25 results on '"Essani, Rahila"'
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2. Stoma Prolapse
- Author
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Essani, Rahila
- Published
- 2012
- Full Text
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3. Colonoscopic injection for murine solid cecal cancer model
- Author
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Karas, Joshua R., Essani, Rahila, Haughn, Christopher, Uchal, Miroslav, Bishawi, Muath M., and Bergamaschi, Roberto
- Published
- 2011
- Full Text
- View/download PDF
4. Prolonged Postoperative Ileus—Definition, Risk Factors, and Predictors after Surgery
- Author
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Artinyan, Avo, Nunoo-Mensah, Joseph W., Balasubramaniam, Swarna, Gauderman, Jim, Essani, Rahila, Gonzalez-Ruiz, Claudia, Kaiser, Andreas M., and Beart, Jr., Robert W.
- Published
- 2008
- Full Text
- View/download PDF
5. Cost-saving effect of treatment algorithm for chronic anal fissure: A prospective analysis
- Author
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Essani, Rahila, Sarkisyan, Grant, Beart, Robert W., Ault, Glenn, Vukasin, Petar, and Kaiser, Andreas M.
- Published
- 2005
- Full Text
- View/download PDF
6. Management of Retained Colorectal Foreign Bodies: Predictors of Operative Intervention
- Author
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Lake, Jeffrey P., Essani, Rahila, Petrone, Patrizio, Kaiser, Andreas M., Asensio, Juan, and Beart, Jr, Robert W.
- Published
- 2004
- Full Text
- View/download PDF
7. Use of High-Dose-Rate Brachytherapy in the Management of Locally Recurrent Rectal Cancer
- Author
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Kuehne, Jonathan, Kleisli, Thomas, Biernacki, Peter, Girvigian, Michael, Streeter, Oscar, Corman, Marvin L., Ortega, Adrian E., Vukasin, Petar, Essani, Rahila, and Beart, Robert W.
- Published
- 2003
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- View/download PDF
8. Treatment of Obstructed Defecation
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Ellis, C. Neal and Essani, Rahila
- Published
- 2012
9. Chapter 159 - Fissure-in-Ano
- Author
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Essani, Rahila and Papaconstantinou, Harry T.
- Published
- 2019
- Full Text
- View/download PDF
10. Molecular Predictors of Lymph Node Metastasis in Colon Cancer: Increased Risk With Decreased Thymidylate Synthase Expression
- Author
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Artinyan, Avo, Essani, Rahila, Lake, Jeffrey, Kaiser, Andreas M., Vukasin, Peter, Danenberg, Peter, Danenberg, Kathleen, Haile, Robert, and Beart, Robert W., Jr.
- Published
- 2005
- Full Text
- View/download PDF
11. Outpatient colectomy—a dream or reality?
- Author
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Campbell, Stephen, Fichera, Alessandro, Thomas, Scott, Papaconstantinou, Harry, and Essani, Rahila
- Abstract
Whereas the advancement of minimally invasive surgical techniques and enhanced recovery after surgery (ERAS) pathways for partial colectomies has shortened postoperative length of stay, the ideal length of stay after partial colectomy with or without diverting loop ileostomy is still up for debate. This article examines the safety and efficacy of discharging select patients home from day surgery following partial colectomy. We performed a retrospective review of 7 patients who underwent partial colectomy at one tertiary care center from December 2020 to August 2021. None of our cases suffered complications such as anastomotic leak, surgical site infection, or bowel obstruction or required admission to the hospital. One patient was seen in the emergency department on postoperative day 1 for nausea and vomiting and was managed as an outpatient. A second patient required a fluid bolus in the clinic for high ileostomy output. In conclusion, our study suggests that appropriately selected patients can be successfully managed in the outpatient setting without increased complications following partial colectomy when preoperative preparation and education are put in place alongside our colon ERAS pathway and minimally invasive surgical techniques. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
12. The Management of Complicated Diverticulitis and the Role of Computed Tomography
- Author
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Kaiser, Andreas M., Jiang, Jeng-Kae, Lake, Jeffrey P., Ault, Glenn, Artinyan, Avo, Gonzalez-Ruiz, Claudia, Essani, Rahila, and Beart, Robert W., Jr
- Published
- 2005
13. Laparoscopic repair of chronic intrathoracic gastric volvulus
- Author
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Katkhouda, Namir, Mavor, Eli, Achanta, Kranthi, Friedlander, Melanie H., Grant, Steven W., Essani, Rahila, Mason, Rodney J., Foster, Megan, and Mouiel, Jean
- Published
- 2000
14. Intraabdominal abscess rate after laparoscopic appendectomy
- Author
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Katkhouda, Namir, Friedlander, Melanie H, Grant, Steven W, Achanta, Kranthi K, Essani, Rahila, Paik, Peter, Velmahos, George, Campos, Guillermo, Mason, Rodney, and Mavor, Eli
- Published
- 2000
- Full Text
- View/download PDF
15. Evaluation of the Educational Environment of a Cadaver Course in Robotic Colorectal Surgery: A Cross-sectional Study.
- Author
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YOU, KAREN, ANGELOS, GEORGE, BENDL, RYAN, ANDERSON, CRISTAN, ESSANI, RAHILA, ZAKHALEVA, JULIA, AMRANI, SALIM, BARNAJIAN, MOSHE, KARAS, JOSHUA, and BERGAMASCHI, ROBERTO
- Published
- 2019
16. Contributors
- Author
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Abbas, Abbas E., Adams, David B., Aggarwal, Piyush, Ahmed, Bestoun H., Albanese, Craig, Albert, Matthew R., Ali, Abubaker, Alicuben, Evan, Allaix, Marco E., Altman, Ashley, Ando, Hisami, Andolfi, Ciro, Annamalai, Alagappan, Asare, Elliot A., Asti, Emanuele, Auchincloss, Hugh G., Babic, Benjamin, Baker, Talia B., Ball, Chad G., Barbetta, Arianna, Barlow, John M., Barr, Justin, Barreto, Juan Camilo, Barry, Linda, Beal, Eliza W., Beard, Kristin Wilson, Beck, David E., Behrns, Kevin E., Bellevue, Oliver C., Bellorin-Marin, Omar E., Bergman, Jacques, Berry, James, Besselink, Marc G.H., Bharucha, Adil E., Bilchik, Anton J., Bildzukewicz, Nikolai A., Bingham, Jason, Birnbaum, Elisa, Black, Sylvester M., Blackmon, Shanda H., Bleier, Joshua I.S., Bodzin, Adam S., Boland, C. Richard, Bolton, John, Bolton, Nathan, Bonavina, Luigi, Bonds, Morgan, Bouwense, Stefan A.W., Boys, Joshua A., Bravo-Infante, Raquel, Bremner, Ross M., Brenner, Bruce M., Brown, Shaun R., Callery, Mark P., Cameron, John L., Camilleri, Michael, Campbell, Jacob, Cassim, Riaz, Castillo-Angeles, Manuel, Cauley, Christy, Cavaness, Keith M., Cerfolio, Robert J., Champagne, Bradley J., Chandrasoma, Parakrama, Chang, Alex L., Chapman, Christopher G., Chapman, William C., Cheek, Susannah, Chen, Harvey S., Cho, Clifford S., Choi, Eric T., Choi, Eugene A., Chojnacki, Karen A., Choti, Michael A., Christie, Ian, Chua, Heidi, Church, James M., Cioffi, Jessica L., Clark, Susannah, Clavien, Pierre-Alain, Cloud, Adam, Colavita, Paul D., Colquhoun, Steven D., Conway, William, Cools-Lartigue, Jonathan, Coosemans, Willy, Cornwell, Edward E., III, Costantini, Mario, Coyle, Yvonne, Craig, Daniel A., Croome, Kristopher P., Cullen, Joseph J., D'Andrea, Anthony P., Dassopoulos, Themistocles, Davila, Marta L., Davila, Raquel E., DeMeester, Steven R., DeMeester, Tom R., Dempsey, Daniel T., dePrisco, Gregory, Depypere, Lieven, Dietz, David W., Dillhoff, Mary E., DiNorcia, Joseph, Doane, Stephen M., Dogeas, Epameinondas, Dozois, Eric J., Dumon, Kristoffel, Dunn, Stephen P., Dunst, Christy M., Dussel, John N., Dyer, Matthew, Efron, Jonathan, El-Gohary, Yousef, Lakis, Mustapha El, Ellison, E. Christopher, Ellsmere, James, Essani, Rahila, Evans, Douglas B., Fang, Sandy H., Fasen, Geoffrey, Fernando, Hiran C., Ferri, Lorenzo, Fichera, Alessandro, Finck, Christine, Fisher, Oliver M., Fleshman, James W., Fong, Yuman, Foreman, Michael L., Francone, Todd D., Franko, Edward R., French, Daniel, Fuchs, Hans Friedrich, Fuchs, Karl Hermann, Funaki, Brian, Funk, Geoffrey A., Fusco, Joseph, Gaitonde, Shrawan G., Gajjar, Aakash H., Garcia-Aguilar, Julio, Gearhart, Susan, Geller, David A., Ghobadi, Comeron, Gilbert, Sebastien, Giles, David, Gillaspie, Erin, Girotti, Micah, Gittes, George K., Goodman, Michael D., Gooszen, Hein G., Gores, Gregory J., Griffin, James F., Griffin, S. Michael, Grimm, Leander, Jr., Grochola, L.F., Habib, Fahim, Hanks, John B., Harris, James E., Jr., Hartwig, Matthew G., Hassan, Imran, Hedrick, Traci L., Hicks, Terry C., Hodin, Richard, Hofstetter, Wayne L., Hogg, Melissa, Hu, Yue-Yung, Hungness, Eric S., Hunt, Steven R., Huseynova, Khumara, Hyman, Neil H., Iannitti, David A., Indes, Jeffrey, Jenkins, Megan, Jensen, Todd, Jeziorczak, Paul M., Jilani, Danial, Jiménez-Toscano, Marta, Jobe, Blair A., Johnston, Lily E., Kahrilas, Peter J., Kalady, Matthew F., Kassira, Noor, Katkhouda, Namir, Katz, Philip O., Keller, Deborah S., Kelley, Matthew P., Kennedy, Gregory D., Kent, Tara Sotsky, Kia, Leila, Kibbe, Melina R., Kim, John, King, Alice, Kiran, Ravi P., Kirton, Orlando C., Klein, Andrew, Klein, Eric N., Kohn, Geoffrey P., Kovell, Robert Caleb, Kozol, Robert, Lacy, Antonio M., Ladner, Daniela P., Lagarde, S.M., Laituri, Carrie A., Landmann, Alessandra, Lee, Janet T., Lee, Lawrence L., Leinicke, Jennifer A., Lerut, Toni, Levi, David M., Li, Chao, Liang, Yu, Lichliter, Andrew H., Lichliter, Warren E., Lightner, Amy L., Lile, Deacon J., Lillemoe, Keith D., Lin, Jules, Lin, Shu S., Lipham, John C., Litle, Virginia R., Lodhia, Nayna A., Longo, Walter E., Lord, Reginald V.N., Louie, Brian E., Low, Donald E., Lowe, Val J., Luc, Jessica G.Y., Luketich, James D., Ma, Yanling, MacCarty, Robert L., MacDonald, Blair, Madoff, Robert D., Magge, Deepa, Maheshwari, Anurag, Mahmoud, Najjia N., Mahvi, David A., Mahvi, David M., Mak, Grace Z., Mansfield, Sara A., Manzano, Maricarmen, Maron, David J., Mathew, Melvy S., Mathis, Kellie L., Matthews, Jeffrey B., McFadden, David W., Merchea, Amit, Messaris, Evangelos, Miller, Daniel L., Miller, Heidi J., Millis, J. Michael, Mittal, Sumeet K., Molena, Daniela, Montgomery, Stephanie C., Moore, Ryan, Morgan, Katherine A., Mortenson, Melinda M., Mulholland, Michael W., Mulvihill, Michael S., Mutch, Matthew, Nafteux, Philippe Robert, Nagaraju, Arun, Nagorney, David M., Nathan, Hari, Natoli, Karen R., Navuluri, Rakesh, Nissen, Nicholas N., Nobel, Tamar B., Noordman, B.J., Norton, Jeffrey A., Novitsky, Yuri W., Nussbaum, Michael S., Nyberg, Scott L., Oelschlager, Brant K., Oh, Daniel S., Otero-Piñeiro, Ana, Oto, Aytekin, Pachter, H. Leon, Paidas, Charles N., Palazzo, Francesco, Paniccia, Alessandro, Papaconstantinou, Harry T., Pappas, Theodore N., Pappou, Emmanouil P., Parikh, Manish, Paruch, Jennifer L., Patel, Asish D., Patel, Mikin, Patti, Marco G., Paulson, Emily Carter, Pawlik, Timothy M., Payne, Isaac, Pemberton, John H., Pendola, Michael, Perez, Alexander, Pernar, Luise I.M., Peters, Walter R., Jr., Petrowsky, Henrik, Peyre, Christian G., Phillips, Alexander W., Pillai, Lashmikumar, Plummer, Joseph M., Pointer, David T., Jr., Poruk, Katherine E., Posner, Mitchell C., Postier, Russell, Prachand, Vivek N., Pritts, Timothy A., Quatrino, Gregory, Ranka, Sagar, Rattner, David W., Reavis, Kevin M., Reddy, Vikram B., Remzi, Feza H., Ricciardi, Rocco, Rice, Thomas W., Richman, Aaron, Rider, Paul, Roberts, John Paul, Roberts, Patricia L., Roggin, Kevin K., Roll, Garrett Richard, Rona, Kais, Rosen, Charles B., Ross, Samuel Wade, Roth, J. Scott, Rushing, Amy P., Safar, Bashar, Saldinger, Pierre F., Samakar, Kamran, Sandhu, Kulmeet K., Schaheen, Lara W., Schirmer, Bruce, Schneider, Andrew, Schulick, Richard D., Schwab, Ben, Scurci, Stephanie, Senagore, Anthony, Shah, Adil A., Shah, Shimul A., Shames, Brian, Shanmugan, Skandan, Shapiro, David S., Silviera, Matthew, Slakey, Douglas P., Sloan, Joshua, Smallwood, Nathan, Smith, Shane P., Smithers, B. Mark, Smoot, Rory L., Soares, Kevin C., Soffer, Edy, Solomina, Julia, Soper, Nathaniel J., Spechler, Stuart Jon, Sridhar, Praveen, Steele, Scott R., Sternbach, Joel M., Stevenson, Christina E., Strong, Scott A., Sucandy, Iswanto, Sundaram, Magesh, Sundaresan, Sudhir, Swanstrom, Lee L., Sylla, Patricia, Takada, Tadahiro, Talbot, Ethan, Tam, Vernissia, Tamm, Eric P., Tatarian, Talar, Tavakkoli, Ali, Te, Helen S., Teitelbaum, Ezra N., Ternent, Charles A., Thompson, Jon S., Thomson, Iain, Thorson, Alan G., Thorson, Chad M., Totten, Crystal F., Truty, Mark J., Tsai, Susan, Tseng, Jennifer, Tullius, Tom, Tzakis, Andreas G., van Lanschot, J.J.B., van Santvoort, Hjalmar C., Van Veer, Hans, Vega, Jorge A., Jr., Velanovich, Vic, Vogler, Sarah A., Wang, Huamin, Ward, Mark A., Warner, Brad W., Warner, Susanne G., Watson, Thomas J., Waxman, Irving, Webster-Lake, Carissa, Wei, Benjamin, Weiser, Martin R., Wells, Dennis, Wells, Katerina, Welton, Mark Lane, Wen, Yuxiang, Wendling, Mark R., Wesson, Hadley K.H., Wexner, Steven D., White, Rebekah R., Whitlow, Charles B., Wijnhoven, B.P.L., Wilkes, Justin, Wilson, Rickesha L., Witkowski, Piotr, Wolfgang, Christopher L., Worrell, Stephanie G., Yang, Jian, Yeo, Charles J., Yeung, Ching, Yung, Evan E., Zafar, Syed Nabeel, Zaninotto, Giovanni, Zeh, Herbert, III, Zehetner, Joerg, Zenilman, Michael E., Zimmerman, Pamela, and Zuccaro, Gregory, Jr.
- Published
- 2019
- Full Text
- View/download PDF
17. Simulated Laparoscopic Sigmoidectomy Training: Responsiveness of Surgery Residents.
- Author
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Essani, Rahila, Scriven, Richard J., McLarty, Allison J., Merriam, Louis T., Ahn, Hongshik, and Bergamaschi, Roberto
- Published
- 2009
- Full Text
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18. Anastomotic leak in colorectal surgery: a review.
- Author
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Essani, Rahila and Bergamaschi, Roberto
- Subjects
- *
COLON surgery , *OPERATIVE surgery , *SURGICAL complications , *SURGICAL instruments , *MEDICAL errors , *PREOPERATIVE risk factors , *MORTALITY - Abstract
Anastomotic leak is a major complication of colorectal surgery, leading to significant morbidity and mortality. This article focuses on definitions of anastomotic and subclinical leaks, risk factors associated with anastomotic leaks, relevance of surgical rituals, and use of imaging studies in diagnosing leaks. Surgeon skill is one of the most important determinants of clinical anastomotic leakage after colorectal surgery. Other factors known to affect anastomotic healing include: blood supply, steroids, contaminated wound, and nutrition. Although a surgeon makes a decision about technique or a clinical judgment based largely upon personal preference and perception of a particular advantage, surgical rituals such as handsewn vs. stapled anastomois, use of pelvic drains, creation of defunctioning ileostomy are reviewed based on the literature available. Computed tomography (CT) imaging has been reported to be effective in identifying patients with anastomotic leaks and can detect intra-abdominal and perianastomotic abscesses, which can mimic the signs and symptoms of an anastomotic leak. However, watersoluble contrast enema seems superior to CT for diagnosis of anastomotic leak. [ABSTRACT FROM AUTHOR]
- Published
- 2009
19. Prophylactic ureteral catheter placement for minimally invasive colorectal surgery.
- Author
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Dowd, Katherine E., Muse, Tommy O., Lowry, Patrick S., and Essani, Rahila
- Abstract
Ureteral catheter placement for identification of ureters during colorectal surgery has been a controversial subject with ill-defined indications. We present a case of ureteral catheter placement wherein the patient required readmission for renal failure with intervention under local anesthesia. This case highlights the importance of patient selection for catheter placement and clinical follow-up, as well as the need for prospective studies to determine the risk-benefit ratio of preoperative catheters. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
20. The Authors Reply.
- Author
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Lake, Jeffrey, Essani, Rahila, Petrone, Patrizio, Kaiser, Andreas, Asensio, Juan, and Beart, Robert
- Abstract
A response by Jeffrey Lake, Rahila Essani, Patrizio Petrone, Andreas Kaiser, Juan Asensio, and Robert Beart to a letter to the editor about the management of the retained rectal foreign bodies is presented.
- Published
- 2006
- Full Text
- View/download PDF
21. Impact of complications on length of stay in elective laparoscopic colectomies.
- Author
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Mrdutt, Mary Megan, Isbell, Claire L., Thomas, J. Scott, Shaver, Courtney N., Essani, Rahila, Warrier, Rajalakshmi, and Papaconstantinou, Harry Troy
- Subjects
- *
COLECTOMY , *COST laws , *QUALITY control , *MYOCARDIAL infarction , *CARDIOGENIC shock - Abstract
Background Length of hospital stay (LOS) is an indirect measure of surgical quality and a surrogate for cost. The impact of postoperative complications on LOS following elective colorectal surgery is not well defined. The purpose of this study is to determine the contribution of specific complications towards LOS in elective laparoscopic colectomy patients. Materials and methods American College of Surgeon's National Surgical Quality Improvement Program database (2011-2014) was queried for patients undergoing elective laparoscopic partial colectomy with primary anastomosis. Demographics, specific 30 d postoperative complications and LOS, were evaluated. A negative binomial regression adjusting for demographic variables and complications was performed to explore the impact of individual complications on LOS, significance set at P < 0.05. Results A total of 42,365 patients were evaluated, with an overall median LOS 4.0 d (interquartile range, 3.0-5.0). Unplanned reoperation and pneumonia each increase LOS by 50%; superficial surgical site infections (SSIs), organ space SSI sepsis, urinary tract infection, ventilation >48 h, pulmonary embolism, and myocardial infarction each increase LOS by at least 25% ( P < 0.0001). When accounting for additional LOS and rate of complications, unplanned reoperation, bleeding requiring transfusion within 72 h, and superficial SSIs were the highest impact complications. Conclusions In laparoscopic colectomy, each complication uniquely impacts LOS, and therefore cost. Utilizing this model, individual hospitals can implement pathways targeting specific complication profiles to improve care and minimize health care cost. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
22. Outpatient colectomy-a dream or reality?
- Author
-
Campbell S, Fichera A, Thomas S, Papaconstantinou H, and Essani R
- Abstract
Whereas the advancement of minimally invasive surgical techniques and enhanced recovery after surgery (ERAS) pathways for partial colectomies has shortened postoperative length of stay, the ideal length of stay after partial colectomy with or without diverting loop ileostomy is still up for debate. This article examines the safety and efficacy of discharging select patients home from day surgery following partial colectomy. We performed a retrospective review of 7 patients who underwent partial colectomy at one tertiary care center from December 2020 to August 2021. None of our cases suffered complications such as anastomotic leak, surgical site infection, or bowel obstruction or required admission to the hospital. One patient was seen in the emergency department on postoperative day 1 for nausea and vomiting and was managed as an outpatient. A second patient required a fluid bolus in the clinic for high ileostomy output. In conclusion, our study suggests that appropriately selected patients can be successfully managed in the outpatient setting without increased complications following partial colectomy when preoperative preparation and education are put in place alongside our colon ERAS pathway and minimally invasive surgical techniques., (Copyright © 2021 Baylor University Medical Center.)
- Published
- 2021
- Full Text
- View/download PDF
23. Prophylactic ureteral catheter placement for minimally invasive colorectal surgery.
- Author
-
Dowd KE, Muse TO, Lowry PS, and Essani R
- Abstract
Ureteral catheter placement for identification of ureters during colorectal surgery has been a controversial subject with ill-defined indications. We present a case of ureteral catheter placement wherein the patient required readmission for renal failure with intervention under local anesthesia. This case highlights the importance of patient selection for catheter placement and clinical follow-up, as well as the need for prospective studies to determine the risk-benefit ratio of preoperative catheters., (Copyright © 2020 Baylor University Medical Center.)
- Published
- 2019
- Full Text
- View/download PDF
24. Evaluation of the Educational Environment of a Cadaver Course in Robotic Colorectal Surgery: A Cross-sectional Study.
- Author
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Gachabayov M, You K, Angelos GA, Bendl R, Anderson C, Essani R, Zakhaleva J, Amrani S, Barnajian M, Karas J, and Bergamaschi R
- Subjects
- Attitude of Health Personnel, Cadaver, Cross-Sectional Studies, Educational Measurement, Humans, Internship and Residency, Surgeons education, Surveys and Questionnaires, Colorectal Surgery education, Program Evaluation, Robotic Surgical Procedures education
- Abstract
Background: The educational environment is a crucial metric of medical education that affects the course participants' motivation, achievement, happiness and success. The aim of this study was to evaluate the educational environment of a cadaver course in robotic colorectal surgery by comparing the perceptions of the participating residents to those of the participating surgeons., Methods: This was a cross-sectional study carried out in 2017. Participants from the U.S. and Europe attended a course using eight fresh frozen cadaver torsos with no prior abdominal surgery. After course completion, participants anonymously completed 50-item Dundee Ready Educational Environment Measure (DREEM) questionnaires to evaluate five components of the educational environment: perception of learning, perception of teachers, academic self-perception, perception of atmosphere, and social self-perception. Internal consistency of the questionnaire was assessed using Cronbach's alpha coefficient. Mean scores were compared using an independent samples t-test., Results: Twenty of 24 participants completed the DREEM questionnaire, consisting of 9 residents and 11 surgeons (12 from the U.S., 8 from Europe). The internal consistency of the questionnaire was excellent (alpha=0.97). The mean total score was excellent for both residents and surgeons, and the difference between the groups was not significant (154.1±25.8 vs. 168.1±18.9, p=0.197). Perception of learning was significantly better among surgeons ("teaching highly thought of") than among residents ("a more positive perception") (40.5±3.6 vs. 35.7±5.6, p=0.04)., Conclusions: This study suggests that the residents' perception of learning may have been negatively influenced by the participation of surgeons in the same cadaver station.
- Published
- 2019
25. Laparoscopic versus open appendectomy: a prospective randomized double-blind study.
- Author
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Katkhouda N, Mason RJ, Towfigh S, Gevorgyan A, and Essani R
- Subjects
- Adolescent, Adult, Aged, Appendicitis surgery, Double-Blind Method, Female, Humans, Laparoscopy, Male, Middle Aged, Postoperative Complications, Prospective Studies, Treatment Outcome, Appendectomy methods
- Abstract
Summary Background Data: The value of laparoscopy in appendicitis is not established. Studies suffer from multiple limitations. Our aim is to compare the safety and benefits of laparoscopic versus open appendectomy in a prospective randomized double blind study., Methods: Two hundred forty-seven patients were analyzed following either laparoscopic or open appendectomy. A standardized wound dressing was applied blinding both patients and independent data collectors. Surgical technique was standardized among 4 surgeons. The main outcome measures were postoperative complications. Secondary outcome measures included evaluation of pain and activity scores at base line preoperatively and on every postoperative day, as well as resumption of diet and length of stay. Activity scores and quality of life were assessed on short-term follow-up., Results: There was no mortality. The overall complication rate was similar in both groups (18.5% versus 17% in the laparoscopic and open groups respectively), but some early complications in the laparoscopic group required a reoperation. Operating time was significantly longer in the laparoscopic group (80 minutes versus 60 minutes; P = 0.000) while there was no difference in the pain scores and medications, resumption of diet, length of stay, or activity scores. At 2 weeks, there was no difference in the activity or pain scores, but physical health and general scores on the short-form 36 (SF36) quality of life assessment forms were significantly better in the laparoscopic group. Appendectomy for acute or complicated (perforated and gangrenous) appendicitis had similar complication rates, regardless of the technique (P = 0.181)., Conclusions: Unlike other minimally invasive procedures, laparoscopic appendectomy did not offer a significant advantage over open appendectomy in all studied parameters except quality of life scores at 2 weeks. It also took longer to perform. The choice of the procedure should be based on surgeon or patient preference.
- Published
- 2005
- Full Text
- View/download PDF
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