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Totally Robotic Vs Hybrid Abdominoperineal Resection: A Retrospective Multicenter Analysis, Jonathan Douissard, Vincent Obias, Craig S. Johnson, Monika E. Hagen, Deborah Keller, James R. Ouellette, Minia Hellan

Department of Surgery Faculty Publications

Introduction

Laparoscopic abdominoperineal resection (APR) for low rectal cancers is technically demanding. Robotic assistance may be of help and can be hybrid (HAPR) or totally robotic (RAPR). The present study describes outcomes of robotic APR and compares both approaches.

Material and methods

A multicentric retrospective analysis of rectal cancer patients undergoing either HAPR or RAPR was conducted. Patients' demographics, surgeons' experience, oncologic results, and intraoperative and postoperative outcomes were collected.

Results

One hundred twenty‐five patients were included, 48 in HAPR group and 77 in RAPR group. Demographics and comorbidities were comparable. Operative time was reduced in RAPR group (266.9 ± …

Management Of Traumatic Subarachnoid Hemorrhage By The Trauma Service: Is Repeat Ct Scanning And Routine Neurosurgical Consultation Necessary?, Stephen W. Cooper, Kimberly B. Bethea, Trevor J. Skrobut, Rod G. Gerardo, Juan Torres-Reveron, Akpofure Peter Ekeh

Department of Surgery Faculty Publications

Subarachnoid hemorrhage (SAH) results frequently from traumatic brain injury (TBI). The standard management for these patients includes brief admission by the acute care surgery (trauma) service with neurological checks, neurosurgical consultation and repeat head CT within 24 hours to identify any progression or resolution. Recent studies have questioned the need for repeat CT imaging and specialty consultation in mild TBI. We reviewed patients with mild TBI specifically with isolated SAH to determine progression of the pathology and need for neurosurgical involvement. All patients with SAH secondary to mild TBI (Glasgow Coma Score (GCS) of 13-15) who presented over a 5-year …

Laparoscopic Cholecystectomy In The Acute Care Surgery Model: Risk Factors For Complications, Emily Fletcher, Erica Seabold, Ronald J. Markert, Alyssa J. Gans, Akpofure Peter Ekeh

Department of Surgery Faculty Publications

Background: The Acute Care Surgery (ACS) model developed during the last decade fuses critical care, trauma, and emergency general surgery. ACS teams commonly perform laparoscopic cholecystectomy (LC) for acute biliary disease. This study reviewed LCs performed by an ACS service focusing on risk factors for complications in the emergent setting. Methods: All patients who underwent LC on an ACS service during a 26-month period were identified. Demographic, perioperative, and complication data were collected and analyzed with Fisher's exact test, χ ² test, and Mann-Whitney U Test. Results: During the study period, 547 patients (70.2% female, mean age 46.1±18.1, …

Crossbow Bolt Injury To The Heart, Deanne Jacobs, Claire Hardman, Syed A. Zaman, Akpofure Peter Ekeh

Department of Surgery Faculty Publications

Case summary A 33-year-old woman was transferred from an outside hospital with a penetrating injury to her right chest. The patient was shot with a crossbow with the entry site to the right breast/chest and a transmediastinal trajectory. She was intubated prior to arrival due to difficulty breathing. Her vital signs remained stable and within normal limits, with good breath sounds, and no evidence of pneumothorax on chest X-ray. The tip of the bolt was palpable at the patient’s left midaxillary line. Chest X-ray in trauma bay showed the transmediastinal trajectory, and the bolt appeared to have a field point …