Featured Publications
How Far Is Too Far? Cost-Effectiveness Analysis of Regionalized Rectal Cancer Surgery
Leeds I, Xu Z, Loria A, Pantel H, Mongiu A, Longo W, Reddy V. How Far Is Too Far? Cost-Effectiveness Analysis of Regionalized Rectal Cancer Surgery. Diseases Of The Colon & Rectum 2022, 66: 467-476. PMID: 36538713, DOI: 10.1097/dcr.0000000000002636.Peer-Reviewed Original ResearchConceptsMultivariable probabilistic sensitivity analysesCost-effectiveness standardsIncremental cost-effectiveness ratioProbabilistic sensitivity analysesCost-effectiveness analysisCost-effectiveness ratioTotal societal costsSensitivity analysisDecision analysis modelEl análisisSocietal perspectiveIncremental costPacientes con cáncerSocietal costsLos costosLargo plazoPolicy levelDecision analysisTotal costCost
2023
Racial disparities in complications following elective colon cancer resection: Impact of laparoscopic versus robotic approaches
Ahuja V, Paredes L, Leeds I, Perkal M, Tsutsumi A, Bhandarkar S, King J. Racial disparities in complications following elective colon cancer resection: Impact of laparoscopic versus robotic approaches. The American Journal Of Surgery 2023, 227: 85-89. PMID: 37806892, PMCID: PMC10842593, DOI: 10.1016/j.amjsurg.2023.09.038.Peer-Reviewed Original ResearchConceptsRC patientsLaparoscopic colectomyElective colon cancer resectionImpact of laparoscopicACS-NSQIP databaseColon cancer resectionMultivariable logistic regressionCancer resectionWhite patientsBlack patientsRobotic colectomyHigher complicationsOperative approachMinority patientsPatientsComplicationsColectomyLogistic regressionRobotic approachRacial disparitiesLaparoscopicCausal pathwaysLower ratesOutcomesMortalityClinical outcomes of elective robotic vs laparoscopic surgery for colon cancer utilizing a large national database
Ahuja V, Paredes L, Leeds I, Perkal M, King J. Clinical outcomes of elective robotic vs laparoscopic surgery for colon cancer utilizing a large national database. Surgical Endoscopy 2023, 37: 7199-7205. PMID: 37365394, DOI: 10.1007/s00464-023-10215-6.Peer-Reviewed Original ResearchConceptsAnastomotic leak rateBody mass indexLarge national databaseOverall complicationsAnastomotic leakOperative timeInvasive colectomyColon cancerElective colon cancer resectionHigher body mass indexNational databaseOperating roomPost-operative lengthColon cancer resectionLonger operative timeRange of surgeryNon-Hispanic whitesCancer resectionACS-NSQIPLaparoscopic colectomyClinical outcomesMass indexLaparoscopic counterpartLaparoscopic surgeryPatient outcomes
2020
Frailer Patients Undergoing Robotic Colectomies for Colon Cancer Experience Increased Complication Rates Compared With Open or Laparoscopic Approaches.
Lo BD, Leeds IL, Sundel MH, Gearhart S, Nisly GRC, Safar B, Atallah C, Fang SH. Frailer Patients Undergoing Robotic Colectomies for Colon Cancer Experience Increased Complication Rates Compared With Open or Laparoscopic Approaches. Diseases Of The Colon & Rectum 2020, 63: 588-597. PMID: 32032198, DOI: 10.1097/dcr.0000000000001598.Peer-Reviewed Original ResearchConceptsInvasive surgical approachSurgical approachPrimary colon cancerFrailer patientsFrail patientsRobotic surgeryPostoperative complicationsComplication rateMajor complicationsRobotic colectomyOpen surgerySurgeons National Surgical Quality Improvement Program databaseColon cancerNational Surgical Quality Improvement Program databaseQuality Improvement Program databasePropensity scoreImprovement Program databaseColon cancer surgeryMultivariable logistic regressionFrailty indexLaparoscopic approachPrimary outcomeCancer surgeryOperative indicationsRetrospective studyIncreased Healthcare Utilization for Medical Comorbidities Prior to Surgery Improves Postoperative Outcomes
Leeds IL, Canner JK, Gani F, Meyers PM, Haut ER, Efron JE, Johnston FM. Increased Healthcare Utilization for Medical Comorbidities Prior to Surgery Improves Postoperative Outcomes. Annals Of Surgery 2020, Publish Ahead of Print: &na;. PMID: 29864092, PMCID: PMC8559326, DOI: 10.1097/sla.0000000000002851.Peer-Reviewed Original ResearchConceptsPostoperative outcomesNonsurgical cliniciansPreoperative comorbiditiesShort-term postoperative outcomesIncreased healthcare utilizationMultivariable logistic regressionNational administrative databasePropensity-score matchingColectomy patientsElective colectomyModifiable comorbiditiesPreoperative optimizationMajor comorbiditiesMedical comorbiditiesPostoperative complicationsClinic visitsOperative interventionOperative riskSubsequent surgeryComorbid patientsSurgical riskAdjusted analysisHealthcare utilizationProspective studySame surgeon
2019
Cost-Benefit Limitations of Extended, Outpatient Venous Thromboembolism Prophylaxis Following Surgery for Crohn's Disease.
Leeds IL, DiBrito SR, Canner JK, Haut ER, Safar B. Cost-Benefit Limitations of Extended, Outpatient Venous Thromboembolism Prophylaxis Following Surgery for Crohn's Disease. Diseases Of The Colon & Rectum 2019, 62: 1371-1380. PMID: 31596763, PMCID: PMC6788772, DOI: 10.1097/dcr.0000000000001461.Peer-Reviewed Original ResearchConceptsVenous thromboembolism prophylaxisMultivariable probabilistic sensitivity analysesCrohn's diseaseHigh thrombotic riskProbabilistic sensitivity analysesThromboembolism prophylaxisExtended prophylaxisSurgical populationAbdominal surgeryThrombotic eventsUtility weightsSocietal perspectiveProductivity costsLifetime horizonIncremental costConventional measuresEnfermedad de CrohnPostoperative venous thromboembolismLow absolute riskHigh-risk individualsLos costosDecision tree modelDecision analysisRange of scenariosTotal costOutcomes for Ulcerative Colitis With Delayed Emergency Colectomy Are Worse When Controlling for Preoperative Risk Factors
Leeds IL, Sundel MH, Gabre-Kidan A, Safar B, Truta B, Efron JE, Fang SH. Outcomes for Ulcerative Colitis With Delayed Emergency Colectomy Are Worse When Controlling for Preoperative Risk Factors. Diseases Of The Colon & Rectum 2019, Publish Ahead of Print: &na;. PMID: 30451754, PMCID: PMC6456379, DOI: 10.1097/dcr.0000000000001276.Peer-Reviewed Original ResearchConceptsTotal abdominal colectomyPreoperative risk factorsUlcerative colitisAbdominal colectomyRisk factorsEmergency colectomyEarly surgeryHospital daysPostoperative complicationsMortality rateSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseEarly operationNational Surgical Quality Improvement ProgramAcute fulminant ulcerative colitisQuality Improvement Program databaseSurgical Quality Improvement ProgramFulminant ulcerative colitisOngoing medical managementImmediate surgical interventionImprovement Program databaseSingle institution experienceAcute ulcerative colitisDay of admissionTiming of surgery
2017
Racial and Socioeconomic Differences Manifest in Process Measure Adherence for Enhanced Recovery After Surgery Pathway
Leeds IL, Alimi Y, Hobson DR, Efron JE, Wick EC, Haut ER, Johnston FM. Racial and Socioeconomic Differences Manifest in Process Measure Adherence for Enhanced Recovery After Surgery Pathway. Diseases Of The Colon & Rectum 2017, 60: 1092-1101. PMID: 28891854, PMCID: PMC5647878, DOI: 10.1097/dcr.0000000000000879.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCohort StudiesColectomyColonic DiseasesColorectal SurgeryElective Surgical ProceduresFemaleHumansMaleMiddle AgedOutcome and Process Assessment, Health CarePatient CompliancePostoperative ComplicationsQuality ImprovementRacial GroupsSocioeconomic FactorsUnited StatesConceptsSurgery pathwayPathway implementationSocioeconomic statusWhite patientsPopulation subgroupsOverall adherenceShort-term surgical outcomesTertiary academic medical centerProcess measure adherenceThirty-day outcomesEnhanced recovery pathwayProcess measuresAcademic medical centerHigher socioeconomic statusElective colonPreoperative characteristicsQuality improvement purposesCohort studyComplication rateNonwhite patientsRectal resectionPain therapyMedian lengthSurgical outcomesMedical CenterEarly Surgical Intervention for Acute Ulcerative Colitis Is Associated with Improved Postoperative Outcomes
Leeds IL, Truta B, Parian AM, Chen SY, Efron JE, Gearhart SL, Safar B, Fang SH. Early Surgical Intervention for Acute Ulcerative Colitis Is Associated with Improved Postoperative Outcomes. Journal Of Gastrointestinal Surgery 2017, 21: 1675-1682. PMID: 28819916, PMCID: PMC6201293, DOI: 10.1007/s11605-017-3538-3.Peer-Reviewed Original ResearchConceptsAcute ulcerative colitisEarly surgical interventionUlcerative colitisLength of staySurgical interventionSurgery groupTotal colectomyHospitalization costsEarly operationMedian total hospitalization costModern immunotherapy eraRefractory ulcerative colitisHours of admissionImmediate surgical interventionUlcerative colitis patientsTotal hospitalization costsFurther prospective studiesNational Inpatient SampleImmunotherapy eraColitis patientsHospital outcomesPostoperative complicationsPostoperative outcomesUrgent surgeryComorbid patients