2022
Surgical Complications and Hospital Costs in Robot-Assisted Versus Conventional Laparoscopic Hysterectomy With Concurrent Sacrocolpopexy: Analysis of the Nationwide Readmissions Database
Andiman SE, Bui A, Ascher-Walsh C, Wright J, Xu X. Surgical Complications and Hospital Costs in Robot-Assisted Versus Conventional Laparoscopic Hysterectomy With Concurrent Sacrocolpopexy: Analysis of the Nationwide Readmissions Database. Urogynecology 2022, 28: e142-e148. PMID: 35113048, DOI: 10.1097/spv.0000000000001133.Peer-Reviewed Original ResearchConceptsConventional laparoscopic procedureConventional laparoscopic hysterectomyNationwide Readmissions DatabasePerioperative complicationsLaparoscopic hysterectomyLaparoscopic proceduresHospital costsMajor perioperative complicationsConventional laparoscopic approachMultivariable regression analysisRobot-assisted approachLarge national databaseProcedure codesSurgical complicationsInvasive hysterectomyLaparoscopic approachHysterectomyLower riskComplicationsReadmissionSacrocolpopexyPatient linkageNational databaseWeighted samplePatients
2021
Endometrial Sampling for Preoperative Diagnosis of Uterine Leiomyosarcoma
Kho RM, Desai VB, Schwartz PE, Wright JD, Gross CP, Hutchison LM, Boscoe FP, Lin H, Xu X. Endometrial Sampling for Preoperative Diagnosis of Uterine Leiomyosarcoma. Journal Of Minimally Invasive Gynecology 2021, 29: 119-127. PMID: 34265441, PMCID: PMC8752465, DOI: 10.1016/j.jmig.2021.07.004.Peer-Reviewed Original ResearchMeSH KeywordsEndometrial NeoplasmsEndometriumFemaleHumansHysterectomyLeiomyosarcomaRetrospective StudiesUterine NeoplasmsConceptsEndometrial samplingUterine leiomyosarcomaPreoperative diagnosisPreoperative detectionNew York State Cancer RegistryNew York Statewide PlanningPreoperative endometrial samplingSuboptimal surgical managementUse of hysteroscopyOutcomes of patientsRetrospective cohort studyState Cancer RegistryMultivariable regression analysisResearch Cooperative SystemAmbulatory surgery centersSample eligibility criteriaRace/ethnicityIndex surgeryCohort studyLocalized stageSupracervical hysterectomyCancer RegistryOutpatient encountersSurgical managementTumor size
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 uteriUnanticipated Uterine and Cervical Malignancy in Women Undergoing Hysterectomy for Uterovaginal Prolapse.
Andiman SE, Bui AH, Hardart A, Xu X. Unanticipated Uterine and Cervical Malignancy in Women Undergoing Hysterectomy for Uterovaginal Prolapse. Urogynecology 2020, 27: e549-e554. PMID: 33208657, DOI: 10.1097/spv.0000000000000990.Peer-Reviewed Original ResearchConceptsMultivariable logistic regressionUterovaginal prolapseUterine cancerCervical cancerSurgeons National Surgical Quality Improvement ProgramNational Surgical Quality Improvement ProgramSurgical Quality Improvement ProgramLogistic regressionUnexpected uterine malignancyQuality Improvement ProgramSample eligibility criteriaPathology-confirmed diagnosisUterine malignanciesRadical hysterectomyTotal hysterectomyPatient characteristicsUterine weightCervical malignancyGynecologic cancerOutcome measuresHysterectomyAmerican CollegeEligibility criteriaBivariate statistical testsConcurrent procedures
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. FoodOutcomesStayPrevalence, 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
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
2013
Cost-effectiveness of endometrial evaluation prior to morcellation in surgical procedures for prolapse
McPencow AM, Erekson EA, Guess MK, Martin DK, Patel DA, Xu X. Cost-effectiveness of endometrial evaluation prior to morcellation in surgical procedures for prolapse. American Journal Of Obstetrics And Gynecology 2013, 209: 22.e1-22.e9. PMID: 23545164, DOI: 10.1016/j.ajog.2013.03.033.Peer-Reviewed Original ResearchConceptsIncremental cost-effectiveness ratioEndometrial biopsyTransvaginal ultrasoundCost-effectiveness ratioPostmenopausal womenEndometrial cancerEndometrial evaluationScreening optionsInvasive sacral colpopexyRisk of upstagingPelvic organ prolapseCancer upstagingSupracervical hysterectomySacral colpopexyCancer prevalenceOrgan prolapsePatient costsPreoperative detectionSurgical proceduresUniversal screeningBiopsyMorcellationCancerUltrasoundUpstaging