Surgery Commons^™

Radiologic And Histologic Findings Of Undifferentiated Sarcoma Treated With Radical Resection, Justina Kasteri, Stefan Johnson, Joseph Hatem, Joel Thompson

Advances in Clinical Medical Research and Healthcare Delivery

Case report of an 89-year-old patient presenting with a nontraumatic painless growing mass on the right thigh. This article presents the diagnostic imaging and histologic microscopic views of the mass following a radical resection. Further discussing the key findings to diagnose undifferentiated sarcomas as well as the clinical management.

Mirizzi Syndrome: A Case Report, Elizabeth Barr, Keng Moua, Kavitha Vemuri

Advances in Clinical Medical Research and Healthcare Delivery

Mirizzi syndrome is a rare complication of chronic gallstone disease that occurs when an impacted gallstone at the gallbladder infundibulum or cystic duct causes common extrinsic hepatic or common bile duct obstruction. Contrary to other gallstone pathologies where gallstones affect the respective location in which they are lodged, Mirizzi syndrome is unique in that it is characterized by extrinsic gallstone compression. Chronic gallstone disease most commonly leads to acute cholecystitis, acute cholangitis, or acute pancreatitis. The extrinsic compression of the common hepatic or common bile duct may lead to eventual erosion which increases the risk for a cholecystocholedochal or cholecystohepatic …

Rigid Sternal Fixation Alone Does Not Result In A Reduction In Postoperative Opiod Administration Following Cardiac Surgery, Jane Branch, Chinedu Okoli, Kyla Wigant, Jaime Rabb, Robert S. Kramer, Anne Hicks, Ansar Hassan

Costas T. Lambrew Research Retreat 2025

Background: Persistent postoperative pain, infection, and sternal dehiscence are devastating complications after cardiac surgery that affect patient quality of life and increase healthcare system burden. Chronic sternal pain lasting more than 1 year affects 25 to 33% of cardiac surgery patients, and wound complications such as infection and sternal nonunion represent significant peri-operative risk factors1,2. Wire cerclage (WC) is the most widely accepted sternal closure technique among cardiac surgeons because of its perceived lower rates of sternal dehiscence, wound infection, and cost.

Dexmedetomidine As An Adjunct To Local Anesthetics In Neuraxial Anesthesia: A Scoping Review, Meaghan Elrod, Jacob Flake, Sarah Eggers, Kieraney Coston, Dwayne Accardo Dnp, Crna, Faana

Doctor of Nursing Practice Projects

Purpose/Background

Neuraxial anesthesia is key for pain management and comfort during surgery. While local anesthetics and opioids have notable side effects, Dexmedetomidine (DEX) offers a promising alternative. Early studies suggest DEX improves pain control, prolongs anesthesia duration, and reduces opioid-related side effects. This review explores the benefits of incorporating DEX into neuraxial anesthesia for better patient safety and comfort

Methods

This scoping literature review took place from August 2023 to April 2024, utilizing PubMed, CINAHL, Cochrane Library, and Google Scholar for sources. After reviewing over 2,000 abstracts, 25 articles met the inclusion criteria, with nine selected as most relevant. Four …

History Of Bariatric Surgery Is Not Associated With Worse Clinical Outcomes At 5 Years In Patients Who Undergo Liver Transplantation, Do Han Kim Md, Donghyun Ko, Pedro Palacios Argueta Md, Wilhelm S. Basegoda Md, Jose A. Porres, Klaus E. Monkemuller, Paul T. Kroner Md

Posters

This study explores and compares outcomes of LT alone with LT in patients with a prior history of RYGB or SG, using a large multinational database.

Pancreatic Ascites: Update On Diagnosis And Management, Lefika Bathobakae, Heba Farhan, Derya Mücahit, Dina Rohira, Kashyap Chauhan, Yana Cavanagh, Walid Baddoura, Derick J Christian

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Pancreatic ascites is a rare condition characterized by the accumulation of high-amylase ascitic fluid in the peritoneal cavity. This condition is often associated with chronic pancreatitis, pancreatic trauma, or pseudocyst rupture. Because of its rarity and ill-defined clinical presentation, pancreatic ascites is often a diagnostic and therapeutic challenge in clinical practice. The current diagnostic criteria include an amylase level >1000 mg/dL, a protein level >3 g/dL, and a serum ascites albumin gradient < 1.1 g/dL. The clinical features vary, but may include progressive abdominal distension, diffuse abdominal pain, weight loss and peritonitis. The management of pancreatic ascites remains controversial, and there is no consensus regarding the optimal approach. Conservative medical management, which includes nutritional support, pain control, therapeutic paracentesis and the use of somatostatin analogs, has been associated with a high failure rate and significant morbidity. Interventional therapies, such as surgery and endoscopic transpapillary stenting, have shown more promising outcomes. However, the choice between these methods is still debated, with some advocating for endoscopic approaches, because of their minimally invasive nature and reduced morbidity compared with surgical options. Endoscopic approaches remain underutilized in practice, probably because of the need for repeated interventions, the potential risks associated with endoscopic retrograde cholangiopancreatography, or a lack of skilled personnel. Although they show significant perioperative morbidity and mortality, surgical options provide definitive resolution of pancreatic ascites. Herein, we provide an updated review of pancreatic ascites, highlighting advances in diagnostic techniques and therapeutic approaches, and summarizing insights from recent clinical cases and retrospective studies.

Impact Of Post-Operative Radiation Therapy On Survival In Nsclc Patients With Incomplete Surgical Resection, Farrah R. Khan Md

Posters

Postoperative radiation therapy (PORT) has a limited role in the management of resectable non-small cell lung carcinoma (NSCLC). A relatively strong indication for its use is in the presence of residual tumor after surgical resection, as PORT has been shown to improve survival in such patients. However, it is unclear how much of the survival detriment of incomplete resection PORT is able to offset compared to negative margins. We aim to answer this question in our study

Addressing Glenoid Defects With Distal Clavicle Autograft In Revision Total Shoulder Arthroplasty, Ryan Bialaszewski, Ross Chapel, Frank Gerold

School of Medicine Publications

No abstract provided.

Case Report: A Severe Case Of Post-Operative Ogilvie Syndrome Requiring Surgical Intervention, Aashna A. Chaudhry

Rowan-Virtua Research Day

Ogilvie Syndrome is an acute colonic pseudo-obstruction described as a paralysis of the colon with no real mechanical obstruction. This condition is oftentimes a benign post-surgical complication but can progress in severity if not treated appropriately. This case report presents a unique clinical case in which an adult female patient developed a severe case of Ogilvie syndrome postoperatively requiring surgical intervention.

Post-Operative Hemodynamic Instability After Tcar (Transcarotid Artery Revascularization): A Retrospective Study, Lutfi Barghuthi, Rebekah Bjorklund, Mya Phelps, Shrina Patel, Lakecia Beasley, Bayli Zink, Alyssa Bedell, Gaurav Singh, Sarah Stokke, Rebecca Swindall, Allen Cook, Mark Robbins

School of Medicine Student Publications and Presentations

Introduction: Postoperative hemodynamic instability following carotid revascularization can lead to adverse outcomes such as Intensive Care Unit (ICU) admission and prolonged hospitalization, leading to an increase in total hospital charges. This study aimed to compare hemodynamic instability between Transcarotid Artery Revascularization (TCAR) and Carotid Endarterectomy (CEA) in a rural setting. Methods: A retrospective cohort study was conducted at a single institution on treatment for carotid artery stenosis between 2021 and 2024. Clinical outcomes following TCAR and CEA were compared. The primary outcome was hemodynamic instability; secondary outcome was ICU admission. Results: In total, 546 patients were included, 72.5% undergoing TCAR …

Toward The Application Of Natural Language Processing In Electronic Health Record Analysis For Taxonomy Development, Latoya Mcdonald

All Dissertations

Electronic health records (EHRs) are pivotal resources for nurse practice because they increase the timeliness and reliability of patient information at the point of care and support access by multiple healthcare providers and the individual patients themselves. However, it is widely recognized that data extraction from EHRs is challenging due to the variability in the language used in clinical care notes and the lack of standardized terminology across healthcare systems. The broad objective of this dissertation is to develop taxonomy-based classification models for nursing care by applying feature engineering approaches to EHRs that include nursing care of ostomy patients following …

Impact Of Michigan Public Act 246 On Opioid Prescribing After Pediatric Surgery, Madison Saunders, Nathan Novotny, Anthony Stallion, Begum Akay, Pavan Brahmamdam, Ryan T. Davis

Conference Presentation Abstracts

Abstract: Background: In December 2017, Michigan enacted Public Act 246(P246) to address rising opioid misuse. P246 states that, as of June 1, 2018, a prescriber of a controlled substance must discuss the risks of opioid addiction, overdose, and the dangers of taking opioids with benzodiazepine, alcohol or any other nervous system depressant with the minor and the minor’s parent or guardian. This study aims to evaluate the impact of this legislation by comparing opioid morphine milligram equivalents (MME) prescribed to pediatric patients undergoing common general, urological, and ENT surgeries before and after June 1, 2018. Methods: A single-center, retrospective chart …

Association Of Perioperative Factors With Lymph Node Positivity In Bladder Cancer Following Radical Cystectomy, Alyssa Laguerta, Kimberly Toumazos, Virgil Kevin Demario, Vaishnavi Patel, Balaji Reddy, Mark Quiring, Evan Jones, Young Son, Ronald Clearie, Thomas Mueller

Rowan-Virtua Research Day

Introduction and objectives: The treatment of bladder carcinoma relies on a multimodal approach, including chemotherapy, radical cystectomy, and lymph node dissection, but clear guidelines for the optimal strategy remain ambiguous. Radical cystectomy is complex, with high morbidity and mortality, yet limited research has focused on its short-term implications for lymph node-positive bladder cancer. This study aims to address these gaps by identifying perioperative factors linked to lymph node positivity and comparing outcomes between lymph node-positive and negative patients.

Methods: We conducted a retrospective analysis of 4382 bladder cancer patients who underwent radical cystectomy, collecting comprehensive clinical and surgical data. Clinical …

The Use Of Intramedullary Screw For Fixation Of Distal Ulnar Fractures, Adam Lencer, John Pignataro, Justin Le, Joyce Daniel Suarez, Michael Rivlin

Rowan-Virtua Research Day

Background

Distal ulna fractures frequently accompany distal radius fractures but are often underappreciated in both clinical and research contexts. While conservative management is frequently employed, particularly following volar locking plate (VLP) fixation of the radius, certain indications, such as distal radioulnar joint (DRUJ) instability, comminution, or high-energy trauma, may necessitate surgical fixation. This study evaluates patient-reported outcomes among patients with distal radius fractures treated operatively, comparing those with and without concomitant distal ulna fractures, and further stratifying based on the method of ulna fixation.

Methods

This retrospective review included 477 patients treated operatively for distal radius fractures by a single …

Volatile Anesthetic Exposure During Organogenesis (Weeks 6-9): Implications For Fetal Brain Development, Cheryce Daniel, Kylon Coombs

Rowan-Virtua Research Day

Organogenesis, particularly during gestational weeks 6 through 9, represent a critical window for fetal brain development. During this period, neurogenesis, neural tube closure and synaptic organization are actively occurring. Disruption of these processes, especially from exogenous agents, can result in lasting developmental consequences.

The U.S Food and Drug Administration has issued warnings regarding the use of anesthetic agents such as isoflurane, sevoflurane, and desflurane. Noting the potential risk of neurotoxic effects on the developing brain. This warning is particularly highlighted when administered drugs are present for long periods of time or during repeated procedures. The goal of this literature review …

Case Report: Petersen Hernia, A Rare Cause Of Bowel Ischemia, Brian Lim, Dhara Patel, Adeshola Fakulujo, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report a case of a 52-year-old female with history Roux-en-Y gastric bypass (RYGB) three years ago prior to presentation to the emergency department (ED) with sudden onset epigastric abdominal pain with radiation into the back of two hours duration. She was diagnosed with bowel ischemia due to internal hernia through a Petersen’s mesenteric defect. A Petersen’s mesenteric defect is one of the three possible internal hernia sites and occurs between the Roux limb mesentery and a defect in the transverse mesocolon.

Abdominal complaints are common in the emergency department with wide differential ranging from benign to emergent with need …

Mapping Fat Embolism As A Complication Of Liposuction And Fat Grafting: A Systematic Review Of Anatomical And Technical Risk Factors, Jared Garfinkle, Jack Hennen, Wen Luo

Rowan-Virtua Research Day

Fat grafting (FG) and liposuction are widely performed aesthetic procedures with associated fat embolism risks. However, no comprehensive review has specifically mapped the anatomical distribution and technical causes of fat embolism events across these procedures. This review aims to characterize regional and procedural frequencies of fat embolism to inform safer surgical practices. A review was conducted using PubMed, Embase, Scopus, and Cochrane. Included studies were English-language case reports/series, retrospective reviews, and systematic analyses reporting fat embolism following liposuction or FG. Among 227 FG cases, the most frequent regions were the face (n=120), gluteal region (n=91), genitalia (n=9), and chest (n=7). …

Laser Atherectomy For Complex Cad In Ischemic Heart Failure: A Systematic Review Of Revascularization Outcomes, Avneet Chawla, Jared Aftel, Moiuz Chaudhri, Mohamad Hammad, Ahmed Al Mahrizi, John Socci, Aditya Mehra

Rowan-Virtua Research Day

This review evaluates how laser atherectomy compares to angioplasty and stenting for revascularization in patients with heart failure and complex coronary artery disease (CAD). The review explored whether laser atherectomy could improve procedural success and reduce the risk of restenosis, major cardiovascular events (MACE), and other complications. A search across multiple medical databases yielded six studies directly comparing these treatment methods. Findings showed that procedural success rates were similar between laser atherectomy (ranging from 80% to 95%) and angioplasty/stenting (85% to 98%). Restenosis rates at six and twelve months were also generally equivalent, although laser atherectomy showed potential advantages in …

Periprosthetic Femur Fractures After Total Hip Arthroplasty: Risk Factors And Management Strategies, Clarence Julian Clark Ii, Adam Friedman, Jaylyn Thompson

Rowan-Virtua Research Day

Background: Periprosthetic femur fractures (PFFs) are increasingly recognized as a significant complication following total hip arthroplasty (THA), particularly as the number of procedures rises. While THA is one of the most successful orthopedic surgeries, PFFs can compromise outcomes and demand complex management.

Objective: To review current literature and identify patient- and implant-related risk factors for PFFs, as well as to summarize effective management strategies guided by classification systems.

Methods: A structured literature review was conducted using PubMed, focusing on articles published in the past 10 years. Eight peer-reviewed studies were selected based on relevance to femoral fractures post-THA. Data on …

Pre-Operative Clinical Characteristics Vary By Race In Patients With Obesity Undergoing Bariatric Surgery, Minjal Patel, Jasmine Park, Melissa Gott, David Kelter, Luke Perry, Ajay Menon, Paul Osterdahl, Casey Connors, Venkateswar Venkataraman, Nicole Stouffer, Gus J. Slotman

Rowan-Virtua Research Day

Background Data and Purpose: With the increasing prevalence of obesity, it impacts the practice of surgeons across various specialties. Non-bariatric surgeons are confronted with morbid obesity need clinical insight in managing medically fragile patients. The objective of this study is to identify pre-operative clinical variation by race among surgical patients with obesity.

Methods: Pre-operative data from 156,502 bariatric surgery patients were analyzed in four groups: Caucasian (C; n=125,492), African American (AA; n=18,226), Hispanic (H; n=12,405), and Asian (A; n=379). Data: Demographics, weight, BMI, and 33 obesity co-morbidities. Statistics: Chi-square and ANOVA.

Results: Pre-operative C/AA/H/A weight (KG) (130+-27/135+-28/127+-27/122+-26), BMI (46+-8/48+-9/47+-8/45+-7), % …