) in patients undergoing colorectal resection.

Methods: The NSQIP database was used to examine the data of patients undergoing colorectal resection from 2005 to 2011.

Risk factors of postoperative upper gastrointestinal bleeding following colorectal resections.

There is limited data regarding the risk factors of postoperative upper GI bleeding (UGIB) in patients undergoing colorectal resection. We sought to identify risk factors of UGIB after colorectal resection. The NIS database was used to evaluate all patients who had colorectal resection complicated by UGIB between 2002 and 2010.

Colorectal Cancer Resections in the Aging US Population: A Trend Toward Decreasing Rates and Improved Outcomes.

Importance: The incidence of colorectal cancer in elderly patients is likely to increase, but there is a lack of large nationwide data regarding the mortality and morbidity of colorectal cancer resections in the aging population.

Objective: To examine the surgical trends and outcomes of colorectal cancer treatment in the elderly.

Design, Setting, And Participants: A review of operative outcomes for colorectal cancer in the United States was conducted in a Nationwide Inpatient Sample from January 1, 2001, through December 31, 2010.

Surgical outcomes of hyperthermic intraperitoneal chemotherapy: analysis of the american college of surgeons national surgical quality improvement program.

Importance: Hyperthermic intraperitoneal chemotherapy (HIPEC) and cytoreductive surgery have been shown to benefit selected patients with peritoneal carcinomatosis. However, these procedures are associated with high morbidity and mortality. Available data investigating the outcomes of HIPEC are mostly limited to single-center studies.