Management of Staple Line Leaks after Laparoscopic Sleeve Gastrectomy.

Background And Objectives: Laparoscopic sleeve gastrectomy has become one of the most popular bariatric surgeries in the United States with a low rate of morbidity and effective weight loss. However, staple line leak remains a feared complication requiring a lengthy and difficult treatment course until resolution. This study outlines the various treatment methods used within a high-volume bariatric practice for successful leak resolution without necessitating a conversion procedure.

De-escalating axillary surgery in early-stage breast cancer.

The role of axillary surgery has evolved over the last three decades from routine axillary lymph node dissection (ALND) to sentinel lymph node biopsy to omission of axillary surgery altogether in select patients. This evolution has been achieved through the design and conduct of multiple clinical trials demonstrating that ALND does not impact survival and is not necessary for local control in patients with early-stage breast cancer and limited nodal involvement. Importantly, this practice-changing shift mirrored the trend towards earlier stage at diagnosis and the recognition of the interplay between local and systemic therapies in maintaining local control.

Establishment of a Fast-Track Gastrectomy Pathway for Patients With Gastric Adenocarcinoma at a U.S. Academic Cancer Center.

Introduction: Implementation of fast-track perioperative care pathways for gastric cancer patients in the U.S. has been challenging due to low disease incidence and limited safety and efficacy data.

Intraarterial delivery of bevacizumab and cetuximab utilizing blood-brain barrier disruption in children with high-grade glioma and diffuse intrinsic pontine glioma: results of a phase I trial.

Objective: Delivery of drugs intraarterially to brain tumors has been demonstrated in adults. In this study, the authors initiated a phase I trial of superselective intraarterial cerebral infusion (SIACI) of bevacizumab and cetuximab in pediatric patients with refractory high-grade glioma (diffuse intrinsic pontine glioma [DIPG] and glioblastoma) to determine the safety and efficacy in this population.

Methods: SIACI was used to deliver mannitol (12.

Colloid cysts of the third ventricle in children.

Objective: The rarity of colloid cysts in children makes it difficult to characterize this entity and offer meaningful advice on treatment. Infrequent case reports exist, but to date there has been no age-specific assessment. The purpose of this study was to define any differences between children and adults who are evaluated and treated for colloid cysts of the third ventricle.

Predictors of Mortality Among Very Low Birth Weight Infants With Gastrointestinal Perforation.

Background: Gastrointestinal (GI) perforation is a risk factor for mortality in very low birth weight (VLBW) infants. Little data exist regarding pretreatment factors and patient characteristics known to independently correlate with risk of death.

Materials And Methods: A retrospective review of all VLBW infants who sustained GI perforation between 2011 and 2018 was conducted.

A toolkit for building medical programs for asylum seekers: Resources from the Mount Sinai Human Rights Program.

Forced migration has reached a peak worldwide and healthcare professionals and trainees are increasingly volunteering with medical human rights programs. The Mount Sinai Human Rights Program (MSHRP) provides pro bono forensic medical, gynecological, and psychological evaluations to document evidence of human rights abuses experienced by asylum seekers. From 2015 through 2018, MSHRP refined its workflow and processes to facilitate the coordination of 305 forensic asylum evaluations and 117 continuity care referrals.

Impact of American Association of Neurological Surgeons Medical Student Interest Groups on Participation in Organized Neurosurgery, Research Productivity, and Residency Match Success.

Background: In 2014, the Young Neurosurgeons Committee under the American Association of Neurological Surgeons (AANS) began allowing medical schools to create AANS Medical Student Chapters. The aim of this study was to assess the impact of these chapters on participation in organized neurosurgery, research productivity, and residency match success.

Methods: Chapter membership and activity data were collected and analyzed from 2014-2019 annual reports.

Patterns of Health Care Costs Due to External Ventricular Drain Infections.

Background: External ventricular drain (EVD) infections are a significant cause of morbidity among neurosurgical patients and have been correlated with increased length of hospital stay and longer requirements for intensive care. To date, no studies have examined the financial impact of EVD infections.

Methods: Patients who underwent EVD placement between December 2010 and January 2016 were included in the study.

Perioperative Risk Factors for Thirty-Day Morbidity and Mortality in the Resection of Extradural Thoracic Spine Tumors.

Objective: Resection of epidural thoracic spine tumors is uniquely challenging owing to the dangers posed by the surrounding anatomy and the unforgiving nature of the thoracic spinal cord. We assessed the preoperative and postoperative risk factors for 30-day morbidity and mortality in patients undergoing resection of these tumors.

Methods: Adults who underwent laminectomy for excision of thoracic spine tumors from 2011 to 2014 were included.

Minimally Invasive Surgery for Intracerebral Hemorrhage.

Purpose Of Review: Recent success in preliminary clinical studies evaluating various forms of minimally invasive surgery for spontaneous intracerebral hemorrhage (ICH) has renewed interest in the surgical treatment of this disease process.

Recent Findings: In December of 2016, phase 2 of the Minimally Invasive Surgery Plus Rt-PA for ICH Evacuation (MISTIE) study demonstrated that this form of stereotactic thrombolysis safely reduces clot burden and may improve functional outcome 6 months after injury. A smaller arm of this study, the Intraoperative Stereotactic Computer Tomography-Guided Endoscopic Surgery (ICES) study, also demonstrated feasibility and good functional outcome for endoscopic minimally invasive evacuation.

Risk Factors for Thirty-Day Morbidity and Mortality in Extradural Lumbar Spine Tumor Resection.

Background: Epidural tumors in the lumbar spine represent a unique cohort of lesions with individual risks and challenges to resection. Knowledge of modifiable risk factors are important in minimizing postoperative complications.

Objective: To determine the risk factors for 30-day morbidity and mortality in patients undergoing extradural lumbar tumor resection.

Tolosa-Hunt Syndrome: Appraising the ICHD-3 beta diagnostic criteria.

Introduction The term Tolosa-Hunt Syndrome was first used more than half a century ago to describe painful ophthalmoplegia accompanied by cranial nerve palsies. In the decades since, its diagnostic criteria have evolved considerably. The beta version of the 3rd Edition of the International Classification of Headache Disorders narrows these criteria to require the demonstration of granulomatous inflammation on MRI or biopsy.

Bone flap explantation, steroid use, and rates of infection in patients with epilepsy undergoing craniotomy for implantation of subdural electrodes.

Object: Subdural implantation of electrodes is commonly performed to localize an epileptic focus. Whether to temporarily explant the bone plate and whether to treat patients with perioperative steroid agents is unclear. The authors' aim was to evaluate the utility and risk of bone plate explantation and perioperative steroid use.