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21 results on '"Maskal, Sara M."'

5. The association of permanent versus absorbable fixation on developing chronic post-herniorrhaphy groin pain in patients undergoing laparoscopic inguinal hernia repair

Author

Woo, Kimberly P., Ellis, Ryan C., Maskal, Sara M., Remulla, Daphne, Shukla, Priya, Rosen, Alexandra J., Wetzka, Isabella, Osei-Koomson, Wilhemina, Phillips, Sharon, Miller, Benjamin T., Beffa, Lucas R., Petro, Clayton C., Krpata, David M., Prabhu, Ajita S., Menzo, Emanuele Lo, and Rosen, Michael J.

Published
2024
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17. Splenectomy outcomes in immune cytopenias: Treatment outcomes and determinants of response.

Author

Ogbue, Olisaemeka D., Bahaj, Waled, Kewan, Tariq, Ahmed, Ramsha, Dima, Danai, Willimas, Nakisha, Durmaz, Arda, Visconte, Valeria, Maskal, Sara M., Gurnari, Carmelo, Steven, Rosenblatt, and Maciejewski, Jaroslaw P.

Subjects
SPLENECTOMY, IDIOPATHIC thrombocytopenic purpura, AUTOIMMUNE hemolytic anemia, TREATMENT effectiveness, TREATMENT failure, CYTOPENIA
Abstract

Background: Splenectomy is commonly used to treat refractory immune–mediated cytopenia, but there are no established factors that are associated with response to the procedure. Objectives: A cohort study was conducted to evaluate the hematologic and surgical outcomes of splenectomy in adult patients with immune cytopenias and identify preoperative factors associated with response. Methods: Data from the Cleveland Clinic Foundation for 1824 patients aged over 18 who underwent splenectomy from 2002 to 2020 were analyzed. Results: The study found that the most common indications for splenectomy were immune thrombocytopenic purpura (ITP) and autoimmune hemolytic anemia, with a median age of 55 years and median time from diagnosis to splenectomy of 11 months. Hematologic response rates were 74% overall, with relapse in 12% of cases. Postsplenectomy discordant diagnoses were present in 13% of patients, associated with higher relapse rates. Surgery‐related complications occurred in 12% of cases, whereas only 3% of patients died from disease complications. On univariate analysis, preoperative factors associated with splenectomy treatment failure were ≥3 lines of pharmacologic treatment, whereas isolated thrombocytopenia, primary ITP, and age ≤40 years had a strong association with response. The multivariable regression confirmed that treatment failure with multiple lines of medical therapy was associated with the failure to respond to splenectomy. Conclusion: Overall, the study demonstrates that splenectomy is an effective treatment option for immune‐mediated cytopenias with a low complication rate. [ABSTRACT FROM AUTHOR]

Published
2024
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18. Robotic Enhanced-View Totally Extraperitoneal vs Intraperitoneal Onlay Mesh Evaluation: 1-Year Exploratory Outcomes of the REVEAL Randomized Clinical Trial.

Author

Petro, Clayton C., Maskal, Sara M., Renton, David B., Yunis, Jonathan P., Meara, Michael P., Diaz, Kayla, Wilber, Melanie, McKenzie, Kristen, Chao Tu, Phillips, Sharon E., Miller, Benjamin T., Beffa, Lucas R., Rosen, Michael J., and Prabhu, Ajita S.

Subjects
*PERITONEUM surgery, *EVALUATION of medical care, *CONFIDENCE intervals, *SURGICAL robots, *RANDOMIZED controlled trials, *COMPARATIVE studies, *SURGICAL meshes, *QUESTIONNAIRES, *REOPERATION, *HERNIA, *QUALITY of life, *DESCRIPTIVE statistics, *ODDS ratio, *DATA analysis software
Abstract

BACKGROUND: Patients with small- to medium-sized ventral hernias randomized to robotic enhanced-view totally extraperitoneal (eTEP) or robotic intraperitoneal onlay mesh (rIPOM) previously demonstrated comparable 30-day patient-reported outcomes. Here we report 1-year exploratory outcomes for this multi-center, patient-blinded randomized clinical trial. STUDY DESIGN: Patients with midline ventral hernias 7 cm wide or less undergoing mesh repair were randomized to robotic eTEP or rIPOM. Planned exploratory outcomes at 1 year include pain intensity (using the Patient-Reported Outcomes Measurement Information system [PROMIs 3a]), Hernia-Related Quality of Life survey (HerQLes) scores, pragmatic hernia recurrence, and reoperation. RESULTS: One hundred randomized patients (51 eTEP, 49 rIPOM) reached a median 12-month follow-up (interquartile range 11 to 13) with 7% lost. After regression analysis adjusting for baseline scores, there was no difference in postoperative pain intensity at 1-year for eTEP compared with rIPOM (odds ratio [OR] 2.1 [95% CI 0.85 to 5.1]; p = 0.11). HerQLes scores were 15 points lower on average (ie less improved) at 1 year after eTEP repairs compared with rIPOM, a difference maintained after regression analysis (OR 0.31 [95% CI 0.15 to 0.67]; p = 0.003). Pragmatic hernia recurrence was 12.2% (6 of 49) for eTEP and 15.9% (7 of 44) for rIPOM (p = 0.834). In the first year, 2 eTEP and 1 rIPOM patients required reoperations related to their index repair (p = 0.82). CONCLUSIONS: Exploratory analyses showed similar outcomes at 1 year in regard to pain, hernia recurrence, and reoperation. Abdominal wall quality of life at 1 year appears to favor rIPOM, and the possibility that an eTEP dissection is less advantageous in that regard should be the subject of future investigation. [ABSTRACT FROM AUTHOR]

Published
2023
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