2020
Hospital variation in responses to safety warnings about power morcellation in hysterectomy
Xu X, Desai VB, Wright JD, Lin H, Schwartz PE, Gross CP. Hospital variation in responses to safety warnings about power morcellation in hysterectomy. American Journal Of Obstetrics And Gynecology 2020, 224: 589.e1-589.e13. PMID: 33359176, PMCID: PMC8180513, DOI: 10.1016/j.ajog.2020.12.1207.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overFemaleGuideline AdherenceHealthcare DisparitiesHospitalsHumansHysterectomyIntraoperative ComplicationsLaparoscopyLogistic ModelsMiddle AgedMorcellationOutcome Assessment, Health CarePatient SafetyPostoperative ComplicationsPractice Guidelines as TopicPractice Patterns, Physicians'Retrospective StudiesRisk AssessmentUnited StatesYoung AdultConceptsLaparoscopic supracervical hysterectomyOpen abdominal hysterectomySupracervical hysterectomyPower morcellationAbdominal hysterectomySurgical complicationsMajor complicationsPatient clinical risk factorsNew York Statewide PlanningClinical risk factorsDistinct trajectory patternsState Ambulatory SurgeryState Inpatient DatabasesSafety warningsTrajectory groupsResearch Cooperative SystemLow useHigher useHysterectomy practiceMinor complicationsBenign hysterectomyBenign indicationsComplication riskHospital variationCorpus uteri
2019
Association Between Power Morcellation and Mortality in Women With Unexpected Uterine Cancer Undergoing Hysterectomy or Myomectomy.
Xu X, Lin H, Wright JD, Gross CP, Boscoe FP, Hutchison LM, Schwartz PE, Desai VB. Association Between Power Morcellation and Mortality in Women With Unexpected Uterine Cancer Undergoing Hysterectomy or Myomectomy. Journal Of Clinical Oncology 2019, 37: 3412-3424. PMID: 31518176, PMCID: PMC6901279, DOI: 10.1200/jco.19.00562.Peer-Reviewed Original ResearchConceptsTotal abdominal hysterectomyOccult uterine sarcomaUncontained power morcellationDisease-specific mortalityOccult uterine cancerSupracervical abdominal hysterectomyPower morcellationOccult endometrial carcinomaAbdominal hysterectomyUterine sarcomaUterine cancerEndometrial carcinomaMortality riskMultivariable Cox regressionPrognosis of patientsSubset of womenTime of hysterectomyHospital discharge recordsCancer registry dataHigher mortality riskOccult leiomyosarcomaCause mortalityLaparoscopic myomectomyPatient characteristicsBenign indicationsLaparoscopic Hysterectomy Route, Resource Use, and Outcomes: Change After Power Morcellation Warning.
Desai VB, Wright JD, Lin H, Gross CP, Sallah YH, Schwartz PE, Xu X. Laparoscopic Hysterectomy Route, Resource Use, and Outcomes: Change After Power Morcellation Warning. Obstetrics And Gynecology 2019, 134: 227-238. PMID: 31348209, DOI: 10.1097/aog.0000000000003375.Peer-Reviewed Original ResearchConceptsLaparoscopic supracervical hysterectomyTotal laparoscopic hysterectomyLaparoscopic hysterectomySupracervical hysterectomySurgical outcomesFDA warningOperative timeSurgeons National Surgical Quality Improvement ProgramNational Surgical Quality Improvement ProgramSurgical Quality Improvement ProgramLength of stayInterrupted time series analysisQuality Improvement ProgramHysterectomy routePatient characteristicsBenign indicationsInpatient stayPower morcellationPatient outcomesHysterectomyAmerican CollegeSurgical settingU.S. FoodOutcomesStayRisk of unexpected uterine Cancer in women undergoing myomectomy: A population-based study
Desai VB, Wright J, Gross C, Lin H, Boscoe F, Schwartz P, Xu X. Risk of unexpected uterine Cancer in women undergoing myomectomy: A population-based study. European Journal Of Obstetrics & Gynecology And Reproductive Biology 2019, 238: 188-190. PMID: 31103353, DOI: 10.1016/j.ejogrb.2019.03.021.Peer-Reviewed Original ResearchPrevalence, characteristics, and risk factors of occult uterine cancer in presumed benign hysterectomy
Desai VB, Wright JD, Gross CP, Lin H, Boscoe FP, Hutchison LM, Schwartz PE, Xu X. Prevalence, characteristics, and risk factors of occult uterine cancer in presumed benign hysterectomy. American Journal Of Obstetrics And Gynecology 2019, 221: 39.e1-39.e14. PMID: 30853364, PMCID: PMC7006101, DOI: 10.1016/j.ajog.2019.02.051.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAsianBlack or African AmericanComorbidityEndometrial NeoplasmsEndometriosisEthnicityFemaleHispanic or LatinoHumansHysterectomyIncidental FindingsLeiomyomaLeiomyosarcomaMenstruation DisturbancesMetrorrhagiaMiddle AgedObesityPrevalenceRisk AssessmentRisk FactorsSarcomaUnited StatesUterine NeoplasmsUterine ProlapseWhite PeopleYoung AdultConceptsOccult uterine cancerUterine cancerBenign indicationsRisk factorsUterine sarcomaBenign hysterectomyEndometrial carcinomaPredictive valueResearch Cooperative System databaseState cancer registry dataNew York Statewide PlanningHigh negative predictive valueLow positive predictive valueAssociated risk factorsCorpus uteri cancerLarge population-based sampleCancer registry dataPopulation-based sampleAmbulatory surgery centersNegative predictive valuePositive predictive valueRisk prediction modelRace/ethnicityPostmenopausal bleedingPatient characteristics
2018
Decreased Surgical Site Infection Rate in Hysterectomy
Andiman SE, Xu X, Boyce JM, Ludwig EM, Rillstone HRW, Desai VB, Fan LL. Decreased Surgical Site Infection Rate in Hysterectomy. Obstetrics And Gynecology 2018, 131: 991-999. PMID: 29742666, DOI: 10.1097/aog.0000000000002594.Peer-Reviewed Original ResearchConceptsSurgical site infection prevention bundleSurgical site infection rateInfection prevention bundleSurgical site infectionPrevention bundleSite infectionInfection rateHospital stayStudy periodPostoperative readmission rateProportion of patientsRate of readmissionMultivariable regression analysisImplementation periodQuality improvement studyPerioperative normothermiaClinical characteristicsPostoperative dayReadmission ratesAntibiotic dosingRetrospective analysisSustained reductionSurgical preparationHysterectomyPatientsOccult Gynecologic Cancer in Women Undergoing Hysterectomy or Myomectomy for Benign Indications
Desai VB, Wright JD, Schwartz PE, Jorgensen EM, Fan L, Litkouhi B, Lin H, Gross CP, Xu X. Occult Gynecologic Cancer in Women Undergoing Hysterectomy or Myomectomy for Benign Indications. Obstetrics And Gynecology 2018, 131: 642-651. PMID: 29528920, DOI: 10.1097/aog.0000000000002521.Peer-Reviewed Original ResearchConceptsCorpus uteriCervix uteriOvarian malignancyBenign indicationsSurgical routeSurgeons National Surgical Quality Improvement ProgramNational Surgical Quality Improvement ProgramLaparoscopic-assisted vaginal hysterectomySurgical Quality Improvement ProgramLaparoscopic supracervical hysterectomyPrimary outcome measureBeginning of surgeryLogistic regression analysisQuality Improvement ProgramTotal laparoscopicPatient agePatient characteristicsSupracervical hysterectomyVaginal hysterectomyGynecologic cancerUndetected malignancyOvarian cancerHysterectomyOutcome measuresAmerican College
2017
Utilization of gynecologic services in women with breast cancer receiving hormonal therapy
Wright JD, Desai VB, Chen L, Burke WM, Tergas AI, Hou JY, Accordino M, Ananth CV, Neugut AI, Hershman DL. Utilization of gynecologic services in women with breast cancer receiving hormonal therapy. American Journal Of Obstetrics And Gynecology 2017, 217: 59.e1-59.e12. PMID: 28341383, PMCID: PMC5499703, DOI: 10.1016/j.ajog.2017.03.011.Peer-Reviewed Original ResearchConceptsAromatase inhibitorsBreast cancerHormonal therapyPostmenopausal womenGynecologic symptomsCumulative incidenceGynecologic proceduresLimited population-level dataSurveillance testingSelective estrogen receptor modulator tamoxifenEstrogen receptor modulator tamoxifenStudy periodPopulation-based analysisYears of agePopulation-level dataTamoxifen useAsymptomatic womenGynecologic problemsMarketScan databaseGynecologic conditionsPathologic diagnosisGynecologic abnormalitiesGynecologic servicesGynecologic interventionsTamoxifenUtilization of sentinel lymph node biopsy for uterine cancer
Wright JD, Cham S, Chen L, Burke WM, Hou JY, Tergas AI, Desai V, Hu JC, Ananth CV, Neugut AI, Hershman DL. Utilization of sentinel lymph node biopsy for uterine cancer. American Journal Of Obstetrics And Gynecology 2017, 216: 594.e1-594.e13. PMID: 28213057, PMCID: PMC5449248, DOI: 10.1016/j.ajog.2017.02.021.Peer-Reviewed Original ResearchConceptsSentinel lymphRobotic-assisted hysterectomyLength of stayEndometrial cancerNodal assessmentAbdominal hysterectomyUterine cancerMultivariable modelSentinel lymph node biopsyUnderwent sentinel lymphLong-term morbidityLymph node biopsyPredictors of useUnderwent lymphadenectomyNode biopsyPerspective databaseInvasive hysterectomyLaparoscopic hysterectomyLymph nodesHospital characteristicsEfficacy dataHysterectomyLymphLymphadenectomyBiopsy
2016
Inpatient Laparoscopic Hysterectomy in the United States: Trends and Factors Associated With Approach Selection
Desai VB, Guo XM, Fan L, Wright JD, Xu X. Inpatient Laparoscopic Hysterectomy in the United States: Trends and Factors Associated With Approach Selection. Journal Of Minimally Invasive Gynecology 2016, 24: 151-158.e1. PMID: 27614151, DOI: 10.1016/j.jmig.2016.08.830.Peer-Reviewed Original ResearchConceptsLaparoscopic supracervical hysterectomyTotal laparoscopic hysterectomyLaparoscopic approachLaparoscopic hysterectomyNational Inpatient SampleHospital characteristicsPatient race/ethnicityFemale adult patientsClinical Modification codesDifferent laparoscopic approachesAssociation of patientHospital teaching statusHospital inpatient careBenign laparoscopic hysterectomyRace/ethnicityNonobstetric indicationsAdult patientsVaginal hysterectomyClinical factorsSupracervical hysterectomyBenign indicationsComorbid conditionsRetrospective studyNinth RevisionNIS databaseHospital Variation in the Practice of Bilateral Salpingectomy With Ovarian Conservation in 2012
Xu X, Desai VB. Hospital Variation in the Practice of Bilateral Salpingectomy With Ovarian Conservation in 2012. Obstetrics And Gynecology 2016, 127: 297-305. PMID: 26942357, DOI: 10.1097/aog.0000000000001203.Peer-Reviewed Original ResearchConceptsLow-risk womenBilateral salpingectomyLow-risk patientsOvarian conservationBenign hysterectomyHospital variationOvarian cancerAdult womenNational Inpatient SampleCross-sectional studyMultivariable regression analysisOvarian surgeryHighest tertileWhite patientsInpatient SampleSalpingectomyHysterectomyHospital's likelihoodLower riskHospital practiceHospitalPatientsWomenHospitalizationTertile
2015
Robotic Versus Laparoscopic Hysterectomy for Benign Disease: A Systematic Review and Meta-Analysis of Randomized Trials
Albright BB, Witte T, Tofte AN, Chou J, Black JD, Desai VB, Erekson EA. Robotic Versus Laparoscopic Hysterectomy for Benign Disease: A Systematic Review and Meta-Analysis of Randomized Trials. Journal Of Minimally Invasive Gynecology 2015, 23: 18-27. PMID: 26272688, PMCID: PMC4698211, DOI: 10.1016/j.jmig.2015.08.003.Peer-Reviewed Original ResearchConceptsLaparoscopic hysterectomyBenign diseaseRisk ratioSystematic reviewAccordion Severity Grading SystemPooled risk ratioBenign uterine diseasesSeverity grading systemQuality of lifeOutcomes of costHospital stayPerioperative complicationsSecondary outcomesBlood lossPrimary outcomeRandomized studyRandomized trialsSurgical outcomesCochrane LibraryLaparoscopic techniqueBenign gynecologyTotal operating timeUterine diseaseHysterectomyInclusion criteria