Search Our Scientific Publications & Authors

Am Surg 2020 Oct;86(10):1269-1276

VA Greater Los Angeles Healthcare System and David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.

Diverting loop ileostomy (DLI) with colonic lavage has been proposed as an alternative to total abdominal colectomy (TAC) for fulminant infection (CDI). Controversy exists regarding the mortality benefit and outcomes of this surgical approach. We conducted a MEDLINE database search for articles between 1999 and 2019 pertaining to DLI for the surgical treatment of CDI. Read More

Dis Colon Rectum 2020 09;63(9):1317-1326

Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, New York.

Background: Emergency surgery is often required for fulminant Clostridium difficile colitis. Total abdominal colectomy has been the treatment of choice despite high morbidity and mortality.

Objective: The aim of this meta-analysis was to evaluate postoperative mortality and morbidity after total abdominal colectomy and loop ileostomy with colonic lavage in patients with fulminant C difficile colitis. Read More

ANZ J Surg 2020 09 3;90(9):1769-1770. Epub 2020 Jul 3.

Department of Colorectal Surgery, Box Hill Hospital, Melbourne, Victoria, Australia.

South Med J 2020 Jul;113(7):345-349

From the Division of Trauma & Surgical Critical Care and the Department of Research Administration, Jersey Shore University Medical Center, Neptune, New Jersey.

Objective: The purpose of the study was to evaluate whether early colectomy in patients who have toxic megacolon due to colitis reduces mortality.

Methods: The study was performed using the American College of Surgeons National Surgical Quality Improvement Program database from 2012 to 2016. All patients 18 to 89 years of age who underwent colectomy for toxic megacolon resulting from colitis were included in the study. Read More

Trials 2020 Jun 29;21(1):590. Epub 2020 Jun 29.

Harvard Medical School, Boston, MA, USA.

Background: Critically ill infants with congenital heart disease (CHD) are often prescribed stress ulcer prophylaxis (SUP) to prevent upper gastrointestinal bleeding, despite the low incidence of stress ulcers and limited data on the safety and efficacy of SUP in infants. Recently, SUP has been associated with an increased incidence of hospital-acquired infections, community-acquired pneumonia, and necrotizing enterocolitis. The objective of this pilot study is to investigate the feasibility of performing a randomized controlled trial to assess the safety and efficacy of withholding SUP in infants with congenital heart disease admitted to the cardiac intensive care unit. Read More

Chirurgia (Bucur) 2020 Mar-Apr;115(2):227-235

The emergency surgery for colorectal cancer is associated with high rates of morbidity and mortality due to factors related to the characteristics of the patients but also the therapeutic attitude. This study aims to identify the surgical interventions associated with the postoperative complications, with the main causes of morbidity, with the reinterventions and with the postoperative deaths. We included in this retrospective study 431 patients hospitalized and operated in an emergency for complicated colorectal malignant tumors in the Surgery II Clinic of the Clinical Emergency County Hospital "Sf. Read More

Clin Transl Gastroenterol 2020 03;11(3):e00134

Department of Medicine B, Gastroenterology and Hepatology, University Hospital Münster, Münster, Germany.

Objectives: In patients with inflammatory bowel disease (IBD), a treat-to-target treatment strategy requires tight monitoring of disease activity. Noninvasive biomarkers may help to monitor the intestinal disease activity. We demonstrated recently that peripheral microRNA (miR)-320a expression in mice follows the course of experimental colitis. Read More

Surg J (N Y) 2020 Jan 3;6(1):e37-e41. Epub 2020 Mar 3.

Department of Internal Medicine and Medical Gastroenterology, Lilavati Hospital and Research Centre, Mumbai, Maharashtra, India.

Hepatic portal venous gas (HPVG), a rare radiological finding, is historically considered an ominous sign with 100% mortality rates. The dictum that HPVG warrants surgical intervention is challenged in the recent literature. This is because of the identification of various causes of HVPG other than bowel gangrene. Read More

Aliment Pharmacol Ther 2020 01;51(1):208-209

Lynda K and David M Underwood Center for Digestive Disorders, Division of Gastroenterology and Hepatology, Houston Methodist Hospital and Weill Cornell Medical College, Houston, TX, USA.

J Infect Chemother 2020 Mar 9;26(3):305-308. Epub 2019 Dec 9.

Department of Bacteriology II, National Institute of Infectious Diseases, Japan. Electronic address:

A 74-year-old male was referred to our critical care department for refractory severe watery diarrhea with advanced leukocytosis (over 70,000/μl) after multiple administrations of eradication therapy against Helicobacter pylori (HP). He was diagnosed as having fulminant colitis due to Clostridioides difficile after antimicrobial eradication therapy. He was given intravenous metronidazole and oral vancomycin. Read More

J Gastrointest Surg 2020 02 25;24(2):484-491. Epub 2019 Nov 25.

Department of Surgery, University of California, Davis, Medical Center, 2335 Stockton Blvd., Sacramento, CA, 95817, USA.

Clostridium difficile infection remains a common nosocomial illness with a significant impact on health care delivery. As molecular phenotyping of this organism has changed our understanding of its transmission and virulence, so too have diagnostic methods and treatment strategies evolved in recent years. The burden of this infection falls predominantly on elderly patients with comorbidities who have recently received antibiotics. Read More

JAMA Surg 2020 02;155(2):174-175

Cardiovascular Outcomes Research Laboratories (CORELAB), Department of Surgery, University of California, Los Angeles.

JAMA Surg 2020 02;155(2):174

Jyoban Hospital of Tokiwa Foundation, Iwaki-City, Fukushima, Japan.

JAMA Surg 2020 02;155(2):173-174

The Queen's Medical Centre, Nottingham, England.

Gut 2020 01 14;69(1):83-91. Epub 2019 Oct 14.

Center for Gut Microbiota Research, The Chinese University of Hong Kong, Hong Kong, China.

Objective: The underlying microbial basis, predictors of therapeutic outcome and active constituent(s) of faecal microbiota transplantation (FMT) mediating benefit remain unknown. An international panel of experts presented key elements that will shape forthcoming FMT research and practice.

Design: Systematic search was performed, FMT literature was critically appraised and a 1-day round-table discussion was conducted to derive expert consensus on key issues in FMT research. Read More

Surg Endosc 2020 09 10;34(9):4101-4109. Epub 2019 Oct 10.

Division of Colon and Rectal Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, Box 1259, New York, NY, 10029, USA.

Background: Transanal total mesorectal excision (taTME) is a surgical approach for low rectal cancer with a learning curve estimated at 40-50 cases. The experience among taTME surgeons beyond their learning curve is limited.

Methods: A retrospective analysis of all taTME cases performed for rectal cancer at two tertiary care hospitals from 2014 to 2019 was conducted. Read More

Arab J Gastroenterol 2019 Sep 27;20(3):148-162. Epub 2019 Sep 27.

Department Gastroenterology-Hepatology, Meibergdreef, 1105 AZ Amsterdam, Netherlands.

ANZ J Surg 2020 01 30;90(1-2):67-71. Epub 2019 Sep 30.

Department of Surgery, St George Hospital, Sydney, New South Wales, Australia.

Background: Laparoscopic ventral repair is safe, with lower wound infection rates compared with open repair. 'Venetian blinds' technique of plication in combination with mesh reinforcement, is totally intra-corporeal, with hernia defect and sac plication to reduce seroma formation. While laparoscopic suturing of the abdominal wall can represent a technical challenge, pre-operative botulinum toxin A (BTA) injections as an adjunct can assist. Read More

J Arthroplasty 2019 Nov 26;34(11):2785-2788. Epub 2019 Jun 26.

Department of Orthopaedic Surgery, Detroit Medical Center, Detroit, MI.

Background: Clostridium difficile-associated diarrhea (CDAD) is associated with adverse events and financial liability. As institutions continue to adopt CDAD rates as a quality control metric, it is important to identify patients at risk before surgery, including revision total knee arthroplasty (rTKA). This study was conducted to (1) determine the incidence of CDAD within 30 days of rTKA and (2) identify perioperative risk factors for CDAD following rTKA. Read More

JAMA Surg 2019 10;154(10):906

Department of Surgery, Amsterdam University Medical Centers, Academic Medical Center Location, Amsterdam, the Netherlands.

JAMA Surg 2019 10;154(10):899-906

Department of Surgery, University of California, Los Angeles, Los Angeles.

Importance: Diverting loop ileostomy and colonic lavage has generated much interest since it was first reported as a potential alternative to total abdominal colectomy for treating Clostridium difficile colitis in 2011. To our knowledge, few studies have validated the benefit reported in the initial description, and the association of this new approach with practice patterns has not been described.

Objective: To examine the national adoption pattern and outcomes of diverting loop ileostomy vs total abdominal colectomy as treatment for fulminant C difficile colitis. Read More

J Minim Invasive Gynecol 2020 May - Jun;27(4):883-891. Epub 2019 Jun 22.

Benign Gynecology Surgery Section, Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, Ohio (Dr. Kho).

Study Objective: To validate the algorithm for selective bowel surgery based on preoperative imaging by comparing the perioperative outcomes of patients who undergo each type of bowel surgery for deep bowel disease, and secondarily to evaluate the incidence, factors, and subsequent outcomes when the actual procedure performed deviated from the preoperative surgical plan.

Design: Retrospective study comparing 3 surgical interventions in an intention-to-treat analysis.

Setting: Tertiary care hospital. Read More

J Trauma Acute Care Surg 2019 10;87(4):856-864

From the Division of Colon and Rectal Surgery (M.A.K., N.M., C.A.V., M.B.), Sir Mortimer B. Davis Jewish General Hospital, Montreal, Quebec, Canada; Lady Davis Institute for Medical Research (S.R.B.), Sir Mortimer B. Davis Jewish General Hospital, Montreal, Quebec, Canada; Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation (L.F.), McGill University, Montreal, Quebec, Canada; Sir Mortimer B. Davis Jewish General Hospital (Y.L.), Montreal, Quebec, Canada; Centre Hospitalier Universitaire de Sherbrooke (A.C.), Sherbrooke, Quebec, Canada.

Background: Clostridium difficile colitis is an increasingly important cause of morbidity and mortality. Fulminant C. difficile colitis (FCDC) is a severe form of the colitis driven by a significant systemic inflammatory response, and managed with a total abdominal colectomy. Read More

Am J Gastroenterol 2019 11;114(11):1708

Division of Gastroenterology, City of Hope National Medical Center, Duarte, California, USA.

Gastroenterology 2019 12 4;157(6):1492-1493. Epub 2019 May 4.

Division of Gastroenterology and Hepatology, Department of Medicine, Cook County Health and Hospital System, County, Chicago, Illinois.

Clin Transplant 2019 09 20;33(9):e13564. Epub 2019 Jun 20.

Department of Medicine, Division of Infectious Diseases, School of Medicine, Washington University, St. Louis, Missouri.

These updated guidelines from the American Society of Transplantation Infectious Diseases Community of Practice address the prevention and management of Clostridium difficile infection in solid organ transplant (SOT) recipients. Clostridioides (formerly Clostridium) difficile infection (CDI) is among the most common hospital acquired infections. In SOT recipients, the incidence of CDI varies by type and number or organs transplanted. Read More

J Dig Dis 2019 Jun 10;20(6):301-307. Epub 2019 May 10.

Department of Gastroenterology, MedStar Georgetown University Hospital, Washington, District of Columbia, USA.

Objective: Significant data support the efficacy and safety of fecal microbiota transplant (FMT) in recurrent Clostridium difficile infection (CDI). The objective of our study was to determine the success rate of FMT in patients diagnosed with severe and complicated CDI with impending colectomy in the intensive care setting.

Methods: This was a 2-center study of 9 patients who met the criteria for severe and complicated CDI and had an impending colectomy. Read More

SAGE Open Med Case Rep 2019 19;7:2050313X19838442. Epub 2019 Mar 19.

Clinic of Gastroenterology, Adana City Research and Education Hospital, University of Health Sciences, Adana, Turkey.

The infection-related disease varies from mild diarrhoea to pseudomembranouscolitis. Although infection is commonly considered to be a hospital-acquired infection, a significant number of cases are community acquired. Community-acquired infection can exhibit itself as ileus or toxic megacolon. Read More

World J Emerg Surg 2019;14. Epub 2019 Feb 28.

Vital Care, Inc, Meridian, MS USA.

In the last three decades, infection (CDI) has increased in incidence and severity in many countries worldwide. The increase in CDI incidence has been particularly apparent among surgical patients. Therefore, prevention of CDI and optimization of management in the surgical patient are paramount. Read More

Pediatr Nephrol 2019 07 6;34(7):1269-1275. Epub 2019 Mar 6.

University Children's Medical Clinic, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Background: During the last two decades, there has been a worldwide increase in frequency and severity of infections with Clostridium difficile (CDI). Solid organ transplant (SOT) recipients receiving immunosuppressing medications are especially at risk.

Methods: We collected data from immunocompromised pediatric patients, including kidney and liver transplant recipients, at our tertiary pediatric care center in Germany. Read More