Annals of surgery
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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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Randomized Controlled Trial Multicenter Study
Preoperative enoxaparin versus postoperative semuloparin thromboprophylaxis in major abdominal surgery: a randomized controlled trial.
To compare efficacy and safety of thromboprophylaxis with semuloparin started postoperatively versus enoxaparin started preoperatively in major abdominal surgery. ⋯ Semuloparin commenced postoperatively did not demonstrate noninferiority to enoxaparin initiated preoperatively for thromboprophylaxis after major abdominal surgery. Study registered with clinicaltrials.gov: NCT00679588.
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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
Disparities in surgical 30-day readmission rates for Medicare beneficiaries by race and site of care.
To determine whether black patients have higher odds of readmission than white patients after major surgery, and to ascertain whether these disparities are related to where black patients receive care. ⋯ Among Medicare beneficiaries, black patients were more likely to be readmitted after hospitalization for surgical procedures. Since racial disparities in readmission rates are mediated both by patients' race and the hospital at which care is delivered, efforts at reducing disparities should focus not only on race-based measures but also on improving outcomes of care at minority-serving hospitals.
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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.