Surgery open science最新文献

{"title":"Development and validation of a mouse model to investigate post surgical pain after laparotomy","authors":"Juan Martinez ,&nbsp;Thomas Maisey ,&nbsp;Nicola Ingram ,&nbsp;Nikil Kapur ,&nbsp;Paul A. Beales ,&nbsp;David G. Jayne","doi":"10.1016/j.sopen.2024.06.002","DOIUrl":"https://doi.org/10.1016/j.sopen.2024.06.002","url":null,"abstract":"<div><h3>Background</h3><p>Postoperative pain following abdominal surgery is a significant obstacle to patient recovery, often necessitating high analgesic doses associated with adverse effects like cognitive impairment and cardiorespiratory depression. Reliable animal models are crucial for understanding the pathophysiology of post surgical pain and developing more effective pain-relieving strategies.</p></div><div><h3>Methods</h3><p>We developed a mouse model to replicate peritoneal trauma induced by abdominal surgery. 30 C57BL/6 mice underwent laparotomy, with half undergoing standardised peritoneal abrasion and the rest serving as controls. Mouse recovery was assessed using two validated scoring systems of surgical recovery: Post surgery Severity Assessment (PSSA) and Mouse Grimace Score (MGS). Blood samples were taken for cytokine analysis. Adhesions were evaluated on day 6, and peritoneal tissue was examined for healing markers.</p></div><div><h3>Results</h3><p>After laparotomy, all mice exhibited expected pain profiles. Mice with peritoneal abrasion had significantly higher PSSA (7.2 ± 1.2 vs 4.68 ± 0.82, <em>p</em> ≤ 0.001) and MGS scores (3.62 ± 0.74 vs 0.82 ± 0.40, <em>p</em> ≤ 0.05) with slower recovery. Serum inflammatory cytokine levels were significantly elevated in the abraded group, and adhesion formation was higher in this group. Immunohistochemical analysis showed significantly increased expression of α-SMA, CD31, CD68, and F4/80 in peritoneal tissue in the abraded group.</p></div><div><h3>Discussion</h3><p>A mouse model involving laparotomy and standardised peritoneal abrasion replicates the expected pathophysiological changes following abdominal surgery. It will be a useful model for better understanding the mechanisms of post surgical pain and developing improved pain-relief strategies. It also has utility for the study of intra-abdominal adhesion formation.</p></div><div><h3>Key message</h3><p>To understand the intricate relationship between peritoneal trauma-induced pain, cytokine response, and post-operative adhesion formation in mouse models for advancing therapeutic interventions and enhancing post-operative recovery outcomes.</p></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"20 ","pages":"Pages 106-115"},"PeriodicalIF":1.4,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589845024000897/pdfft?md5=dcc2cee8e34059c1814ac5cfe7e2a7a2&pid=1-s2.0-S2589845024000897-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141444625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in neoadjuvant chemotherapy for pancreatic adenocarcinoma with vascular involvement","authors":"Nikhil Chervu ,&nbsp;Shineui Kim ,&nbsp;Sara Sakowitz ,&nbsp;Nguyen Le ,&nbsp;Saad Mallick ,&nbsp;Hanjoo Lee ,&nbsp;Peyman Benharash ,&nbsp;Timothy Donahue","doi":"10.1016/j.sopen.2024.06.003","DOIUrl":"https://doi.org/10.1016/j.sopen.2024.06.003","url":null,"abstract":"<div><h3>Background</h3><p>Multiagent neoadjuvant chemotherapy (NAT) has been linked with improved survival for locally advanced (LA) or borderline resectable (BR) pancreatic ductal adenocarcinoma (PDAC). However, the existence of disparities in its utilization remains to be elucidated.</p></div><div><h3>Methods</h3><p>All adults with PDAC were tabulated from the 2011–2017 Nationwide Cancer Database. Tumor vascular involvement was determined using the clinical T stage and CS_EXTENSION variables. The significance of temporal trends was calculated using Cuzick's non-parametric test. A Cox proportional hazard model was used to assess the impact of NAT utilization on hazard of two-year mortality. A logistic regression model was developed to determine factors associated with receipt of NAT.</p></div><div><h3>Results</h3><p>Of 3811 patients meeting inclusion criteria, 50.8 % received NAT. NAT utilization significantly increased over the study period, from 31.7 % in 2011 to 81.1 % in 2017 (<em>p</em> &lt; 0.001). NAT was associated with significantly reduced two-year mortality (Hazards Ratio 0.34, 95 % Confidence Interval [CI] 0.18–0.67).</p><p>After adjustment, younger (Adjusted Odds Ratio [AOR] 0.97/year, CI 0.96–0.98) and Black (AOR 0.65, CI 0.48–0.89; ref: White) patients demonstrated reduced odds of NAT. Furthermore, patients with Medicare (AOR 0.73, CI 0.59–0.90; ref: Private) or Medicaid insurance (AOR 0.67, CI 0.46–0.97; ref: Private) had lower odds of NAT, as did those treated at non-academic institutions (Community: AOR 0.42, CI 0.35–0.52, Integrated: 0.68, CI 0.54–0.85) or in the lowest education quartile (AOR 0.52, CI 0.29–0.95; ref: Highest).</p></div><div><h3>Conclusions</h3><p>We identified increasing utilization of NAT for BR/LA pancreatic adenocarcinoma. Despite being linked with significantly reduced two-year mortality, socioeconomic disparities affect odds of NAT.</p></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"20 ","pages":"Pages 101-105"},"PeriodicalIF":1.4,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589845024000885/pdfft?md5=19db5235d50a1ff3c25e43db5ccdff30&pid=1-s2.0-S2589845024000885-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141438515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of pain after prophylactic anticoagulant injections to prevent venous thromboembolism","authors":"Margaret Shyu ,&nbsp;Tyler P. Robinson ,&nbsp;Allison M. Morgan ,&nbsp;Julie K. Johnson ,&nbsp;Ying Shan ,&nbsp;Karl Y. Bilimoria ,&nbsp;Anthony D. Yang","doi":"10.1016/j.sopen.2024.06.001","DOIUrl":"https://doi.org/10.1016/j.sopen.2024.06.001","url":null,"abstract":"<div><p>Subcutaneous injection of unfractionated heparin (UH) or low molecular weight heparin (LMWH) is frequently utilized for venous thromboembolism chemoprophylaxis. We previously discovered that nurses believe patients experience more pain with UH compared to the LMWH enoxaparin; however, no published studies that are appropriately powered exist comparing pain associated with subcutaneous chemoprophylaxis. Our objective was to assess if differences exist in pain associated with subcutaneous administration of UH and enoxaparin. We conducted an observational study of patients who underwent major abdominal surgery between 11/2017–4/2019. All patients received one of three prophylactic regimens: (1) UH only, (2) Initial dose of UH followed by enoxaparin, or (3) enoxaparin only. Of the 74 patients observed, 40 patients received UH followed by enoxaparin, 17 received UH only, and 17 received enoxaparin only. There was a significant difference in patients' mean perceived pain between subcutaneous UH and enoxaparin injections (mean post-injection pain after UH 3.3 vs. enoxaparin 1.5; <em>p</em> &lt; 0.001). There was no significant difference in perceived pain for patients who received consecutive UH or enoxaparin injections. Differences in pain associated with different chemoprophylaxis agents may be an unrecognized driver of patient refusals of VTE chemoprophylaxis and may lead to worse VTE outcomes.</p></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"20 ","pages":"Pages 98-100"},"PeriodicalIF":1.4,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589845024000873/pdfft?md5=0f9bf5cde71b22b28003d013f50a5c37&pid=1-s2.0-S2589845024000873-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141429245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing surgical internship experiences: The potential of a supporting digital curriculum","authors":"Tim M. Feenstra ,&nbsp;Marianne C. Mak-van der Vossen ,&nbsp;Melissa Montoya Buitrago ,&nbsp;Danielle Sent ,&nbsp;Susanne van der Velde","doi":"10.1016/j.sopen.2024.06.005","DOIUrl":"https://doi.org/10.1016/j.sopen.2024.06.005","url":null,"abstract":"<div><h3>Background</h3><p>Centralization of care jeopardizes interns' learning experiences and necessitates educational changes. Here we present the development and evaluation of a structured digital curriculum, offered in addition to the clinical internship, to address these challenges.</p></div><div><h3>Methods</h3><p>The structured digital curriculum was implemented in a the VUmc/Amsterdam UMC surgical internship program in the Netherlands. The curriculum used a modular format built around a skill or clinical condition. Each module included background information, digital elements like e-learnings and interactive vlogs, and self-assessments. From April 1st to June 30th, 2022, we conducted a mixed-methods evaluation comparing interns' experiences between the conventional and digital curriculum through surveys and interviews.</p></div><div><h3>Results</h3><p>Thirty-nine interns (28.1 %) completed the survey, 17 (24.2 %) from the traditional curriculum and 22 (31.9 %) from the structured blended curriculum. Results from the interviews triangulated and complemented survey results. Interns appreciated both curricula (course marks 7.4 ± 2.0 vs. 8.1 ± 1.1, <em>P</em> = 0.207). The intervention cohort specifically appreciated the structured and comprehensive presentation of available study materials, which resulted in a sense of empowerment.</p></div><div><h3>Conclusions</h3><p>Integrating a structured digital curriculum to support clinical internships provides interns with comprehensive, readily accessible knowledge, refines their understanding of clinical topics, and results in feelings of empowerment. The combination of clinical and digital education ensures adequate exposure to subjects vital for future doctors, even if clinical exposure is limited. Thus, using a structured digital curriculum prepares the intern and helps the internship program to adequately navigate future medical challenges.</p></div><div><h3>Key message</h3><p>Centralization of care jeopardizes interns' learning experiences and necessitates educational changes. A structured digital curriculum can empower interns in this scenario by providing readily accessible knowledge which refines their understanding of clinical topics.</p></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"20 ","pages":"Pages 116-122"},"PeriodicalIF":1.4,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589845024000861/pdfft?md5=b885932749c304900d7d0d7398cac729&pid=1-s2.0-S2589845024000861-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141484436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A structured curriculum for the acquisition of basic surgical endoscopic skills for surgical residents and quantification of skills improvement","authors":"Marc Fischer ,&nbsp;Michail Galanis ,&nbsp;Konstantinos Gioutsos,&nbsp;Jon Andri Lutz ,&nbsp;Filipe Azenha Figueiredo ,&nbsp;Patrick Dorn","doi":"10.1016/j.sopen.2024.05.021","DOIUrl":"https://doi.org/10.1016/j.sopen.2024.05.021","url":null,"abstract":"<div><h3>Introduction</h3><p>New strategies and methods are needed to ensure that new generations can train and acquire surgical skills in a safe environment.</p></div><div><h3>Materials and methods</h3><p>From January 2020 to October 2020, we performed a single centre, prospective observational cohort study. 19 participants (15 students, 4 residents) enrolled and 16 participants (13 students, 3 residents) successfully completed the curriculum. We performed a quantitative data analysis to evaluate its effectiveness in gaining and improving basic surgical endoscopic skills.</p></div><div><h3>Results</h3><p>The time for single knot tying pre-, mid-, and post-training was reduced significantly, the average time (<em>sec</em>) decreased by 79.5 % (<em>p</em> &lt; 0.001), the total linear distance (cm) by 74.5 % (<em>p</em> &lt; 0.001) and the total angular distance (rad) by 71.7 % (p &lt; 0.001). The average acceleration (mm/s²) increased by 20 % (<em>p</em> = 0.041). Additionally, the average speed increased by 23.5 % (<em>p</em> &lt; 0.001), while motion smoothness (m/s³) increased by 20.4 % (<em>p</em> = 0.02).</p></div><div><h3>Conclusion</h3><p>The obtained performance scores showed a significant increase in participants improving their basic surgical performance skills on the endoscopic simulator. This curriculum can be easily implemented in any surgical specialty as part of the residency training curriculum before first exposure in the operation room. All 16 participants recommended the implementation of such simulator training in their surgical training curriculum.</p></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"20 ","pages":"Pages 82-93"},"PeriodicalIF":1.4,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589845024000836/pdfft?md5=84c0c8c54ee7670354716b41fa4c8777&pid=1-s2.0-S2589845024000836-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141324347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of surgery clerkship grades on applicant competitiveness for orthopaedic surgery residency match","authors":"Sean M. Richards,&nbsp;Nicolas J. Nadeau","doi":"10.1016/j.sopen.2024.05.019","DOIUrl":"https://doi.org/10.1016/j.sopen.2024.05.019","url":null,"abstract":"<div><p>Medical school clerkship grades are an important method for applicants to distinguish themselves when applying to residency programs. Given the lack of standardization among medical schools in the clerkship grading process, it has become more challenging for orthopaedic surgery residencies to ascertain the true value of surgery clerkship grades between applicants. This letter to the editor is a response to the article by Hoy et al., “Analysis of variability and trends in medical school clerkship grades,” and offers further perspectives on the variability of surgery clerkship grading and its effect on applicants.</p></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"20 ","pages":"Pages 55-56"},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589845024000812/pdfft?md5=982fc15d12e30ed0eda2a9f0fe0cd474&pid=1-s2.0-S2589845024000812-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141243421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individualized care or ad hoc care: Is evidence based, personalized care for diverticulitis currently possible?","authors":"David B. Stewart Professor and Division Chief of General Surgery","doi":"10.1016/j.sopen.2024.05.007","DOIUrl":"10.1016/j.sopen.2024.05.007","url":null,"abstract":"","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"19 ","pages":"Pages 230-231"},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589845024000691/pdfft?md5=590c411f97cae5861dab2906068c249e&pid=1-s2.0-S2589845024000691-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141145008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Board Page","authors":"","doi":"10.1016/S2589-8450(24)00085-X","DOIUrl":"https://doi.org/10.1016/S2589-8450(24)00085-X","url":null,"abstract":"","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"19 ","pages":"Page i"},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S258984502400085X/pdfft?md5=b3810b1924c42b645b5c297a9aaf92d1&pid=1-s2.0-S258984502400085X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141294649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for recurrent colorectal peritoneal metastases","authors":"Peter Harald Cashin MD, PhD ,&nbsp;Dan Asplund MD, PhD ,&nbsp;Elinor Bexe Lindskog MD, PhD ,&nbsp;Lana Ghanipour MD, PhD ,&nbsp;Ingvar Syk MD, PhD ,&nbsp;Wilhelm Graf MD, PhD ,&nbsp;Per J. Nilsson MD, PhD ,&nbsp;Gabriella Jansson Palmer MD, PhD","doi":"10.1016/j.sopen.2024.05.018","DOIUrl":"https://doi.org/10.1016/j.sopen.2024.05.018","url":null,"abstract":"<div><h3>Background</h3><p>Secondary treatment of recurrent colorectal peritoneal metastases after previous cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is poorly investigated.</p></div><div><h3>Objectives</h3><p>To evaluate the overall survival outcome of secondary (repeat) CRS + HIPEC compared to palliative treatment in recurrent peritoneal disease.</p></div><div><h3>Methods</h3><p>Patients with colorectal peritoneal metastases treated with an index CRS + HIPEC and subsequently having recurrent peritoneal disease were identified from the prospective Swedish national HIPEC registry. Patients were divided into interventional group (secondary CRS + HIPEC) or palliative group. Multivariable logistic regression, propensity-score matching, and survival outcomes were calculated.</p></div><div><h3>Results</h3><p>Among 575 patients who underwent complete CRS between 2010 and 2021, 208 (36 %) were diagnosed with a subsequent recurrent peritoneal disease. Forty-two patients (20 %) were offered secondary CRS + HIPEC. Propensity-score matching of secondary interventional cases with palliative cases succeeded in 88 % (<em>n</em> = 37) in which female sex, lower peritoneal cancer index at index surgery, longer disease-free interval, and absence of extra-peritoneal metastases were identified as the most relevant matching covariates. Median OS from date of recurrence was 38 months (95%CI 30–58) in the interventional group and 19 months (95%CI: 15–24) in the palliative group (HR 0.35 95%CI: 0.20–0.63, <em>p</em> = 0.0004). Sensitivity analyses confirmed the results. As reference, the median OS from index CRS + HIPEC in the whole colorectal registry (<em>n</em> = 575) was 41 months (95%CI: 38–45).</p></div><div><h3>Conclusion</h3><p>After matching for relevant factors, the hazard ratio for death was significantly reduced in patients who were offered a secondary CRS + HIPEC procedure for recurrent peritoneal disease. Selection bias is inherent, but survival outcomes were comparable to those achieved after the initial procedure.</p></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"20 ","pages":"Pages 45-50"},"PeriodicalIF":1.4,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589845024000848/pdfft?md5=7283d17e1269114b08224a2bce659265&pid=1-s2.0-S2589845024000848-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141243438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world assessment of longitudinal opioid use and healthcare resource utilization in patients undergoing colorectal resection","authors":"Gary Schwartz ,&nbsp;Jennifer H. Lin ,&nbsp;Swapnabir Kakoty","doi":"10.1016/j.sopen.2024.05.022","DOIUrl":"https://doi.org/10.1016/j.sopen.2024.05.022","url":null,"abstract":"<div><p>Liposomal bupivacaine (LB) has been used in multimodal pain management regimens to improve postsurgical analgesia. This retrospective cohort analysis assessed clinical and economic outcomes of LB vs non-LB analgesia in minimally invasive colorectal resection surgery using real-world patient data from the IQVIA linkage claims databases. Patients who received LB were 1:1 matched to patients who did not receive LB (non-LB) via propensity scores. Outcomes included opioid use during the perioperative (2 weeks before surgery to 2 weeks after discharge), continued (&gt;2 weeks to 3 months after discharge), and persistent (&gt;3 months to 6 months after discharge) periods and healthcare resource utilization (HRU) during the first 3 months after discharge. Mean opioid consumption was lower in the LB (<em>n</em> = 4397) versus non-LB (n = 4397) cohort perioperatively (483 vs 538 morphine milligram equivalents [MMEs]; <em>P</em> = 0.001) and after discharge within ∼3 months (222 vs 328 MMEs; <em>P</em> &lt; 0.0001) and 3–6 months (245 vs 384 MMEs; <em>P</em> &lt; 0.0001). The LB cohort had shorter mean length of stay (5.2 vs 5.7 days; <em>P</em> &lt; 0.0001) and fewer inpatient readmissions (odds ratio [OR], 0.71; <em>P</em> &lt; 0.0001), emergency department visits (OR, 0.78; <em>P</em> &lt; 0.0001), and outpatient/office visits (OR, 0.91; <em>P</em> = 0.028) than the non-LB cohort 3 months after discharge. These data suggest use of LB in minimally invasive colorectal resection surgery may reduce perioperative and postdischarge opioid use as well as HRU. Although additional studies are needed to confirm these findings, this analysis provides valuable real-world data from large claims databases to evaluate clinical and economic outcomes that complement other types of retrospective and prospective studies.</p></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"20 ","pages":"Pages 94-97"},"PeriodicalIF":1.4,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589845024000794/pdfft?md5=196ad89e9c104e6dec290b138248a975&pid=1-s2.0-S2589845024000794-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141324348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}