Surgery Commons^™

Total Intestinal Atresia In A Neonate: A Case Report., Cory Nonnemacher, Seth Saylors, Naomi-Liza Denning, Vatche Melkonian, Pablo Aguayo

Manuscripts, Articles, Book Chapters and Other Papers

Intestinal atresias are a common cause of neonatal intestinal obstruction. An extremely rare variant is total intestinal atresia, where no lumen is appreciable from the duodenum through the colon. We describe a case of a 33-week female who was born at an outside hospital and underwent laparotomy for concern for intrauterine perforation and proximal intestinal obstruction. Laparotomy revealed a duodenal perforation and an atresia in the proximal jejunum. Resection of this segment revealed no intestinal lumen distally, and the patient was left in discontinuity and transferred to our tertiary children's hospital. Repeat laparotomy revealed atretic bowel with no lumen through …

Impact Of Perioperative Organ Injury On Morbidity And Mortality In 28 Million Surgical Patients, Felix Kork, Yafen Liang, Adit A Ginde, Xiaoyi Yuan, Rolf Rossaint, Hongfang Liu, Alex S Evers, Holger K Eltzschig

Faculty, Staff and Student Publications

Perioperative organ injury contributes to morbidity and mortality of surgical patients. This cohort study included all elective and emergent surgeries in Germany over 4 years to address the impact of perioperative organ injuries on outcomes. We analyzed 28,350,953 cases. In-hospital mortality was 1.4% (n = 393,157), and 4.4% of cases (n = 1,245,898) experienced perioperative organ injury. Perioperative organ injury was associated with 9-fold higher odds of death and prolonged hospital stay by 11.2 days. Acute kidney injury had the highest incidence (2.0%) and was associated with 25.0% mortality. While delirium had the second highest incidence (1.5%), it was associated …

Ketorolac And Dexamethasone Injection Comparison On Postoperative-Pain In Impacted Mandibular Third Molars Surgery In Pterygomandibular Space: A Randomized Clinical Trial, E. Farokh-Gisour, S. Hajmohamadi, M. Shokrizadeh, S.Y. Shahrbabaki, Homa Kamyabi

School of Public Health Faculty Publications

Objective: To compare the effects of ketorolac and dexamethasone on postoperative pain in patients who underwent impacted mandibular third molars surgery. Material and Methods: A double-anonymized clinical trial study involving 60 patients with impacted third molars. The samples were randomly divided into two groups by block randomization method: DG: Dexamethasone (8 mg) and KG: Ketorolac (30 mg). The severity of pain was assessed using the visual analog scale and Wong-Baker Faces Pain Rating Scale immediately and during the first to seventh days after the surgery. Results: Among the participants, 65% were female, and the mean age was 40.8 years. The …

Canary In The Carpal Tunnel: A Pilot Study Of The Value Of The Screening For Amyloidosis In Carpal Tunnel Syndrome, Trevor Ruesch, Nevil Khurana, Logan Hansen Md, Katiya Barkho, Julia Malewicz, Charles Day Md

Medical Student Research Symposium

Introduction/Purpose:

Transthyretin amyloidosis occurs in two forms, hereditary transthyretin amyloidosis (hATTR), and wild-type ATTR (wtATTR)². Amyloidosis can result in restrictive cardiomyopathy presenting as heart failure with preserved ejection fraction (HFpEF)⁴. A growing body of evidence demonstrates that amyloidosis may be underdiagnosed and can be caught earlier in the disease course⁵. The proteins causing amyloidosis can also deposit into various tissues including the carpal tunnel leading to carpal tunnel syndrome ².

In this pilot study, we propose that early detection of amyloid via a biopsy of the transverse carpal ligament or tenosynovium in the …

Calling The Burn Center: Why Do Our Referring Hospitals Call Us?, Moon Usman Md, Alisa Savetamal

Posters

This study seeks to analyze and evaluate referral data received by a single state burn center, focusing on the allocation of resources for referrals and consultations, and determining the proportion of these that result in patient admissions.

A Heart Full Of Nails: Complex Management Of Multiple Nail Gun Cardiac Injuries, Shaun Abid Md, Stuart Zarich

Posters

A 54-year-old male presented after a suicide attempt, suffering severe cardiac and extracardiac injuries from firing a nail gun into both temples (Figure 1A) and his chest. Imaging showed six 5cm nails embedded in his heart: two in the left ventricle, two in the right ventricle, one traversing the ascending aorta into the left atrium, and one entering the right ventricle from the left parasternal chest wall (Figure 1B, C, D). These injuries resulted in hemorrhagic pericardial effusion with tamponade, acute aortic regurgitation, mitral valve/pulmonary artery perforations, and a ventricular septal defect.

The Profound Role Of An Adult Survivor Program Adaptive Sports Retreat On Quality Of Life And Self Perception For Adult Burn Survivors, Roselle E. Crombie Md/Mph, Facs, Faba, Theresa E. Abrams Lcsw, Phd, Cindy Rutter Bsn, Lmft, Josh Mishell Ba, Philip E. Fidler Md

Posters

Mental health struggles amongst adult burn survivors has recently been documented as an ongoing need for therapy in peer reviewed journals.1 Although there are many robust programs, camps, reintegration programs and support systems through child life for children, the analogous programs for adults are lacking in comparison to the pediatric ones. Ten years ago, a subset of this author group ran an adult adaptive sports survivor program in conjunction with a national burn meeting. At that time, all the participants, mental health providers and participating surgeons were able to experience the profound impact a program like this can have on …

Reevaluating Informed Consent: Integrating Shared Decision-Making Into Spinal Surgery For Better Patient Outcomes., Jeffrey N Wang, Mohamed A Elhakeem, Matthew J Mesimer, Paul G Mastrokostas, Salman Ahmad, Tim Reed, Brandon Klein, Lucas E Bartlett, Adam D Bitterman, Andrew Megas

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Study Design: Narrative review.

Objectives: The objectives of this study were to answer the following questions: (1) What is the quality of informed consent in spine surgery, including both neurosurgery and orthopaedic spine surgery? (2) What limitations impede the ability of surgeons to engage in effective shared decision-making (SDM) and obtain adequate informed consent? (3) What strategies and solutions may improve the quality of informed consent and SDM? (4) What factors decrease the incidence of litigation in spine surgery?

Methods: N/A.

Results: SDM is a collaborative process where patients are involved in their treatment choices through open communication about risks, …

Limbgod(Pat. Pending): Wearable Garment For Amputation Prevention, Naomi Choi Dpm, Mba, Phuc An Dinh Bs, Ms, Eric Lee Bs, Francois M. Lokenye Dpm

Posters

Approximately 1.6 million people in the U.S. have lower limb amputations, which is expected to double by 2050 (Wong et al.). Socio-economic factors: income, education, rural residency & race, impact amputation risk (Okesina et al.), with Black Americans 70% are more likely to undergo major lower limb amputations than white Americans, even after adjusting for care access & comorbidities (Feinglass et al., Holman et al., Regenbogen et al.). Within 5 years, up to 50% of first-time amputees require another amputation (Dilingham et al., Glaser et al.) & those with comorbidities face a 77% five-year mortality rate (Fortington et al.).

Discussion Of “Biggest” Problems Facing Burn Units Today; A Survey Based Analysis And Discussion From Our Aba Burn Surgeon Forum Workgroups 2024, Roselle E. Crombie Md/Mph Facs Faba, Alexandra Lacey Md, Facs, Faba, Kathleen Romanowski Md, Facs, Faba

Posters

Burn Units are a unique environment and microcosm of patients. Additionally, there have been certain factors contributing to what burn care providers consider the most important challenges facing optimal delivery of care. Formally exploring these issues may elucidate solutions by gathering different perspectives.

A Preliminary Analysis Of Transaminitis Observed In Oxandrolone Versus Testosterone Therapy In Major Burn Injury, Alexandra Dewitt, Athena Hoppe, Anastasiya Ivanko, Victoria Miles

School of Medicine Faculty Publications

57th Annual Meeting of the American Burn Association, ABA 2025, April 8 - 11, 2025, Phoenix, AZ

Optimal Restoration Of Spermatogenesis After Testosterone Therapy Using Human Chorionic Gonadotropin And Follicle-Stimulating Hormone, Blair T Stocks, Amelia G Oppenheimer, Kevin J Campbell, John P Lindsey, Taylor P Kohn, Juliet M Alexander, Jason B Huang, Larry I Lipshultz

Faculty, Staff and Students Publications

Objective: To study improvements in spermatogenesis in men with a history of testosterone therapy using a novel fertility treatment regimen.

Design: A single-center retrospective cohort analysis.

Subjects: Seventy-seven men with previous testosterone use seeking fertility treatment from January 2020 to March 2024.

Exposure: A treatment regimen of 3,000 IU of human chorionic gonadotropin (hCG) and 75 IU of follicle-stimulating hormone (FSH) three times a week was used.

Main outcome measures: The primary outcome measured was change in sperm concentration during hCG/FSH therapy. The secondary outcome measured was whether concurrent testosterone therapy during hCG/FSH therapy affected recovery of spermatogenesis.

Results: Within …

Obesity And Outcomes After Elective Thoracoabdominal Aortic Aneurysm Repair, Sanford Zeigler, Kyle W Blackburn, Ahmad Tabatabaeishoorijeh, Veronica A Glover, Susan Y Green, Marc R Moon, Scott A Lemaire, Joseph S Coselli

Faculty, Staff and Students Publications

Objective: Obesity can complicate surgical repair, but its relationship to outcomes after open thoracoabdominal aortic aneurysm (TAAA) repair remains uncertain. Therefore, we examined whether obesity is associated with greater operative risk after elective TAAA repair.

Methods: We retrospectively evaluated data from 2517 open, elective, single-practice TAAA repairs (from 1986 to 2023) and compared patients without obesity or underweight (body mass index [BMI] 18.6-29.9; n = 1977) with patients with obesity (BMI ≥30; n = 540 [21.5%]). Multivariable logistic regression modeling identified predictors of operative mortality in patients with obesity. We created propensity-matched cohorts (n = 540 pairs) and compared their …

Ibuprofen, Flurbiprofen Or Naproxen Sodium Minimally Influences Musculoskeletal Adaptations To Treadmill Exercise In Rats, Brandon Roberts, Alyssa Geddis, Alexandra Ciuciu, Marinaliz Reynoso, Nikhil Mehta, Alyssa Varanoske, Alyssa Kelley, Maximus Leiss, Alexander Kolb, Julie Hughes, Marshall Naimo, Ryan Tomlinson, Jeffery Staab

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs) may influence musculoskeletal health. The purpose of this study was to compare the effects of three different NSAIDS: naproxen sodium, ibuprofen, flurbiprofen or a placebo on musculoskeletal adaptations in rodents with or without 6 weeks of aerobic exercise.

METHODS: Nine-week-old male Wistar rats (n = 80) were randomized to either exercise (EX) or no-exercise control (CON) conditions and treated with naproxen, ibuprofen (IBU), flurbiprofen (FLU) or placebo (PLA). For exercise, rats ran 5 days per week for 6 weeks at a 5% incline on a motorized treadmill for 30 min. Three-point bending (3 PB) and …

Frozen Section Mohs: A Hybrid Technique And One Plastic Surgeon's Experience With 1714 Consecutive Skin Cancer Removals, Michael L. Chang, Steven L. Chang, Fady Gerges, Matthew M. Delancy, Amanda C. Yang, Lawrence D. Chang

Student Papers, Posters & Projects

While US nonmelanoma skin cancer (NMSC) mortality rate has decreased in the past decade, its incidence is rising. Traditional surgical treatments include wide local excision, intraoperative frozen section analysis (IFSA), and Mohs micrographic surgery (MMS). IFSA and MMS are techniques that provide intraoperative analysis allowing the surgeon to confirm margins clear of malignancy and minimize tissue damage, especially in cosmetically sensitive subunits. MMS, with cure rates up to 99%-100%, is considered the gold standard but is limited geographically and financially because of specialized training. We report a hybrid surgical technique that effectively excises cutaneous malignancy but can be utilized by …

Fruits Of The Professional Educator Appreciation And Recognition (Pear) Awards: Learning What Students Value In Their Medical Educators, Madeline Tomlinson, Kristiana Nasto, Kevin Gosselin, Ellen M Friedman, Anne Gill, Stacey Rose

Faculty, Staff and Students Publications

Purpose: The Professional Educator Appreciation and Recognition (PEAR) awards program was created by students at Baylor College of Medicine (BCM) in 2020 to recognize exemplary educators. We reviewed our 3-year experience of this initiative to identify characteristics of award-winning educators, and to assess the award's impact.

Materials and methods: We reviewed the title, department, and clinical affiliation of award winners. Using ChatGPT, we qualitatively analyzed de-identified nomination narratives to identify themes of educator characteristics most valued by students. Following refinement by the study team, each award was then assigned one or more themes. Unsolicited thank-you emails were reviewed to consider …

International Multispecialty Expert Physician Preoperative Identification Of Extranodal Extension In Patients With Oropharyngeal Cancer Using Computed Tomography: Prospective Blinded Human Inter-Observer Performance Evaluation, Onur Sahin, Serageldin Kamel, Kareem A Wahid, Cem Dede, Nicolette Taku, Renjie He, Mohamed A Naser, Christina S Sharafi, Antti Mäkitie, Benjamin H Kann, Kimmo Kaski, Jaakko Sahlsten, Joel Jaskari, Moran Amit, Gregory M Chronowski, Eduardo M Diaz, Adam S Garden, Ryan P Goepfert, Jeffrey P Guenette, G Brandon Gunn, Jussi Hirvonen, Frank Hoebers, Katherine A Hutcheson, Nandita Guha-Thakurta, Jason Johnson, Diana Kaya, Shekhar D Khanpara, Kristofer Nyman, Stephen Y Lai, Miriam Lango, Kim O Learned, Anna Lee, Carol M Lewis, Anastasios Maniakas, Amy C Moreno, Jeffrey N Myers, Jack Phan, Kristen B Pytynia, David I Rosenthal, Vlad C Sandulache, Dawid Schellingerhout, Shalin J Shah, Andrew G Sikora, Abdallah S R Mohamed, Melissa M Chen, Clifton D Fuller, Multidisciplinary Oropharyngeal Cancer Extra‐Nodal Extension (Opc Ene) Assessment Working Group

Faculty, Staff and Students Publications

Background: Pathologic extranodal extension (pENE) is a crucial prognostic factor in oropharyngeal cancer (OPC), but determining pENE from imaging has high inter-observer variability. The role of clinician specialty in the accuracy of imaging-detected extranodal extension (iENE) remains unclear. The purpose of this study is to assess the influence of clinician specialty on the accuracy of preoperative iENE detection in human papillomavirus (HPV)-positive OPC using computed tomography (CT) imaging.

Methods: This prospective observational study evaluated pretherapy CT images from 24 HPV-positive OPC patients (30 scans, including duplicates). Thirty-four expert observers (11 radiologists, 12 surgeons, 11 radiation oncologists) assessed iENE and reported …

Statins And Middle Meningeal Artery Embolization: A Literature Review In The Treatment Of Chronic Subdural Hematoma, Basel Musmar, Joanna M. Roy, Samantha Spellicy, Stavropoula I. Tjoumakaris, Michael R. Gooch, Robert H. Rosenwasswer, David Hasan, Pascal Jabbour

Department of Neurosurgery Faculty Papers

Chronic subdural hematoma (cSDH) presents a multifaceted challenge in contemporary neurological practice, necessitating innovative therapeutic strategies. This comprehensive review explores the convergence of two promising interventions: statins and middle meningeal artery (MMA) Embolization. With cSDH incidence on the rise, particularly among the aging population and those with long-term anticoagulant usage, the traditional surgical avenues face limitations in recurrence rates and associated risk factors. Statins, heralded for their anti-inflammatory, vasculogenic, and angiogenic properties, are emerging as potential allies in cSDH management. Concurrently, MMA embolization offers a nuanced approach to target the neomembrane's blood supply, with evidence supporting its efficacy and safety. …

Status Gizi Sebagai Faktor Risiko Mortalitas Di Rumah Sakit Pada Pasien Lanjut Usia Pasca Reseksi Tumor Kolorektal, Ayu Fitri Sekar Wulandari, Parish Budiono, Yudo Murti Mupangati

Jurnal Penyakit Dalam Indonesia

Introduction. Malnutrition in elderly patients, particularly those with colorectal cancer, increases morbidity, mortality, and length of hospital stay due to metabolic dysregulation and hypermetabolic perioperative response, affecting wound healing, infection risk, postoperative complications, and nutritional deficits. This study aimed to analyze whether nutritional status is a risk factor for in-hospital mortality in elderly patients after colorectal tumor resection.

Methods. A case-control matching study was conducted on elderly patients who underwent colorectal tumor resection, using secondary data from elderly inpatients at Dr. Kariadi General Hospital from January 2020 to April 2024. The collected data were analyzed using bivariate analysis …

Spetzler-Martin Grade Iv Cerebral Arteriovenous Malformations In Adult Patients: A Propensity-Score Matched Analysis Of Resection And Stereotactic Radiosurgery, Salem M. Tos, Mahmoud Osama, Georgios Mantziaris, Bardia Hajikarimloo, Nimer Adeeb, Sandeep Kandregula, Hamza Adel Salim, Basel Musmar, Christopher Ogilvy, Douglas Kondziolka, Adam A. Dmytriw, Kareem El Naamani, Ahmed Abdelsalam, Deepak Kumbhare, Sanjeev Gummadi, Cagdas Ataoglu, Muhammed Amir Essibayi, Ufuk Erginoglu, Abdullah Keles, Sandeep Muram, Daniel Sconzo, Howard Riina, Arwin Rezai, Johannes Pöppe, Rajeev D. Sen, Louis J. Kim, Omar Alwakaa, Christoph J. Griessenauer, Pascal Jabbour, Stavropoula I. Tjoumakaris, Jan-Karl Burkhardt, Robert M. Starke, Mustafa K. Baskaya, Laligam N. Sekhar, Michael R. Levitt, David J. Altschul, Neil Haranhalli, Malia Mcavoy, Abdallah Abushehab, Assala Aslan, Christian Swaid, Adib Abla, Christopher Stapleton, Matthew Koch, Visish M. Srinivasan, Peng R. Chen, Spiros Blackburn, Omar Choudhri, Bryan Pukenas, Darren Orbach, Edward Smith, Markus Möhlenbruch, Ali Alaraj, Ali Aziz-Sultan, Aman B. Patel, Amey Savardekar, Hugo H. Cuellar, Kathleen Dlouhy, Tarek El Ahmadieh, Michael Lawton

Department of Neurosurgery Faculty Papers

Spetzler-Martin Grade IV arteriovenous malformations (AVMs) are challenging due to high risks associated with both treatment and natural progression. This study compares the outcomes of microsurgical resection and stereotactic radiosurgery (SRS) in high-grade AVMs, analyzing obliteration rates, complications, and functional outcomes. A retrospective cohort of 96 patients treated with either microsurgical resection (33 patients) or SRS (63 patients) was analyzed. Propensity-score matching was employed to account for baseline variables such as AVM size (cm), preoperative embolization and rupture status. Primary endpoints included AVM obliteration, complication rates, and modified Rankin Scale (mRS) scores. After matching, 31 patients per group were analyzed. …