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Health care costs are an important policy focus in the United States. The magnitude and drivers of variation in the costs of common operative procedures are not well understood. We sought to characterize variation in costs across hospitals.We used data from the Nationwide Inpatient Sample from 2001–2011 for 5 elective operations: colectomy, coronary artery bypass graft, total knee arthroplasty, cesarean...
Data from small retrospective studies have argued that perioperative packed red blood cell transfusions may increase the risk of developing metastatic recurrence in cancer patients. This study tests this assumption in a large cohort spanning a decade of operatively treated colon cancer patients.All patients undergoing primary resection of a colon cancer at a tertiary care center between 2004–2014...
Emergency general surgery during hospitalization has not been well characterized. We examined emergency operations remote from admission to identify predictors of postoperative 30-day mortality, postoperative duration of stay >30 days, and complications.Patients >18 years in The American College of Surgeons National Surgical Quality Improvement Program (2011–2014) who had 1 of 7 emergency operations...
Liver transplantation to treat neuroendocrine tumors, especially in the setting of diffuse liver involvement not amenable to operative resection remains controversial. We sought to perform a systematic review of the current literature to summarize data on patients undergoing liver transplantation with neuroendocrine tumors liver metastases as the indication.A systematic review was conducted in accordance...
Dr Egeland is senior director of business development and licensing in the Early Technologies business unit of the Minimally Invasive Therapies Group at Medtronic.Mr Rapp is an associate consultant at Pharmagellan, a biotech consultancy.Dr David is the founder and managing director of Pharmagellan.
Heidi A. Krantz, RN, BSN is the Director of Value Analysis at Johns Hopkins Bayview Medical Center in the Johns Hopkins Health System.Barbara Strain, MA, CVAHP is the Director of Value Management at the University of Virginia Health System.Jane Torzewski RN, MAN, MBA is a Senior Category Manager for the Mayo Clinic Physician Preference Contracting team. She previously was a Senior Clinical Value Analyst...
In biliary atresia mechanisms of progressive liver injury leading to need of liver transplantation after successful portoenterostomy remain unknown. A better understanding is a prerequisite for development of novel therapies to extend native liver survival, and we aimed to unravel molecular characteristics of liver injury after successful portoenterostomy.Liver biopsies obtained from 28 biliary atresia...
Recently, mobile health technology has emerged as a promising avenue for improving physician-patient communication and patient outcomes. The objective of our study was to determine the public's perception of barriers and benefits to using mobile health technology technologies to enhance recovery after operation.We used the Empire State Poll to ask 2 open-ended questions to 800 participants assessing...
Tumor location is a prognostic factor for survival in patients with T2 gallbladder cancer. However, the optimal extent of resection according to tumor location remains unclear.We reviewed the records of 192 patients with T2 gallbladder cancer who underwent R0 or R1 resection at 6 institutions. Perioperative and oncologic outcomes were compared according to the extent of resection between hepatic-sided...
Although systems of 3-dimensional image-guided surgery are a valuable adjunct across numerous procedures, differences in organ shape between that reflected in the preoperative image data and the intraoperative state can compromise the fidelity of such guidance based on the image. In this work, we assessed in real time a novel, 3-dimensional image-guided operation platform that incorporates soft tissue...
Multimodal therapy is recommended for early stage pancreatic cancer, although whether all patients benefit and the optimal timing of chemotherapy remain unclear.Retrospective cohort study of patients aged 18–79 years with stage I-II pancreatic ductal adenocarcinoma in the National Cancer Database (2004–2012). Patients were grouped based on treatment strategy as surgery only, adjuvant, and preoperative...
Debate persists over the impact of Collis gastroplasty (CG) on outcomes after anti reflux surgery. This study analyzed operative and quality of life (QOL) outcomes from one of the largest series of laparoscopic anti reflux surgery (LARS) with CG reported to date.A retrospective review was conducted to compare outcomes between patients undergoing LARS with CG versus without CG at two large centers...
Sleeve gastrectomy is one of the most commonly performed procedures in obesity and metabolic operation with leakage and stenosis being serious complications. The management of these complications is challenging, with different operative options available. The aim of our study was to evaluate the incidence and management strategies of leakage and stenosis after sleeve gastrectomy at our institution...
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