Annals of surgery
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Randomized Controlled Trial Multicenter Study
Long-term follow-up for adhesive small bowel obstruction after open versus laparoscopic surgery for suspected appendicitis.
The aim of the present study was to compare the frequency of readmissions due to small bowel obstruction (SBO) after open versus laparoscopic surgery performed for suspected acute appendicitis. ⋯ Hospitalization due to SBO, between open and laparoscopic procedures, in patients operated on because of suspected appendicitis demonstrated a significant difference, favoring the laparoscopic approach. The frequency of SBO after the index surgery was, though, low in both groups.
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Multicenter Study Comparative Study
Variation in practice and resource utilization associated with the diagnosis and management of appendicitis at freestanding children's hospitals: implications for value-based comparative analysis.
To characterize the scope and magnitude of practice variation associated with the diagnosis and treatment of appendicitis at freestanding children's hospitals. ⋯ Significant variation exists in practice, resource utilization, and treatment-related cost associated with the management of appendicitis at freestanding children's hospitals. Value-based measures are needed for benchmarking and to prioritize collaborative quality improvement efforts.
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Multicenter Study
The HARM score: a novel, easy measure to evaluate quality and outcomes in colorectal surgery.
To develop a measurement tool based on HospitAl stay, Readmission, and Mortality rates (HARM) score, which is easily calculated from routine administrative data. Secondary goals were to validate the HARM score on a national inpatient sample. ⋯ The HARM score is easy, reliable, and valid for assessing quality in colorectal surgery. It may provide a low-cost solution for comparative quality assessment in surgery focused on true outlier performance rather than process or clinical outcome metrics alone.
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Multicenter Study
Incidence of groin hernia repair after radical prostatectomy: a population-based nationwide study.
To assess the incidence of groin hernia repair after radical prostatectomy for prostate cancer compared with the incidence in a control population without prostate cancer in a nationwide, population-based study. ⋯ An almost 4-fold increase in groin hernia repair was observed after radical prostatectomy compared with controls, and men who received radiation therapy had an almost 2-fold increase in incidence. As well as postoperative changes in the abdominal wall, increased vigilance for groin hernia seems to be important for the increased incidence of groin hernia repair seen after radical prostatectomy or radiation therapy for prostate cancer.
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To use regret decision theory methodology to assess three treatment strategies in pancreatic adenocarcinoma. ⋯ Regret-based decision curve analysis provides a novel perspective for making treatment-related decisions by incorporating the decision maker's preferences expressed as his or her estimates of benefits and harms associated with the treatment considered.