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John Migaly

Associate Professor of Surgery
Surgical Oncology

Selected Publications


Who Benefits? An Assessment of Resident Benefits at Top 50 Academic Institutions.

Journal Article J Surg Educ · March 2024 OBJECTIVE: Residency serves as a crucial time in the professional and personal development of young physicians. Extensive effort is devoted to the clinical training of residents across the country. However, many residents report concerns with compensation, ... Full text Link to item Cite

Surgical Residents as Clerkship Scholars May Improve Student Perception of the Surgery Clerkship.

Journal Article J Surg Res · February 2024 INTRODUCTION: The surgical clerkship is a formative experience in the medical school curriculum and can leave a lasting impression on students' perception of surgery. Given the historical negative stereotypes of surgeons, the clerkship represents an opport ... Full text Link to item Cite

Revisiting Medical Student Expectations on the Surgery Clerkship.

Journal Article J Surg Educ · October 2023 OBJECTIVE: Medical students frequently report ambiguity of expectations in their feedback of the surgery clerkship. Herein, we aimed to gauge general surgery resident and attending expectations of students on their clerkship. DESIGN: Residents and attendin ... Full text Link to item Cite

A novel low-cost model of superficial abscess for trainee education in incision and drainage.

Journal Article Surg Open Sci · August 2023 BACKGROUND: Proficiency in ultrasound usage is quickly becoming an expectation in multiple residency programs: emergency medicine, obstetrics-gynecology, surgery, and internal medicine. There is a lack of affordable training devices for ultrasound training ... Full text Link to item Cite

The Surgical Subinternship: A Unique Opportunity for Early Leadership Development.

Journal Article J Surg Educ · June 2023 Subinternships are formative rotations in the surgery-bound medical student's journey to surgical training. This experience allows for further exploration of career goals, plays an important evaluative role in the residency selection process, and offers on ... Full text Link to item Cite

Outcomes of an Algorithmic, Multidisciplinary Approach to Rectourethral Fistula Repair: A Pre- and Postintervention Quasi-Experimental Study.

Conference Dis Colon Rectum · April 1, 2023 BACKGROUND: Rectourethral fistulas are a rare yet severe complication of prostate surgery, pelvic irradiation therapy, or both. Multiple surgical repairs exist with widely varying success rates. OBJECTIVE: This study aimed to present our institutional mult ... Full text Link to item Cite

Management of neuroendocrine tumors of the rectum

Journal Article Seminars in Colon and Rectal Surgery · September 1, 2022 Rectal neuroendocrine tumors (NETs) have increased in prevalence due to increased detection via endoscopic screening for colorectal neoplasia, advances and availability of imaging tools along with the indolent nature of the tumor. Imaging techniques to ide ... Full text Cite

Combined Primary Resection with Hepatic Artery Infusion Pump Implantation Is Safe for Unresectable Colorectal Liver Metastases.

Journal Article J Gastrointest Surg · April 2022 BACKGROUND: Colorectal liver metastases (CRLM) are the most common cause of disease-specific mortality in patients with colorectal cancer. Hepatic artery infusion (HAI) combined with systemic chemotherapy improves survival for these patients. The safety of ... Full text Link to item Cite

Postoperative changes in cognition and cerebrospinal fluid neurodegenerative disease biomarkers.

Journal Article Ann Clin Transl Neurol · February 2022 OBJECTIVE: Numerous investigators have theorized that postoperative changes in Alzheimer's disease neuropathology may underlie postoperative neurocognitive disorders. Thus, we determined the relationship between postoperative changes in cognition and cereb ... Full text Open Access Link to item Cite

Two Compartment Evaluation of Liver Grafts During Acellular Room Temperature Machine Perfusion (acRTMP) in a Rat Liver Transplant Model.

Journal Article Front Med (Lausanne) · 2022 BACKGROUND: Subnormothermic machine perfusion (SNMP) of liver grafts is currently less clinically developed than normothermic and hypothermic approaches, but may have logistical advantages. At intermediate temperatures, the oxygen demand of the graft is lo ... Full text Link to item Cite

Perioperative neurocognitive and functional neuroimaging trajectories in older APOE4 carriers compared with non-carriers: secondary analysis of a prospective cohort study.

Journal Article Br J Anaesth · December 2021 BACKGROUND: Cognitive dysfunction after surgery is a major issue in older adults. Here, we determined the effect of APOE4 on perioperative neurocognitive function in older patients. METHODS: We enrolled 140 English-speaking patients ≥60 yr old scheduled fo ... Full text Open Access Link to item Cite

Quantified electronic health record (EHR) use by academic surgeons.

Journal Article Surgery · June 2021 BACKGROUND: The electronic health record has improved medical billing, research, and sharing of patient data, but its clinical use by physicians has been linked to rising physician burnout leading to numerous subjective editorials about the electronic heal ... Full text Link to item Cite

Does Fragmentation of Care in Locally Advanced Rectal Cancer Increase Patient Mortality?

Journal Article J Gastrointest Surg · May 2021 OBJECTIVE: To evaluate health care fragmentation in patients with stage II and III rectal cancers. BACKGROUND: Fragmentation of care among multiple hospitals may worsen outcomes for cancer patients. METHODS: National Cancer Database was queried for adult p ... Full text Link to item Cite

Immunomodulatory lipid mediator profiling of cerebrospinal fluid following surgery in older adults.

Journal Article Sci Rep · February 4, 2021 Arachidonic acid (AA), docosahexaenoic acid (DHA), and eicosapentaenoic acid (EPA) derived lipids play key roles in initiating and resolving inflammation. Neuro-inflammation is thought to play a causal role in perioperative neurocognitive disorders, yet th ... Full text Open Access Link to item Cite

Evolution of minimally invasive surgery for rectal cancer: update from the national cancer database.

Journal Article Surg Endosc · January 2021 BACKGROUND: As the use of minimally invasive techniques in colorectal surgery has become increasingly prevalent, concerns remain about the oncologic effectiveness and long-term outcomes of minimally invasive low anterior resection (MI-LAR) for the treatmen ... Full text Link to item Cite

Who Benefits? An Assessment of Resident Benefits at Top 50 Academic Institutions.

Journal Article J Surg Educ · March 2024 OBJECTIVE: Residency serves as a crucial time in the professional and personal development of young physicians. Extensive effort is devoted to the clinical training of residents across the country. However, many residents report concerns with compensation, ... Full text Link to item Cite

Surgical Residents as Clerkship Scholars May Improve Student Perception of the Surgery Clerkship.

Journal Article J Surg Res · February 2024 INTRODUCTION: The surgical clerkship is a formative experience in the medical school curriculum and can leave a lasting impression on students' perception of surgery. Given the historical negative stereotypes of surgeons, the clerkship represents an opport ... Full text Link to item Cite

Revisiting Medical Student Expectations on the Surgery Clerkship.

Journal Article J Surg Educ · October 2023 OBJECTIVE: Medical students frequently report ambiguity of expectations in their feedback of the surgery clerkship. Herein, we aimed to gauge general surgery resident and attending expectations of students on their clerkship. DESIGN: Residents and attendin ... Full text Link to item Cite

A novel low-cost model of superficial abscess for trainee education in incision and drainage.

Journal Article Surg Open Sci · August 2023 BACKGROUND: Proficiency in ultrasound usage is quickly becoming an expectation in multiple residency programs: emergency medicine, obstetrics-gynecology, surgery, and internal medicine. There is a lack of affordable training devices for ultrasound training ... Full text Link to item Cite

The Surgical Subinternship: A Unique Opportunity for Early Leadership Development.

Journal Article J Surg Educ · June 2023 Subinternships are formative rotations in the surgery-bound medical student's journey to surgical training. This experience allows for further exploration of career goals, plays an important evaluative role in the residency selection process, and offers on ... Full text Link to item Cite

Outcomes of an Algorithmic, Multidisciplinary Approach to Rectourethral Fistula Repair: A Pre- and Postintervention Quasi-Experimental Study.

Conference Dis Colon Rectum · April 1, 2023 BACKGROUND: Rectourethral fistulas are a rare yet severe complication of prostate surgery, pelvic irradiation therapy, or both. Multiple surgical repairs exist with widely varying success rates. OBJECTIVE: This study aimed to present our institutional mult ... Full text Link to item Cite

Management of neuroendocrine tumors of the rectum

Journal Article Seminars in Colon and Rectal Surgery · September 1, 2022 Rectal neuroendocrine tumors (NETs) have increased in prevalence due to increased detection via endoscopic screening for colorectal neoplasia, advances and availability of imaging tools along with the indolent nature of the tumor. Imaging techniques to ide ... Full text Cite

Combined Primary Resection with Hepatic Artery Infusion Pump Implantation Is Safe for Unresectable Colorectal Liver Metastases.

Journal Article J Gastrointest Surg · April 2022 BACKGROUND: Colorectal liver metastases (CRLM) are the most common cause of disease-specific mortality in patients with colorectal cancer. Hepatic artery infusion (HAI) combined with systemic chemotherapy improves survival for these patients. The safety of ... Full text Link to item Cite

Postoperative changes in cognition and cerebrospinal fluid neurodegenerative disease biomarkers.

Journal Article Ann Clin Transl Neurol · February 2022 OBJECTIVE: Numerous investigators have theorized that postoperative changes in Alzheimer's disease neuropathology may underlie postoperative neurocognitive disorders. Thus, we determined the relationship between postoperative changes in cognition and cereb ... Full text Open Access Link to item Cite

Two Compartment Evaluation of Liver Grafts During Acellular Room Temperature Machine Perfusion (acRTMP) in a Rat Liver Transplant Model.

Journal Article Front Med (Lausanne) · 2022 BACKGROUND: Subnormothermic machine perfusion (SNMP) of liver grafts is currently less clinically developed than normothermic and hypothermic approaches, but may have logistical advantages. At intermediate temperatures, the oxygen demand of the graft is lo ... Full text Link to item Cite

Perioperative neurocognitive and functional neuroimaging trajectories in older APOE4 carriers compared with non-carriers: secondary analysis of a prospective cohort study.

Journal Article Br J Anaesth · December 2021 BACKGROUND: Cognitive dysfunction after surgery is a major issue in older adults. Here, we determined the effect of APOE4 on perioperative neurocognitive function in older patients. METHODS: We enrolled 140 English-speaking patients ≥60 yr old scheduled fo ... Full text Open Access Link to item Cite

Quantified electronic health record (EHR) use by academic surgeons.

Journal Article Surgery · June 2021 BACKGROUND: The electronic health record has improved medical billing, research, and sharing of patient data, but its clinical use by physicians has been linked to rising physician burnout leading to numerous subjective editorials about the electronic heal ... Full text Link to item Cite

Does Fragmentation of Care in Locally Advanced Rectal Cancer Increase Patient Mortality?

Journal Article J Gastrointest Surg · May 2021 OBJECTIVE: To evaluate health care fragmentation in patients with stage II and III rectal cancers. BACKGROUND: Fragmentation of care among multiple hospitals may worsen outcomes for cancer patients. METHODS: National Cancer Database was queried for adult p ... Full text Link to item Cite

Immunomodulatory lipid mediator profiling of cerebrospinal fluid following surgery in older adults.

Journal Article Sci Rep · February 4, 2021 Arachidonic acid (AA), docosahexaenoic acid (DHA), and eicosapentaenoic acid (EPA) derived lipids play key roles in initiating and resolving inflammation. Neuro-inflammation is thought to play a causal role in perioperative neurocognitive disorders, yet th ... Full text Open Access Link to item Cite

Evolution of minimally invasive surgery for rectal cancer: update from the national cancer database.

Journal Article Surg Endosc · January 2021 BACKGROUND: As the use of minimally invasive techniques in colorectal surgery has become increasingly prevalent, concerns remain about the oncologic effectiveness and long-term outcomes of minimally invasive low anterior resection (MI-LAR) for the treatmen ... Full text Link to item Cite

A Novel Model for a Student-Led Surgical Anatomy Seminar.

Journal Article J Surg Educ · 2021 OBJECTIVE: We describe a novel educational model for a student-led anatomy interest group that utilizes an efficient method of knowledge sharing among peers in order to supplement the standard gross anatomy curriculum and expose medical students to advance ... Full text Link to item Cite

Cerebrospinal Fluid Proteome Changes in Older Non-Cardiac Surgical Patients with Postoperative Cognitive Dysfunction.

Journal Article J Alzheimers Dis · 2021 BACKGROUND: Postoperative cognitive dysfunction (POCD), a syndrome of cognitive deficits occurring 1-12 months after surgery primarily in older patients, is associated with poor postoperative outcomes. POCD is hypothesized to result from neuroinflammation; ... Full text Open Access Link to item Cite

Proctectomy for Rectal Cancer

Chapter · January 1, 2021 This chapter describes the conceptual framework of surgical management of rectal cancer. The anatomic basis for the technical components of proctectomy is discussed. The importance of multidisciplinary care and decision-making is emphasized. A variety of a ... Full text Cite

A protocol to reduce self-reported pain scores and adverse events following lumbar punctures in older adults.

Journal Article J Neurol · July 2020 OBJECTIVE: Lumbar punctures (LPs) are important for obtaining CSF in neurology studies but are associated with adverse events and feared by many patients. We determined adverse event rates and pain scores in patients prospectively enrolled in two cohort st ... Full text Link to item Cite

Comparison of survival of stage I-III colon cancer by travel distance and hospital volume.

Journal Article Tech Coloproctol · July 2020 BACKGROUND: Previous studies have demonstrated improved outcomes at high-volume colorectal surgery centers; however, the benefit for patients who live far from such centers has not been assessed relative to local, low-volume facilities. METHODS: The 2010-2 ... Full text Link to item Cite

Author's Reply.

Journal Article J Minim Invasive Gynecol · February 8, 2020 Full text Link to item Cite

Medical Student Involvement and Learning Objectives in Morbidity and Mortality Conferences: A National Survey of the Association for Surgical Education's Committee of Clerkship Directors.

Journal Article J Surg Educ · 2020 BACKGROUND: Despite implementation of Morbidity and Mortality (M&M) Conference across surgical graduate medical education, sparse literature exists regarding the attendance and involvement of medical students. We sought to examine student involvement and l ... Full text Link to item Cite

Utilizing transcranial direct current stimulation to enhance laparoscopic technical skills training: A randomized controlled trial.

Journal Article Brain Stimul · 2020 BACKGROUND: Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that delivers constant, low electrical current resulting in changes to cortical excitability. Prior work suggests it may enhance motor learning giving ... Full text Open Access Link to item Cite

The MARBLE Study Protocol: Modulating ApoE Signaling to Reduce Brain Inflammation, DeLirium, and PostopErative Cognitive Dysfunction.

Journal Article J Alzheimers Dis · 2020 BACKGROUND: Perioperative neurocognitive disorders (PND) are common complications in older adults associated with increased 1-year mortality and long-term cognitive decline. One risk factor for worsened long-term postoperative cognitive trajectory is the A ... Full text Open Access Link to item Cite

New innovations in anal fistula surgery

Journal Article Seminars in Colon and Rectal Surgery · December 1, 2019 The management of anal fistula remains a source of frustration for patients and surgeons alike. The continued challenge posed by this condition has led to considerable innovation and investigation with the ongoing refinement of surgical techniques, the dev ... Full text Cite

Flow Cytometry Characterization of Cerebrospinal Fluid Monocytes in Patients With Postoperative Cognitive Dysfunction: A Pilot Study.

Journal Article Anesth Analg · November 2019 Animal models suggest postoperative cognitive dysfunction may be caused by brain monocyte influx. To study this in humans, we developed a flow cytometry panel to profile cerebrospinal fluid (CSF) samples collected before and after major noncardiac surgery ... Full text Open Access Link to item Cite

Disparity of Colon Cancer Outcomes in Rural America: Making the Case to Travel the Extra Mile.

Journal Article J Gastrointest Surg · November 2019 OBJECTIVES: Rural patients experience disparities in cancer care compared to urban patients. We hypothesized that rural patients with colon cancer who traveled to high-volume centers for treatment have similar survival compared to urban patients who also t ... Full text Link to item Cite

Documentation Burden on General Surgery Faculty

Conference JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS · October 1, 2019 Link to item Cite

Association between Survival and Fragmented Care in Stage II and III Rectal Cancer

Conference JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS · October 1, 2019 Link to item Cite

Adjuvant Chemotherapy Improves Survival Following Resection of Locally Advanced Rectal Cancer with Pathologic Complete Response.

Conference J Gastrointest Surg · August 2019 BACKGROUND: Controversy exists over the use of adjuvant chemotherapy for locally advanced (stages II-III) rectal cancer (LARC) patients who demonstrate pathologic complete response (pCR) following neoadjuvant chemoradiation. We conducted a retrospective an ... Full text Link to item Cite

Neoadjuvant chemoradiation followed by transanal local excision for T2 rectal cancer confers equivalent survival benefit as traditional transabdominal resection.

Journal Article Surgery · June 2019 BACKGROUND: Despite clinical guidelines classifying T2 rectal cancer as a contraindication for transanal local excision attributable to unacceptably high rates of local recurrence, it is a practice that persists clinically. Recent clinical trials have sugg ... Full text Link to item Cite

The side of the primary tumor affects overall survival in colon adenocarcinoma: an analysis of the national cancer database.

Journal Article Tech Coloproctol · June 2019 BACKGROUND: Due to conflicting study results on the effect of laterality on overall survival in primary colon cancers, we sought to examine the impact of left compared to right-sided primary tumors on overall survival for stage I-III colon cancer using the ... Full text Link to item Cite

The Authors Reply.

Journal Article Dis Colon Rectum · May 2019 Full text Link to item Cite

Disparities in colostomy reversal after Hartmann's procedure for diverticulitis.

Journal Article Tech Coloproctol · May 2019 BACKGROUND: Hartmann's procedure for diverticulitis is a common procedure, with highly variable rates and timing of colostomy reversal. The aim of this study was to evaluate the impact of race and insurance coverage on reversal within 2 years of Hartmann's ... Full text Link to item Cite

Surgical Site Infection: The Clinical and Economic Impact.

Journal Article Clin Colon Rectal Surg · May 2019 Surgical site infection (SSI) following colorectal surgery is associated with worse postoperative outcomes, longer length of stay, and higher rates of readmission. SSI rates have been established as a surrogate metric for the overall quality of surgical ca ... Full text Link to item Cite

The INTUIT Study: Investigating Neuroinflammation Underlying Postoperative Cognitive Dysfunction.

Journal Article J Am Geriatr Soc · April 2019 BACKGROUND/OBJECTIVES: Every year, up to 40% of the more than 16 million older Americans who undergo anesthesia/surgery develop postoperative cognitive dysfunction (POCD) or delirium. Each of these distinct syndromes is associated with decreased quality of ... Full text Open Access Link to item Cite

Modified V-Y Fasciocutaneous Flap Reconstruction After Abdominoperineal Resection in Irradiated Patients Prevents Wound Dehiscence and Associated Complications: A Retrospective Analysis and Benchtop Confirmation.

Journal Article Ann Plast Surg · February 2019 BACKGROUND: Primary perineal closure following abdominal perineal resection (APR) is reported to have a wound complication rate as high as 66%, whereas flap reconstruction reduces wound complications to 15% to 35%. A modified de-epithelialized V-Y fasciocu ... Full text Link to item Cite

With widespread adoption of MIS colectomy for colon cancer, does hospital type matter?

Journal Article Surg Endosc · January 2019 BACKGROUND: Recent studies have shown that hospital type impacts patient outcomes, but no studies have examined hospital differences in outcomes for patients undergoing minimally invasive surgery (MIS) for segmental colectomies. METHODS: The 2010-2014 Nati ... Full text Link to item Cite

Health Career Academy: Addition of a Surgical Case-Based Learning Curriculum Captures the Interest of High School Students.

Journal Article J Surg Educ · 2019 OBJECTIVE: The Health Career Academy (HCA) is a national program which provides a structure to introduce underserved high school students to healthcare careers. Utilizing the HCA framework, we adapted the curriculum to emphasize surgical cases and invited ... Full text Link to item Cite

Impact of Disgust on Intentions to Undergo Colorectal Surgery.

Journal Article Dis Colon Rectum · December 2018 BACKGROUND: Surgeons present patients with complex information at the perioperative appointment. Emotions likely play a role in surgical decision-making, and disgust is an emotion of revulsion at a stimulus that can lead to avoidance. OBJECTIVE: The purpos ... Full text Link to item Cite

Response to Slim et al.

Journal Article Colorectal Dis · November 2018 Full text Link to item Cite

Validation of the Omni: A Novel, Multimodality, and Longitudinal Surgical Skills Assessment.

Journal Article J Surg Educ · November 2018 OBJECTIVE: The breadth of technical skills included in general surgery training continues to expand. The current competency-based training model requires assessment tools to measure acquisition, learning, and mastery of technical skill longitudinally in a ... Full text Link to item Cite

Documenting or Operating: Where Is Time Spent in General Surgery Residency?

Journal Article J Surg Educ · November 2018 OBJECTIVE: The utilization of electronic health records (EHR) has become essential in the daily activities of physicians for documentation and as an information source. However, the amount of time spent by residents utilizing the EHR has not been thoroughl ... Full text Link to item Cite

Local excision results in comparable survival to radical resection for early-stage rectal carcinoid.

Journal Article J Surg Res · October 2018 BACKGROUND: Controversy exists regarding current National Comprehensive Cancer Network guidelines, which recommend local excision for rectal carcinoids ≤2 cm and radical resection for tumors >2 cm. Given the limited data examining optimal surgical approach ... Full text Link to item Cite

Resected irradiated rectal cancers: Are twelve lymph nodes really necessary in the era of neoadjuvant therapy?

Conference Am J Surg · September 2018 BACKGROUND: Our study aims to identify the minimum number of lymph nodes (LN) associated with improved survival in patients who underwent NRT for stage II-III rectal cancer. METHODS: Adults with clinical stage II and III rectal adenocarcinoma in the Nation ... Full text Link to item Cite

Response to Mroczkowski.

Journal Article Colorectal Dis · May 2018 Full text Link to item Cite

Response to Letter to the Editor.

Journal Article Dis Colon Rectum · May 2018 Full text Link to item Cite

Delay in Adjuvant Chemotherapy and Survival Advantage in Stage III Colon Cancer.

Journal Article J Am Coll Surg · April 2018 BACKGROUND: Adjuvant chemotherapy after resection is the standard of care for stage III colon cancer, yet many patients omit chemotherapy. We aimed to describe the impact of delayed chemotherapy on overall survival across multiple time points. STUDY DESIGN ... Full text Link to item Cite

Delay in Adjuvant Chemotherapy and Survival Advantage in Stage III Colon Cancer Discussion

Journal Article JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS · April 1, 2018 Link to item Cite

Supervisor, Colleague, or Assistant: General Surgery Resident Perceptions of Advanced Practitioners.

Conference Am Surg · February 1, 2018 Integration of advanced practitioners (APs) into academic medical centers can improve processes of care and decrease physician workload but may adversely impact general surgery residency training. The aim of the present study was to characterize general su ... Link to item Cite

The appropriateness of 30-day mortality as a quality metric in colorectal cancer surgery.

Journal Article Am J Surg · January 2018 BACKGROUND: Our study compares 30-day vs. 90-day mortality following colorectal cancer surgery (CRS), and examines hospital performance ranking based on this assessment. METHODS: Mortality rates were compared between 30 vs. 90 days following CRS for patien ... Full text Link to item Cite

Association between neoadjuvant chemoradiation and survival for patients with locally advanced rectal cancer.

Journal Article Colorectal Dis · December 2017 AIM: To examine the overall survival differences for the following neoadjuvant therapy modalities - no therapy, chemotherapy alone, radiation alone and chemoradiation - in a large cohort of patients with locally advanced rectal cancer. METHOD: Adults with ... Full text Link to item Cite

Adjuvant Chemotherapy After Preoperative Chemoradiation Improves Survival in Patients With Locally Advanced Rectal Cancer.

Journal Article Dis Colon Rectum · October 2017 BACKGROUND: Practice guidelines differ in their support of adjuvant chemotherapy use in patients who received preoperative chemoradiation for rectal cancer. OBJECTIVE: The purpose of this study was to evaluate the impact of adjuvant chemotherapy among pati ... Full text Link to item Cite

Association Between Incomplete Neoadjuvant Radiotherapy and Survival for Patients With Locally Advanced Rectal Cancer.

Journal Article JAMA Surg · June 1, 2017 IMPORTANCE: Failing to complete chemotherapy adversely affects survival in patients with colorectal cancer. However, the effect of incomplete delivery of neoadjuvant radiotherapy is unclear. OBJECTIVE: To determine whether incomplete radiotherapy delivery ... Full text Link to item Cite

Clinical Acuity Shorthand System: a standardized classification tool to facilitate handoffs.

Journal Article J Surg Res · May 1, 2017 BACKGROUND: The handoff of medical information from one provider to another can be inefficient and error prone, potentially undermining patient safety. Although several tools for structuring handoffs exist, none provide a brief, standardized framework for ... Full text Link to item Cite

Insurance Status, Not Race, is Associated With Use of Minimally Invasive Surgical Approach for Rectal Cancer.

Journal Article Ann Surg · April 2017 OBJECTIVE: To determine the impact of race and insurance on use of minimally invasive (MIS) compared with open techniques for rectal cancer in the United States. BACKGROUND: Race and socioeconomic status have been implicated in disparities of rectal cancer ... Full text Link to item Cite

Hand-Assisted Laparoscopic Colectomy Improves Perioperative Outcomes Without Increasing Operative Time Compared to the Open Approach: a National Analysis of 8791 Patients.

Journal Article J Gastrointest Surg · April 2017 INTRODUCTION: Hand-assisted laparoscopic surgery (HALS) is often used in procedures too complex for completely minimally invasive approaches. However, there are concerns for whether this hybrid approach abrogates perioperative benefits of the completely mi ... Full text Link to item Cite

Determining the Optimal Quantitative Threshold for Preoperative Albumin Level Before Elective Colorectal Surgery.

Journal Article J Gastrointest Surg · April 2017 BACKGROUND: Hypoalbuminemia is associated with adverse surgical outcomes. A minimum threshold and the impact of incrementally decreasing albumin remain undefined for colorectal surgery patients. STUDY DESIGN: The 2011-2013 National Surgical Quality Improve ... Full text Link to item Cite

V-Y fasciocutaneous flap closure technique is a safe and efficacious alternative to primary closure of the perineal wound following abdominoperineal resection.

Journal Article Am J Surg · February 2017 BACKGROUND: The aim of this study was to compare wound complications from V-Y flap vs primary closure in the setting of abdominoperineal resection. METHODS: This was a single institution retrospective review (1999-2014). The main outcome measures were any ... Full text Link to item Cite

Intensity-Modulated Radiation Therapy Is Not Associated with Perioperative or Survival Benefit over 3D-Conformal Radiotherapy for Rectal Cancer.

Journal Article J Gastrointest Surg · January 2017 INTRODUCTION: The use of intensity-modulated radiation therapy (IMRT) in rectal cancer has steadily increased over traditional 3D conformal radiotherapy (3D-CRT) due to perceived benefit of delivering higher treatment doses while minimizing exposure to sur ... Full text Link to item Cite

Intraoperative Frontal Alpha-Band Power Correlates with Preoperative Neurocognitive Function in Older Adults.

Journal Article Front Syst Neurosci · 2017 Each year over 16 million older Americans undergo general anesthesia for surgery, and up to 40% develop postoperative delirium and/or cognitive dysfunction (POCD). Delirium and POCD are each associated with decreased quality of life, early retirement, incr ... Full text Open Access Link to item Cite

Hand-Assisted Laparoscopic Versus Standard Laparoscopic Colectomy: Are Outcomes and Operative Time Different?

Journal Article J Gastrointest Surg · November 2016 BACKGROUND: HAL colectomy is a technique perceived to provide the benefits of laparoscopic surgery while improving tactile feedback and operative time. Published data are largely limited to small, single-institution studies. METHODS: The 2012-2013 National ... Full text Link to item Cite

The Use of Re-irradiation in Locally Recurrent, Non-metastatic Rectal Cancer.

Journal Article Ann Surg Oncol · October 2016 BACKGROUND: The optimal approach to patients with locally recurrent, non-metastatic rectal cancer is unclear. This study evaluates the outcomes and toxicity associated with pelvic re-irradiation. METHODS: Patients undergoing re-irradiation for locally recu ... Full text Link to item Cite

The Use of Reirradiation in Locally Recurrent, Nonmetastatic Rectal Cancer.

Journal Article Int J Radiat Oncol Biol Phys · October 1, 2016 Full text Link to item Cite

Robotic-Assisted Versus Laparoscopic Colectomy Results in Increased Operative Time Without Improved Perioperative Outcomes.

Journal Article J Gastrointest Surg · August 2016 BACKGROUND: Interest in robotic technology is burgeoning within the field of colorectal surgery. However, benefits of robotic-assisted colectomy (RAC) compared with laparoscopic colectomy (LC) remain ambiguous. STUDY DESIGN: Patients who underwent minimall ... Full text Link to item Cite

Minimally Invasive Versus Open Low Anterior Resection: Equivalent Survival in a National Analysis of 14,033 Patients With Rectal Cancer.

Journal Article Ann Surg · June 2016 OBJECTIVE: To examine survival of patients who underwent minimally invasive versus open low anterior resection (LAR) for rectal cancer. BACKGROUND: Utilization of laparoscopic and robotic LAR for rectal cancer has steadily increased. Short-term outcomes be ... Full text Link to item Cite

Does Conversion in Laparoscopic Colectomy Portend an Inferior Oncologic Outcome? Results from 104,400 Patients.

Journal Article J Gastrointest Surg · May 2016 BACKGROUND: Limited data exist regarding the effect of conversion from laparoscopic to open colectomy on perioperative and oncologic outcomes in colon cancer. STUDY DESIGN: The National Cancer Data Base was used to identify patients who underwent colectomy ... Full text Link to item Cite

Optimal Timing to Surgery after Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer.

Journal Article J Am Coll Surg · April 2016 BACKGROUND: Neoadjuvant chemoradiotherapy (nCRT) has demonstrated proven benefit in tumor regression and improved long-term local control for patients with locally advanced rectal cancer. However, precise analysis of the optimal waiting time that maximizes ... Full text Link to item Cite

Surgical Resection of the Primary Tumor in Stage IV Colorectal Cancer Without Metastasectomy is Associated With Improved Overall Survival Compared With Chemotherapy/Radiation Therapy Alone.

Journal Article Dis Colon Rectum · April 2016 BACKGROUND: Controversy exists over whether resection of the primary tumor in stage IV colorectal cancer with inoperable metastases improves patient outcomes. OBJECTIVE: The purpose of this study was to evaluate whether resection of the primary tumor witho ... Full text Link to item Cite

Review of Hemorrhoid Disease: Presentation and Management.

Journal Article Clin Colon Rectal Surg · March 2016 Symptomatic hemorrhoid disease is one of the most prevalent ailments associated with significant impact on quality of life. Management options for hemorrhoid disease are diverse, ranging from conservative measures to a variety of office and operating-room ... Full text Link to item Cite

Determining the Optimal Timing for Initiation of Adjuvant Chemotherapy After Resection for Stage II and III Colon Cancer.

Journal Article Dis Colon Rectum · February 2016 BACKGROUND: Several reports suggest that the efficacy of adjuvant chemotherapy on survival diminishes over time for colon cancer; however, precise timing of its loss of benefit has not been established. OBJECTIVE: This study aimed to determine the relation ... Full text Link to item Cite

Effect of combined neoadjuvant chemoradiation on overall survival for patients with locally advanced rectal cancer.

Conference Journal of Clinical Oncology · February 1, 2016 657 Background: Prospective randomized trials have demonstrated that neoadjuvant chemoradiation improves local control and results in a higher rate of sphincter-sparing surgery for patients with locally advanced rectal cancer. Ho ... Full text Cite

Management of colonic diverticular bleeding and bleeding colitis

Chapter · January 1, 2016 Colonic diverticular bleeding and colitis account for the majority of cases of lower gastrointestinal bleeding, with diverticular bleeding being by far the most common etiology. In contrast to diverticulitis, colonic diverticular bleeding most commonly ori ... Full text Cite

Robotic Low Anterior Resection for Rectal Cancer: A National Perspective on Short-term Oncologic Outcomes.

Journal Article Ann Surg · December 2015 OBJECTIVE: This study examines short-term outcomes and pathologic surrogates of oncologic results among patients undergoing robotic versus laparoscopic low anterior resection for rectal cancer. A total of 6403 patients met inclusion criteria. Although the ... Full text Link to item Cite

Combined Mechanical and Oral Antibiotic Bowel Preparation Reduces Incisional Surgical Site Infection and Anastomotic Leak Rates After Elective Colorectal Resection: An Analysis of Colectomy-Targeted ACS NSQIP.

Journal Article Ann Surg · August 2015 OBJECTIVE: To determine the association between preoperative bowel preparation and 30-day outcomes after elective colorectal resection. METHODS: Patients from the 2012 Colectomy-Targeted American College of Surgeons National Surgical Quality Improvement Pr ... Full text Link to item Cite

Faculty evaluations of resident medical knowledge: can they be used to predict American Board of Surgery In-Training Examination performance?

Journal Article Am J Surg · June 2015 BACKGROUND: The American Board of Surgery In-Training Examination (ABSITE) offers annual assessment of resident medical knowledge. We sought to determine if ongoing end-of-rotation evaluations by faculty of residents' medical knowledge correlate with ABSIT ... Full text Link to item Cite

Adjuvant chemotherapy for t1 node-positive colon cancers provides significant survival benefit.

Journal Article Dis Colon Rectum · December 2014 BACKGROUND: Contemporary treatment of node-positive (N+) colon cancer consists of adjuvant chemotherapy; however, randomized data supporting this practice were derived from lesions T2 or greater. Minimal data exist regarding the use and need for adjuvant c ... Full text Link to item Cite

Surgical management of complex rectourethral fistulas in irradiated and nonirradiated patients.

Journal Article Dis Colon Rectum · September 2014 BACKGROUND: Rectourethral fistulas are an uncommon, yet devastating occurrence after treatment for prostate cancer or trauma, and their surgical management has historically been nonstandardized. Anecdotally, irradiated rectourethral fistulas portend a wors ... Full text Link to item Cite

Trials of nonoperative management exceeding 3 days are associated with increased morbidity in patients undergoing surgery for uncomplicated adhesive small bowel obstruction.

Journal Article J Trauma Acute Care Surg · June 2014 BACKGROUND: Controversy exists over how long trials of nonoperative management should be pursued in patients with uncomplicated adhesive small bowel obstructions (ASBOs) before deciding to proceed with surgery. The purpose of this study was to determine th ... Full text Link to item Cite

Reduced length of hospital stay in colorectal surgery after implementation of an enhanced recovery protocol.

Journal Article Anesth Analg · May 2014 BACKGROUND: Enhanced recovery after surgery (ERAS) is a multimodal approach to perioperative care that combines a range of interventions to enable early mobilization and feeding after surgery. We investigated the feasibility, clinical effectiveness, and co ... Full text Open Access Link to item Cite

A simple scoring system for risk-stratifying rectal cancer patients prior to radical resection.

Journal Article Tech Coloproctol · May 2014 BACKGROUND: Various predictors of perioperative risk for patients with rectal cancer undergoing radical resection have been well described, but no simple scoring system for surgeons to estimate this risk currently exists. The objective of this study was to ... Full text Link to item Cite

Laparoscopic versus open Hartmann procedure for the emergency treatment of diverticulitis: a propensity-matched analysis.

Journal Article Dis Colon Rectum · January 2013 BACKGROUND: A laparoscopic approach has been proposed to reduce the high morbidity and mortality associated with the Hartmann procedure for the emergency treatment of diverticulitis. OBJECTIVE: The objective of our study was to determine whether a laparosc ... Full text Link to item Cite

Resident designed intern orientation to address the new ACGME Common Program Requirements for resident supervision.

Journal Article J Surg Educ · 2013 OBJECTIVE: To design an orientation for surgical interns to meet the new Accreditation Council for Graduate Medical Education Common Program Requirements regarding supervision, to test patient-management competencies, and to assess confidence on skills and ... Full text Link to item Cite

Effect of surgeon specialization on long-term survival following colon cancer resection at an NCI-designated cancer center.

Journal Article J Surg Oncol · September 1, 2012 BACKGROUND: Recent studies have documented improved outcomes for patients undergoing colorectal cancer resection at NCI cancer centers compared to hospitals without this designation. Proposed contributory factors include a higher proportion of surgeons wit ... Full text Link to item Cite

Detection of intestinal dysplasia using angle-resolved low coherence interferometry.

Journal Article J Biomed Opt · October 2011 Angle-resolved low coherence interferometry (a/LCI) is an optical biopsy technique that allows for depth-resolved, label-free measurement of the average size and optical density of cell nuclei in epithelial tissue to assess the tissue health. a/LCI has pre ... Full text Link to item Cite

Advanced fellowship training is associated with improved lymph node retrieval in colon cancer resections.

Journal Article J Surg Res · September 2011 BACKGROUND: Examination of at least 12 lymph nodes has been established as the standard of care for adequate staging of colon cancer. The purpose of this study was to determine whether surgeon fellowship training, patient body mass index (BMI), and surgica ... Full text Link to item Cite

Management of bleeding colitis and colonic diverticular disease

Chapter · December 1, 2010 Inflammatory bowel disease, infectious, or ischemic colitis can all present with lower gastrointestinal (GI) bleeding. Overall, colitis contributes to approximately 20% of all causes of lower GI bleed [1]. Bleeding from colitis is usually intermittent, sel ... Full text Cite

Pneumorrhachis, subcutaneous emphysema, pneumomediastinum, pneumopericardium, and pneumoretroperitoneum after proctocolectomy for ulcerative colitis: report of a case.

Journal Article Dis Colon Rectum · April 2002 This article presents the first known case of pneumorrhachis (spinal air), pneumomediastinum, pneumopericardium, pneumoretroperitoneum, and subcutaneous emphysema after proctocolectomy for ulcerative colitis. We review the patient's medical history, clinic ... Full text Link to item Cite

Comparison of outcomes for gastrostomy placement methods.

Conference AMERICAN JOURNAL OF CLINICAL NUTRITION · February 1, 2002 Link to item Cite

Perioperative morbidity and mortality in combined vs. staged approaches to carotid and coronary revascularization.

Journal Article Ann Vasc Surg · March 1996 Between 1986 and 1994 we identified 57 patients who underwent carotid endarterectomy (CEA) and coronary artery bypass grafting (CABG) during the same hospitalization. Simultaneous CABG and CEA was performed in 28 patients (mean age 70.5 years, 58% male). I ... Full text Link to item Cite