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  1. Article ; Online: Neurogenic Bowel Dysfunction: The Impact of the Central Nervous System in Constipation and Fecal Incontinence.

    Hakim, Seifeldin / Gaglani, Tanmay / Cash, Brooks D

    Gastroenterology clinics of North America

    2022  Volume 51, Issue 1, Page(s) 93–105

    Abstract: Spinal cord injury and neurogenic bowel dysfunction (NBD) are life-changing events for affected patients. The clinical manifestations of NBD vary depending on the level and severity of the spinal cord lesion. Managing patients with NBD can be complicated ...

    Abstract Spinal cord injury and neurogenic bowel dysfunction (NBD) are life-changing events for affected patients. The clinical manifestations of NBD vary depending on the level and severity of the spinal cord lesion. Managing patients with NBD can be complicated by comorbidities, such as immobility, bladder dysfunction, progressive neurologic decline, psychological factors, loss of independence, and social withdrawal, and ideally involves a multimodal, multidisciplinary approach. Evaluation and management should be individualized, depending on the residual neurologic capabilities of the patient and their predominant gastrointestinal symptoms, and commonly involves lifestyle modifications, physical therapy, laxative medications, and surgical interventions.
    MeSH term(s) Central Nervous System ; Constipation/etiology ; Constipation/therapy ; Fecal Incontinence/etiology ; Fecal Incontinence/therapy ; Humans ; Neurogenic Bowel/etiology ; Neurogenic Bowel/therapy ; Spinal Cord Injuries/complications ; Spinal Cord Injuries/therapy
    Language English
    Publishing date 2022-01-07
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 92114-2
    ISSN 1558-1942 ; 0889-8553
    ISSN (online) 1558-1942
    ISSN 0889-8553
    DOI 10.1016/j.gtc.2021.10.006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Fecal microbiota transplantation as a mean of overcoming immunotherapy-resistant cancers - hype or hope?

    Baruch, Erez N / Gaglani, Tanmay / Wargo, Jennifer A

    Therapeutic advances in medical oncology

    2021  Volume 13, Page(s) 17588359211045853

    Language English
    Publishing date 2021-09-28
    Publishing country England
    Document type Editorial
    ZDB-ID 2503443-1
    ISSN 1758-8359 ; 1758-8340
    ISSN (online) 1758-8359
    ISSN 1758-8340
    DOI 10.1177/17588359211045853
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Trends and Outcomes for Minimally Invasive Surgery for Inflammatory Bowel Disease.

    Gaglani, Tanmay / Davis, Catherine H / Bailey, Harold R / Cusick, Marianne V

    The Journal of surgical research

    2018  Volume 235, Page(s) 303–307

    Abstract: Background: The relapsing and remitting nature of inflammatory bowel disease (IBD) predisposes patients to the development of fibrotic strictures, which must often be managed surgically. Laparoscopy provides the potential for enhanced perioperative care. ...

    Abstract Background: The relapsing and remitting nature of inflammatory bowel disease (IBD) predisposes patients to the development of fibrotic strictures, which must often be managed surgically. Laparoscopy provides the potential for enhanced perioperative care. Previous studies comparing morbidity and trends of open versus laparoscopic resection have been constrained by length of study and sample size.
    Methods: Using the American College of Surgeons National Surgical Quality Improvement Program database, patients with primary diagnosis of IBD undergoing surgical resection from 2005 to 2015 were identified. Morbidity and mortality rates were then compared between open and laparoscopic resections using multiple logistic regression analyses.
    Results: A total of 10,699 resections were performed on IBD patients; 4816 (45.0%) of which were performed laparoscopically. The use of laparoscopy increased annually from 20.9% in 2005 to 55.4% in 2015. Comparing laparoscopic versus open, all 30-d outcomes tended to favor laparoscopy with the exception of operating room time, which was equal between the two groups. The difference in 30-d outcomes was statistically significant in laparoscopy versus open technique for pneumonia (1.0% versus 2.0%), ventilator use >48 h (0.6% versus 1.9%), acute renal failure (0.1% versus 0.4%), renal insufficiency (0.2% versus 0.6%), superficial surgical site infection (4.6% versus 7.7%), deep incisional surgical site infection (1.1% versus 1.8%), organ space infection (5.4% versus 7.3%), urinary tract infection (1.3% versus 2.2%), death (0.2% versus 0.7%), and length of hospital stay (6.4 versus 9.4 d).
    Conclusions: These data not only display trends that indicate that the number of laparoscopic resections for IBD have increased over time but are associated with favorable complication rates, operating time, and length of hospital stay, suggesting that laparoscopy may be a safer option for treatment of fibrotic strictures associated with IBD.
    MeSH term(s) Adult ; Constriction, Pathologic/etiology ; Constriction, Pathologic/surgery ; Female ; Fibrosis ; Humans ; Inflammatory Bowel Diseases/complications ; Inflammatory Bowel Diseases/pathology ; Inflammatory Bowel Diseases/surgery ; Intestine, Small/pathology ; Intestine, Small/surgery ; Laparoscopy/statistics & numerical data ; Laparoscopy/trends ; Male ; Middle Aged ; Retrospective Studies
    Language English
    Publishing date 2018-11-03
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 80170-7
    ISSN 1095-8673 ; 0022-4804
    ISSN (online) 1095-8673
    ISSN 0022-4804
    DOI 10.1016/j.jss.2018.09.075
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 178: Show issues Location:
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  4. Article ; Online: Trends and outcomes in laparoscopic versus open surgery for rectal cancer from 2005 to 2016 using the ACS-NSQIP database, a retrospective cohort study.

    Davis, Catherine H / Gaglani, Tanmay / Moore, Linda W / Du, Xianglin L / Hwang, Hyunsoo / Yamal, Jose-Miguel / Bailey, H Randolph / Cusick, Marianne V

    International journal of surgery (London, England)

    2019  Volume 63, Page(s) 71–76

    Abstract: Background: There is controversy regarding the use of laparoscopy for rectal cancer, especially after the ACOSOG Z6051 Randomized Clinical Trial determined that laparoscopy failed to meet non-inferiority compared with open surgery. With these new ... ...

    Abstract Background: There is controversy regarding the use of laparoscopy for rectal cancer, especially after the ACOSOG Z6051 Randomized Clinical Trial determined that laparoscopy failed to meet non-inferiority compared with open surgery. With these new recommendations, the current practices for the treatment of rectal cancer across the country are unknown.
    Methods: Using the ACS-NSQIP database from 2005 to 2016, resections for rectal cancer were studied. The proportion of laparoscopic versus open surgeries performed was determined by year, and 16 30-day outcomes were studied in each group. Multiple logistic regression was utilized to determine the association between laparoscopic and open technique as well as odds of outcome over time.
    Results: A total of 31,795 resections were performed, 12,371 (38.9%) laparoscopically. Laparoscopy increased yearly from 9.8% in 2005 to 52.8% in 2016. All 30-day outcomes tended to favor laparoscopy with the exception of operating room time.
    Conclusions: These data suggest that laparoscopic surgery has been widely adopted for treating patients with rectal cancer, and the trend continues despite the ACOSOG Z6051 recommendations suggesting that laparoscopic resection may not be best technique for resection. Stronger recommendations are needed to change current trends if laparoscopic surgery is not the appropriate treatment method for rectal cancer.
    MeSH term(s) Adult ; Aged ; Databases, Factual ; Female ; Humans ; Laparoscopy ; Logistic Models ; Male ; Middle Aged ; Rectal Neoplasms/surgery ; Retrospective Studies ; Time Factors
    Language English
    Publishing date 2019-02-13
    Publishing country England
    Document type Comparative Study ; Journal Article
    ZDB-ID 2212038-5
    ISSN 1743-9159 ; 1743-9191
    ISSN (online) 1743-9159
    ISSN 1743-9191
    DOI 10.1016/j.ijsu.2019.02.006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Trends in laparoscopic colorectal surgery over time from 2005-2014 using the NSQIP database.

    Davis, Catherine H / Shirkey, Beverly A / Moore, Linda W / Gaglani, Tanmay / Du, Xianglin L / Bailey, H Randolph / Cusick, Marianne V

    The Journal of surgical research

    2017  Volume 223, Page(s) 16–21

    Abstract: Background: Laparoscopy, originally pioneered by gynecologists, was first adopted by general surgeons in the late 1980s. Since then, laparoscopy has been adopted in the surgical specialties and colorectal surgery for treatment of benign and malignant ... ...

    Abstract Background: Laparoscopy, originally pioneered by gynecologists, was first adopted by general surgeons in the late 1980s. Since then, laparoscopy has been adopted in the surgical specialties and colorectal surgery for treatment of benign and malignant disease. Formal laparoscopic training became a required component of surgery residency programs as validated by the Fundamentals of Laparoscopic Surgery curriculum; however, some surgeons may be more apprehensive of widespread adoption of minimally invasive techniques. Although an overall increase in the use of laparoscopy in colorectal surgery is anticipated over a 10-year period, it is unknown if a similar increase will be seen in higher risk or more acutely ill patients.
    Methods: Using the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database from 2005-2014, colorectal procedures were identified by Current Procedural Terminology codes and categorized to open or laparoscopic surgery. The proportion of colorectal surgeries performed laparoscopically was calculated for each year. Separate descriptive statistics was performed and categorized by age and body mass index (BMI). American Society of Anesthesiology (ASA) classification and emergency case status variables were added to the project to help assess complexity of cases.
    Results: During the 10-year study period, the number of colorectal cases increased from 3114 in 2005 to 51,611 in 2014 as more hospitals joined NSQIP. A total of 277,376 colorectal cases were identified; of which, 114,359 (41.2%) were performed laparoscopically. The use of laparoscopy gradually increased each year, from 22.7% in 2005 to 49.8% in 2014. Laparoscopic procedures were most commonly performed in the youngest age group (18-49 years), overweight and obese patients (BMI 25-34.9), and in ASA class 1-2 patients. Over the 10-year period, there was a noted increase in the use of laparoscopy in every age, BMI, and ASA category, except ASA 5. The percent of emergency cases receiving laparoscopic surgery also doubled from 5.5% in 2005 to 11.5% in 2014.
    Conclusions: Over a 10-year period, there was a gradual increase in the use of laparoscopy in colorectal surgery. Further, there was a consistent increase of laparoscopic surgery in all age groups, including the elderly, in all BMI classes, including the obese and morbidly obese, and in most ASA classes, including ASA 3-4, as well as in emergency surgeries. These trends suggest that minimally invasive colorectal surgery appears to be widely adopted and performed on more complex or higher risk patients.
    MeSH term(s) Colorectal Surgery/trends ; Databases, Factual ; Humans ; Laparoscopy/trends ; Minimally Invasive Surgical Procedures/trends ; Quality Improvement ; Time Factors
    Language English
    Publishing date 2017-11-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80170-7
    ISSN 1095-8673 ; 0022-4804
    ISSN (online) 1095-8673
    ISSN 0022-4804
    DOI 10.1016/j.jss.2017.09.046
    Database MEDical Literature Analysis and Retrieval System OnLINE

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