Surgery Commons^™

Use Of Electrical Bone Growth Stimulators In High-Risk Patients Following Spinal Fusion, Soumya Malhotra, Khavir Sharieff

HCA-NSU MD Research Day

Title: Use of Electrical Bone Growth Stimulators in High-Risk Patients Following Spinal Fusion Authors: Soumya Malhotra, BA., MS1 & Khavir Sharieff, DO, MBA2 1Class of 2027, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, FL 2Assistant Professor of Surgery, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Tampa Bay, FLNova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine Objective: This study aimed to elucidate the advantages of EBGSs following high-risk spinal fusions. Background: Pseudarthrosis is a condition where bones fail to fuse after an injury or surgery. It causes significant …

Flexor Tenosynovitis Of The Wrist And Hand Due To Non-Tuberculous Mycobacteria, Mariafe Reyes, Tatevik Malisetyan, Skylar Harmon, Mohammadali M. Shoja Md, Gary B. Schwartz Md

HCA-NSU MD Research Day

Title: Flexor Tenosynovitis of the Wrist and Hand Due to Non-tuberculous Mycobacteria Authors: Mariafe Reyes1,Tatevik Malisetyan1, Skylar Harmon1, Mohammadali M. Shoja, MD1 Gary B. Schwartz, MD1 1Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, USA INTRODUCTION: Non-tuberculous mycobacteria (NTM) are a group of bacteria, including Mycobacterium marinum, Mycobacterium kansasii, and Mycobacterium avium intracellulare (MAI), that usually exist in the soil and water sources. The most common site of infection is the lungs, but extra-pulmonary involvement of the skin and rarely the musculoskeletal (MSK) system does occur, especially the hands and wrists. CASE PRESENTATION: A 45-year-old, …

A Contemporary Review Of Robotic Resection For Hepatocellular Carcinoma, William A. Preston, Nina R. Spitofsky, Adam S. Bodzin

Department of Surgery Faculty Papers

Background: Robotic hepatectomy represents an appealing treatment modality for resectable hepatocellular carcinoma (HCC). A contemporary review of robotic hepatectomy compared to laparo- scopic/open hepatectomy is necessary. Methods: We performed a literature review to identify studies between 2018–2024 comparing robotic to laparoscopic/open hepatectomy for HCC with measurable outcomes. Results: A total of 10 studies were identified, including 943 patients undergoing robotic hepatectomy compared to 1678 patients undergoing laparoscopic/open hepatectomy. Generally, while similar short/long-term survival was noted across all resection modalities, robotic hepatectomy was associated with longer operative time, shorter length of stay, and less post-operative compli- cations. An additional 4 studies …

The Polymeric Fluoropyrimidine Cf10 Overcomes Limitations Of 5-Fu In Pancreatic Ductal Adenocarcinoma Cells Through Increased Replication Stress, Jennifer M. Finan, Roberto Di Niro, Soon Young Park, Kang Jin Jeong, Madeline D. Hedberg, Alexander Smith, Grace A. Mccarthy, Alex O. Haber, John Muschler, Rosalie C. Sears, Gordon B. Mills, William H. Gmeiner, Jonathan R. Brody

Department of Surgery Faculty Papers

Pancreatic ductal adenocarcinoma (PDAC) is a lethal disease soon to become the second leading cause of cancer deaths in the US. Beside surgery, current therapies have narrow clinical benefits with systemic toxicities. FOLFIRINOX is the current standard of care, one component of which is 5- Fluorouracil (5-FU), which causes serious gastrointestinal and hematopoietic toxicities and is vulnerable to resistance mechanisms. Recently, we have developed polymeric fluoropyrimidines (F10, CF10) which unlike 5-FU, are, in principle, completely converted to the thymidylate synthase inhibitory metabolite FdUMP, without generating appreciable levels of ribonucleotides that cause systemic toxicities while displaying much stronger anti-cancer activity. Here, …

Real-World Assessment (Rwa): Validity Evidence For Cataract Surgery With A Tool Your Faculty Will Actually Use, Grace L. Paley, Hui Zhao, Victoria M. Addis, Casey J. Beal, Geetha K. Davis, Gabriela M. Espinoza, Michael S. Lee, Stacy L. Pineles, Jamie B. Rosenberg, Robert T. Swan, Misha F. Syed, Evan L. Waxman, Susan M. Culican

Journal of Academic Ophthalmology

Background: We developed and implemented a real-world assessment tool (RWA) for resident surgery. It was designed to improve utility by reducing faculty and trainee cost (completion and training time, cognitive burden). RWA uses an entrustability scale where higher scores indicate a resident’s readiness for independent surgical practice. We describe a two-phase implementation of RWA and report validity evidence for cataract surgery assessment.

Methods: RWA was developed iteratively with resident and faculty input and piloted at a single residency program in phase 1. Phase 2 implemented RWA at 11 ophthalmology residency programs. The main outcome measures were 1) number …

Evaluation Of Sirtuin 1 As A Predictor Of Cardiovascular Outcomes In Diabetic Patients With Limb-Threatening Ischemia, Federico Biscetti, Maria Margherita Rando, Maria Anna Nicolazzi, Enrica Rossini, Michele Santoro, Flavia Angelini, Roberto Iezzi, Luis H. Eraso, Paul J. Dimuzio, Dario Pitocco, Massimo Massetti, Antonio Gasbarrini, Andrea Flex

Department of Surgery Faculty Papers

Chronic limb-threatening ischemia (CLTI) significantly increases the risk of major adverse limb events (MALE) and major adverse cardiac events (MACE) after lower extremity revascularization (LER). This study aims to identify novel biomarkers that help to further reduce the risk of postoperative cardiovascular complications. In this prospective, nonrandomized, observational study, baseline serum levels of sirtuin 1 (SIRT1) were assessed in 147 diabetic patients scheduled for LER due to CLTI, and participants were followed for the occurrence of MALE and MACE over 12 months. Fifty-three patients experienced MALE, and 33 experienced MACE within the follow-up period. Lower baseline SIRT1 levels were significantly …

Peptide Receptor Radionuclide Therapy And Clinical Associations With Renal And Hematological Toxicities And Survival In Patients With Neuroendocrine Tumors: An Analysis From Two U.S. Medical Centers, Tao Xu, Joseph S. Dillon, Mary A. Maluccio, Dawn E. Quelle, Sarah H. Nash, Hyunkeun Cho, Kristen E. Limbach, Nicholas J. Skill, Yvette Bren-Mattison, Michael A. O’Rorke

School of Medicine Faculty Publications

Purpose: Renal and hematological toxicity are side effects and dose-limiting factors of Peptide Receptor Radionuclide Therapy (PRRT). We aimed to assess the changes in renal and hematological function and associations with survival in neuroendocrine tumor (NET) patients treated with PRRT. Methods: A retrospective cohort of 448 NET patients treated with either 177Lu-DOTATATE or 90Y-DOTATOC were followed for changes of renal and hematological function. Renal function was assessed by monitoring changes in serum creatinine, blood urea nitrogen and estimated glomerular filtration rate. Hematological function was determined by examining changes in white blood cell counts (WBC), platelet counts, and hemoglobin levels over …

Combined Single-Shot Intra-Articular Injection Of Ropivacaine And Contrast Media For Magnetic Resonance Imaging: Surgical Decision Making For Hip Arthroscopy In Young Patients, Neil Sarna, Gabriel I. Onor, Kathleen E. Schenker, Alvin W. Su

Rothman Institute Papers

Introduction:

Hip impingement syndrome with labral tear is debilitating for young patients. When magnetic resonance arthrogram (MRA) is equivocal for surgical decision making, an additional intra-articular diagnostic injection (IA) can further confirm the diagnosis. We assessed the effectiveness on surgical decision making by combining hip MRA + IA in one single procedure.

Methods:

We conducted a retrospective review of a prospectively enrolled cohort of patients with hip impingement syndrome who underwent a combined MRA + IA procedure. A 10-mL cocktail containing 0.2% ropivacaine and Omnipaque 300 contrast media was injected into the hip joint, followed by magnetic resonance scanning, in …

Malignant Transformation And Tumour Recurrence In Sacrococcygeal Teratoma: A Global, Retrospective Cohort Study., Lieke J. Van Heurn, Joep P M Derikx, Nigel Hall, Jennifer H. Aldrink, Maria M. Bailez, Lohfa B. Chirdan, Shigehisa Fumino, Afua Hesse, Tuktu Soyer, Shawn D. St Peter, Jos Twisk, Tianyou Yang, Ernst L W Van Heurn, Sct-Study Consortium

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Sacrococcygeal teratoma (SCT) is a rare congenital tumour. The risk of malignancy and recurrence are not well defined. Previous studies are small and report differing conclusions about the timing of surgery and the duration of follow-up. We studied the risk of malignant transformation and SCT recurrence after surgery to address these gaps.

METHODS: This was a global retrospective cohort study. Data of consecutive SCT patients was obtained from 145 institutes in 62 countries. Malignant transformation, defined as malignancy at initial resection, malignant recurrence or death due to malignancy, and its risk factors were analysed.

RESULTS: Of the 3612 included …

Endoscopic And Immunohistochemical Aspects In An Inverted Papilloma With Unilateral Total Obstruction Of The Nasal Fossa, Irina Enache, Florin Anghelina, Mircea -Sorin Ciolofan, Carmen Aurelia Mogoanta, Alex Emilian Stepan, Ioana-Cristina Vilcea, Cosmin Vasile Obleaga, Andrei Osman

Journal of Mind and Medical Sciences

An inverted papilloma is a medical condition in which epithelial cells placed on the surface grow in depth into the underlying supporting tissue. The case of a 68-year-old man with a 6-month history of right-sided complete nasal obstruction, who was referred to the ENT Department of our hospital, is presented. The associated symptoms were represented by repeated epistaxis, rhinorrhea and anosmia. From a clinical point of view, a polypous reddish-gray irregular mass, with cauliflower-like appearance, has been described. The formation was friable, richly vascularized, and with minor bleeding on light touch. The patient was diagnosed with inverted papilloma which was …

Spontaneous Rupture Of A Splenic Artery Aneurysm With Hemoperitoneum; Case Presentation, Vlad Denis Constantin, Ion Motofei, Gelu Valentin Stefanescu, Adrian Silaghi

Journal of Mind and Medical Sciences

Aneurysms of the splenic artery are relatively rare, being found in patients with portal hypertension, multiparous, atherosclerosis, or in young people with various genetic diseases. In the uncomplicated forms, splenic artery aneurysms are often difficult to diagnose either because of the asymptomatic evolution, or because of the non-specific symptoms. In cases of trauma or large sizes, aneurysms can be complicated by rupture, which can cause hemoperitoneum with the risk of death if specific treatment is not initiated as soon as possible. Depending on the location of the splenic aneurysm, comorbidities, the patient's general condition or life-threatening complications, laparotomy, laparoscopy, endovascular …

The Role Of Computed Tomography And Esophageal Ultrasonography In The Preoperative Evaluation Of Esophageal Cancer Resection, Vasile Cosmin Obleaga, Dan Ionuț Gheonea, Ioana Andreea Gheonea, Cecil Sorin Mirea, Emil Moraru, Mihai Călin Ciorbagiu, Ionică Daniel Vîlcea, Tiberiu Ștefăniță Cojan-Țenea

Journal of Mind and Medical Sciences

Objectives. Esophageal cancer is one of the most aggressive types of cancer, with a 5-year relative survival rate of only 18%-20.5%. Survival is highly dependent on accurate positive diagnosis and staging, in which the imaging modalities available have a primary role. The study is focused on the analysis of the preoperative T and M staging strategy and the reliability of computed tomography and endoscopic esophageal ultrasound in predicting resectability. A second objective was to evaluate the influence of preoperative imaging modalities on decreasing the number of unnecessary thoracotomies and laparotomies. Material and Methods. This study was conducted on a lot …

Magnetic Resonance Used As A Differential Diagnostic Tool Between Inflammatory Cancer Of The Sigmoid And Acute Sigmoid Diverticulitis, Cornel Dragos Cheregi, Teodora Gabriela Alexescu, Andrei Vasile Pascalau, Ovidiu Laurean Pop, Calin Magheru, Ioana Maria Muresan, Nicoleta Ramona Suciu, Maur Sebastian Horgos, Mihai Stefan Muresan

Journal of Mind and Medical Sciences

Sigmoid diverticulitis is a common disease characterized by a well-standardized diagnostic approach and treatment. Colorectal cancer is the third most common malignancy worldwide, irrespective of gender. In 2020, CRC global-related mortality rate was estimated at 935 173 cases, with an incidence of 9.3% in men and 9.5% in women. The diagnosis of acute diverticulitis is always made by performing a contrast-enhanced-computed tomography (CT) of the abdomen. Current diagnosis guidelines do not recommend the use of a magnetic resonance imaging (MRI) for further and more precise assessment of a suspected sigmoid diverticulitis diagnosed by CT. Early lower-gastrointestinal (lower-GI) endoscopy is rarely …

Approaches And Indications In Laparoscopic Choledoscopy, Iulian Slavu, Raluca Tulin, Ileana Dima, Alexandru Dogaru, Florin Filipoiu, Bogdan Socea, Anca Monica Oprescu Macovei, Adrian Tulin

Journal of Mind and Medical Sciences

Objectives. Up to 20% of patients with biliary lithiasis have bile duct stones, which are asymptomatic in 50% of cases. The aim of the study was to evaluate the role of choledoscopy in extracting stones from the main bile ducts. Materials and Methods. This is a retrospective study (January 2014 - December 2024) on 2309 patients who underwent a laparoscopic cholecystectomy. Laparoscopic choledoscopy was performed in 32 cases. Of the 32 patients with complete clearance, none had residual common bile duct stones (CBDS) at 1 year postoperatively. Results. The ideal approach in our study was the transcystic approach, with the …

Evaluation Of Short-Term Complications In Laparoscopic Peritoneal Dialysis Catheter Placement - A Single Tertiary Center Experience, Cristina Raluca Iorga, Iuliana Andreiana, Simona Hildegrad Stancu, Traian Constantin, Victor Strambu, Cristian Iorga

Journal of Mind and Medical Sciences

Background. Peritoneal dialysis is a form of kidney function replacement that is not as widespread as hemodialysis. However, it has recognized advantages, such as preservation of residual renal function, lack of vascular access, and the ability to be performed at home. On the other hand, it requires the correct insertion of a peritoneal dialysis (PD) catheter and maintaining its patency. Methods. We conducted a retrospective study of 126 patients with end-stage renal disease who underwent laparoscopic Tenckhoff catheter placement for peritoneal dialysis between January 2016 and December 2022. The study analyzed the frequency and type of complications registered within three …

Gastrointestinal Stromal Tumors: A Focus On The Impact Of Interstitial Cells Of Cajal In Disease Development, Petru Radu, Mihai Zurzu, Anca Tigora, Vlad Paic, Mircea Bratucu, Dragos Garofil, Valeriu Surlin, Stefan Patrascu, Virgiliu Prunoiu, Ionut Simion Coman, Valentin Georgescu, Razvan Daniel Chivu, Florian Popa, Victor Strambu, Raluca Gabriela Ioan

Journal of Mind and Medical Sciences

Introduction. Interstitial Cells of Cajal (ICCs) play a critical role in the regulation of gastrointestinal motility and have been implicated in various functional gastrointestinal disorders. Recent research indicates a possible association between ICCs and the tumor risk of Gastrointestinal Stromal Tumors (GISTs). This research aims to examine the clinical, histopathological, and biomolecular characteristics of ICCs and their relevance in assessing GIST risk. Materials and Methods. This study examined fourteen GIST patients who underwent surgical intervention at the Surgery Department of Carol Davila Nephrology Hospital in Bucharest. Parameters including age, gender, tumor location/ dimensions were scrutinized. Immunohistochemistry employing markers CD117, DOG-1, …

Postoperative Pain Management In The Enhanced Recovery After Surgery (Eras) For Emergency Laparoscopic Cholecystectomy, Antonio Mihai Istrate, Dragos Serban, Dan Dumitrescu, Corneliu Tudor, Laurentiu Simion, Vlad Denis Constantin, Ciprian Tanasescu, Dan Giorgian Bratu, Bogdan Mihai Cristea, Catalin Cicerone Grigorescu, Ana Maria Dascalu

Journal of Mind and Medical Sciences

Introduction. Enhanced recovery after surgery (ERAS) is a new patient-centered concept that aims to deliver high-quality perioperative care to surgical patients. This study was performed to compare the effectiveness of the pain management measures in an ERAS-protocol versus the traditional approach of postoperative pain. Materials and Methods. A comparative prospective study was performed on 50 patients admitted in the Fourth General Surgery of University Emergency Hospital of Bucharest between 2022 and 2024, with the diagnosis of acute cholecystitis, undergoing emergency laparoscopic cholecystectomy. The patients were randomly assigned into two study groups, an ERAS-group and a Traditional group, according to the …

Artificial Intelligence And Liver Transplantation; Literature Review, Maria Serban, Irina Balescu, Sorin Petrea, Bogdan Gaspar, Lucian Pop, Valentin Varlas, Marilena Stoian, Camelia Diaconu, Cristian Balalau, Nicolae Bacalbasa

Journal of Mind and Medical Sciences

Liver transplantation is the last life-saving solution for patients with end stage liver disease. The discrepancy between waiting list and available organs has led to the appearance of extended donation criteria and the development of several scores (Child-Pugh score, MELD score, DRI score, SOFT score), in order to find the most suitable donor-recipient match. But none of these scores can predict survival after transplantation. Artificial Intelligence (AI) has recently been shown as an excellent tool for the study of the liver and comes in this aid with its various methods (random forest, artificial neural networks, decision tree, Bayesian networks, and …

Diabetes Mellitus And Associated Complications In The Digestive Tract, Ioana Paunica, Vlad Denis Constantin, Dragos Serban, Cristian Paius, Bogdan Gaspar, Dragos Epistatu, Valentin Verlas, Roxana Sfetea, Liliana Florina Andronache, Cristian Balalau, Daniela Gabriela Bălan, Alexandru Florin Motofei, Adrian Silaghi

Journal of Mind and Medical Sciences

Diabetes mellitus presents an increasing prevalence and severe multisystemic complications, with notable personal, professional and social implications. Diabetes is generally known by hyperglycemia and subsequent metabolic disorders. In addition to hyperglycemia, it appears that other factors (related to anthropometric-pathophysiology and genome-based subphenotyping) are involved not only in the clinical course but also in the occurrence of diabetes complications. This review presents several diabetes-induced complications on the digestive tract (periodontal disease, xerostomia, oral infections, dental caries, taste disturbances, gastroesophageal reflux disease, gastroparesis, gastric ulcer and cancer, diabetic enteropathy, inflammatory bowel diseases, colorectal cancer, etc.), many of them with major implications and …

Giant Adrenal Myelolipomas: A Literature Review, Mircea Hogea, Anda Hogea, Marius Moga, Roxana Dragomir, Simona Grigorescu, Bogdan Socea

Journal of Mind and Medical Sciences

Myelolipomas are described as small tumors, with some authors referring to sizes less than 4 cm in diameter. However, when greater than 10 cm, myelolipomas are labeled as giant tumors and thus, have a definite indication for surgical resection. Myelolipomas represent a small percentage of adrenal tumors. Giant myelolipomas are usually discovered incidentally during imaging studies performed for other conditions. They are often slow-growing and may reach sizes that significantly distort the anatomy of the affected area. Despite their large size, they are usually benign and do not spread to other parts of the body. Adrenal myelolipoma is a benign …