Racial disparities in survival of early onset colon cancer (Age<50): A matched NCDB analysis.

Background: Early-onset colon cancer (EOCC) has increasing incidence and disproportionately affects African-Americans. This analysis aims to compare EOCC survival among Black and White patients after matching relevant socio-demographic factors and stage.

Methods: The 2004-2017 NCDB database was queried for Black and White patients, age<50, who underwent colectomy for adenocarcinoma.

Assessing the Quality of Online Health Information and Trend Data for Colorectal Malignancies.

Introduction: Patients often refer to the internet to learn about different health conditions. This study aims to assess the landscape of online health information on malignant colorectal conditions, focusing on the popularity, quantity, and quality of internet resources pertaining to these conditions. This information can be used as a guide for surgeons to supplement patient information at the time of surgical evaluation and to help design optimal online health information.

Efficacy and satisfaction of asynchronous TeleHealth care compared to in-person visits following colorectal surgical resection.

Background: The feasibility of remote visits following abdominal colorectal surgery has not been studied in relation to efficacy, patient satisfaction, and surgeon satisfaction. This study aims to assess reliability and satisfaction with a web-based questionnaire for post-operative visits following abdominal colorectal surgery.

Methods: This was a prospective single-arm cohort study at single-tertiary care center during admission for abdominal colorectal surgery.

S184: preoperative sarcopenia is associated with worse short-term outcomes following transanal total mesorectal excision (TaTME) for rectal cancer.

Introduction: Malnutrition and deconditioning impact postoperative morbidity and mortality. Computed tomography (CT) body composition variables are used as markers of nutritional status and sarcopenia. The objective of this study is to evaluate the impact of sarcopenia, using CT variables, on postoperative outcomes following transanal total mesorectal excision (TaTME) for rectal cancer.

Oncologic Outcomes After Transanal Total Mesorectal Excision for Rectal Cancer.

Background: Recent series have raised concerns about the oncologic outcomes of transanal total mesorectal excision for mid and low rectal cancer. There is a paucity of large data sets from the United States to contribute to the ongoing international discourse.

Objective: This study aimed to investigate the rate of local recurrence and other oncologic outcomes in patients undergoing transanal total mesorectal excision for rectal adenocarcinoma.

Development of a Practice Guideline for Discharge Opioid Prescribing After Major Colorectal Surgery.

Background: Better alignment of opioid prescription quantities with patient need could help reduce excessive prescribing.

Objective: The study sought to develop an institutional prescribing guideline based on defined opioid consumption patterns after inpatient colorectal operations.

Design: This was a retrospective cohort study.

Total Transperineal Laparoscopic Proctectomy for the Treatment of Crohn's Proctitis.

Introduction: Completion proctectomy is traditionally performed using a combination of abdominal and perineal approaches. Access to and exposure of the pelvis through the abdominal cavity can be limited in patients with prior surgery or inflammatory conditions. We describe a novel technique for a total transperineal approach for proctectomy for Crohn's proctitis, avoiding technical challenges, risks, and recovery associated with abdominal surgery.

Prospective Evaluation of a Tiered Opioid Prescribing Guideline for Inpatient Colorectal Operations.

Objective: This study sought to prospectively validate an institutional prescribing guideline based on previously defined opioid consumption patterns following inpatient colorectal operations.

Background: In light of the opioid epidemic, reducing excess prescription quantities is key while still tailoring to patient needs.

Methods: This is a cohort study of elective colorectal operations (colectomies, proctectomies, and ostomy reversals) at a single tertiary care medical center.

Use of medical chaperones by colon and rectal surgeons in outpatient practice.

Background: The purpose of this study is to determine the frequency and motivations for medical chaperone use during anorectal exams by colon and rectal surgeons in the outpatient setting.

Study Design: This cross-sectional study examined factors impacting chaperone use via an anonymous online survey distributed via the American Society of Colon and Rectal Surgeons email list. Routine chaperone use was defined as ≥ 90%.

Transanal Minimally Invasive Surgery: An Effective Approach for Patients Who Require Redo Pelvic Surgery for Anastomotic Failure.

Background: Anastomotic leaks cause significant patient morbidity that may require redo pelvic surgery. Transanal minimally invasive surgery facilitates direct access to the pelvis with increased visualization and maneuverability for technically difficult redo surgery.

Objective: This study aimed to assess the feasibility and outcomes of transanal minimally invasive surgery in redo proctectomy for anastomotic complications.

Opioid Consumption Patterns After Anorectal Operations: Development of an Institutional Prescribing Guideline.

Background: Closer scrutiny of prescription patterns following surgery could contribute to the national effort to combat the opioid epidemic.

Objective: This study aimed to define opioid consumption patterns following anorectal operations for development of an institutional prescribing guideline.

Design: This was a retrospective cohort study.

Not All Discharge Settings Are Created Equal: Thirty-Day Readmission Risk after Elective Colorectal Surgery.

Background: Discharge to nonhome settings after colorectal resection may increase risk of hospital readmission.

Objective: The purpose of this study was to determine the impact of various discharge dispositions on 30-day readmission after adjusting for confounding demographic and clinical factors.

Design: This was a retrospective cohort study.

Creation and Institutional Validation of a Readmission Risk Calculator for Elective Colorectal Surgery.

Background: Readmissions reflect adverse patient outcomes, and clinicians currently lack accurate models to predict readmission risk.

Objective: We sought to create a readmission risk calculator for use in the postoperative setting after elective colon and rectal surgery.

Design: Patients were identified from 2012-2014 American College of Surgery-National Surgical Quality Improvement Program data.

Twitter Use Among Departments of Surgery With General Surgery Residency Programs.

Objective: To examine patterns of Twitter use by surgery departments with residency programs and understand relevant motivations and concerns. The primary outcome was to quantify account prevalence and activity. The secondary outcomes were to identify reasons for use and perceived benefits and concerns.

Data Accuracy and Predictors of High Ratings of Colon and Rectal Surgeons on an Online Physician Rating Website.

Background: Online physician rating Web sites are used by over half of consumers to select doctors. No studies have examined physician rating Web sites for colon and rectal surgeons.

Objective: The purpose of this study was to evaluate the accuracy and rating patterns of colon and rectal surgeons on the largest physician rating Web site.

Distribution of Elective Ileal Pouch-Anal Anastomosis Cases for Ulcerative Colitis: a Study Utilizing the University Health System Consortium Database.

Background: Trends and distribution of ileal pouch-anal anastomosis (IPAA) procedures for patients with ulcerative colitis (UC) are unknown. We examined the frequency, distribution, and volume-outcome relationship for this relatively infrequent procedure using a large national data source.

Methods: Data were obtained from the University HealthSystem Consortium (UHC) for patients with a primary diagnosis of UC admitted electively and who underwent surgical intervention between 2012 and 2015.

Impact of Preoperative Care for Rectal Adenocarcinoma on Pathologic Specimen Quality and Postoperative Morbidity: A NSQIP Analysis.

Background: Comprehensive and multidisciplinary care are critical in rectal cancer treatment. We sought to determine if completeness of preoperative care was associated with pathologic specimen quality and postoperative morbidity.

Study Design: Clinical stage I-III rectal adenocarcinoma patients who underwent elective low anterior resection or abdominoperineal resection were identified from the 2016-2017 American College of Surgeons-National Surgical Quality Improvement Project (ACS-NSQIP) database.

The utility of the delphi method in defining anastomotic leak following colorectal surgery.

Background: Almost a decade after international guidelines defining anastomotic leak (AL) were published, the definition of AL remains inconsistent.

Methods: A 3-round modified Delphi study was conducted among a national panel of 8 surgeon experts to assess consensus related to the definition of AL following colorectal resection. Consensus was defined when a scenario was rated as very important or absolutely essential by at least 85% of the experts in round 3.

Getting to the bottom of treatment of rectal prolapse in the elderly: Analysis of the National Surgical Quality Improvement Program (NSQIP).

Background: Many approaches to treat rectal prolapse exists, yet little is known regarding their safety in the elderly.

Method: NSQIP (2008-2014) was queried to identify patients ≥ 70 years who underwent open rectopexy (OR), laparoscopic rectopexy (LR) and perineal rectosigmoidectomy (PR). Patients were selected using NSQIP's estimated probability of morbidity of ≥50 percentile.

CO embolism can complicate transanal total mesorectal excision.

Background: Carbon dioxide (CO) embolism is a rare but potentially devastating complication of minimally invasive abdominal and retroperitoneal surgery. Characterized by a decrease in end-tidal CO (ETCO) and oxygen saturation (SpO), CO emboli can cause rapid intraoperative hypotension and cardiovascular collapse. Transanal total mesorectal excision (taTME) is a novel surgical approach for rectal resection, which requires high flow CO insufflation in a low volume operative field.

Impact of the "Weekend Effect" for Hospital Discharges on Readmissions After Elective Colectomy.

Background: Hospital readmissions after elective colectomy are costly and potentially preventable. It is unknown whether hospital discharge on a weekend impacts readmission risk.

Objective: This study aimed to use a national database to determine whether discharge on a weekend versus weekday impacts the risk of readmission, and to determine what discharge-related factors impact this risk.

Initiation of a Transanal Total Mesorectal Excision Program at an Academic Training Program: Evaluating Patient Safety and Quality Outcomes.

Background: Short-term results have shown that transanal total mesorectal excision is safe and effective for patients with mid to low rectal cancers. Transanal total mesorectal excision is considered technically challenging; thus, adoption has been limited to a few academic centers in the United States.

Objective: The aim of this study is to describe outcomes after the initiation of a transanal total mesorectal excision program in the setting of an academic colorectal training program.

Diffusion of technology: Trends in robotic-assisted colorectal surgery.

Following FDA approval, robotic-assisted colorectal surgery (RACS) has increased in prevalence. We aimed to identify trends in utilization and patient characteristics of RACS in the United States using the University HealthSystem Consortium database between October 2011-September 2015. Outcome measures were number and percentage of procedures performed with robotic-assistance.

Location is everything: The role of splenic flexure mobilization during colon resection for diverticulitis.

Introduction: Routine splenic flexure mobilization (SFM) has been previously recommended to ensure an adequate length for a tension free anastomosis during resection for diverticulitis. We sought to evaluate the role of selective SFM for diverticulitis, and its impact on outcomes.

Materials And Methods: Retrospective review of elective colectomies at a tertiary care center (2007-2015) for left-sided diverticulitis were identified from the National Surgical Quality Improvement Program.