NWSCRS 2017 Thursday

1. Use of Robotic Surgical Platforms for the Treatment of IBD: a single Institution's ExperiencePresenter: Sarah StringfieldA patient is planning to undergo robotic subtotal colectomy with end ileostomy for ulcerative colitis. What can you tell him about outcomes compared to laparoscopic?

Robotic operative time is longer

Laparoscopic is less likely to require a transfusion

Robotic has longer length of stay and higher readmission rates

Both robotic and laparoscopic have worse outcomes than open surgery

2. Improving colorectal patient outcomes with an enhanced recovery bundlePresenter: Amanda Hayman, MD, MPHWhat is the risk-stratified measure NSQIP reports for hospital perfomance on patient outcomes?

Relative risk

Absolute reduction

Observed/Expected

Bonferroni correction

3. The use of a patient engagement platform (Twistle™) to improve outcomes among patients undergoing colon and rectal resectionsPresenter: Amir BastawrousPatient care pathways are most firmly established for which phase of patient care in colorectal surgical resections?

Prehospital care

In hospital care

Post hospital care

Long term care

4. Management of anticoagulation/antiplatelet therapy before and after colonoscopic polypectomy: how long are we holding?Presenter: William Oh, MDA 64 year old male with history of coronary artery disease, on Aspirin and Plavix, visits your office for colonoscopy. Per ASGE guidelines, how would you manage the patient's antiplatelet therapy before the colonoscopy and likely polypectomy?

Continue both Aspirin and Plavix

Discontinue both medications 14 days prior to procedure

Discontinue both medicaitons 7 days prior to procedure

Continue with Aspirin and stop Plavix 5 days prior to procedure

5. Correction of Anemia before Colorectal Cancer Surgery: A review of the literature and retrospective review of cases at a single institutionPresenter: Andrew Discolo, MDA 65 M undergoes laparoscopic resection of a cecal adenocarcinoma found during screening colonoscopy. CT C/A/P is negative for evidence of metastatic disease. Pre-op HCT is 30. Intraoperatively, he becomes unstable and requires 3 u of pRBCs to maintain his blood pressure. Post operatively he makes a full recovery. Final pathology is T2N1aM0. At 6 month follow up he is noted to have a liver lesion consistent with metastasis. Which of the following is most accurate regarding this patient's care?

This patient needed a PET for adequate preoperative staging

His recurrence could be related to his need for transfusion

He was a candidate for autologous blood donation and transfusion

EPO could have been used preoperatively to increase his HCT

6. A Multi-institutional Report of Postoperative Outcomes in Vedolizumab-Treated Patients Undergoing Major Abdominal Operations for Inflammatory Bowel DiseasePresenter: Amy Lightner, MDA referring gastroenterologist sent you a patient with terminal ileal Crohn's disease in need of an ileocolic resection. The patient is taking vedolizumab. What should you tell the patient they're at increased risk for following the operation?

Ileus

Urinary tract infection

Surgical site infection

Anastomotic leak

7. Adjuvant chemotherapy after radical resection for rectal cancer: Are goals of treatment being achieved?Presenter: Ryan Rochon, MD What is the most frequent toxicity associated with adjuvant chemotherapy in rectal cancer?

Neuropathy

Gastrointestinal related

Hand-foot syndrome

Neutropenia

8. Development of CosatsPresenter: Patricia RobertsWhen compared to summative assessment, a formative assessment:

Needs to have high reliability

Is used to make certification decisions

Is used on a regular basis to aid learning

Has significant consequences for the learner

9. Adipose derived mesechymal stem cells bound to artificial matrix for the treatment of perianal fistulas in Crohn's diseasePresenter: Amy L. LightnerHow are perianal fistula healing defined in the study?

Cessation of drainage

No tracts seen on MRI

Cessation of drainage and resolution on MRI

Resolution of perianal pain

10. Analysis of the impact of using a clinical decision support tool in reducing red blood cell transfusion utilization in colorectal surgeryPresenter: Kim Nguyen-TaA 65 year-old male with a history of coronary artery disease, hypertension, diabetes, and colon cancer undergoing open right hemicolectomy, the patient's intraoperative arterial blood gas shows a hemoglobin of 7.9 g/dL. Should the patient be transfused?

No, should wait until hemoglobin

Yes, should transfuse intraoperative

No, should wait to transfuse postoperatively.

We need to obtain vitals and other labs to determine whether to transfuse or not.

11. Reconstructive and Revisional Surgery for Failing Ileal Pouch-Anal Anastomosis is Associated with Good Function and Pouch Salvage in Highly Selected PatientsPresenter: Amy L. LightnerWhat factor was associated with ultimate pouch excision following reconstructive surgery?

Pelvic abscess

Age above 50

Active smoker

Antibiotic resistant pouchitis

12. Development of CosatsPresenter: Patricia Roberts A technical skills examination is able to discriminate between junior residents and senior residents. This property is best described as:

Content validity

Criterion validity

Face validity

Construct validity

13. Higher Robotic Colorectal Surgery Volume Improves Outcomes: A Retrospective Review from a Large Healthcare SystemPresenter: Canaan BaerThe greatest improvement in direct costs between low volume and high volume robotic surgeons is seen in which operation?

Low anterior resection

Right colectomy

Left colectomy

Abdominal perineal resection

Nwscrs 2017 Thursday