Surgery Commons^™

Hepatocellular Carcinoma Treated With Microwave Ablation Prior To Liver Transplantation, Nicole Wagner, Amanda Smolock, Michael Markovitz, Varun Danda, Christopher Neely, Warren Maley, Jesse Civan, Colette Shaw

Phase 1

Introduction: Ablation is a minimally invasive procedure that limits local liver tumor progression and prolongs patients’ transplantation eligibility. Microwave ablation (MWA) utilizes higher temperatures than the standard of care, radiofrequency ablation (RFA), which increases efficiency. Meta-analyses compared MWA with RFA for the treatment of HCC and showed similar efficacy and safety between these modalities. However, limited pathologic data exists determining whether explanted tumors remained viable after MWA.

Methods: Our database was reviewed retrospectively for patients with HCC who underwent MWA prior to liver transplantation between 2013 and 2019. Patient demographics, etiology of disease, tumor size, procedure details, bilirubin, MELD, …

Continuous-Flow Left Ventricular Assist Device Outflow Graft Stenting: Indications And Outcomes, Chelsey T. Wood, Mfa, Elizabeth J. Maynes, Md, Thomas J. O'Malley, Md, Rohinton J. Morris, Md, Louis E. Samuels, Md, H. Todd Massey, Md, Vakhtang Tchantchaleishvili

Phase 1

Introduction: Stenosis in the continuous-flow left ventricular assist device (CF-LVAD) outflow graft can be caused by various mechanical and anatomical factors. Increasingly, percutaneous management has been utilized to re-establish adequate CF-LVAD flow. We sought to evaluate indications for such interventions and their outcomes.

Methods: An electronic search was performed to identify all studies in the English literature reporting CF-LVAD outflow graft stenting for various etiologies. Twenty-one studies consisting of 26 patients were included in the analysis.

Results: Median patient age was 59 years [45.8-67.0] and 65.4% (17/26) were male. 58.3% (14/24) of patients had HeartWare HVAD, 37.5% (9/24) had HeartMate …

Treatment Of Persistent Air Leaks Using Endobronchial Valves, Michael Zimmerman, Cole Zingas, Achala Donuru, Scott W. Cowan, Nathaniel Evans Iii, Boyd Hehn

Phase 1

Introduction: Persistent air leaks (PAL) are from bronchopleural fistula resulting from communication between the bronchial tree and pleural space. Endobronchial valves (EBVs) are unidirectional valves placed bronchoscopically preventing airflow to the diseased lung lobe. For non-operable patients with PALs, EBVs offer a potential non-invasive treatment approach to stop air leak and allow lung healing. The purpose of this study is to retrospectively analyze EBV placement to treat non-operable adult patients with PALs.

Methods: We retrospectively analyzed all adult patients that underwent EBV placement for PAL treatment at our institution from January 2016 to June 2019. All patients failed conservative …

Telemedicine For Outpatient Neurosurgical Oncology Care: Lessons Learned For The Future During The Covid-19 Pandemic., Lc Daggubati, Dg Eichberg, Me Ivan, S Hanft, A Mansouri, Rj Komotar, Rs D'Amico, Be Zacharia

Journal Articles

No abstract provided.

Applying Triage Principles Of Mass Casualty Events To The Sars-Cov-2 Pandemic: From The Perspective Of The Acute Care Surgeons At Long Island Jewish Medical Center In The Covid Epicenter Of The United States., M Giangola, S Siskind, B Faliks, R Dela Cruz, A Lee, M Shebes, G Ritter, J Prince, G Coppa, R Barrera, V Patel

Journal Articles

No abstract provided.

Limiting Hospital Resources For Acute Appendicitis In Children: Lessons Learned From The U.S. Epicenter Of The Covid-19 Pandemic, Cl Kvasnovsky, Y Shi, B S. Rich, R D. Glick, S Z. Soffer, A M. Lipskar, S Dolgin, A Hong, J M. Prince, C Sathya, +2 Additional Authors

Journal Articles

No abstract provided.

Primer For Intensive Care Unit (Icu) Redeployment Of The Noncritical Care Surgeon: Insights From The Epicenter Of The Coronavirus Disease 2019 (Covid-19) Pandemic, Dk Deperalta, Ar Hong, C Choy, J Wang, Jp Ricci, Bv Marcano-Benfante, Am Lipskar

Journal Articles

No abstract provided.

Acute Arterial Thromboembolism In Patients With Covid-19 In The New York City Area, Y. Etkin, A. M. Conway, J. Silpe, K. Qato, A. Carroccio, P. Manvar-Singh, G. Giangola, J. S. Deitch, L. Davila-Santini, J. A. Schor, K. Singh, F. F. Mussa, G. S. Landis

Journal Articles

© 2020 Elsevier Inc. Background: Coronavirus disease 2019 (COVID-19) predisposes to arterial and venous thromboembolic complications. We describe the clinical presentation, management, and outcomes of acute arterial ischemia and concomitant infection at the epicenter of cases in the United States. Methods: Patients with confirmed COVID-19 infection between March 1, 2020 and May 15, 2020 with an acute arterial thromboembolic event were reviewed. Data collected included demographics, anatomical location of the thromboembolism, treatments, and outcomes. Results: Over the 11-week period, the Northwell Health System cared for 12,630 hospitalized patients with COVID-19. A total of 49 patients with arterial thromboembolism and confirmed …

Estimated National And Regional Impact Of Covid-19 On Elective Case Volume In Aesthetic Plastic Surgery., D. E. Bregman, T. Cook, C. Thorne

Journal Articles

BACKGROUND:In efforts to help alleviate the strain placed on healthcare during the COVID-19 pandemic, The American Society of Plastic Surgery (ASPS) recommended suspending elective procedures on March 19, 2020. When this suspension was enacted, it was unknown when cases would resume. OBJECTIVES:This analysis aims to estimate the regional economic impact of the pandemic specifically with regards to elective, aesthetic surgical procedures. As knowledge regarding the effects of the pandemic has grown, the authors then evaluated the accuracy of our projected estimates when compared to actual events. METHODS:Using the ASPS 2018 Plastic Surgery Statistics Report, regional case volume and surgeons' fees …

Reply To Letter To The Editor Regarding New York's Covid-19 Shelter-In-Place And Acute Appendicitis In Children, C. .. Kvasnovsky, Y. Shi, B. Rich, R. D. Glick, S. Z. Soffer, A. M. Lipskar, S. Dolgin, N. Bagrodia, J. M. Prince, C. Sathya, +2 Additional Authors

Journal Articles

No abstract provided.

Fusiform Superior Cerebellar Artery Aneurysm Treated With Flow Diversion: A Case Report, Y. Serulle, D. Khatri, J. Fletcher, A. Pappas, A. Heidbreder, D. Langer, R. A. Ortiz

Journal Articles

© 2020 Published by Scientific Scholar on behalf of Surgical Neurology International. Background: Fusiform aneurysms of the distal superior cerebellar artery are rare and challenging to treat. Due to the rarity of these lesions, there is little consensus regarding their management. Treatment options have traditionally included parent artery sacrifice with either an endovascular approach or microsurgical clipping. Given the small diameter of the superior cerebellar artery, flow diversion has not been typically considered as a viable treatment option for these aneurysms. Case Description: A 67-year-old female presented complaining of severe sudden onset headache. Noncontrast head CT demonstrated no intracranial hemorrhage. …

The Covid-19 Pandemic And Acute Aortic Dissections In New York: A Matter Of Public Health., I. El-Hamamsy, D. R. Brinster, J. J. Derose, L. N. Girardi, K. Hisamoto, M. N. Imam, S. Itagaki, P. A. Kurlansky, C. Lau, H. Takayama, +3 Additional Authors

Journal Articles

No abstract provided.

A Comparison Of Existing Risk Prediction Models In Patients Undergoing Venoarterial Extracorporeal Membrane Oxygenation, B. Worku, M. Gaudino, D. Avgerinos, K. Ramasubbu, I. Gambardella, I. Gulkarov, S. Khin

Journal Articles

© 2020 The Author(s) Background: Patients undergoing consideration for venoarterial extracorporeal membrane oxygenation (VA-ECMO) require an immediate risk profile assessment in the setting of incomplete information. A number of survival prediction models for critically ill patients and patients undergoing elective cardiac surgery or institution of VA-ECMO support have been designed. We assess the ability of these models to predict outcomes in a cohort of patients undergoing institution of VA-ECMO for cardiogenic shock or cardiac arrest. Methods: Fifty-one patients undergoing institution of VA-ECMO support were retrospectively analyzed. APACHE II, SOFA, SAPS II, Encourage, SAVE, and ACEF scores were calculated. Their ability …

Multifocal Extracranial Mycotic Aneurysms In A Patient With Endocarditis, A. M. Spring, M. A. Catalano, B. F. Farber, K. V. Krishnasastry, P. J. Yu

Journal Articles

© 2020 This report describes the case of a 44-year-old man with Streptococcus gallolyticus (formerly S. bovis) endocarditis requiring surgical mitral valve replacement who developed multifocal extracranial mycotic aneurysms after the resolution of infection.

Management Of Elective Aortic Valve Replacement Over The Long Term In The Era Of Covid-19, C. Basman, C. A. Kliger, L. Pirelli, S. J. Scheinerman

Journal Articles

No abstract provided.

Confirmation And Identification Of Biomarkers Implicating Environmental Triggers In The Pathogenesis Of Type 1 Diabetes, Robert Z. Harms, Katie R. Ostlund, Monina S. Cabrera, Earline Edwards, Marisa Fisher, Nora Sarvetnick

Journal Articles: Surgery

Multiple environmental triggers have been proposed to explain the increased incidence of type 1 diabetes (T1D). These include viral infections, microbiome disturbances, metabolic disorders, and vitamin D deficiency. Here, we used ELISA to examine blood plasma from juvenile T1D subjects and age-matched controls for the abundance of several circulating factors relevant to these hypotheses. We screened plasma for sCD14, mannose binding lectin (MBL), lipopolysaccharide binding protein (LBP), c-reactive protein (CRP), fatty acid binding protein 2 (FABP2), human growth hormone, leptin, total adiponectin, high molecular weight (HMW) adiponectin, total IgG, total IgA, total IgM, endotoxin core antibodies (EndoCAbs), 25(OH) vitamin D, …

Heightened Levels Of Antimicrobial Response Factors In Patients With Rheumatoid Arthritis, Prathapan Ayyappan, Robert Z. Harms, Jennifer A. Seifert, Elizabeth A. Bemis, Marie L. Feser, Kevin D. Deane, M Kristen Demoruelle, Ted R. Mikuls, V Michael Holers, Nora Sarvetnick

Journal Articles: Surgery

Rheumatoid arthritis (RA) is a chronic progressive autoimmune disease leading to considerable disability over time. The disease can be characterized by the presence of multiple autoantibodies in the serum and synovial fluid. Microbial dysbiosis is proposed to play a role in the pathogenesis of RA. Increased systemic bacterial exposure leads to elevated levels of antimicrobial response factors (ARFs) in the circulation. In the present study, we tested whether RA patients have increased levels of ARFs by analyzing the levels of multiple ARFs in serum from RA patients and healthy age and sex-matched controls. The levels of soluble CD14 (sCD14), lysozyme, …

Complexation-Induced Resolution Enhancement Of 3d-Printed Hydrogel Constructs, Jiaxing Gong, Carl C. L. Schuurmans, Anne Metje Van Genderen, Xia Cao, Wanlu Li, Feng Cheng, Jacqueline Jialu He, Arturo López, Valentin Huerta, Jennifer Manríquez, Ruiquan Li, Hongbin Li, Clément Delavaux, Shikha Sebastian, Pamela E. Capendale, Huiming Wang, Jingwei Xie, Mengfei Yu, Rosalinde Masereeuw, Tina Vermonden, Yu Shrike Zhang

Journal Articles: Surgery

Three-dimensional (3D) hydrogel printing enables production of volumetric architectures containing desired structures using programmed automation processes. Our study reports a unique method of resolution enhancement purely relying on post-printing treatment of hydrogel constructs. By immersing a 3D-printed patterned hydrogel consisting of a hydrophilic polyionic polymer network in a solution of polyions of the opposite net charge, shrinking can rapidly occur resulting in various degrees of reduced dimensions comparing to the original pattern. This phenomenon, caused by complex coacervation and water expulsion, enables us to reduce linear dimensions of printed constructs while maintaining cytocompatible conditions in a cell type-dependent manner. We …

Massive Megarectum Secondary To Constipation In Institutionalized Patient, Dawit Ayalew, Yahya Alwatari, Lin M. Riccio

Surgery Publications

Chronic constipation is a common cause of morbidity in the elderly and institutionalized population. It can be associated with significant morbidity and socioeconomical burden. Chronic resistance constipation can rarely be associated with megarectum. Herein, we present the case of a patient with physical and mental disability that presented with refractory constipation associated with extreme stool burden and a massive megarectum. We discuss chronic constipation in the elderly population, its etiologies and diagnostic work-up including surgical options. The management of chronic constipation with megarectum should be on a case-by-case basis.

Reduced Length Of Stay In Major Hepatectomy Surgery After Implementation Of An Enhanced Recovery Pathway In The United States Veteran Population, Yvonne Nguyen Md, Marilyn Mcnulty Np, Leopoldo Fernandez Md, Michael R. Kazior Md

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

Introduction

Enhanced recovery after surgery (ERAS) pathways are associated with better postoperative recovery, however, evidence is lacking in major liver surgery, .This study aimed to evaluate the impact of an ERAS pathway in U.S. veterans undergoing major hepatectomy surgery. We hypothesized that the adoption of an ERAS pathway reduces decreased length of stay (LOS).

Methods

After approval from the Hunter Holmes McGuire VA Medical Center IRB, we compared data from consecutive patients undergoing elective open hepatectomy within an ERAS pathway (January 2019-December 2019) to a previous cohort of patients before introduction of ERAS (July 2016-December 2017). One surgeon performed all …