Keep Them on the Table: Outcomes Are Improved After Minimally Invasive Colectomy Despite Longer Operative Times in Patients With High-Risk Colon Cancer.

Background: For high-risk patients, traditional surgical dogma advises open operations, with short operative times, to "get them off the table" instead of longer minimally invasive surgery approaches.

Objective: The aim of this study was to compare postoperative outcomes in patients with high-risk colon cancer undergoing elective longer minimally invasive surgery operations compared with shorter open operations.

Design: Retrospective comparative cohort study.

A New Bibliometric Index: The Top 100 Most Disruptive and Developmental Publications in Colorectal Surgery Journals.

Background: A new bibliometric index called the disruption score was recently proposed to identify innovative and paradigm-changing publications.

Objective: The goal was to apply the disruption score to the colorectal surgery literature to provide the community with a repository of important research articles.

Design: This study is a bibliometric analysis.

Surgical Residents' Perspective on Informed Consent-How Does It Compare With Attending Surgeons?

Background: The informed consent discussion (ICD) is a compulsory element of clinical practice. Surgical residents are often tasked with obtaining informed consent, but formal instruction is not included in standard curricula. This study aims to examine attitudes of surgeons and residents concerning ICD.

I want to go home: should we abandon open surgery for treatment of rectal prolapse? Consideration of discharge destination following surgery for rectal prolapse.

Aim: Despite the financial and value-based implications associated with higher levels of care at discharge, few studies have evaluated modifiable treatment factors that may optimize postacute care. The aim of this work was to assess the association between operative approach and disposition to a higher level of care and other outcomes following surgery for rectal prolapse.

Method: Using a retrospective cohort study design, the database of the National Surgical Quality Improvement Program was used to identify patients with rectal prolapse who underwent perineal repair or open or laparoscopic rectopexy with or without resection between 2012 and 2017.

It Takes a Village: The First 100 Patients Seen in a Multidisciplinary Pelvic Floor Clinic.

Objective: This study aimed to assess the characteristics of patients assessed and treated at a multidisciplinary pelvic floor program that includes representatives from multiple specialties. Our goal is to describe the process from triaging patients to the actual collaborative delivery of care. This study examines the factors contributing to the success of our multidisciplinary clinic as evidenced by its ongoing viability.

Early feeding in colorectal surgery patients: safe and cost effective.

Purpose: Enhanced recovery after surgery (ERAS) pathways has demonstrated improved outcomes in colorectal surgery. An important component of ERAS is early oral intake. The aim of this study is to determine the impact of early oral intake in patients following colorectal surgery.

A national analysis of operative treatment of adult patients with Hirschsprung's disease.

Purpose: Hirschsprung's disease is primarily a disease of infancy, but in rare cases, adults with this condition require surgery. The aim of this study is to identify the types of operations and postoperative outcomes in adults with Hirschsprung's disease on a national level.

Methods: The National Surgical Quality Improvement Program database was used to perform a retrospective review of all adult patients diagnosed with Hirschsprung's disease.

Transanal Endoscopic Microsurgery.

Transanal endoscopic microsurgery (TEM) was developed by Professor Gerhard Buess 30 years ago at the dawn of minimally invasive surgery. TEM utilizes a closed proctoscopic system whereby endoluminal surgery is accomplished with high-definition magnification, constant CO2 insufflation, and long-shafted instruments. The end result is a more precise excision and closure compared to conventional instrumentation.

Patient factors may predict anastomotic complications after rectal cancer surgery: Anastomotic complications in rectal cancer.

Purpose: Anastomotic complications following rectal cancer surgery occur with varying frequency. Preoperative radiation, BMI, and low anastomoses have been implicated as predictors in previous studies, but their definitive role is still under review. The objective of our study was to identify patient and operative factors that may be predictive of anastomotic complications.

Hospital readmission for fluid and electrolyte abnormalities following ileostomy construction: preventable or unpredictable?

Background: Ileostomy creation has complications, including rehospitalization for fluid and electrolyte abnormalities. Although studies have identified predictors of this morbidity, readmission rates remain high.

Methods: The researchers conducted a retrospective chart review of all patients with ileostomy creation at a tertiary institution from January 2008 to June 2011.

Tumor scatter after neoadjuvant therapy for rectal cancer: are we dealing with an invisible margin?

Background: After the impressive response of rectal cancers to neoadjuvant therapy, it seems reasonable to ask: can we can excise the small ulcer locally or avoid a radical resection if there is no gross residual tumor? Does gross response reflect what happens to tumor cells microscopically after radiation?

Objective: The aim of this study was to identify microscopic tumor cell response to radiation.

Design: This study is a retrospective review of a prospectively collected database.

Setting: This investigation was conducted at a single tertiary medical center.

Surgery after colonic stenting.

Colonic stenting is an accepted treatment of large bowel obstruction. The literature is sparse regarding surgical difficulties associated with an indwelling stent. We report our experience focusing on outcomes, complications, and whether the stent created intraoperative concerns.

Incisionless laparoscopic total proctocolectomy with ileal J-pouch anal anastomosis.

Minimally invasive surgery continues to evolve. Recent innovations have included single-incision access, robotic technology, and natural orifice dissection and/or specimen extraction. Many argue that there is minimal patient benefit to these advanced techniques.

Laparoscopic colectomy: complications causing reoperation or emergency room/hospital readmissions.

The purpose of this study was to determine the incidence of complications causing reoperation or emergency room(ER)/hospital readmission after laparoscopic colectomy (LC). We retrospectively reviewed a prospectively managed database of 358 patients undergoing LC. Nonhand assisted LC was jointly performed by two surgeons assisted by a general surgery resident.

Endobronchial colorectal metastasis versus primary lung cancer: a tale of two sleeve right upper lobectomies.

Endobronchial metastasis from colorectal carcinoma is relatively uncommon whereas primary bronchogenic carcinoma is more common. These two disease entities can both appear to be similar clinically and radiographically. Palliative treatment rather than a curative-intent anatomic resection is typically employed in the setting of endobronchial metastatic disease.

Morbidity and mortality in octogenarians and older undergoing major intestinal surgery.

Purpose: The elderly constitute an increasing portion of the world's population. Our study assessed morbidity, mortality, and outcome in octogenarians who have undergone lower intestinal operations, and compared outcome between subsequent decades.

Methods: A total of 138 octogenarians who underwent 157 operations were retrospectively studied (1995-2005).

Repeat pulmonary resection for metachronous colorectal carcinoma is beneficial.

Background: Initial pulmonary metastatectomy for limited colorectal carcinoma metastases is associated with improved survival. The role of repeat thoracic interventions is less well defined. The purpose of this study is to clarify the role of repeat pulmonary resection for metastatic colorectal carcinoma.