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Papers by yaniv fenig

Mixed Neuroendocrine-Nonneuroendocrine Neoplasm (MiNEN), a Rare and Aggressive Combined Primary Liver Cancer

The Impact of Donor Hepatectomy Time on Liver Transplantation Outcomes

Transplantation, 2022

Bariatric Surgery and Cancer

Global Bariatric Surgery, 2018

The Centers for Disease Control and Prevention (CDC) has recently reported the prevalence of obes... more The Centers for Disease Control and Prevention (CDC) has recently reported the prevalence of obesity, defined as a BMI ≥ 30, within the adult population in the USA to be 36.5%. These numbers have been steadily growing since the 1960s. Obesity is higher in females than in males, middle-aged and older than younger adults, white, black, and Hispanic than Asian adults. Obesity has a major impact on the global health and contributes to many other disease processes, like cancer. Bariatric surgery seems to have a protective effect on the incidence of cancer and the overall mortality. This holds especially true for hormonal-driven cancers, like breast, as well as for cancers where inflammation is a major precursor.

Coronavirus Disease 2019 Pandemic: Early Observations in Abdominal Organ Transplantation

The recent COVID-19 outbreak has quickly become a worldwide pandemic emergency. The course of thi... more The recent COVID-19 outbreak has quickly become a worldwide pandemic emergency. The course of this pandemic is still unknown, with more than 6 million cases identified and over 370 000 deaths globally as of June 1, 2020. The uncertainty and anxiety during this period will have a detrimental effect on the global health system. The organ transplantation field has been negatively affected by the COVID-19 pandemic, especially in regions where the intensity of cases exceeds the available capacity of the health care resources. Recently, scattered data have been published in the English literature, mainly in case reports and letters to the editor, that describe the effect of COVID-19 on donors and recipients of abdominal solid organs. Our objective is to review and draw conclusions from these data.

Outcomes of Severe Alcohol‐Related Hepatitis with or without Early Liver Transplantation

Hepatology, 2021

Impact of Donors Who Are Extremely Obese on Early Graft Loss and 30‐Day Mortality After Liver Transplantation

Liver Transplantation, 2021

We read with interest the article by Valvi et al, where the authors categorized donors whose body... more We read with interest the article by Valvi et al, where the authors categorized donors whose body mass index (BMI) > 40 kg/m2 as extremely obese (EO) using national registry database from 2005 to 2019.[1] EO donors had a 38% higher 30-day mortality risk and 53% increased risk of early graft loss (EGL) after liver transplantation (LT).

Evaluation of Early Liver Transplantation for Alcohol-Related Cirrhosis

Gastroenterology, 2021

The Impact of Donor Liver Fibrosis on Early Allograft Dysfunction and Ischemia‐Reperfusion Injury

Hepatology, 2021

We read with great interest the article by Hirao et al.[1] On the basis of the correlations of Si... more We read with great interest the article by Hirao et al.[1] On the basis of the correlations of Sirius red-positive area (SRA) and the BARD score, with increased ischemia-reperfusion injury (IRI) and early allograft dysfunction (EAD) in liver transplantation (LT) recipients, the authors concluded that the evaluation of donor liver fibrosis may help refine donor-recipient matching in LT. Although the authors should be congratulated on their substantial effort, we believe that several points warrant emphasis in order to interpret the authors' work in the proper context.

Clinical Transplantation, 2021

The influence of patient characteristics and immunosuppression management on COVID-19 outcomes in... more The influence of patient characteristics and immunosuppression management on COVID-19 outcomes in kidney transplant recipients (KTRs) remains uncertain. We performed a single-center, retrospective review of all adult KTRs admitted to the hospital with confirmed COVID-19 between 03/15/2020 and 05/15/2020. Patients were followed from the date of admission up to 1 month following hospital discharge or study conclusion (06/15/2020). Baseline characteristics, laboratory parameters, and immunosuppression were compared between survivors and patients who died to identify predictors of mortality. 38 KTRs with a mean baseline eGFR of 52.5 ml/ min/1.73 m 2 were hospitalized during the review period. Maintenance immunosuppression included tacrolimus (84.2%), mycophenolate (89.5%), and corticosteroids (81.6%) in the majority of patients. Eleven patients (28.9%) died during the hospitalization. Older age (OR = 2.05; 1.04-4.04), peak D-dimer (OR = 1.20; 1.04-1.39), and peak white blood cell count (OR = 1.11; 1.02-1.21) were all associated with mortality among KTRs hospitalized for COVID-19. Increased mortality was also observed among KTRs with concomitant HIV infection (87.5% vs. 36.1%; p < .01). Conversely, immunosuppression intensity and degree of reduction following COVID-19 diagnosis were not associated with either survival or acute allograft rejection. Our findings potentially support a strategy of individualization of immunosuppression targets based on patient-specific risk factors, rather than universal immunosuppression reduction for KTRs at risk from COVID-19.

Journal of Neonatal Surgery, 2017

Background: Knowledge of the correlation between maternal conditions, especially during pregnancy... more Background: Knowledge of the correlation between maternal conditions, especially during pregnancy and fetal outcomes is paramount to optimal care in pediatrics. One which has not been frequently studied in the literature is pre-eclampsia, eclampsia and hemolysis, elevated liver enzymes and low platelets (HELLP).Methods: A retrospective review of all documented cases of pre-eclampsia, eclampsia and HELLP was done at a community Regional Neonatal Center. Over a five year period, 291 mothers were diagnosed with one of the three diseases and gave birth to 318 children. The children were stratified for gestational age and birth weight. Selected conditions were screened for in the medical record over the first year of life.Results: Of the 318 neonates, two were still births and one mother died from intracranial hemorrhage in the face of HELLP. Two hundred and twelve (66.67%) were born before 37 weeks, which is higher than the expected rate for these conditions. A total of 114 neonates wer...

European Journal of Gastroenterology & Hepatology, 2018

Refers to Gadd, S. et al. A Children's Oncology Group and TARGET initiative exploring the genetic... more Refers to Gadd, S. et al. A Children's Oncology Group and TARGET initiative exploring the genetic landscape of Wilms tumor. Nat. Genet.

Simultaneous local excision of synchronous rectal polyps by transanal endoscopic microsurgery

European Journal of Gastroenterology & Hepatology, 2019

BACKGROUND The approach to surgical resection of multiple rectal lesions when endoscopic polypect... more BACKGROUND The approach to surgical resection of multiple rectal lesions when endoscopic polypectomy is unsuccessful has historically been radical rectal resection with total mesorectal excision. This approach is fraught with high morbidity and mortality. We explored the possibility of performing one transanal endoscopic microsurgery procedure to resect multiple synchronous rectal lesions. MATERIALS AND METHODS A retrospective analysis of all adult patients undergoing transanal endoscopic microsurgery at a single institution between 2004 and 2015. Clinical, demographic, and pathologic data were analyzed for all patients with synchronous rectal lesions that were excised via one transanal endoscopic microsurgery procedure. RESULTS Of the 158 patients who underwent transanal endoscopic microsurgery during the study period, 14 (8.8%) had two or more synchronous rectal lesions resected. The mean tumor size was 2.5 cm (range 0.5-3.5). The mean distance from the anal verge for the upper/proximal lesions: 10 ± 2.5 cm, and for the lower/distal lesions: 7 ± 2 cm. Mean operative time was 112 minutes (range 75-170). Median hospitalization time was 3 days (range 2-4). Two patients had urinary retention. No other complications were noted. All the transanal endoscopic microsurgery specimens were with clear margins. CONCLUSION Transanal endoscopic microsurgery is a safe and feasible procedure for patients with multiple rectal lesions. We demonstrate no increase in surgical time, completeness of specimen resection, no increase in complications or hospital length or stay when compared to patients undergoing transanal endoscopic microsurgery for a single lesion.

Laparoscopic Total Mesorectal Excision Following Transanal Endoscopic Microsurgery for Rectal Cancer

Journal of Laparoendoscopic & Advanced Surgical Techniques, 2018

BACKGROUND Patients' selection for transanal endoscopic microsurgery (TEM) depends on diagnos... more BACKGROUND Patients' selection for transanal endoscopic microsurgery (TEM) depends on diagnostic modalities; however, there are still some limitations in the preoperative diagnosis of rectal lesions, and in some reports, up to third of the adenomas resected by TEM were found to be adenocarcinoma; therefore, salvage radical resection (RR) remains necessary for achieving oncological resection. Salvage RR may encounter some technical problems as the violation of the mesorectum and the scar formation. In this study, we aimed to report the outcome in patients undergoing salvage RR in terms of morbidity and oncological results. MATERIALS AND METHODS Demographic and clinical data pertaining to patients undergoing RR following TEM between 2004 and 2014 were retrospectively collected. RESULTS One hundred forty one TEM were performed in the study period, 53 (38%) for malignant rectal lesions. Indication for TEM: 15 (28%) benign adenoma, 25 (47%) early rectal cancer, and 13 (25%) had clinical complete response after neoadjuvant radiochemotherapy. Ten (19%) patients had no residual tumor in TEM specimen, 15 (28%) had T1, and 2 of them underwent salvage low anterior resection (LAR). Ten (19%) had T2, 4 had LAR, and 1 had abdominoperineal resection (APR). Five (9%) had a T3, 3 underwent LAR, and 2 had APR. Among the 13 (25%) after chemo-radiotherapy (CRT), 4 had salvage AR. The time from TEM to RR was 47 days (range32-70). Of 16 salvage surgeries, 8 (50%) were laparoscopic. The median operative time was 210 minutes (range165-360). Five patients had protective ileostomy. Rectal perforation occurred in 2 (12%) patients; both had a posterior location, one after CRT. Two (12%) postoperative small-bowl obstruction and three wound infections occurred. There was no perioperative mortality in any of the patients who underwent RR. The final pathology was no residual disease in 9, T3N1 in 1, T3N0 in 3, T2N1 in 1, and T2N0 in 2 patients. Eight (50%) had adjuvant chemotherapy. CONCLUSION Laparoscopic total mesorectal excision following TEM seems to be safe, and with no negative impact of the completeness of the resection. The concern of intraoperative specimen perforation is real, and should be dealt with meticulous technique and careful dissection, particularly after CRT.

Annals of Surgical Oncology, 2018

Outcomes were analyzed for patients treated for low-grade appendiceal mucinous neoplasms (LAMN) w... more Outcomes were analyzed for patients treated for low-grade appendiceal mucinous neoplasms (LAMN) with remote mucinous peritoneal deposits (MPD). Patients with acellular remote MPD had better outcomes on average than patients with cellular MPD. Approaches such as active surveillance may have a role in selected patients with LAMN and AMPD.

Journal of Coloproctology, 2017

Presacral tumors are rare lesions of the retrorectal space that can present diagnostic and therap... more Presacral tumors are rare lesions of the retrorectal space that can present diagnostic and therapeutic difficulty because of their anatomic location and the different tissue types and etiology. Although the diagnosis and management of these tumors has evolved in recent years, several points still to be addressed in order to improve perioperative diagnosis and treatment. In the upcoming we will try to highlight some controversial points; the pre-operative biopsies, neoadjuvant therapy, the necessity of surgery and the role of minimally invasive surgeries of presacral tumors.

Five Years, Two Surgeons, and over 500 Bariatric Procedures: What Have We Learned?

Obesity surgery, Oct 9, 2017

Bariatric surgery has become an increasingly popular method for weight loss and mitigation of co-... more Bariatric surgery has become an increasingly popular method for weight loss and mitigation of co-morbidities in the obese population. Like any field, there is a desire to standardize and accelerate the postoperative period while maintaining safe outcomes. All laparoscopic sleeve gastrectomies (LSG) and gastric bypasses (LGB) were performed over a 5-year period were logged along with several aspects of postoperative care. Trends were followed in aspects of postoperative care over years as well as any documentation of complications or re-admissions. A total of 545 LSGs and LBPs were performed between 2012 and 2016. Improvements were noted in nearly every field over time, including faster Foley removal, decreased length of hospital stay, decreased use of patient controlled analgesics (PCAs), and faster advancement of diet. There was also an abandonment of utilization of the ICU and step down setting for these patients, leading to significant decreases in hospital cost. There was no cha...

Transanal Endoscopic Microsurgery Combined with Laparoscopic Colectomy for Synchronous Colorectal Tumors, a Word of Caution

Journal of laparoendoscopic & advanced surgical techniques. Part A, Jan 19, 2016

The incidence of malignant synchronous colorectal tumors (SCRT) is between 2% and 5%, and the ass... more The incidence of malignant synchronous colorectal tumors (SCRT) is between 2% and 5%, and the association of synchronous adenomatous polyps in colon cancer has been reported to be 15%-50%. Surgical resection is the primary treatment option for SCRT not amendable to endoscopic resection. Lesions in adjacent segments are usually treated with more extensive resection; however, there is still some controversy on how to best treat synchronous lesions in separate segments, especially when the rectum is involved. In this study, we aimed to report the outcome of patients with SCRT treated by laparoscopic colectomy combined with Transanal Endoscopic Microsurgery. Data pertaining patients undergoing combined colectomy and Transanal Endoscopic Microsurgery (TEM) between 2004 and 2014 were retrospectively collected. 141 TEM performed in the study period, 9 (6.5%) with combined laparoscopic colectomy were included. Mean age was 69.1 ± 10.6 years. There were 6 (66%) right, 2 (22%) left, and one (...

Kidney transplantation using lymphocyte depleting induction and standard maintenance immunosuppression at the height of the SARS‐CoV‐2 pandemic in New York City: A single‐center experience

Clinical Transplantation, 2020

Concerns have been raised regarding proceeding with kidney transplantation using standard immunos... more Concerns have been raised regarding proceeding with kidney transplantation using standard immunosuppression in COVID‐19 endemic areas.

Mixed Neuroendocrine-Nonneuroendocrine Neoplasm (MiNEN), a Rare and Aggressive Combined Primary Liver Cancer

The Impact of Donor Hepatectomy Time on Liver Transplantation Outcomes

Transplantation, 2022

Bariatric Surgery and Cancer

Global Bariatric Surgery, 2018

The Centers for Disease Control and Prevention (CDC) has recently reported the prevalence of obes... more The Centers for Disease Control and Prevention (CDC) has recently reported the prevalence of obesity, defined as a BMI ≥ 30, within the adult population in the USA to be 36.5%. These numbers have been steadily growing since the 1960s. Obesity is higher in females than in males, middle-aged and older than younger adults, white, black, and Hispanic than Asian adults. Obesity has a major impact on the global health and contributes to many other disease processes, like cancer. Bariatric surgery seems to have a protective effect on the incidence of cancer and the overall mortality. This holds especially true for hormonal-driven cancers, like breast, as well as for cancers where inflammation is a major precursor.

Coronavirus Disease 2019 Pandemic: Early Observations in Abdominal Organ Transplantation

The recent COVID-19 outbreak has quickly become a worldwide pandemic emergency. The course of thi... more The recent COVID-19 outbreak has quickly become a worldwide pandemic emergency. The course of this pandemic is still unknown, with more than 6 million cases identified and over 370 000 deaths globally as of June 1, 2020. The uncertainty and anxiety during this period will have a detrimental effect on the global health system. The organ transplantation field has been negatively affected by the COVID-19 pandemic, especially in regions where the intensity of cases exceeds the available capacity of the health care resources. Recently, scattered data have been published in the English literature, mainly in case reports and letters to the editor, that describe the effect of COVID-19 on donors and recipients of abdominal solid organs. Our objective is to review and draw conclusions from these data.

Outcomes of Severe Alcohol‐Related Hepatitis with or without Early Liver Transplantation

Hepatology, 2021

Impact of Donors Who Are Extremely Obese on Early Graft Loss and 30‐Day Mortality After Liver Transplantation

Liver Transplantation, 2021

We read with interest the article by Valvi et al, where the authors categorized donors whose body... more We read with interest the article by Valvi et al, where the authors categorized donors whose body mass index (BMI) > 40 kg/m2 as extremely obese (EO) using national registry database from 2005 to 2019.[1] EO donors had a 38% higher 30-day mortality risk and 53% increased risk of early graft loss (EGL) after liver transplantation (LT).

Evaluation of Early Liver Transplantation for Alcohol-Related Cirrhosis

Gastroenterology, 2021

The Impact of Donor Liver Fibrosis on Early Allograft Dysfunction and Ischemia‐Reperfusion Injury

Hepatology, 2021

We read with great interest the article by Hirao et al.[1] On the basis of the correlations of Si... more We read with great interest the article by Hirao et al.[1] On the basis of the correlations of Sirius red-positive area (SRA) and the BARD score, with increased ischemia-reperfusion injury (IRI) and early allograft dysfunction (EAD) in liver transplantation (LT) recipients, the authors concluded that the evaluation of donor liver fibrosis may help refine donor-recipient matching in LT. Although the authors should be congratulated on their substantial effort, we believe that several points warrant emphasis in order to interpret the authors' work in the proper context.

Clinical Transplantation, 2021

The influence of patient characteristics and immunosuppression management on COVID-19 outcomes in... more The influence of patient characteristics and immunosuppression management on COVID-19 outcomes in kidney transplant recipients (KTRs) remains uncertain. We performed a single-center, retrospective review of all adult KTRs admitted to the hospital with confirmed COVID-19 between 03/15/2020 and 05/15/2020. Patients were followed from the date of admission up to 1 month following hospital discharge or study conclusion (06/15/2020). Baseline characteristics, laboratory parameters, and immunosuppression were compared between survivors and patients who died to identify predictors of mortality. 38 KTRs with a mean baseline eGFR of 52.5 ml/ min/1.73 m 2 were hospitalized during the review period. Maintenance immunosuppression included tacrolimus (84.2%), mycophenolate (89.5%), and corticosteroids (81.6%) in the majority of patients. Eleven patients (28.9%) died during the hospitalization. Older age (OR = 2.05; 1.04-4.04), peak D-dimer (OR = 1.20; 1.04-1.39), and peak white blood cell count (OR = 1.11; 1.02-1.21) were all associated with mortality among KTRs hospitalized for COVID-19. Increased mortality was also observed among KTRs with concomitant HIV infection (87.5% vs. 36.1%; p < .01). Conversely, immunosuppression intensity and degree of reduction following COVID-19 diagnosis were not associated with either survival or acute allograft rejection. Our findings potentially support a strategy of individualization of immunosuppression targets based on patient-specific risk factors, rather than universal immunosuppression reduction for KTRs at risk from COVID-19.

Journal of Neonatal Surgery, 2017

Background: Knowledge of the correlation between maternal conditions, especially during pregnancy... more Background: Knowledge of the correlation between maternal conditions, especially during pregnancy and fetal outcomes is paramount to optimal care in pediatrics. One which has not been frequently studied in the literature is pre-eclampsia, eclampsia and hemolysis, elevated liver enzymes and low platelets (HELLP).Methods: A retrospective review of all documented cases of pre-eclampsia, eclampsia and HELLP was done at a community Regional Neonatal Center. Over a five year period, 291 mothers were diagnosed with one of the three diseases and gave birth to 318 children. The children were stratified for gestational age and birth weight. Selected conditions were screened for in the medical record over the first year of life.Results: Of the 318 neonates, two were still births and one mother died from intracranial hemorrhage in the face of HELLP. Two hundred and twelve (66.67%) were born before 37 weeks, which is higher than the expected rate for these conditions. A total of 114 neonates wer...

European Journal of Gastroenterology & Hepatology, 2018

Refers to Gadd, S. et al. A Children's Oncology Group and TARGET initiative exploring the genetic... more Refers to Gadd, S. et al. A Children's Oncology Group and TARGET initiative exploring the genetic landscape of Wilms tumor. Nat. Genet.

Simultaneous local excision of synchronous rectal polyps by transanal endoscopic microsurgery

European Journal of Gastroenterology & Hepatology, 2019

BACKGROUND The approach to surgical resection of multiple rectal lesions when endoscopic polypect... more BACKGROUND The approach to surgical resection of multiple rectal lesions when endoscopic polypectomy is unsuccessful has historically been radical rectal resection with total mesorectal excision. This approach is fraught with high morbidity and mortality. We explored the possibility of performing one transanal endoscopic microsurgery procedure to resect multiple synchronous rectal lesions. MATERIALS AND METHODS A retrospective analysis of all adult patients undergoing transanal endoscopic microsurgery at a single institution between 2004 and 2015. Clinical, demographic, and pathologic data were analyzed for all patients with synchronous rectal lesions that were excised via one transanal endoscopic microsurgery procedure. RESULTS Of the 158 patients who underwent transanal endoscopic microsurgery during the study period, 14 (8.8%) had two or more synchronous rectal lesions resected. The mean tumor size was 2.5 cm (range 0.5-3.5). The mean distance from the anal verge for the upper/proximal lesions: 10 ± 2.5 cm, and for the lower/distal lesions: 7 ± 2 cm. Mean operative time was 112 minutes (range 75-170). Median hospitalization time was 3 days (range 2-4). Two patients had urinary retention. No other complications were noted. All the transanal endoscopic microsurgery specimens were with clear margins. CONCLUSION Transanal endoscopic microsurgery is a safe and feasible procedure for patients with multiple rectal lesions. We demonstrate no increase in surgical time, completeness of specimen resection, no increase in complications or hospital length or stay when compared to patients undergoing transanal endoscopic microsurgery for a single lesion.

Laparoscopic Total Mesorectal Excision Following Transanal Endoscopic Microsurgery for Rectal Cancer

Journal of Laparoendoscopic & Advanced Surgical Techniques, 2018

BACKGROUND Patients' selection for transanal endoscopic microsurgery (TEM) depends on diagnos... more BACKGROUND Patients' selection for transanal endoscopic microsurgery (TEM) depends on diagnostic modalities; however, there are still some limitations in the preoperative diagnosis of rectal lesions, and in some reports, up to third of the adenomas resected by TEM were found to be adenocarcinoma; therefore, salvage radical resection (RR) remains necessary for achieving oncological resection. Salvage RR may encounter some technical problems as the violation of the mesorectum and the scar formation. In this study, we aimed to report the outcome in patients undergoing salvage RR in terms of morbidity and oncological results. MATERIALS AND METHODS Demographic and clinical data pertaining to patients undergoing RR following TEM between 2004 and 2014 were retrospectively collected. RESULTS One hundred forty one TEM were performed in the study period, 53 (38%) for malignant rectal lesions. Indication for TEM: 15 (28%) benign adenoma, 25 (47%) early rectal cancer, and 13 (25%) had clinical complete response after neoadjuvant radiochemotherapy. Ten (19%) patients had no residual tumor in TEM specimen, 15 (28%) had T1, and 2 of them underwent salvage low anterior resection (LAR). Ten (19%) had T2, 4 had LAR, and 1 had abdominoperineal resection (APR). Five (9%) had a T3, 3 underwent LAR, and 2 had APR. Among the 13 (25%) after chemo-radiotherapy (CRT), 4 had salvage AR. The time from TEM to RR was 47 days (range32-70). Of 16 salvage surgeries, 8 (50%) were laparoscopic. The median operative time was 210 minutes (range165-360). Five patients had protective ileostomy. Rectal perforation occurred in 2 (12%) patients; both had a posterior location, one after CRT. Two (12%) postoperative small-bowl obstruction and three wound infections occurred. There was no perioperative mortality in any of the patients who underwent RR. The final pathology was no residual disease in 9, T3N1 in 1, T3N0 in 3, T2N1 in 1, and T2N0 in 2 patients. Eight (50%) had adjuvant chemotherapy. CONCLUSION Laparoscopic total mesorectal excision following TEM seems to be safe, and with no negative impact of the completeness of the resection. The concern of intraoperative specimen perforation is real, and should be dealt with meticulous technique and careful dissection, particularly after CRT.

Annals of Surgical Oncology, 2018

Outcomes were analyzed for patients treated for low-grade appendiceal mucinous neoplasms (LAMN) w... more Outcomes were analyzed for patients treated for low-grade appendiceal mucinous neoplasms (LAMN) with remote mucinous peritoneal deposits (MPD). Patients with acellular remote MPD had better outcomes on average than patients with cellular MPD. Approaches such as active surveillance may have a role in selected patients with LAMN and AMPD.

Journal of Coloproctology, 2017

Presacral tumors are rare lesions of the retrorectal space that can present diagnostic and therap... more Presacral tumors are rare lesions of the retrorectal space that can present diagnostic and therapeutic difficulty because of their anatomic location and the different tissue types and etiology. Although the diagnosis and management of these tumors has evolved in recent years, several points still to be addressed in order to improve perioperative diagnosis and treatment. In the upcoming we will try to highlight some controversial points; the pre-operative biopsies, neoadjuvant therapy, the necessity of surgery and the role of minimally invasive surgeries of presacral tumors.

Five Years, Two Surgeons, and over 500 Bariatric Procedures: What Have We Learned?

Obesity surgery, Oct 9, 2017

Bariatric surgery has become an increasingly popular method for weight loss and mitigation of co-... more Bariatric surgery has become an increasingly popular method for weight loss and mitigation of co-morbidities in the obese population. Like any field, there is a desire to standardize and accelerate the postoperative period while maintaining safe outcomes. All laparoscopic sleeve gastrectomies (LSG) and gastric bypasses (LGB) were performed over a 5-year period were logged along with several aspects of postoperative care. Trends were followed in aspects of postoperative care over years as well as any documentation of complications or re-admissions. A total of 545 LSGs and LBPs were performed between 2012 and 2016. Improvements were noted in nearly every field over time, including faster Foley removal, decreased length of hospital stay, decreased use of patient controlled analgesics (PCAs), and faster advancement of diet. There was also an abandonment of utilization of the ICU and step down setting for these patients, leading to significant decreases in hospital cost. There was no cha...

Transanal Endoscopic Microsurgery Combined with Laparoscopic Colectomy for Synchronous Colorectal Tumors, a Word of Caution

Journal of laparoendoscopic & advanced surgical techniques. Part A, Jan 19, 2016

The incidence of malignant synchronous colorectal tumors (SCRT) is between 2% and 5%, and the ass... more The incidence of malignant synchronous colorectal tumors (SCRT) is between 2% and 5%, and the association of synchronous adenomatous polyps in colon cancer has been reported to be 15%-50%. Surgical resection is the primary treatment option for SCRT not amendable to endoscopic resection. Lesions in adjacent segments are usually treated with more extensive resection; however, there is still some controversy on how to best treat synchronous lesions in separate segments, especially when the rectum is involved. In this study, we aimed to report the outcome of patients with SCRT treated by laparoscopic colectomy combined with Transanal Endoscopic Microsurgery. Data pertaining patients undergoing combined colectomy and Transanal Endoscopic Microsurgery (TEM) between 2004 and 2014 were retrospectively collected. 141 TEM performed in the study period, 9 (6.5%) with combined laparoscopic colectomy were included. Mean age was 69.1 ± 10.6 years. There were 6 (66%) right, 2 (22%) left, and one (...

Kidney transplantation using lymphocyte depleting induction and standard maintenance immunosuppression at the height of the SARS‐CoV‐2 pandemic in New York City: A single‐center experience

Clinical Transplantation, 2020

Concerns have been raised regarding proceeding with kidney transplantation using standard immunos... more Concerns have been raised regarding proceeding with kidney transplantation using standard immunosuppression in COVID‐19 endemic areas.