Surgery Commons^™

A Prospective, Multicenter Analysis Of The Integrated 31-Gene Expression Profile Test For Sentinel Lymph Node Biopsy (I31-Gep For Slnb) Test Demonstrates Reduced Number Of Unnecessary Slnbs In Patients With Cutaneous Melanoma., J Michael Guenther, Andrew Ward, Brian J Martin, Mark Cripe, Rohit Sharma, Stanley P Leong, Joseph I Clark, John Hamner, Timothy Beard

Oncology Articles

BACKGROUND: National Comprehensive Cancer Network guidelines recommend sentinel lymph node biopsy (SLNB) for patients with > 10% risk of positivity, consider SLNB with 5-10% risk, and foregoing with <  5% risk. The integrated 31-gene expression profile (i31-GEP) algorithm combines the 31-GEP with clinicopathologic variables, estimating SLN positivity risk.

METHODS: The i31-GEP SLNB risk prediction accuracy was assessed in patients with T1-T2 tumors enrolled in the prospective, multicenter DECIDE study (n = 322). To determine if incorporating the i31-GEP into decision-making resulted in fewer SLNBs performed, propensity score-matching was performed to a non-overlapping cohort for whom the 31-GEP was not used for SLNB decision-making.

RESULTS: No patients with <  5% i31-GEP predicted risk had a positive SLNB (0/35). Propensity matching demonstrated an 18.5% reduction in SLNBs performed (43.7% vs. 62.2%. p <  0.001). The i31-GEP could have reduced the number of unnecessary biopsies by 25.0% (35/140).

CONCLUSIONS: This prospective study confirmed the performance and clinical utility of the i31-GEP for …

Minimally Invasive Non-Expansile Tubular Extradural Posterior Fossa Decompression (Minted Technique) For The Management Of Chiari I.5 Malformation: Historical Overview Of Surgical Techniques, Technical Note, Proof Of Concept, Illustrative Case And Case Series. Lesser Is Better, José Alberto Israel Romero Rangel, Manuel Eduardo Soto García, Sergio Soriano Solís, Carlos Raúl Rangel Morales, Gerson Reyes Rodríguez, José Antonio Soriano Sánchez

Archives of Neurosurgery

BACKGROUND: Chiari's Malformation surgical treatment has significantly changed since the "classical" technique description by Gardner (1950). It is probably the most commonly performed approach, even when multiple techniques are available because no substantial changes nor any clear surgical objectives have been made. OBJECTIVE: To demonstrate a new cutting-edge surgical technique mastering the advantage of each surgical procedure ever described in the history of Chiari's Malformation establishing three critical points in surgical technique: clear patient-specific surgical goals, dynamic posterior fossa reconstruction, and extradural occipitoatlantal dense-adhesions release. METHODS: A comprehensive review of historically described approaches, proof of concept of surgical technique in …

Traumatic Injuries Of The Common Peroneal Nerve And Current Surgical Strategies For Improving Foot Drop. A Clinical Series And Literature Review., Carlos Alberto Rodríguez Aceves, María Elena Córdoba Mosqueda, Racob Alberto García Velazco, Humberto González Ugalde, Héctor Antonio Soriano Solís, Fabiola Estela Elizabeth Ortega Ponce, Kartik G. Krishnan

Archives of Neurosurgery

Background: Common peroneal nerve injuries are the most frequent nerve injuries in the lower extremity. They may produce severe gait deficits because of weakness or absence in ankle dorsiflexion. Functional improvement after injury, despite any intervention, remains unpredictable. There are various surgical strategies aimed to restore foot drop, but no consensus exists regarding the best surgical treatment.

Objective: In this article, we report our experience and reviewing general aspects of common peroneal nerve anatomy and lesions, current surgical strategies to restore functionality, and the overall outcomes previously published in the literature.

Methods: Retrospective review of patients with foot drop secondary …

Suprameatal Tubercle Classification; Its Implementation On Clinical Cases, Humberto Reyna Mendez, Jose Alfredo Espinosa Mora, Laura Ubaldo Reyes, Alberto Angeles Castellanos, Ignacio Mora Magaña, Mauro Alberto Segura Lozano, Rachel Blue, John Yk Lee, Diego Mendez Rosito

Archives of Neurosurgery

Abstract:

Background: The suprameatal tubercle (SMT) is a variable prominence of the petrosal surface of the temporal bone that lies above the internal acoustic meatus. An enlarged SMT may present an obstacle during surgeries of the posterior fossa, including microvascular decompression or by itself cause trigeminal neuralgia.

Methods: Based on our prior study of 200 temporal bones, its data collection and establishing a classification of the SMT this extension study exemplifies its clinical application.

Results: According to the classification of the SMT four selected cases are clinically and anatomically correlated to exemplify the utility of this classification.

Conclusion: The SMT …

Appendicular Band Syndrome As A Cause Of Infantile Small Bowel Obstruction, Brandon M. Epps, Alexis Smith

South Atlantic Division GME Research Day 2025

No abstract provided.

From Lost Balance To Leaky Chyle: A Case Report Of Traumatic Chylothorax, Taylor Johnson, Glenn Carlos

South Atlantic Division GME Research Day 2025

No abstract provided.

Effects Of Rideshare Services On Alcohol Related Motor Vehicle Collision (Mvc) Outcomes, David Bassa, Morgan Johnson, Devika Pavuluri, Michael Truitt

North Texas Research Forum 2025

BACKGROUND: In 2022, The National Highway Traffic Safety Administration (NHTSA) reported over 42,000 motor vehicle collisions (MVCs) deaths with 31% of MVC deaths secondary to alcohol (AR-MVCs). In 2010, rideshare services (RSS) were introduced to the market providing a new method of transportation with the potential to reduce the incidence of driving under the influence (DUI). We analyzed the NHTSA database to evaluate trends in alcohol related MVC deaths (AR-MVC Deaths) since the initiation of ride share services. METHODS: Fatality Analysis Reporting System (FARS) source from the NHTSA was used to obtain data from years 2009 and 2022 from 50 …

The Sellar Barrier’S: An Important New Concept In Pituitary Surgery., Juan F. Villalonga, Alvaro Campero

Archives of Neurosurgery

The sellar barrier's concept was created by our team in Tucumán in 2019. There are currently 3 well-defined subtypes: strong, weak and mixed. Published case series studies indicate that there is a strong correlation between radiological, intraoperative findings and risk of cerebrospinal fluid (CSF) leakage. Patients with weak sellar barrier have more risk of intraoperative CSF leak. The strong sellar barrier is a protective factor for intraoperative CSF leak. The sellar barrier's concept is useful for clinical-surgical practice and for the physician-patient relationship.

Endoscopic–Assisted Surgery For Cerebello Pontine Angle Pathology: Technical Note And Surgical Results In A Series Of Patients, Jaime Jesus Martinez Anda, Pablo David Guerrero Suarez, Diego Pineda Martínez, Rafael Avendaño Pradel, Ernesto Javier Jurado Delgado, Ricardo Santiago Villlagrana Sánchez, Juan Carlos Cisneros Lesser, Carolina De La Llata Segura, Rogelio Revuelta Gutiérrez

Archives of Neurosurgery

Objectives: Endoscopic–assisted surgery combined with the operating microscope has been described for several surgical techniques and pathologies of the cerebellopontine angle (CPA). The use of an endoscope allows for a panoramic view of the CPA cistern and a high degree of maneuverability in narrow cisternal spaces that enable the surgeon to deal with most CPA lesions safely. We performed an observational study to describe the surgical anatomy and technique for endoscopic-assisted CPA surgery, describing our experience in a case series of patients with CPA pathology. Methods: Anatomical and surgical technique description of endoscopic-assisted surgery for CPA pathology, based on observations …

A Primer On Performing Meaningful Systematic Review And Meta-Analysis, Kayla Nguyen, Duyen Quach, Michael Flynn, Zuhair Ali, Andrey Manov, Mike Liang

Gulf Coast Division GME Research Day 2025

No abstract provided.

Osteopathic Representation In Orthopedic Literature: A 25-Year Analysis Of Publication Trends Of Former Aoa Residency Programs And Osteopathic Medical Schools, Troy Puga, Ibraheem Qureshi, Hans Drawbert, Michael Muncy, John T. Riehl

North Texas Research Forum 2025

Background Orthopedic surgery remains one of the most competitive specialties. Osteopathic candidates have recently matched at lower rates than allopathic students. One disparity that may exist is research, which has become a critical component of candidate applications. This study aimed to examine the representation of osteopathic-affiliated first authors, senior authors, and overall osteopathic-affiliated authors, in the top 25 leading U.S. orthopedic journals published between 2000 and 2024. Methods A retrospective bibliometric review was conducted on articles published from 2000 to 2024 in orthopedic journals. Journals were selected based on their h-index score. Institutional affiliations were used to identify osteopathic authors. …

Atypical Hemorrhoid Or Hidden Malignancy? Anal Melanoma And Palliative Strategies, Osamuyi Asemota, Kayla Brown, Megan Turley

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Prevention Of Transmetatarsal Amputation In A Diabetic Patient With A Chronic Foot Ulcer Including Osteomyelitis By Minimally Invasive Surgery Floating Lesser Metatarsal Osteotomies In Conjunction With Adipose Injectable Filler, Francois M. Lokenye Dpm, Orlexia Thomas Dpm, Lady Paula Dejesus Dpm, Facfas, Facpm, Dwsp

Posters

Problem: Diabetic foot ulcers (DFUs) complicated by osteomyelitis often result in transmetatarsal amputations, leading to significant morbidity.

Objective: To evaluate a minimally invasive surgical approach combining floating lesser metatarsal osteotomies with adipose injectable filler to prevent transmetatarsal amputation, enhance wound resolution, and improve foot biomechanics

Research Priotitization In Hernia Surgery: A Modified Delphi Achqc And Vhoc Expert Consensus, Rachel Wright, Daphne Remulla, Mazen R. Al-Mansour, Christopher Schneider, Sharon Phillips, William W. Hope

Gulf Coast Division GME Research Day 2025

No abstract provided.

Lessons Learned: A Multicenter Approach To A Mass-Casualty Incident, Kristen Payne, Elizabeth Kim, Luis Taveras, Morgan Collom, Danielle Pigneri

North Texas Research Forum 2025

Background: On May 6, 2023, an armed gunman opened fire at a shopping mall in Allen, Texas. Eight people including the perpetrator were killed with more injured. Medical City McKinney, a level 2 trauma center received seven patients. Medical City Plano, a level one trauma center received one patient. Medical City Dallas Children’s Hospital, a level three pediatric trauma center received one pediatric patient. Methods: Medical City North Texas Division command center engaged Emergency Department leadership at North Texas facilities to prepare for transfer of patients. Ground transport and an air medic team on standby was staged early on. Nearby …

Tricuspid Valve Repair For A Chronically Migrated Venous Stent, John W. Jackson, Mary Rachel Nute, Jeffrey D. Mcneil

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Comparison Of Transcarotid Artery Revascularization & Carotid Endarterectomy For Atherosclerotic Carotid Artery Disease, Adel Hanandeh, Victor Cabrera Bou, Gerard De Castro, Giancarlo Cires, Julio Calderin, Richard Deane, Frederick Fisher

North Florida Division GME Research Day 2025

No abstract provided.

Ventral Hernia Repair Preoperative Risk Assessment Review, Sophia Ahmed, J Griepentrog, M Phillips, K Blake

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Traumatic Rupture Of Gall Bladder After Blunt Trauma, Chris Robert, Alicia Lay

North Texas Research Forum 2025

Introduction: Gallbladder injury accounts for less than 1% of the patient presenting with blunt abdominal trauma, due to its protected location in the undersurface of the liver. Case report: A 41-year-old male presented to the emergency department after a motor vehicle collision. Patient was hemodynamically stable; on exam, patient had focal tenderness in the lower abdomen. Initial lab results revealed elevated blood alcohol of 302 mg/dl, elevated lactate of 3.9 mmol/l, a white blood cell count of 6.76 K/mm3, and a hemoglobin of 15.2 g/dl. Patient was pan-scanned as per trauma protocol. A computed tomography scan revealed a mesenteric hematoma …

Complete Gastric Transection After Blunt Force Trauma, Sydney Parker, Sophia Jimenez, Riley Blanton, Samprit Karra, Alejandro Garcia

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.