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Friedman AJ, Elseth AJ, Brockmeyer JR. Proton Pump Inhibitors, Associated Complications, and Alternative Therapies: A Shifting Risk Benefit Ratio. Am Surg 2021; 88:20-27. [PMID: 33560890 DOI: 10.1177/0003134821991988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Our goal was to compile the most recent and accurate data on the side effects of proton pump inhibitors (PPI). We also compared the efficacy of PPI to the efficacy of different surgical options for acid reflux control. BACKGROUND Proton pump inhibitors are the primary therapy for chronic control of gastroesophageal reflux disease (GERD), but newer studies demonstrate deleterious side effects. Collating this information and contrasting it with surgical therapy for GERD provides evidence for possible practice changes in treatment. METHODS A literature search utilizing PubMed was performed evaluating for PPI and anti-reflux surgery (ARS), focusing on articles that reflected information regarding the usage and efficacy of symptom control of both PPI and ARS. Search terms included "ARS, fundoplication, MSA, acute interstitial nephritis, acute kidney injury, chronic kidney disease, meta-analysis, PPI, H2 blocker, cardiovascular risk, and gut dysbiosis." We evaluated 271 articles by title, abstract, and data for relevance and included 70. RESULTS Long-term control of GERD with PPI may have a greater than expected side effect profile than initially thought. Surgical options may provide greater symptom control than PPI without the side effects of long-term medical therapy. CONCLUSIONS Anti-reflux control can be safely achieved with either PPI or surgical options; however, the long-term side effects noted in the review such as increased risk of cardiovascular events, renal disease, and gut dysbiosis may suggest surgical anti-reflux control as a better long-term option.
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Affiliation(s)
- Alexander J Friedman
- General Surgery Department, 19911Dwight D. Eisenhower Army Medical Center, Fort Gordon, GA, USA
| | - Anna J Elseth
- General Surgery Department, 19911Dwight D. Eisenhower Army Medical Center, Fort Gordon, GA, USA
| | - Joel R Brockmeyer
- General Surgery Department, 19911Dwight D. Eisenhower Army Medical Center, Fort Gordon, GA, USA
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Huh J, Brockmeyer JR, Bertsch SR, Vanderspurt C, Batig TS, Clemens M. Conducting Pre-deployment Training in Honduras: The 240th Forward Resuscitative Surgical Team Experience. Mil Med 2021; 187:e690-e695. [PMID: 33502520 DOI: 10.1093/milmed/usaa545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 07/30/2020] [Accepted: 01/25/2021] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Since January 2002, pre-deployment training of forward resuscitative and surgical units has taken place at the U.S. Army Trauma Training Center (ATTC) in Miami, FL. In June 2019, the 240th Forward Resuscitative Surgical Team (FRST) conducted the first pre-deployment Surgical Readiness Training Exercise (SURGRETE) in San Pedro Sula, Honduras, to allow the team to rehearse in a resource-constrained environment more similar to that expected on deployment. The purpose of this study is to describe and compare the pre-deployment training experiences of the 240th FRST during their SURGRETE in Honduras and ATTC rotation in Miami, FL. MATERIALS AND METHODS A descriptive analysis of prospectively collected data was performed for surgical cases, trauma resuscitations, and nonsurgical procedures by the 240th FRST over a 2-week SURGRETE in Honduras and 2-week ATTC rotation in Miami, FL. Items accomplished within the Individual Critical Task Lists (ICTLs) of key clinical providers on the team (general surgeon, orthopedic surgeon, emergency medicine physician, and Certified Registered Nurse Anesthetist) were identified and compared to those accomplished at the ATTC. RESULTS During the SURGRETE in Honduras, 64 surgical cases, 1 trauma resuscitation, 2 Advanced Cardiac Life Support codes, and 213 nonsurgical procedures were performed collectively by the team. During ATTC rotation, the team performed a combined total of 10 surgical cases, 6 trauma resuscitations, and 56 nonsurgical procedures. For each key clinical provider, more of their assigned ICTLs were conducted during the Honduras SURGRETE than during ATTC rotation. The ATTC, however, offered more cases of acute life-threatening trauma. CONCLUSION Appropriately planned SURGRETEs can provide a concentrated case volume in a resource-constrained setting and challenge the team to consider definitive management algorithms. The cases performed may not necessarily reflect the type and acuity of operations performed in a deployed environment; however, they facilitate repetition of basic skills, team cohesion, and cross-training. The SURGRETE experience could be improved by locating a facility with a trauma-dominant patient population that allows increased autonomy of U.S. physicians.
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Affiliation(s)
- Jeannie Huh
- 240th Forward Resuscitative Surgical Team, Womack Army Medical Center, Fort Bragg, NC 28310, USA
| | - Joel R Brockmeyer
- 240th Forward Resuscitative Surgical Team, Womack Army Medical Center, Fort Bragg, NC 28310, USA
| | - Stephen R Bertsch
- 240th Forward Resuscitative Surgical Team, Womack Army Medical Center, Fort Bragg, NC 28310, USA
| | - Cecily Vanderspurt
- 240th Forward Resuscitative Surgical Team, Womack Army Medical Center, Fort Bragg, NC 28310, USA
| | - Timothy S Batig
- 240th Forward Resuscitative Surgical Team, Womack Army Medical Center, Fort Bragg, NC 28310, USA
| | - Michael Clemens
- 240th Forward Resuscitative Surgical Team, Womack Army Medical Center, Fort Bragg, NC 28310, USA
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Chang WW, Hawkins DN, Brockmeyer JR, Faler BJ, Hoppe SW, Prasad BM. Factors influencing long-term weight loss after bariatric surgery. Surg Obes Relat Dis 2019; 15:456-461. [PMID: 30713118 DOI: 10.1016/j.soard.2018.12.033] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 11/17/2018] [Accepted: 12/24/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND Bariatric surgery provides sustained weight loss and improves comorbidities. However, long term data has shown that patients gradually regain weight after 1 year. Several factors have been associated with poor weight loss after bariatric surgery. OBJECTIVE Our goal is to investigate factors associated with poor weight loss following laparoscopic sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB). SETTING Military academic medical center. METHODS Retrospective review of 247 patients who underwent laparoscopic SG or RYGB between 2010-2012 at Eisenhower Army Medical Center and followed for 5 years postoperatively. Factors of age, type of surgery, sex, hypertension, depression, and type 2 diabetes (T2D) are analyzed in univariate and multivariate analysis with percent total weight loss (%TWL) and Body Mass Index (BMI) change as primary endpoints measured at 3 and 5 years. RESULTS Average BMI change are maximized at 1 year and decreased at 3 and 5 years post-surgery. Age, diabetes, hypertension and type of surgery significantly influenced weight loss at 3 and 5 years on univariate analysis. However, patients with diabetes, hypertension and sleeve gastrectomy were significantly older than comparable control group. Multivariable analysis showed that age and type of surgery, not diabetes or hypertension, were associated with poor %TWL and BMI change at 3 and 5 years. CONCLUSION While presence of hypertension and diabetes initially appeared to be associated with weight recidivism, their impacts were negligible on multivariable analysis. However, age and sleeve gastrectomy are independent risk factors. Our data can be used to counsel patients on expected weight loss after bariatric surgery.
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Affiliation(s)
- William W Chang
- Department of General Surgery, Dwight D. Eisenhower Army Medical Center, Fort Gordon, Georgia.
| | - Devon N Hawkins
- Department of General Surgery, Dwight D. Eisenhower Army Medical Center, Fort Gordon, Georgia
| | - Joel R Brockmeyer
- Department of General Surgery, Dwight D. Eisenhower Army Medical Center, Fort Gordon, Georgia
| | - Byron J Faler
- Department of General Surgery, Dwight D. Eisenhower Army Medical Center, Fort Gordon, Georgia
| | - Samuel W Hoppe
- Department of General Surgery, Dwight D. Eisenhower Army Medical Center, Fort Gordon, Georgia
| | - Balakrishna M Prasad
- Department of Clinical Investigations, Dwight D. Eisenhower Army Medical Center, Fort Gordon, Georgia
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Plackett TP, Brockmeyer JR, Holt DB, Rush RM, Sarkar J, Satterly SA, Seery JM, Zagol BR. Achieving Mastery of General Surgery Operative Skill in the Army Healthcare System. Mil Med 2018; 184:e279-e284. [DOI: 10.1093/milmed/usy222] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 07/29/2018] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - Joel R Brockmeyer
- Dwight D. Eisenhower Army Medical Center, 300 W. Hospital Road, Fort Gordon, GA
| | - Danielle B Holt
- Walter Reed National Military Medical Center, 4494 N. Palmer Road, Bethesda, MD
| | - Robert M Rush
- PeaceHealth St Joseph Medical Center, 2901 Squalicum Parkway, Bellingham, WA
| | - Joy Sarkar
- Brian Allgood Army Community Hospital, Seoul, South Korea
| | | | - Jason M Seery
- Martin Army Community Hospital, 600 Van Aalst Boulevard, Fort Benning, GA
| | - Bradley R Zagol
- Augusta University Medical Center, 1120 Fifteenth Street, Augusta, GA
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Brockmeyer JR, Grover BT, Kallies KJ, Kothari SN. Management of biliary symptoms after bariatric surgery. Am J Surg 2015; 210:1010-6; discussion 1016-7. [DOI: 10.1016/j.amjsurg.2015.07.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 07/21/2015] [Accepted: 07/23/2015] [Indexed: 10/23/2022]
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Brockmeyer JR, Kallies KJ, Baker MT, Grover BT, Kothari SN. Management of bleeding complications after bariatric surgery. J Am Coll Surg 2015. [DOI: 10.1016/j.jamcollsurg.2015.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Simon TE, Johnson RJ, Naig AL, Brockmeyer JR, Prasad BM, White PW. Permacol Interposition Graft as an Alternative to Vein in Contaminated Wounds Using a Rabbit Model. Ann Vasc Surg 2015; 29:1307-14. [DOI: 10.1016/j.avsg.2015.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Revised: 05/04/2015] [Accepted: 05/08/2015] [Indexed: 11/29/2022]
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Simon TE, Scott JA, Brockmeyer JR, Rice RC, Frizzi JD, Husain FA, Choi YU. Comparison of Staple-Line Leakage and Hemorrhage in Patients Undergoing Laparoscopic Sleeve Gastrectomy with or Without Seamguard. Am Surg 2011. [DOI: 10.1177/000313481107701240] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Laparoscopic sleeve gastrectomy (LSG) has been recognized as a primary procedure for the surgical management of morbid obesity. Staple-line leaks and hemorrhage are two associated complications. Staple-line buttressing materials have been suggested to decrease these complications. When used during LSG, few published papers exist that compare the incidence of leak or hemorrhage to that of nonreinforced staple-lines. The purpose of this study was to compare the incidence of leak and hemorrhage in patients who did and did not receive reinforcement with Seamguard (W.L. Gore & Associates, Flagstaff, AZ). This is a retrospective analysis of patients undergoing LSG. All patients met National Institutes of Health criteria and each had an extensive preoperative evaluation. Data was collected from inpatient and outpatient medical records. Fifty-nine patients received reinforcement and 80 patients did not. There was no significant difference in mean body mass index, age, or gender make-up between the two groups. The overall incidence of leak was 3.60 per cent. The incidence was 3.39 per cent in patients who received reinforcement and 3.75 per cent in those who did not. This was not statistically significant. There was no incidence of staple-line hemorrhage in either group. There is no conclusive evidence that Seamguard reduces staple-line leakage or hemorrhage. Studies involving a larger number of patients are necessary before recommending staple-line reinforcement.
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Affiliation(s)
- Todd E. Simon
- Dwight D. Eisenhower Army Medical Center, Department of General Surgery, Fort Gordon, Georgia
| | - Joshua A. Scott
- Dwight D. Eisenhower Army Medical Center, Department of General Surgery, Fort Gordon, Georgia
| | - Joel R. Brockmeyer
- Dwight D. Eisenhower Army Medical Center, Department of General Surgery, Fort Gordon, Georgia
| | - Robert C. Rice
- Dwight D. Eisenhower Army Medical Center, Department of General Surgery, Fort Gordon, Georgia
| | - James D. Frizzi
- Dwight D. Eisenhower Army Medical Center, Department of General Surgery, Fort Gordon, Georgia
| | - Farah A. Husain
- Dwight D. Eisenhower Army Medical Center, Department of General Surgery, Fort Gordon, Georgia
| | - Yong U. Choi
- Dwight D. Eisenhower Army Medical Center, Department of General Surgery, Fort Gordon, Georgia
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Simon TE, Scott JA, Brockmeyer JR, Rice RC, Frizzi JD, Husain FA, Choi YU. Comparison of staple-line leakage and hemorrhage in patients undergoing laparoscopic sleeve gastrectomy with or without Seamguard. Am Surg 2011; 77:1665-1668. [PMID: 22273227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Laparoscopic sleeve gastrectomy (LSG) has been recognized as a primary procedure for the surgical management of morbid obesity. Staple-line leaks and hemorrhage are two associated complications. Staple-line buttressing materials have been suggested to decrease these complications. When used during LSG, few published papers exist that compare the incidence of leak or hemorrhage to that of nonreinforced staple-lines. The purpose of this study was to compare the incidence of leak and hemorrhage in patients who did and did not receive reinforcement with Seamguard (W.L. Gore & Associates, Flagstaff, AZ). This is a retrospective analysis of patients undergoing LSG. All patients met National Institutes of Health criteria and each had an extensive preoperative evaluation. Data was collected from inpatient and outpatient medical records. Fifty-nine patients received reinforcement and 80 patients did not. There was no significant difference in mean body mass index, age, or gender make-up between the two groups. The overall incidence of leak was 3.60 per cent. The incidence was 3.39 per cent in patients who received reinforcement and 3.75 per cent in those who did not. This was not statistically significant. There was no incidence of staple-line hemorrhage in either group. There is no conclusive evidence that Seamguard reduces staple-line leakage or hemorrhage. Studies involving a larger number of patients are necessary before recommending staple-line reinforcement.
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Affiliation(s)
- Todd E Simon
- Dwight D. Eisenhower Army Medical Center, Department of General Surgery, Fort Gordon, Georgia 30905, USA.
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Burgess PL, Brockmeyer JR, Johnson EK. Amyand hernia repaired with Bio-A: a case report and review. J Surg Educ 2011; 68:62-66. [PMID: 21292218 DOI: 10.1016/j.jsurg.2010.09.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2010] [Revised: 09/07/2010] [Accepted: 09/13/2010] [Indexed: 05/30/2023]
Abstract
A 53-year-old man with an Amyand hernia with indirect and direct components was repaired with a Bio-A (Gore, Newark, Delaware) plug and a patch made of Bio-A tissue reinforcement material. The repair of an Amyand hernia addresses the pathology of the appendix as well as the hernia. We report a case in which a plug and patch repair was undertaken using Bio-A implants in a clean-contaminated field with no signs of infection or recurrence in the follow-up period, and we review the literature regarding the diagnosis and repair of an Amyand hernia.
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Affiliation(s)
- Pamela L Burgess
- Dwight David Eisenhower Army Medical Center, Ft. Gordon, Georgia 30905, USA.
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Affiliation(s)
- Joel R. Brockmeyer
- Department of General Surgery Dwight D. Eisenhower Army Medical Center Fort Gordon, Georgia
| | - Robert D. Rice
- Department of General Surgery Dwight D. Eisenhower Army Medical Center Fort Gordon, Georgia
| | - Jason M. Seery
- Department of General Surgery Dwight D. Eisenhower Army Medical Center Fort Gordon, Georgia
| | - Mark G. Ziemba
- Department of General Surgery Dwight D. Eisenhower Army Medical Center Fort Gordon, Georgia
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Brockmeyer JR, Rice RD, Seery JM, Ziemba MG. Sclerosing sweat duct carcinoma in the left axilla presenting as metastatic breast cancer. Am Surg 2010; 76:119-120. [PMID: 20135957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Affiliation(s)
- Joel R. Brockmeyer
- Department of General Surgery Dwight D. Eisenhower Army Medical Center Fort Gordon, Georgia
| | - Robert D. Rice
- Department of General Surgery Dwight D. Eisenhower Army Medical Center Fort Gordon, Georgia
| | - Jason M. Seery
- Department of General Surgery Dwight D. Eisenhower Army Medical Center Fort Gordon, Georgia
| | - Cletus A. Arciero
- Department of General Surgery Dwight D. Eisenhower Army Medical Center Fort Gordon, Georgia
| | - Trent D. Sterenchock
- Department of General Surgery Dwight D. Eisenhower Army Medical Center Fort Gordon, Georgia
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Brockmeyer JR, Rice RD, Seery JM, Arciero CA, Sterenchock TD. Primary embryonal rhabdomyosarcoma of the prostate in an adult. Am Surg 2010; 76:122-123. [PMID: 20135959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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