Abstract:
INTRODUCTION:There is little consensus of quality measurements for restorative proctocolectomy with ileal pouch-anal anastomosis(RPC-IPAA) performed for ulcerative colitis(UC). The National Surgical Quality Improvement Program(NSQIP) cannot accurately classify RPC-IPAA staged approaches. We formed an IBD-surgery registry that added IBD-specific variables to NSQIP to study these staged approaches in greater detail. METHODS:We queried our validated database of IBD surgeries across 11 sites in the US from March 2017 to March 2019, containing general NSQIP and IBD-specific perioperative variables. We classified cases into delayed versus immediate pouch construction and looked for independent predictors of pouch delay and postoperative Clavien-Dindo complication severity. RESULTS:430 patients received index surgery or completed pouches. Among completed pouches, 46(28%) and 118(72%) were immediate and delayed pouches, respectively. Significant predictors for delayed pouch surgery included higher UC surgery volume(p = 0.01) and absence of colonic dysplasia(p = 0.04). Delayed pouch formation did not significantly predict complication severity. CONCLUSIONS:Our data allows improved classification of complex operations. Curating disease-specific variables allows for better analysis of predictors of delayed versus immediate pouch construction and postoperative complication severity. SHORT SUMMARY:We applied our previously validated novel NSIP-IBD database for classifying complex, multi-stage surgical approaches for UC to a degree that was not possible prior to our collaborative effort. From this, we describe predictive factors for delayed pouch formation in UC RPC-IPAA with the largest multicenter effort to date.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Luo WY,Holubar SD,Bordeianou L,Cosman BC,Hyke R,Lee EC,Messaris E,Saraidaridis J,Scow JS,Shaffer VO,Smith R,Steinhagen RM,Vaida F,Eisenstein S,National Surgical Quality Improvement Program-Inflammatory Bowel Disease (NSQIP-IBdoi
10.1016/j.amjsurg.2020.05.035subject
Has Abstractpub_date
2021-01-01 00:00:00pages
174-182issue
1eissn
0002-9610issn
1879-1883pii
S0002-9610(20)30348-2journal_volume
221pub_type
杂志文章abstract::A phase I clinical trial of immunotherapy with "Immune" RNA was undertaken fifteen months ago. Twenty-six cancer patients were treated with RNA extracted from the lymphoid organs of sheep immunized with either autologous tumor cells or allogeneic tumor cells of the same histologic type. Eighteen patients had gross dis...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90360-3
更新日期:1976-11-01 00:00:00
abstract:BACKGROUND:Platelets are thought to participate in tumor metastasis. However, the relationship between platelet count and prognosis in pancreatic cancer remains unresolved. METHODS:A chart review of patients undergoing resection for pancreatic adenocarcinoma was undertaken. Demographic, perioperative, and outcome data...
journal_title:American journal of surgery
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doi:10.1016/j.amjsurg.2004.11.014
更新日期:2005-03-01 00:00:00
abstract::Mediastinal tracheostomy has been associated with high morbidity and mortality, often due to skin necrosis, with resultant exposure of the great vessels and subsequent hemorrhage. During a 4 year period, 11 patients underwent mediastinal tracheostomy. Reconstruction included the use of a pectoralis major musculocutane...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90377-5
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abstract:BACKGROUND:Intestinal obstruction (IO) is a common pediatric surgical emergency in sub-Saharan Africa with high morbidity and mortality, but little is known about its etiopathogenesis in Malawi. METHODS:Retrospective analysis of patients seen from February 2012 to June 2014 at Kamuzu Central Hospital in Lilongwe, Mala...
journal_title:American journal of surgery
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更新日期:2016-04-01 00:00:00
abstract::Percentage and levels of circulating T-lymphocytes were studied in forty-six patients with squamous cell carcinoma of the head and neck before and/or after treatment and compared with control values obtained in fifty-one healthy volunteers. Mean percentages of circulating T-cells and mean T-cell levels in cancer patie...
journal_title:American journal of surgery
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doi:10.1016/0002-9610(75)90481-x
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abstract::Experience with 37 patients with adult colovesical fistula over the past 19 years is reviewed. Specific guidelines for treatment of adult colovesical fistula are influenced by the location and cause of the fistula, the patient's general condition, the presence of a pelvic abscess and the presence of colonic obstructio...
journal_title:American journal of surgery
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doi:10.1016/0002-9610(80)90421-3
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journal_title:American journal of surgery
pub_type: 杂志文章
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更新日期:1983-05-01 00:00:00
abstract:BACKGROUND:Most studies of trauma deaths include non-preventable deaths, potentially limiting successful intervention efforts. In this study we aimed to compare the potentially preventable trauma deaths between 2 time periods at our institution. METHODS:Trauma patients who died in our hospital in 2005-2006 or 2012-201...
journal_title:American journal of surgery
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doi:10.1016/j.amjsurg.2018.12.022
更新日期:2019-09-01 00:00:00
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journal_title:American journal of surgery
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journal_title:American journal of surgery
pub_type: 杂志文章
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journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2004.03.017
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abstract:BACKGROUND:Residents are more likely to learn from educational experiences when properly prepared from the start of instruction and expectations are clear and consistent. The purpose of this study was to examine what first year residents need to know and be able to perform before starting their rotation in the intensiv...
journal_title:American journal of surgery
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更新日期:1996-06-01 00:00:00
abstract:BACKGROUND:Injury epidemiology fluctuates with economic activity in many countries. These relationships remain unclear in Canada. METHODS:The annual risk of admission for major injury (Injury Severity Score ≥12) to a high-volume, level-1 Canadian trauma center was compared with indicators of economic activity over a 1...
journal_title:American journal of surgery
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更新日期:2014-05-01 00:00:00
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journal_title:American journal of surgery
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doi:10.1016/j.amjsurg.2010.11.014
更新日期:2011-09-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90349-4
更新日期:1976-11-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90010-1
更新日期:1977-05-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(91)90070-t
更新日期:1991-09-01 00:00:00
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journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
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journal_title:American journal of surgery
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journal_title:American journal of surgery
pub_type: 杂志文章
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journal_title:American journal of surgery
pub_type: 杂志文章
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journal_title:American journal of surgery
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journal_title:American journal of surgery
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abstract:BACKGROUND:We examined practice referral patterns for primary retroperitoneal sarcoma (PRS) in British Columbia (BC) and associations between the timing of referral to tertiary care and patient outcomes. METHODS:Using ICD-10 coding, the Cancer Agency Information System was used to identify patients with PRS from 2000 ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.01.006
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abstract::In a multicenter prospective, randomized study, the efficacy of a single preoperative dose of 1 g of cefotaxime for avoiding wound infections was compared with four 2-g doses of cefoxitin. In the study, 1,451 patients with infection risk factors who underwent gastroduodenal or biliary surgery were included, of whom 72...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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abstract::A quantitative endotoxin assay was applied in this study of endotoxin transport from the infected abdomen. In rats with fecal peritonitis, extremely high concentrations were found in thoracic duct lymph (approximately 400 times higher than those found in arterial and portal vein plasma). Taking flow rates into account...
journal_title:American journal of surgery
pub_type: 杂志文章
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journal_title:American journal of surgery
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