Prediction of Outcomes in the Non-Operative Management of Small Bowel Obstructions
In this study, we will use various machine learning methods to predict the outcomes of non-operative management of small bowel obstructions.
GI Surgery/Surgical Oncology
Predictors of Complicated Clostridium difficile Infection
An analysis of all patients at UPMC Presbyterian Shadyside over the past 10 years to develop a demographic profile of patients with Clostridium difficile infection, as well as to identify predictors of a complicated disease course. The study will also include the development of computable phenotypes of disease (phekb.org) for both routine and complicated Clostridium difficile infection.
Light therapy in acute appendicitis,diverticulitis, pneumonia and sepsis
Our murine studies suggest that exposure to blue (480nm) light, by comparison to ambient white or amber (580nm) light, reduces the inflammatory response (i.e., cytokine concentration), risk of organ failure (i.e., kidney failure), and improves the clearance and control of the infectious focus (i.e., reduced abdominal and pulmonary bacterial counts and bacterial dissemination into tissues of the liver and spleen) in mice subjected to a model of cecal ligation and puncture (CLP) or a model of pneumonia. These data directly support the proposed project and experimentation.
Identifying clinically relevant variables associated with early versus delayed postoperative venous thromboembolic disease.
Venous thromboembolic disease (VTE), which encompasses deep vein thrombosis (DVT) and pulmonary embolism (PE), is a common and preventable source of post-operative morbidity and mortality. The high incidence of VTE reflects both underutilization of standard thromboprophylactic regimens and also an incomplete understanding of how surgery and critical illness affect the risk of post-operative VTE over time.
COVID-19: Surgical Implications Study
We will be collaborating on a GlobalSurg project [https://globalsurg.org/] on COVID19, which will be open to ALL centers worldwide who have COVID+ patients requiring an operation. This project is extremely important to get the data out there on how each hospital is managing these novel cases, surgeons around the world stand to benefit from this.
A Pilot Study: Metformin as an immune and inflammatory modulating therapy in older adults without diabetes.
The objective of our study is to evaluate and understand the dose relationship between metformin, inflammation, thrombosis, and the microbiome, while correlating changes in cellular respiration with changes in physiologic parameters in non diabetic, pre-frail adults. We plan to gather stool samples, blood samples, and baseline physiologic parameters on all patients. Patients will then be exposed to 90 days of metforminER (at either 500mg, 1000mg, or 1500mg) or placebo. The same samples will be gathered again at 30, 60, and 90 days. At 90 days, we may retest physiologic parameters.
A Multi-institutional Comparison of Perioperative Outcomes of Robotic and Open Pancreaticoduodenectomy
This is a comparative effectiveness study of centers comparing whipple data of surgeons beyond their learning curve for open (6 sites) and robotic (2 sites) surgery. This analysis found that while the robotic approach took more time, there was a decrease in blood loss and complications, without any compromise of other preoperative factors.
Grading of Surgeon Technical Performance Predicts Postoperative Pancreatic Fistula for Pancreaticoduodenectomy Independent of Patient-related Variables
This study showed that lower technical scoring of intra-op PJ video correlated with higher post-op pancreatic fistula rate. This was an independent predictor on MVA and added to the known risk factors for pancreatic fistulas based on clinical factors.
Safety in Numbers: Progressive Implementation of a Robotics Program in an Academic Surgical Oncology Practice
This study found that as a robotic program grows, there is a decrease in OR time and conversion. Preoperative morbidity and mortality is similar to what can be see in published literature and no 90 day mortality was attributed to technical incorporation of the platform.