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Department of Surgery Faculty Papers

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Full-Text Articles in Surgery

Surgical Outcomes Of Hidradenitis Suppurativa Excision: Factors Impacting Wound Healing Time, Christina Huang, Scott H. Koeneman, Sherry Yang, Sami Tannour Aug 2026

Surgical Outcomes Of Hidradenitis Suppurativa Excision: Factors Impacting Wound Healing Time, Christina Huang, Scott H. Koeneman, Sherry Yang, Sami Tannour

Department of Surgery Faculty Papers

Hidradenitis suppurativa (HS) can be treated surgically to excise recurrent and recalcitrant regions of disease activity. However, surgical outcomes are highly variable depending on closure method, concomitant medical management and area of excision. In this study, we aim to characterise the healing courses from HS excision in a case series. To reduce operator variability, we opted to conduct a case series from a single surgeon. Surgeries conducted from June 2024-December 2025 by surgeon S.T. were included, and the postoperative course was followed until February 2026. Surgical details and postoperative course for 34 sites of HS across 20 patients were analysed. …


Neoadjuvant Immunotherapy For Hepatocellular Carcinoma Is Associated With Improved Survival After Hepatectomy: A Matched Analysis Of The 2017 To 2022 National Cancer Database, Lawrence Chiang, Adam Bodzin, Daniel Lin, Nader Hanna, Scott Koeneman, Hien Dang, Charles J. Yeo, Christopher Shubert, R. Zheng Jul 2026

Neoadjuvant Immunotherapy For Hepatocellular Carcinoma Is Associated With Improved Survival After Hepatectomy: A Matched Analysis Of The 2017 To 2022 National Cancer Database, Lawrence Chiang, Adam Bodzin, Daniel Lin, Nader Hanna, Scott Koeneman, Hien Dang, Charles J. Yeo, Christopher Shubert, R. Zheng

Department of Surgery Faculty Papers

Background: Effects of neoadjuvant immunotherapy (NIT) before liver resection are not well-described in hepatocellular carcinoma (HCC). Survival and R0 resection rates in HCC patients undergoing curative-intent resection with or without NIT were evaluated.

Methods: A retrospective study of stage I-III HCC patients undergoing hepatectomy from the 2017–2022 National Cancer Database was performed. Patients receiving NIT were exactly matched 1:3 to non-NIT patients by clinical stage. Primary outcomes were margin positivity, 30- and 90-day mortality, and overall survival.

Results: After matching 510 patients, 97 received NIT and 291 did not (non-NIT). Resections included segmental (178, 45.9%), lobar (149, 38.4%), and extended …


Apolipoprotein B100 Predicts Cardiovascular And Limb Events In Type 2 Diabetes Patients With Chronic Limb-Threatening Ischemia, Federico Biscetti, Maria Margherita Rando, Maria Anna Nicolazzi, Flavia Angelini, Roberto Iezzi, Luis H. Eraso, Paul J. Dimuzio, Dario Pitocco, Massimo Massetti, Antonio Gasbarrini, Andrea Flex Jun 2026

Apolipoprotein B100 Predicts Cardiovascular And Limb Events In Type 2 Diabetes Patients With Chronic Limb-Threatening Ischemia, Federico Biscetti, Maria Margherita Rando, Maria Anna Nicolazzi, Flavia Angelini, Roberto Iezzi, Luis H. Eraso, Paul J. Dimuzio, Dario Pitocco, Massimo Massetti, Antonio Gasbarrini, Andrea Flex

Department of Surgery Faculty Papers

BACKGROUND: Patients with type 2 diabetes mellitus (T2DM) and chronic limb-threatening ischemia (CLTI) undergoing lower extremity revascularization (LER) face high risks of major adverse cardiovascular events (MACE) and major adverse limb events (MALE), despite guideline-directed lipid-lowering therapy. Apolipoprotein B100 (ApoB100), reflecting total atherogenic particle number, may identify residual risk beyond LDL-cholesterol (LDL-C). Therefore, we investigated whether baseline ApoB100 levels independently predict MACE and MALE beyond conventional risk factors in this high-risk population.

METHODS: In this prospective cohort study, 167 T2DM patients with CLTI undergoing LER were followed for 12 months with visits at 1, 3, 6, and 12 months post-procedure. …


Financial Implications Of Vascular Surgery Conference Fees, Alexandra Kats, Gerard M. Martin, Sanath Patil, Joshua R. Chen, Paul J. Dimuzio, Dawn Salvatore, Michael Nooromid, Babak Abai Jun 2026

Financial Implications Of Vascular Surgery Conference Fees, Alexandra Kats, Gerard M. Martin, Sanath Patil, Joshua R. Chen, Paul J. Dimuzio, Dawn Salvatore, Michael Nooromid, Babak Abai

Department of Surgery Faculty Papers

BACKGROUND: Conferences are an important venue for trainees and students to engage in scholarly activities and networking. However, cost presents a significant consideration for students looking to attend conferences as institutional funding varies. In this study, we analyze the attendance costs of vascular conferences.

METHODS: Thirty-one vascular surgery conferences were identified with 12 regional and 6 national, and 13 international. Invitation-only conferences were excluded from the analysis. Cost of attendance was stratified by early and regular registration timing and attending, trainee, and student status. Additionally, conference websites were queried individually for scholarship opportunities. Data was presented descriptively and compared using …


Beyond Regulation: Why Europe Must Lead Ai Stewardship In Health, Luca Saba, Ignazio R. Marino Jun 2026

Beyond Regulation: Why Europe Must Lead Ai Stewardship In Health, Luca Saba, Ignazio R. Marino

Department of Surgery Faculty Papers

No abstract available


Lymph Node Dissection And Postoperative Complications After Lung Cancer Resection, Isheeta Madeka, Khaled Noueihed, Jacob Woodroof, Shale Mack, Hamza Rshaidat, Gregory L Whitehorn, Sneha Alaparthi, Scott H. Koeneman, Tyler R. Grenda, Nathaniel R. Evans, Iii, Olugbenga T. Okusanya Jun 2026

Lymph Node Dissection And Postoperative Complications After Lung Cancer Resection, Isheeta Madeka, Khaled Noueihed, Jacob Woodroof, Shale Mack, Hamza Rshaidat, Gregory L Whitehorn, Sneha Alaparthi, Scott H. Koeneman, Tyler R. Grenda, Nathaniel R. Evans, Iii, Olugbenga T. Okusanya

Department of Surgery Faculty Papers

Importance: Current lung cancer guidelines recommend lymph node sampling (LNS) with the 3 + 1 rule, which recommends station-based sampling with at least 3 N2 (mediastinal) and 1 N1 (hilar) nodal stations. Although there is oncologic benefit to rigorous LNS, potential negative impacts on surgical outcomes have not been well investigated. As adoption of the 3 + 1 rule increases given its formalization as guideline-concordant care, associations with adverse outcomes are crucial to characterize.

Objective: To evaluate whether satisfying the 3 + 1 rule is associated with increased postoperative complications.

Design, setting, and participants: This retrospective cohort study used the …


Organ Procurement Organization Utilization Of Portable Hypothermic Oxygenated Machine Perfusion In Liver Transplantation: The First Us Experience, Christine E. Haugen, Muhammad Bilal Moeen-Ud-Din, Abdalla M. Hadhoud, Achintya Kaw, James R. Butler, James V. Guarrera, Sherry Quire, Ralph C. Quillin Apr 2026

Organ Procurement Organization Utilization Of Portable Hypothermic Oxygenated Machine Perfusion In Liver Transplantation: The First Us Experience, Christine E. Haugen, Muhammad Bilal Moeen-Ud-Din, Abdalla M. Hadhoud, Achintya Kaw, James R. Butler, James V. Guarrera, Sherry Quire, Ralph C. Quillin

Department of Surgery Faculty Papers

BACKGROUND: Advanced machine perfusion techniques have increased the use of hard-to-place organs, effectively changing the liver transplantation landscape. Liver transplantation machine perfusion has been driven largely by industry or individual transplant centers. We describe the implementation of a portable, organ procurement organization-initiated hypothermic oxygenated machine perfusion strategy for liver transplantation as a proof of concept.

METHODS: Surgeons and staff at a regional organ procurement organization (Indiana Donor Network) were trained to use and cannulate liver allografts using a portable hypothermic oxygenated machine perfusion platform. We evaluated all liver transplantations recovered and placed on hypothermic oxygenated machine perfusion (N = 18) …


Single-Center Experience Using Endologix Anatomically Fixated Endograft Device For Treatment Of Aortoiliac Occlusive Disease, Isabella Muti, Gaurang Joshi, Dawn M. Salvatore, Michael J. Nooromid, Paul J. Dimuzio, Babak Abai Apr 2026

Single-Center Experience Using Endologix Anatomically Fixated Endograft Device For Treatment Of Aortoiliac Occlusive Disease, Isabella Muti, Gaurang Joshi, Dawn M. Salvatore, Michael J. Nooromid, Paul J. Dimuzio, Babak Abai

Department of Surgery Faculty Papers

OBJECTIVE: The covered endovascular reconstruction of the aortic bifurcation (CERAB) technique was developed in recent years as a novel surgical intervention for aortoiliac occlusive disease (AIOD). One tool frequently used in such procedures is the anatomically fixated endograft (AFX), manufactured by Endologix. The present study aimed to review the outcomes of patients with AIOD after CERAB procedure using the Endologix AFX device.

METHODS: This is an institutional review board-approved retrospective study investigating the experience of a single center in using Endologix's AFX device as CERAB for AIOD from September 2018 to June 2024. Data were obtained from the medical records …


Initial Site Of Metastasis Influences Prognosis In Pancreatic Ductal Adenocarcinoma, Eleanor Mancheski, David Baek, Wilbur Bowne, Harish Lavu, Charles Yeo, Avinoam Nevler Apr 2026

Initial Site Of Metastasis Influences Prognosis In Pancreatic Ductal Adenocarcinoma, Eleanor Mancheski, David Baek, Wilbur Bowne, Harish Lavu, Charles Yeo, Avinoam Nevler

Department of Surgery Faculty Papers

INTRODUCTION: Metastatic pancreatic ductal adenocarcinoma (mPDAC) is a highly aggressive malignancy. Prior studies suggest that the initial site of metastasis may impact prognosis. This study investigates whether overall survival in mPDAC patients differs between patients first presenting with lung metastases versus those presenting with liver metastases.

METHODS: This retrospective analysis utilized the multi-institutional TriNetX database, identifying patients with histologically diagnosed PDAC who initially presented with either liver or lung metastases. Demographic, histologic, and outcome data were collected and analyzed. Patients were matched 1:1 using a nearest neighbor propensity score (PS) algorithm, and Kaplan-Meier survival analyses were performed. Cox regression was …


Operative Confidence In Open And Endovascular Procedures Among Vascular Surgery Graduates Reflects Procedural Exposure During Training, Jin Park, Nicola Habash, Dawn Salvatore, Michael Nooromid, Paul J. Dimuzio, Babak Abai Mar 2026

Operative Confidence In Open And Endovascular Procedures Among Vascular Surgery Graduates Reflects Procedural Exposure During Training, Jin Park, Nicola Habash, Dawn Salvatore, Michael Nooromid, Paul J. Dimuzio, Babak Abai

Department of Surgery Faculty Papers

Objective: The shift toward minimally invasive techniques has transformed vascular surgery practice and training. As endovascular procedures replace many traditional open operations, concerns have emerged about whether current training adequately prepares graduates for independent practice, particularly in complex open procedures.

Methods: A web-based survey was distributed to recent graduates of Accreditation Council for Graduate Medical Education-accredited vascular surgery training programs from 2022 and 2024. The survey assessed demographics, program characteristics, estimated case volumes, and confidence in 22 core vascular operations using a five-point Likert scale. Mann-Whitney U and Kruskal-Wallis tests, as well as multivariable logistic regression, identified factors associated with …


Improving Vaccination In People With Ckd: Report From A National Kidney Foundation Working Group, Susan F. Massengill, Kenneth A. Andreoni, Keith A. Bellovich, Cheryl Courtlandt, Vimal K. Derebail, David L. Feldman, Gia J. Oh, John W. Sleasman, Kristina A. Bryant, Improving Vaccination In Ckd Working Group Mar 2026

Improving Vaccination In People With Ckd: Report From A National Kidney Foundation Working Group, Susan F. Massengill, Kenneth A. Andreoni, Keith A. Bellovich, Cheryl Courtlandt, Vimal K. Derebail, David L. Feldman, Gia J. Oh, John W. Sleasman, Kristina A. Bryant, Improving Vaccination In Ckd Working Group

Department of Surgery Faculty Papers

People with chronic kidney disease (CKD) are particularly vulnerable to vaccine-preventable infections. Therefore, the National Kidney Foundation organized a multidisciplinary working group, including people with CKD and family care partners, to develop recommendations to improve vaccination rates, vaccination effectiveness, and health care for the CKD population. A modified Delphi process was used to achieve consensus on the recommendations. Recommendations on vaccination in CKD patients were organized into these categories: (1) patient preferences; (2) assessing the vaccination status of patients with CKD; (3) assessing vaccine response in patients with CKD; (4) vaccination of immunocompromised patients; (5) vaccination in posttransplant patients; (6) …


Factors Associated With Upstaging In Patients With Resectable Non-Small Cell Lung Cancer: A Modern Institutional Sample, Sneha Alaparthi, Hamza Rshaidat, Luke Meredith, Scott H. Koeneman, Christina Grindley, Jacob Heilizer, Purab Kothari, Prarthna Chandar, Tyler Grenda, Nathaniel R. Evans Iii, Olugbenga T. Okusanya Jan 2026

Factors Associated With Upstaging In Patients With Resectable Non-Small Cell Lung Cancer: A Modern Institutional Sample, Sneha Alaparthi, Hamza Rshaidat, Luke Meredith, Scott H. Koeneman, Christina Grindley, Jacob Heilizer, Purab Kothari, Prarthna Chandar, Tyler Grenda, Nathaniel R. Evans Iii, Olugbenga T. Okusanya

Department of Surgery Faculty Papers

BACKGROUND: There is significant value in predicting and better assessing patients who are at risk of post-surgery upstaging in lung cancer. The objective of this study is to review patients who were upstaged following resection and evaluate their clinical and demographic data to elucidate which factors portend an increased risk of pathologic upstaging at our institution (the Thomas Jefferson University Hospital).

METHODS: A retrospective review of institutional data was performed between 2011 and 2023. Patients with stage I-II non-small cell lung cancer (NSCLC) were included. Patients were excluded if they received neoadjuvant systemic therapy, including chemotherapy and/or immunotherapy, and were …


Development Of Dirofilaria Immitis Adult Worms In Nsg Mice, Detection Of Parasite-Derived Microrna And Comparative Analysis Of Laboratory Isolates, Mohini Nakhale, Jessica A. Hess, Ellie Oliver, Nathan M. Ryan, Kirsten Mallon, Omair Sultan, Elinor Willis, Esha Banerjee, Enrico Radaelli, Charles-Antoine Assenmacher, Michael Povelones, Duncan Wells, Russ Morphew, Jennifer Willingham-Lane, Christine Henderson, John Harrington, Paul Mcveigh, David Abraham Jan 2026

Development Of Dirofilaria Immitis Adult Worms In Nsg Mice, Detection Of Parasite-Derived Microrna And Comparative Analysis Of Laboratory Isolates, Mohini Nakhale, Jessica A. Hess, Ellie Oliver, Nathan M. Ryan, Kirsten Mallon, Omair Sultan, Elinor Willis, Esha Banerjee, Enrico Radaelli, Charles-Antoine Assenmacher, Michael Povelones, Duncan Wells, Russ Morphew, Jennifer Willingham-Lane, Christine Henderson, John Harrington, Paul Mcveigh, David Abraham

Department of Surgery Faculty Papers

Global efforts to control heartworm disease are challenged by increasing drug resistance and inadequate early detection methods, which hinder the effective diagnosis and treatment of Dirofilaria immitis infection. This study presents an in vivo model for investigating D. immitis development and host-parasite interactions. The growth and migration of the D. immitis JYD-34 isolate were analyzed in immunodeficient NSG mice over 177 days, revealing parasite migration to the heart and lungs, which mirrors infection dynamics in the natural canine host. Pathophysiological examination of host tissues revealed early adult-stage worms elicited minimal inflammation. However, with chronicity, mild pulmonary hemosiderin accumulation was observed. …


Factors Influencing Match Success In Integrated Vascular Surgery Residency Programs From 2019 To 2023, Antony A. Fuleihan, Melissa C. Xu, Scott H. Koeneman, Paul J. Dimuzio, Babak Abai, Michael Nooromid Jan 2026

Factors Influencing Match Success In Integrated Vascular Surgery Residency Programs From 2019 To 2023, Antony A. Fuleihan, Melissa C. Xu, Scott H. Koeneman, Paul J. Dimuzio, Babak Abai, Michael Nooromid

Department of Surgery Faculty Papers

INTRODUCTION: Integrated vascular surgery residency (IVSR) programs have grown increasingly competitive. However, the factors influencing successful matching remain unclear. This study evaluates the impact of medical school and applicant characteristics on IVSR match outcomes.

METHODS: A list of ACGME-accredited IVSRs was obtained from the Society for Vascular Surgery, and resident data from the 2019-2023 match cycles were collected from publicly available sources. Applicant characteristics consisted of additional graduate degrees, Alpha Omega Alpha (AOA) status, and research productivity. Medical school characteristics consisted of ranking, research funding, vascular surgery interest group (VSIG) presence, and vascular surgery faculty size. Logistic regression models were …


Upper Hemisternotomy Vs. Full Sternotomy For Hemiarch And Proximal Aortic Replacement, Jeffrey A. Zucker, Vishal N. Shah, Joshua R. Chen, Christopher Pritting, Colin King, Jacqueline Mcgee, Megary Mccoy, Konstadinos A. Plestis Jan 2026

Upper Hemisternotomy Vs. Full Sternotomy For Hemiarch And Proximal Aortic Replacement, Jeffrey A. Zucker, Vishal N. Shah, Joshua R. Chen, Christopher Pritting, Colin King, Jacqueline Mcgee, Megary Mccoy, Konstadinos A. Plestis

Department of Surgery Faculty Papers

Introduction: Hemiarch replacement with proximal aortic replacement is seldom performed via upper hemisternotomy (UHS). We report our surgical technique and postoperative outcomes in 11 patients who underwent UHS for hemiarch and proximal aortic replacement, compared with 15 patients who underwent the procedure via full sternotomy (FS).

Methods: A UHS was performed at the right third or fourth intercostal space. Cardiopulmonary bypass (CPB) was established via the distal ascending aorta or right axillary artery and right common femoral vein. After aortic cross-clamping (ACC), the heart was arrested with single-dose antegrade crystalloid cardioplegia. After proximal aortic replacement, hypothermic circulatory arrest (HCA) between …


Post-Traumatic Rupture Of Primary Solid Pseudopapillary Epithelial Neoplasm (Spen) Of The Pancreas In A Male Adolescent: A Case Report, Paulo Castro, Heather Hartman, Yashasvi Shukla, Michael Moore, Dennis Drehner, Harish Lavu Jan 2026

Post-Traumatic Rupture Of Primary Solid Pseudopapillary Epithelial Neoplasm (Spen) Of The Pancreas In A Male Adolescent: A Case Report, Paulo Castro, Heather Hartman, Yashasvi Shukla, Michael Moore, Dennis Drehner, Harish Lavu

Department of Surgery Faculty Papers

Introduction Solid pseudopapillary epithelial neoplasm (SPEN) is a rare pancreatic tumor that typically presents in adult women and is usually asymptomatic. Case presentation A 12-year-old male presented to the emergency department with worsening abdominal pain one day after suffering mild abdominal trauma during a soccer match. Physical exam showed diffuse abdominal tenderness and guarding. CT abdomen with IV contrast showed a heterogeneous, round structure adjacent to the pancreatic tail with mass effect upon the spleen. MRI abdomen revealed a “claw sign” of pancreatic tissue surrounding the structure, suggesting a an underlying pancreatic mass with capsular rupture measuring 8.3 x 8.1 …


Perioperative Fluid Management In Pancreaticoduodenectomy In The Era Of Goal-Directed Fluid Therapy: A Review Of The Literature, Meghan D Grim, Richard Zheng, Nader Hanna, Harish Lavu, Charles J. Yeo, Avinoam Nevler Jan 2026

Perioperative Fluid Management In Pancreaticoduodenectomy In The Era Of Goal-Directed Fluid Therapy: A Review Of The Literature, Meghan D Grim, Richard Zheng, Nader Hanna, Harish Lavu, Charles J. Yeo, Avinoam Nevler

Department of Surgery Faculty Papers

BACKGROUND: Pancreaticoduodenectomy (PD) is the only curative option for localized pancreatic head and periampullary malignancies. However, PD is associated with significant perioperative morbidity. Perioperative fluid management has emerged as an important modifiable factor influencing surgical outcomes in PD.

METHODS: In this qualitative review, PubMed/Medline searches were performed between March and August 2025 to review the terms "pancreaticoduodenectomy," "fluid management," "Enhanced Recovery After Surgery," "complications," and related terms.

RESULTS: Historically, liberal fluid administration was favored to compensate for third-space losses, but contemporary evidence has linked excessive fluid volumes to complications, such as postoperative pancreatic fistula, anastomotic edema, and increased inflammatory responses. …


Medicaid Expansion And Breast Cancer Care And Outcomes-What Lies Ahead?, Meghan H. Maceyko, Oluwadamilola M. Fayanju Jan 2026

Medicaid Expansion And Breast Cancer Care And Outcomes-What Lies Ahead?, Meghan H. Maceyko, Oluwadamilola M. Fayanju

Department of Surgery Faculty Papers

No abstract provided.


Large Language Models Improve Readability Of Patient Education Materials On Vascular Conditions, Melissa Chen Xu, Nicola Habash, Justin Do, Jiaying Bi, Dawn Salvatore, Paul J Dimuzio, Michael Nooromid, Babak Abai Jan 2026

Large Language Models Improve Readability Of Patient Education Materials On Vascular Conditions, Melissa Chen Xu, Nicola Habash, Justin Do, Jiaying Bi, Dawn Salvatore, Paul J Dimuzio, Michael Nooromid, Babak Abai

Department of Surgery Faculty Papers

Objective: Patient education materials frequently exceed the recommended sixth-grade reading level. Although large language models (LLMs) have shown inconsistent accuracy in medical query responses, they have demonstrated promise in simplifying complex text. This capability has not yet been studied in vascular patient education materials. This study evaluates whether ChatGPT-4o and Gemini 1.5 Pro can improve the readability of Society for Vascular Surgery (SVS) patient education flyers. Methods: SVS health flyers were selected based on five common vascular conditions: abdominal aortic aneurysm, carotid artery disease, deep vein thrombosis, peripheral artery disease, and varicose veins. Each flyer was submitted to ChatGPT-4o and …


A Contemporary Guide To An International Aortic Super-Fellowship For Surgical Trainees And Surgeons In The United States, Roberto G. Aru, Adam W. Beck, Stéphan Haulon Dec 2025

A Contemporary Guide To An International Aortic Super-Fellowship For Surgical Trainees And Surgeons In The United States, Roberto G. Aru, Adam W. Beck, Stéphan Haulon

Department of Surgery Faculty Papers

Fenestrated and branched technology for endovascular aortic repair of the thoracoabdominal aorta and aortic arch has evolved significantly over the last decade. The spectrum of these devices is largely available outside the United States (US), while patient-specific company manufactured devices are limited to ten sites in the US, with ongoing expanding use of market-approved off-the-shelf devices. The necessary environment for appropriate education to ensure safe dissemination of these technologies is limited, and the current centralization of both device availability and skillsets affects trainee education. In order to refine their endovascular treatment algorithm and planning/implantation skillsets at these multidisciplinary aortic centers, …


Oculocardiac Reflex Causing Bradycardia In A Trauma Patient Following Firearm Injury, Jennifer E. Geller, Saba Daneshpooy, Sophia Block, Meera Kohli, Megan Lundy Nov 2025

Oculocardiac Reflex Causing Bradycardia In A Trauma Patient Following Firearm Injury, Jennifer E. Geller, Saba Daneshpooy, Sophia Block, Meera Kohli, Megan Lundy

Department of Surgery Faculty Papers

The oculocardiac reflex is a vagal response to pressure on the globe or periorbital structures resulting in a reduction in heart rate greater than 20 %. Here, we describe the case of a patient who sustained extensive craniofacial and orbital trauma from a firearm injury whose otherwise unexplained bradycardia resolved following surgical decompression.


Management Of Stenotrophomonas Mediastinitis After Heart Transplantation For Persistent Driveline Infection: A Case Report, James Lee West, Charles W. Hoopes, Jeremey Walker, Anoma Nellore, Erik J. Orozco-Hernandez Nov 2025

Management Of Stenotrophomonas Mediastinitis After Heart Transplantation For Persistent Driveline Infection: A Case Report, James Lee West, Charles W. Hoopes, Jeremey Walker, Anoma Nellore, Erik J. Orozco-Hernandez

Department of Surgery Faculty Papers

We report a 62-year-old male who had a Heartware left ventricular assist device (LVAD) implantation and subsequently developed a persistent driveline infection, culminating in an abscess along the driveline site despite 18 months of antibiotic treatment. His situation was further complicated post-transplant by the onset of mediastinitis, linked to a previously undervalued Stenotrophomonas maltophilia infection. This report highlights the potential risks of heart transplantation in patients with unresolved LVAD driveline infections, particularly mediastinitis. The presence of existing driveline infections, combined with the immunosuppressed status of patients, necessitates aggressive surgical measures. Our treatment approach, involving multiple mediastinal washouts, omental flap use, …


Aberrant Expression Of A Disintegrin And Metalloproteinase With Thrombospondin Motifs 13 (Adamts13) In Pancreatic Cancer Leads To Dichotomic Functions, Stephanie Allmang, Hagen R. Witzel, Anne Hausen, Simone Marquard, Christoph Eckert, Nicole Marnet, Nina Hörner, Philipp Mayer, Stefan Heinrich, Hien Dang, Wilfried Roth, Matthias M. Gaida Nov 2025

Aberrant Expression Of A Disintegrin And Metalloproteinase With Thrombospondin Motifs 13 (Adamts13) In Pancreatic Cancer Leads To Dichotomic Functions, Stephanie Allmang, Hagen R. Witzel, Anne Hausen, Simone Marquard, Christoph Eckert, Nicole Marnet, Nina Hörner, Philipp Mayer, Stefan Heinrich, Hien Dang, Wilfried Roth, Matthias M. Gaida

Department of Surgery Faculty Papers

Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive cancers characterized by highly invasive growth into the surrounding peripancreatic fat tissue, where tumor cells can directly interact with adipocytes. Due to poor response to the currently available (radio)chemotherapies, there is an urgent need for advanced therapy concepts. The present study shows that ADAMTS13 (a disintegrin and metalloproteinase with thrombospondin motifs 13), a key factor in blood coagulation, is significantly overexpressed in human PDAC. Immunohistochemical analysis revealed that ADAMTS13 expression is associated with prolonged survival and negatively correlated with vascular density. In vitro and in vivo experiments demonstrate its partial …


Assessment Of Long-Term Endocrine Sequelae Of Completion (2-Stage) Versus Total (Single-Stage) Pancreatectomy: A Multi-Institutional Research Network And Single-Institution Analysis, Michael Chang, Matthew Kraft, Zachary Kaplan, Harish Lavu, Charles Yeo, Wilbur Bowne, Avinoam Nevler Oct 2025

Assessment Of Long-Term Endocrine Sequelae Of Completion (2-Stage) Versus Total (Single-Stage) Pancreatectomy: A Multi-Institutional Research Network And Single-Institution Analysis, Michael Chang, Matthew Kraft, Zachary Kaplan, Harish Lavu, Charles Yeo, Wilbur Bowne, Avinoam Nevler

Department of Surgery Faculty Papers

BACKGROUND: Total pancreatectomy can be associated with severe endocrine complications. This study compares endocrine outcomes of patients who underwent a single-stage total pancreatectomy versus a 2-stage completion pancreatectomy.

METHODS: We used data from a multi-institutional research network (TriNetX), which identified 1,079 propensity score-matched total pancreatectomy and completion pancreatectomy patient pairs for age, gender, and race. These data were validated by a single-center review of a prospectively maintained database of 1,600 pancreatectomies, from which 88 completion and total pancreatectomy patients treated between 2013 and 2023 were identified. The primary endpoints were postoperative rates of hypoglycemia and diabetic ketoacidosis during the first …


Analysis Of Physician-Modified Endograft Utilization Using Online Databases And Social Media, Robert Tatum, Michael Nooromid, Paul Dimuzio, Babak Abai Oct 2025

Analysis Of Physician-Modified Endograft Utilization Using Online Databases And Social Media, Robert Tatum, Michael Nooromid, Paul Dimuzio, Babak Abai

Department of Surgery Faculty Papers

Background: To characterize the present landscape of physician-modified endograft (PMEG) use and the impact of an institution's investigational device exemption (IDE) status on endograft use by analyzing publication trends and social media coverage.

Methods: We used the social media platform X and three online bibliographic databases to perform a keyword search using the following terms: PMEG, physician-modified endograft, and laser fenestration. Data extracted from X and online articles included authorship, IDE protocol status, pertinent clinical outcome measures, and others. An internet search was performed to determine which institutions offered revascularization with a custom-made device within an IDE protocol and which …


Robotic Ureteral Reconstruction For Endometriosis-Induced Strictures: Insights From A Multi-Institutional Experience, Matthew Lee, Sonam Saxena, Kelley Zhao, Cameron Dodd, Randall Lee, Michael Stifelman, Lee Zhao, Daniel D. Eun Oct 2025

Robotic Ureteral Reconstruction For Endometriosis-Induced Strictures: Insights From A Multi-Institutional Experience, Matthew Lee, Sonam Saxena, Kelley Zhao, Cameron Dodd, Randall Lee, Michael Stifelman, Lee Zhao, Daniel D. Eun

Department of Surgery Faculty Papers

PURPOSE: To investigate outcomes of robotic ureteral reconstruction (RUR) in female patients with ureteral strictures caused by peri-ureteral endometriosis lesions.

METHODS: We retrospectively reviewed our multi-institutional Collaborative of Reconstructive Robotic Ureteral Surgery (CORRUS) database to identify all consecutive patients undergoing RUR for surgical management of endometriosis-induced ureteral strictures between 2017 and 2022. Indications for surgery included female patients with radiographic evidence of ureteral strictures and/or decreasing renal function on renal scan. We performed a descriptives analysis of perioperative outcomes in patients who met inclusion criteria. Surgical success was defined as freedom from additional interventions for recurrent ureteral stenosis.

RESULTS: Overall, …


Outcomes Of The Modified Cabrol Technique In Aortic Root Replacement: Early And Midterm Experience, Nayeem Nasher, Joshua R. Chen, Purab Kothari, Colin King, Jacqueline Mcgee, Vishal Shah, Saarah Khairi, Konstadinos A. Plestis Sep 2025

Outcomes Of The Modified Cabrol Technique In Aortic Root Replacement: Early And Midterm Experience, Nayeem Nasher, Joshua R. Chen, Purab Kothari, Colin King, Jacqueline Mcgee, Vishal Shah, Saarah Khairi, Konstadinos A. Plestis

Department of Surgery Faculty Papers

OBJECTIVES: The modified Cabrol technique has been associated with excellent graft patency. However, prior studies were limited to patients largely on long-term anticoagulation. We sought to analyze outcomes in patients primarily managed without mechanical prostheses.

METHODS: We retrospectively analyzed all patients who underwent aortic root replacement by a single surgeon from 2014 to 2024. Patients who underwent reimplantation of one or both coronary ostia using the modified Cabrol technique with separate interposition grafts were identified. Baseline characteristics and postoperative outcomes were reported. Predictors of mortality were analyzed using Cox proportional hazards, and overall survival was reported using Kaplan-Meier analysis.

RESULTS: …


Early Blood Pressure Targets In Acute Spinal Cord Injury: A Randomized Clinical Trial, Ruba Sajdeya, N. David Yanez, Michael Kampp, Michael D. Goodman, David Zonies, Brandon Togioka, Andrew Nunn, Robert D. Winfield, Niels D. Martin, Anirudh Kohli, Toan T. Huynh, David O. Okonkwo, Roy A. Poblete, Emily J. Gilmore, Randall M. Chesnut, Aaron E. Bunnell, Tetsu Ohnuma, Mona Hashemaghaie, Miriam M. Treggiari Sep 2025

Early Blood Pressure Targets In Acute Spinal Cord Injury: A Randomized Clinical Trial, Ruba Sajdeya, N. David Yanez, Michael Kampp, Michael D. Goodman, David Zonies, Brandon Togioka, Andrew Nunn, Robert D. Winfield, Niels D. Martin, Anirudh Kohli, Toan T. Huynh, David O. Okonkwo, Roy A. Poblete, Emily J. Gilmore, Randall M. Chesnut, Aaron E. Bunnell, Tetsu Ohnuma, Mona Hashemaghaie, Miriam M. Treggiari

Department of Surgery Faculty Papers

IMPORTANCE: Early blood pressure management is central to neurologic resuscitation of spinal cord injury; however, the role of augmented blood pressure is unclear.

OBJECTIVE: To compare the efficacy and safety of augmented vs conventional blood pressure on 6-month neurologic outcomes after acute spinal cord injury.

DESIGN, SETTING, AND PARTICIPANTS: This multicenter randomized clinical trial took place from October 3, 2017, to July 26, 2023, and assessed patients 18 years or older with spinal cord injury followed up for 6 months at 13 large US trauma centers.

INTERVENTIONS: Patients were equally randomized to augmented (>85-90 mm Hg) or conventional ( …


Bard1: A Friend Or Foe In Pancreatic Ductal Adenocarcinoma?, Lily Zekavat, Aditi Jain Sep 2025

Bard1: A Friend Or Foe In Pancreatic Ductal Adenocarcinoma?, Lily Zekavat, Aditi Jain

Department of Surgery Faculty Papers

Pancreatic ductal adenocarcinoma (PDAC) is an aggressive solid malignancy with poor overall prognosis and limited response to standard treatments. Growing interest in the modulation of DNA repair mechanisms, including the homologous recombination (HR) repair pathway, has opened new avenues for therapeutic development. BARD1 (BRCA1-Associated RING Domain 1) plays a complex role in tumor biology, functioning either as a tumor suppressor or as an oncogenic driver, depending on isoform expression, cellular context, and regulatory environment. In this review, we examine the dual roles of BARD1, focusing on its regulation and paradoxical activities in PDAC. We summarize evidence that BARD1 and BARD1 …


Temporary Intravascular Shunting Using A Carotid Shunt For Traumatic Femoral Artery And Vein Injury In A Hemodynamically Unstable Patient, Nicola Habash, Fari Fall, Jin Park, Babak Abai, Michael Nooromid Aug 2025

Temporary Intravascular Shunting Using A Carotid Shunt For Traumatic Femoral Artery And Vein Injury In A Hemodynamically Unstable Patient, Nicola Habash, Fari Fall, Jin Park, Babak Abai, Michael Nooromid

Department of Surgery Faculty Papers

Vascular trauma involving the peripheral arteries of the extremities can lead to limb loss and, in severe cases, death. The use of intravascular shunts can help to temporarily perfuse the limb, while allowing for resuscitation of a critically injured patient. Here we present a case of a concomitant complex injury of the common femoral artery and common femoral vein, and the complementary vascular strategies used to achieve limb salvage.