Readmissions reflect adverse patient outcomes, and clinicians currently lack accurate models to predict readmission risk.
 
  We sought to create a readmission risk calculator for use in the postoperative setting after elective colon and rectal surgery.
 
  Patients were identified from 2012-2014 American College of Surgery-National Surgical Quality Improvement Program data. A model was created with 60% of the National Surgical Quality Improvement Program sample using multivariable logistic regression to stratify patients into low/medium- and high-risk categories. The model was validated with the remaining 40% of the National Surgical Quality Improvement Program sample and 2016-2018 institutional data.
 
  The study included both national and institutional data.
 
  Patients who underwent elective abdominal colon or rectal resection were included.
 
  The primary outcome was readmission within 30 days of surgery. Secondary outcomes included reasons for and time interval to readmission.
 
  The model discrimination (c-sen general; de pacientes con riesgo alto, la tasa de reingreso observada fue del 22.1% en el NSQIP y del 12.4% en las cohortes institucionales. El intervalo medio general desde la cirugía hasta el reingreso fue de 14 días en NSQIP y 11 días institucionalmente. Las razones más comunes para el reingreso fueron infección del espacio orgánico, obstrucción intestinal / íleo paralítico y deshidratación tanto en NSQIP como en datos institucionales.Esta fue una revisión observacional retrospectiva.Para los pacientes que se someten a cirugía electiva de colon y recto, el uso de una calculadora de riesgo de reingreso desarrollada para el uso postoperatorio puede identificar a los pacientes de alto riesgo para una posible mejora de los factores de riesgo modificables, un seguimiento ambulatorio más intensivo o un reingreso planificado. Consulte Video Resumen en http//links.lww.com/DCR/B284. (Traducción-Dr Yesenia Rojas-Khalil).
  Discharge on postoperative day 3 after laparoscopic colorectal resections is now common, and same-day discharge has been proposed recently as an option.
 
  The purpose of this study was to determine the safety of same-day and next-day discharge after laparoscopic colorectal surgery and to delineate which characteristics may make a patient eligible for this pathway.
 
  This was a retrospective cohort study.
 
  The American College of Surgeons National Surgical Quality Improvement Project Targeted Colectomy Participant User File was used.
 
  Patients underwent elective laparoscopic colorectal resection and were discharged without complications on or before postoperative day 5 (early discharge postoperative day 0 or 1, intermediate postoperative day 2, standard postoperative day 3 to 5).
 
  Early readmission (on or before postoperative day 7), anastomotic leak, ileus, and overall readmission were measured.
 
  Of 36,526 patients total, 906 (2.5%) were discharged on postoperative day 0 or 1. Patients discharged on posutilización de las vías de alta acelerada, reducirían costos hospitalarios y utilización de recursos. Consulte Video Resumen en http//links.lww.com/DCR/B331. (Traducción-Dr Fidel Ruiz Healy).
  The anal-external sphincter continence reflex and the puborectal continence reflex control fecal continence by involuntary contractions of the external anal sphincter and puborectal muscle.  https://www.selleckchem.com/products/nu7441.html  To date it is unknown what the effect of liquid stool is on these reflexes.
 
  The purpose of this study was to analyze the consequence of liquid stool on the presence and function of these fecal continence reflexes.
 
  This was a prospective, observational study.
 
  The study was conducted at the Anorectal Physiology Laboratory, University Medical Center Groningen.
 
  Forty-two healthy subjects were included.
 
  Pressure changes at the level of the external anal sphincter and the puborectal muscle during the anorectal pressure test used to measure voluntary contractions, the balloon retention test used to measure involuntary contractions mimicking solid stool, and the rectal infusion test used to investigate the effect of only water mimicking liquid stool were measured.
 
  During the test mimicking solid stool, the pressure a (26 ± 9 mm Hg versus 26 ± 7 mm Hg, p = 0,655).Solo realizamos pruebas de función anorrectal que imitan dos tipos de consistencia de heces, a saber, discriminando entre a agua y sólidos.El reflejo de continencia del esfínter anal-externo controla la continencia fecal de las heces sólidas y líquidas. Por el contrario, el reflejo de continencia puborrectal contribuye solo a la continencia de heces sólidas. Consulte Video Resumen en http//links.lww.com/DCR/B286. (Traducción-Dr Adrian Ortega).
  Stoma reversal is associated with a high risk of wound infection. The gunsight and purse-string closure techniques are both effective alternatives for stoma reversal, but comparative studies are lacking.
 
  The purpose of this study was to compare the gunsight procedure with the purse-string closure technique when closing wounds after loop stoma reversal.
 
  This was a nonblinded, multicenter prospective randomized study (clinicaltrials.gov No. NCT02053948).
 
  The study was conducted at a general surgery unit of 7 tertiary academic medical centers.
 
  A total of 143 patients undergoing loop stoma reversal were included in the study (72 in the gunsight group and 71 in the purse-string group) between November 2013 and December 2017.
 
  Patients were randomly assigned to undergo either gunsight or purse-string closure procedure.
 
  Primary outcome was wound healing time. Secondary outcomes were the incidence of surgical site infection, morbidity, and patient satisfaction.
 
  No differences were found between the 2 gación de la herida, en comparación con el procedimiento de jareta (17 días frente a 25 días, p less then 0,001). Un cuestionario de satisfacción del paciente, mostró que el grupo de gunsight tenía una puntuación más alta en relación al tiempo de cicatrización de la herida (p less then 0.001) y la puntuación total en satisfacción del paciente (p = 0.01), que en el grupo de jareta.Los equipos de tratamiento quirúrgico, no fueron cegados y hubo en los cirujanos, dependencia en las técnicas.Las técnicas de gunsight y de jareta son procedimientos efectivos para la reversión de estoma y ambas tienen una baja incidencia de infección en el sitio quirúrgico. La técnica de gunsight está asociada con un tiempo más corto en cicatrización de heridas, mejores niveles en satisfacción del tiempo de cicatrización y en la puntuación general final. Se recomienda como la técnica de cierre de elección. Consulte Video Resumen en http//links.lww.com/DCR/B319. (Traducción-Dr Fidel Ruiz Healy).