Surgery Commons^™

Do Cervical Spine Injuries Require Airway Monitoring In The Surgical Intensive Care Unit?, Nikki Rimlinger, Tom Parker, Sujay Deshpande, Kyle Yang, Alison Muller Msph, Mls, Anthony Martin Rn, Bsn, Tcrn, Adrian Ong Md, Eugene F. Reilly Md, Mhci, Christopher A. Butts Phd, Do

Tower Health Research Day

No abstract provided.

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 …

Early Postoperative Intraocular Pressure Profile Following Micropulse Vs Continuous Wave Transscleral Cyclophotocoagulation: Cohort Study, Wesam S. Shalaby, Amirmohsen Arbabi, Jae-Chiang Wong, Aakriti G. Shukla, Reza Razeghinejad, Daniel Lee, Marlene R. Moster, Jonathan S. Myers, Natasha N. Kolomeyer

Wills Eye Hospital Papers

Aim: To compare the risk of early intraocular pressure (IOP) spikes following micropulse (MP) vs continuous wave (CW) transscleral cyclophotocoagulation (CPC).

Methods: Single-center, prospective, nonrandomized study that included glaucoma patients planned for MP- or CW-CPC at Wills Eye Hospital (2020–2021). IOP was measured using rebound tonometry (iCare) immediately before, immediately after, and 1 hour after the CPC, then on postoperative day 1. The primary outcome measure was the incidence of IOP spikes, defined as IOP elevation ≥10 mm Hg vs baseline. Patients with severe IOP spikes received IOP-lowering agents (topical or oral).

Results: Twenty-six eyes (15 CW and 11 MP) …

A Workflow Enabling The Automated Synthesis, Chain-End Degradation, And Rapid Mass Spectrometry Analysis For Molecular Information Storage In Sequence-Defined Oligourethanes, Julia R Shuluk, Christopher D Wight, James R Howard, Mary E King, Sarah R Moor, Rachel J Dehoog, Samuel D Dahlhauser, Livia S Eberlin, Eric V Anslyn

Faculty, Staff and Students Publications

The field of molecular information storage has recently expanded to include abiotic sequence-defined polymers. While robust methods have been developed, there is a current bottleneck in the throughput of this work as information density is increased. Herein, we introduce an automated workflow in which a commercial peptide synthesizer composed of a single XYZ liquid-handling robot was adapted to both synthesize and sequence sequence-defined oligourethanes. Our sequencing method was improved to cut down the number of samples required for each oligomer from 13 to one. Additionally, we introduce the use of desorption electrospray ionization mass spectrometry as our analysis method for …

Stingers—A Review Of Current Understanding And Management, Teleale Gebeyehu, James Harrop, Stavros Matsoukas, Alexander Vaccaro

Department of Neurosurgery Faculty Papers

Abstract: A stinger is the transient sensory and motor loss of one upper extremity caused by a stretch or compression injury to the brachial plexus or the exiting cervical nerve roots. Athletes from contact sports like American football, rugby, wrestling, and horseback riding are most affected. Given today’s competitive athletic culture and recent advancements in sports medicine, understanding the clinical, diagnostic, and therapeutic aspects of stingers is crucial. Thus, this narrative review highlights current knowledge of pathology, clinical features, diagnostic modalities, radiologic measurements, management, rehabilitation, and return-to-play protocols. Recent and prominent English publications on adult athletes revealed that the brachial …

Prediction Of Persistent Incomplete Occlusion Of Intracranial Aneurysms Treated With Woven Endobridge Device, Muhammed Amir Essibayi, Mohamed Sobhi Jabal, Hasan Jamil, Hamza Adel Salim, Basel Musmar, Nimer Adeeb, Mahmoud Dibas, Nicole M. Cancelliere, Jose Danilo Bengzon, Oktay Algin, Sherief Ghozy, Sovann V. Lay, Adrien Guenego, Leonardo Renieri, Joseph Carnevale, Guillaume Saliou, Panagiotis Mastorakos, Kareem El Naamani, Eimad Shotar, Markus Möhlenbruch, Michael Kral, Charlotte Chung, Mohamed M. Salem, Ivan Lylyk, Paul M. Foreman, Hamza Shaikh, Vedran Župančić, Muhammad U. Hafeez, Joshua Catapano, Muhammad Waqas, Muhammed Said Besler, Yasin Celal Gunes, James D. Rabinov, Julian Maingard, Clemens M. Schirmer, Mariangela Piano, Anna L. Kühn, Caterina Michelozzi, Robert M. Starke, Ameer Hassan, Mark Ogilvie, Anh Nguyen, Jesse Jones, Waleed Brinjikji, Marie T. Nawka, Marios Psychogios, Christian Ulfert, Bryan Pukenas, Jan-Karl Burkhardt, Thien Huynh, Juan Carlos Martinez-Gutierrez, Sunil A. Sheth, Diana Slawski, Rabih Tawk, Benjamin Pulli, Boris Lubicz, Pietro Panni, Ajit S. Puri, Guglielmo Pero, Eytan Raz, Christoph J. Griessenauer, Hamed Asadi, Adnan Siddiqui, Elad I. Levy, Deepak Khatri, Neil Haranhalli, Andrew F. Ducruet, Felipe C. Albuquerque, Robert W. Regenhardt, Christopher J. Stapleton, Peter Kan, Vladimir Kalousek, Pedro Lylyk, Srikanth Boddu, Jared Knopman, Stavropoula I. Tjoumakaris, Hugo H. Cuellar-Saenz, Pascal Jabbour, Frédéric Clarençon, Nicola Limbucci, Vitor Mendes Pereira, Aman B. Patel, David J. Altschul, Adam A. Dmytriw, Worldwideweb Consortium Collaborators

Department of Neurosurgery Faculty Papers

While the Woven EndoBridge (WEB) device has transformed the treatment of wide-neck intracranial aneurysms, incomplete occlusion remains a significant challenge requiring better understanding of contributing factors. A retrospective analysis was conducted on multicenter data from patients who underwent WEB device treatment for intracranial aneurysms between January 2011 and December 2022. Using machine learning models, Cox regression, and time-stratified analyses, we evaluated factors associated with persistent incomplete occlusion, defined as non-improving Raymond-Roy Occlusion Classification grade 2 or 3 at final follow-up. Among 813 patients (607 with < 24 months follow-up, 206 with ≥ 24 months), machine learning analysis identified aneurysm height, Acom location, neck diameter, and pretreatment mRS as predictors of persistent incomplete occlusion. On Cox regression. larger aneurysm neck diameter (HR 1.13, 95% CI 1.01-1.27, p = 0.027) and height (HR 1.14, 95% CI 1.02-1.26, p = 0.017), and radial …

Intraoperative Code Status: Moving From Misinformation To Respect For Patient Autonomy, Jacob Applegarth, Jacob M. Morton, Nathan M. Novotny, Ngan Nguyen, Abram Brummett

Conference Presentation Abstracts

Introduction: Intraoperative code status represents a complicated topic for patients and providers. Prior studies demonstrated a lack of understanding of intraoperative code status, specifically do not resuscitate (DNR) orders. This misunderstanding appears common despite clear professional recommendations. A recent survey of surgery residents at our institution showed variability in understanding of intraoperative code status policy despite clear institutional guidelines. Few studies utilized simulated education for surgeons and surgical residents to navigate intraoperative DNR status. This project aims to create a simulation-based program for residents to navigate intraoperative DNR status ethically and to assess its impact on learning, practice patterns and …

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 …

Comparing Postoperative Opioid Use In Primary And Revision Lumbar Fusion: A Propensity-Matched Analysis, Jonathan Dalton, Jarod Olson, Nicholas B. Pohl, Rajkishen Narayanan, Omar Tarawneh, Yunsoo Lee, Michael V. Carter, Gokul Karthikeyan, Logan Witt, Aayush Mehta, John J. Mangan, Mark F. Kurd, Jose A. Canseco, Alan S. Hilibrand, Alex R. Vaccaro, Gregory D. Schroeder, Christopher K. Kepler

Department of Orthopaedic Surgery Faculty Papers

OBJECTIVE: This study compared postoperative opioid use for patients undergoing short segment primary versus revision lumbar fusion.

METHODS: Patients who underwent primary or revision 1-2 level lumbar fusion (2017-2021) were included in this study. The state Prescription Drug Monitoring Program was reviewed for all patients to quantify preoperative and postoperative opioid, benzodiazepine, muscle relaxant, and gabapentin use. A 1:1 propensity match was performed to match primary lumbar fusion patients with revision lumbar fusion patients. Revision lumbar fusion patients were substratified into those with or without persistent postoperative opioid use to identify demographic differences between these patient cohorts.

RESULTS: The final …

Should Proximal Fixation Be At C2 Or C3-C4? An Application Of The Operative Value Index For Elective Posterior Cervical Decompression And Fusion, Advith Sarikonda, D. Mitchell Self, Danyal Quraishi, Ashmal Sami, Emily L. Isch, Steven Glener, Joshua Heller, Srinivas Prasad, Ashwini Sharan, Jack Jallo, Alex R. Vaccaro, James Harrop, Ahilan Sivaganesan

Department of Neurosurgery Faculty Papers

BACKGROUND: There is clinical equipoise regarding the ideal upper instrumented vertebrae (UIV) for elective posterior cervical decompression and fusion (PCDF). Instrumentation may be performed at the axial C2 level, or at the subaxial C3/C4 vertebrae. To our knowledge, a true "value" (outcomes per dollar spent) comparison axial versus subaxial UIV for PCDF has never been performed.

METHODS: We retrospectively identified 275 long-segment (≥3-levels fused) PCDFs with available Neck Disability Index (NDI) scores at baseline and at 3 months postoperatively. C2 UIV (n = 67) was compared to C3/C4 UIV (n = 208). Time-driven activity-based costing was applied to identify the …

Preoperative Brain Volume Loss Is Associated With Postoperative Delirium In Advanced Heart Failure Patients Supported By Left Ventricular Assist Device, Iván Murrieta-Álvarez, Jacob P Scioscia, José M Benítez-Salazar, Jason Uwaeze, Zicheng Xu, Guangyao Zheng, Shiyi Li, Vladimir Braverman, Carl P Walther, Alexis E Shafii, Camila Hochman-Mendez, Todd K Rosengart, Kenneth K Liao, Nandan K Mondal

Faculty, Staff and Students Publications

Delirium is a common neurological complication in patients with advanced heart failure (ADHF) following left ventricular assist device (LVAD) implantation, significantly impacting recovery. This study aimed to analyze non-contrast computed tomography (CT) scans of the brain in ADHF patients undergoing LVAD implantation to determine the association between pre-existing brain atrophy and postoperative delirium. A study involving 166 ADHF patients was conducted from March 2020 to July 2023. Non-contrast CT scans were analyzed using advanced quantitative neuroimaging techniques before implantation. The primary marker assessed was the lateral ventricle fraction (LVF), with secondary markers including cortical gray matter fraction (cGMF), white matter …

A Perspective On Reoperations After Surgical Treatments Of Degenerative Lumbar Diseases, Guoan Li, Won Man Park, Thomas Cha

Abington Jefferson Health Papers

Clinical data including reoperation rates are comparable for lumbar patients after decompression-alone or decompression-with-fusion surgeries. However, there could exist different mechanisms causing complications after the two surgeries. We discussed research and technology development perspectives for improvement of the surgeries using published clinical outcome data.

Are Mildly Disabled Patients Appropriate For Spine Bundles? An Application Of The Operative Value Index, Advith Sarikonda, Ashmal Sami, D. Mitchell Self, Emily Isch, Alexander Zavitsanos, Antony A. Fuleihan, Ayra Khan, Conor Dougherty, Danyal A. Quraishi, Jack Jallo, Joshua Heller, Srinivas K. Prasad, Ashwini Sharan, James Harrop, Alex R. Vaccaro, Ahilan Sivaganesan

Department of Neurosurgery Faculty Papers

BACKGROUND: Many studies have evaluated the effect of preoperative disability status on functional outcomes following spine surgery. However, no research has compared the "value" (outcomes per dollar spent) of surgery for patients with different levels of diagnosis-specific disability.

METHODS: We retrospectively reviewed 429 patients who underwent neurosurgical anterior cervical discectomy and fusion. Time-driven activity-based costing was used to calculate total intraoperative costs. Neck Disability Index (NDI) scores were recorded at baseline and 3 months postsurgery. Patients were categorized into groups based on their preoperative NDI score. Our primary outcome was a novel Operative Value Index (OVI), defined as the percent …

Epigastric Hernia Containing Incarcerated Gallbladder, Katelyn R. Ward, Melanie Ermler, Kathryn M. Ziegler

Conference Presentation Abstracts

Introduction: Epigastric hernias represent 1.6–3.6% of all abdominal hernias, and usually contain preperitoneal fat and occasionally omentum or small bowel. Rarely, epigastric hernias may contain portions of other organs, such as colon or stomach. We report an unusual case of a patient whose incarcerated epigastric hernia contained her stone-filled gallbladder.over a million performed in the US, and over 20 million worldwide annually. We aim to study and compare interest trends in the US and the World for IHR techniques (open, laparoscopic, robotic) using GT. Methods: The following search topics were analyzed from January 2010 to August 2024 in ‘‘US’’ and …

Left Behind: A Rare Case Of True Gallbladder Sinistroposition And Surgical Implications, Daniel Finn, Jacob Applegarth, Jacob Mesiti, Mario Villalba

Conference Presentation Abstracts

Objectives: Encountering aberrant biliary anatomy is a known risk factor for inadvertent injury while performing biliary surgery. One described anatomic aberrancy, sinistroposition of the gallbladder (also known as ‘‘left sided gallbladder’’), is a rarely seen anatomic abnormality with an incidence of 0.2% to 1.1%. Given the infrequent encounters with this abnormality and its association with other anatomic anomalies, extreme care and caution should be exercised when performing a cholecystectomy in this patient population. Methods: We present the case of a 37-year-old male who presented with abdominal pain and was diagnosed with Tokyo Grade I acute calculous cholecystitis. An ultrasound of …

Two-Dimensional Preoperative Digital Templating Is Less Accurate When Using A Collared Triple Taper Stem Versus A Single Taper Design, Claudio Diaz-Ledezma, Angel X. Xiao, Juan David Lizcano, Erik N. Hansen, Camilo Restrepo, William J. Hozack

Rothman Institute Papers

Background

Collared triple taper stems (CTTS) and single taper stems (STS) have an excellent performance in primary total hip arthroplasty (THA). While 2-dimensional radiographic templating is accurate for STS, data are lacking for CTTS. We hypothesize that CTTS’ more anatomical design in the anteroposterior dimension may lead to inaccurate templating sizing. This study compared templating accuracy of CTTS to a predecessor STS in THA patients.

Methods

106 THA performed with CTTS were compared to 106 THA performed with STS by 2 high-volume surgeons. The stems chosen for comparison were manufactured by the same company, use the same templating software, shared …

Changes In Matches Into Surgical Residencies And Fellowships Following The Acgme Merger., Sara S Soliman, Gabrianna Andrews, Salma Emara, Naomi Watkins-Granville, Alicia Podwójniak, Iman Hasan, Jha Stuti, Alissa Brotman

Rowan-Virtua School of Osteopathic Medicine Departmental Research

OBJECTIVE: In 2015, a transition was initiated among the Accreditation Council for Graduate Medical Education (ACGME), American Osteopathic Association (AOA), and American Association of Colleges of Osteopathic Medicine (AACOM), resulting in a single accrediting body for residencies and fellowships as of 2020. This study aims to elucidate whether this had an impact on osteopathic students' matching into general surgery residencies, integrated surgery residencies, and surgical fellowships.

DESIGN, SETTING, AND PARTICIPANTS: Using the Results and Data Residency Match data file and the Results and Data: Specialties Matching Service data from the National Resident Matching Program from 2015 to 2024, data was …

Investing In Limb Preservation: A Case Report In Avoiding Bilateral Amputation In A Vasculopathy Patient, Stephanie N. Campbell, Craig J. Verdin, Heather V. Tran, Nikita Gambhir

Research Symposium

Background: Limb salvage and prosthetics play vital roles in restoring function and mobility for patients with severe injuries or metabolic conditions. Limb salvage involves surgical techniques aimed at preserving a limb rather than resorting to amputation, while prosthetics provide artificial devices to replace lost limbs. Key considerations for limb salvage include restoring a functional foot, maintaining patient independence, minimizing hospitalizations, and avoiding bilateral lower limb amputations.

Case Presentation: The patient, already at single-limb status, presented with a necrotic heel ulcer, exposed calcaneus, and necrotic Achilles tendon. After vascular optimization, the risks and benefits of final aggressive measures were discussed, leading …

Assessing Patient Satisfaction: The Role Of Net Promoter Scores In Healthcare, Paul Bonilla, Victoria Elizondo, Juan Pablo Flanagan

Research Symposium

Background: The Net Promoter Score (NPS) is a widely used tool for measuring customer satisfaction and loyalty through a simple question: “How likely are you to recommend [company name] to a friend or colleague?” Responses categorize individuals as Promoters (9–10), Passives (7–8), or Detractors (0–6), with the final score calculated by subtracting the percentage of Detractors from Promoters. Introduced in 2003, NPS has become popular across industries for its simplicity, predictive value, and benchmarking capabilities. In healthcare, NPS adoption is increasing as hospitals seek concise, standardized tools to assess patient satisfaction—an essential metric in the shift toward value-based care. …

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 …

Outcomes Of Double Free Flap Reconstruction For Advanced Head And Neck Tumors In A Safety-Net Hospital Population, Yossef Alsabawi, John M. Gaddis, Angela D. Haskins, Jonathan Shum, David J. Hernandez

Research Symposium

Background: Double-free flap reconstruction has emerged as a viable option for addressing more complicated defects after oncologic resection. We aim to report the feasibility of this approach at a single-institutional safety net hospital.

Methods: A retrospective chart review was performed between November 2020 and October 2023 for adult patients who underwent multiple, simultaneous free tissue transfers for head and neck defects following tumor resection. This study occurs at Ben Taub Hospital, a safety net hospital in Houston, Texas. Data collected included demographics, risk factors, oncologic and operative details, complications, and functional and disease outcomes. Socioeconomic status was assessed …

Symptomatic Manifestations Of Hip Dysplasia In Young Adults: How Do Patients Present Before And After Surgery?, John M. Gaddis, Amanda Wheeler, Yossef Alsabawi, Erika Shults, Charles South, Joel E. Wells

Research Symposium

Background: Hip dysplasia is a common source of hip pain in young adults that can lead to early-onset osteoarthritis. The Bernese periacetabular osteotomy (PAO) and total hip arthroplasty (THA) have shown good results as surgical treatment options for this disorder, yet pain may persist after surgery. A previous study described the clinical features of pre-treated hip dysplasia in a traditional clinical cohort; however, to our knowledge, no previous studies have examined the symptomatic manifestations of hip dysplasia in young adults before and after various surgical treatments including the analysis of pain locations in numerous anatomical areas through a body pain …

Staged Reconstruction And Salvage Of 5th Finger With Corticocancellous Distal Radius Autograft: A Case Report, Emmanuel Franco, Zayd Ayas, Frank Gerold

Research Symposium

Background: Finger reconstruction in the aftermath of severe trauma poses significant challenges in restorative surgery, particularly when addressing extensive soft tissue damage, comminuted fractures, and simultaneous neurovascular complications. This study presents a case of a patient with a complicated distal phalangeal fracture that pursued digit salvage.

Case Presentation: Patient is a 31-year-old woman who sustained a severe injury to her right 5th digit during an ATV rollover. The trauma resulted in an exposed and comminuted fracture of the proximal phalanx with associated loss of soft tissues, flexor tendon, radial nerve injury, and vascular compromise. She elected to pursue digit salvage …

Intraoperative Imaging In Orthopedic Settings: An Assessment Of Changes In Adherence To Imaging Guidelines, Emmanuel Franco, Tabitha Abraham, Zayd Ayas, Frank Gerold

Research Symposium

Background: High-quality intraoperative photography is vital for treatment planning, patient counseling, and surgical education. Inconsistencies in image quality are prevalent in orthopedic literature due to the absence of formalized criteria specific to orthopedic settings. In 2014, "Medical Photography: Principles for Orthopedics" introduced guidelines intending to standardize protocols for capturing clinical images. By comparing the quality of images taken both before and after these proposed guidelines, this project aims to evaluate whether this has influenced a trend toward standardization and consistency in intraoperative orthopedic photography.

Methods: To assess quality differences in orthopedic images before and after the 2014 guidelines, 60 intraoperative …

Every Jump Is A Leap Of Faith-Just Ask Evel Knievel!, Vicente Orozco-Sevilla, Joseph S Coselli

Faculty, Staff and Students Publications

No abstract provided.

Enhancing Surgical Interest Through Pre-Clerkship Interventions: Insights For Student-Run Interest Groups, Anesu K. Murambadoro, Antoinette Burrell, Karina Zamora, Daniela Gonzalez, Theresa M. Biju, Paul Bonilla, Blake Martin, Ayesha Usman

Research Symposium

Background: The Association of American Medical Colleges (AAMC) projects a shortage of 10,100 to 19,900 surgeons by 2036. Despite the need for physicians in surgical specialties, exposure to surgical education remains limited to the third and fourth year, posing a barrier to fostering early interest in surgical careers. Medical school student interest groups (SIGs) may be an avenue to increase surgical exposure pre-clerkship curriculum. We seek to establish effective interventions that can be utilized by SIGs to increase and maintain surgical interest to the point of matriculation into surgical residency.

Methods: We conducted a systematic review using electronic databases, …

Spine Surgery In South Texas: The Impact Of Rurality On Surgeon Demographics And Access To Care, Anesu K. Murambadoro, Kevin Garcia Valdez, Patrick De La Torre Schutz, Allison J. Mcadams, Anjali Rose Binoy, Kelsey Baker

Research Symposium

Introduction: Female representation in spine surgery remains low, with only 4% of orthopedic spine surgeons and 9% of neurosurgeons identifying as female. Studies have shown that factors such as societal perceptions, limited support for family planning, and a lack of mentorship deter women from pursuing surgical careers. We hypothesize that representation may be further impacted in US-Border regions. Specifically, over 90% of Texas' 32 border counties lack sufficient primary care services, including specialty care such as orthopedic surgery and neurosurgery, leading residents to seek care outside the region. Here, we sought to evaluate the demographics of spine surgeons (orthopedic and …

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.

Pseudocholinesterase Deficiency In Ambulatory Surgery: A Case Report., Elizabeth Johnson-Gray, Austin J Shaffer, Priyanka Pandey, Greeshma Allareddy, Matthias Franzen

Surgery Articles

Pseudocholinesterase (PCHE) deficiency is a rare condition that results in increased sensitivity to certain medications, including the paralytic agents succinylcholine and mivacurium. PCHE deficiency typically presents when patients cannot be weaned off the ventilator because of residual paralysis. These patients require mechanical ventilation and sedation until they are strong enough to be safely extubated. This report presents the case of a 53-year-old male patient whose only known surgical and anesthetic complication was post-op nausea and vomiting and who was diagnosed with PCHE deficiency after he could not be safely extubated in the operating room (OR) after a robotic inguinal hernia …

Cilostazol After Endovascular Therapy For Femoropopliteal Peripheral Arterial Disease: A Systematic Review And Meta-Analysis, Christian D. Cerecedo, Aaron Silva, Valentine S. Alia, Ana Vargas, Alejandro Garza, Omar El Shazly, Alejandro J. Candil

School of Medicine Publications

Background

Endovascular therapy (ET) outcomes for femoropopliteal peripheral arterial disease (FP-PAD) remain suboptimal. Cilostazol therapy may improve patency rates and decrease major adverse limb events after ET for FP-PAD. Our goal was to analyze published studies evaluating the use of cilostazol after ET for FP-PAD.

Methods

We searched MEDLINE, EMBASE, and CENTRAL for randomized and observational studies (OSs) evaluating cilostazol therapy after ET for FP-PAD. We only included OSs adjusting for confounding variables. We analyzed observational and randomized studies separately and explored heterogeneity by estimating an I2 statistic. A fixed-effects model was chosen if the I2 statistic was low. If …