Annals of surgery
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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
Differences in circumferential resection margin involvement after abdominoperineal excision and low anterior resection no longer significant.
The aim of this study was to evaluate whether the abdominoperineal excision (APE) is associated with an increased risk of circumferential resection margin (CRM) involvement after rectal cancer surgery in comparison with low anterior resection (LAR). ⋯ The results suggest that on a national level the APE procedure itself is not a strong predictor anymore for CRM involvement after rectal cancer surgery. However, in advanced tumors, results after APE are inferior to LAR.
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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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This study hypothesized that tumor size, number of tumors, surgical approach, and tumor histology significantly affected microwave ablation (MWA) success and recurrence-free survival. ⋯ In this large data set, patients with 3 cm or more tumors showed a propensity for early recurrence, regardless of histology. Higher rates of local recurrence were noted in HCC patients, which may reflect underlying liver disease. There were no significant differences in morbidity or survival based on the surgical approach; however, local recurrence rates were highest for percutaneously ablated tumors.
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Multicenter Study Comparative Study
Relationship between cancer center accreditation and performance on publicly reported quality measures.
To evaluate differences in hospital structural quality characteristics and assess the association between national publicly reported quality indicators and cancer center accreditation status. ⋯ Accredited cancer centers performed better on most process and patient experience measures but showed worse performance on most outcome measures. These discordant findings emphasize the need to focus on oncology-specific measurement strategies.