Surgery Commons^™

Anorectal Malformations In Monozygotic Twins: An Illustration Of Management Of Anorectal Malformations In A Tertiary Hospital In Indonesia, Hardian Gunardi, Asri D. Rachmawati, Nanok E. Susilo

The New Ropanasuri Journal of Surgery

A case of monozygotic twin boys with anorectal malformation with delayed presentation of bowel perforation. Both are managed surgically with a colostomy; after a definite diagnosis of anorectal malformation with a urethral fistula based on distal colostography, both boys underwent anoplasty with a posterior sagittal approach. Stoma closure was performed, and we found no complication during eight months of follow-up. Delay in the management of the twins was due to a lack of anal screening of the newborn. The unavailability of the neonatal intensive care unit became a significant concern. Distal colostography was performed for the definitive procedure. Despite that …

Outcomes Of Percutaneous Transluminal Angioplasty For Central Vein Stenosis In Hemodialysis: A Literature Review, Hilman Ibrahim, Akhmadu Muradi, Eka A. Limianto

The New Ropanasuri Journal of Surgery

Percutaneous transluminal angioplasty (PTA) is the mainstay treatment for central vein stenosis. However, the recurrent rate of the stenotic lesion after PTA remains high. Thus, we ran a review found on some databases. Out of thirteen articles, five articles were eligible and reviewed. Drug-coated balloon angioplasty, plain old balloon angioplasty, percutaneous transluminal angioplasty, and stenting angioplasty were discussed regarding the outcomes with a focus on interest to prevent the stenosis.

Management Of Internal Hernia In Neonates With Multiple Heart Diseases: A Case Report, Riana P. Tamba, Andi Wiradeni

The New Ropanasuri Journal of Surgery

Internal hernia is a rare clinical entity. In all cases, less than 1% found as the cause of intestinal obstruction. However, delayed treatment of internal hernia may lead to necrosis of the intestines. Neonates with congenital heart disease may be at increased risk of morbidity and mortality than another concurrent disease.

A male infant was delivered with a Cesarean section due to a congenital disorder of umbilical hernia, ventricular septal defect, and aortic transposition. The infant was born full-term with a 2,515 g birth weight and 3, 5, 7 APGAR score, positive ventilation, and intubation proceeded. Prostaglandin E1 10 mcg/kg/minute, …

Prediction Of Liver Volume From Liver Transplant Donor Using Biometric Formula Compared With Computed Topography Volumetry, Agi S. Putranto, Adinda B. Syafina, Damayanti Sekarsari, Yarman Mazni, Yefta Moenadjat

The New Ropanasuri Journal of Surgery

Introduction. Liver volume calculation is critical in assessing the compatibility and resectability of the graft in living donor liver transplants (LDLT). An accurate estimation of liver volume is a predictor for successful LDLT. The gold standard of liver volume estimation is CT Volumetry. Despite several limitations in the availability of software, facility, and time consumed, there is still disagreement of biometric formula to predict liver volume in Indonesia.

Methods: A cross-sectional design study was carried out in Dr. Cipto Mangunkusumo General Hospital, enrolling those who underwent liver transplantation from 1^st January 2010 – 3^rd October 2019. Bodyweight, body …

Management Of Pararenal Aortic Aneurysms : A Literature Review, Hilman Ibrahim, Akhmadu Muradi, Ihza Fachriza

The New Ropanasuri Journal of Surgery

Abdominal aortic aneurysms (AAA) are the most common group of aortic aneurysms. Pararenal aortic aneurysm (PAA) is a classification of AAA where there is no normal aortic segment between the renal artery and the proximal border of the aneurysm. This group has a prevalence of around 20% of all AAA cases. In open repair (open surgery), PAA requires suprarenal clamps or even supraceliac which causes high morbidity. In endovascular procedures, PAA presents difficulties due to the absence of a landing zone to place the graft and the possibility of reintervention after action. A literature review is needed to discuss the …

Co2 Contrast As Alternative Media Contrast For Renal Insufficiency Patient In Angiography: An Evidence Based Case Report, Frengky Bermana, Dedy Pratama

The New Ropanasuri Journal of Surgery

The use of iodine contrast, which is more commonly used, is associated with systemic effects in nephrogenic systemic fibrosis, contrast-induced nephropathy (CIN) in patients with kidney function disorders, geriatric, hypertension, and patients with comorbid diabetes mellitus and hypersensitivity reactions. An evidence-based case report was carried out in the Medical Department of Surgery, FKUI-RSCM. The study indicated that the safety of CO₂ angiography did not cause CIN to manifest and showing CO₂ contrast proved to be safe for patients who have impaired renal function

Preoperative Ca 19-9 Level As Additional Predictor Of Pancreatic Head Adenocarcinoma Resectability, Pasihulizan Pasihulizan, Agi S. Putranto

The New Ropanasuri Journal of Surgery

Introduction. Determining eligibility criteria for resection is the basis of pancreatic head adenocarcinoma treatment planning, yet the currently used CT scan only has 80% accuracy as its primary modality. This study aimed to investigate preoperative CA 19-9 level use to help predict resectability of pancreatic head adenocarcinoma.

Method. Determining eligibility criteria for resection is the basis of pancreatic head adenocarcinoma treatment planning, yet the currently used CT scan only has 80% accuracy as its primary modality. This study aimed to investigate preoperative CA 19-9 level use to help predict resectability of pancreatic head adenocarcinoma.

Results. There were …

Quality Of Life Of Post-Gastrectomy Patients: A Study In Indonesia's National Central Hospital, Herlan Napitupulu, Agi S. Putranto

The New Ropanasuri Journal of Surgery

Introduction. Several studies suggest gastrectomy is associated with deterioration in a patient's quality of life (QOL). This study is conducted to assess the impact of distal (DG), proximal (PG), or total (TG) gastrectomy and the cause of disease on a patient's QOL.

Method. This retrospective study was conducted in dr. Cipto Mangunkusumo Hospital with collected data from the medical records throughout July-September 2020. Inclusion criteria were patients after proximal, distal, or total gastrectomy for a tumor or any non-tumor indications. They were assessed using the World Health Organization Quality of Life Questionnaire Abbreviated Version (WHOQOL-BREF). Collected data were …

The Development Of Lived Experience-Centered Word Clouds To Support Research Uncertainty Gathering In Degenerative Cervical Myelopathy: Results From An Engagement Process And Protocol For Their Evaluation, Via A Nested Randomized Controlled Trial, Benjamin M Davies, Oliver D Mowforth, Danyal Z Khan, Xiaoyu Yang, Sybil R L Stacpoole, Olesja Hazenbiller, Toto Gronlund, Lindsay Tetreault, Sukhvinder Kalsi-Ryan, Michelle L Starkey, Iwan Sadler, Ellen Sarewitz, Delphine Houlton, Julia Carter, Evangeline Howard, Vafa Rahimi-Movaghar, James D Guest, Bizhan Aarabi, Brian K Kwon, Shekar N Kurpad, James Harrop, Jefferson R Wilson, Robert Grossman, Emma K Smith, Angus G K Mcnair, Michael G Fehlings, Mark R N Kotter

Department of Neurosurgery Faculty Papers

OBJECTIVES: AO Spine REsearch objectives and Common Data Elements for Degenerative Cervical Myelopathy [RECODE-DCM] is a multi-stakeholder consensus process aiming to promote research efficiency in DCM. It aims to establish the top 10 research uncertainties, through a James Lind Alliance Priority Setting Partnership [PSP]. Through a consensus process, research questions are generated and ranked. The inclusion of people with cervical myelopathy [PwCM] is central to the process. We hypothesized that presenting PwCM experience through word cloud generation would stimulate other key stakeholders to generate research questions better aligned with PwCM needs. This protocol outlines our plans to evaluate this as …

The Utility Of Continuous Passive Motion After Anterior Cruciate Ligament Reconstruction: A Systematic Review Of Comparative Studies, Taylor D'Amore, Somnath Rao, John Corvi, Robert Jack Ii, Fotios Tjoumakaris, Michael G. Ciccotti, Kevin Freedman

Department of Orthopaedic Surgery Faculty Papers

Background: The application of continuous passive motion (CPM) after anterior cruciate ligament reconstruction (ACLR) was popularized in the 1990s, but advancements in the understanding of ACLR rehabilitation have made the application of CPM controversial. Many sports medicine fellowship–trained surgeons report using CPM machines postoperatively. Purpose: To determine the efficacy of CPM use for recovery after ACLR with respect to knee range of motion (ROM), knee swelling, postoperative pain, and postoperative complications. Study Design: Systematic review; Level of evidence, 3. Methods: The PubMed (MEDLINE), EMBASE, Cochrane, Cumulative Index of Nursing, and Allied Health Literature databases were searched from inception to January …

Applying A Mixed-Method Approach To Improve On-The-Job Learning And Job Satisfaction In A Cohort Of Interns At A University Hospital, Amna Subhan Butt, Muhammad Shahzad Shamim, M Asghar Ali, Farah Naz Qamar, Irum Qamar Khan, Swaleha Tariq, Syeda Amrah Hashmi, Quratulain Hafeez, Muhammed Tariq

Section of Gastroenterology

Introduction: Job satisfaction is vital for the optimal functioning of medical practitioners. Herein, we report our experience of restructuring the internship program by identifying the gaps, developing, implementing strategies to overcome gaps and sharing the results of the pre-implementation and post-implementation audit, as an example for establishing a system for improving intern's work-based learning and satisfaction in a university hospital setting.
Methods: Using Kern's six-step instructional model, a prospective mixed-method study was conducted at Aga Khan University Hospital. In phase 1 (2013) gaps were identified by evaluating various aspects of the internship program. Strategies were developed and implemented to overcome …

A Rare Case Of Jejunal Perforation Due To Post-Transplant Lymphoproliferative Disease 27 Years After Liver Transplant, Marcos Rosado, Thomas Serena, Zophia Martinez, Erich Schwartz, Harris Mainster

Articles

Post-transplant lymphoproliferative disease (PTLD) is a well-known post-transplant malignancy common in both solid organ and stem cell transplants. The incidence of PTLD in adult liver transplant recipients is approximately 2.8%. While most often presenting in the first year after transplant, PTLD can occur at any time. This case report narrates a 61-year-old female with a history of liver transplant in 1992 for autoimmune hepatitis that was found to have a jejunal perforation due to PTLD 27 years later. The patient presented to the hospital with a fifteen hour history of left sided abdominal pain that was progressively worsening. The patient …

Trends In Leadership At Orthopaedic Surgery Sports Medicine Fellowships, Nicholas C. Schiller, Andrew J. Sama, Amanda F. Spielman, Chester J. Donnally, Benjamin I. Schachner, Dhanur M. Damodar, Christopher C. Dodson, Michael G. Ciccotti

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Fellowship directors (FDs) in sports medicine influence the future of trainees in the field of orthopaedics. Understanding the characteristics these leaders share must be brought into focus. For all current sports medicine FDs, our group analyzed their demographic background, institutional training, and academic experience.

AIM: To serve as a framework for those aspiring to achieve this position in orthopaedics and also identify opportunities to improve the position.

METHODS: Fellowship programs were identified using both the American Orthopaedic Society for Sports Medicine and the Arthroscopy Association of North America Sports Medicine Fellowship Directories. The demographic and educational background data for …

Outcomes Of Rescue Endovascular Treatment Of Emergent Large Vessel Occlusion In Patients With Underlying Intracranial Atherosclerosis: Insights From Star., Sami Al Kasab, Eyad Almallouhi, Ali Alawieh, Stacey Wolfe, Kyle M. Fargen, Adam S. Arthur, Nitin Goyal, Travis Dumont, Peter Kan, Joon-Tae Kim, Reade De Leacy, Ilko Maier, Joshua Osbun, Ansaar Rai, Pascal Jabbour, Jonathan A. Grossberg, Min S. Park, Robert M. Starke, Roberto Crosa, Alejandro M. Spiotta

Department of Neurosurgery Faculty Papers

Background: Some emergent large vessel occlusions (ELVOs) are refractory to reperfusion because of underlying intracranial atherosclerosis (ICAS), often requiring rescue therapy (RT) with balloon angioplasty, stenting, or both. In this study, we investigate the safety, efficacy, and long-term outcomes of RT in the setting of mechanical thrombectomy for ICAS-related ELVO.

Methods and Results: We queried the databases of 10 thrombectomy‐capable centers in North America and Europe included in STAR (Stroke Thrombectomy and Aneurysm Registry). Patients with ELVO who underwent ICAS‐related RT were included. A matched sample was produced for variables of age, admission National Institute of Health Stroke …

Are Guidelines Important? Results Of A Prospective Quality Improvement Lumbar Fusion Project., James Harrop, Alexandra Emes, Ameet Chitale, Chengyuan Wu, Fadi Al-Saiegh, Geoffrey Stricsek, Glenn A. Gonzalez, Jack Jallo, Joshua Heller, Kevin Hines, Lucas Philipp, Sara Thalheimer, Srinivas K. Prasad, Thiago Montenegro, Umma Fatema, Ashwini Sharan

Department of Neurosurgery Faculty Papers

BACKGROUND: United States (U.S.) healthcare is a volume-based inefficient delivery system. Value requires the consideration of quality, which is lacking in most healthcare disciplines.

OBJECTIVE: To assess whether patients who met specific evidence-based medicine (EBM)-based criteria preoperatively for lumbar fusion would achieve higher rates of achieving the minimal clinical important difference (MCID) than those who did not meet the EBM indications.

METHODS: All elective lumbar fusion cases, March 2018 to August 2019, were prospectively evaluated and categorized based on EBM guidelines for surgical indications. The MCID was defined as a reduction of ≥5 points in Oswestry Disability Index (ODI). Multiple …

Off-Pump Heartmate Ii Exchange In A Patient With Severe Lower Extremity Peripheral Artery Disease: A Case Report, Mehmet H. Akay, Ismael A. Salas De Armas, Manish K. Patel, Rajko Radovancevic, Igor D. Gregoric

The VAD Journal

Thrombosis of left ventricular assist device (LVAD) pumps is a serious complication that often requires exchange of the device. A 66-year-old man with severe peripheral vascular disease presented with pump thrombosis of the HeartMate II (HMII) LVAD 1.5 years after implantation. The HMII was exchanged to another HMII through a subcostal incision and without the use of cardiopulmonary bypass. For safety, the patient was prepared for cardiopulmonary bypass by exposing the right subclavian artery and insertion of a 5 FR cannula in the left common femoral vein. The pump was exchanged through a subcostal incision made over the LVAD pump …

Leveraging Advancements In Tissue Engineering For Bioprinting Dental Tissues, Devin Grace Morrison, Ryan E. Tomlinson

Department of Orthopaedic Surgery Faculty Papers

3D bioprinting allows biocompatible materials and cells to be deposited in precise locations in three-dimensional space, enabling researchers to surpass the limitations of traditional 2D cell culture and to create innovative therapies. 3D bioprinting is one of the newest tools developed in the field of tissue engineering, which has traditionally utilized a paradigm revolving around scaffolds, cells, and signals. In this review, we discuss how new developments in each of these three research areas relates to bioprinting dental tissues – specifically teeth, periodontal ligament, and alveolar bone. Important considerations include how scaffold materials and geometry affect regeneration of dental tissues, …

Tumor Metabolism And Associated Serum Metabolites Define Prognostic Subtypes Of Asian Hepatocellular Carcinoma., Yotsawat Pomyen, Anuradha Budhu, Jittiporn Chaisaingmongkol, Marshonna Forgues, Hien Dang, Mathuros Ruchirawat, Chulabhorn Mahidol, Xin Wei Wang

Department of Surgery Faculty Papers

Treatment effectiveness in hepatocellular carcinoma (HCC) depends on early detection and precision-medicine-based patient stratification for targeted therapies. However, the lack of robust biomarkers, particularly a non-invasive diagnostic tool, precludes significant improvement of clinical outcomes for HCC patients. Serum metabolites are one of the best non-invasive means for determining patient prognosis, as they are stable end-products of biochemical processes in human body. In this study, we aimed to identify prognostic serum metabolites in HCC. To determine serum metabolites that were relevant and representative of the tissue status, we performed a two-step correlation analysis to first determine associations between metabolic genes and …

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

School of Medicine Faculty Research

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

Iatrogenic Electrocautery Damage And Cellular-Based Corrosion Of Total Joint Arthroplasty Biomaterials, Kirsten Carol Miller

Theses and Dissertations (ETD)

Introduction. The number of patients undergoing a Primary Total Knee Arthroplasty (PTKA) has been increasing steadily each year. Of those PTKA patients, 20% report long-term pain and/or some functional deficit. Cobalt-Chromium-Molybdenum (CoCrMo) alloy is one of the most used materials in Total Joint Arthroplasty (TJA) implants due the material’s high strength, high corrosion resistance, and biocompatibility. The release of metal ions and potential occurrence of metallosis in TJA has been shown to be detrimental to the longevity of the implant. The mechanisms leading to this increase in metal ion concentrations have been up for debate, with some believing it is …

Pediatric Surgery Nurses Lead And Coordinate Covid-19 Recovery Efforts, Shelly Johnson, Alice E. Dupler

2021 Providence Nurse Research Conference

Background: In early 2020, the appearance of the novel COVID-19 virus became a global concern, infecting hundreds of thousands of people. To reduce the spread of the virus, the United States government instituted social distancing and required hospitals to take steps to create extra beds for patient with COVID. One method to increase hospital capacity was the cancellation of scheduled, elective surgeries. In one large pediatric hospital in the Pacific Northwest, there was no formal process in place for cancelling elective procedures or for prioritizing when or how to reschedule the case. Because nurses were being called on to provide …

Post-Operative Seizure Control In Patients With Glioblastoma, Ummey Hani, Muhammad Ammar Haider, Saqib Kamran Bakhshi, Muhammad Shahzad Shamim

Section of Neurosurgery

While the median survival in patients with glioblastoma has not improved significantly over the past decade, aggressive attempts have been made on palliation and improving quality of life in these patients. A confluence of two debilitating pathologies which massively distorts the normal day-to-day functioning of the patients who experience it, seizures in glioblastoma patients portends a poor prognosis. There exists a paucity of reported seizure outcomes after glioblastoma treatment in neurosurgical literature. Herein we present a review examining post-operative seizure control in patients with glioblastoma.

Robotic Gastrotomy And Bezoar Removal In A Six-Year-Old., Lior Kopel, Joshua Volin, Anthony Iacco, Begum Akay, Pavan Brahmamdam

Conference Presentation Abstracts

No abstract provided.

Paediatric Pseudo Papillary Pancreatic Tumour: A Case Based Review, Mir Ibrahim Sajid, Ayesha Saleem, Muhammad Arshad

Medical College Documents

Solid pseudopapillary neoplasms are rare and represent approximately 4% of all cystic pancreatic tumours, and predominately affect females. They have an excellent prognosis, however 10-15% of the patients show metastasis at the time of surgery or recurrence of tumour during follow-up after pancreatectomy. Surgical resection is the recommended treatment. We present a rare case of a 15-year-old female, with a pseudopapillary tumour of the pancreas which was diagnosed pre-operatively.

The Association Of Symptoms Of Overactive Bladder With Pelvic Organ Prolapse And Its Improvement After Pelvic Reconstructive Surgery, Saida Abrar, Raheela Mohsin Rizvi, Nida Zahid

Department of Obstetrics & Gynaecology

Objectives: This study asseses the association of overactive bladder symptoms and pelvic organ prolapse severity and evaluates the effect of pelvic reconstructive surgery on overactive bladder (OAB) symptoms in women with pelvic organ prolapse (POP). It also looks into any pre and post-operative factors responsible for persistent postoperative OAB symptoms.
Methods: This was a retrospective cross-sectional study conducted at the Aga Khan University Hospital, Karachi between 1st January 2014 and 31st December 2018. In this study women presenting with POP and concommitent OAB who underwent surgery for site specific defects, measured using Pelvic Organ Prolapse Quantification (POP-Q) staging system. OAB …

Intraoperative Uses Of Near-Infrared Fluorescence Spectroscopy In Pediatric Surgery: A Systematic Review, Heba Alghoul, Farah Al Farajat, Osaid Alser, Andrea Rogers-Snyr, Carroll Harmon, Nathan Novotny

Conference Presentation Abstracts

No abstract provided.

Esophageal Magnamosis For The Treatment Of Type-B Esophageal Atresia In A Child With Prohibitive Operative Risk: A Novel Device And Indication., Irving J. Zamora, Muhammad Oa Ghani, Lauren L. Evans, Nathan M. Novotny, Lyndy J. Wilcox, Harold N. Lovvorn, Kristina A. Betters, Mohammad Sahlabadi, Matthew R. Lucas, Jeffrey S. Upperman, Oliver J. Muensterer, Michael R. Harrison

Conference Presentation Abstracts

No abstract provided.

Patients’ Perceptions And Understanding Of Pre-Operative Informed Consent In Tertiary Care Setting- Dar-Es-Salaam, Steven Michael Esanju

Master of Medicine in General Surgery

Background: Informed consent under the ethical principle of autonomy demonstrates patient’s agreement to have procedure/intervention done to them. Considering its importance in safeguarding human rights and autonomy, it is now mandatory to take informed consent before any surgery/procedure. Many studies have questioned whether informed consent is being taken in tr ue spirit that ensures proper understanding of the disclosed information or it is just adhered to as a medico legal formality. Globally, studies have demonstrated that majority of patients do not fully understand even small matters regarding their health i ncluding diagnosis, treatment modalities and possible associated risks, because of …

Isolated Volar Dislocation Of The Distal Radioulnar Joint Treated With Successful Closed Reduction., Matthew T Glazier, Hayden B Schuette, Benjamin A Schnee, Brian Skura, Craig Goubeaux

Surgery Articles

We report the case of A 34-year-old right-hand-dominant male who presented with an isolated left volar dislocation of the distal radioulnar joint (DRUJ) without any associated fractures. The patient had sustained the injury in an altercation in the evening prior to the presentation and had woken up the next morning with left wrist pain and restricted wrist motion. Closed reduction was successful under conscious sedation and the patient was treated conservatively with splint immobilization without needing operative intervention. This report highlights a rare injury pattern - an isolated volar DRUJ dislocation - that was successfully closed reduced, despite reports that …

Knowledge, Attitudes And Practice Of Venous Thromboembolism Risk Assessment Among Surgical Doctors In Tanzania, Biswalo Mugeta Yango

Master of Medicine in General Surgery

Introduction Surgical patients are at increased risk of venous thromboembolism due to the nature of their conditions and treatments. The incidence ranges from 61.3% to 64.9% in developed countries, compared to 43% in Africa. Although venous thromboembolism is fatal, it is potentially preventable. Physician-implemented risk assessment models reduce events by 70%. No country in sub-Sahara Africa has implemented a national venous thromboembolism risk assessment guideline. The subsequent burden is probably a reflection of low awareness and knowledge, negative attitudes, and substandard practice among physicians towards risk assessment. Justification In the current study, we assessed Tanzanian surgical doctors' knowledge, attitudes, and …