Assessments of surgical workflow offer insight regarding procedure variability, case complexity and surgeon proficiency. We utilize an objective method to evaluate step-by-step workflow and step trans...
We annotated 31 RPs using a procedure-specific annotation card. Using Spearman's correlation, we measured strength of association of...
Across 31 RPs, a mean (± standard deviation) of 49.0 (± 20.3) steps occurred per procedure. Mean CT and TOT were 213 (± 90) and 283 (± 108) minutes. Posterior mesorectal dissection required most visit...
This study correlates individual surgical steps with CT and TOT through standardized annotation. It provides an objective approach to quantify workflow....
It is critical to avoid iatrogenic injuries affecting genitourinary organs in order to prevent postoperative urinary or sexual dysfunction, which lead to lengthier recovery and possibly reoperation....
Using the 2016-2019 American College of Surgeons National Quality Improvement Program (ACS NSQIP) Targeted Proctectomy Database, we collated 2577 patients with non-metastatic rectal cancer who underwe...
The rates of preoperative comorbidities were significantly higher among patients who received an open operation. The proportion of GUIs was also significantly higher in this patient population. Multiv...
Patients who undergo a laparoscopic proctectomy are associated with a lower risk of GUI. On the other hand, patients with >10% body weight loss and ASA class 3: Severe Systemic Disease were associated...
Perineal proctectomy is a complex procedure that requires advanced skills. Currently, there are no simulators for training in this procedure. As part of our objective of developing a virtual reality s...
In phase I, we utilized hierarchical task analysis to formulate the metrics. In phase II, a survey involving expert colorectal surgeons determined the significance of the developed metrics. Phase III ...
In phase II, a total of 23 colorectal surgeons were recruited and consensus was obtained on all the task-specific metrics. In phase III, participants (n = 22) included novices (n = 15) and experts (n ...
Using a biotissue rectal prolapse model, this study documented high IRR and significant discriminant validity evidence in support of video-based assessment using task-specific metrics....
Robotic surgery is perceived to be more complex in obese patients. Objective performance indicators, machine learning-enabled metrics, can provide objective data regarding surgeon movements and roboti...
Endoscopic videos were annotated to delineate individual surgical steps across 39 robotic proctectomies (1880 total steps). Thirteen patients were obese and 26 were nonobese. Objective performance ind...
The following differences were noted during robotic proctectomy in obese patients: during splenic flexure mobilization, more arm swaps, longer camera path length and velocity; during left colon mobili...
We report step-specific objective performance indicators that differ during robotic proctectomy for obese and nonobese patients. This is the first study to use objective performance indicators to corr...
Traditionally, 2 surgical techniques for proctectomy in ulcerative colitis have been used: total mesorectal excision (TME), and close rectal dissection (CRD). Recently, our research group has proposed...
Colectomies and proctectomies are commonly performed by both general surgeons (GS) and colorectal surgeons (CRS). The aim of our study was to examine the outcomes of elective colectomy, urgent colecto...
Data were obtained from the Vizient database for adults who underwent elective colectomy, urgent colectomy, and elective proctectomy from 2020-2022. Operations performed in the setting of trauma and p...
Of 149,516 elective colectomies, 75,711(50.6%) were performed by GS and 73,805(49.4%) by CRS. Compared to elective colectomies performed by CRS, elective colectomies performed by GS had higher rates o...
In this nationwide study, colectomies and proctectomies performed by CRS were associated with improved outcomes compared to GS. Hospitals without a CRS on staff should consider prioritizing recruiting...
Prophylactic surgery for familial adenomatous polyposis has evolved over several decades. Restorative proctocolectomy with ileal pouch anal anastomosis provides an alternative to total abdominal colec...
To determine the rate of proctectomy and rectal cancer among familial adenomatous polyposis patients and relative-rectal sparing (< 20 rectal polyps) selected for total abdominal colectomy with ileore...
Retrospective cohort study....
Single tertiary care institution with a hereditary colorectal cancer registry....
Familial adenomatous polyposis patients who underwent total abdominal colectomy with ileorectal anastomosis between 1993 and 2020....
Incidence of proctectomy for any indication and rectal cancer....
A total of 197 patients with median age of 24 years (range, 10-67) were included. Median follow-up after total abdominal colectomy with ileorectal anastomosis was 13 years (IQR 6-17). Sixteen patients...
Retrospective data collection....
Patients with familial adenomatous polyposis selected for total abdominal colectomy with ileorectal anastomosis by rectal polyp number have low rates of proctectomy and rectal cancer compared to histo...
How patients make treatment choices in rectal cancer is poorly understood and may affect long-term regret and satisfaction. The objective of this study is to characterize decision-making preferences a...
A prospective cohort study was conducted in a single academic specialist rectal cancer center from October 2018 to June 2022. Adult patients who underwent restorative proctectomy at least one year pri...
Overall, 123 patients were included. Health literacy was categorized as adequate in 63%, marginal in 25%, and limited in 12%. Patients with adequate health literacy were more likely to prefer a collab...
A significant proportion of patients with rectal cancer undergoing restorative proctectomy do not have a decision-making role that is congruent with their preferences, and these patients experience a ...
Most patients with rectal cancer experience bowel symptoms post-restorative proctectomy. The incidence of mental health disorders post-restorative proctectomy and its association with bowel symptoms a...
This study aimed 1) to describe the incidence of mental health disorders in patients who underwent restorative proctectomy for rectal cancer and 2) to study the association between incident mental hea...
This retrospective cohort study used the Clinical Practice Research Datalink and Hospital Episode Statistics databases....
The databases were based in the United Kingdom....
All adult patients who underwent restorative proctectomy for a rectal neoplasm between 1998 and 2018 were included....
The primary outcome was an incident mental health disorder. The associations between bowel, sexual, and urinary dysfunctions and incident mental health disorders were studied using Cox proportional ha...
In total, 2197 patients who underwent restorative proctectomy were identified. Of 1858 patients without preoperative bowel, sexual, or urinary dysfunction, 1455 had no preoperative mental health disor...
This study was limited by its observational study design and residual confounding....
Incident mental health disorders after restorative proctectomy for rectal cancer are common. The presence of bowel and urinary functional impairment significantly increases the risk of poor psychologi...
ANTECEDENTES: La mayoría de los pacientes con cáncer de recto experimentan síntomas intestinales después de la proctectomía restauradora. Se desconoce la incidencia de trastornos de salud mental poste...
Robotic-assisted complete mesorectal excision (RATME) is increasingly being used by colorectal surgeons. Most surgeons consider RATME a safe method, and believe it can facilitate total mesorectal exci...
This is a multicenter, superiority, randomized controlled trial designed to compare RATME and LATME in middle and low rectal cancer. The primary endpoint is the ISR rate. The secondary endpoints are c...
This trial will clarify if RATME improves ISR and promotes anus preservation in patients with mid- and low-rectal cancer. Furthermore, this trial will provide evidence on the optimal treatment strateg...
ClinicalTrials.gov NCT06105203. Registered on October 27, 2023....
