DAVID R contact FLUM

..Common bile duct (CBD) injury during cholecystectomy is a significant source of patient morbidity, but its impact on survival is unclear...

..Computed tomography, ultrasonography, and laparoscopy have been suggested for use in patients with equivocal signs of appendicitis to decrease unnecessary surgery...

..Case series demonstrate that bariatric surgery can be performed with a low rate of perioperative mortality (0.5%), but the rate among high-risk patients and the community at large is unknown...

..This study assessed the validity of a research technique using administrative data to determine whether patients undergoing an appendectomy actually had appendicitis or if they had a negative appendectomy (NA)...

..The aim of this study was to establish a survival model of Roux-en-Y gastric bypass (RYGBP) in swine and to evaluate its potential in studies of physiology...

..Negative appendectomy (NA)--the nonincidental removal of a normal appendix--occurs commonly but the associated clinical- and system-level costs are not well studied...

..Common bile duct (CBD) injury is a serious complication of laparoscopic cholecystectomy (LC). Predictors of this adverse outcome have not been well documented...

..Intraoperative cholangiography (IOC) may decrease the risk of common bile duct (CBD) injury during cholecystectomy by helping to avoid misidentification of the CBD...

..To determine if certain outcomes of incisional hernia repair have improved in recent eras...

..To determine the impact of the Centers for Medicare and Medicaid Services' (CMS) bariatric surgery national coverage decision (NCD) on the use, safety, and cost of care CMS beneficiaries...

..We hypothesized that the proportion of patients operated on would increase over time coincident with increasing adherence to practice guidelines and improved patient/provider education over time...

..Management options for pleural space infections have changed over the last 2 decades. This study evaluated trends over time in the incidence of disease and use of different management strategies and their associated outcomes...

..Routine IOC is not universal, and barriers to its use, including surgeon knowledge, behavior, and attitudes, should be understood in developing quality-improvement interventions aimed at increasing IOC use...

..It is unknown how frequently multimodality mediastinal staging is used, or whether its use is associated with better health outcomes...

..Little is known about how physicians approach disclosure. The objective of the present study was to describe how physicians disclose errors to patients...

..Radiofrequency ablation (RFA) is a relatively new modality to treat liver tumors that is being incorporated into practice despite the fact that its risk profile has not been well described...

..The Surgical Care and Outcomes Assessment Program (SCOAP) gathers chart-abstracted process of care data (such as CT/US accuracy) for general surgical procedures (including appendectomy) at most Washington State hospitals...

..Individualization of recommendations regarding elective colectomy based on these factors may be more appropriate than the application of previously published strategies...

..We conclude that perioperative rofecoxib with PL reduces in-hospital recovery time, decreases pain scores and opioid use, and improves satisfaction scores in the first 24 h after surgery...

..The optimal treatment of children with empyema remains controversial. The purpose of this review was to compare reported results of nonoperative and primary operative therapy for the treatment of pediatric empyema...

..Anorectal melanoma (AM) is a rare tumor with a poor prognosis. Treatment with abdominoperineal resection (APR) over wide local excision (WLE) is still debated. This study aimed to compare median survival of WLE and APR in patients with AM...

..Risk-taking preferences can influence physician behavior and practice. We evaluated self-reported differences in characteristics and risk-taking preference among surgeons with and without a reported history of CBDI...

..It has yet to be determined if EBHR has led to regionalized surgical care and whether it has improved patient outcomes...

..This study evaluated changes in the use and short-term outcomes of PTA among patients with claudication and other manifestations of peripheral arterial disease (PAD)...

..To describe the population-level risk of adverse outcomes among older adults undergoing common abdominal surgical procedures...

..A modest overall survival benefit was associated with the procedure but a marked survival advantage was noted for patients who survive to the first postoperative year...

..This study describes temporal trends and variables in the operative management and outcomes of patients with T4 lung tumors in the general community...

..Routine IOC use among less experienced surgeons and in high-risk operations is the most cost effective, but the cost implications of routine use for the general population should also be considered cost effective...

..We designed a model to evaluate the incremental cost-effectiveness of these procedures compared with nonoperative weight loss interventions and with each other...

..Long-term outcomes and processes of care in patients undergoing pulmonary resection for lung cancer may vary by surgeon type. Associations between surgeon specialty and processes of care and long-term survival have not been described...

..Patients with unruptured aneurysms who undergo clipping have improved survival compared with those who do not undergo clipping. This study supports the use of early intervention in the management of patients with unruptured aneurysms...

..We sought to determine the prevalence of low health literacy (LHL) among patients in a preoperative clinic, the characteristics associated with LHL, and the association between LHL and adherence to preoperative instructions...

..Surgical experience with the procedure was linked to better outcomes...

..Markers of increased health care utilization are surrogates for adverse events, and one such metric--prolonged length of stay greater than 14 days (PLOS)--was recently endorsed as a provider-level performance measure...

..We identified a higher than expected mortality rate among older patients undergoing colostomy reversal. The impact of colostomy and reversal operations on both patients and the health care system is significant...

..Understanding the behaviors, attitudes and beliefs that make up surgical "judgment" remains a challenge for those interested in influencing behavior...

..This study cautions against overreliance on CT/US in diagnosing appendicitis and emphasizes the need for test benchmarking in routine practice before establishing protocols for presumed appendicitis...

..We sought to evaluate the use of video-assisted thoracoscopy among patients with lung cancer and its safety and effectiveness relative to conventional resection...

..Epithelioid sarcoma is a rare sarcoma with a high local recurrence rate that frequently metastasizes to lymph nodes. We reviewed our experience with adjuvant therapy in patients with this disease...

..The proportion of patients undergoing colostomy remained stable, and there does not seem to be a significant increase in the use of one-stage procedures for diverticulitis...

..Expectant management is the preferred strategy for pancreas and/or kidney transplant recipients with asymptomatic cholelithiasis...

..To describe the reproductive health history and characteristics of women having bariatric surgery and to determine whether this differs by age of onset of obesity...

..The incidence of hepatocellular carcinoma (HCC) is rising and radiofrequency ablation (RFA) appears to be increasingly used. The nationwide use and impact of RFA have not been well characterized...

..We hypothesized that there would be no significant evidence of racial disparities among patients with early-stage lung cancer who are recommended surgical therapy...

..Older adults frequently undergo abdominopelvic surgical operations, yet the risk and significance of postoperative discharge disposition has not been well characterized...

..CONCLUSIONS: This study suggests that expectant management is associated with lower rates of death and colostomy and is cost-saving for both younger and older patients...

..To assess the relationship between lung function tests and clinical characteristics in a cohort of morbidly obese patients undergoing evaluation for bariatric procedures in a university hospital in the United States...

..This systematic literature review was designed to summarize and compare the reported outcomes of one-stage and two-stage operations for the treatment of perforated diverticulitis with peritonitis...

..A prospective comparative trial of CT with and without oral contrast for appendicitis should be performed to assess the adequacy of this modality...

..The objective of this study was to determine whether pediatric antireflux procedures are associated with a decreased rate of reflux-related hospitalizations...

..We hypothesized that AGI occurs more often in patients with periprocedural nosocomial infections and less often after endovascular aneurysm repair (EVAR)...

..CONCLUSIONS: Moderate to severe hepatic steatosis and NASH are common among individuals undergoing gastric bypass procedures. Diabetes mellitus but not BMI is associated with NASH and advanced hepatic fibrosis in these patients...

..Outcomes analyses should consider the potential for the confounding of BMI with demographic and clinical characteristics...

..To facilitate research in this field, the National Institute of Diabetes and Digestive and Kidney Diseases responded to this knowledge gap by establishing the Longitudinal Assessment of Bariatric Surgery (LABS) consortium...

..3. Perform a modeled cost effectiveness analysis of bariatric procedures compared to non-surgical approaches. ..

..Lastly the study will begin to evaluate the relationship of PYY3-36 and ghrelin and determine if it is altered by or in response to the physiologic changes associated with gastric bypass. ..

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..Surgical and interventional services span the continuum of healthcare conditions and SCOAP CERTN will have immediate capacity for investigators interested in almost any of AHRQ's priority conditions. ..