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Author: search.filters.author.Arias-Espinosa, LuisLanguage: search.filters.language.English

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    Perioperative outcomes associated with ventral hernia repair concomitant to gynecologic procedures: similar to hernia repair alone
    (Springer Science and Business Media LLC, 2025)
    Melo Bianchi, Juliana
    ;
    Arias-Espinosa, Luis
    ;
    Freyria, Ana
    ;
    Chauhan, Anupam Singh
    ;
    Xie, Weipeng
    Purpose: The aim of this paper is to compare outcomes of patients who underwent combined gynecologic procedures with ventral hernia repair (VHR) with patients that underwent only VHR. Methods: Patients who underwent VHR with a combined gynecological procedure from 2012 to 2023 were retrospectively identified in the Abdominal Core Health Quality Collaborative and categorized into two groups with surgical wound contamination in mind. Group one included patients with concomitant salpingo-oophorectomy (SO), bilateral tubal ligation (BTO), and/or ovarian cystectomy (OC) without hysterectomy. Group two consisted of patients who underwent hysterectomy with or without SO/BTO/OC/ER. C-Sections were excluded. Mesh location was 90% in the sublay space for both groups. Patients who underwent VHR without any concomitant procedure were the control group. Propensity score matching (PSM; ratio 3:1 for control vs. group one and 1:1 for control vs. group two) was performed based on relevant demographic and perioperative covariates (age, hernia width, operative approach, ASA class, BMI, mesh used, current smoker, wound status, year of operation, and recurrent). Postoperative outcomes at 30 days were compared between group one and control and between group two and control based on post-PSM cohorts. Results: Out of 13,982 patients undergoing VHR, 279 (2%) also underwent a concurrent gynecological procedure. Following PSM, 88 patients in Group 1 were matched with 264 patients that underwent VHR alone. Similarly, 186 patients in Group 2 were compared with 186 patients in the control group. Operative time was significantly higher in both groups as compared to control (p < 0.001). A longer LOS and more EBL were observed group 2 but not group 1. No statistically significant differences were observed in either group regarding surgical site infection (SSI), surgical site occurrence (SSO), Surgical site occurrences requiring procedural interventions (SSOPI), recurrence of hernia, reoperations, or readmissions. Conclusion: This study compares the outcomes of patients that underwent VHR with simultaneous gynecological procedure to patients with VHR alone. Combining hernia repair and gynecologic surgery did not appear to have an adverse impact on clinical outcomes. Our study suggests that further collaboration between gynecology and general surgery can be considered for management of concurrent abdominopelvic pathologies. ©The authors ©Springer.
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    The impact of externalized pancreatic stents in our practice: A comparison of outcomes after pancreaticoduodenectomy in two time periods
    (Elsevier, 2025)
    Arias-Espinosa, Luis
    ;
    Nordmann-Gomes, Alberto
    ;
    Zorrilla-Villalobos, A.
    ;
    Vargas-España Andres
    ;
    Malcher, Flavio
    Background: Postoperative pancreatic fistula is a severe complication of pancreaticoduodenectomy. Using an externalized pancreatic stent is a potential mitigation strategy not previously studied in Latin America. Methods: Pancreaticoduodenectomies performed in a single center between 2006 and 2019 were retrospectively analyzed. Clinical variables were collected with a 90-day follow-up according to stent intervention: externalized stent (ES), internal stent (IS), or no stent. Before and after ES implementation (2016) periods were also compared. ©The authors ©The American Journal of Surgery (AJS) © Elsevier.
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    Mobilization Success and Bariers for Autologous Hematopoietic Stem Cell Transplantation in a Constrained-Resource Nation
    (2020)
    Acosta-Medina, Aldo A.
    ;
    Arias-Espinosa, Luis
    ;
    Villaseñor-Echavarri, Rodrigo
    ;
    Chouciño, Pedro
    ;
    Mayo Maldonado, Jonathan
    Introduction: Autologous stem cell transplantation (ASCT) is a well-established therapy for various hematologic and solid malignancies. Optimal mobilization and harvest of peripheral blood-stem cells (PBSC) is crucial. A failed mobilization attempt (MA) can preclude transplantation in up to 40% of cases, however, novel agents have increased success rates. The aim of our study was to evaluate factors impacting MA failure and remobilization efficacy in a resource-constrained setting. Methods: Retrospective single-center study including patients with at least one MA of PBSC for ASCT between June 2010 to June 2019.
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