Surgery Commons^™

Routine Evaluation With Gastric Ultrasound To Reduce Gastric Aspiration (Regurga), Joel Jackson

Doctor of Nursing Practice Scholarly Projects

When a patient undergoes anesthesia, there are inherent risks that the providers should protect the patient from. Despite adherence to fasting guidelines established by the American Society of Anesthesiologists (ASA), patients undergoing anesthesia continue to experience intrapulmonary aspiration of gastric contents. There are several factors that delay gastric emptying, including coexisting disease, trauma, pain, and opioid use. Gastric ultrasound assessment of the gastric antrum is a relatively new technology in anesthesia and can be used to assess the gastric antrum and provide information to anesthesia providers regarding the risk of aspiration in the perioperative period. The primary aim of this …

A Clinical Review Of Antibiotic Therapy Versus Appendectomy For Treatment Of Acute Uncomplicated Appendicitis, Taylor Mcclard

SIU Journal of Medical Science Scholarly Works

Purpose: The purpose of this manuscript is to review the efficacy of antibiotic therapy in the treatment of acute uncomplicated appendicitis versus standard appendectomy.

Method: A PubMed literature search was conducted with keywords of acute appendicitis, antibiotics, and appendectomy. The publication date was limited to the last five years. Sample size less than 100 people, patient population less than five years of age, and articles examining only acute complicated appendicitis were excluded. Pertinent articles reviewing the efficacy of antibiotics compared to appendectomy serve as the basis for this clinical review.

Results: Antibiotic therapy alone could be a …

Expedited Recovery Pain Management Pathway For Minimally Invasive Repair Of Pectus Excavatum (Mirpe), Maria E. Tecos, Jessica Goeller, Robert Cusick, Stephen Raynor

Graduate Medical Education Research Journal

Introduction: Pectus Excavatum (PEX) is the most common anterior chest wall deformity. While minimally invasive repair of pectus excavatum (MIRPE) has improved perioperative outcomes, there continue to be opportunities to optimize postoperative pain management and reduce length of stay (LOS). We compared the impact of a multimodal expedited protocol utilizing a combination of systemic and regional analgesia (with single shot paravertebral truncal blocks), along with coping techniques (such as meditation), and physical therapy, with systemic analgesia on LOS and opioid requirements.

Methods: 51 patients underwent MIRPE with an expedited recovery protocol in comparison with 112 historical control patients at a …

Partial Support In Chronic Heart Failure, Bart Meyns, Walter Droogne, Steven Jacobs

The VAD Journal

Partial left ventricular assist device (LVAD) support offers several advantages in treating chronic heart failure. It also raises concerns about insufficient support, worsening symptoms, and impediment of myocardial recovery. The clinical trial results for the CircuLite device (Medtronic) have shown that close monitoring can ensure improved outcomes for partial support. Another study on the ovine model demonstrated that partial and full support have similar effects regarding reverse remodeling. Thus, patients receiving partial LVAD support need regular follow-up care. Clinical assessment of symptoms and organ function must be used alongside objective judgment of patients’ needs to ensure support levels are appropriately …

Comparative Evaluation Of Scar Tissue From Chest Tube Wound Closure Using Knotless And Conventional Methods Using The Patient And Observer Scar Assessment Scale, Adrian N. Tangkilisan, Mendy H. Oley, Maximillian C. Oley, Claudia Loho, Wega Sukanto, Christha Zenithy Tamburian, Fima L.F.G. Langi

The New Ropanasuri Journal of Surgery

Introduction. Chest tube placement is widely practiced; most medical doctors can do this safely. However, releasing the chest tube can be a painful and challenging experience for the patient. A novel method has been developed with a new suture material that does not need to be knotted. The Patient and Observer Scar Assessment Scale (POSAS) provides objective and subjective scar assessment. This study aimed to compare the scars associated with chest tube release between the conventional and knotless methods.

Methods. The study was a controlled trial in which patients were divided into two groups. The scar assessment was …

Secondary Spontaneous Tension Pneumothorax: A Case Report Of An Uncommon Presentation Of Post-Tuberculosis Sequelae, Herick Alvenus Willim

The New Ropanasuri Journal of Surgery

Introduction. Tuberculosis (TB) remains one of the top life-threatening infectious diseases worldwide. Even after completion of treatment, numerous patients had post-TB sequelae as a consequence of lung damage during TB infection. We reported an uncommon case of secondary spontaneous tension pneumothorax in a patient with post-TB sequelae.

Case Presentation. A 68-year-old smoker man presented with sudden shortness of breath since 2 hours ago. He had a history of pulmonary TB 15 years ago which had completed antituberculosis treatment and had been experiencing symptoms associated with post-TB sequelae for the last 1 year. Physical examinations and chest X-ray showed tension pneumothorax. …

Factors Affecting The Survival Of Soft Tissue Sarcoma Patients Of The Extremities At Cipto Mangunkusumo Hospital, Indonesia, Erwin D. Yulian, Kezia M. Sinaga, Diani Kartini, Aria Kekalih

The New Ropanasuri Journal of Surgery

Introduction. The strategy for treating limb soft tissue sarcoma (STS) is challenging due to delayed diagnosis and the non-specific clinical picture, leading to the mortality of nearly 50% of newly diagnosed patients. Various therapeutic modalities have been applied to increase the survival of patients with extremity soft tissue sarcoma. However, clinicopathological factors can influence the survival rate and thus affect the effectiveness of therapy. This study aims to determine the numbers and factors influencing overall survival five years after treatment for patients with soft tissue sarcoma of the extremities at Dr. Cipto Mangunkusumo General Hospital (CMGH) in 2011-2015.

Method. A …

Abo Blood Group Type And The Risks Of Peripheral Artery Disease In Type Ii Diabetes Mellitus, Dedy Pratama, Adi N.D Puruboyo

The New Ropanasuri Journal of Surgery

Introduction. Peripheral artery disease (PAD) is a common complication of diabetes mellitus (DM), affecting up to 20% of people over 65. Blood type is hypothesized to influence PAD, although it has yet to be extensively studied. We aim to investigate the correlation between ABO blood group type and the severity of PAD in patients with type II DM.

Methods. We conducted a cross-sectional study on DM type II patients with PAD at the Cipto Mangunkusumo National Hospital in Indonesia between January 2022 to June 2022. PAD was diagnosed based on the ankle-brachial index (ABI) measurement. The PAD severity was grouped …

Seroma As A Biological Tissue Expander On Post-Mastectomy Reconstruction: A Case Report, Ahmad Kurnia, Fatahillah Muazdhani

The New Ropanasuri Journal of Surgery

Introduction. Previous studies have reported that patient satisfaction with breast cancer management is related to the success of breast reconstruction. The tissue expander used in breast reconstruction today has several disadvantages: the high cost, the nature of the foreign body, and the risk of failure. Seroma has the potential as a natural tissue developer in post-mastectomy reconstruction. This case report aims to describe the technique, results, advantages, and limitations of post-mastectomy breast reconstruction using a seroma as a natural tissue expander that has never been done before.

Case Presentation. A 37-year-old woman was diagnosed with stage IIIA non-special type (NST) …

Impact Of Advanced Trauma Life Support Training For Improving Mortality Outcome: A Systematic Review And Meta-Analysis, Afid B. Putra, Luthfian A. Nurachman, Bagus A. Suryawiditya, Muftah Risyaldi, Lam Sihardo

The New Ropanasuri Journal of Surgery

Introduction. The Global Burden of Disease Study has identified injuries as one of the top ten causes of death and disability worldwide. Injury is predicted to rise in the rankings by the year 2030. This study aimed to quantify the effectiveness of an Advanced Trauma Life Support (ATLS) training in improving mortality outcome after trauma injury.

Method. This is a systematic review (of experimental and observational studies) and meta-analysis, reporting mortality outcome from trauma injury between ATLS-trained/certified physicians vs non-ATLS-certified. We performed literature searching through 3 electronic databases, including Cochrane (CENTRAL), MEDLINE (PubMed), and Scopus.

Results. There are summarized results …

Effect Of Everolimus On The Liver Function Of Children Receiving Liver Transplant With Chronic Rejection: An Evidence–Based Case Report, Adi Nd Puruboyo, Tri H. Rahayatri, Marini Stephanie

The New Ropanasuri Journal of Surgery

Introduction. Chronic rejection, a complication after pediatric living donor liver transplantation (LDLT), is challenging to treat as management generally requires retransplantation. However, retransplantation is avoided because of rejection risks, longer operating time, higher mortality, and lower survival rates. Immunosuppressant therapy has potential as an option for nonsurgical treatment. Everolimus, a mammalian target of rapamycin inhibitors (mTOR inhibitors), is a well-known immunosuppressant in treating chronic rejection of LDLT. However, studies in the pediatric field remain minimum.

Method. The discussion was based on evidence found from studies found through a systematic literature search. These three studies showed permanent liver function improvement after …

State Of The Art Bowel Management For Pediatric Colorectal Problems: Functional Constipation., Elizaveta Bokova, Wendy Jo Svetanoff, John Rosen, Marc A. Levitt, Rebecca M. Rentea

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Functional constipation (FC) affects up to 32% of the pediatric population, and some of these patients are referred to pediatric surgery units to manage their constipation and/or fecal incontinence. The aim of the current paper is to report the recent updates on the evaluation and management of children with FC as a part of a manuscript series on bowel management in patients with anorectal malformations, Hirschsprung disease, spinal anomalies, and FC.

METHODS: A literature search was performed using Medline/PubMed, Google Scholar, Cochrane, and EMBASE databases and focusing on the manuscripts published within the last 5-10 years.

RESULTS: The first …

Bibliometric Analysis Of Spinopelvic Alignment In Total Hip Arthroplasty, Samantha Harrer, Justin A. Magnuson, Gregory R. Toci, Andrew M. Star, Arjun Saxena

Rothman Institute Faculty Papers

INTRODUCTION: Postoperative dislocation of unclear etiology remains a concern after total hip arthroplasty (THA). Interest is growing in the importance of spinopelvic alignment on stability in THA. The purpose of this study was to analyze publication trends, areas of interest, and future research direction of spinopelvic alignment in THA.

METHODS: Articles on the topic of spinopelvic alignment in THA published between 1990 and 2022 were obtained through Web of Science Core Collection of Clarivate Analytics (WSCCA). Results were screened by title, abstract, and full text. The inclusion criterion was English-language peer-reviewed journal publications on the clinical topic of spinopelvic alignment …

Highlights Of The 2022 Brano Heart Failure Forum: Part Two, Ugolino Livi, Rajko Radovancevic, Bojan Vrtovec, Igor D. Gregoric

The VAD Journal

Since 2007, the Branislav “Brano” Radovancevic Heart Failure Forum (BHFF) has been held annually to provide a venue for experts to present and discuss “Innovations and New Treatment Strategies in Heart Failure.” Clinicians and researchers gather yearly in a different Eastern European city to discuss the latest in heart failure diagnostics and therapeutics. The 2022 BHFF forum was held on the 6^th thru 8^th of September 2022 in Trieste, Italy. It was attended by over 94 faculty from 14 countries. In addition, participation through online streaming was available. Throughout the forum, 17 sessions focused on challenges and solutions …

Osteoporosis In The Setting Of Shoulder Arthroplasty: A Narrative Review, Mohammad Daher, Mohamad Fares, Peter Boufadel, Akshay Khanna, Ziad Zalaquett, Joseph A. Abboud

Rothman Institute Faculty Papers

Patients who undergo shoulder surgery are frequently affected by osteoporosis and osteopenia, and the prevalence of this association is expected to increase due to the growing number of elderly individuals undergoing these procedures. It may be advisable to conduct a preoperative DXA scan for orthopedic surgical candidates at high risk, to detect those who could benefit from early intervention and avoid any related adverse events. Some of these complications include periprosthetic fractures, infection, subsequent fragility fractures, and have an all-cause revision arthroplasty at 2 years post-op. Some studies analyzed the beneficence of antiresorptive medications pre-operatively but the latter did not …

The Dome Technique For Managing Massive Anterosuperior Medial Acetabular Bone Loss In Revision Total Hip Arthroplasty: Short-Term Outcomes, Tyler J. Humphrey, Colin M. Baker, P. M. Courtney, Wayne G. Paprosky, Hany S. Bedair, Neil P. Sheth, Christopher M. Melnic

Rothman Institute Faculty Papers

PURPOSE: The dome technique is a technique used in performance of revision total hip arthroplasty (THA) involving intraoperative joining of two porous metal acetabular augments to fill a massive anterosuperior medial acetabular bone defect. While excellent outcomes were achieved using this surgical technique in a series of three cases, short-term results have not been reported. We hypothesized that excellent short-term clinical and patient reported outcomes could be achieved with use of the dome technique.

MATERIALS AND METHODS: A multicenter case series was conducted for evaluation of patients who underwent revision THA using the dome technique for management of Paprosky 3B …

Radiologic And Histologic Findings Of Locally Advanced Mucoepidermoid Carcinoma Managed With Total Surgical Excision, Christopher R. Huber, Don Truong, Joseph Hatem, Joel Thompson, Bryan Scott

Advances in Clinical Medical Research and Healthcare Delivery

The present case report provides images from computed tomography and histology of a patient with a salivary gland neoplasm consistent with mucoepidermoid carcinoma.

3rd Jakarta Annual Surgical Symposia: Comprehensive Surgical Update Proceeding Abstracts, Scientific Committee Jass

The New Ropanasuri Journal of Surgery

Introduction. The need for arteriovenous fistula (AVF) as access to hemodialysis is increasing, but the failure rate of AVF maturity is also relatively high. Umbilical cord mesenchymal stem cells (MSCs) have anti-inflammatory properties that can occur in homeostasis, repair, and regeneration in pathological responses caused by vascular injury. This study aims to determine how administering cord mesenchymal stem cells (MSC) affects vascular maturity based on Doppler ultrasound examination in AVF rabbit models.

Method. An experimental study proceeded using a local male rabbit (Lepus Domestica). The administration of umbilical cord mesenchymal stem cells was applied in situ on AVF and intravenously. …

A Review Of The Current State Of Global Surgical Oncology And The Role Of Surgeons Who Treat Cancer: Our Profession’S Imperative To Act Upon A Worldwide Crisis In Evolution, Aaron C. Saunders, Miriam Mutebi, T. Subramanyeshwar Rao

General Surgery, East Africa

Worldwide, the capacity of healthcare systems and physician workforce is woefully inadequate for the surgical treatment of cancer. With major projected increases in the global burden of neoplastic disease, this inadequacy is expected to worsen, and interventions to increase the workforce of surgeons who treat cancer and strengthen the necessary supporting infrastructure, equipment, staffing, financial and information systems are urgently called for to prevent this inadequacy from deepening. These efforts must also occur in the context of broader healthcare systems strengthening and cancer control plans, including prevention, screening, early detection, safe and effective treatment, surveillance, and palliation. The cost of …

Ethical Perspectives On Surgical Video Recording For Patients, Surgeons And Society: Systematic Review, Ross Walsh, Emma C. Kearns, Alice Moynihan, Sara Gerke, Mindy Duffourc, Marcelo Corrales Compagnucci, Timo Minssen, Ronan A. Cahill

Faculty Scholarly Works

Background

Operating-room audiovisual recording is increasingly proposed, although its ethical implications need elucidation. The aim of this systematic review was to examine the published literature on ethical aspects regarding operating-room recording. Methods

MEDLINE (via PubMed), Embase, and Cochrane databases were systematically searched for articles describing ethical aspects regarding surgical (both intracorporeal and operating room) recording from database inception to the present (the last search was undertaken in July 2022). Medical subject headings used in the search included ‘operating room’, ‘surgery’, ‘video recording’, ‘black box’, ‘ethics’, ‘consent’, ‘confidentiality’, ‘privacy’, and more. Title, abstract, and full-text screening determined relevance. The quality of …