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5 results on '"Janice F. Rafferty"'

1. Enhanced recovery protocol improves postoperative outcomes and minimizes narcotic use following resection for colon and rectal cancer

Author

Alexander R. Cortez, Al-Faraaz Kassam, Nick C. Levinsky, Andrew D. Jung, Meghan C. Daly, Shimul A. Shah, Janice F. Rafferty, and Ian M. Paquette

Subjects
Surgery, RD1-811
Abstract

Background: Enhanced recovery protocols are associated with improved recovery. However, data on outcomes following the implementation of an enhanced recovery protocol in colorectal cancer are limited. We set out to study the postoperative outcomes, opioid use patterns, and cost impact for patients undergoing colon or rectal resection for cancer. Methods: A retrospective review of all elective colorectal cancer resections from January 2015 to June 2018 at a single institution was performed. Patient demographics, operative details, and postoperative outcomes were collected. Colon and rectal patients were studied separately, with comparison of patients before and after the implementation of an enhanced recovery protocol. Results: One hundred ninety-two patients underwent elective colorectal resection for cancer. In January 2016, an enhanced recovery protocol was implemented for all elective resections – 71 patients (33 colon and 38 rectal) underwent surgery before implementation and 121 patients (56 colon and 65 rectal) underwent surgery after implementation of the enhanced recovery protocol. There were no differences with regard to age, gender, or body mass index before or after implementation (all P > .05). For both colon and rectal cancer patients, the enhanced recovery protocol reduced time to regular diet (both P

Published
2019
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3. Use of fluorescence imaging and indocyanine green during colorectal surgery: Results of an intercontinental Delphi survey

Author

Steven Wexner, Mahmoud Abu-Gazala, Luigi Boni, Kenneth Buxey, Ronan Cahill, Thomas Carus, Sami Chadi, Manish Chand, Chris Cunningham, Sameh Hany Emile, Abe Fingerhut, Chi Chung Foo, Roel Hompes, Argyrios Ioannidis, Deborah S. Keller, Joep Knol, Antonio Lacy, F. Borja de Lacy, Gabriel Liberale, Joseph Martz, Ido Mizrahi, Isacco Montroni, Neil Mortensen, Janice F. Rafferty, Aaron S. Rickles, Frederic Ris, Bashar Safar, Danny Sherwinter, Pierpaolo Sileri, Michael Stamos, Paul Starker, Jacqueline Van den Bos, Jun Watanabe, Joshua H. Wolf, Shlomo Yellinek, Oded Zmora, Kevin P. White, Fernando Dip, Raul J. Rosenthal, RS: NUTRIM - R2 - Liver and digestive health, Surgery, CCA - Cancer Treatment and Quality of Life, and CCA - Imaging and biomarkers

Subjects
Indocyanine Green, Sentinel Lymph Node Biopsy, Optical Imaging, Humans, Surgery, Colorectal Surgery, Digestive System Surgical Procedures
Abstract

BACKGROUND: Fluorescence imaging with indocyanine green is increasingly being used in colorectal surgery to assess anastomotic perfusion, and to detect sentinel lymph nodes.METHODS: In this 2-round, online, Delphi survey, 35 international experts were asked to vote on 69 statements pertaining to patient preparation and contraindications to fluorescence imaging during colorectal surgery, indications, technical aspects, potential advantages/disadvantages, and effectiveness versus limitations, and training and research. Methodological steps were adopted during survey design to minimize risk of bias.RESULTS: More than 70% consensus was reached on 60 of 69 statements, including moderate-strong consensus regarding fluorescence imaging's value assessing anastomotic perfusion and leak risk, but not on its value mapping sentinel nodes. Similarly, although consensus was reached regarding most technical aspects of its use assessing anastomoses, little consensus was achieved for lymph-node assessments. Evaluating anastomoses, experts agreed that the optimum total indocyanine green dose and timing are 5 to 10 mg and 30 to 60 seconds pre-evaluation, indocyanine green should be dosed milligram/kilogram, lines should be flushed with saline, and indocyanine green can be readministered if bright perfusion is not achieved, although how long surgeons should wait remains unknown. The only consensus achieved for lymph-node assessments was that 2 to 4 injection points are needed. Ninety-six percent and 100% consensus were reached that fluorescence imaging will increase in practice and research over the next decade, respectively.CONCLUSION: Although further research remains necessary, fluorescence imaging appears to have value assessing anastomotic perfusion, but its value for lymph-node mapping remains questionable.

Published
2022

4. Gordon and Nivatvongs' Principles and Practice of Surgery for the Colon, Rectum, and Anus

Author

David E. Beck, Steven D. Wexner, Janice F. Rafferty, David E. Beck, Steven D. Wexner, and Janice F. Rafferty

Subjects
Colonic Diseases--surgery, Rectal Diseases--surgery, Anus Diseases--surgery, Colorectal Neoplasms--surgery
Abstract

The most comprehensive and authoritative reference available today on colorectal surgeryThis revised fourth edition of Gordon and Nivatvongs'Principles and Practice of Surgery for the Colon, Rectum, and Anus edited by David Beck, Steven Wexner, and Janice Rafferty strikes a perfect balance between evidence-based medicine, in-depth details, and clinical pearls. The result is a highly engaging and authoritative tome in the grand tradition of Philip Gordon and Santhat Nivatvongs. Building on the widely acclaimed previous editions'reputation for superb quality and reader-friendliness, the fourth edition includes contributions from an expanded cadre of internationally known experts.Significant advances have been made in this field since the third edition was published. The latest diagnostic modalities are highlighted such as MRI, CT angiography, and enterography. The first section covers essentials such as anatomy, physiology, diagnosis, colonoscopy, and patient management. Sections two through four discuss a full spectrum of anorectal diseases, colorectal disorders, trauma, unexpected challenges, and complications. Among the additions are expanded sections on transanal total mesorectal excision, genetics, personalized medicine,'wait and watch'principles, outpatient management of anorectal surgery, and large bowel obstruction.Key HighlightsThirty-seven chapters cover a wide array of gastrointestinal disorders such as fecal incontinence, ulcerative colitis, Crohn's disease, diverticulitis, carcinomas, and other malignant lesionsA multidisciplinary team approach to rectal cancer encompasses rectal cancer protocol MRI, synoptic reporting, and various neoadjuvant therapy protocolsThe use of cutting-edge approaches including laparoscopy, robotics, hyperbaric oxygen, and radiofrequency tissue remodelingSuperb full-color plates, illustrations, photographs, diagrams, detailed tables, graphics, and surgical videos elucidate underlying disease and managementAs the most comprehensive resource on colorectal surgery available on the market today, this is a must-have for every colon and rectal surgeon – from residents to veteran practitioners.

Published
2019

5. Laparoscopy for Benign Colorectal Diseases

Author

Janice F. Rafferty and Thomas Shin

Subjects
Laparoscopic surgery, medicine.medical_specialty, medicine.diagnostic_test, business.industry, medicine.medical_treatment, General surgery, Gastroenterology, Disease, Diverticulitis, medicine.disease, Ulcerative colitis, Article, Surgery, Bowel obstruction, Rectal prolapse, medicine, Colitis, business, Laparoscopy
Abstract

The applicability of laparoscopy to many complex intraabdominal colorectal procedures continues to expand, and has been shown to be feasible and safe in experienced hands. Data are available on the elderly, rectal prolapse, diverticulitis, Hartman's takedown, small bowel obstruction, Crohn's disease, and ulcerative colitis. Clinically relevant advantages have been clearly demonstrated in selected patient populations. Laparoscopic surgery for benign colorectal disease should be considered in patients suitable for this approach to an abdominal operation.

Published
2010

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