Total Parenteral Nutrition in Patients Following Pancreaticoduodenectomy: Lessons from 1184 Patients
Cullen Worsh; Talar Tatarian, MD, PGY-4; Awinder Singh; Michael J. Pucci, MD; Jordan M Winter, MD; Charles J. Yeo, MD; and Harish Lavu, MD
Poster presented at Sigma XI Student Research Day at Thomas Jefferson University.
Total parenteral nutrition (TPN) has historically been used conservatively in the management of patients after pancreaticoduodenectomy (PD).
In this study, we evaluate the indications for and outcomes associated with TPN use in a high-volume pancreatic surgery center.
Surgical Apgar Score (SAS) Predicts Perioperative Morbidity and Length of Stay in Patients Undergoing Esophagectomy at a High-Volume Center
Danica Giugliano, MD; Andrew Morgan; Francesco Palazzo, MD; Nathaniel R. Evans III, M.D.; Ernest L Rosato, MD; Adam C. Berger, MD; and Benjamin E Leiby, PhD
Esophagectomy is a procedure that carries considerable morbidity. Many studies have evaluated factors to predict patients at risk and improve clinical outcomes. The aim of this study was to determine whether the SAS predicts complications, length of stay, and anastomotic leak for patients undergoing esophagectomy at a high-volume institution.
Danica N. Giugliano, MD; Danielle Fortuna, MD; Scott D. Goldstein, MD; Benjamin Philllips, MD; and Gerald A. Isenberg, MD
Introduction, Case Report, Discussion, Conclusion and References.
Dual Kidney Allocation Score: A Novel Algorithm Utilizing Expanded Donor Criteria for the Allocation of Dual Kidneys in Adults
Adam P. Johnson, MD, MPH; Thea P. Price, MD; Benjamin E Leiby, PhD; and Cataldo Doria, MD, PhD, FACS
Dual kidney transplantation (DKT) of expanded criteria donors is a cost intensive procedure to help increase the pool of available deceased organ donors. In studies to day, expanded criteria single kidney (eSKT) or dual kidney transplantation (DKT) have demonstrated equivalence, but a more rigorous allocation system is needed to optimize limited resources for improved operative outcomes.
Role of Target Specific Oral Anticoagulation After Operative Management of Venous Thoracic Outlet Syndrome
Jeontaik Kwon, MD; Paul J. DiMuzio, MD; Babak Abai, MD; Dawn Salvatore, MD; Taki Galanis, MD; Geno J. Merli, MD; and Luis H. Eraso, MD
The purpose of this study is to review the efficacy of Target Specific Oral Anticoagulants (TSOAC) versus vitamin K antagonist (VKA) for post-surgical anticoagulation in patient with primary subclavian vein thrombosis. Rivaroxaban, a factor Xa inhibitor, was the first TSOAC approved by the FDA in 2012 for the treatment and prevention of deep vein thrombosis. However, the efficacy and safety of TSOAC for prevention of recurrent deep vein thrombosis after revascularization of upper extremity compression syndromes is largely unknown.
W. Mohiuddin; Kamini D. Patel; Steven E. Copit, MD; and Patrick J. Greaney, MD, FACS
There has been an increasing use of postmastectomy radiation therapy (PMRT) in breast cancer patients, especially in cases of large tumors (T3 or greater) or node-positive disease (N1 or greater).1 When radiation for the treatment of breast cancer is expected, tissue-based breast reconstruction is generally preferred to implant-based reconstruction. This distinction is attributed to the high rate of complications with postoperative radiation after implant-based reconstruction, ranging from 20% to 70%.2
In cases when the need for radiation is likely, breast reconstruction with autologous tissue is typically deferred until the completion of the radiation therapy. Reasons for deferring include avoiding additional morbidity that may delay adjuvant therapy, avoiding irradiating the flap, and maintaining a planar field to optimize radiation delivery.3-9 Additionally, radiation is known to cause tissue fibrosis, edema, and vasculitis, all of which can interfere with wound healing.3 These reasons must be balanced against the increased psychological discomfort of delayed breast reconstruction, as defect of the breast can affect a woman’s self-esteem.10 Few studies have examined the effects of prior radiotherapy on autologous breast reconstruction.11,12 The purpose of this study is to delineate the effects of postmastectomy radiation therapy on outcomes of lower abdominal free flap breast reconstruction by a single surgeon.
Higher Body Mass Index (BMI) and Low-Volume Surgeons Confer Increased Operative Complications in Anterior Spinal Exposures
Aisha Shaheen, MD, MHA; Naveed A. Rahman; Abhay Mathur, BS; Deepika Koganti, MD, PGY-4; Alec C. Beekley, MD, FACS; John R. Eisenbrey, PhD; Joshua A. Marks, MD; Michael S. Weinstein, MD, FACS, FCCM; and Murray J. Cohen, MD, FACS
Anterior spinal exposures performed by spine or vascular surgeons have a known complication rate of 2-11%. We present the largest single institution experience of anterior spinal exposures performed by Acute Care Surgeons.
The purpose of this study was to characterize the incidence of vascular and visceral injuries during spinal exposures and to identify risk factors contributing to operative complications during the exposure. We hypothesized that patients with a BMI >30 as well as low-volume surgeons (<20>operations) would have an increased complication rate.
Poster presented at: American Association for Surgery of Trauma (AAST) in Hawaii