Surgical Procedures, Operative Commons^™

Redefining Resectability In Pancreatic Cancer: A Modified Appleby And Radical Antegrade Modular Pancreatosplenectomy Procedure With Concomitant Left Lateral Sectionectomy In A Patient With Replaced Right And Left Hepatic Arteries, Monica Sciturro, Nada Belal, Jamii St. Julien

West Florida Division GME Research Day 2026

No abstract provided.

When To Biopsy Incidentally Noted, Radiologically Relevant Lymph Nodes In Dcis, John B. Chiari, Jillian Giblin, Brooke Hassan, Katie Bennett

South Atlantic Division GME Research Days 2026

No abstract provided.

Safety And Feasibility Of Talimogene Laherparepvec In Peritoneal Surface Malignancies: Results From The Tempo Trial, John H. Stewart, Donna Niedzwiecki, Melissa Lowe, Ashley Moyer, Emily Bolch, Shannon Diane Maclaughlan, Edward A. Levine, Omeed Moaven, Niharika Mettu, John H. Strickler, Dan G. Blazer

School of Medicine Faculty Publications

Peritoneal surface malignancies (PSMs) remain a therapeutic challenge, particularly in patients with unresectable disease who cannot benefit from cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. The Talimogene Laherparepvec for the Treatment of Peritoneal Surface Malignancies (TEMPO) trial (NCT03663712) is the first phase 1, multicenter, open-label study to evaluate intraperitoneal (i.p.) administration of talimogene laherparepvec (T-VEC), an FDA-approved oncolytic virus, in this setting. Nineteen patients with unresectable PSMs from appendiceal, ovarian, small bowel, and peritoneal carcinomas were enrolled; 18 received treatment across three escalating dose cohorts (4 × 10-4×10 PFU). The primary endpoint was safety and tolerability, with secondary endpoints assessing viral …

Ensuring Safety And Optimization In Total Joint Arthroplasty Of Cancer Patients: A Comprehensive Analysis Of Complication Risks And Modifiable Risk Factors, Tara Korbal, Robert Branstetter Iv, Matthew Cable, Deryk Jones, Lizheng Shi, Lauren Hall, Andrew Chapple

School of Medicine Faculty Publications

AIMS & OBJECTIVES: The primary objective of this study is to determine whether an active cancer diagnosis results in an increased risk of perioperative TJA complications and postoperative mortality. The secondary objective is to analyze the effects of demographic factors on perioperative complication rates in cancer patients undergoing TJA. MATERIALS & METHODS: Patients with active cancer diagnoses undergoing total joint arthroplasty from 2014 to 2020 were included in this retrospective analysis. Patient data was obtained through ReachNet, which consisted of data from the University Medical Center, Tulane University Medical Center, Ochsner Health System, and Baylor Scott & White Health. ICD-9/10 …

Treatment Of Biopsy-Proven Laryngeal Squamous Cell Carcinoma In Situ, Praneet C. Kaki, Aman M. Patel, Lily Huang, Gavin Turner, Afash Haleem, Jason A. Brant, Robert M. Brody, Ryan M. Carey

SKMC Student Presentations and Publications

OBJECTIVE: To investigate the impact of clinical surveillance, primary radiotherapy, and primary surgery on overall survival (OS) in laryngeal carcinoma in situ (Cis).

METHODS: The 2006-2020 National Cancer Database was queried for adults with a biopsy-proven diagnosis of laryngeal Cis. Multivariable binary logistic and Cox proportional hazards regression models were implemented.

RESULTS: Of 3567 unique patients satisfying inclusion criteria, 514 (14.4%) underwent clinical surveillance, 1074 (30.1%) underwent primary radiotherapy, and 1979 (55.5%) underwent primary surgery. Receiving treatment at an academic/research facility was associated with higher odds of undergoing primary surgery compared to primary radiotherapy. Among 646 patients undergoing primary surgery …

Optimizing Stereotactic Intracranial Neoplasm Treatment: A Systematic Review Of Pet Integration With Gamma Knife Radiosurgery, Robert C. Subtirelu, Eric M. Teichner, Milo Writer, Kevin Bryan, Shiv Patil, Talha Khan, Lancelot Herpin, Raj N. Patel, Emily Christner, Chitra Parikh, Thomas Werner, Abass Alavi, Mona-Elisabeth Revheim

SKMC Student Presentations and Publications

OBJECTIVE: Traditional imaging modalities for the planning of Gamma Knife radiosurgery (GKRS) are non-specific and do not accurately delineate intracranial neoplasms. This study aimed to evaluate the utility of positron emission tomography (PET) for the planning of GKRS for intracranial neoplasms (ICNs) and the post-GKRS applications of PET for patient care.

METHODS: PubMed, Scopus, and ScienceDirect were searched in order to assemble relevant studies regarding the uses of PET in conjunction with GKRS for ICN treatment. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed to identify relevant studies on the use of PET in conjunction with …

Slow-Growing Lung Mass In A Patient With Multiple Endocrine Neoplasia Type I: Consider Carcinoid Tumor, Ramin Talebi, Charalambos C. Solomides, Nathaniel R. Evans Iii, Gregory C. Kane

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

A 23-year-old man with multiple endocrine neoplasia type 1 (MEN 1) with pancreatic tail masses and Cushing syndrome (status after transsphenoidal adenomectomy) presented with a slow-growing, asymptomatic right lower lung lobe mass confirmed to be an atypical carcinoid tumor by pathologic staging following successful basilar segmentectomy with mediastinal lymphadenectomy. Pulmonary carcinoid tumor (PCT) is a rare neoplasm in patients with MEN 1, but there is limited data on trends in atypical versus typical carcinoid tumors in these patients. This case emphasizes the need to characterize these trends given the implications for metastatic potential and 5-year survival, which can help guide …

Early Results With Hypofractionated Gamma Knife Radiotherapy For Treatment Of Vestibular Schwannoma, Omar Azmeh, Samuel R. Barber, Maurice King, Moisés A. Arriaga

School of Medicine Faculty Publications

OBJECTIVE: Vestibular schwannoma (VS) management with stereotactic radiation previously only included stereotactic radiosurgery with Gamma Knife (GKRS) or LINAC-based radiotherapy (LBR). Hypofractionated Gamma Knife radiotherapy (hfGKRS) is a novel protocol potentially producing less toxicity than the alternatives. This study examines early results in tumor control, complications and hearing preservation outcomes in a consecutive series of VS patients treated with hfGKRS. STUDY DESIGN: A retrospective review was conducted for all patients with unilateral VS treated with primary hfGKRS at an academic center between 2017 and 2023. SETTING: Tertiary referral center. INTERVENTIONS: Therapeutic. MAIN OUTCOME MEASURES: Pre- and post-treatment imaging, notes and …

Atypical Presentation Of Non-Small Cell Lung Carcinoma With Metastasis To Breast Tissue, Tylar P. Seckman, Diane Krutzler-Berry, Mohamed Ashal, Waqas Mahmud, Krista L. Denning, Logan M. Lawrence

Marshall Journal of Medicine

Malignant neoplasms of the lung commonly metastasize to lymph nodes, bone, brain, and liver via hematogenous and lymphatic routes. Much less commonly, metastasis occurs in the breast. Secondary metastatic disease of the breast is very rare, with a reported incidence ranging from 0.4-1.3%­­—with primary lung cancer being one of the most anomalous sources. This case details non-small cell lung cancer metastasis to the breast with proven primary contralateral lung origination. This atypical finding prompts medical professionals to consider these malignant cells' immunologic, histologic, and pathologic makeup to understand further and treat the neoplasm.

Denovo Malignancy After Liver Transplantation In Patients With And Without Hepatocellular Carcinoma, Mohammad Abuassi, Carson Creamer, Harsimran Kalsi, Kobina Essilfie-Quaye, Tony S. Brar, Yaseen Perbtani

North Florida Division GME Research Day 2025

No abstract provided.

Skin Grafting After Reconstruction For Head And Neck Cancer: Does Thickness Matter?, P Larson Miller, Nicholas Hrdlicka, Eric Shaw, Robert Liebman, Matthew Ochsner

South Atlantic Division GME Research Day 2025

No abstract provided.

Robotic Whipple Procedure, Chris Robert, Soomal Memon, Umar Butt, Furrukh Jabbar

North Texas Research Forum 2025

Introduction: Pancreatic cancer is an aggressive tumor with surgery being the corner stone of multidisciplinary treatment. Pancreaticoduodenectomy is a technically demanding procedure associated with significant morbidity. Case presentation: 70-year-old man with a past history of hypertension presented with jaundice, dark urine and a total bilirubin of 24. His CT scan showed biliary and pancreatic ducal dilation. An EUS revealed a 2cm pancreatic mass with an intact interface between the mass and splenoportal confluence, the biopsy was suggestive of poorly differentiated adenocarcinoma. We performed a Robotic Whipple procedure. Robotic Whipple surgery is superior in meticulous dissection of the retro pancreatic tunnel. …

Surgical Management Of Gastroenteropancreatic Neuroendocrine Tumors, Lisa M. Kenney, Marybeth Hughes

Department Surgery Faculty Publications

Background/Objectives: Neuroendocrine tumors (NETs) are heterogeneous malignancies arising from enterochromaffin cells that can arise from the gastrointestinal (GI) tract and pancreas. Surgical management is the cornerstone of treatment, with the optimal approach tailored by tumor grade, size, location, and presence of metastasis. This review discusses the current strategies for the surgical management of NETs of the gastroenteropancreatic tract. Methods: A review of the available literature was conducted to evaluate surgical approaches to NETs. Consensus guidelines were incorporated to synthesize evidence-based recommendations. Results: For gastric NETs, surgical approach depends on Rindi Classification, WHO grade, and tumor size, with endoscopic approaches favored …

Use Of Indocyanine Green Angiography To Reduce Postoperative Complications In Post-Mastectomy Breast Reconstruction: An Umbrella Review, William R. Clifton, Phil Moon, Emily V. Clifton, Julia C. Stager, Spencer R. Anderson

South Atlantic Division GME Research Day 2025

No abstract provided.

Social Vulnerabilities In Head-Neck Melanoma Care: A Retrospective Cohort Study In The United States, Lillian Mccampbell, David Jun Fei-Zhang, Daniel Chelius, Ling-Lun Bob Hsia, Robert Dellavalle, Jill D'Souza, David Bentrem, Jeffrey Wayne, Jeffrey Rastatter, Anthony Sheyn

School of Medicine Faculty Publications

BACKGROUND: Studies addressing social determinants of health (SDH) in head-neck melanomas (HNM) have only assessed socioeconomic factor impact but not a wider scope of SDH. OBJECTIVE: Utilizing the Social Vulnerability Index (SVI), to assess the influence of specific SDH and their quantifiable associations with HNM management disparities across the varied community contexts in the United States. METHODS: This retrospective cohort study analyzed adults diagnosed with HNM from 1975 to 2017 from the Surveillance, Epidemiology, and End Results Program database. RESULTS: A total of 374,138 HNM in adults from 1975 to 2017 were assessed for disparities affiliated with increasing overall vulnerability/SVI …

An Unexpected Finding During A Breast Excisional Biopsy: A Case Report, Emily Forester, Anjeanette Brown

Rowan-Virtua Research Day

Background: Pacemaker leads within the breast are rare. Although it is infrequent, there are some reports of implanted cardiac devices or wires migrating into breast tissue or through the chest wall. To the best of our knowledge, there are no current reports of pacemaker leads within the breast tissue of a patient with concurrent breast cancer. This case aims to detail the surgical management of this rare phenomenon.

Case Presentation: A pacemaker-dependent, female patient presented to the operating room for a left breast excisional biopsy. Intraoperatively, two epicardial leads were unexpectedly found within the center of the patient’s breast tissue. …

Resection And Reconstruction Of Ewing Sarcoma Of The Cuboid Utilizing Vascularized Fibular Autograft: A Case Report, Brandon Cunha, Alexandre Arkader

Rowan-Virtua Research Day

Ewing Sarcoma (EWS) rarely presents in the bones of the foot, and particularly in the cuboid, making it an exceedingly rare occurrence. We present the case of a 7-year-old female diagnosed with EWS of the right cuboid, detailing the management and outcomes of this rare presentation. The patient, now almost 5 years post-initial local control, exhibits restored foot function, a normalized gait, and no evidence of disease recurrence. This case underscores the potential for preserving lower extremity function and improving postoperative quality of life in rare presentations of EWS through innovative reconstruction strategies.

Comparative Analysis Of Health Outcomes In Gastric Cancer: Robotic Vs. Laparoscopic Gastrectomy, Maftuna Kurbonnazarova

Rowan-Virtua Research Day

Exploring the most effective surgical approach for gastrectomy is crucial for determining superior health outcomes in patients. This research compares robotic and laparoscopic techniques with the aim of pinpointing the optimal method, offering valuable insights for improved postoperative well-being.

Investigating Acetowhitening As A Method To Minimize Mohs Micrographic Surgical Margins In Squamous Cell Carcinoma In Situ Of The Head And Neck Abstract, Alexander Howell, Karthik Krishnamurthy

South Atlantic Division GME Research Day 2024

No abstract provided.

Post-Mastectomy Resconstruction And Disparities Amongst Race During The Covid Pandemic (Pradar): A Retrospective Analysis, Jamie L. Bolden, Robyn Meadows, D Scott Lind, Noaman Ali

South Atlantic Division GME Research Day 2024

No abstract provided.

Inhibiting Pi3k/Akt To Enhance Brain Uptake Of Anticancer Agents In Glioblastoma, Louis Rodgers

Theses and Dissertations--Pharmacy

Glioblastoma (GBM) is the deadliest and most common malignant CNS tumor. Despite advances in understanding its biology and the development of targeted therapies, effective treatment options remain limited. As a result, patient survival rates are dismal, with a 5-year survival rate of only 6.8% and an overall survival of less than two years. This poor outcome is partly due to our inability to treat GBM cells that infiltrate the whole brain. Focal treatments like surgery and radiotherapy alone are insufficient due to these invasive tumor cells. Therefore, chemotherapy following resection and irradiation of the primary tumor is essential to eliminate …

Colon Adenocarcinoma Mimicking Acute Appendicitis In A 28-Year-Old, Bridget Kowalczyk, Edward Pingenot, Vivek Bansal

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

Investigation Of The Effectiveness Of Intraoperative Radiotherapy In Treatment Of Unifocal Invasive Breast Cancer, Julie Schultz, Annie M. Oslund

Physician Assistant Capstones, 2020-current

Objective: Assess the 5 year local recurrence rate of intraoperative radiotherapy (IORT) in relation to the conventional treatment of external breast radiotherapy (EBRT) in eligible females diagnosed with breast cancer over age 40.

Design: Systematic literature review.

Methods: PubMed was searched using the following limits and terms: breast neoplasms, intraoperative radiotherapy, randomized control trial, clinical trial, females, English, and published in the last 10 years.

Results: Three studies were found to directly compare IORT and EBRT regarding 5 year local recurrence rates.

Conclusion: IORT was shown to be non-inferior to EBRT in two of the three studies that were examined; …

The Clinical Definition And Characterization Of Field Of Cancerization In Patients With Actinic Keratoses, Stuti Prajapati, Christina Kontzias, Mallory Zaino, Steven Feldman

Rowan-Virtua Research Day

Introduction: Chronic UV radiation affects the entire area of skin exposed, leading to visible actinic keratoses (AK) and subclinical changes in the surrounding skin. AKs are hyperkeratotic lesions, with a 0.025-16% risk of transforming into squamous cell carcinoma (SCC).1 Cellular atypia around AKs is the field of cancerization (FOC). Topical AK therapies can treat the FOC, while destructive treatments address visible lesions. FDA-approved products may be approved for field sizes up to 25 cm2.1,2

Objective: To characterize the FOC and assess the correlation between the FOC and number of AKs.

Methods: 100 patients with AKs were recruited. FOC was defined …

Barriers To Dermatological Care In Patients Who Received Extensive Mohs Surgery - An In-Depth Qualitative Analysis, Stuti Prajapati, Mallory Zaino, Christina Kontzias, Laura Doerfler, Steven R. Feldman

Rowan-Virtua Research Day

Background: Dermatological care needs to be accessible for the elderly, but they face prominent challenges contributing to delays in diagnosis and treatment. Prolonged management of may lead to widespread cutaneous malignancies, necessitating extensive Mohs surgery.

Objective: To identify areas for early intervention in the geriatric population who have undergone extensive Mohs surgery.

Methods: We performed a qualitative study on 10 patients 65 years and older (68-91) from Atrium Health Wake Forest Baptist dermatology clinics between December 2022 and February 2023, who had extensive Mohs surgery (3 or more layers removed).

Results: Three major areas for potential intervention for cutaneous carcinoma …

Perioperative Ketamine Use For Post Mastectomy Pain, Alessia Cooney, Jaylyn Thompson, Naomi Watkins-Granville

Rowan-Virtua Research Day

PMPS is defined as chronic neuropathic pain following breast cancer procedures in the ipsilateral arm, chest wall, axilla or shoulder.1-3 Approximately 20 to 50% of post mastectomy patients suffer from Post Mastectomy Pain Syndrome (PMPS).1 With more than 3.8 million breast cancer survivors, due to advances in treatment, there is increased importance in findings ways to better manage the quality of life of breast cancer survivors.1,4 Ketamine induces analgesic effects through its non-competitive antagonism of NDMA receptors.5 Low doses of ketamine infusion (20–30 mg x h−1) have been shown to produce analgesia in neuropathic pain states with benefits lasting up …

Distance To Radiation Therapy Facility Influences Surgery Type Among Older Women With Early-Stage Breast Cancer, Pratibha Shrestha, Quyen D. Chu, Mei Chin Hsieh, Yong Yi, Edward S. Peters, Edward Trapido, Qingzhao Yu, Tekeda Ferguson, Xiao-Cheng Wu

School of Public Health Faculty Publications

Background: Breast-conserving surgery plus radiation (BCT) yields equivalent or better survival than mastectomy for early-stage breast cancer (ESBC) women. However, nationwide mastectomy trends increased in recent decades, attracting studies on underlying causes. Prior research identified that long distance to the radiation treatment facility (RTF) was associated with mastectomy. Still, it is unclear whether such association applies to young and old ESBC women comparably. We sought to delineate such impacts by age. Methods: Women diagnosed with stages 0–II breast cancer in 2013–2017 receiving either BCT or mastectomy were identified from the Louisiana Tumor Registry. We assessed the association of surgery (mastectomy …

Cardiac Metastasis After Curative Treatment Of Hepatocellular Carcinoma: Risk Factors, Treatment Options, And Prognosis, Gaurav Jain, Mathew Otto, Mubeen Khan Mohammed Abdul, Manpreet Chadha, Ajay Sahajpal

Journal of Patient-Centered Research and Reviews

Hepatocellular carcinoma (HCC) is primary hepatic malignancy with a high incidence of recurrence. The risk of recurrence directly correlates to patient’s overall prognosis. Management of advanced HCC involves a combination of surgical resection, locoregional therapy, and systemic treatment. Distant metastases are rare, and intraventricular cardiac metastases are even more infrequent. This brief review details an illustrative case of cardiac metastasis after curative treatment of primary HCC and then summarizes the literature on risk factors, treatment options, and patient prognosis in the setting of distant metastases from HCC. Prognosis of metastasis to the heart is generally poor, and available evidence emphasizes …

Factors And Outcomes Contributing To Pelvic Lymph Node Dissection In Non-Muscle Invasive Bladder Cancer, Young Son, Brian Thomas, Lance Earnshaw, Mark Quiring, Erica Martel, Benjamin Fink, Raeann Dalton, Thomas Mueller, Philip Dorsey

Rowan-Virtua Research Day

Bladder cancer represents the 6th most common for men and is classified into muscle-invasive bladder cancer (MIBC) and non-muscle-invasive bladder cancer (NMIBC). NMIBC (T1, Ta, Tis), accounting for approximately 75% of new bladder cancer diagnoses, is limited to the mucosa, submucosa, and lamina propria. Studies have approximated the rate of recurrence in NMIBC between 50 - 70%, which sometimes progresses to muscle invasive disease. Management of NMIBC ranges from surveillance, intravesical chemotherapy to radical cystectomy (RC) and is dependent upon the TNM staging and grading of the tumor. Clinically, staging is determined via imaging, physical exam, and histology on transurethral …

The Utilization Of Osteoarticular Transfer System In The Treatment Of Distal Femur Osteoid Osteoma: A Case Report, Nikki A. Doerr, Efstratios A. Papadelis, Alec S. Kellish, Matthew T. Kleiner, Christina Gutowski

Rowan-Virtua Research Day

We describe a technique for excision of subchondral epiphyseal bone lesions in the distal femur in skeletally immature patients that mitigates risk of complications associated with physeal injury, incomplete tumor resection, and iatrogenic injury to the overlying cartilage.