Strategies to reduce pulmonary complications after transhiatal esophagectomy.

Background: By eliminating a thoracotomy, transhiatal esophagectomy (THE) is purported to reduce postoperative pulmonary complications. However, data from many early series do not support this contention, documenting pulmonary complications in up to 50% of patients and pneumonia in 5%-20%. Since 1990, we have implemented a management strategy designed to maximize airway protection in the postoperative period.

William Francis Rienhoff, Jr., MD - Halsted's Last Resident.

: William Francis Rienhoff Jr. was a skilled and innovative surgeon whose career spanned over 4 decades of patient care, clinical investigative research, and surgical education. He was an unforgettable character for those who knew him.

Delayed Axillary Artery Occlusion after Reverse Total Shoulder Arthroplasty.

Axillary artery injury has been associated with shoulder dislocation and surgery. We describe a case of delayed axillary artery occlusion after reverse total shoulder arthroplasty. The injury was confirmed by Doppler and angiography and was treated with angioplasty and stenting.

The First 100 Years of American College of Surgeons Presidential Addresses.

Introduction: We reviewed the first 100 years of presidential addresses delivered at the fall congress of the American College of Surgeons (ACS). Our hypothesis was that these addresses would be an excellent indicator of the College's position on surgical policy, ethics, methods, and education.

Methods: All ACS presidential addresses from 1913 to 2013 were identified through the ACS archives website.

Pedunculated colonic lipoma prolapsing through the anus.

Colorectal lipomas are the second most common benign tumors of the colon. These masses are typically incidental findings with over 94% being asymptomatic. Symptoms-classically abdominal pain, bleeding per rectum and alterations in bowel habits-may arise when lipomas become larger than 2 cm in size.

Surgical relief work in Haiti: a practical resident learning experience.

Introduction: A once-a-year, week-long surgical missionary trip to Haiti has become incorporated into our residency experience on a voluntary basis since 2007. The purpose of this article is to describe our experience with this mission effort during the last 4 years.

Methods: Since 2007, at least one PGY 3-5 surgical resident from our program has traveled to the Hôpital Sacré Coeur in Milot, Haiti for a voluntary, week-long surgical mission working with the local health care providers.

Recurrence after neoadjuvant chemoradiation and surgery for esophageal cancer: does the pattern of recurrence differ for patients with complete response and those with partial or no response?

Objective: We hypothesized that most relapses in patients with esophageal cancer having neoadjuvant chemoradiation therapy would occur outside of the surgical and radiation fields.

Methods: Recurrence patterns, time to recurrence, and median survival were examined in 267 patients who had esophagectomy after neoadjuvant chemoradiation therapy at Johns Hopkins over 19 years.

Results: Of 267 patients, 82 (30.

Neurectomy for treatment of intercostal neuralgia.

Background: Intercostal neuralgia due to surgical injury of the intercostal nerve is difficult to treat. No treatment modality has given effective pain relief. Experience with other painful neuromas has demonstrated that neuroma resection and muscle implantation has been effective in the upper and lower extremities.

Union Memorial Hospital: an insight to the origin of community-based surgical training.

Community-based surgical training centers comprise almost half of the current ACGME-approved programs. Yet the histories of these community hospital programs have not been defined clearly. University programs were founded with the time-honored mission to deliver patient care, teaching, and research.

Resection of apical lung tumors in high-risk patients using partial sternotomy.

Surgical management of patients with compromised lung function remains a challenge. We describe a technique that uses a partial sternotomy to manage high-risk patients with clinical stage 1 apical lung tumors. In our experience with four patients we found this method to be effective, quick, safe, and with good short term outcome.

Imaging delta- and mu-opioid receptors by PET in lung carcinoma patients.

Unlabelled: In the present study, we measured the kinetics and distribution in vivo of the selective delta-opioid antagonist 11C-methylnaltrindole (11C-MeNTI) and the mu-opioid agonist 11C-carfentanil (11C-CFN) in patients with lung carcinoma using PET.

Methods: Paired measurements of 11C-MeNTI and 11C-CFN binding were performed in biopsy-proven small-cell (n = 2), squamous (n = 2), and adenocarcinoma (n = 3) lung cancer patients. Dynamic PET scans of increasing duration (0.

MKK4 status predicts survival after resection of gastric adenocarcinoma.

Hypothesis: Lack of expression of the tumor-suppressor gene MKK4 is significantly correlated with poor survival after resection of gastric adenocarcinoma.

Design: Retrospective review of medical records after construction and immunolabeling of tissue microarrays for clinical correlation.

Setting: The Johns Hopkins Hospital, Baltimore, Md.

Delayed diagnosis and elevated mortality in an urban population with HIV and lung cancer: implications for patient care.

Objective: Lung cancer is more common in HIV-infected patients than in the general population. We examined how effectively lung cancer was being diagnosed in our HIV-infected patients.

Methods: Retrospective study assessing clinical diagnosis of lung cancer in HIV-infected patients at Johns Hopkins Hospital between 1986 and 2004.

Esophageal conduit necrosis.

A cumulative review of the prevalence of esophageal conduit necrosis is summarized in Table 4. The spectrum of conduit ischemia is broad and includes cases in which there is anastomotic leak or stricture as well as cases in which there is frank graft necrosis. Many of the studies that the authors reviewed do not specify the exact nature of postoperative ischemic complications or how they are defined.

Surgical repair of redundant intra-thoracic stomach after Ivor Lewis esophagectomy.

We present two patients with low esophagogastric anastomosis, redundant intrathoracic stomach, and markedly symptomatic reflux and regurgitation after Ivor Lewis esophagectomy. The diagnosis, technique of surgical revision, and outcome is discussed.