Surgery Commons^™

Pre-Operative Anxiety Related To Major Urogynecologicsurgery, Nadi Nina Kaonga, Mary C Brandes, Caroline Foust-Wright

Costas T. Lambrew Research Retreat 2022

Introduction •Higher levels of pre-operative anxiety are associated with adverse outcomes1-3(e.g., delayed recovery, higher post-op pain levels) •Most evidence arose from cardiothoracic and orthopedic literature (on emergent surgeries) and there is opportunity to further understand perioperative anxiety and elective/quality of life surgeries [within gynecology]4

Perioperative And Postoperative Outcomes Of Morbidly Obese Patients Undergoing Primary Elective Total Hip Arthroplasty With A Muscle Sparing Approach, Brian J. Mcgrory, George Babikian, Adam Rana

Costas T. Lambrew Research Retreat 2022

Obesity is associated with an increased risk of complications after total hip arthroplasty (THA), including infection and dislocation. •Due to the higher risk of osteoarthritis in obese individuals, understanding factors that can reduce the risk of complications is important. •This study examined the outcomes of morbidly obese (BMI ≥ 40) compared to healthy weight patients(BMI between 18.5-24.9 kg/m2)who underwent a THA with the ABLEapproach. •The ABLE approach: •This approach uses the interval between the anterior aspect of the gluteus mediusand the posterior aspect of the tensor fascia lata. •ABLE is minimally invasive, muscle sparing, and is associated with less painful …

Pain Management In Postoperative Pediatric Craniotomy Patients: A Scoping Review, Jessica M. Hiltenbrand Bsn, Rn, Sydney A. Scarbrough Bsn, Rn, Kaitlyn E. Shirley Bsn, Rn, Michelle Rickard Dnp, Cpnp-Ac

Doctor of Nursing Practice Projects

Purpose/Background The pediatric craniotomy procedure is a complex and painful procedure that requires adequate pain management and frequent neurological assessments. Generally, evidence for pediatric pain management is severely lacking in research, and evidence for pediatric craniotomy patients is lacking even further. This scoping review aims to collect, condense, and review the current data in order to fuel future studies to establish more data, protocols, and evidence-based recommendations for analgesia in the pediatric craniotomy patient population.

Methods The studies selected were peer-reviewed, published in a medical or nursing journal, included study ages 0-21 years, or provided evidence on pediatric analgesia. Sources …

The Impact Of The Covid-19 Pandemic On Care Delivery And Quality Of Life In Lung Cancer Surgery, Dede K. Teteh, Jovani Barajas, Betty Ferrell, Ziaoke Zhou, Loretta Erhunmwunsee, Dan J. Raz, Jae Y. Kim, Virginia Sun

Health Sciences and Kinesiology Faculty Articles

Background

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (COVID-19) pandemic and associated restrictions have altered the delivery of surgical care. The purpose of this study was to explore the impact of COVID-19 on care delivery and quality of life (QOL) from the perspectives of lung cancer surgery patients, family caregivers (FCGs), and thoracic surgery teams.

Methods

Patients/FCGs enrolled in a randomized trial of a self-management intervention for lung cancer surgery preparation/recovery were invited to participate in this qualitative study. Patients/FCGs data were collected separately 1-month postdischarge. Interviews were also conducted with thoracic surgery team members. Content analysis approaches were …

Hand Surgery Patient Perspectives On Medical Cannabis: A Survey Of Over 600 Patients, Lilah Fones, Clay Townsend, Harry Hoyen, Frederic Liss, Mark L. Wang, Ari C. Greis, Asif M. Ilyas

Rothman Institute Papers

Purpose: Medical cannabis (MC) has been proposed as a potential addition to multimodal pain man- agement regimens in orthopedics. This study evaluates hand and upper-extremity patient perspectives of MC as a treatment for common orthopedic and musculoskeletal pain conditions. This study also aims to identify the proportion of patients already using MC, perceived barriers to MC use, and opinions on insurance coverage and legality of cannabis.

Methods: An anonymous cross-sectional survey study was conducted of all patients at least 18 years old presenting from October 2020 to January 2021 to a hand and upper-extremity outpatient clinic. The survey collected information …

Advancements In Left Ventricular Assist Devices To Prevent Pump Thrombosis And Blood Coagulopathy, Grainne Malone, Gerges Abdelsayed, Fianait Bligh, Fatma Al Qattan, Saifullah Syed, Prateepan Varatharajullu, Augustin Msellati, Daniela Mwipatayi, Maimoona Azhar, Saulat Hasnain Fatimi

Section of Cardiothoracic Surgery

Mechanical circulatory support (MCS) devices, such as left ventricular assist devices (LVADs) are very useful in improving outcomes in patients with advanced-stage heart failure. Despite recent advances in LVAD development, pump thrombosis is one of the most severe adverse events caused by LVADs. The contact of blood with artificial materials of LVAD pumps and cannulas triggers the coagulation cascade. Heat spots, for example, produced by mechanical bearings are often subjected to thrombus build-up when low-flow situations impair washout and thus the necessary cooling does not happen. The formation of thrombus in an LVAD may compromise its function, causing a drop …

Pnc-27, A Chimeric P53-Penetratin Peptide Binds To Hdm-2 In A P53 Peptide-Like Structure, Induces Selective Membrane-Pore Formation And Leads To Cancer Cell Lysis, Ehsan Sarafraz-Yazdi, Stephen Mumin, Diana Cheung, Daniel Fridman, Brian Lin, Lawrence Wong, Ramon Rosal, Rebecca Rudolph, Matthew Frenkel, Anusha Thadi, William F. Morano, Wilbur B. Bowne, Matthew R. Pincus, Josef Michl

Department of Surgery Faculty Papers

PNC-27, a 32-residue peptide that contains an HDM-2 binding domain and a cell-penetrating peptide (CPP) leader sequence kills cancer, but not normal, cells by binding to HDM-2 associated with the plasma membrane and induces the formation of pores causing tumor cell lysis and necrosis. Conformational energy calculations on the structure of PNC-27 bound to HDM-2 suggest that 1:1 complexes form between PNC-27 and HDM-2 with the leader sequence pointing away from the complex. Immuno-scanning electron microscopy was carried out with cancer cells treated with PNC-27 and decorated with an anti-PNC-27 antibody coupled to 6 nm gold particles and an anti-HDM-2 …

Targeted Therapy In The Management Of Modern Craniopharyngiomas, Maikerly Reyes, Mohammad Taghvaei, Siyuan Yu, Anish Sathe, Sarah Collopy, Giyarpuram Prashant, James J. Evans, Michael Karsy

Department of Neurosurgery Faculty Papers

Background: The proximity of craniopharyngiomas (CPs) to critical neurovascular structures can lead to a host of neurologic and endocrine complications that lead to difficulty with surgical management. In this review, we examine the molecular and genetic markers implicated in CP, their involvement in tumorigenic pathways, and their impact on CP prognosis and treatment.

Methods: We undertook a focused review of relevant articles, clinical trials, and molecular summaries regarding CP.

Results: Genetic and immunological markers show variable expression in different types of CP. BRAF is implicated in tumorigenesis in papillary CP (pCP), whereas CTNNB1 and EGFR are often overexpressed in adamantinomatous …

Optimizing The Performance And Treatment Of The Female Athlete, Sommer Hammoud, Robin V. West

Department of Orthopaedic Surgery Faculty Papers

No abstract provided.

What Did We Learn About Vads In 2021?, Maya Guglin

The VAD Journal

This is our 8th annual literature review on mechanical circulatory support (MCS) devices.

Our previous reports were well received by the readers. The full text of the reviews for 2014, 2015, 2016, 2017, 2018, 2019, and 2020^1-7 were downloaded 821, 861, 701, 869, 951, 272, and 365 times, respectively.

In this review, we summarized the most interesting and important, from our standpoint, publications from 2021. There may be some slight overlap with the end of 2020 because some papers were published online first, and the year of the publication changed when they became …

“Cystectomy…What Bugs You?” Creation Of An Institutional Antibiogram, Erin Santos

Costas T. Lambrew Research Retreat 2022

BACKGROUND: Radical cystectomy is associated with high rates of post operative morbidity and mortality to improve readmission rates following radical cystectomy, a post cystectomy discharge pathway was created. We set out to create an institution specific antibiogram to identify and target most common causative organisms to specifically decrease genitourinary infection related complications.

Multi-Modality Breast Mri Segmentation Using Nn-Unet For Preoperative Planning Of Robotic Surgery Navigation, Motaz Alqaoud, John Plemmons Md, Eric Feliberti Md, Facs, Krishnanand Kaipa, Siqin Dong, Gabor Fichtinger, Yimming Xiao, Michel Audette

Modeling, Simulation and Visualization Student Capstone Conference

Segmentation of the chest region and breast tissues is essential for surgery planning and navigation. This paper proposes the foundation for preoperative segmentation based on two cascaded architectures of deep neural networks (DNN) based on the state-of-the-art nnU-Net. Additionally, this study introduces a polyvinyl alcohol cryogel (PVA-C) breast phantom based on the segmentation of the DNN automated approach, enabling the experiments of navigation system for robotic breast surgery. Multi-modality breast MRI datasets of T2W and STIR images were acquired from 10 patients. Segmentation evaluation utilized the Dice Similarity Coefficient (DSC), segmentation accuracy, sensitivity, and specificity. First, a single class labeling …

Comprehensive Analysis Of Opioid Use After Common Elective Outpatient Orthopaedic Surgeries, Michael U Okoli, Alexander J. Rondon, Clay B Townsend, Matthew Sherman, Asif M. Ilyas, Rothman Opioid Foundation

Rothman Institute Papers

Background: Prescription opioid abuse remains an ongoing public health crisis, especially in orthopaedic surgery. The purpose of the present study is to analyze opioid-prescribing patterns and investigate risk factors for prolonged opioid use after common outpatient orthopaedic surgical procedures.

Methods: After institutional review board approval, a review of 1,384 patients undergoing common elective outpatient orthopaedic procedures from January 2018 to June 2019 was conducted. Data on controlled substance prescriptions were obtained from the prescription drug monitoring program website. Statistical analysis was done to identify predictors for a second opioid prescription and prolonged opioid use (>6 months).

Results: Over 10% …

The Customized Therapeutic Approach Of A Giant Pancreatic Pseudocyst. A Case Report And Literature Review, Petrișor Banu, Bogdan Socea, Daniela Gabriela Balan, Vladimir Sandu, Tiberiu Onicel, Adrian Silaghi, Ioana Paunica, Vlad Denis Constantin

Journal of Mind and Medical Sciences

Giant pancreatic pseudocysts are considered those cysts whose dimensions exceed 10 cm and are sporadically reported in the literature. Although there are multiple treatment modalities, there are currently no treatment guidelines or consensus on the best therapeutic approach for giant pancreatic pseudocysts. We report the case of a 32-year-old male patient with a giant pancreatic pseudocyst after an episode of acute pancreatitis, which was treated by internal surgical drainage through cyst-jejunal anastomosis. This surgical procedure was followed by the formation of a retroperitoneal abscess which was resolved by ultrasound-guided drainage. The subsequent evolution of the patient was favorable, without other …

Asymptomatic Jejunal Metastatic Melanoma. A Case Report Of Anemia Of Uncertain Origin, Cornelia Nitipir, Andreea Parosanu, Cristina Orlov-Slavu, Cătălin Piriianu, Radu Vrabie, Iulian Slavu, Valentin Calu

Journal of Mind and Medical Sciences

Gastrointestinal metastases from cutaneous melanoma are rare and usually asymptomatic, with most patients not being clinically diagnosed throughout their lifetime. We report a case of how melanoma may metastasize insidiously in the small bowel. Unexplained iron deficiency anemia was assumed to be the result of underlying gastrointestinal bleeding. Therefore, the diagnosis of jejunal metastasis from cutaneous melanoma was suggested based on imaging findings and made through the histopathological examination. According to the international guidelines, the patient underwent the complete excision of the primary tumor and therapeutic lymph node dissection. Furthermore, an adjuvant treatment was required to reduce the risk of …

Transabdominal Pre-Peritoneal Repair Procedure (Tapp) Versus Open Hernia Repair (Ohr) In The Treatment Of Inguinal Hernia, Victor Dumitrescu, Dan Dumitrescu, Paul Lorin Stoica, George Draghici, Alexandru Chirca

Journal of Mind and Medical Sciences

Inguinal hernia is a common condition, with about 30% of men and 6% of women developing this condition throughout their lifetime. Laparoscopic hernia repair procedures have become more and more important lately, due to the advantages of a fast recovery and reduced postoperative pain. The paper presents our clinical experience involving the TAPP repair procedure, compared to open hernia repair (OHR). We retrospectively compared our first 50 cases comprising patients who underwent the TAPP hernia repair procedure between January 2018 and June 2020, with 50 cases who underwent the OHR procedure in the same period. The total operation duration was …

The Surgical Management Of Pancreatic Pseudocysts – Outcomes On A Group Of Seven Patients, Mihai Faur, Andrei Moisin, Alexandru Dan Sabau, Dan Sabau

Journal of Mind and Medical Sciences

The pancreatic pseudocyst represents the main complication that occurred 3 to 6 weeks after an outbreak of acute or chronic pancreatitis represented by a collection containing pancreatic enzymes without their own epithelial wall. In the present paper, we present a study performed on 7 patients admitted to the Surgical Department of Sibiu County Emergency Clinical Hospital who were diagnosed with pancreatic pseudocyst between 2016 and 2020, and the drainage of the mini-invasive pancreatic pseudocyst by an incision in the right lumbar area, in the case of a 53-year-old patient known to have a history of multiple cardiac defects, the pancreatic …

Pain Management In The Right Iliac Fossa During The Covid-19 Pandemic, Daniel Ovidiu Costea, Lucian Serbanescu, Diana Badiu, Valeriu Ardeleanu, Cristian Mihai Branescu, Anca Zgura, Andreea Cristina Costea

Journal of Mind and Medical Sciences

Abdominal pain in the right iliac fossa in women may be caused by a complicated ovarian cyst, adnexitis, and appendicitis. The paper analyses the characteristics of patients with right iliac fossa pain admitted during the Covid-19 pandemic. A retrospective analysis on 25 cases with abdominal pain in the right iliac fossa admitted to “St. Apostol Andrei” Emergency County Clinical Hospital Constanta, Romania between March 2020 and March 2021 was performed. In 52% of the cases, the symptomatology remitted with antispasmodics, 4 (16%) patients had cystic torsion and right adnexectomy (group A, without adnexa), 6 (24%) patients had ruptured cysts and …

Colonic Diverticulosis - Diagnostic And Therapeutic Difficulties, Cristian Meșină, Theodor Viorel Dumitrescu, Mihai Calin Ciorbagiu, Cosmin Vasile Obleaga, Ionica Daniel Vilcea, Mihaela Iustina Mesina-Botoran

Journal of Mind and Medical Sciences

Objectives. The objectives of this study are to highlight the diagnostic and therapeutic difficulties in patients with complicated acute colonic diverticulosis. Methods. The study group comprised 40 patients hospitalized to the Second Surgical Clinic of the Emergency County Hospital in Craiova, Romania, through the emergency service between 2015 and 2021. Regarding the sex distribution of the patients with colonic diverticular disease studied, there was a predominance of males. The distribution of patients was as follows: 22 patients with acute colonic diverticulitis, out of whom 21 patients suffered from left acute colonic diverticulitis and 1 patient suffered from right acute colonic …

Laparoscopic Versus Open Surgical Treatment Of Umbilical Hernia, Andrei Moisin, Mihai Faur, Carmen Popa, Claudia Diana Gherman, Victor Dumitrescu, Denisa Tanasescu, Adrian Boicean, Simona Balasescu, Meda Comandasu, Dan Dumitrescu, Anca Zgura, Calin Mohor

Journal of Mind and Medical Sciences

Umbilical hernia is one of the types of ventral hernias of the abdominal wall and it represents the externalization of a part of the abdominal contents through a defect of the anterior abdominal wall located in the umbilical region. It is estimated that more than 20 million abdominal wall hernia surgeries are performed worldwide each year. The paper presents a retrospective study on the patients diagnosed with umbilical hernia and admitted to the First and Second Surgery Departments of the Sibiu County Emergency Clinical Hospital. The study includes 82 cases diagnosed with umbilical hernias over a period of 4 years, …