Community-wide feasibility of the Lower Extremity Amputation Protocol amongst vascular amputees.

Background: The Lower Extremity Amputation Protocol (LEAP) is a multidisciplinary enhanced recovery after surgery pathway for vascular amputees. The objective of this study was to examine feasibility and outcomes of community-wide implementation of LEAP.

Methods: LEAP was implemented at three safety net hospitals for patients with peripheral artery disease or diabetes requiring major lower extremity amputation.

Lower extremity amputation protocol: a pilot enhanced recovery pathway for vascular amputees.

Vascular patients, an inherently older, frail population, account for >80% of major lower extremity amputations (transtibial or transfemoral) in the United States. Retrospective data have shown that early physical therapy and discharge to an acute rehabilitation facility decreases the postoperative length of stay (LOS) and expedites ambulation. In the present study, we sought to determine whether patients treated with the lower extremity amputation protocol (LEAP) will have improved outcomes.

Primary arterial closure after carotid endarterectomy is a safe and expeditious technique in appropriately selected patients.

Background: Carotid endarterectomy (CEA) remains a safe and durable operation for both symptomatic and asymptomatic carotid stenosis, however conflicting evidence exists on the benefit of patch angioplasty and its effects on post-operative outcomes.

Methods: A retrospective review of all patients undergoing CEA from 2011 to 2018 was performed.

Results: Of 851 patients, primary closure was performed in 277 (33%).

Barrett's Esophagus in Obese Patient Post-Roux-en-Y Gastric Bypass: a Systematic Review.

Purpose: Barrett's esophagus (BE) is a relative contraindication for sleeve gastrectomy, but not for Roux-en-Y gastric bypass (RNY). However, studies assessing the effect of RNY on BE are limited. We aimed to conduct a systematic review and meta-analysis of studies of obese patients who also had BE and underwent RNY.

Carotid endarterectomy is safe for octogenarians.

Background: Carotid endarterectomy (CEA) has demonstrated superior results in stroke risk reduction for patients with symptomatic and asymptomatic high-grade carotid stenosis. However, this benefit has long been questioned for the elderly and high-risk populations. In the present study, we aimed to provide high-volume, single-institution data with long-term follow-up examining the risk factors for postoperative stroke and stroke-free survival stratified by age for asymptomatic and symptomatic patients undergoing CEA.

Outcomes of major lower extremity amputations n dysvascular patients: Room for improvement.

Objectives: Dysvascular patients account for >80% of major amputations in the US. We sought to determine if early mobilization and discharge disposition decreased post-operative hospital length of stay (PO-LOS) and expedited independent ambulation.

Methods: A retrospective review of dysvascular patients undergoing major amputations was performed.

Comparison of endoscopic treatment modalities for Barrett's neoplasia.

Background: There are few data comparing endoscopic treatment outcomes for Barrett's esophagus (BE).

Objective: To compare treatment outcomes in BE patients treated with radiofrequency ablation (RFA), RFA after EMR, and porfimer sodium photodynamic therapy (Ps-PDT).

Design: Retrospective, observational study.