2023
Clinical 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 outcomesSo You Want to be a Program Director? Career Paths of Colon and Rectal Surgery Residency Program Directors
Esposito A, Coppersmith N, Flom E, Chung M, Reddy V, Leeds I, Longo W, Pantel H, Yoo P, Mongiu A. So You Want to be a Program Director? Career Paths of Colon and Rectal Surgery Residency Program Directors. Journal Of Surgical Education 2023, 80: 588-596. PMID: 36658062, DOI: 10.1016/j.jsurg.2022.12.009.Peer-Reviewed Original Research
2022
Do Cultures From Percutaneously Drained Intra-abdominal Abscesses Change Treatment? A Retrospective Review
Esposito A, Zhang Y, Nagarkatti N, Laird W, Coppersmith N, Reddy V, Leeds I, Mongiu A, Longo W, Hao R, Pantel H. Do Cultures From Percutaneously Drained Intra-abdominal Abscesses Change Treatment? A Retrospective Review. Diseases Of The Colon & Rectum 2022, 66: 451-457. PMID: 36538708, DOI: 10.1097/dcr.0000000000002644.Peer-Reviewed Original ResearchConceptsIntra-abdominal abscessPercutaneous drainAntimicrobial therapyLos pacientesAbdominal abscessSingle university-affiliated institutionRetrospective medical record reviewEmpiric antibiotic regimensSolid organ transplantsMedical record reviewUniversity-affiliated institutionCulture dataAntibiotic coursesAbdominal infectionAntibiotic regimensActive smokersMedian ageActive chemotherapyRecord reviewEvidence-based practiceMedian lengthUtility of cultureFemale sexIntraoperative culturesInclusion criteria
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
Delay in emergency hernia surgery is associated with worse outcomes
Leeds IL, Jones C, DiBrito SR, Sakran JV, Haut ER, Kent AJ. Delay in emergency hernia surgery is associated with worse outcomes. Surgical Endoscopy 2019, 34: 4562-4573. PMID: 31741158, PMCID: PMC8710144, DOI: 10.1007/s00464-019-07245-4.Peer-Reviewed Original ResearchConceptsEmergent surgeryMajor complicationsTiming of surgeryUrgent surgical interventionDay of surgeryLonger operative timeMultivariable logistic regressionEmergency hernia surgeryNext-day surgeryPhysiologic optimizationPostoperative lengthUrgent surgeryMajor morbidityNSQIP databaseOperative timeSurgical timingSurgical outcomesSurgical interventionDiaphragmatic herniaMedical clearanceMultinomial propensity scoresHernia typeWorse outcomesAbdominal herniaHernia surgeryCost-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 costEarly Discontinuation of Infliximab in Pregnant Women With Inflammatory Bowel Disease
Truta B, Leeds IL, Canner JK, Efron JE, Fang SH, Althumari A, Safar B. Early Discontinuation of Infliximab in Pregnant Women With Inflammatory Bowel Disease. Inflammatory Bowel Diseases 2019, 26: 1110-1117. PMID: 31670762, DOI: 10.1093/ibd/izz250.Peer-Reviewed Original ResearchConceptsInflammatory bowel diseaseIFX groupDisease activityIFX discontinuationSteroid prescriptionEarly discontinuationPregnancy outcomesPreterm babiesBowel diseaseRisk babiesPregnant womenTruven Health Analytics MarketScan databaseContinuation of infliximabMore preterm babiesAcute respiratory infectionsPoor pregnancy outcomesIntrauterine growth retardationRisk of diseaseDisease flareIBD mothersIBD patientsFetal exposureHospital admissionRespiratory infectionsMarketScan databaseDoes Perceived Resident Operative Autonomy Impact Patient Outcomes?
Fieber JH, Bailey EA, Wirtalla C, Johnson AP, Leeds IL, Medbery RL, Ahuja V, VanderMeer T, Wick EC, Irojah B, Kelz RR. Does Perceived Resident Operative Autonomy Impact Patient Outcomes? Journal Of Surgical Education 2019, 76: e182-e188. PMID: 31377204, DOI: 10.1016/j.jsurg.2019.06.006.Peer-Reviewed Original ResearchConceptsGeneral surgery training programsColorectal resectionSurgery serviceSurgery training programsPatient outcomesTrainee autonomyProspective multi-institutional studyColorectal surgery serviceOpen partial colectomyPrior abdominal surgeryRate of readmissionPatients' clinical outcomesPost-graduate year 3Multi-institutional studyImpact patient outcomesMixed effects regression modelsLower ratesAnesthesiologists classificationSeparate mixed-effects regression modelsColorectal surgeryPrimary outcomeSecondary outcomesAbdominal surgerySerious morbidityClinical outcomesMissed psychosocial risk factors during routine preoperative evaluations are associated with increased complications after elective cancer surgery
Meyers PM, Leeds IL, Enumah ZO, Burkhart RA, He J, Haut ER, Efron JE, Johnston FM. Missed psychosocial risk factors during routine preoperative evaluations are associated with increased complications after elective cancer surgery. Surgery 2019, 166: 177-183. PMID: 31160060, PMCID: PMC8828252, DOI: 10.1016/j.surg.2019.04.015.Peer-Reviewed Original ResearchMeSH KeywordsAcademic Medical CentersAgedCohort StudiesDatabases, FactualDigestive System NeoplasmsDisease-Free SurvivalElective Surgical ProceduresFemaleHumansMaleMiddle AgedNeoplasm InvasivenessNeoplasm StagingPostoperative ComplicationsPreoperative CarePrognosisPsychologyRetrospective StudiesSurvival AnalysisConceptsPsychosocial risk factorsRisk factorsChart reviewCancer surgeryPostoperative outcomesComplication ratePreoperative evaluationThirty-day postoperative complicationsTertiary academic medical centerAbdominal cancer surgeryElective cancer surgeryPatient's preoperative evaluationRoutine preoperative evaluationOverall complication rateRetrospective chart reviewWorse postoperative outcomesPreoperative risk stratificationIndividual risk factorsAcademic medical centerInadequate social supportPostoperative complicationsAdult patientsMajor complicationsRisk stratificationFormal screeningOutcomes 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 surgeryPsychosocial Risks are Independently Associated with Cancer Surgery Outcomes in Medically Comorbid Patients
Leeds IL, Meyers PM, Enumah ZO, He J, Burkhart RA, Haut ER, Efron JE, Johnston FM. Psychosocial Risks are Independently Associated with Cancer Surgery Outcomes in Medically Comorbid Patients. Annals Of Surgical Oncology 2019, 26: 936-944. PMID: 30617868, PMCID: PMC8710142, DOI: 10.1245/s10434-018-07136-3.Peer-Reviewed Original ResearchConceptsPsychosocial risk factorsRisk factorsPsychosocial risksSurgical outcomesPrimary tumorShort-term surgical outcomesMultiple psychosocial risk factorsCancer surgery patientsColorectal primary tumorsProspective observational studyCancer surgery outcomesMultiple psychosocial risksThreefold oddsChart reviewComplication ratePostoperative courseSurgery patientsComorbid patientsMedian ageCancer surgeryMultivariable analysisPreoperative assessmentCancer patientsSurgery outcomesObservational study
2018
Cost Effectiveness of Meningococcal Serogroup B Vaccination in College-Aged Young Adults
Leeds IL, Namasivayam V, Bamogo A, Sankhla P, Thayer WM. Cost Effectiveness of Meningococcal Serogroup B Vaccination in College-Aged Young Adults. American Journal Of Preventive Medicine 2018, 56: 196-204. PMID: 30573332, PMCID: PMC6340776, DOI: 10.1016/j.amepre.2018.09.020.Peer-Reviewed Original ResearchConceptsQuality-adjusted life yearsMultivariable probabilistic sensitivity analysesUniversal vaccinationProbabilistic sensitivity analysesLife yearsSerogroup BSocietal perspectiveYoung adultsHealth sector perspectiveUniversal vaccination strategyNeisseria meningitidis serogroup BN. meningitidis serogroup BCost effectivenessU.S. vaccineB vaccinationMeningococcal infectionVaccination strategiesSpecific vaccinesVaccinationSensitivity analysisIncremental costOutbreak responseSector perspectiveCollege entryCommon formEye of the beholder: Risk calculators and barriers to adoption in surgical trainees
Leeds IL, Rosenblum AJ, Wise PE, Watkins AC, Goldblatt MI, Haut ER, Efron JE, Johnston FM. Eye of the beholder: Risk calculators and barriers to adoption in surgical trainees. Surgery 2018, 164: 1117-1123. PMID: 30149939, PMCID: PMC8383120, DOI: 10.1016/j.surg.2018.07.002.Peer-Reviewed Original ResearchConceptsRisk calculatorRisk assessment toolSurgical traineesCurrent risk calculatorsClinical workflow integrationPrimary outcomeMultivariable regressionDomain scoresRoutine useDirect verbal communicationSurgical residentsAccurate risk assessmentBehavioral factorsSystem usability scoreAssessment toolSurgical Gatekeeping — Modifiable Risk Factors and Ethical Decision Making
Leeds IL, Efron DT, Lehmann LS. Surgical Gatekeeping — Modifiable Risk Factors and Ethical Decision Making. New England Journal Of Medicine 2018, 379: 389-394. PMID: 30044939, DOI: 10.1056/nejmms1802079.Peer-Reviewed Original ResearchUsing Audience Response Systems for Real-Time Learning Assessments During Surgical Morbidity and Mortality Conference
Leeds IL, DiBrito SR, Jones CD, Higgins RSD, Haut ER. Using Audience Response Systems for Real-Time Learning Assessments During Surgical Morbidity and Mortality Conference. Journal Of Surgical Education 2018, 75: 1535-1543. PMID: 30523799, DOI: 10.1016/j.jsurg.2018.05.010.Peer-Reviewed Original ResearchConceptsTertiary academic medical centerMortality conferencesGeneral surgical residency programsSurgical risk estimationUnique case presentationAcademic medical centerTargeted educational interventionsComplication rateSurgical morbiditySurgical residency programsMedical CenterCase presentationClinical fellowsMorbidityMajority of respondentsEducational interventionCategorical residentsPreliminary residentsJunior residentsCohen's kappaResidency programsResponse systemRisk estimationCauseConcordanceMalnutrition increases the risk of 30-day complications after surgery in pediatric patients with Crohn disease
Ladd MR, Garcia AV, Leeds IL, Haney C, Oliva-Hemker MM, Alaish S, Boss E, Rhee DS. Malnutrition increases the risk of 30-day complications after surgery in pediatric patients with Crohn disease. Journal Of Pediatric Surgery 2018, 53: 2336-2345. PMID: 29843908, PMCID: PMC8841062, DOI: 10.1016/j.jpedsurg.2018.04.026.Peer-Reviewed Original ResearchConceptsCrohn's diseaseAge z-scoreBowel surgeryPediatric patientsACS NSQIP-Pediatric databaseZ-scoreMajor bowel surgeryNSQIP-Pediatric databaseOdds of complicationsOverall complication ratePediatric CD patientsDegree of malnutritionSeverity of malnutritionEffects of malnutritionCDC growth chartsEffects of malnourishmentASA classImportant screening toolMalnutrition effectsPostoperative complicationsCD patientsComplication rateElective surgeryMultivariable analysisSevere malnutrition
2017
Quantification of Resident Work in Colorectal Surgery
Bailey EA, Johnson AP, Leeds IL, Medbery RL, Ahuja V, VanderMeer T, Wick EC, Irojah B, Kelz RR. Quantification of Resident Work in Colorectal Surgery. Journal Of Surgical Education 2017, 75: 564-572. PMID: 28986275, DOI: 10.1016/j.jsurg.2017.09.001.Peer-Reviewed Original ResearchMeSH KeywordsAcademic Medical CentersAdultClinical CompetenceColorectal SurgeryEducation, Medical, GraduateFemaleHumansInternship and ResidencyInterprofessional RelationsLogistic ModelsMaleMultivariate AnalysisOperating RoomsProfessional AutonomyProspective StudiesSurveys and QuestionnairesUnited StatesConceptsSurgery serviceProspective multi-institutional studyColorectal surgery serviceDay of surgeryGeneral surgery serviceGeneral surgery residency programsMulti-institutional studyAcademic medical centerColorectal resectionColorectal surgerySurgery residency programsFascial closureSkin closureMedical CenterSurvey toolNovel survey toolResponse rateIndependent training programsOperating roomStudy periodSurgeonsSurgeryResidency programsDegree of involvementResidents' workRacial 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 CenterThe independent effect of cancer on outcomes: a potential limitation of surgical risk prediction
Leeds IL, Canner JK, Efron JE, Ahuja N, Haut ER, Wick EC, Johnston FM. The independent effect of cancer on outcomes: a potential limitation of surgical risk prediction. Journal Of Surgical Research 2017, 220: 402-409.e6. PMID: 28923559, PMCID: PMC5712450, DOI: 10.1016/j.jss.2017.08.039.Peer-Reviewed Original ResearchConceptsCancer patientsDiagnosis of cancerBenign diseaseCancer populationNational Surgical Quality Improvement Program 2005Chronic obstructive pulmonary diseaseSurgical risk modelsSurgical risk predictionObstructive pulmonary diseaseWorse surgical outcomesMalignant gastrointestinal diseasesOdds of deathHigh complication rateMultivariable logistic regressionParticipant Use FileRisk of deathPrimary procedure codeHigh mortality rateComplication rateSurgical complicationsIndependent predictorsMultiple complicationsPulmonary diseaseElective surgeryNoncancer patients