A Case of Pseudoangiomatous Stromal Hyperplasia in an Adolescent Patient
Jason McCartt, Sarah Heaton, Juan Lopez, Randy Hamill, William Thomas, Heather Burch, Bradley Bandera. DDEAMCObjective: Pseudoangiomatous stromal hyperplasia (PASH) is a rare benign breast condition characterized by the proliferation of mesenchymal cells. PASH typically effects pre and perimenopausal women. It is extremely rare in the adolescent population. It must be clearly distinguished from other benign… Continue Reading
Antibiotic Prophylaxis for Elective Laparscopic Cholecystectomy – A Meta-Analysis of RCTs since 2010
Dylan M Russell, MD. Tripler Army Medical CenterIntroduction: The aim of this meta-analysis was to assess the beneficial or harmful effects of antibiotic prophylaxis in elective laparoscopic cholecystectomies for non-acute gallbladder disease. This meta-analysis strictly involved randomized controlled trials (RCTs) that have been published since the publication of the relevant Cochrane Review (Sanabria et al.,… Continue Reading
Bigger Is Not Better: Twenty-Year Institutional Experience of Atypical Ductal Hyperplasia Discovered by 11- and 8-Gauge Core Needle Biopsies
Jessica B Weiss, MD, Woo S Do, MD, Dominic M Forte, MD, Rowan R Sheldon, MD, Charles K Childers, Andrew D Mosier, DO, Vance Y Sohn, MD. Madigan Army Medical Center, Tacoma, WAObjectives: The increasing accuracy of large-bore (11- or 8-gauge) vacuum-assisted core needle biopsies (VACNB) has challenged the commonly-accepted practice that surgery is needed for… Continue Reading
Endoscopic Appendectomy in a Patient with Malrotation and Previous Ladd Procedure
Alicia D Gaidry, MD, Sarah B Buckley, MD, Joseph G Cheatham, MD, Romeo C Ignacio, MD. Naval Medical Center San DiegoWe present the unusual case of a 19 year-old female with history of chronic abdominal pain in the setting of previous Ladd procedure for intestinal malrotation who was found to have a retained appendix on… Continue Reading
Evaluating Operative Experience and Career Satisfaction Among Military Pediatric Surgeons
Jonathan L Halbach, DO1, Rober Ricca, MD2, Marion Henry, MD1, Romeo C Ignacio, MD1. 1Naval Medical Center San Diego, 2Naval Medical Center PortsmouthOBJECTIVES: Military surgical subspecialists are challenged to maintain surgical skills and competency in the setting of low-volume practice interrupted by deployments. This potentially compromises the ability to care for pediatric patients and may… Continue Reading
“HEAD TO HEAD” COMPARISON OF THREE STATE OF THE ART VIRTUAL REALITY ROBOTIC SURGERY SIMULATORS
Alexandria M Hertz, MD, Evalyn I George, BS, Christine M Vaccaro, DO, Timothy C Brand, MD. Madigan Army Medical CenterObjectives: Compare the face and content validity of the three most prevalent robotic simulators, and to include discussion regarding pricing and availability. Materials/Methods: 15 participants were asked to complete one task on three different robotic trainers,… Continue Reading
Impact of Number of Lymph Nodes in Lung Cancer Resection on Survival: A 10-Year Experience in a Department of Defense Institution to Include Quality of Lymph Node Sampling, Operative Procedure, Staging, and 5-year Survival
Bethany M Heidenreich, CPT, DO, Andrew S Durkee, CPT, DO, Julia O Bader, PhD, Vincent J Mase Jr., LTC, MD. William Beaumont Army Medical CenterObjectives: Assess a 10-year experience at our institution with regard to thoracic oncology, to include quality of regional lymph node (RLN) dissection as compared to the Commission on Cancer (CoC) surveillance… Continue Reading
IMPROVING COLORECTAL CANCER SCREENING WITHIN MILITARY FACILITIES BY UTILIZING STANDARDIZED QUALITY METRICS
Michelle Ganyo, MD, Lawson Robert, MD, Amanda Cimsit, MD. Naval Medical Center San DiegoINTRODUCTION: In 2015, the American Society of Gastrointestinal Endoscopy/American College of Gastroenterology Task Force on Quality in Endoscopy released updated guidelines on measuring quality in colonoscopy. This identified metrics and provided benchmark goals to serve as proxy measures for the quality of… Continue Reading
Interim Analysis of a Prospective, Randomized Phase II Trial of Trastuzumab vs Trastuzumab + E75 for the Prevention of Recurrence in HER2 Overexpressing Breast Cancer Patients
Tommy A Brown, MD1, John W Myers, MD1, Kaitlin M Peace, MD1, Jennifer K Litton, MD2, Rashmi Murthy, MD3, Timothy J Vreeland, MD2, Diane F Hale, MD1, Garth S Herbert, MD1, Guy T Clifton, MD1, Mark O Hardin, MD4, George E Peoples, MD5, Elizabeth A Mittendorf, MD2. 1Department of Surgery, Brooke Army Medical Center, 2The… Continue Reading
Laparoscopic Management of Congenital Abdominal Wall Hypoplasia
John M McClellan, MD1, Josh Dilday, DO2, John Horton, MD1. 1Madigan Army Medical Center, 2William Beaumont Medical CenterLumbocostoverterbral syndrome is uncommon disorder often associated with congenital abdominal wall hypoplasia resulting in large abdominal wall eventrations. Given the patient's age, size, and other associated anomalies, these defects are often difficult to address. While most of the… Continue Reading
LINX MAGNETIC ESOPHAGEAL SPHINCTER AUGMENTATION IN THE ACTIVE DUTY POPULATION: A CASE SERIES
Michelle Ganyo, MD, James Prieto, MD. Naval Medical Center San DiegoINTRODUCTION: Since the FDA’s approval of the LINX device in 2012 for the treatment of GERD, multiple studies have demonstrated the safety, efficacy, short and long-term outcomes of using this device. It has been well demonstrated to help with reducing the amount of reflux and… Continue Reading
Mastery of General Surgery: An Impossible Task In The Army Healthcare System
Timothy P Plackett, DO, MPH1, Joel R Brockmeyer, MD2, Danielle B Holt, MD3, Robert M Rush, Jr, MD4, Joy Sarkar, MD5, Steven A Satterly, MD1, Jason M Seery, MD6, Bradley R Zagol, MD7. 1Womack Army Medical Center, 2Eisenhower Army Medical Center, 3Walter Reed National Military Medical Center, 4Madigan Army Medical Center, 5Brian Allgood Army Community… Continue Reading
Multimodal Pain Control in the Humanitarian Setting
Jonathan L Halbach, DO, Paul Lewis, DO, Jason Brill, MD, James Wallace, MD, Ashley Zander, DO, Mike VanGent, DO, Kyle Gadbois, MD. Naval Medical Center San DiegoObjective: The prescribing of narcotic pain medication during humanitarian medical missions presents an ethical dilemma with the potential for adverse events without reliable follow-up. Some countries prohibit the distribution… Continue Reading
Spontaneous Hemorrhagic Cystic Lesion of the Thyroid
Alexander J Friedman, DO, Marcos Aranda, MD, Pamela Burgess, MD, Christopher Mangieri, MD, Bradley Bandera, MD. Eisenhower Army Medical CenterObjective: Acute development of neck swelling secondary to spontaneous hemorrhagic thyroid pathology is a rare event with very few cases reported in the literature. Reported cases are secondary to: degeneration of a solid mass, trauma or a… Continue Reading
Surgery at Sea: Are Military Surgery Training Programs Preparing New Graduates for Shipboard Surgery?
Matthew D Nealeigh, DO, Walter B Kucera, MD, Matthew J Bradley, MD, E. Matthew Ritter, MD, W. Brian Sweeney, MD, Elliot M Jessie, MD, Carlos J Rodriguez, DO. Uniformed Services University / Walter Reed National Military Medical CenterIntroduction: Recent decades brought revolutionary applications of technology to address surgical disease. Residency programs appropriately integrated advances into… Continue Reading