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 ResearchMeSH KeywordsColectomyCost-Effectiveness AnalysisHumansPostoperative ComplicationsProctectomyRectal NeoplasmsRectumRetrospective StudiesConceptsMultivariable 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 ResearchMeSH KeywordsColectomyColonic NeoplasmsHumansLaparoscopyLength of StayMalePostoperative ComplicationsRetrospective StudiesRobotic Surgical ProceduresTreatment OutcomeConceptsRC 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
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 ResearchMeSH KeywordsAbdominal AbscessAdolescentAdultAgedAged, 80 and overAppendicitisDiverticulitisDrainageFemaleHumansMaleMiddle AgedRetrospective StudiesYoung AdultConceptsIntra-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 criteriaShort- and Long-term Outcomes of Ileal Pouch Anal Anastomosis Construction in Obese Patients With Ulcerative Colitis
Leeds IL, Holubar SD, Hull TL, Lipman JM, Lightner AL, Sklow B, Steele SR. Short- and Long-term Outcomes of Ileal Pouch Anal Anastomosis Construction in Obese Patients With Ulcerative Colitis. Diseases Of The Colon & Rectum 2022, 65: e782-e789. PMID: 34958050, DOI: 10.1097/dcr.0000000000002169.Peer-Reviewed Original ResearchMeSH KeywordsCohort StudiesColitis, UlcerativeHumansMiddle AgedObesityPostoperative ComplicationsProctocolectomy, RestorativeQuality of LifeRetrospective StudiesConceptsLong-term pouch failureObese patientsUlcerative colitisNonobese patientsPostoperative complicationsPouch failurePouch surgeryColitis ulcerosaASA class 3Intraoperative technical difficultiesOutcomes of obeseAssociation of obesityPouch failure rateWorse clinical outcomesQuaternary referral centerLong-term outcomesLength of stayIleoanal pouch surgeryQuality of lifePouch leakPouch survivalPreoperative steroidsASA 3Anastomotic leakCohort studyDo Cost Limitations of Extended Prophylaxis After Surgery Apply to Ulcerative Colitis Patients?
Leeds IL, Canner JK, DiBrito SR, Safar B. Do Cost Limitations of Extended Prophylaxis After Surgery Apply to Ulcerative Colitis Patients? Diseases Of The Colon & Rectum 2022, 65: 702-712. PMID: 34840290, PMCID: PMC8995329, DOI: 10.1097/dcr.0000000000002056.Peer-Reviewed Original ResearchMeSH KeywordsColitis, UlcerativeColorectal SurgeryHumansPostoperative ComplicationsQuality-Adjusted Life YearsRetrospective StudiesVenous ThromboembolismConceptsMultivariable probabilistic sensitivity analysesUlcerative colitis patientsIncremental cost-effectiveness ratioProbabilistic sensitivity analysesCost-effectiveness ratioDecision analysisColorectal surgery patientsExtended prophylaxisColitis patientsEl análisisSocietal perspectiveLifetime horizonSurgery patientsVenous thromboembolismColitis ulcerosaDecision analysis methodologyUn análisisPostoperative venous thromboembolismRange of scenariosType of thrombosisMain outcome measuresTotal costIndividual risk profileCostSensitivity analysis
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 study
2019
Early 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 databaseMissed 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 screening
2017
Early 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 patientsGracilis Flap for Perineal Closures in Minimally Invasive Abdominoperineal Resection
Leeds IL, Taylor JP, Pozo M, Safar B, Sacks JM, Fang SH. Gracilis Flap for Perineal Closures in Minimally Invasive Abdominoperineal Resection. The American Surgeon 2017, 83: 194-196. PMID: 28637543, DOI: 10.1177/000313481708300606.Peer-Reviewed Original Research
2016
Discharge decision-making after complex surgery: Surgeon behaviors compared to predictive modeling to reduce surgical readmissions
Leeds IL, Sadiraj V, Cox JC, Gao XS, Pawlik TM, Schnier KE, Sweeney JF. Discharge decision-making after complex surgery: Surgeon behaviors compared to predictive modeling to reduce surgical readmissions. The American Journal Of Surgery 2016, 213: 112-119. PMID: 28029373, PMCID: PMC5362294, DOI: 10.1016/j.amjsurg.2016.03.010.Peer-Reviewed Original ResearchMeSH KeywordsAcademic Medical CentersAdultAgedAged, 80 and overAlgorithmsAttitude of Health PersonnelCohort StudiesDatabases, FactualDecision Making, Computer-AssistedDecision Support TechniquesFemaleHumansIncidenceLogistic ModelsMaleMiddle AgedPatient ReadmissionPredictive Value of TestsRetrospective StudiesRisk AssessmentSurgeonsSurgical Procedures, OperativeTertiary Care CentersUnited StatesYoung AdultOutcomes of abdominoperineal resection for management of anal cancer in HIV-positive patients: a national case review
Leeds IL, Alturki H, Canner JK, Schneider EB, Efron JE, Wick EC, Gearhart SL, Safar B, Fang SH. Outcomes of abdominoperineal resection for management of anal cancer in HIV-positive patients: a national case review. World Journal Of Surgical Oncology 2016, 14: 208. PMID: 27495294, PMCID: PMC4974747, DOI: 10.1186/s12957-016-0970-x.Peer-Reviewed Original ResearchMeSH KeywordsAbdomenAdultAge FactorsAgedAnus NeoplasmsCarcinoma, Squamous CellComorbidityFemaleFollow-Up StudiesHealth Status DisparitiesHIV InfectionsHospital MortalityHumansIncidenceLength of StayMaleMiddle AgedNeoplasm Recurrence, LocalPerineumPostoperative ComplicationsRetrospective StudiesRisk FactorsSalvage TherapyTreatment OutcomeConceptsHIV-positive patientsLength of stayHIV-negative patientsAnal cancerNational Inpatient SampleAbdominoperineal resectionHospitalization costsHIV infectionAnal squamous cell cancerAnal squamous cell carcinomaUtilization Project National Inpatient SampleGreater hospitalization costsWorse postoperative recoveryHIV-positive groupMethodsA retrospective reviewAnal cancer patientsSquamous cell cancerHuman immunodeficiency virusMultivariable logistic regressionSquamous cell carcinomaHospital mortalityHospital stayPerioperative complicationsPostoperative hemorrhagePostoperative outcomes
2012
Risk Factors for 30-Day Hospital Readmission among General Surgery Patients
Kassin MT, Owen RM, Perez SD, Leeds I, Cox JC, Schnier K, Sadiraj V, Sweeney JF. Risk Factors for 30-Day Hospital Readmission among General Surgery Patients. Journal Of The American College Of Surgeons 2012, 215: 322-330. PMID: 22726893, PMCID: PMC3423490, DOI: 10.1016/j.jamcollsurg.2012.05.024.Peer-Reviewed Original ResearchConceptsGeneral surgery proceduresGeneral surgery patientsRisk of readmissionPostoperative complicationsRisk factorsSurgery proceduresSurgery patientsHospital readmissionInpatient general surgery proceduresInstitutional clinical data warehousePoor quality patient careSignificant independent risk factorsPreoperative open woundSepsis/shockPostoperative pulmonary complicationsDays of dischargeIndependent risk factorUrinary tract infectionSingle academic centerType of procedureClinical data warehousePostoperative readmissionsPulmonary complicationsIndex hospitalizationPostoperative occurrence