Surgery Commons^™

Antimicrobial Peptide Screening For Designing Custom Bactericidal Hydrogels, Matthias Recktenwald, Muskanjot Kaur, Mohammed M. Benmassaoud, Aryanna Copling, Tulika Khanna, Michael Curry, Dennise Cortes, Gilbert Fleischer, Valerie J. Carabetta, Sebastian Vega

Rowan-Virtua School of Translational Biomedical Engineering & Sciences Departmental Research

Staphylococcus aureus (S. aureus) is an opportunistic pathogen that lives on surfaces and skin and can cause serious infections inside the body. Antimicrobial peptides (AMPs) are part of the innate immune system and can eliminate pathogens, including bacteria and viruses, and are a promising alternative to antibiotics. Although studies have reported that AMP-functionalized hydrogels can prevent bacterial adhesion and biofilm formation, AMP dosing and the combined effects of multiple AMPs are not well understood. Here, three AMPs with different antibacterial properties were synthesized and the soluble minimum inhibitory concentrations (MICs) of each AMP against methicillin-susceptible S. aureus (MSSA) and methicillin-resistant …

A Systematic Review Of Telehealth Utilization For Bowel Management Programs In Pediatric Colorectal Surgery., Elizaveta Bokova, Ismael Elhalaby, Seth Saylors, Irene Isabel P. Lim, Rebecca M. Rentea

Manuscripts, Articles, Book Chapters and Other Papers

Recent advancements in pediatric surgery have embraced telehealth (TH) modalities, transitioning from traditional in-person consultations to virtual care. This shift has broadened access to healthcare, potentially enhancing affordability, patient and caregiver satisfaction, and clinical outcomes. In pediatric colorectal surgery, telehealth has been effectively utilized to support Bowel Management Programs (BMPs) for children suffering from constipation and fecal incontinence. A systematic review was conducted to assess the effectiveness of virtual BMPs, analyzing studies from January 2010 to December 2023, sourced from MEDLINE (via PubMed), Embase, and the Cochrane Library, with five studies included. Remote BMPs, implemented through video or telephone consultations, …

Long-Term Patency Of Stent Angioplasty For Aortoiliac Occlusive Disease: A Literature Review, Ira H. Siagian, Alexander J. Utama

The New Ropanasuri Journal of Surgery

Introduction. Surgical revascularization remains a definitive therapy for aortoiliac occlusive disease. Revascularization could be achieved via endovascular treatment using angioplasty or open surgery. A limited number of studies currently assess the long-term patency of stent angioplasty of aortiliac occlusive disease. This study aims to evaluate or find recent evidence regarding the evaluation of the long-term patency of stent angioplasty for the treatment of aortoiliac occlusive disease.

Method. Literature searching was conducted through several online databases, including Cochrane, PubMed, and EBSCOHost. Several cohort and randomized controlled studies assessing long-term patency of stent angioplasty ranging from bare metal stent to balloon angioplasty …

Recurrence Analysis Of Pediatric Thyroid Carcinoma In Dr. Cipto Mangunkusumo General Hospital And Its Associated Factors, Erwin D. Yulian, Marlin Mp Prawirodihardjo

The New Ropanasuri Journal of Surgery

Introduction. Thyroid cancer is the most common endocrine malignancy in children aged 0-14 years, frequently occurring in adolescents and young adults. The global incidence rate stands at 0.54 cases per 100,000 individuals. Pediatric patients exhibit higher recurrence rates compared to adults, although their mortality rates are low. Research exclusively for the pediatric population is still sparse in Indonesia. Thus, This study aimed to provide essential data on recurrence and mortality rates of pediatric thyroid cancer, along with an analysis of contributing factors.

Method. This study is a retrospective cohort focusing on survival analysis. The research sample was drawn from the …

Safety And Efficacy Of Rivaroxaban-Aspirin Combination Compared To Aspirin Monotherapy On Lower Peripheral Artery Disease After Revascularization: Systematic Review And Meta-Analyses, Robby E. Thio, Dedy Pratama

The New Ropanasuri Journal of Surgery

Introduction. Currently, single antiplatelet treatments using aspirin or clopidogrel are recommended for post-revascularization peripheral artery disease (PAD) patients. However, a recent study suggested that a combination of rivaroxaban and aspirin was more favorable to use. We conducted a systematic review to determine the efficacy and safety of rivaroxaban and aspirin combination compared to aspirin alone.

Method. A systematic review conducted based on the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocol. Search using keywords was conducted on Cochrane, PubMed, Scopus, EBSCOHost, and Google Scholar. Inclusion and exclusion criteria were applied. Selected studies were appraised using the Cochrane risk …

Outcome Of Benign Breast Tumor Excision Using Ultrasound-Guided Vacuum Assisted Breast Biopsy: A Literature Review, I Gusti N.G Wibisana, Elisabet L.A Kinanthi

The New Ropanasuri Journal of Surgery

Introduction. Benign breast tumors have a significant incidence among breast diseases that cause anxiety for patients. Surgical management is one of the managements. Vacuum-assisted breast biopsy (VABB) could be applied to tumors with a size of less than 3 cm or multiple lesions. One of its techniques is guided by ultrasonography (USG). In Indonesia, the ultrasound-guided (USG-guided) VABB has already been applied in several healthcare instances. Nevertheless, there are still opinions about tumor recurrence after the procedure. This study’s purpose is to observe the tumor recurrence and patients' satisfaction with benign breast tumor excision with USG-guided VABB.

Method. Literature was …

Methylene Blue As An Adjuvant Analgesic Postoperative Anal Fistula: A Randomized Clinical Trial, Wifanto S. Jeo, Muhammad Fa Irsal, Riana P. Tamba, Yefta Moenadjat, Dewi Friska

The New Ropanasuri Journal of Surgery

Introduction. Anal fistula is a pathological condition that connects the anorectal mucosa to the perianal skin, requiring various types of surgical procedures. However, surgery often causes postoperative pain. The use of methylene blue is being studied as a potential analgetic adjuvant in anal fistula surgery. Previous studies have shown that methylene blue can effectively reduce postoperative pain in various types of anorectal surgery. This study aims to determine methylene blue's clinical efficacy as an analgetic adjuvant.

Methods. A double-blind, randomized controlled trial was conducted. Subjects consisting of subjects with simple anal fistula to undergo fistulectomy were randomly allocated into two …

Evaluation Of Antimicrobial Stewardship Implementation In Elective Surgery In Dr Cipto Mangunkusumo General Hospital Using Gyssens Method, Rhea P. Ulima, Yefta Moenadjat

The New Ropanasuri Journal of Surgery

Introduction. Nowadays, surgical site infections (SSI) remain the most common complication of surgical procedures. In prevention, prophylactic antibiotics are the first option, which leads to the high use of antibiotics. However, antibiotic administration should be based on strategies such as stewardship. Thus, the study aimed to assess the situation using Gyssens' method.

Method. A retrospective cohort study analyzed the antibiotic administration of most major elective surgeries, including thyroidectomy, mastectomy, and cholecystectomy, proceeded in Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia, from January to July 2023. Indication, type, dosage, timing, interval, duration, and route of administration were the variables of interest. …

Correlation Between Age, Initial Body Mass Index (Bmi) With Excessive Weight Loss In Very Early Postoperative Period, Fanny Indarto, Jeffrey -, Peter I. Limas

The New Ropanasuri Journal of Surgery

Introduction. As a major outcome of bariatric surgery, weight loss can be affected by many factors, such as sociodemographic, behavioral problems, genetics, patient status, and the surgical technique. However, limited data were available. This research aimed to seek a correlation between age and BMI with excessive weight loss after bariatric surgery.

Method. Cross–sectional study design from 2 bariatric centers in Jakarta, using data from 2018–2022. Percentage Excessive Weight Loss (%EWL) 3 months was an outcome measurement tool.

Results. Of 87 subjects enrolled with male to female ratio was 1:4. Age ranged from 14–62 years (median 39 years). Type 1 obesity, …

Efficacy Of Full Dose And Sandwich Neoadjuvant Chemotherapy In Breast Cancer: A Literature Review, I Gusti Ng Wibisana, Shandy V. Putra

The New Ropanasuri Journal of Surgery

Introduction. Breast cancer is the leading cause of death in productive-age women, and that needs to be addressed with systemic medication. There has been a big-scale success using adjuvant chemotherapy; however, the optimal method of chemotherapy administration has yet to be determined. Two methods have been introduced today: full dose and sandwich methods. In full dose, we administer chemotherapy before surgical intervention, whereas in the sandwich method, we administer chemotherapy before and after surgical intervention. In this literature review, we aim to observe the effectiveness of chemotherapy administration through both full-dose and sandwich methods.

Method. In the initial phase, 51 …

The Attainment Of A Patient Acceptable Symptom State In Patients Undergoing Revision Spine Fusion, Tariq Z. Issa, Omar H. Tarawneh, Teeto Ezeonu, Ameer A. Haider, Rajkishen Narayanan, Jose A. Canseco, Alan S. Hilibrand, Alexander R. Vaccaro, Gregory D. Schroeder, Christopher K. Kepler

Rothman Institute Papers

INTRODUCTION: Revision lumbar fusion is most commonly due to nonunion, adjacent segment disease (ASD), or recurrent stenosis, but it is unclear if diagnosis affects patient outcomes. The primary aim of this study was to assess whether patients achieved the patient acceptable symptom state (PASS) or minimal clinically important difference (MCID) after revision lumbar fusion and assess whether this was influenced by the indication for revision.

METHODS: We retrospectively identified all 1-3 level revision lumbar fusions at a single institution. Oswestry Disability Index (ODI) was collected at preoperative, three-month postoperative, and one-year postoperative time points. The MCID was calculated using a …

Clinical And Genomic Profile Of Primary Cranial Neurolymphomatosis, Emily B Wolf, Robin Imperial, Liuyan Jiang, Amit K Agarwal, Han W Tun

Faculty, Staff and Student Publications

Primary cranial neurolymphomatosis (PCNL) is a rare subtype of primary CNS lymphoma (PCNSL) in which infiltrative lymphomatous involvement is confined to cranial nerves. Here, we report a case of PCNL with successful genomic profiling. A 57-year-old male had a lengthy prediagnostic phase spanning approximately 30 months, characterized by multiple episodes of cranial neuropathies managed by steroids. At the time of diagnosis, the patient had right-sided cranial neuropathies involving cranial nerves (CN) V, VI, and VII. Pathological findings of the right cavernous lesion biopsy were consistent with large B-cell lymphoma-infiltrating nerve fibers. The clinical course was aggressive and refractory, characterized by …

Aso Author Reflections: Isolated Margin Positivity In Localized Pancreatic Ductal Adenocarcinoma And Operative Margin Revision, Lee M. Ocuin

Faculty Scholarship

No abstract provided.

An Incidentally Found Mass On The Remnant Stomach After A Roux-En-Y Gastric Bypass, Jennifer E. Geller, Santosh Swaminathan, Kristin Noonan

Abington Jefferson Health Papers

BACKGROUND: Incidentally found masses are a widely discussed area of medicine, and there are conflicting opinions as to how to deal with these findings, particularly in the stomach-which has limited documentation in the literature. Here we present a middle-aged female who was found to have an incidentally found mass on her remnant stomach 10 years after a Roux-en-Y gastric bypass (RYGB) surgery.

CASE PRESENTATION: We present the case of a 66-year-old female who is 10 years post-op from a RYGB. After a bout of self-resolving diarrheal illness prompted a computed tomography (CT) scan in the emergency department, she was diagnosed …

To Revise Or Not Revise? Isolated Margin Positivity In Localized Pancreatic Ductal Adenocarcinoma, Victoria S. Wu, Henry J. Stitzel, John B. Ammori, Jeffrey Hardacre, Lee M. Ocuin

Faculty Scholarship

Background: The study determined the proportion of patients with pancreatic adenocarcinoma (PDAC) who had margin-positive disease and no other adverse pathologic findings (APF) using institutional and administrative datasets. Methods: Patients with clinical stage I or II PDAC in the National Cancer Database (NCDB 2010–2020) and those who underwent pancreatectomy at the authors’ institution (2010–2021) were identified. Isolated margin positivity (IMP) was defined as a positive surgical margin with no APF (negative nodes, no lymphovascular/perineural invasion). Results: The study included 225 patients from the authors’ institution and 23,598 patients from the NCDB. The margin-positive rates were 21.8% and 20.3%, and the …

Does The Use Of Double Hormone Replacement Therapy For Trauma Patient Organ Donors Improve Organ Recovery For Transplant, Eden M. Gallegos, Tanner Reed, Paige Deville, Blake Platt, Claudia Leonardi, Lillian Bellfi, Jessica Dufrene, Saad Chaudhary, John Hunt, Lance Stuke, Patrick Greiffenstein, Jonathan Schoen, Alan Marr, Anil Paramesh, Alison A. Smith

School of Graduate Studies Faculty Publications

BACKGROUND With an ongoing demand for transplantable organs, optimization of donor management protocols, specifically in trauma populations, is important for obtaining a high yield of viable organs per patient. Endocrine management of brain-dead potential organ donors (BPODs) is controversial, leading to heterogeneous clinical management approaches. Previous studies have shown that when levothyroxine was combined with other treatments, including steroids, vasopressin, and insulin, BPODs had better organ recovery and survival outcomes were increased for transplant recipients. AIM To determine if levothyroxine use in combination with steroids in BPODs increased the number of organs donated in trauma patients. METHODS A retrospective review …

Incidence Of Orbital Mucocele Following Orbital Floor Fracture Repair, Adeem M. Nachabe, Genevieve E. Messa, Jonathan C. Boraski

School of Medicine Faculty Publications

Mucoceles can often present as a complication after prior sinus surgery or maxillofacial trauma when mucosal drainage is obstructed. Their presence in the orbit following orbital wall fracture and subsequent repair represent an exceedingly rare complication whose occurrence is limited to a few reported cases in the literature. In these patients, continuous cyst expansion and subsequent mass effect may lead to ophthalmic symptoms, including orbital pain, proptosis, diplopia, and globe dystopia. We report the discovery of an orbital mucocele after orbital floor fracture repair and its possible association with the nonporous reconstruction plate utilized for fixation. When a patient with …

Bidirectional Needs Assessment Of Otolaryngology-Head And Neck Surgery Short-Term Surgical Trips In Zimbabwe, Katerina J. Green, Naboth Matinhira, Amiti Jain, Priya Arya, Dontre' M. Douse, Titus Dzongodza, Clemence Chidziva, Joshua P. Wiedermann

Student Papers, Posters & Projects

OBJECTIVES: To describe findings from an otolaryngology-specific needs assessment tool in Zimbabwe.

METHODS: Surveys were developed and shared with Low-Middle Income Country (LMIC) hosting institutions in Zimbabwe and to High-Income Country surgical trip participants (HIC). Respondents were otolaryngologists identified online and through professional networks who had participated in a surgical trip.

RESULTS: The most common procedures Zimbabwe otolaryngologists reported treating were adenotonsillectomy (85.7%), chronic rhinosinusitis (71.4%), chronic otitis (57.1%), and head and neck tumor intervention (57.1%). The most common untreatable conditions that host physicians wanted to treat were skull base surgery (71.4%), flap reconstructions (57.1%), and laryngotracheal reconstruction (57.1%). The …

Appropriateness Of Care: Deep Venous Procedures, Karem C. Harth

Faculty Scholarship

In the past decade, technologies to treat venous pathologies have increased dramatically, to the benefit of an often underserved and overlooked population of patients with venous disease. However, given the rapid release of various technologies, including venous-dedicated stents and thrombectomy devices across varied venous pathologies, evidence-based guidelines have been slow to develop. When discussing appropriateness of care, one needs to consider optimal patient selection, technical approach, medical management, and surveillance protocols, to name a few. All of which, in the venous space, are currently widely varied in practice. The future of deep venous work is limitless, but multicenter, randomized controlled …

Digital Twin Mathematical Models Suggest Individualized Hemorrhagic Shock Resuscitation Strategies, Jeremy W Cannon, Danielle S Gruen, Ruben Zamora, Noah Brostoff, Kelly Hurst, John H Harn, Fayten El-Dehaibi, Zhi Geng, Rami Namas, Jason L Sperry, John B Holcomb, Bryan A Cotton, Jason J Nam, Samantha Underwood, Martin A Schreiber, Kevin K Chung, Andriy I Batchinsky, Leopoldo C Cancio, Andrew J Benjamin, Erin E Fox, Steven C Chang, Andrew P Cap, Yoram Vodovotz

Faculty, Staff and Student Publications

BACKGROUND: Optimizing resuscitation to reduce inflammation and organ dysfunction following human trauma-associated hemorrhagic shock is a major clinical hurdle. This is limited by the short duration of pre-clinical studies and the sparsity of early data in the clinical setting.

METHODS: We sought to bridge this gap by linking preclinical data in a porcine model with clinical data from patients from the Prospective, Observational, Multicenter, Major Trauma Transfusion (PROMMTT) study via a three-compartment ordinary differential equation model of inflammation and coagulation.

RESULTS: The mathematical model accurately predicts physiologic, inflammatory, and laboratory measures in both the porcine model and patients, as well …