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Waseem Lutfi, Mark S Talamonti, Olga Kantor, Chi-Hsiung Wang, Susan J Stocker, David J Bentrem, Kevin K Roggin, David J Winchester, Robert Marsh, Richard A Prinz, Marshall S Baker
OBJECTIVE: Neoadjuvant protocols for early stage pancreatic adenocarcinoma (PDAC) frequently involve external beam radiation used in combination with systemic chemotherapy. The benefit of radiation in these protocols has not been determined. METHODS: We examined patients with stage I and II PDAC within the National Cancer Data Base between 2006 and 2012. Propensity score matching was used to compare patients receiving neoadjuvant chemotherapy including radiation (NCRT) to those receiving neoadjuvant chemotherapy without radiation (NCT) prior to pancreaticoduodenectomy...
November 30, 2016: American Journal of Surgery
Olga Kantor, Mark S Talamonti, Susan Sharpe, Waseem Lutfi, David J Winchester, Kevin K Roggin, David J Bentrem, Richard A Prinz, Marshall S Baker
BACKGROUND: The long-term efficacy of laparoscopic pancreaticoduodenectomy (LPD) relative to open pancreaticoduodenectomy (OPD) for pancreatic adenocarcinoma has not been well studied. METHODS: The National Cancer Data Base was used to compare patients undergoing LPD and OPD for stage I-II pancreatic adenocarcinoma between 2010 and 2013. RESULTS: 828 (10%) patients underwent LPD and 7385 (90%) OPD. There were no differences in tumor or demographic characteristics between groups...
December 28, 2016: American Journal of Surgery
Olga Kantor, Andrew B Schneider, Marko Rojnica, Andrew J Benjamin, Nancy Schindler, Mitchell C Posner, Jeffrey B Matthews, Kevin K Roggin
BACKGROUND: To simulate the duties and responsibilities of an attending surgeon and allow senior residents more intraoperative and perioperative autonomy, our program created a new resident acute care surgery consult service. METHODS: We structured resident acute care surgery as a new admitting and inpatient consult service managed by chief and senior residents with attending supervision. When appropriate, the chief resident served as a teaching assistant in the operation...
December 5, 2016: Surgery
Waseem Lutfi, Mark S Talamonti, Olga Kantor, Chi-Hsiung Wang, Erik Liederbach, Susan J Stocker, David J Bentrem, Kevin K Roggin, David J Winchester, Robert Marsh, Richard A Prinz, Marshall S Baker
BACKGROUND: The value of neoadjuvant chemotherapy in the treatment of early stage pancreatic cancer is not yet clear. METHODS: We evaluated patients from the National Cancer Data Base who underwent pancreaticoduodenectomy for clinical stage I and II pancreatic adenocarcinoma between 2006 and 2012. RESULTS: In total, 7,881 patients were identified. Of these, 27.5% received no chemotherapy, 57.4% received adjuvant chemotherapy, 10.2% received neoadjuvant chemotherapy alone, and 4...
September 2016: Surgery
Malini D Sur, Jukes P Namm, Joshua A Hemmerich, Mary M Buschmann, Kevin K Roggin, William Dale
INTRODUCTION: Sarcopenia is linked to poor outcomes after abdominal surgery. We hypothesized that radiographic sarcopenia metrics enhance prediction of complications after pancreaticoduodenectomy (PD) when combined with clinical and frailty data. METHODS: Preoperative geriatric assessments and CT scans of patients undergoing PD were reviewed. Sarcopenia was assessed at L3 using total psoas area index (TPAI) and weighted average Hounsfield units (HU), i.e., estimates of psoas muscle volume and density...
November 2015: Annals of Surgical Oncology
Susan M Sharpe, Mark S Talamonti, Chihsiung E Wang, Richard A Prinz, Kevin K Roggin, David J Bentrem, David J Winchester, Robert D W Marsh, Susan J Stocker, Marshall S Baker
BACKGROUND: There is considerable debate about the safety and clinical equivalence of laparoscopic pancreaticoduodenectomy (LPD) and open pancreaticoduodenectomy (OPD) for pancreatic ductal adenocarcinoma (PDCA). STUDY DESIGN: We queried the National Cancer Data Base to identify patients undergoing LPD and OPD for PDCA between 2010 and 2011. Chi-square and Student's t-tests were used to evaluate differences between the 2 approaches. Multivariable logistic regression modeling was performed to identify patient, tumor, or facility factors associated with perioperative mortality...
July 2015: Journal of the American College of Surgeons
Susan M Sharpe, Mark S Talamonti, Edward Wang, David J Bentrem, Kevin K Roggin, Richard A Prinz, Robert D W Marsh, Susan J Stocker, David J Winchester, Marshall S Baker
BACKGROUND: The oncologic equivalence of laparoscopic distal pancreatectomy (LDP) to open pancreatectomy (ODP) for ductal adenocarcinoma (DAC) is not established. METHODS: The National Cancer Data Base was used to compare perioperative outcomes following LDP and ODP for DAC between 2010 and 2011. RESULTS: One hundred forty-five patients underwent LDP; 625 underwent ODP. Compared with ODP, patients undergoing LDP were older (68 ± 10.1 vs 66 ± 10...
March 2015: American Journal of Surgery
Shaun C Daly, Matthew Klairmont, Bulent Arslan, Yalini Vigneswaran, Kevin F Roggin, Michael B Ujiki, Woody Denham, Keith W Millikan, Minh B Luu, Daniel J Deziel, Jonathan A Myers
INTRODUCTION: To date, no study has compared laparoscopy (LB) to percutaneous (PB) biopsy for the diagnosis of abdominal lymphoma. The objective of this study is to compare the success rate and safety profile of laparoscopic lymph node biopsy to the percutaneous approach in patients with intra-abdominal lymphadenopathy concerning for lymphoma. MATERIALS AND METHODS: We performed a multi-institution, retrospective review of patients undergoing lymph node biopsy for suspected intra-abdominal lymphoma between 2005 and 2013...
September 2015: Surgical Endoscopy
Jovenel Cherenfant, Mark S Talamonti, Curtis R Hall, Tiffany A Thurow, Mistry K Gage, Susan J Stocker, Brittany Lapin, Edward Wang, Jonathan C Silverstein, Kathy Mangold, Melanie Odeleye, Karen L Kaul, Ihab Lamzabi, Paolo Gattuso, David J Winchester, Robert W Marsh, Kevin K Roggin, David J Bentrem, Marshall S Baker, Richard A Prinz
BACKGROUND: This study compares the predictability of 5 tumor markers for distant metastasis and mortality in pancreatic neuroendocrine tumors (PNETs). METHODS: A total of 128 patients who underwent pancreatectomy for nonfunctioning PNETs between 1998 and 2011 were evaluated. Tumor specimens were stained via immunochemistry for cytoplasmic and nuclear survivin, cytokeratin 19 (CK19), c-KIT, and Ki67. Univariate and multivariate regression analyses and receiver operating characteristics curve were used to evaluate the predictive value of these markers...
December 2014: Surgery
Katherine J Baxter, Nicholas Govsyeyev, Jukes P Namm, Ricardo J Gonzalez, Kevin K Roggin, Kenneth Cardona
BACKGROUND AND OBJECTIVES: The treatment of patients with pure (<5% round cell component) myxoid liposarcomas (pMLS) has not been well characterized. We hypothesized that multimodality therapy (oncological resection with radiation therapy) may not be necessary for pMLS. METHODS: Patients who underwent resection of localized pMLS at three institutions from 2000 to 2010 were identified and treatment variables were analyzed. RESULTS: Of 75 pts with pMLS, the median tumor size was 10 cm, the majority (95%) were deep tumors, and located in lower extremity...
February 2015: Journal of Surgical Oncology
Brian R Untch, Keisha P Bonner, Kevin K Roggin, Diane Reidy-Lagunes, David S Klimstra, Mark A Schattner, Yuman Fong, Peter J Allen, Michael I D'Angelica, Ronald P DeMatteo, William R Jarnagin, T Peter Kingham, Laura H Tang
BACKGROUND: Duodenal neuroendocrine tumors are rare and few studies exist to guide surgical management. This study identifies factors associated with recurrence after resection. METHODS: A retrospective, single institution review was performed between 1983 and 2011 on patients with a pathologic diagnosis of duodenal neuroendocrine tumor. Tumor grade was assigned based on WHO 2010 criteria (Ki-67 and mitotic rate). RESULTS: Seventy-five patients were identified that underwent curative resection...
March 2014: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Nancy Schindler, Julia C Corcoran, Megan Miller, Chih-Hsiung Wang, Kevin Roggin, Mitchell Posner, Jonathan Fryer, Debra A DaRosa
PURPOSE: Teaching awards have been suggested to serve a variety of purposes. The specific characteristics of teaching awards and the associated effectiveness at achieving planned purposes are poorly understood. A needs analysis was performed to inform recommendations for an Excellence in Teaching Recognition System to meet the needs of surgical education leadership. METHOD: We performed a 2-part needs analysis beginning with a review of the literature. We then, developed, piloted, and administered a survey instrument to General Surgery program leaders...
November 2013: Journal of Surgical Education
William Dale, Joshua Hemmerich, Alaine Kamm, Mitchell C Posner, Jeffrey B Matthews, Randi Rothman, Aparna Palakodeti, Kevin K Roggin
OBJECTIVE: To prospectively evaluate the additional value of geriatric assessment (GA) for predicting surgical outcomes in a cohort of older patients undergoing a pancreaticoduodenectomy (PD) for pancreatic tumors. BACKGROUND: Older patients are less often referred for possible PD. Standard preoperative assessments may underestimate the likelihood of significant adverse outcomes. The prospective utility of validated GA has not been studied in this group. METHODS: PD-eligible patients were enrolled in a prospective outcome study...
May 2014: Annals of Surgery
Jovenel Cherenfant, Susan J Stocker, Mistry K Gage, Hongyan Du, Tiffany A Thurow, Melanie Odeleye, Scott W Schimpke, Karen L Kaul, Curtis R Hall, Ihab Lamzabi, Paolo Gattuso, David J Winchester, Robert W Marsh, Kevin K Roggin, David J Bentrem, Marshall S Baker, Richard A Prinz, Mark S Talamonti
PURPOSE: The biologic potential of nonfunctioning pancreatic neuroendocrine tumors (PNETs) is highly variable and difficult to predict before resection. This study was conducted to identify clinical and pathologic factors associated with malignant behavior and death in patients diagnosed with PNETs. METHODS: We used International Classification of Diseases 9th edition codes to identify patients who underwent pancreatectomy for PNETs from 1998 to 2011 in the databases of 4 institutions...
October 2013: Surgery
Steven C Stain, Jonathan R Hiatt, Ashar Ata, Stanley W Ashley, Kevin K Roggin, John R Potts, Richard A Moore, Joseph M Galante, L D Britt, Karen E Deveney, E Christopher Ellison
IMPORTANCE: With duty hour debates, specialization, and sex distribution changes in the applicant pool, the relative competitiveness for general surgery residency (GSR) is undefined. OBJECTIVE: To determine the modern attributes of top-ranked applicants to GSR. DESIGN Validation cohort, survey. SETTING: National sample of university and community-based GSR programs. PARTICIPANTS: Data were abstracted from Electronic Residency Application Service files of the top 20-ranked applicants to 22 GSR programs...
May 2013: JAMA Surgery
James J Mezhir, Mitchell C Posner, Kevin K Roggin
BACKGROUND AND OBJECTIVES: Positive peritoneal cytology equates M1 disease in patients with gastric cancer. Diagnostic peritoneal lavage (DPL) is a proven test to detect occult visceral injury in trauma patients. The objective of this study is to determine whether DPL can be used to assess peritoneal cytology in patients with gastric cancer. METHODS: Patients with gastric adenocarcinoma were prospectively enrolled to undergo DPL prior to diagnostic laparoscopy (DL)...
June 2013: Journal of Surgical Oncology
Kevin K Roggin, Mitchell C Posner
Gastrointestinal stromal tumors (GIST) are rare mesenchymal smooth muscle sarcomas that can arise anywhere within the gastrointestinal tract. Sporadic mutations within the tyrosine kinase receptors of the interstitial cells of Cajal have been identified as the key molecular step in GIST carcinogenesis. Although many patients are asymptomatic, the most common associated symptoms include: abdominal pain, dyspepsia, gastric outlet obstruction, and anorexia. Rarely, GIST can perforate causing life-threatening hemoperitoneum...
December 14, 2012: World Journal of Gastroenterology: WJG
Sabha Ganai, Vivek N Prachand, Mitchell C Posner, John C Alverdy, Eugene Choi, Mustafa Hussain, Irving Waxman, Marco G Patti, Kevin K Roggin
BACKGROUND: While laparoscopy has become integral to the performance of foregut surgery, its optimal use in resection of gastric submucosal neoplasms, including gastrointestinal stromal tumors (GISTs), remains uncertain. Concern exists for technical feasibility related to tumor size and location, as well as oncologic outcome. METHODS: From 2002 to 2012, 106 patients underwent resection for gastric submucosal neoplasms, comprising 79 laparoscopic and 27 open resections...
February 2013: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
David F Moore, Roggin Miranda, Geoffrey S F Ling
No abstract text is available yet for this article.
January 2012: IEEE Pulse
Chad M Teven, Eric Grossman, Kevin K Roggin, Jeffrey B Matthews
INTRODUCTION: Juxtapapillary duodenal diverticula (DD), although usually asymptomatic, are occasionally associated with pancreaticobiliary conditions such as recurrent bile duct stones, cholangitis, and pancreatitis. MATERIALS AND METHODS: An unusual case of DD associated with a dorsal duct stricture in a patient with recurrent pancreatitis and pancreas divisum is presented along with three additional instances of surgically treated DD and a review of the literature...
July 2012: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
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