Comparative analysis of robotic, laparoscopic, and open ileal pouch-anal anastomosis outcomes: retrospective cohort study.

Introduction: Ileal pouch-anal anastomosis (IPAA) is a common surgical procedure for patients with ulcerative colitis or familial adenomatous polyposis. This study compared the outcomes of robotic, laparoscopic, and open IPAA techniques, with a focus on surgical complications and pouch failure rates.

Methods: A retrospective study was conducted of patients who underwent IPAA at three Mayo Clinic locations between 2015 and 2020.

Pathologic Rate of Cancer After Surgery for Dysplasia Detected on Chromoendoscopy for Inflammatory Bowel Disease.

Introduction: The objective of the study was to investigate the characteristics of patients who underwent surgery for dysplasia detected during chromoendoscopy (CE) surveillance for inflammatory bowel disease (IBD) and the incidence of cancer in the surgical specimen.

Methods: A retrospective review of medical records of all patients with dysplasia on a background of underlying IBD diagnosed through CE was carried out at a tri-site enterprise tertiary referral center between 2006 and 2019. We aimed to assess the clinical characteristics of patients requiring surgery for dysplasia and the incidence of cancer in the surgical specimen.

Multiple robotic stapler firings to transect the rectum are not associated with anastomotic leakage.

Aim: The relationship between the number of stapler firings (SFs) during robotic rectal transection and the risk of colorectal/coloanal anastomotic leakage (AL) is controversial. This study investigates whether the number of robotic SFs is associated with an increased risk of AL.

Method: Retrospective review of adult patients who underwent robotic total mesorectal excision (TME) and partial mesorectal excision (PME) with double-stapled colorectal or coloanal anastomosis for both benign and malignant colorectal diseases between 2015 and 2023 across three enterprise-wide hospitals.

Delayed malignant appendiceal fistula with ileal conduit following radical cystectomy: A case report.

Fistula formation after radical cystectomy is rare, often presenting early and involving the small bowel. Herein we describe a case of an appendiceal fistula in a patient who underwent chemoradiotherapy and pelvic exenteration over a decade prior to the presentation of their fistula. Initially suspected to be radiation-induced, final pathology revealed a mucinous neoplasm of the appendix, which had fistulized with the ileal conduit.

Does timing of ileostomy closure impact postoperative morbidity?

Aim: Reversal of diverting loop ileostomy (DLI) traditionally occurs at ≥12 weeks after formation. Early closure has been performed in attempts to reduce DLI-associated morbidity. Therefore, the aim of this study was to determine whether time to stoma reversal impacts postoperative morbidity.

Market-Level Features May Influence a Hospital's Decision to Perform Robotic Radical Cystectomy in Florida.

Introduction: Adoption of robotic radical cystectomy (RC) occurred before the availability of randomized data supporting oncologic noninferiority of this approach. We hypothesized that market-level features may have influenced a hospital's likelihood of offering robotic RC.

Methods: We used the Florida Inpatient Discharge dataset to identify patients who underwent RC for bladder cancer from 2013 to 2020 and compared characteristics between facilities that performed robotic or only open RC.

Comparative Outcomes of Robotic Versus Open Proctectomy for Rectal Cancer at High Risk of Positive Circumferential Resection Margin.

Background: Concerns persist regarding the effectiveness of robotic proctectomy compared with open proctectomy for locally advanced rectal cancer with a high risk of circumferential resection margin involvement.

Objective: Comparison of surrogate cancer outcomes after robotic versus open proctectomy in this subpopulation.

Design: Retrospective cohort study.

Trends and Distribution of IPAAs in the United States: Becoming Harder to Find in Colon and Rectal Surgery Residency Training?

Background: There has been concern among colon and rectal surgery residency programs in the United States that IPAA procedures have been decreasing, but evidence is limited.

Objective: The study aimed to evaluate the number of IPAAs performed by colon and rectal surgery residents in the United States and analyze the distribution of these cases on a national level.

Design: Retrospective.

Room for Improvement: The Impact of Guideline-Recommended Extended Thromboprophylaxis in Patients Undergoing Abdominal Surgery for Colorectal and Anal Cancer at a Tertiary Referral Center.

Background: Venous thromboembolism occurs in approximately 2% of patients undergoing abdominal and pelvic surgery for cancers of the colon, rectum, and anus and is considered preventable. The American Society of Colon and Rectal Surgeons recommends extended prophylaxis in high-risk patients, but there is low adherence to the guidelines.

Objective: This study aims to analyze the impact of venous thromboembolism risk-guided prophylaxis in patients undergoing elective abdominal and pelvic surgeries for colorectal and anal cancers from 2016 to 2021.

Risk factors for surgical site infections and trends in skin closure technique after diverting loop ileostomy reversal: A multi-institutional analysis.

Background: Surgical site infections (SSIs) are one of the most common complications following diverting loop ileostomy (DLI) closures. This study assesses SSIs after DLI closure and the temporal trends in skin closure technique.

Methods: A retrospective review was conducted using the American College of Surgeons National Surgical Quality Improvement Program database for adult patients who underwent a DLI closure between 2012 and 2021 across a multistate health system.

Features associated with travel distance for radical cystectomy in Florida: Implications for access to care.

Introduction: Characteristics associated with travel distance for radical cystectomy (RC) remain incompletely defined but are needed to inform efforts to bridge gaps in care. Therefore, we assessed features associated with travel distance for RC in a statewide dataset.

Methods: We identified RC patients in the Florida Inpatient Discharge dataset from 2013 to 2019.

Caprini assessment utilization and impact on patient safety in gynecologic surgery.

Purpose: Postoperative venous thromboembolism (VTE) can potentially be associated with significant morbidity, mortality, and healthcare costs. The aim of this study was to determine the utilization of Caprini guideline indicated VTE in elective gynecologic surgery patients and its impact on postoperative VTE and bleeding complications.

Methods: This was a retrospective cohort study of elective gynecologic surgical procedures performed between January 1, 2016, and May 31, 2021.

The SAGES MASTERS program presents: the top 10 seminal articles for laparoscopic left and sigmoid colectomy pathway for uncomplicated disease.

Background: As one of the 8 Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Masters Program clinical pathways, the Colorectal Pathway aims to deliver educational content for the general surgeon organized along 3 levels of performance (competency, proficiency and mastery) each represented by an anchoring procedure. In this article, the SAGES Colorectal Task Force presents focused summaries of the top 10 seminal articles selected for laparoscopic left/sigmoid colectomy for uncomplicated disease.

Methods: Using a systematic literature search of Web of Science, the most cited articles on laparoscopic left and sigmoid colectomy were identified, reviewed, and ranked by members of the SAGES Colorectal Task Force.

Risk adjusted venous thromboembolism prophylaxis following pancreatic surgery.

This study analyzes pancreatectomy cases performed between 2016 and 2021 to determine the impact of using Caprini guideline indicated VTE prophylaxis on VTE and bleeding complications. This is a retrospective study of cases performed in a single academic health care system, in which Caprini score and VTE prevention measures were determined retroactively and prevention practices binarized as appropriate or not appropriate. Univariate and multivariate analyses were performed of 1,299 pancreatectomy case.

Continuous Glucose Monitoring for Patients with COVID-19 Pneumonia: Initial Experience at a Tertiary Care Center.

Objective: Patients hospitalized with COVID-19 and hyperglycemia require frequent glucose monitoring, usually performed with glucometers. Continuous glucose monitors (CGMs) are common in the outpatient setting but not yet approved for hospital use. We evaluated CGM accuracy, safety for insulin dosing, and CGM clinical reliability in 20 adult patients hospitalized with COVID-19 and hyperglycemia.

Disparities in access to high-volume centers and in hospital discharge status following radical cystectomy in Florida.

Introduction: Centralization of radical cystectomy (RC) improves outcomes but may unintentionally exacerbate existing disparities in care. Our objective was to assess disparities in access to high-volume RC centers and in postoperative recovery.

Methods: We identified RC patients in the Florida Inpatient Data File from 2013 to 2019.

The Association Between Mood and Anxiety Disorders With Perioperative Outcomes Following Radical Cystectomy.

Objective: To identify associations between preoperative psychiatric diagnoses and perioperative outcomes after RC.

Methods: The Florida Inpatient Data File was used to identify patients who underwent RC from 2013 to 2019. ICD-10 codes for a mood or anxiety disorder were identified and analyzed as a 3-level variable: neither, one of these, or both.

Assessment of length of stay and cost of minimally invasive versus open thymectomies in patients with myasthenia gravis in Florida.

Background: Thymectomy has become a standard component in treatment for myasthenia gravis. The best surgical approach is still subject to debate. Minimally invasive surgery may have a lower mortality and morbidity rate, improved cosmetic results, and equivalent efficacy at improving neurologic symptoms to open approaches.

Re-resection of Microscopically Positive Margins Found on Intraoperative Frozen Section Analysis Does Not Result in a Survival Benefit in Patients Undergoing Surgery and Intraoperative Radiation Therapy for Locally Recurrent Rectal Cancer.

Background: Intraoperative frozen-section analysis provides real-time margin resection status that can guide intraoperative decisions made by the surgeon and radiation oncologist. For patients with locally recurrent rectal cancer undergoing surgery and intraoperative radiation therapy, intraoperative re-resection of positive margins to achieve negative margins is common practice.

Objective: This study aimed to assess whether re-resection of positive margins found on intraoperative frozen-section analysis improves oncologic outcomes.

Temporary vs. permanent stoma: factors associated with the development of complications and costs for rectal cancer patients.

Objective: To compare in-hospital complication rates and treatment costs between rectal cancer patients receiving permanent and temporary stomas. Surgical complications and costs associated with permanent stoma formation are still poorly understood. While choosing between the two stoma options is usually based on clinical and technical factors, disparities exist.

Postoperative Safety Profile of Minimally Invasive Ileocolonic Resections for Crohn's Disease in the Era of Biologic Therapy.

Background: There is controversy regarding the postoperative outcomes in Crohn's disease [CD] patients exposed to vedolizumab [VDZ] or ustekinumab [UST]. We aimed to describe our surgical outcomes in patients who underwent minimally invasive ileocolonic resection [MIS-ICR] for CD who had preoperative biologic therapy.

Methods: All consecutive adult patients who had MIS-ICR for CD between 2014 and 2021 at our institution were included.

Risk of malignancy and outcomes of surgically resected presacral tailgut cysts: A current review of the Mayo Clinic experience.

Aim: The aim of this study was to describe the surgical management, outcomes and risk of malignancy of presacral tailgut cysts.

Method: A retrospective analysis of all patients who underwent resection of tailgut cyst at Mayo Clinic in Arizona, Florida and Minnesota between 2008 and 2020 was performed. Demographics, presentation, evaluation, surgical approach, postoperative complications, pathology and recurrence rates were reviewed.