The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Judy C Boughey - One of the best experts on this subject based on the ideXlab platform.
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Reoperation for complications after lumpectomy and mastectomy for breast cancer from the 2012 national surgical quality improvement program acs nsqip
Annals of Surgical Oncology, 2015Co-Authors: Zahraa Alhilli, Kristine M Thomsen, James W Jakub, Elizabeth B Habermann, Judy C BougheyAbstract:Hospital readmissions and Reoperations are quality indicators of patient care. In 2012, the National Surgical Quality Improvement Program (ACS-NSQIP) began reporting details regarding unplanned Reoperations within 30 days of initial procedure. The main objective of this study was to identify Reoperation rates as a result of complications and evaluate complications by type of breast surgery. Patients who underwent surgery for breast cancer were identified from the 2012 ACS-NSQIP Participant User File. Breast procedures were categorized as mastectomy or lumpectomy, each with or without immediate breast reconstruction (IBR). All Reoperations and complication-related Reoperations were categorized on the basis of procedure and diagnosis codes, and rates were compared by breast procedure by Chi square tests. Of 18,500 patients, 781 (4 %) required an unplanned Reoperation within 30 days (single Reoperation in 747, 2+ Reoperations in 34). Mean time to first Reoperation was 13.4 days and varied by procedure. A majority (73 %) of ACS-NSQIP coded unplanned Reoperations were due to complications. Rates of Reoperation due to complication were highest in mastectomy with IBR (7 %). Most common complications requiring Reoperation were bleeding, followed by infection and wound-related problems. Unplanned Reoperations after breast cancer surgery are more frequent after mastectomy with IBR than other breast operations. Bleeding is the most common complication requiring Reoperation.
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impact of analysis of frozen section margin on Reoperation rates in women undergoing lumpectomy for breast cancer evaluation of the national surgical quality improvement program data
Surgery, 2014Co-Authors: Judy C Boughey, Tina J Hieken, James W Jakub, Amy C Degnim, Clive S Grant, David R Farley, Kristine M Thomsen, John B Osborn, Gary L Keeney, Elizabeth B HabermannAbstract:Background Reoperation for positive margins after lumpectomy for breast cancer is common. Intraoperative analysis of frozen-section (FS) margins permits immediate re-excision, avoiding Reoperation. The aim of this study was to compare Reoperation rates between an institution using routine FS analysis of all margins and the National Surgical Quality Improvement Program (NSQIP) data. Methods We designed a retrospective cohort analysis comparing the NSQIP data from a FS single institution with the national NSQIP data from 2006 to 2010. Women undergoing lumpectomy for cancer were identified (N = 24,217), and Reoperation rates were compared by the use of χ2 analyses and multivariable logistic regression. During this time period, NSQIP did not differentiate between Reoperations for complications or oncologic reasons. Reoperation rates for mastectomy patients (N = 21,734) and lumpectomy patients without cancer (N = 2,777) over the same time period were analyzed as controls, because Reoperations after these procedures likely would be for reasons other than positive margins. Results The 30-day Reoperation rate after lumpectomy for cancer was greater nationally than at the FS institution (13.2% vs 3.6%, P Conclusion Intraoperative FS margin analysis decreases the number of Reoperations for patients undergoing breast conservation for breast cancer. This technique has important implications for patient satisfaction and cost of care.
Byung Joo Park - One of the best experts on this subject based on the ideXlab platform.
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Reoperation rate after surgery for lumbar spinal stenosis without spondylolisthesis a nationwide cohort study
The Spine Journal, 2013Co-Authors: Chun Kee Chung, Choon Seon Park, Boram Choi, Byung Joo Park, Seokyung HahnAbstract:Abstract Background context Lumbar spinal stenosis is one of the most common degenerative spine diseases. Surgical options are largely divided into decompression only and decompression with arthrodesis. Recent randomized trials showed that surgery was more effective than nonoperative treatment for carefully selected patients with lumbar stenosis. However, some patients require Reoperation because of complications, failure of bony fusion, persistent pain, or progressive degenerative changes, such as adjacent segment disease. In a previous population-based study, the 10-year Reoperation rate was 17%, and fusion surgery was performed in 10% of patients. Recently, the lumbar fusion surgery rate has doubled, and a substantial portion of the Reoperations are associated with a fusion procedure. With the change in surgical trends, the longitudinal surgical outcomes of these trends need to be reevaluated. Purpose To provide the longitudinal Reoperation rate after surgery for spinal stenosis and to compare the Reoperation rates between decompression and fusion surgeries. Study design/setting Retrospective cohort study using national health insurance data. Patient sample A cohort of patients who underwent initial surgery for lumbar stenosis without spondylolisthesis in 2003. Outcome measures The primary end point was any type of second lumbar surgery. Cox proportional hazards regression modeling was used to compare the adjusted Reoperation rates between decompression and fusion surgeries. Methods A national health insurance database was used to identify a cohort of patients who underwent an initial surgery for lumbar stenosis without spondylolisthesis in 2003; a total of 11,027 patients were selected. Individual patients were followed for at least 5 years through their encrypted unique resident registration number. After adjusting for confounding factors, the Reoperation rates for decompression and fusion surgery were compared. Results Fusion surgery was performed in 20% of patients. The cumulative Reoperation rate was 4.7% at 3 months, 7.2% at 1 year, 9.4% at 2 years, 11.2% at 3 years, 12.5% at 4 years, and 14.2% at 5 years. The adjusted Reoperation rate was not different between decompression and fusion surgeries (p=.82). The calculated Reoperation rate was expected to be 22.9% at 10 years. Conclusions The Reoperation rate was not different between decompression and fusion surgeries. With current surgical trends, the Reoperation rate appeared to be higher than in the past, and consideration of this problem is required.
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Reoperation rate after surgery for lumbar herniated intervertebral disc disease nationwide cohort study
Spine, 2013Co-Authors: Chi Heon Kim, Chun Kee Chung, Choon Seon Park, Boram Choi, Min Jung Kim, Byung Joo ParkAbstract:STUDY DESIGN Retrospective cohort study using national health insurance data. OBJECTIVE To provide a longitudinal Reoperation rate after surgery for lumbar herniated intervertebral disc (HIVD) disease, and to compare the Reoperation rates of surgical methods. SUMMARY OF BACKGROUND DATA Herniated intervertebral disc disease is the most common cause of lumbar spinal surgery. Despite improved surgical techniques and instrumentation, Reoperation cannot be avoided. The Reoperation rates were in the range of 6% to 24% in previous studies. A population-based study is less subject to bias; hence, a nationwide longitudinal analysis was warranted. METHODS A national health insurance database was used to identify a cohort of patients who underwent first surgery for herniated intervertebral disc disease in 2003 and 18,590 patients were selected. Individual patients were followed for at least 5 years through their encrypted unique resident registration number. The primary endpoint was any type of second lumbar surgery. After adjusting for confounding factors, 5 surgical methods (fusion, laminectomy, open discectomy, endoscopic discectomy, and nucleolysis [including mechanical nucleus decompression]) were compared. Open discectomy was used as the reference method. RESULTS Open discectomy was the most common procedure (68.9%) followed by endoscopic discectomy (16.1%), laminectomy (7.9%), fusion (3.9%), and nucleolysis (3.2%). The cumulative Reoperation rate was 5.4% at 3 months, 7.4% at 1 year, 9% at 2 years, 10.5% at 3 years, 12.1% at 4 years, and 13.4% at 5 years. The Reoperation rates were 18.6%, 14.7%, 13.8%, 12.4%, and 11.8% after laminectomy, nucleolysis, open discectomy, endoscopic discectomy, and fusion, respectively. Compared with open discectomy, the Reoperation rate was higher after laminectomy at 3 months, whereas the other surgical methods had similar rates. CONCLUSION The cumulative Reoperation rate after 5 years was 13.4% and half of the Reoperations occurred during the first postoperative year. With the exception of laminectomy, the Reoperation rates of the other procedures were not different from that of open discectomy.
Elizabeth B Habermann - One of the best experts on this subject based on the ideXlab platform.
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Reoperation for complications after lumpectomy and mastectomy for breast cancer from the 2012 national surgical quality improvement program acs nsqip
Annals of Surgical Oncology, 2015Co-Authors: Zahraa Alhilli, Kristine M Thomsen, James W Jakub, Elizabeth B Habermann, Judy C BougheyAbstract:Hospital readmissions and Reoperations are quality indicators of patient care. In 2012, the National Surgical Quality Improvement Program (ACS-NSQIP) began reporting details regarding unplanned Reoperations within 30 days of initial procedure. The main objective of this study was to identify Reoperation rates as a result of complications and evaluate complications by type of breast surgery. Patients who underwent surgery for breast cancer were identified from the 2012 ACS-NSQIP Participant User File. Breast procedures were categorized as mastectomy or lumpectomy, each with or without immediate breast reconstruction (IBR). All Reoperations and complication-related Reoperations were categorized on the basis of procedure and diagnosis codes, and rates were compared by breast procedure by Chi square tests. Of 18,500 patients, 781 (4 %) required an unplanned Reoperation within 30 days (single Reoperation in 747, 2+ Reoperations in 34). Mean time to first Reoperation was 13.4 days and varied by procedure. A majority (73 %) of ACS-NSQIP coded unplanned Reoperations were due to complications. Rates of Reoperation due to complication were highest in mastectomy with IBR (7 %). Most common complications requiring Reoperation were bleeding, followed by infection and wound-related problems. Unplanned Reoperations after breast cancer surgery are more frequent after mastectomy with IBR than other breast operations. Bleeding is the most common complication requiring Reoperation.
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impact of analysis of frozen section margin on Reoperation rates in women undergoing lumpectomy for breast cancer evaluation of the national surgical quality improvement program data
Surgery, 2014Co-Authors: Judy C Boughey, Tina J Hieken, James W Jakub, Amy C Degnim, Clive S Grant, David R Farley, Kristine M Thomsen, John B Osborn, Gary L Keeney, Elizabeth B HabermannAbstract:Background Reoperation for positive margins after lumpectomy for breast cancer is common. Intraoperative analysis of frozen-section (FS) margins permits immediate re-excision, avoiding Reoperation. The aim of this study was to compare Reoperation rates between an institution using routine FS analysis of all margins and the National Surgical Quality Improvement Program (NSQIP) data. Methods We designed a retrospective cohort analysis comparing the NSQIP data from a FS single institution with the national NSQIP data from 2006 to 2010. Women undergoing lumpectomy for cancer were identified (N = 24,217), and Reoperation rates were compared by the use of χ2 analyses and multivariable logistic regression. During this time period, NSQIP did not differentiate between Reoperations for complications or oncologic reasons. Reoperation rates for mastectomy patients (N = 21,734) and lumpectomy patients without cancer (N = 2,777) over the same time period were analyzed as controls, because Reoperations after these procedures likely would be for reasons other than positive margins. Results The 30-day Reoperation rate after lumpectomy for cancer was greater nationally than at the FS institution (13.2% vs 3.6%, P Conclusion Intraoperative FS margin analysis decreases the number of Reoperations for patients undergoing breast conservation for breast cancer. This technique has important implications for patient satisfaction and cost of care.
Michael G Deeb - One of the best experts on this subject based on the ideXlab platform.
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aortic valve Reoperation after stentless bioprosthesis short and long term outcomes
The Annals of Thoracic Surgery, 2018Co-Authors: Bo Yang, Himanshu J Patel, Elizabeth L Norton, Christina Debenedictus, Linda Farhat, Kevin He, Whitney E. Hornsby, Xiaoting Wu, Donald S. Likosky, Michael G DeebAbstract:Abstract Background Limited data are available regarding outcomes for stentless aortic valve Reoperation. The reported reoperative mortality has been unacceptably high. Methods Between 1997-2017, a retrospective analysis was performed on 143 patients that underwent open aortic valve Reoperations for failed stentless aortic valve bioprostheses. We evaluated both short- and long-term outcomes on this cohort of patients. Results Bicuspid aortic valve was present in 107/143 (75%) of patients at the time of the initial Freestyle procedure and 84% (120/143) patients underwent a modified inclusion aortic root replacement procedure. The interval from first operation to Reoperation was 9.0 (5.4, 11.8) years, which was significantly shorter for patients with infectious endocarditis [4.1 (1.8, 7.1) years] compared to patients with structural valvular deterioration [10.4 (8.1, 12.4) years, p Conclusions Aortic valve Reoperation following stentless valve implantation can be performed with low operative mortality and favorable long-term survival.
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aortic valve Reoperation after stentless bioprosthesis short and long term outcomes
The Annals of Thoracic Surgery, 2018Co-Authors: Bo Yang, Himanshu J Patel, Elizabeth L Norton, Christina Debenedictus, Linda Farhat, Whitney E. Hornsby, Donald S. Likosky, Michael G DeebAbstract:Background Limited data are available regarding outcomes for stentless aortic valve Reoperation. The reported reoperative mortality has been unacceptably high. Methods Between 1997 and 2017, a retrospective analysis was performed on 143 patients who underwent open aortic valve Reoperations for failed stentless aortic valve bioprostheses. We evaluated both short-term and long-term outcomes on this cohort of patients. Results Bicuspid aortic valve was present in 107 of 143 patients (75%) at the time of the initial Freestyle (Medtronic, Minneapolis, MN) procedure, and 120 of 143 patients (84%) underwent a modified inclusion aortic root replacement procedure. The interval from first operation to Reoperation was 9 years (range, 5.4 to 11.8), which was significantly shorter for patients with infectious endocarditis (4.1 years; range, 1.8 to 7.1) compared with patients with structural valvular deterioration (10.4 years; range, 8.1 to 12.4, p Conclusions Aortic valve Reoperation after stentless valve implantation can be performed with low operative mortality and favorable long-term survival.
Bo Yang - One of the best experts on this subject based on the ideXlab platform.
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influence of age on longevity of a stentless aortic valve
The Annals of Thoracic Surgery, 2019Co-Authors: Bo Yang, Elizabeth L Norton, Linda Farhat, Aroosa Malik, Alexander Makkinejad, Mohamedali Sareini, Emma St Pierre, Xiaoting Wu, Jonathan W Haft, Matthew A RomanoAbstract:Background The longevity of a stentless valve in a younger population (20-60 years old) is unknown. Methods From 1992 to 2015, 1947 patients underwent aortic valve/root replacement for aortic stenosis, insufficiency, root aneurysm, or aortic dissection with stentless bioprostheses (median size, 26 mm). At operation 105 patients were Results The 30-day mortality rate was 2.6%. During follow-up 807 patients (41%) died before Reoperation, 993 (51%) were alive without Reoperations because of deterioration, and 113 patients (5.8%) underwent Reoperation for structural valve deterioration. After adjusting death and Reoperation for non–structural valve deterioration causes as competing risks, the cumulative incidence of Reoperation was significantly different between the younger groups ( Conclusions The stentless aortic valve provides satisfactory durability as a conduit for aortic valve/root replacement for patients who prefer a bioprosthesis. However it should be judiciously considered for patients younger than 60 years because of an increased incidence of Reoperation for structural valve deterioration.
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aortic valve Reoperation after stentless bioprosthesis short and long term outcomes
The Annals of Thoracic Surgery, 2018Co-Authors: Bo Yang, Himanshu J Patel, Elizabeth L Norton, Christina Debenedictus, Linda Farhat, Kevin He, Whitney E. Hornsby, Xiaoting Wu, Donald S. Likosky, Michael G DeebAbstract:Abstract Background Limited data are available regarding outcomes for stentless aortic valve Reoperation. The reported reoperative mortality has been unacceptably high. Methods Between 1997-2017, a retrospective analysis was performed on 143 patients that underwent open aortic valve Reoperations for failed stentless aortic valve bioprostheses. We evaluated both short- and long-term outcomes on this cohort of patients. Results Bicuspid aortic valve was present in 107/143 (75%) of patients at the time of the initial Freestyle procedure and 84% (120/143) patients underwent a modified inclusion aortic root replacement procedure. The interval from first operation to Reoperation was 9.0 (5.4, 11.8) years, which was significantly shorter for patients with infectious endocarditis [4.1 (1.8, 7.1) years] compared to patients with structural valvular deterioration [10.4 (8.1, 12.4) years, p Conclusions Aortic valve Reoperation following stentless valve implantation can be performed with low operative mortality and favorable long-term survival.
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aortic valve Reoperation after stentless bioprosthesis short and long term outcomes
The Annals of Thoracic Surgery, 2018Co-Authors: Bo Yang, Himanshu J Patel, Elizabeth L Norton, Christina Debenedictus, Linda Farhat, Whitney E. Hornsby, Donald S. Likosky, Michael G DeebAbstract:Background Limited data are available regarding outcomes for stentless aortic valve Reoperation. The reported reoperative mortality has been unacceptably high. Methods Between 1997 and 2017, a retrospective analysis was performed on 143 patients who underwent open aortic valve Reoperations for failed stentless aortic valve bioprostheses. We evaluated both short-term and long-term outcomes on this cohort of patients. Results Bicuspid aortic valve was present in 107 of 143 patients (75%) at the time of the initial Freestyle (Medtronic, Minneapolis, MN) procedure, and 120 of 143 patients (84%) underwent a modified inclusion aortic root replacement procedure. The interval from first operation to Reoperation was 9 years (range, 5.4 to 11.8), which was significantly shorter for patients with infectious endocarditis (4.1 years; range, 1.8 to 7.1) compared with patients with structural valvular deterioration (10.4 years; range, 8.1 to 12.4, p Conclusions Aortic valve Reoperation after stentless valve implantation can be performed with low operative mortality and favorable long-term survival.
