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School of Medicine Faculty Publications

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Full-Text Articles in Surgery

The Vascular Density/Angiogenesis Marker Cd31/Pecam1 Does Not Correlate With Overall Survival In Neuroendocrine Tumors, Nicholas J. Skill, Kenneth Avanzino, Yvette Bren-Mattison, J. Philip Boudreaux, Ramcharan Thiagarajan, Mary Maluccio Jan 2026

The Vascular Density/Angiogenesis Marker Cd31/Pecam1 Does Not Correlate With Overall Survival In Neuroendocrine Tumors, Nicholas J. Skill, Kenneth Avanzino, Yvette Bren-Mattison, J. Philip Boudreaux, Ramcharan Thiagarajan, Mary Maluccio

School of Medicine Faculty Publications

Abstract: Neuroendocrine neoplasms (NENs) are rare cancers. CD31/PECAM1 is an adhesion molecule that modulates endothelial cell-to-cell contact. Increased CD31 expression is a marker for tumor growth, and cancer aggressiveness. The purpose of this study was to better understand the prognostic value of CD31 expression in primary and metastatic NEN tumors in terms of correlations with overall survival and pathological metrics, tumor grade, and tumor primary/metastatic location. As NENs are highly vascular tumors, the hypothesis is that CD31 staining is an important prognostic biomarker and target. This is based on prior correlations between CD31 staining and 3-year recurrence-free survival in pancreas …

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Osteoprogenitor Cells From Non-Regenerative Bone Show Greater Resistance To Cellular Stress Than Those From Regenerative Bone, Joshua Broussard, Sylvia Culpepper, Tyrel Long, Alexander J. Trostle, Robert J. Tower, Mimi C. Sammarco, Jennifer Simkin Dec 2025

Osteoprogenitor Cells From Non-Regenerative Bone Show Greater Resistance To Cellular Stress Than Those From Regenerative Bone, Joshua Broussard, Sylvia Culpepper, Tyrel Long, Alexander J. Trostle, Robert J. Tower, Mimi C. Sammarco, Jennifer Simkin

School of Medicine Faculty Publications

INTRODUCTION: Bone regeneration following injury depends on osteoprogenitor cells derived predominantly from the periosteum. Incomplete regeneration has been attributed to both cell-extrinsic factors (e.g., environment, inflammation, mechanical instability) and cell-intrinsic factors (e.g., impaired proliferation or differentiation of stem cells). In the digit amputation mouse model, amputation through the third phalanx (P3) supports complete regeneration, while amputation through the second phalanx (P2) results in callus formation and scarring. Periosteal cells are known to be the major contributing cell source for repair and regeneration. Yet the healing outcomes of P2 and P3 amputations are significantly different. This study tests whether P2 and …

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Transient Neuromonitoring Changes And Delayed Vertebrobasilar Infarction Following Anterior Cervical Discectomy And Fusion: Illustrative Case, Jacob M. Chaisson, Jack A. Leoni, Ellery A. Hayden, Gabriel C. Tender, Amit K. Bhandutia Dec 2025

Transient Neuromonitoring Changes And Delayed Vertebrobasilar Infarction Following Anterior Cervical Discectomy And Fusion: Illustrative Case, Jacob M. Chaisson, Jack A. Leoni, Ellery A. Hayden, Gabriel C. Tender, Amit K. Bhandutia

School of Medicine Faculty Publications

BACKGROUND: Anterior cervical discectomy and fusion (ACDF) is a common spinal procedure with a well-established safety profile. While direct vertebral artery injury is rare and typically recognized intraoperatively, delayed posterior circulation stroke is an even less common but major complication. In patients with risk factors for vascular disease, vascular stress from surgical manipulation may predispose them to thromboembolic events that are not immediately apparent. Transient intraoperative neuromonitoring (IONM) changes may represent early, underrecognized indicators of such vascular compromise. OBSERVATIONS: The authors present the case of a 61-year-old male who underwent elective three-level ACDF for degenerative cervical myelopathy. During cage placement, …

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The Anatomy Of Change: A Scoping Review Of Surgical Curriculum Renewal Processes, Marc A. Seifman, Robyn Woodward-Kron, Roi Y. Kagan, Kirsten Dalrymple, Aimee K. Gardner, Ian Incoll, Lars Konge, John T. Paige, Debra Nestel Dec 2025

The Anatomy Of Change: A Scoping Review Of Surgical Curriculum Renewal Processes, Marc A. Seifman, Robyn Woodward-Kron, Roi Y. Kagan, Kirsten Dalrymple, Aimee K. Gardner, Ian Incoll, Lars Konge, John T. Paige, Debra Nestel

School of Medicine Faculty Publications

PURPOSE: Renewal of surgical curricula is critical in maintaining relevance to contemporary healthcare needs. A curriculum document usually describes its purpose, intended outcomes, content, methods, and assessment and evaluation processes. The document may also consider cultural, professional, political, and social contexts. While there are published curriculum development approaches, guidance on renewal processes is limited. This scoping review aims to synthesise literature on surgical curriculum renewal, to understand the key elements of this process, and identify areas for improvement. METHODS: A scoping review was conducted by the core author team, with co-creation involving a Knowledge User Group (KUG). Seven databases were …

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Acute Dislocations Of The Sternoclavicular Joint: Treatment And Outcomes, Elsa B. Rodriguez-Baron, Fidel Moreno-Diaz, Daniel E. Pereira, Kathy Mcgurk, Langdon Hartsock, Lucy Bowers, Paul Matuszewski, Kevin Murr, John Sharpe, Michael Tucker, Nathan Redlich, Peter Krause, Clay Spitler, Bradley Foulke, Grant Quilling, Abbey Debruin, Richard Behlmer, Paul Whiting, Stephanie Tanner, Kyle Jeray, Joseph Brock Walker, Sarah Obudzinski, Julie Titter, Andrew Chen, Aseel Dib, Christine Churchill, Benjamin Averkamp, Joseph Hsu, Kimberly Tann, Et Al Dec 2025

Acute Dislocations Of The Sternoclavicular Joint: Treatment And Outcomes, Elsa B. Rodriguez-Baron, Fidel Moreno-Diaz, Daniel E. Pereira, Kathy Mcgurk, Langdon Hartsock, Lucy Bowers, Paul Matuszewski, Kevin Murr, John Sharpe, Michael Tucker, Nathan Redlich, Peter Krause, Clay Spitler, Bradley Foulke, Grant Quilling, Abbey Debruin, Richard Behlmer, Paul Whiting, Stephanie Tanner, Kyle Jeray, Joseph Brock Walker, Sarah Obudzinski, Julie Titter, Andrew Chen, Aseel Dib, Christine Churchill, Benjamin Averkamp, Joseph Hsu, Kimberly Tann, Et Al

School of Medicine Faculty Publications

OBJECTIVES: Identify treatment and describe outcomes and complications of acute anterior and posterior sternoclavicular joint dislocation. DESIGN: Retrospective case series. SETTING: Twelve level-one trauma centers. PATIENT/PARTICIPANTS: One hundred twenty-five patients with acute sternoclavicular joint dislocation, most were male (67%), White (61%), 18-29 years old (57%), involved in a motorized collision (60%), with anterior (35%) or posterior (65%) sternoclavicular joint dislocation treated by operative or nonoperative technique. MAIN OUTCOME MEASUREMENTS: Outcomes and complications of joint instability, post-traumatic arthritis, neurovascular injury, chronic pain, and cosmetic deformities after operative and nonoperative treatment of anterior and posterior acute sternoclavicular joint dislocation are reported. RESULTS: …

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Acute Gastropericardial Fistula With Cardiac Tamponade And Septic Pericarditis Due To Helicobacter Pylori–Induced Gastric Ulcer Perforation, Stephen J. Bordes, Christopher D. Oubre, Preethi H. Kanumuri, Nicholas Leblanc, Richard Lewis, Thomas Marsden, Terry Stelly Nov 2025

Acute Gastropericardial Fistula With Cardiac Tamponade And Septic Pericarditis Due To Helicobacter Pylori–Induced Gastric Ulcer Perforation, Stephen J. Bordes, Christopher D. Oubre, Preethi H. Kanumuri, Nicholas Leblanc, Richard Lewis, Thomas Marsden, Terry Stelly

School of Medicine Faculty Publications

No abstract provided.

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Roux-En-Y Gastric Bypass Is Associated With Increased Intestinal Glucose Uptake In Humans, Florina Corpodean, Maryam Naseri, Michael Kachmar, Julia St Amant, Denis P. Blondin, Owen T. Carmichael, Vance L. Albaugh Nov 2025

Roux-En-Y Gastric Bypass Is Associated With Increased Intestinal Glucose Uptake In Humans, Florina Corpodean, Maryam Naseri, Michael Kachmar, Julia St Amant, Denis P. Blondin, Owen T. Carmichael, Vance L. Albaugh

School of Medicine Faculty Publications

CONTEXT: In animal models, Roux-en-Y gastric bypass (RYGB) is associated with increased Roux limb intestinal glucose uptake that may contribute to early metabolic benefits, though prospective clinical studies are lacking. OBJECTIVE: The present study aimed to test the hypothesis that Roux limb glucose uptake would increase relative to baseline in a cohort of patients undergoing RYGB. METHODS: RYGB patients underwent preoperative baseline, and 3- and 6-month positron emission tomography/computed tomography postoperative imaging. Maximum and mean standardized uptake values (SUV) were measured from the following predefined regions of interest: cecum, hepatic flexure, splenic flexure, sigmoid colon, duodenal bulb, Roux limb, and …

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Impact Of Surgical Refusal On Overall Survival In Patients With Rectal Cancer, Vishal Abhimutt Mahesh, Anjali Yadav, Harsheen Kaur Manaise, Berkay Demirors, Paola Berrios Jiminez, Angel Aguayo-Merly, Jade C. Bowers, Bansi P. Savaliya, Reed Popp, Ramin Shekouhi, Guido Chiriboga, Syeda Hoorulain Ahmed, Fatima Mubarak, Esinam Ekpeh, Emmanuel Gabriel Oct 2025

Impact Of Surgical Refusal On Overall Survival In Patients With Rectal Cancer, Vishal Abhimutt Mahesh, Anjali Yadav, Harsheen Kaur Manaise, Berkay Demirors, Paola Berrios Jiminez, Angel Aguayo-Merly, Jade C. Bowers, Bansi P. Savaliya, Reed Popp, Ramin Shekouhi, Guido Chiriboga, Syeda Hoorulain Ahmed, Fatima Mubarak, Esinam Ekpeh, Emmanuel Gabriel

School of Medicine Faculty Publications

BACKGROUND/AIM: While surgery is a major component of treatment for managing rectal cancer, some individuals opt against it, potentially affecting their chances of survival. This study investigated the clinical and demographic elements linked to the decision to refuse surgery and assessed the potential impact of this decision on overall survival (OS). PATIENTS AND METHODS: We conducted a retrospective cohort study using the U.S. National Cancer Database to analyze factors linked to surgery refusal in patients with rectal cancer. Clinical, demographic and treatment characteristics were compared using Pearson chi-square and Wilcoxon rank-sum tests. RESULTS: Among the 115,066 patients with rectal cancer …

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Survival Impact And Sociodemographic Correlates Of Colon Cancer Surgery, Refusal, Paola Berrios Jimenez, Angel Aguayo Merly, Ramin Shekouhi, Berkay Demirors, Jade C. Bowers, Vishal Abhimutt Mahesh, Anjali Yadav, Bansi P. Savaliya, Reed Popp, Syeda Hoorulain Ahmed, Esinam Ekpeh, Guido Chiriboga, Emmanuel Gabriel Sep 2025

Survival Impact And Sociodemographic Correlates Of Colon Cancer Surgery, Refusal, Paola Berrios Jimenez, Angel Aguayo Merly, Ramin Shekouhi, Berkay Demirors, Jade C. Bowers, Vishal Abhimutt Mahesh, Anjali Yadav, Bansi P. Savaliya, Reed Popp, Syeda Hoorulain Ahmed, Esinam Ekpeh, Guido Chiriboga, Emmanuel Gabriel

School of Medicine Faculty Publications

Background/Aim: Surgical treatment for colon cancer is often curative when diagnosed early. This study evaluated the sociodemographic characteristics and survival outcomes associated with refusal of surgery among patients with colon cancer. The objective was to identify disparities to improve patient outcomes. Patients and Methods: We conducted a retrospective cohort study using National Cancer Data Base (NCDB) data from 2004 to 2019, including 1,048,575 patients with colon cancer. Variables analyzed included demographics, tumor characteristics, treatment facility type, and geographic and socioeconomic factors. Descriptive statistics were assessed using Wilcoxon Rank Sum and Chi-square tests. Survival outcomes were evaluated using Kaplan–Meier analysis and …

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Redefining The Albumin-Bilirubin Score: Predictive Modeling And Multidimensional Integration In Liver And Systemic Disease, Berkay Demirors, Ramin Shekouhi, Paola Berrios Jimenez, Anjali Yadav, Guido Chiriboga, Vishal A. Mahesh, Harsheen K. Manaise, Jade Bowers, Angel Aguayo Merly, Emmanuel Gabriel Sep 2025

Redefining The Albumin-Bilirubin Score: Predictive Modeling And Multidimensional Integration In Liver And Systemic Disease, Berkay Demirors, Ramin Shekouhi, Paola Berrios Jimenez, Anjali Yadav, Guido Chiriboga, Vishal A. Mahesh, Harsheen K. Manaise, Jade Bowers, Angel Aguayo Merly, Emmanuel Gabriel

School of Medicine Faculty Publications

This editorial comment is on the article by Xu et al. It offers an in-depth analysis of liver function assessment tools and their prognostic roles in non-malignant liver diseases, with a focus on the albumin-bilirubin (ALBI) score. ALBI’s components, grading system, and clinical relevance across various liver conditions are reviewed and compared with traditional models such as the Child-Pugh and model for end-stage liver disease scores. We included recent studies evaluating ALBI’s role in estimating liver function, suggesting it may help differentiate patients who appear similar under other staging systems, and assist in guiding clinical decisions. Although ALBI is primarily …

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Standardizing Assessment Of Open Vascular Skills: National Roll-Out And Early Impact Of The Fundamentals Of Vascular Surgery Curriculum, Yana Etkin, Kristyn Mannoia, Pail Dimusto, Libby Weaver, Khalil Qato, Gabriela Velazquez, Malachi Sheahan Sep 2025

Standardizing Assessment Of Open Vascular Skills: National Roll-Out And Early Impact Of The Fundamentals Of Vascular Surgery Curriculum, Yana Etkin, Kristyn Mannoia, Pail Dimusto, Libby Weaver, Khalil Qato, Gabriela Velazquez, Malachi Sheahan

School of Medicine Faculty Publications

Background: Exposure to open vascular case is declining in surgical training, creating a need for standardized, objective assessment of fundamental open skills. The Association of Program Directors in Vascular Surgery developed the Fundamentals of Vascular Surgery (FVS) curriculum to teach and assess three core skills—end-to-side anastomosis, patch angioplasty, and clockface precision suturing. This study describes FVS development and validation, nationwide rollout, and early implementation experience across U.S. training programs. Methods: A multiphase project was conducted: (1) validation (2012–2019) of the 3 FVS tasks with 313 trainees scored by trained raters using OSATS checklists and global rating scales; reliability and construct …

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Utilization Of The Fundamentals Of Vascular Surgery Symposium In Surgical Curricula, Priscilla Tanamal, Amit Chawla, Amanda Tullos, Claudie Sheahan, Malachi Sheahan Sep 2025

Utilization Of The Fundamentals Of Vascular Surgery Symposium In Surgical Curricula, Priscilla Tanamal, Amit Chawla, Amanda Tullos, Claudie Sheahan, Malachi Sheahan

School of Medicine Faculty Publications

Objective: Simulation is a helpful adjunct to vascular surgery training, in which high-volume surgical experience portends better patient outcomes. Louisiana State University Health New Orleans hosts a 3-day program, the Fundamentals of Vascular Surgery (FVS) Symposium, during which vascular trainees from across the nation can participate in didactic and hands-on lessons with an emphasis on procedures less frequently performed during residency, taught by attending surgeons from various institutions. The objective of this study was to examine the effect of the FVS Symposium on participant confidence in endovascular and open procedures and evaluate any differences between junior and senior level residents. …

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Antibiotic Stewardship In Pediatric Head And Neck Surgery, Mary Grace Robichaux, Zhide Fang, Jill N. D'Souza Sep 2025

Antibiotic Stewardship In Pediatric Head And Neck Surgery, Mary Grace Robichaux, Zhide Fang, Jill N. D'Souza

School of Medicine Faculty Publications

OBJECTIVE: This study seeks to determine the rate of postoperative surgical site infections (SSI) among clean head and neck surgeries and review perioperative antibiotic administration practices. STUDY DESIGN: Retrospective review. SETTING: Pediatric tertiary care institution in New Orleans over a ten-year period. METHODS: A retrospective review was undertaken to identify clean head and neck surgical procedures performed at Manning Family Children's between 2013 and 2023. EPIC SlicerDicer™ was used to identify patients between ages 0-18 who underwent clean head and neck surgeries. Each chart was reviewed for perioperative antibiotic administration and occurrence of postoperative SSI. Rates of SSI were compared …

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Efficacy Of Submuscular Transposition For Revision Cubital Tunnel Release: Comparative Outcomes Analysis, Joshua Riklan, Alexzandra Mattia, Markos Mardourian, Harvey Chim Aug 2025

Efficacy Of Submuscular Transposition For Revision Cubital Tunnel Release: Comparative Outcomes Analysis, Joshua Riklan, Alexzandra Mattia, Markos Mardourian, Harvey Chim

School of Medicine Faculty Publications

Purpose: To assess outcomes after revision cubital tunnel release and submuscular transposition and compare these to a cohort of patients undergoing primary release with in situ decompression. Methods: Patients who underwent revision cubital tunnel release and submuscular transposition (n = 16) were enrolled. Mean follow-up was 21.4 months (range 12.8–55.6). Patients were evaluated in person using the Michigan Hand Outcomes Questionnaire (MHQ) and Disabilities of the Arm, Shoulder and Hand (DASH). Dellon stage, McGowan grade, visual analog scale for pain, and improvement of symptoms using the Messina's criteria and Modified Bishop score were assessed. Comparative analysis was performed with a …

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Incidental Finding Of An Infarcted Epiploic Appendage Attached To The Sigmoid Colon, Ifeanyi K. Uche, Alec A. Hirsch Jun 2025

Incidental Finding Of An Infarcted Epiploic Appendage Attached To The Sigmoid Colon, Ifeanyi K. Uche, Alec A. Hirsch

School of Medicine Faculty Publications

Background: Epiploic appendagitis is a condition usually caused by infarction of the epiploic appendages, small outpouchings of adipose tissue found on the serosal surface of the colon. Epiploic appendagitis is a rare cause of acute lower abdominal pain, but the condition does not have any specific presenting clinical features and is often misdiagnosed as acute diverticulitis, appendicitis, or other gastrointestinal disorder. Case Report: A 53-year-old female presented with abnormal uterine bleeding and pelvic pain and was seeking definitive surgical management. During the patient’s total laparoscopic hysterectomy with bilateral salpingo-oophorectomy, an infarcted epiploic appendage attached to the sigmoid colon was found. …

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Renal Denervation Improves Cardiac Function And Exercise Duration In A Miniswine Model Of Heart Failure With Preserved Ejection Fraction, David J. Lefer, Thomas E. Sharp, Amy L. Scarborough, Amelia G. Haydel, Sanjiv J. Shah, Zhen Li, Traci T. Goodchild May 2025

Renal Denervation Improves Cardiac Function And Exercise Duration In A Miniswine Model Of Heart Failure With Preserved Ejection Fraction, David J. Lefer, Thomas E. Sharp, Amy L. Scarborough, Amelia G. Haydel, Sanjiv J. Shah, Zhen Li, Traci T. Goodchild

School of Medicine Faculty Publications

Aims: Overactivity of the sympathetic nervous system is a common underlying mechanism in development and progression of several heart failure with preserved ejection fraction (HFpEF) comorbidities. Decreasing renal sympathetic nerve activity using catheter-based renal denervation (RDN) systems have shown efficacy in treating resistant hypertension and cardiac dysfunction in heart failure with reduced ejection fraction. The purpose of this study was to determine if modulation of renal sympathetic nerve activity by RDN improves cardiac function and exercise tolerance in a clinically-relevant minipig model of cardiometabolic HFpEF. Methods and results: Multiple HFpEF comorbidities were induced in adult female Göttingen minipigs by mineralocorticoid …

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Supercharged And Delayed Thoracodorsal And Dorsal Intercostal Artery Perforator Flaps For Autologous Breast Reconstruction, Adeem M. Nachabe, Mohammed S. Rais, Mark A. Maier, Hugo St Hilaire, Robert J. Allen Apr 2025

Supercharged And Delayed Thoracodorsal And Dorsal Intercostal Artery Perforator Flaps For Autologous Breast Reconstruction, Adeem M. Nachabe, Mohammed S. Rais, Mark A. Maier, Hugo St Hilaire, Robert J. Allen

School of Medicine Faculty Publications

In patients seeking total autologous breast reconstruction following mastectomy, prior abdominal surgery can present as a contraindication to utilizing traditional abdominal-based free flaps. The thoracodorsal artery perforator (TDAP) flap has emerged as a suitable alternative, providing adequate tissue and minimal donor site morbidity. This case report demonstrates further improvement to this technique by utilizing the dorsal intercostal artery perforator vessels to supercharge this pedicled flap, along with a surgical delay of the TDAP and dorsal intercostal artery perforator. This adaptation can provide added bulk and improved perfusion to the traditional TDAP-based total autologous breast reconstruction.

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Fundamentals Of Vascular Surgery: A Plan For The Uniform Instruction And Assessment Of Basic Skills In Vascular Surgery, Priscilla Tanamal, Claudie Sheahan, Malachi Sheahan Apr 2025

Fundamentals Of Vascular Surgery: A Plan For The Uniform Instruction And Assessment Of Basic Skills In Vascular Surgery, Priscilla Tanamal, Claudie Sheahan, Malachi Sheahan

School of Medicine Faculty Publications

Training surgeons poses many unique challenges. In addition to the clinical acumen that must be learned, a minimum threshold of technical competency is a requisite for independent practice. The trends of endovascular interventions and open surgical procedures add another layer of complexity to vascular surgery training. Simulation can provide a solution for both technical skills training and evaluating proficiency. The Education Committee of the Association of Program Directors of Vascular Surgery (APDVS) developed the Fundamentals of Vascular and Endovascular Surgery platform to provide an opportunity for more uniform basic technical skill teaching and assessment across all vascular training programs. Evaluation …

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A Preliminary Analysis Of Transaminitis Observed In Oxandrolone Versus Testosterone Therapy In Major Burn Injury, Alexandra Dewitt, Athena Hoppe, Anastasiya Ivanko, Victoria Miles Apr 2025

A Preliminary Analysis Of Transaminitis Observed In Oxandrolone Versus Testosterone Therapy In Major Burn Injury, Alexandra Dewitt, Athena Hoppe, Anastasiya Ivanko, Victoria Miles

School of Medicine Faculty Publications

57th Annual Meeting of the American Burn Association, ABA 2025, April 8 - 11, 2025, Phoenix, AZ

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Periclavicular Multifocal, Infiltrative Extraneural Soft Tissue Perineuriomas: Illustrative Case, Ankur Khanna, Matthew Darlow, Rachna Jetly Shridhar, Matthew G. Cable Mar 2025

Periclavicular Multifocal, Infiltrative Extraneural Soft Tissue Perineuriomas: Illustrative Case, Ankur Khanna, Matthew Darlow, Rachna Jetly Shridhar, Matthew G. Cable

School of Medicine Faculty Publications

BACKGROUND Perineuriomas are benign, typically solitary tumors with intraneural and extraneural subtypes presenting distinct clinical manifestations and symptomatology. Here, the authors report a unique case of multifocal, infiltrative extraneural soft tissue perineuriomas localized to the shoulder. OBSERVATIONS A 33-year-old female presented with 1 year of right neck and shoulder pain accompanied by a new onset of numbness and tingling down her right arm. MRI of a mass apparent over her right trapezius and scapula revealed several mixed cystic and solid neoplasms encroaching on the C5–6 nerve roots and brachial plexus. The tumors were biopsied and confirmed by immunohistochemical staining to …

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International Expert Consensus On The Current Status And Future Prospects Of Artificial Intelligence In Metabolic And Bariatric Surgery, Mohammad Kermansaravi, Sonja Chiappetta, Shahab Shahabi Shahmiri, Julian Varas, Chetan Parmar, Yung Lee, Jerry T. Dang, Asim Shabbir, Daniel Hashimoto, Amir Hossein Davarpanah Jazi, Ozanan R. Meireles, Edo Aarts, Hazem Almomani, Aayad Alqahtani, Ali Aminian, Estuardo Behrens, Dieter Birk, Felipe J. Cantu, Ricardo V. Cohen, Maurizio De Luca, Nicola Di Lorenzo, Bruno Dillemans, Mohamad Hayssam Elfawal, Daniel Moritz Felsenreich, Michel Gagner, Hector Gabriel Galvan, Carlos Galvani, Khaled Gawdat, Omar M. Ghanem, Et Al Mar 2025

International Expert Consensus On The Current Status And Future Prospects Of Artificial Intelligence In Metabolic And Bariatric Surgery, Mohammad Kermansaravi, Sonja Chiappetta, Shahab Shahabi Shahmiri, Julian Varas, Chetan Parmar, Yung Lee, Jerry T. Dang, Asim Shabbir, Daniel Hashimoto, Amir Hossein Davarpanah Jazi, Ozanan R. Meireles, Edo Aarts, Hazem Almomani, Aayad Alqahtani, Ali Aminian, Estuardo Behrens, Dieter Birk, Felipe J. Cantu, Ricardo V. Cohen, Maurizio De Luca, Nicola Di Lorenzo, Bruno Dillemans, Mohamad Hayssam Elfawal, Daniel Moritz Felsenreich, Michel Gagner, Hector Gabriel Galvan, Carlos Galvani, Khaled Gawdat, Omar M. Ghanem, Et Al

School of Medicine Faculty Publications

Artificial intelligence (AI) is transforming the landscape of medicine, including surgical science and practice. The evolution of AI from rule-based systems to advanced machine learning and deep learning algorithms has opened new avenues for its application in metabolic and bariatric surgery (MBS). AI has the potential to enhance various aspects of MBS, including education and training, decision-making, procedure planning, cost and time efficiency, optimization of surgical techniques, outcome and complication prediction, patient education, and access to care. However, concerns persist regarding the reliability of AI-generated decisions and associated ethical considerations. This study aims to establish a consensus on the role …

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High Rate Of Complications With Exchange Nailing For Femoral Nonunions, Benjamin Averkamp, Ziqing Yu, Julia C. Mastracci, Matthew J. Braswell, Andrew T. Chen, Luke A. Lopas, Ishani Sharma, Hassan Farooq, Hassan Mir, Jessica Rivera, Rachel B. Seymour, Joseph R. Hsu, Evidence-Based Musculoskeletal Injury & Trauma Collaborative, Robert D. Zura, Marc Schatz, Et Al Mar 2025

High Rate Of Complications With Exchange Nailing For Femoral Nonunions, Benjamin Averkamp, Ziqing Yu, Julia C. Mastracci, Matthew J. Braswell, Andrew T. Chen, Luke A. Lopas, Ishani Sharma, Hassan Farooq, Hassan Mir, Jessica Rivera, Rachel B. Seymour, Joseph R. Hsu, Evidence-Based Musculoskeletal Injury & Trauma Collaborative, Robert D. Zura, Marc Schatz, Et Al

School of Medicine Faculty Publications

Objectives: To evaluate rates of nonunion repair, osseous healing, and outcomes in femoral nonunions with contemporary healing. Design: Retrospective review. Setting: Five academic level 1 trauma centers. Patients/Participants: This study includes adult patients (age older than 18) seen at one of the participating institutions between 2012 and 2019 who sustained a femur fracture (OTA/AO 31, 32, 33) initially treated with intramedullary fixation that developed nonunion and were treated with exchange nailing for the index nonunion surgery. Seventy-nine patients with femoral nonunion met inclusion criteria. Intervention: Exchange nailing for treatment of femoral nonunion. Main Outcome Measurements: The primary outcome measure was …

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Markers Of Growth And Nutrition In Children With Acquired Chylothorax Post Chd Surgery, Kevin N. Marzotto, Karin R. Videlefsky, Meghan P. Howell, Thomas R. Kimball, Frank A. Pigula, Kurt D. Piggott Mar 2025

Markers Of Growth And Nutrition In Children With Acquired Chylothorax Post Chd Surgery, Kevin N. Marzotto, Karin R. Videlefsky, Meghan P. Howell, Thomas R. Kimball, Frank A. Pigula, Kurt D. Piggott

School of Medicine Faculty Publications

Background: Acquired chylothorax is an established complication of CHD surgery, affecting 2-9% of patients. CHD places a child at risk for failure to thrive, with subsequent chylothorax imposing additional risk. Objective: We conducted a retrospective chart review to ascertain quantitative markers of nutrition and growth in children affected by chylothorax following CHD surgery between 2018 and 2022 compared to controls. Methods: We utilised electronic medical record system, EPIC, at Children's Hospital, New Orleans, targeting subjects < 18 years old who underwent CHD surgery between 2018 and 2022 and developed a subsequent chylothorax. Study subjects were identified using the 10th revision of the International Classification of Diseases codes (ICD-10 codes: J94.0, I89.8, and J90.0). Each chylothorax case (n = 20) was matched by procedure type and age to a control with no chylothorax (n = 20). Data were recorded in REDCap and analysed using SPSS. Results: After removal of outliers, we analysed 19 total matched pairs. There was no statistical difference in growth velocity (p = 0.12), weight change (operation to discharge) (p = 0.95), weight change (admission to discharge) (p = 0.35), Z-score change (operation to discharge) (p = 0.90), Z-score change (admission to discharge) (p = 0.21), serum protein (p = 0.88), or serum albumin (p = 0.82). Among cases, linear regression demonstrated no significant association between maximum chylous output and growth velocity (p = 0.91), weight change (operation to discharge) (p = 0.15), or weight change (admission to discharge) (p = 0.98). Conclusions: We did not observe statistically significant markers of growth or nutrition in children with chylothorax post-CHD surgery compared to those without chylothorax. Multisite data collection and analysis is required to better ascertain clinical impact and guide clinical practice.

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Interprofessional Simulation Education In Surgery, John T. Paige, Laura Bonanno Feb 2025

Interprofessional Simulation Education In Surgery, John T. Paige, Laura Bonanno

School of Medicine Faculty Publications

Despite the increased emphasis on simulation-based interprofessional education (Sim-IPE) over the last 2 decades, surgical teamwork continues to suffer from ineffective dynamics requiring educational interventions to help improve it. This paper will provide an overview of the status of interprofessional simulation education in surgery by addressing the following topics: (1) team dynamics in surgery, (2) key concepts related to IPE and its benefits, and (3) salient examples of Sim-IPE in surgery with implementation tips.

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Anatomy And Variations Of The Carina And Its Cartilaginous Makeup: A Cadaveric Study, Chung Yoh Kim, Kristen Rizzuto, Daniel Tahan, Devendra Shekhawat, Rarinthorn Samrid, Yoko Tabira, Stephen J. Bordes, Joe Iwanaga, R. Shane Tubbs Feb 2025

Anatomy And Variations Of The Carina And Its Cartilaginous Makeup: A Cadaveric Study, Chung Yoh Kim, Kristen Rizzuto, Daniel Tahan, Devendra Shekhawat, Rarinthorn Samrid, Yoko Tabira, Stephen J. Bordes, Joe Iwanaga, R. Shane Tubbs

School of Medicine Faculty Publications

Purpose: The carina, located at the bifurcation of the trachea, has been regarded as a part of the trachea. Although clinically useful as an anatomical landmark, studies of its detailed morphology are lacking in the literature. Methods: The distal trachea and left and right main bronchi were harvested from 32 cadavers and the carina studied using microsurgical dissection, endoscopy, micro-CT, and histology. Results: The right bronchial cartilages were most commonly involved in forming the carina (72.41%), and the left bronchial cartilages were the second most commonly involved (37.93%). The carinal cartilages were slightly deviated to the left of midline in …

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Early Surgical Decompression For The Treatment Of Hourglass-Like Constriction Of The Posterior Interosseus Nerve, Nathan Redlich, Matan Ozery, Adam Haydel, Charles Cush, Rasheed Ahmad Feb 2025

Early Surgical Decompression For The Treatment Of Hourglass-Like Constriction Of The Posterior Interosseus Nerve, Nathan Redlich, Matan Ozery, Adam Haydel, Charles Cush, Rasheed Ahmad

School of Medicine Faculty Publications

Posterior interosseous nerve (PIN) syndrome refers to a rare compressive neuropathy of the PIN resulting in motor dysfunction of the forearm extensor compartment. Often, surgical exploration will reveal extrinsic structures that mechanically compress the nerve. Less frequently, PIN syndrome has been reported with a visible hourglass-like constriction and no identifiable causative adjacent structures. In our report, we describe an adolescent patient with PIN syndrome and associated hourglass-like constriction of the PIN. For diagnosis, we used physical examination, preoperative imaging, nerve studies, and intraoperative findings. To monitor recovery, we performed serial neurological examinations and documented patient-reported functional outcomes. The patient underwent …

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Validation Of A Novel Landmark-Guided Intra-Articular Postero-Medial Surgeon-Administered Injection Technique, Nicolas S. Piuzzi, Andrew I. Spitzer, Jason Mussell, Ignacio Pasqualini, Stan Dysart, Jeffrey Gonzales, Michael A. Mont, Jess H. Lonner, William Mihalko Feb 2025

Validation Of A Novel Landmark-Guided Intra-Articular Postero-Medial Surgeon-Administered Injection Technique, Nicolas S. Piuzzi, Andrew I. Spitzer, Jason Mussell, Ignacio Pasqualini, Stan Dysart, Jeffrey Gonzales, Michael A. Mont, Jess H. Lonner, William Mihalko

School of Medicine Faculty Publications

Background: This study aimed to define an intra-articular surgeon-administered technique that may be comparable to ultrasound (US)-guided adductor canal block (ACB). Methods: Five cadaver lower limbs were examined. An anesthesiologist administered a US-guided ACB using 20 mL of dilute indocyanine dye. An orthopedic surgeon performed a medial parapatellar arthrotomy and introduced an 18-gauge needle 1-2 cm proximal to the palpated adductor tubercle angled posteromedially. Needle position and dye spread were fluoroscopically documented. Results: This technique consistently reached the infrapatellar branch of the saphenous nerve, nerve to the vastus medialis muscle, and posterior capsule, with minimal proximal dye spread. Conclusions: This …

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Routine Overnight Assessments In Stable Pediatric Surgery Patients: A Critical Reconsideration, Morgan Brown, Rebecca Moreci, Hannah Megison, Elizabeth Long, Michael Maurer, Benjamin Bienvenue, Denise M. Danos, James H. Wood Jan 2025

Routine Overnight Assessments In Stable Pediatric Surgery Patients: A Critical Reconsideration, Morgan Brown, Rebecca Moreci, Hannah Megison, Elizabeth Long, Michael Maurer, Benjamin Bienvenue, Denise M. Danos, James H. Wood

School of Medicine Faculty Publications

Background: Hospitalized patients are subject to overnight vital sign (OVS) monitoring which leads to subsequent sleep disturbance and contributes to adverse outcomes and negative hospital experiences. Studies in pediatric populations have shown that routine OVS checks infrequently detect significant events. We hypothesized that OVS monitoring in pediatric surgery patients rarely detects abnormalities resulting in meaningful interventions. Materials and methods: We performed a retrospective chart review of patients ≥ 5 years old admitted to the pediatric surgery service at a stand-alone Children's Hospital from 2019 to 2021. ICU patients were excluded from analysis. Overnight vital signs were defined as those recorded …

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Viscoelastic Hemostatic Assays Are Associated With Mortality And Blood Transfusion In A Multicenter Cohort, Shyam Murali, Eric Winter, Nicolas M. Chanes, Allyson M. Hynes, Madhu Subramanian, Alison A. Smith, Mark J. Seamon, Jeremy W. Cannon Jan 2025

Viscoelastic Hemostatic Assays Are Associated With Mortality And Blood Transfusion In A Multicenter Cohort, Shyam Murali, Eric Winter, Nicolas M. Chanes, Allyson M. Hynes, Madhu Subramanian, Alison A. Smith, Mark J. Seamon, Jeremy W. Cannon

School of Medicine Faculty Publications

Objectives: Trauma-induced coagulopathy (TIC) carries significant risks, including increased mortality. Traditional TIC definitions rely on laboratories that result slowly and do not highlight therapeutic targets. We hypothesized that a TIC score, based on thromboelastography (TEG) and rotational thromboelastometry (ROTEM), collectively termed viscoelastic hemostatic assays, is associated with in-hospital mortality and packed red blood cell (pRBC) transfusion. Methods: This retrospective cohort study used a database of adult patients undergoing institutional massive transfusion at seven level 1 trauma centers (2013-2018). A “TIC score” was developed, with 1 point assigned for abnormal TEG R-time ( ≥ 9 min) or ROTEM clot time ( …

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Medicaid Expansion Increases Treatment For Patients With Colon Cancer, John Morgan Lyons, Denise M. Danos, Lauren S. Maniscalco, Yong Yi, Omeed Moaven, Xiaocheng Wu, Quyen Chu Jan 2025

Medicaid Expansion Increases Treatment For Patients With Colon Cancer, John Morgan Lyons, Denise M. Danos, Lauren S. Maniscalco, Yong Yi, Omeed Moaven, Xiaocheng Wu, Quyen Chu

School of Medicine Faculty Publications

Introduction: Medicaid expansion (ME) has positively impacted colon cancer screening. ME’s effect on colon cancer treatment is less clear. This study analyses the effect of ME on patterns of colon cancer treatment. Methods: Patients with primary invasive colon cancer were identified using the Louisiana Tumor Registry. Patients diagnosed with colon cancer prior to ME (2014–2015) were compared to those diagnosed after (2017–2018). Coordinate variables were analyzed using Fisher’s exact test. Treatment status was modeled with multivariable logistic regression and the results are reported as adjusted odds ratios. Results: The proportion of uninsured patients decreased following ME (5.5 versus 1.9, p < 0.001), with the greatest reductions among patients between 45 and 54 years old (13.5% to 3.5%, p < 0.0001), African Americans (8.9 to 2.1%, p < 0.0001), and those in high-poverty neighborhoods (7.1 to 2.1%, p < 0.0001). Following ME, all patients with Stage I-III disease were more likely to receive surgery (OR = 1.95; 95%: CI 1.21–3.14)—especially the extremely impoverished (OR = 2.39; 95% CI 1.41–4.02). Young patients with Stage IV colon cancer were more likely to receive chemotherapy (OR-1.6; 95% CI 1.03–2.4). Patients with Stage IV colon cancer were less likely to receive treatment within 30 days of diagnosis (OR = 0.7; 95% CI 0.5–0.9), but, on subset analysis, this was only observed in non-Medicaid patients. Conclusion: ME is associated with increased treatment for patients with colon cancer, and it did not appear to affect time to treatment. However, it seems to affect different subsets of the population differently.

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