Surgery Commons^™

Adjunctive Embolization Of Target Vessel Dissections To Improve Suitability For Fenestrated-Branched Endovascular Aortic Repair, Zemia C Ferreira, Hannah V Oden-Brunson, Ying Huang, Steven Maximus, Naveed Saqib, Erin Greenleaf, Thanila A Macedo, Gustavo S Oderich

Faculty, Staff and Students Publications

Suitability of renal-mesenteric target arteries is an essential criterion for fenestrated-branched endovascular aortic repair (FB-EVAR). We describe a staged adjunctive technique of target vessel false lumen (FL) embolization to improve suitability for FB-EVAR in patients with chronic postdissection thoracoabdominal aortic aneurysms (PD-TAAA) and dissection extension into the superior mesenteric artery (SMA). Three patients with SMA dissection and ectasia (diameter > 12-14 mm) underwent staged FL embolization with pre-emptive stent placement to optimize SMA incorporation. Using bilateral transfemoral access with intravascular ultrasound guidance, the proximal SMA true lumen was stented with an 8 L × 39 mm VBX balloon-expandable stent graft (W. …

A Worldwide Cross-Sectional Survey Seeks The Current Global Practice Patterns On Perioperative Management In Elective Shoulder Replacement Surgery, Maciej Simon, Farhad Moola, Jennifer Coghlan, Osvandre Lech, Carlos Ramos, Njalalle Baraza, Hadrian Platzer, Simone Gantz, Andreas Seekamp, Babak Moradi

General Surgery, East Africa

Background Perioperative management in elective shoulder arthroplasty varies widely, with no universal consensus on best practices. This study aimed to characterize current global standards of perioperative care, including pre-operative, intraoperative, and post-operative management, among orthopedic surgeons performing elective shoulder replacement surgery, with the aim of contributing to a global standard of care.

Methods A comprehensive online questionnaire was designed and anonymously distributed to orthopedic societies on each continent. Participants were cross-sectionally surveyed with the goal of identifying current global pre-operative, intraoperative, and post-operative practices in patient care and discharge management.

Results Eighteen societies from 5 continents participated in the survey. …

Retrieval Strategies For Embolized Left Atrial Appendage Closure Devices, Usama Sadiq, Muneeba Ali, Stacey Damito, Maxwell Ambrosino, Muhammad Sabri, Muhammad Ahmad Sadiq, Muhammad Hamza Sadiq, Richard Kovach, Sheena Rastogi, Muhammad Raza

Abington Jefferson Health Papers

BACKGROUND: Device embolization (DE) is a rare but potentially life-threatening complication of left atrial appendage occlusion (LAAO). As landmark trials broaden the eligible population for LAAO, operator preparedness for DE management becomes increasingly critical.

CASE SUMMARY: We present 4 cases of LAAO DE managed with distinct retrieval strategies: 1) open surgical retrieval with concurrent AtriClip ligation for an endothelialized left atrial device; 2) sequential transseptal then retrograde arterial snaring for intraprocedural migration to the abdominal aorta; 3) transseptal retrieval using a dedicated ONO system with cerebral embolic protection for partial left atrial dislodgment; and 4) retrograde large-bore arterial retrieval for …

Mechanism Of Injury And Fracture Status Influence Outcomes After Central Cord Injury, Karlo M. Pedro, Mohammed Ali Alvi, Kathleen Zang, Christopher Lozano, Jetan H. Badhiwala, Jefferson R. Wilson, James Harrop, James D. Guest, Bizhan Aarabi, Christopher I. Shaffrey, Michael G. Fehlings

Department of Neurosurgery Faculty Papers

Central cord syndrome (CCS) is the most common form of incomplete cervical spinal cord injury (SCI), yet its optimal management remains controversial. We examined whether stratifying CCS by injury stability improves treatment assessment. CCS was defined as an American Spinal Injury Association Impairment Scale (AIS) C/D cervical SCI with a ≥5-point lower-upper extremity motor score difference and classified as CCS-stable (CCS-S) or -unstable (CCS-U) based on the absence or presence of fracture/dislocation. Functional recovery at 1 year was assessed using the functional independence measure (FIM) motor score. Among 291 patients, 131 (45%) had CCS-S. These patients were older and more …

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. …

Decreased Frequency Of Splenectomy For High-Grade Splenic Injuries Following The Implementation Of An Interventional Radiology Alert Protocol., Maura Kopchak, John Bach, William B Devoe, Brian Dusseau, Katherine A Graham, John Dillis, Thomas Glusich, Jeff Hubartt

OhioHealth Research Institute Articles

Background A vascular interventional radiology (VIR) protocol was initiated at a mature level 2 trauma center on 3/1/2023 to reduce time to vessel puncture to < 60 minutes as per American College of Surgeons (ACS) guidelines. The average time to vessel puncture in the two years prior to protocol initiation was 102 minutes. Following initiation, time to vessel puncture was reduced to 48.2 minutes (p < 0.001). A statistically significant increase in the number of splenic embolizations was noted in the post-protocol group. The primary outcome of the current study was to evaluate if the initiation of a VIR protocol correlated with a statistically significant decrease in splenectomies for high-grade splenic injuries (American Association for the Surgery of Trauma (AAST) grade 3 or higher) in favor of splenic embolization. The secondary outcomes of the study were to assess whether the initiation of the VIR alert protocol improved our rate of splenic salvage, defined as preserved splenic immune function, and if there was a decreased rate of splenectomies across all injury grades. Methods The trauma registry database was queried for all splenic injuries from 1/1/2021 to 9/1/2024. Admission CT scans were used to grade injuries using the AAST Organ Injury Scale. Demographic and clinical characteristics, including severity of illness (ISS), admission INR, age, blood product required pre- and post-intervention, mortality, sex, length of stay, anticoagulant (AC)/antiplatelet (AP) use, mechanism of injury, and need for REBOA (resuscitative endovascular balloon occlusion of the aorta) placement, were collected for all patients. Patients were further broken down into those requiring splenectomy, embolization, or no intervention. Data were analyzed using chi-square and Mann-Whitney U with Jamovi Version 2.3.26.0 (The Jamovi Project, 2023). Results No statistically significant difference was found for clinical or demographic characteristics between groups. Fewer splenectomies and more splenic embolizations were performed in the post-protocol group for high-grade splenic injuries (grade 3), which was statistically significant (p< 0.001). This was also true when all grade splenic injuries were compared (p< 0.001). Conclusion Following the establishment of an institutional VIR alert protocol for active hemorrhage control in trauma patients, more frequent utilization of angioembolization for high-grade splenic injuries was found with a subsequent decrease in splenectomy rate. Implementation of the VIR alert protocol directly correlated with a shift in practice pattern reflecting attempts at splenic salvage for all injury grades.

Endoscopic Versus Catheter-Based Minimally Invasive Evacuation Of Spontaneous Supratentorial Intracerebral Hemorrhage: A Systematic Review And Meta-Analysis, Shaan Patel, Shiva A Nischal, Kush M Kale, Angelette Mendonca, Keenan Piper, Pious D. Patel, Michael R. Gooch, Stavropoula Tjoumakaris, Pascal M. Jabbour

Department of Neurosurgery Faculty Papers

Minimally invasive surgery (MIS) for spontaneous supratentorial intracerebral hemorrhage (sICH) includes endoscopic evacuation and catheter-based evacuation (aspiration or drainage ± thrombolysis), but comparative performance remains uncertain. We performed a systematic review and meta-analysis comparing MIS approaches. PubMed, Embase, and CENTRAL were searched (December 2025) for studies in adults undergoing endoscopic or catheter-based MIS for supratentorial sICH. Random-effects meta-analysis was conducted. Prespecified subgroup analyses stratified catheter-based techniques by thrombolysis use. Risk of bias and certainty of evidence was assessed. Twenty-nine studies (8221 patients; 5041 endoscopic; 3180 catheter-based) were included. Endoscopic evacuation was associated with lower mortality (RR 0.64; 95% CI: 0.47–0.87; …

Multi-Level Disparities In Survival Among Patients Diagnosed With Oral Cavity Cancer In Texas Between 1995 And 2020, Guillermo A Tortolero, Erich M Sturgis, Jose-Miguel Yamal, Melissa F Peskin, Cici Bauer, Caitlin C Murphy

Faculty, Staff and Students Publications

Background: Multi-level factors, including demographic and neighborhood social conditions, related to disparities in oral cavity cancer (OCC) are not fully understood. We examined the association between these factors and survival outcomes among patients diagnosed with OCC.

Methods: We identified 14,416 patients diagnosed with OCC from 1995 to 2020 using population-based data from the Texas Cancer Registry. Neighborhood-level social vulnerability was measured using the 2010 US Centers for Disease Control and Prevention's Neighborhood Social Vulnerability Index (CDC-SVI). We examined race and ethnicity, CDC-SVI (as sample-based quintiles), and their joint effects with survival outcomes.

Results: Five-year survival probability was 38.6% (95% CI: …

Quantitative Imaging Of Pyruvate Metabolism In A Patient With Anaplastic Thyroid Cancer, James A Bankson, Joshua S Niedzielski, Collin J Harlan, Yunyun Chen, Christopher M Walker, Philip L Lorenzi, Lin Tan, Vikas Kundra, Matthew E Merritt, Mukundan Ragavan, Dawid Schellingerhout, Renjie He, Yao Ding, Sahana Datar, Qing Wang, Christine B Peterson, Clifton D Fuller, Vlad C Sandulache, Stephen Y Lai

Faculty, Staff and Students Publications

Purpose: Magnetic resonance imaging using hyperpolarized (HP) [1-13C]-pyruvate enables assessment of pyruvate metabolism in vivo and offers new insight into metabolic changes in response to cancer therapy. Widely used semi-quantitative metrics of pyruvate metabolism can be affected by physiological factors that are extrinsic to intracellular metabolism. A validated pharmacokinetic (PK) model for analysis of intracellular pyruvate metabolism is needed to enhance the accuracy of quantitative metrics and clinical translation of metabolic MRI using HP pyruvate.

Methods: A PK model with two physical compartments and two chemical pools was developed to analyze the conversion of labeled pyruvate into lactate in vitro. …

"I Can See Where This Is Taking Me": Medical Students' Perceptions Of Humanities Courses At Aga Khan University, Kenya, Catherine Gathu, Marthaclaire Zammit, Urvi Saboo, Robert Opoka

Family Medicine, East Africa

Background Humanities courses in medical training are increasingly recognized as essential for developing empathetic, reflective and socially responsive physicians. Although well-established globally, their integration into medical education in African contexts remains limited. In Kenya, humanities are often peripheral within curricula dominated by biomedical sciences and clinical medicine. Aga Khan University (AKU), Nairobi, has introduced a novel medical curriculum that embeds seven core humanities courses as central components of the initial phase of its MBChB program. This study explored students’ perceptions and lived experiences of these humanities courses.

Methods A retrospective descriptive study using an embedded mixed-methods design was conducted among …

Impact Of Trisomy 21 On Post Pull-Through Enterocolitis And Bowel Function In Children With Hirschsprung Disease: A Pcplc Analysis., Marshall W. Wallace, Scott S. Short, Rachel C. Crady, Ron W. Reeder, Hira Ahmad, Kelly Austin, Andrea Badillo, Casey M. Calkins, Megan M. Durham, Julie R. Fuchs, Christopher Gayer, Julia E. Grabowski, Jamie C. Harris, Charles R. Hong, Ankur Rana, Rebecca M. Rentea, Nelson Rosen, Payam Saadai, Caitlin A. Smith, K Elizabeth Speck, Cristine S. Velazco, Richard J. Wood, Michael D. Rollins

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: We evaluated whether Trisomy 21 (T21) affected bowel management use, ability to toilet train for stool, and rates of Hirschsprung-Associated Enterocolitis (HAEC) in children with Hirschsprung disease (HD). We hypothesized that T21 would be associated with increased rates of HAEC, bowel management program (BMP) use, and delayed toilet training for stool.

METHODS: Children with HD in the Pediatric Colorectal and Pelvic Learning Consortium (PCPLC) database who underwent primary pull-through were included and stratified by T21 status: HD only versus HD + T21. Children requiring a redo pull-through, initially managed with a stoma, or those who had inadequate follow-up were …

Advancing Health Equity In Global Oncology: A Collaborative Academic-Cancer Society-Industry Program To Address Health Disparities In Sub-Saharan Africa, Kenneth Merrell, Ben Kamdem-Talom, Hannah Anie, Christine Wekesa, Nomsa Tsikai, Miriam Mutebi, Rakiya Saidu, Nwamaka Lasebikan, Adamu Bojude, Randiak Alaro

General Surgery, East Africa

Purpose Cancer care capacity in sub-Saharan Africa (SSA) is constrained by late diagnosis and limited treatment access. Few funding mechanisms support innovative, locally led programs to address these challenges. A collaborative initiative was developed to strengthen oncology care through quality improvement (QI) projects.

Materials and Methods The program was developed by Global Bridges Oncology (GBO) at Mayo Clinic, Pfizer Global Medical Grants, and the African Organisation for Research and Training in Cancer. A committee composed primarily of African oncology experts guided the process. An RFP was disseminated across SSA in English, French, and Portuguese, inviting applications to improve diagnostic and …

Expanding Cleft Surgical Workforce Capacity In Low- And Middle-Income Countries Through Competency-Based Training, Daniel Bradley, Jonathan Diaz, Emily Jones, Kealani Unkel, Atenas Bustamante, Zenebe Gebremariyam, Daniel Abate, Mamy Andriamanarivo, Mekonen Abebe, Armando Siu

General Surgery, East Africa

Objective To evaluate a competency-based cleft surgery training pathway designed to expand local surgical capacity in low- and middle-income countries (LMICs).

Design Prospective observational study of cleft surgery training outcomes between July 2022 and September 2024.

Setting Operation Smile cleft surgery programs and partner hospitals in LMICs, with integrated virtual education.

Patients/Participants Twenty trainee cleft surgeons from 11 countries.

Interventions A competency-based training pathway combining virtual education and mentored operative experience, with assessment using a validated surgical competency tool.

Main Outcome Measures Changes in self-reported surgical confidence and educator-rated surgical competency

Results Trainee cleft surgeons participated in 1168 cleft lip …

Defining The Value Of Elective Lumbar Fusion: A Systematic Review Of Existing Methodologies And Framework For The Operative Value Index, Advith Sarikonda, Anthony Chen, Theo S. Biddle, Danyal A. Quraishi, Preston Carey, Arbaz A. Momin, Matthews Lan, Dwight Mitchell Self, Ashmal S. Kabani, Ahilan Sivaganesan

Department of Neurosurgery Faculty Papers

BACKGROUND: Despite wide variation in the outcomes and costs of lumbar fusion, few studies have integrated these domains together within a single metric to assess "value" (outcomes achieved per dollar spent). In this review, we sought to 1) characterize existing metrics of cost-effectiveness for lumbar fusion, 2) evaluate all applications of time-driven activity-based costing (TDABC) in spine surgery, and 3) outline the conceptual foundation for a standardized Operative Value Index (OVI).

METHODS: Two PRISMA-concordant systematic reviews were performed on PubMed and Scopus databases. The first review examined all studies which reported a cost-effectiveness metric for lumbar fusion. The second review …

Benefits Of Regional Anesthesia Versus Opioids In The Management Of Postoperative Pain Following Excision Of A Peripheral Nerve Sheath Tumor., Duveen Nalamothu, Mauricio Arce Villalobos, Joseph D Tobias

Ambulatory and Primary Care Articles

Postoperative opioid exposure in opioid-naive patients may carry a risk of persistent opioid use. We present the case of a 16-year-old female with no significant family history who was recently diagnosed with neurofibromatosis type 1 and found to have a rapidly enlarging mass in her left upper extremity. She was scheduled for excisional biopsy. To minimize the need for postoperative opioids, analgesia via a continuous peripheral nerve catheter was employed following resection of the malignant peripheral nerve sheath tumor. This case report reviews the clinical applications of multimodal analgesia via a continuous peripheral nerve catheter in pediatric patients, including placement …

The Biological Response Of Human Np Cells To Soluble Collagen Vi, Jonathan Dalton, Srikanth N. Divi, Yasmine Eichbaum, Panya Luksanapruksa, Mitchell K. Ng, Rachel Huang, Alan S. Hilibrand, Alex R. Vaccaro, Dessislava Z. Markova, Christopher K. Kepler

Department of Orthopaedic Surgery Faculty Papers

Extracellular matrix (ECM) dysregulation plays a significant role in the development of intervertebral disc disease (IVDD). The ECM around the chondrocytes in the nucleus pulposus (NP) is unique in that it contains ColVI. While linked to chondrocyte proliferation in cartilage, ColVI's specific role in IVD degeneration is less clear. Our aim was to determine the expression of ColVI in NP cells from degenerative IVDs, along with the effects of soluble ColVI on NP cells. Thus, we compared the expression levels of ColVI in human degenerated IVD samples, along with the effect of soluble ColVI on primary human NP cells. A …

Beyond 72 Hours: A Retrospective Evaluation Of Factors Associated With Delayed Surgical Stabilization Of Rib Fractures., Alexis A Schweibinz, Clarisse Solis, Anna Michaud, John Dillis, Katherine A Graham, William B Devoe

OhioHealth Research Institute Articles

BACKGROUND: Surgical stabilization of rib fractures (SSRF) is recognized as a key intervention in reducing morbidity among patients with multiple displaced rib fractures or flail chest. Early SSRF, typically within 72 hours of admission, has been associated with improved outcomes. The factors contributing to delayed stabilization, defined as 72 hours or greater following admission, remain unclear.

METHODS: A retrospective cohort study was performed, evaluating 492 trauma patients who underwent SSRF at a level II trauma center. Patient demographics, injury characteristics, and associated injuries were analyzed to identify factors associated with delayed SSRF. Groups were defined as early (≤72 hours) and …

Serial Drilling Technique For Sequential Subtrochanteric Femur Fracture Fixation In Pediatric Osteopetrosis: A Technical Report., Adam Mansour, Josiah J Wolf, Ivan Slyepkan, Morgan Turnow, Michael Anderson, Anthony Wing, Jack Iandoli, Craig Goubeaux, Craig Smith, Allen Kadado

Surgery Articles

Pediatric osteopetrosis presents a significant technical challenge for fracture fixation due to the bone's dense yet brittle nature and frequently absent medullary canal. Traditional drilling methods risk excessive torque, drill-bit breakage, and iatrogenic fractures. Here, we describe a serial drilling technique for plate-and-screw fixation in a 5-year-old child with osteopetrosis who sustained sequential subtrochanteric femur fractures 8 months apart. By creating a small pilot hole, sequentially enlarging it with intermediate bits under copious irrigation, and inserting locking screws manually, we achieved stable fixation with no observed instrument failure or intraoperative complications. This method may provide a practical technical strategy for …

Long-Term Outcomes Of A Drug-Eluting Resorbable Scaffold Vs Angioplasty In Infrapopliteal Chronic Limb-Threatening Ischemia: 3-Year Results From The Life-Btk Trial., Sahil A Parikh, Brian G Derubertis, Marc P Bonaca, Prakash Krishnan, Richard H Pin, Jen-Kuang Lee, David C Metzger, Raghu Kolluri, Mehdi H Shishehbor, Andrew H Holden, Osamu Iida, Ehrin Armstrong, Steven W C Kum, David J O'Connor, Danielle R Bajakian, Lawrence A Garcia, Shih-Wa Ying, Jin Wang, Karine Ruster, Brad J Martinsen, Zsuzsanna Igyarto, Ramon L Varcoe

Surgery Articles

Background: Chronic limb-threatening ischemia (CLTI) caused by infrapopliteal disease is a major therapeutic challenge, with percutaneous transluminal angioplasty (PTA) associated with high rates of restenosis and reintervention. The LIFE-BTK trial previously demonstrated superior efficacy of the Esprit (Abbott Vascular) BTK drug-eluting resorbable scaffold (DRS) over PTA at 1 year, with sustained benefits at 2 years, with comparable safety at both time points. This report presents the 3-year outcomes.

Objectives: We aimed to compare the 3-year safety and efficacy of DRS vs PTA in patients with CLTI and infrapopliteal artery disease.

Methods: In this randomized trial, 261 patients with CLTI were …

Perspective On Lessons Not Learned: From Coley’S Toxins To Microbial Drug Delivery, Guidance For Institutional Review Boards (Irbs), Brian P. Hanley, Alejandro J. Betancourt, Gustavo Gross, Wilbur (Bo) Bowne

School of Medicine Publications

The bacterial and toxin methods of cancer treatment date back 130 years. This paradigm rests on nonspecific bacterial-toxin-generated immunotherapy. This high-risk oncology research is experiencing a renaissance of methods that are among the most effective yet. Glioblastomas and other resistant cancers are the modern touchpoint, because of remission history following sepsis. Spurred by recent research deaths, we discuss protocols IRBs should consider in live bacterial or synthetic immuno-stimulatory trials. Human systemic inflammatory response syndrome immunology is unique due to non-functioning SIGLEC-13 and 17, which control excessive Toll-like receptor 4 (TLR-4) signaling. This is not a technicality like human CD8+/CD4+ T …

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 …

Donor-Derived Cell-Free Dna As A Prognostic Biomarker After Heart Transplantation: The Define-Ht Study, Palak Shah, Paul J. Kim, Kelly H. Schlendorf, David A. Baran, Monica M. Colvin, Adam D. Devore, Howard Eisen, Kambiz Ghafourian, Michael M. Givertz, Eileen Hsich, Jaime L. W. Kennedy, Evan P. Kransdorf, Jose N. Nativi-Nicolau, Jignesh Patel, Eleni Tseliou, Omar Wever-Pinzon, Andrew Doud, Michelle S. Bloom, Sandra A. Carey, Navchetan Kaur, D Giovanni Biagini, Kyle E. Marshall, Michael Olympios, Mandeep R. Mehra, Josef Stehlik

Department of Medicine Faculty Papers

BACKGROUND: Measurement of donor-derived cell-free DNA fraction (dd-cfDNA%) and donor quantity score (DQS) is a noninvasive biomarker of acute rejection in heart transplantation (HT). Its prognostic value beyond histopathology remains uncertain.

OBJECTIVES: This study sought to evaluate associations between donor-derived cell-free DNA (dd-cfDNA) and clinically meaningful outcomes using a composite endpoint of treated rejection, graft dysfunction, retransplantation, or death within 1 year post-HT.

METHODS: The DEFINE-HT (Development of Noninvasive Cell-free DNA to Supplant Invasive Biopsy in Heart Transplantation) was a prospective, observational study following adult HT recipients at 10 U.S. centers for 1-year post-HT; blood was collected for dd-cfDNA testing …

Comprehensive Assessment Of Direct And Passive Smoking Across The Pancreatitis Spectrum, Samuel Han, Dhiraj Yadav, Jun Xu, Melena D Bellin, William E Fisher, Evan L Fogel, Chris Forsmark, Phil A Hart, Liang Li, Stephen J Pandol, Walter G Park, Guru Trikudanathan, Stephen K Van Den Eeden, Santhi Swaroop Vege, Darwin L Conwell, Christie Y Jeon, Consortium For The Study Of Chronic Pancreatitis, Diabetes, And Pancreatic Cancer (Cpdpc)

Faculty, Staff and Students Publications

Objectives: Smoking is a key risk factor for pancreatitis, contributing to pathogenesis and disease progression. Data regarding second-hand smoking, or passive smoking (PS) exposure, are lacking. We therefore aimed to assess the impact of PS exposure across the pancreatitis spectrum.

Methods: We analyzed baseline data from the PROCEED study, a multicenter study in the United States including patients with acute (AP), recurrent acute (RAP), and chronic (CP) pancreatitis. Participants detailed their individual smoking history and PS exposure, which was compared between AP, RAP, and CP subgroups. Participant factors and clinical characteristics were compared by level of individual and PS exposure. …

Clinical Features And Dental Pathologies In Maxillary Sinus Fungal Balls And Odontogenic Sinusitis, Eunice Im, Lane Donaldson, Avraham Adelman, Nithin D Adappa, Yi-Wei Chen, Nikita Chapurin, Jennifer E Douglas, Glen E D'Souza, Jacob Eide, Maria Espinosa, Chia-Hsiang Fu, Meha G Fox, Rohit Garg, Edward C Kuan, Michael A Kohanski, Marta Kwiatkowska, Kevin Li, Derek H Liu, Tran Bao Locke, Chih-Feng Lin, Chadi Makary, Alice Ottavi, Peter Papagiannopoulos, James N Palmer, Charles C L Tong, Bobby A Tajudeen, Sanjena Venkatesh, Kimberly Wei, Frederick Yoo, Alison J Yu, Jun Jin, Alberto M Saibene, John R Craig

Faculty, Staff and Students Publications

Objectives: While maxillary sinus fungal balls (MSFB) can be associated with odontogenic conditions (MSFBO), MSFBO clinical and dental features have not been compared to odontogenic sinusitis (ODS). This multicenter study aimed to compare characteristics of MSFB, MSFBO, and ODS.

Methods: A multicenter international retrospective cohort study was conducted on adults with MSFBs and ODS who underwent sinus surgery. First in MSFBs, it was determined whether different dental conditions were more likely in FB versus non-FB sides. Second, clinical features and dental pathologies were compared between MSFBO and ODS. For analyses, dental conditions were considered individually and as two groups: infectious …

Social Determinants As Pathways In Disparities In Oral Cavity Cancer Stage At Diagnosis: A Registry-Based Analysis From 2010–2020, Guillermo A Tortolero, Erich M Sturgis, Itunu O Sokale, Abiodun Oluyomi, Kristina R Dahlstrom, Aaron P Thrift

Faculty, Staff and Students Publications

Purpose: Racial and ethnic differences in oral cavity cancer (OCC) stage at diagnosis are substantial, but the reasons remain unclear. We assessed insurance status and social neighborhood factors as potential pathways.

Methods: Using the Texas Cancer Registry, we identified adults diagnosed with OCC between 2010 and 2020. We examined the crude and multivariable associations of race and ethnicity, insurance status, and social neighborhood factors with stage at diagnosis. We investigated the mediating effects of insurance status and neighborhood-level social factors on racial and ethnic differences in stage at diagnosis using four-way decomposition with modified Poisson regression and robust standard errors. …

Myelomalacia Severity On Preoperative Magnetic Resonance Imaging Does Not Predict Patient-Reported Outcomes After Anterior Cervical Discectomy And Fusion, Mitchell K. Ng, Joshua Mathew, Robert J. Oris, Yulia Lee, Jonathan Dalton, Gregorio Baek, Ashley Thommana, William A. Green, Yasmine Eichbaum, Morgan Hitchner, Brandon Martinazzi, Ali Farooqi, Alec Giakas, Paul Gunter, Vinay Bijoor, Andrew Vanchikorn, John J. Mangan, David I. Kaye, Mark F. Kurd, Thomas Cha, Jose A Canseco, Alan S. Hilibrand, Alexander R. Vaccaro, Christopher K. Kepler, Gregory D. Schroeder

Department of Orthopaedic Surgery Faculty Papers

STUDY DESIGN/SETTING: Retrospective cohort study.

BACKGROUND: Signal changes within the spinal cord on magnetic resonance imaging (MRI) or myelomalacia, are frequently seen in patients with cervical myelopathy. While often assumed to predict the outcomes, their prognostic value remains uncertain. Therefore, this study aimed to: (1) describe the clinical characteristics of patients with myelomalacia undergoing Anterior cervical discectomy and fusion (ACDF); (2) evaluate whether MRI findings correlate with patient-reported outcomes (PROMs); and (3) determine whether morphology predict recovery.

METHODS: A retrospective review at a single tertiary care center was performed (2014-2021). Patients were included if they underwent a primary elective ACDF …

Transforaminal Endoscopic Lumbar Decompression: Defining Its Scope And Limitations, Kai-Uwe Lewandrowski, Álvaro Dowling, Jun Ho Lee, Benedikt W Burkhardt, Óscar L. Alves, Avelino Parajón, Jorge Felippe Ramirez, Nicola Montemurro, Alex R. Vaccaro, Morgan P. Lorio

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Transforaminal endoscopic lumbar decompression (TELD) has emerged as a minimally invasive alternative for managing lumbar stenosis and disc herniations. While the literature consistently reports favorable outcomes, real-world adoption remains variable, with discrepancies often linked to surgeon experience and case complexity.

OBJECTIVE: To evaluate surgeon perspectives on the clinical applicability of TELD across different pathologies and compare these findings with published evidence.

METHODS: An international cross-sectional survey was conducted among spine surgeons. Responses were analyzed using Rasch modeling to assess consensus levels, with agreement categorized as strong, moderate, weak, or disagreement. Differential Item Functioning (DIF) and correlation analyses were applied …

Transoral Endoscopic Stapled Diverticulotomy For Pediatric Esophageal Diverticulum: A Case Report, Nadeen Alturki, Huma Quraishi, Keith A. Kuenzler

Manuscripts, Articles, Book Chapters and Other Papers

Introduction

Case presentation

Immediate Postoperative Pacing Dependency Is Not Associated With Worse Mid-Term Survival In Redo Mitral Valve Surgery, Devon Kelley, Joyce Ho, Andrew Belec, Takahiro Tashima, Victoria Li, James Lao, Varun Kathawate, Kazuhiro Ueno, Amit Iyengar, Jessica Dominic, Pavan Atluri

Division of Cardiology Faculty Papers

Risk factors (RF) for permanent pacemaker (PPM) placement in cardiac surgery include valvular operations and redo operations. We aim to identify RF for PPM placement prior to discharge (DC) specifically among redo mitral valvular operations, and to analyze outcomes in this population. Our retrospective review considered 943 patients undergoing redo MV operations between 01/2002 and 12/2021, excluding patients experiencing in-hospital death within 48 hours of their operation and patients with existing PPM or implanted cardiac defibrillator (ICD). Patients (n = 742) were categorized based on whether they received a PPM before DC or not. Of the 742 patients analyzed, 47 …

Unlocking The Potential Of Sub-Saharan Africa In Globalized Cancer Clinical Trials: A Perspective From The 2024 Aortic-Asco Stakeholder Meeting, Abiola Ibraheem, Adedayo Joseph, Miriam Mutebi, Mansoor Saleh, Sitna Mwanzi, Olusegun Alatise

General Surgery, East Africa

Sub-Saharan Africa (SSA) remains significantly underrepresented in global cancer clinical trials, despite having the largest population of individuals of African descent, an essential demographic for ensuring diversity in clinical research. This study, developed from the 2024 African Organization for Research and Training in Cancer (AORTIC)-ASCO stakeholder meeting, addresses the critical need to involve SSA in cancer trials to improve global trial diversity and patient outcomes. Although globalization of trials has shifted research sites to regions like Eastern Europe and Asia, < 1% occur in Africa. This report highlights emerging solutions such as regional alliances, decentralized trial models, capacity-building initiatives, and public-private partnerships. The role of AORTIC and its Clinical Trial Special Interest Group in advancing training, infrastructure development, and international collaboration is discussed, with notable clinical trial networks, such as HypoAfrica, ARETTA, African Research Group for Oncology, and regional consortia, illustrating growing momentum and capability. This study advocates for a coordinated strategy to integrate SSA into global trials, ensuring more inclusive, effective, and equitable cancer treatment outcomes.