Surgical Infection Society Guidelines for Total Abdominal Colectomy versus Diverting Loop Ileostomy with Antegrade Intra-Colonic Lavage for the Surgical Management of Severe or Fulminant, Non-Perforated Clostridioides difficile Colitis. Login to your accountUsername Password Forgot password? Keep me logged in OpenAthens New User Institutional Login Change Password Old Password New Password Too
Impact of Disease Etiology and Indication for Colectomy on Postoperative Outcomes: A NSQIP Colectomy-Targeted Database Study. The ACS-NSQIP Colectomy-Targeted database provides valuable metrics on surgical outcomes by utilizing clinical data to enhance quality improvement efforts. However, the quality measures offered in the ACS-NSQIP semiannual report do not stratify for the indication for colectomy. We aim to compare postoperative outcomes in patients undergoing colectomy for colon cancer, infectious causes, and inflammatory bowel disease (IBD). A retrospective review of patients undergoing colectomy was performed using the ACS-NSQIP Colectomy-Targeted database from 2012-2022. Logistic regression models were used to compare the 30-day postoperative outcomes of patients who underwent
Robotic right colectomy versus laparoscopic right colectomy in patients with right colon cancer: a comparative study. The study aimed to compare the clinical outcomes of robotic right colectomy (RRC) versus laparoscopic right colectomy (LRC) in patients diagnosed with right colon cancer, given the increasing adoption of robotic surgical techniques and their potential benefits in oncologic surgery. This retrospective comparative study included patients who underwent right colectomy at Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, between January 2019 and May 2022. The primary outcomes measured were the number of lymph nodes harvested. Key secondary outcomes included the operation time, intraoperative blood loss, postoperative complications, hospitalization costs
Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality
Early discharge following colectomy for colon cancer: A national perspective. Although early discharge after colectomy has garnered significant interest, contemporary, large-scale analyses are lacking. The present study utilized a national cohort of patients undergoing colectomy to examine costs and readmissions following early discharge. All adults undergoing elective colectomy for primary colectomy and laparoscopic operations. Following multivariable adjustment, expedited discharge was associated with a $4,500 reduction in costs as well as lower 30-day (adjusted odds ratio [AOR] 0.74, p<0.001) and 90-day non-elective readmissions (AOR 0.74, p<0.001). However, among those readmitted within 90 days, Early patients were more commonly readmitted for gastrointestinal conditions (45.8 vs 36.4
Development and internal validation of time-to-event risk prediction models for major medical complications within 30 days after elective colectomy. Patients undergoing colectomy are at risk of numerous major complications. However, existing binary risk stratification models do not predict when a patient may be at highest risks of each complication. Accurate prediction of the timing of complications facilitates targeted, resource-efficient monitoring. We sought to develop and internally validate Cox proportional hazards models to predict time-to-complication of major complications within 30 days after elective colectomy. We studied a retrospective cohort from the multicentered American College of Surgeons National Surgical Quality Improvement Program procedure-targeted colectomy dataset
Colectomy reconstruction for ulcerative colitis in Sweden and England: a multicenter prospective comparison between ileorectal anastomosis and ileal pouch-anal anastomosis after colectomy in patients with ulcerative colitis. (CRUISE-study). There are no prospective trials comparing the two main reconstructive options after colectomy for Ulcerative colitis, ileal pouch anal anastomosis and ileorectal anastomosis. An attempt on a randomized controlled trial has been made but after receiving standardized information patients insisted on choosing operation themselves. Adult Ulcerative colitis patients subjected to colectomy eligible for both ileal pouch anastomosis and ileorectal anastomosis are asked to participate and after receiving standardized information the get to choose reconstructive
Laparoscopic total colectomy with ileorectal anastomosis and subtotal colectomy with antiperistaltic cecorectal anastomosis for slow transit constipation. To investigate the clinical efficacy of laparoscopic total colectomy with ileorectal anastomosis (TC-IRA) and laparoscopic subtotal colectomy with antiperistaltic cecorectal anastomosis (SC-ACRA) on adults with slow transit constipation (STC
Area Deprivation, Fragmented Care, and Colectomy Case Acuity in the Veterans Health Administration. Colectomy for benign or malignant disease may be elective, urgent, or emergent. Data suggest successively worse outcomes for non-elective colectomy. Few data exist on the contribution of high area deprivation index and care fragmentation to non-elective colectomy. Determine the association between area deprivation and non-elective colectomy in the Veterans Health Administration and assess whether accounting for differences in care fragmentation alters the association across indications and for benign and malignant conditions separately. Retrospective cohort with multivariable multinomial logit models to evaluate associations between high deprivation care fragmentation, and the adjusted odds
The Impact of Advanced Medical Therapies on Time to Resection and Colorectal Cancer Outcomes in Ulcerative Colitis Patients Undergoing Colectomy. We aimed to evaluate the impact of advanced medical therapies (biologicals and small molecules) on time to colectomy and oncological outcomes in UC. This cohort study included UC patients who underwent colectomy between 2003 and 2022 at two referral centres in Belgium and the Netherlands. Exposure was use of advanced medical therapies. Primary outcomes were time to colectomy and colorectal cancer (CRC) rate, compared between four periods: P1 (2003-2007), P2 (2008-2012), P3 (2013-2017), P4 (2018-2022). Secondary outcomes were oncological outcomes, including incidental cancers found unexpectedly in resection specimens or during endoscopic follow-up
Difference in the Prognostic Benefit Between Extended and Segmental Colectomy for Patients With Neoplasia Associated With Ulcerative Colitis: A Nationwide Multicenter Study. Extended colectomy is considered standard treatment for neoplasia associated with ulcerative colitis, but there is limited supporting evidence, particularly from large-scale studies. This study aimed to assess the prognostic benefits of extended colectomy in patients with neoplasia associated with ulcerative colitis using a nationwide database. Multicenter retrospective study. Forty-three institutions in Japan participated in this study. Patients with ulcerative colitis diagnosed with intestinal neoplasia between 1983 and 2020 at 43 institutions were analyzed. Five-year overall survival and disease-free survival were
Usefulness of intraoperative colonoscopy and synchronous scoring system for determining the integrity of the anastomosis in left-sided colectomy: a single-center retrospective cohort study. The aim of this study is to evaluate the utilization of intraoperative colonoscopy (IOC) for determining the integrity of the anastomosis and to establish an IOC scoring system. A retrospective cohort study was conducted from January 2021 to June 2024, we analyzed the clinical data of 160 patients registered in a database who underwent laparoscopic left-sided colectomy at Pusan National University Yangsan Hospital. IOC was performed on all patients, and Mucosal color (MC), stapled line bleeding (BL), proximal redundancy (PR), and bowel preparation (BP) were evaluated and scored as variables. Logistic regression
Muscle-specific strength predicts postoperative complications and survival in patients undergoing curative colectomy for colorectal cancer. Muscle-specific strength was recently proposed as a component for the definition of sarcopenia. However, no previous study has investigated the association between muscle-specific strength and postoperative outcomes. The present study aims to explore the association between muscle-specific strength and postoperative outcomes in patients undergoing colectomy for colorectal cancer. We also aimed to investigate whether addition of muscle-specific strength to the definition of sarcopenia could lead to an increased prognostic value for postoperative outcomes. Clinical data of 1252 patients who underwent curative colectomy for colorectal cancer were prospectively
Perspectives of Older Adults Undergoing Elective Major Surgery: A Qualitative Study of Patients Undergoing Colectomy. Understand challenges faced by older adults who undergo elective major surgery. Preparation for and recovery from elective major surgery is often described from clinician perspectives, limiting insights into older patients' experiences. We conducted a qualitative study with adults age 65+ years, 30-90 days post colectomy, using interviews and surveys at a Northeastern U.S. tertiary surgical clinic. Guided by a modified Framework method, we arranged data into domains, themes and subthemes. We categorized patient-identified challenges using the Geriatric 5 Ms framework as deductive themes. Then, we identified additional themes and subthemes inductively. From November 2022
Postoperative Outcomes in Tofacitinib-treated Patients with Acute Severe Ulcerative Colitis Undergoing Colectomy. Up to 30% of patients with acute severe ulcerative colitis (ASUC) will require urgent colectomy despite initiation of IV corticosteroids and rescue therapies. Janus kinase inhibitors, such as tofacitinib, have emerged as an effective agent for ASUC; however, there is currently limited data evaluating the risk of postoperative complications among patients who received tofacitinib treatment for an episode of ASUC compared to infliximab. We conducted a multicenter, retrospective, case-control study of patients hospitalized with ASUC who underwent colectomy, comparing patients tofacitinib-treated patients to infliximab-treated patients prior to colectomy. The primary outcome
Decreasing rates of colectomy for benign neoplasms: A nationwide analysis. Despite advances in endoscopic techniques for management of benign colonic neoplasms, a rise in rates of surgical treatment has been reported. We used a nationally representative cohort to characterize temporal trends, patient characteristics, and outcomes associated with colectomy for colonic neoplasms. All patients undergoing elective partial colectomy for benign or malignant colonic neoplasms were identified using the 2012-2019 National Inpatient Sample. Those presenting with inflammatory bowel disease, or experiencing intestinal perforation were excluded. Patients with benign neoplasms were classified as the Benign cohort (others: Malignant). Trends, characteristics, and outcomes were assessed between groups
Association of hospital volume with conversion to open from minimally invasive colectomy in patients with diverticulitis: A national analysis. Despite the known advantages of minimally invasive surgery (MIS) for diverticular disease, the impact of conversions to open (CtO) colectomy remains understudied. The present study used a nationally representative database to characterize risk factors and outcomes associated with CtO in patients with diverticular disease. All elective adult hospitalizations entailing colectomy for diverticulitis were identified in the 2017-2019 Nationwide Readmissions Database. Annual institutional caseloads of MIS and open colectomy were independently tabulated. Restricted cubic splines were utilized to non-linearly estimate the risk-adjusted association between hospital
Colectomy in Patients with Liver Disease: Albumin-Bilirubin Score Accurately Predicts Outcomes. Patients with liver disease undergoing colectomy have higher rates of complications and mortality. The Albumin-Bilirubin score is a recently developed system, established to predict outcomes after hepatectomy, that accounts for liver dysfunction. All patients undergoing colectomy were identified in the 2015-2018 American College of Surgeons National Surgical Quality Improvement Program colectomy-targeted database. Demographics and outcomes were compared between patients with Albumin-Bilirubin Grade 1 vs. 2/3. Multivariable regression was performed for outcomes including colorectal-specific complications. Areas under the receiver operative characteristic curves were calculated to determine accuracy
Safety and Efficacy of a Novel Miniaturized Robotic Assisted Surgery System in Colectomy: A Prospective, Investigational Device Exemption Clinical Study Using the IDEAL Framework. Robotics has increased rates of minimally invasive surgery, with distinct advantages over open surgery. However, current commercially available robotic platforms have device and system issues that limit robot-assisted surgery expansion. To demonstrate the safety and efficacy of a novel miniaturized robotic assisted surgery device in colectomy. Prospective, Investigational Device Exemption clinical study following the idea, development, exploration, assessment, and long-term follow-up (IDEAL) framework (Stage 2b, exploration). Three centers with high-volume robotic colorectal cases and surgeons. Patients scheduled
Segmental Colectomy in Ulcerative Colitis. Segmental colectomy in ulcerative colitis is performed in select patients who may be at increased risk for postoperative morbidity. To identify ulcerative colitis patients who underwent segmental colectomy and assess their postoperative and long-term outcomes. Retrospective case series. A tertiary-care inflammatory bowel disease center. Ulcerative colitis patients who underwent surgery between 1995 and 2022. Segmental colectomy. Postoperative complications, early and late colitis, metachronous cancer development, completion proctocolectomy-free survival rates and stoma at follow-up. Fifty-five patients were included [20 (36.4%) female; 67.8 (57.4-77.1) years of age at surgery; body mass index 27.7 (24.2-31.1) kg/m2; median follow-up 37.3 months