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Delman surgery

Lauren M Postlewait, Clara R Farley, Alexandra M Seamens, Nina Le, Monica Rizzo, Maria C Russell, Michael C Lowe, Keith A Delman
BACKGROUND: Limited data exist characterizing complications after axillary lymphadenectomy for melanoma. With high rates of complications reported after dissection for breast cancer and data suggesting that completion lymphadenectomy may have limited therapeutic benefit, this study characterized morbidity to facilitate clinical decision-making. METHODS: Using a broad definition for complications, patients who underwent axillary dissection for melanoma at a single center (from 2003 to 2015) were assessed through retrospective chart review...
February 2018: Annals of Surgical Oncology
Joshua S Mincer, Mark G Baxter, Patrick J McCormick, Mary Sano, Arthur E Schwartz, Jess W Brallier, Heather G Allore, Bradley N Delman, Margaret C Sewell, Prantik Kundu, Cheuk Ying Tang, Angela Sanchez, Stacie G Deiner
BACKGROUND: Mechanistic aspects of cognitive recovery after anesthesia and surgery are not yet well characterized, but may be vital to distinguishing the contributions of anesthesia and surgery in cognitive complications common in the elderly such as delirium and postoperative cognitive dysfunction. This article describes the aims and methodological approach to the ongoing study, Trajectory of Recovery in the Elderly (TORIE), which focuses on the trajectory of cognitive recovery from general anesthesia...
September 7, 2017: Anesthesia and Analgesia
Thomas F Barrett, Hadrien A Dyvorne, Francesco Padormo, Puneet S Pawha, Bradley N Delman, Raj K Shrivastava, Priti Balchandani
BACKGROUND: Successful endoscopic endonasal surgery for the resection of skull base tumors is reliant on preoperative imaging to delineate pathology from the surrounding anatomy. The increased signal-to-noise ratio afforded by 7-T MRI can be used to increase spatial and contrast resolution, which may lend itself to improved imaging of the skull base. In this study, we apply a 7-T imaging protocol to patients with skull base tumors and compare the images with clinical standard of care...
July 2017: World Neurosurgery
Keith A Delman, Michael C Lowe
No abstract text is available yet for this article.
September 12, 2016: Annals of Surgical Oncology
Hasan H Danish, Kirtesh R Patel, Jeffrey M Switchenko, Theresa W Gillespie, Jaymin Jhaveri, Mudit Chowdhary, Mustafa Abugideiri, Keith A Delman, David H Lawson, Mohammad K Khan
Recently, TROG 02.01 results showed that in stage III melanoma patients with nodal metastasis, adjuvant radiation to lymph node basin after nodal dissection improves lymph node field relapse without an overall survival (OS) benefit. However, this trial was neither designed nor powered to detect an OS difference. In the present study, we analyzed patients in the National Cancer Database (NCDB) with stage III melanoma with pathologically involved nodes and compared survival outcomes of adjuvant radiation and no-radiation cohorts...
December 2016: Melanoma Research
Mary E Klingensmith, Michael Awad, Keith A Delman, Karen Deveney, Thomas J Fahey, Jason S Lees, Pamela Lipsett, John T Mullen, Douglas S Smink, Jeffrey Wayne
OBJECTIVE: To assess the attitudes of residents and program directors (PDs) involved in flexible training to gauge satisfaction with this training paradigm and elicit limitations. DESIGN: Anonymous surveys were sent to residents and PDs in participant programs. Respondents were asked to rate responses on a 5-point Likert scale (1 = strongly disagree and 5 = strongly agree). SETTING: A total of 9 residency programs that are collaborating to prospectively study the effect of flexible tracks on resident performance and outcome...
November 2015: Journal of Surgical Education
Rebecca M Minter, Keith D Amos, Michael L Bentz, Patrice Gabler Blair, Christopher Brandt, Jonathan D'Cunha, Elisabeth Davis, Keith A Delman, Ellen S Deutsch, Celia Divino, Darra Kingsley, Mary Klingensmith, Sarkis Meterissian, Ajit K Sachdeva, Kyla Terhune, Paula M Termuhlen, Patricia B Mullan
PURPOSE: To evaluate interns' perceived preparedness for defined surgical residency responsibilities and to determine whether fourth-year medical school (M4) preparatory courses ("bootcamps") facilitate transition to internship. METHOD: The authors conducted a multi-institutional, mixed-methods study (June 2009) evaluating interns from 11 U.S. and Canadian surgery residency programs. Interns completed structured surveys and answered open-ended reflective questions about their preparedness for their surgery internship...
August 2015: Academic Medicine: Journal of the Association of American Medical Colleges
Timothy P Love, Benjamin M Martin, Ronald Tubasiime, Jahnavi Srinivasan, Jonathan D Pollock, Keith A Delman
No abstract text is available yet for this article.
July 2015: Journal of Surgical Education
Daniel E Oliver, Kirtesh R Patel, Douglas Parker, Keith A Delman, David H Lawson, Ragini R Kudchadkar, Mohammad K Khan
The National Comprehensive Cancer Network (NCCN) 2014 guidelines are unclear about the role of radiotherapy in the management of desmoplastic melanoma. The guidelines specify that radiotherapy can be 'considered' for select patients with desmoplastic melanoma with narrow surgical margins. Patient selection criteria, including margins, are not well defined, causing considerable differences in practice patterns across the country. There are also several conflicting reports about the role of radiotherapy in improving postsurgical outcomes when other adverse pathological risks factors, such as increased Clark level, head and neck involvement, perineural invasion, positive margins, or recurrent disease, are also present...
April 2015: Melanoma Research
Lindsey A Herrel, Aaron D Weiss, Michael Goodman, Timothy V Johnson, Adeboye O Osunkoya, Keith A Delman, Viraj A Master
BACKGROUND: Extramammary Paget's disease (EMPD) is a rare intraepithelial malignancy with poorly described outcomes. EMPD in men is primarily found in the perianal and penoscrotal areas. We assessed incidence and time trends of EMPD in men as well as extent and predictors of survival using the Surveillance, Epidemiology, and End Results (SEER) program. METHODS: The data from 18 SEER registries were queried for men diagnosed with EMPD from 1973 to 2009. Cases were categorized by primary skin location: perianal, penoscrotal, and other truncal...
May 2015: Annals of Surgical Oncology
Benjamin M Martin, Joanna W Etra, Maria C Russell, Monica Rizzo, David A Kooby, Charles A Staley, Viraj A Master, Keith A Delman
BACKGROUND: Open inguinal lymphadenectomy for regionally metastatic melanoma is associated with a high wound-related morbidity. Videoscopic inguinal lymphadenectomy (VIL) is a minimally invasive approach with fewer wound-related complications, yet its adoption has been hindered by a lack of oncologic outcomes data. STUDY DESIGN: Data were prospectively collected on all VILs performed for melanoma from 2008 to 2012 (n = 40) and compared with a retrospective cohort of open superficial inguinal lymphadenectomies from 2005 to 2012 (n = 40)...
April 2014: Journal of the American College of Surgeons
Benjamin M Martin, Viraj A Master, Keith A Delman
The selection of a treatment modality involves a balance between risk and benefit. Surgical decision making is intrinsically dependent on potential morbidity; therefore, the desire to minimize adverse outcomes remains paramount in the effort to provide patients with the widest range of therapeutic options. The adoption of sentinel lymph node biopsy for the evaluation of regionally metastatic melanoma has reduced the number of complete lymphadenectomies and their attendant comorbidities. For patients who require completion lymphadenectomy, selective lymphadenectomy and, more recently, videoscopic inguinal lymphadenectomy have been shown to further reduce wound-related complications, while maintaining equivalent regional control and lymph node yield, respectively...
October 2013: Oncology (Williston Park, NY)
Benjamin M Martin, Viraj A Master, Keith A Delman
BACKGROUND: The standard treatment of care for melanoma metastatic to the inguinal lymph node basin is lymphadenectomy. However, up to 50% of patients forgo the operation partly due to concerns about morbidity. Videoscopic inguinal lymphadenectomy (VIL) is a minimally invasive technique designed to minimize wound complications while achieving comparable oncological control. METHODS: We reviewed pertinent literature related to open inguinal lymphadenectomy and VIL specific to melanoma, offering personal experience where appropriate...
October 2013: Cancer Control: Journal of the Moffitt Cancer Center
Sarah B Fisher, Steven C Kim, David A Kooby, Kenneth Cardona, Maria C Russell, Keith A Delman, Charles A Staley, Shishir K Maithel
Large single-institution series of patients undergoing resection for gastrointestinal stromal tumors (GIST) are lacking. Clinicopathologic characteristics and postoperative outcomes were retrospectively collected and analyzed from patients undergoing resection for GIST from 2002 to 2011. One hundred seventy-six patients were identified; 156 underwent resection of primary nonmetastatic disease. KIT mutations were identified in 131 patients (84.0%). Of the 156 patients with primary disease, the most common site was the stomach (75...
July 2013: American Surgeon
Viraj A Master, S Mohammad A Jafri, Kelvin A Moses, Kenneth Ogan, David A Kooby, Keith A Delman
PURPOSE: Open inguinal lymphadenectomy has been associated with significant postoperative morbidity. Recently, small series have demonstrated the feasibility and efficacy of endoscopic groin lymphadenectomy as an alternative to open surgery. Previously we reported the favorable results of our initial experience. Few reports of novel surgical methods include long-term complications. In this report we present a detailed analysis of immediate and long-term complications associated with the procedure using standardized complications reporting methodology including the Clavien classification...
October 2012: Journal of Urology
Don Hoang, Kurt E Roberts, Edward Teng, Deepak Narayan
Regional lymphadenectomy in the iliac and groin, originally devised by Basset in 1912, is performed for the treatment of melanoma metastatic to this lymphatic basin. Laparoscopic iliac node dissection may be a valuable management option because it allows performance of the same procedure as in open surgery but with significant benefits such as decreased operative morbidity due to decreased surgical trauma, less violation of the abdominal muscles or the inguinal ligament, reduced postoperative pain, and increased patient satisfaction with the cosmetic appearance...
December 2012: Surgical Endoscopy
Lindsey A Herrel, Ryan M Butterworth, Syed M Jafri, Carl Ying, Keith A Delman, David A Kooby, Kenneth E Ogan, Daniel J Canter, Viraj A Master
Inguinal lymphadenectomy plays a critical role in the diagnosis and treatment of several neoplastic diseases. Frequently, bilateral lymphadenectomy is undertaken for staging and/or treatment of genitourinary cancers. Our objective was to determine if bilateral endoscopic lymphadenectomy could be performed simultaneously, in an effort to decrease overall anesthetic and operative time. This was accomplished by utilizing two carbon dioxide insufflators concurrently. This approach requires careful positioning of the patient, surgical team, and instrumentation, as well as special anesthetic considerations necessary to avoid severe hypercarbia...
June 2012: Canadian Journal of Urology
Peter J Kneuertz, Sameer H Patel, Carrie K Chu, Shishir K Maithel, Juan M Sarmiento, Keith A Delman, Charles A Staley, David A Kooby
BACKGROUND: The premise that allogeneic red blood cell transfusion (RBCT) contributes to adverse oncologic outcomes after surgery remains controversial. We examined the effects of RBCT during and after pancreaticoduodenectomy (PD) for pancreatic ductal adenocarcinoma (PDAC) on disease recurrence and survival. METHODS: A prospective database of 220 patients undergoing PD for PDAC from 2000 to 2008 was reviewed and transfusion data collected. Univariate and multivariate analyses were performed for factors influencing RBCT, recurrence-free survival (RFS), and overall survival (OS)...
May 2011: Annals of Surgical Oncology
Keith A Delman, David A Kooby, Monica Rizzo, Kenneth Ogan, Viraj Master
BACKGROUND: Inguinofemoral lymphadenectomy is associated with frequent and marked incision-related morbidity. Our initial feasibility study of videoscopic inguinal lymphadenectomy (VIL) for melanoma showed appropriate nodal yield and anatomic dissection. Although a limited suprafascial dissection has been reported in the urologic literature, we report our growing experience with VIL applying a comprehensive approach to dissection. METHODS: Patients with inguinal metastases from varied malignancies were offered VIL...
April 2011: Annals of Surgical Oncology
George M Fuhrman, Jana MacLeod, Carole Ehleben, Keith Delman
OBJECTIVES: To stimulate increased interest in the annual American College of Surgery (ACS) chapter meeting, a state-wide mock oral examination for senior level surgical residents was organized. The purpose of this study was to evaluate the impact of and the results from our state's initial attempt to conduct a state-wide mock oral examination. METHODS: The mock oral examination was structured as a 90-minute assessment in 9 content areas. Residents at or above the postgraduate year (PGY)-3 level were offered the examination and every attempt was made to ensure that examiners were from institutions different than the examinee's training program...
May 2010: Journal of Surgical Education
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