Surgery Commons^™

A Rare Presentation Of Extra-Appendiceal Mucinous Neoplasm Of The Anus, Pincus Joshua, Marianne Estrada, Lance Horner University Of Nevada, Las Vegas

School of Medicine Research Poster Showcase

Introduction: Mucinous neoplasm of the anus is an uncommon malignancy, representing less than 3% of all anal cancers. Even more rare is extra-appendiceal mucinous neoplasm. As a result, limited literature exists to define diagnostic strategies and optimal management. Our case report details the presentation and management of a patient with recurrent mucinous neoplasm of the anus. Methods: A retrospective chart review was performed which includes clinic documentation., operative notes, pathology reports. Results: The patient is a 76-year-old male with a history of T3N0M0 anal mucinous carcinoma diagnosed in 2015 and treated with neoadjuvant chemoradiation with complete pathological response. In 2024, …

Horseshoe Kidneys In Transplantation: Underutilization Despite Comparable Quality And Favorable Outcomes: Unos Registry Analysis (2007-2023), Abigail W. Cheng, Samrawi Misiker, Roberto Sagaribay, Kavita Batra

School of Medicine Research Poster Showcase

Introduction: Horseshoe kidneys (HSKs) are the most common renal fusion anomaly, occurring in approximately 1 in 500 individuals and often discovered incidentally. Historically excluded from transplantation due to complex anatomy, advances in surgical techniques have made HSK transplantation increasingly feasible. Although successful procurement and transplantation have been described in case reports, national-level data comparing donor characteristics and organ utilization between HSK and non-HSK donors remain limited. This study characterizes donor demographics, clinical profiles, and organ utilization of HSK donors using the United Network for Organ Sharing (UNOS) database.

Methods: A retrospective analysis of the UNOS kidney transplant registry was performed, …

Mirizzi Syndrome: The Trojan Horse Of Gallbladder Disease, Mary Froehlich, Elizabeth M. Sodomin, Taylor Fontenot, Noama Iftekhar, Christian N. Chan

Department of Surgery Faculty Research

Background: The incidence of Mirizzi Syndrome ranges from 0.05 to 5.7 % of patients who undergo cholecystectomy. The purpose of this study is to examine the preoperative workup and postoperative outcomes for patients diagnosed with Mirizzi Syndrome. Methods: Retrospective chart review was conducted between January 2018 and January 2022 at a single institution. All adult patients who underwent cholecystectomy were included. Results: 1628 patients underwent cholecystectomy of which 47 were diagnosed with Mirizzi Syndrome. The majority of patients had type 1 Mirizzi Syndrome. Preoperative studies were often nondiagnostic and 81 % of cases were diagnosed intraoperatively. 66 % of cases …

Prevalence Of Central Venous Stenosis Among Black And White Eskd Patients With Dysfunctional Dialysis Access, Vipul Chitalia Md, Jonathan Ravid, Arinze Nkiruka, Kristina Yamkovoy, Matthew Diamond, Rohit Pillai, Tyler J. Ryan, Saran Lotfollahzadeh, Janice Weinberg, Alik Farber, Rajendran Vivendhan, Jean Francis, Nathanael Fillmore, Najia Idrees

Journal of Health Disparities Research and Practice

In the United States, significant racial and ethnic disparities exist in chronic kidney disease (CKD) and its management. Hemodialysis constitutes the main stay of renal replacement therapy for end-stage kidney disease (ESKD), which is initiated using central venous catheters (CVC) in most CKD patients in the United States. Black ESKD patients have higher usage and greater time on CVC for hemodialysis compared to White patients. This trend places Black patients at a potentially higher risk for CVC-related complications such as central venous stenosis (CVS). We posited that Black patients would have a higher prevalence and a greater risk of CVS. …

Physician Workforce In The Mountain West, Hira Ahmed, Caitlin J. Saladino, William E. Brown Jr.

Health

Using data from the Association of American Medical College’s State Physician Workforce Data Report, this fact sheet synthesizes Mountain West data on the numbers of active physicians and active physician demographics in Arizona, Colorado, Nevada, New Mexico, and Utah. This fact sheet focuses on active physicians in the Mountain West region by gender, race and ethnicity, as well as the number of students pursuing medical and premedical education.

Pancreaticoduodenectomy In 11-Year-Old Male With A Non-Functional Pancreatic Neuroendocrine Tumor, Whitney Elks, Jessa Rose Li, Alexander Zajack, Lance Horner, Alan Ikeda, Charles St Hill, Michael Scheidler, Shirong Chang

School of Medicine Faculty Research

Pancreatic neuroendocrine tumors (pNETs) are rare pancreatic neoplasms and are even more uncommon in the pediatric patients, thus leading to a lack of clinical research on diagnosis and management in this population. The purpose of this report is to review relevant literature and discuss a rare occurrence of a non-functioning pNET in a pediatric patient. This is a report of an 11-year-old male who presented with symptomatic anemia and was found to have a 6 cm mass near the pancreatic head with erosion into the duodenum. Surgical biopsy demonstrated a non-functioning pNET. He was successfully managed with complete surgical resection …

A Rapidly Growing Mesenchymal Hamartoma In A Neonate With Known Placental Anomalies, Justin Bauzon, Desiree Morris, Charles St. Hill, Taylor Schanda, Michael Scheidler, Shirong Chang

Department of Surgery Faculty Research

Hepatic mesenchymal hamartomas (HMH) are benign liver lesions that present as cystic, slow growing masses within the first few years of life. Few cases demonstrate placental abnormalities and abnormal levels of alpha-fetoprotein (AFP). We report an unusual case of a rapidly growing HMH with associated placental anomalies and elevated AFP. A 2-month-old female born prematurely due to concerning placental findings presented with a prenatally-identified liver mass. Magnetic resonance imaging (MRI) showed a marked increase in the size of the mass over a three- month period. Prior to surgery, the AFP was elevated and decreased after operative resection. Histopathology confirmed the …

The Role Of Socioeconomic Status, Race, And Gender In Patient-Reported Outcomes Following Total Hip Arthroplasty, Allyn M. Bove, James Porter, Aatif Sayeed, Clair Smith, Brian A. Klatt

Journal of Health Disparities Research and Practice

Background

Disparities in total joint arthroplasty are well-documented. However, much of the research regarding disparities in vulnerable populations receiving total hip arthroplasty (THA) have focused on short-term outcomes. The purpose of this study was to examine the effects of race, gender, and socioeconomic status (SES) on patient-reported outcomes six months following THA.

Methods

Electronic health record data were retrospectively analyzed for 269 individuals who underwent THA at a large urban hospital from 2013-16. Data retrieved included patient demographics, baseline health information, data regarding hospital length of stay when undergoing THA, post-operative complications, and patient-reported function, measured by the Harris Hip …

Intracorporeal And Extracorporeal Anastomosis For Robotic-Assisted And Laparoscopic Right Colectomy: Short-Term Outcomes Of A Multi-Center Prospective Trial, Robert K. Cleary, Matthew Silviera, Tobi J. Reidy, James Mccormick, Craig S. Johnson, Patricia Sylla, Jamie Cannon, Henry Lujan, Andrew Kassir, Ron Landmann, Wolfgang Gaertner, Edward Lee, Amir Bastawrous, Ovunc Bardakcioglu, Sushil Pandey, Vikram Attaluri

Department of Surgery Faculty Research

Background: Studies to date show contrasting conclusions when comparing intracorporeal and extracorporeal anastomoses for minimally invasive right colectomy. Large multi-center prospective studies comparing perioperative outcomes between these two techniques are needed. The purpose of this study was to compare intracorporeal and extracorporeal anastomoses outcomes for robotic assisted and laparoscopic right colectomy. Methods: Multi-center, prospective, observational study of patients with malignant or benign disease scheduled for laparoscopic or robotic-assisted right colectomy. Outcomes included conversion rate, gastrointestinal recovery, and complication rates. Results: There were 280 patients: 156 in the robotic assisted and laparoscopic intracorporeal anastomosis (IA) group and 124 in the robotic …

Lobectomy For Acquired Lobar Emphysema Months Following Newborn Repair Of Congenital Diaphragmatic Hernia, Mary Froehlich, Lance Horner, Joseph Stathos, Craig Nakamura, Michael G. Scheidler

School of Medicine Faculty Research

Chronic lung disease is a known morbidity of congenital diaphragmatic hernia repair. Although described as a diffuse lung process, we present a case of localized lobar emphysema in a child with a congenital diaphragmatic hernia repair successfully treated with lobectomy. We aim to describe this unique clinical manifestation, detail the intraoperative findings, and describe the successful postoperative course.

American Association For The Surgery Of Trauma Prevention Committee Review: Family Justice Centers-A Not-So-Novel, But Unknown Gem, Thomas K. Duncan, Ronald Stewart, Kimberly Joseph, Deborah A. Kuhls, Tracey Dechert, Sharven Taghavi, Stephanie Bonne, Kazuhide Matsushima

School of Medicine Faculty Research

The American College of Surgeons Committee on Trauma requires that trauma centers demonstrate adequate financial support for an injury prevention program as part of the verification process. With the ongoing challenges that arise with important social determinants of health, trauma centers have the important task of navigating a patient through the complex process of obtaining services and tools for success. This summary from the American Association for the Surgery of Trauma Prevention Committee focuses on a model that has been present for several years, but has not been brought to full awareness in the trauma world. It highlights the importance …

Seasonal Impact In Admissions And Burn Profiles In A Desert Burn Unit, Syed F. Saquib, Joseph T. Carroll, Paul J. Chestovich

Department of Surgery Faculty Research

In much of the world, pattern of burn injuries can vary depending on the season. This study examines the seasonal impact of admissions, acuity, mortality, and resource utilization at an accredited burn center located in a desert climate. It is a retrospective analysis of patients admitted from March 1, 2014 to February 28, 2019 for acute burns. Patients were categorized into four groups according to each season based on their date of admission: Spring (March, April, May), Summer (June, July, August), Fall (September, October, November), and Winter (December, January, February).

A total of 1519 patients were included. 1016 were male …

Patterns Of Lumbar Disc Degeneration: Magnetic Resonance Imaging Analysis In Symptomatic Subjects, Monchai Ruangchainikom, Michael D. Daubs, Akinobu Suzuki, Chengjie Xiong, Tetsuo Hayashi, Trevor P. Scott, Kevin Phan, Jeffrey C. Wang

School of Medicine Faculty Research

Study Design: Cross-sectional study. Purpose: To evaluate lumbar disc degeneration (LDD) on magnetic resonance imaging (MRI) in symptomatic subjects to accumulate baseline data on the pattern of degeneration. Overview of Literature: LDD plays an important role in the diagnosis and treatment of low-back pain in patients. Few studies have focused on the pattern of LDD to understand how the lumbar spine ages. Methods: This study included 1,095 patients (mean age, 44.29 years; range, 16–85 years) who underwent upright lumbar MRI. LDD was graded into five categories (I–V). Positive LDD was defined as grade III or greater. The prevalence and pattern …

Use Of Pericranial Flaps With Dermal Substitute For Scalp Reconstruction: A Case Series, Kongkrit Chaiyasate Md, Facs, Lauren N. Oliver Do, Scott A. Kreitzberg Do, Mitchell Lyons Md, Joshua Goldman Md, Stephen M. Lu Md, Tracey Bastiaans Do, Christopher Lumley Do, Neil S. Sachanandani Md

School of Medicine Faculty Research

Background: Skin cancer incidence has been rapidly increasing over the past 2 decades, and the resulting defects from excision have significant aesthetic and functional implications. In particular, wound coverage for large scalp and forehead defects with calvarial exposure can lead to hairline distortion, contour irregularities, and alopecia. We describe a 2-stage technique for scalp reconstruction, which preserves the normal hairline, covers exposed bone with vascularized tissue, and restores an aesthetic soft-tissue contour. Methods: This is a retrospective case series of 13 adults with ages ranging from 50 to 89 years. All patients underwent Mohs surgery on the forehead or scalp …

The Effect Of Language Barriers On Variation And Receipt Of Early Stage Breast Cancer Treatment, Abigail R. Madans Do, Richard T. Zera Md, Phd, Rachel M. Nygaard Phd

Journal of Health Disparities Research and Practice

Background: Arriving at and implementing an appropriate patient centered treatment plan for early stage breast cancer requires significant dialogue between healthcare providers and patients. How language barriers affect this process has not been thoroughly explored in the literature. The aim of this paper is to examine the effect of language barrier on variation and receipt of early stage breast cancer treatment.

Methods: Rates of lumpectomy, mastectomy, and contralateral prophylactic mastectomy (CPM) with or without reconstruction were compared between English speaking and Low English Proficiency (LEP) cohorts. Patients with recurrent or bilateral breast cancer, male patients, and/or known genetic mutations …

Drug-Induced Autoimmune Hepatitis From Hydralazine Leading To Acute Liver Failure And Liver Transplantation, Jasleen Grewal, Angela Doan, Annie S. Hong, Arpit Amin, Jason V. Scapa, Ramy Hanna, Francisco Durazo, Beshoy Yanny

School of Medicine Faculty Research

We describe a woman with no previous liver disease who developed drug-induced autoimmune hepatitis from hydralazine prescribed to her for hypertension. Despite the discontinuation of the medication, she developed acute liver failure and subsequently underwent successful liver transplantation. She survived and had a good clinical outcome.

Possible Skull Base Erosion After Prolonged Frontal Sinus Stenting, Nathaniel H. Reeve Md, Harry H. Ching Md, Yuna Kim Md, Walter W. Schroeder Md

School of Medicine Faculty Research

Frontal sinus stenting is widely used with the goal of maintaining nasofrontal duct patency after sinus surgery. The general recommendation is to leave stents in place for 6 months; however, prolonged stenting up to 6 years has been reported with no complication. We present the first reported case of frontal sinus posterior table and skull base erosion following prolonged frontal sinus stenting. A 57-year-old female presented with chronic sinusitis and nasal obstruction. Imaging revealed pansinusitis with retained stents in each frontal sinus that were placed 8 years prior. On the right, there was an area of skull base erosion at …

Impact Of Race And Insurance On Door-To-Appendectomy Time Among Pediatric Patients, Carla M. Lopez, Emily R. Christison-Lagay, Daniel Solomon

Journal of Health Disparities Research and Practice

Racial and ethnic disparities in the rate of appendiceal rupture have been widely reported among the pediatric population. The main reasons for this remain largely unknown given that previous explanations pointing to signs of poor health care access have recently been shown to account for only a small percentage of the difference in perforation rates between white and minority children. Because the risk of perforation increases with time, racial disparities in time delay from emergency department presentation to OR appendectomy may help account for the higher appendiceal perforation rates observed among minority children. This is the first study dedicated to …

Emergent Chest Wall Reconstruction For An Incarcerated Pulmonary Hernia, Allison G. Mcnickle Md, Timonthy Dickhudt Md, Jorge A. Vega Md, Paul J. Chestovich, Douglas R. Fraser

School of Medicine Faculty Research

No abstract provided.

Physicians' Attitudes About Recommending Surgery For Early Stage Lung Cancer And Possible Reasons For Racial Disparities, Franklin R. Mcguire

Journal of Health Disparities Research and Practice

PHYSICIANS’ ATTITUDES ABOUT RECOMMENDING SURGERY FOR EARLY STAGE LUNG CANCER AND POSSIBLE REASONS FOR RACIAL DISPARITIES

ABSTRACT

Purpose: Patient refusal for lung cancer surgery is significant, but other factors, such as negative framing of the treatment discussion, may be involved. Physician attitudes could influence the nuances of and therefore the conclusions of these discussions. We determined physicians’ attitudes and the influence it has on possible decisions against lung cancer surgery, particularly surgical rates for blacks, using a companion survey.

Methods: The study is a prospective, multicenter observational trial conducted at five sites in North and South Carolina from December …

Population-Based Survey Of Lumbar Surgery Beliefs In The United States, Amanda Elyse Mccauley, Zachery Clark Rasmussen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Studies have shown that poor lumbar surgery outcomes may be influenced by a person’s preconceived perceptions of low back surgery (LBS). However, the perceptions of the general population about issues related to lumbar surgery are not known. Therefore, the purpose of this study was to investigate the general population’s perceptions regarding LBS.

Number of Subjects: This study included 262 participants (Average age: 46.1, SD=16.9; 125 Males, 137 Females) who completed the questionnaire from the general population in the Las Vegas area.

Materials/Methods: Questionnaire development involved expert panel feedback from three physical therapists, three spine surgeons, two surgeon assistants/nurses, two …

She’S A Survivor: Post-Operative Counseling And Its Importance To The Recovery Of A Woman Victimized By Female Genital Mutilation, Jacent Wamala

McNair Poster Presentations

The prevalence of Female Genital Mutilation and the difficulty in preventing its practice call for a fresh way of resolving the problem. As the availability of medical professionals equipped with the ability to correct clitoral mutilation grows, there is also an increasing need for professionals that can help the victims after the reconstructive surgery. Post-operative therapy for victims that have opted to receive reconstructive surgery is necessary in order to fully recover. Furthermore, more research in this area is needed to support the findings of this review and will fill the physical and emotional gap exhibited in prior studies related …

Lake Mead Hospital Conversion To Complete Delivery System, Roger W. Noorda

UNLV Theses, Dissertations, Professional Papers, and Capstones

The objective of this case study is to determine the cost difference between using a conventional type of inventory system in the operating room versus using a pack system in the operating room. In this study three different ways of delivering disposables for a laminectomy procedure were considered: 1) multiple distributors of disposables, 2) single distributor of disposables, and 3) the pack system (CDS by Medline). The first comparison was of multiple distributors vs. a single distributor with a cost difference of $90.08 per procedure and $18,916.80 annually, multiple distributor costing less. The second comparison was between Medline as a …

Three Cheers For Elective Hysterectomy, Mary Guinan

School of Public Health Faculty Research

Hysterectomy is the second (after cesarean section) most commonly performed major surgical procedure in the United States today.1 About [650,000 American women will have hysterectomies in 1989. Thirty-seven percent of all US women will have had a hysterectomy by the time they reach age 60. The number of hysterectomies increased dramatically Born 1965 to 1975, but then leveled off and decreased to the present level of about 7 per 1000 women. The ~ghest rates occur in women aged 35 to 44 years, the age group the so called baby boomers are now entering in large numbers. Therefore, if the age-specific …