Department of Surgery Boston University School of Medicine/Boston Medical Center ANNUAL REPORT 2018

Building a Healthier Future for All Introduction

CONTENTS Message from the Chair Boston Medical Center Introduction 3 Faculty 4 oston Medical Center (BMC) is a private, not-for-profit, has been a little over a year since I Alumni Profile 12 B 567-bed, academic medical center. Located in Boston’s It had the honor of becoming Chair historic South End, BMC is the primary teaching hospital Highlights 14 of the Department of Surgery. Education 22 of the Boston University School of Medicine (BUSM) and was created When my appointment became public, by the 1996 merger of Boston City Hospital (founded in 1855) and Research 28 some of my fellow new chairs around the Support Surgery 31 Boston University Medical Center Hospital (founded in 1864). nation privately confided to me that my BMC is the largest and busiest provider of trauma and emergency first year would be difficult, but advised services, and the largest safety-net hospital, in New England. BMC me to persevere and persist and I would provides a full spectrum of pediatric and adult care services, from “get through it.” To some eyes, the fact primary care and family medicine to advanced surgical and medical The Department of Surgery that I happen to be female and nonwhite specialty care. would make it even more challenging to By the Numbers* lead an important Department of Surgery at a historically significant hospital located in a tradition-rich city and region. Prepared as I was to meet the challenge, I was in for a very pleasant The Department of Surgery 14 Clinical Divisions/Sections surprise. Since day one, colleagues throughout BUSM and BMC, especially my fellow surgeons, have been incredibly welcoming and 44 Clinical Faculty (BMC) supportive. This has enabled me — joined by a remarkably talented, he Department of and Gerard Doherty. In July residents, and fellows, but Offering a full range of specialty dedicated, and hardworking team of faculty, trainees, and staff — to T Surgery has a long, 2017, Jennifer F. Tseng, MD, also on many research and and subspecialty services, proud history with MPH, was recruited as Chair clinical programs. Under the Roger Williams Medical Center 1 ACGME-Accredited Surgical Residency focus our collective efforts on what matters most: building a healthier future for all, which is the theme of this year’s annual report. As you roots that extend back more and Utley Professor of Surgery leadership of Kamal Itani, MD, performs approximately 7,300 will discover on the following pages, we are making considerable than 150 years. In 1873, Boston at Boston University School of Chief of Surgery, the VA Boston inpatient and outpatient 37 Interns and Residents progress toward that goal. University School of Medicine Medicine and Surgeon-in-Chief Healthcare System Department surgical procedures annually, I understand better now why I did not face the hurdles my well- opened its doors, combining the at Boston Medical Center. of Surgery is a valued partner and is a major source of 2 ACGME-Accredited Surgical Fellowships meaning colleagues suggested I might. This is a very special place New England Female Medical The Department of Surgery of the Boston University School teaching and training for Boston that, since its founding in 1873, has been defined by diversity. In fact, College with the medical comprises 14 divisions or of Medicine/Boston Medical University School of Medicine/ staff of the Massachusetts sections and includes 44 full- Center Department of Surgery. Boston Medical Center. Fellows we were born this way: One of BUSM’s founding institutions, New 4 England Female Medical College, was the first medical school in the Homeopathic Hospital. Dr. Israel time clinical faculty members The department also has This annual report provides country to train women as physicians, including, in 1864, Rebecca Lee T. Talbot was the first chairman at Boston Medical Center. A close ties to the Department an overview of some of the 5 CPME-Accredited Podiatric Residency Residents Crumpler, the first black female physician. This is also where, in 1890, of the Department of Surgery well-established relationship of Surgery at Roger Williams clinical programs, research, Charles Eastman became the first Native American physician. while also serving as the first with Boston Children’s Hospital Medical Center, led by Chairman and educational initiatives of 7,393 Operations Today, that legacy of diversity and inclusion lives on at BUSM/BMC dean of Boston University provides shared faculty in N. Joseph Espat, MD, MS. Roger the previous year (July 1, 2017 and the Department of Surgery. Indeed, our department is widely School of Medicine. pediatric critical care and Williams Medical Center has through June 30, 2018), and The modern history of the pediatric general surgery, as a proud history of more than highlights some of the many Outpatient Visits considered a model of diversity — to quote Massachusetts Bay Colony 71,315 governor John Winthrop, we are a “city on a hill,” to be emulated. Department of Surgery at well as pediatric training for a century, and is the largest accomplishments and activities Our faculty, trainees, and staff hail from all regions of the nation and Boston University dates to residents. The department academic Comprehensive of our faculty, trainees, and * July 1, 2017 — June 30, 2018 the globe, and from all walks of life, reflecting the wonderful diversity 1946, when Dr. Reginald H. also has 19 affiliated Boston Cancer Center in Rhode Island. alumni. We invite you to visit of the world in which we live and the patients we care for. I am very Smithwick was recruited from University School of Medicine our website and follow us on proud to be among them. Massachusetts General Hospital faculty members from Roger social media to keep abreast I hope you will enjoy reading our annual report, and encourage to serve as Surgeon-in-Chief and Williams Medical Center, the of our activities throughout you to keep abreast of our activities throughout the year on Twitter Chairman of Surgery at Boston Veterans Administration (VA) the year. (@BMCSurgery). If you have comments to share with me or would University School of Medicine Boston Healthcare System, and like to receive future communications about the department, please (BUSM). Dr. Smithwick served in Cape Cod Hospital (Cape Cod those positions for nearly Healthcare). Dr. Israel T. Talbot, the first chairman contact us at [email protected]. of the Department of Surgery. 20 years. The Department of Surgery Among the surgeons who has had a unique partnership have led and contributed to with the Department of Surgery the international stature of at the VA Boston Healthcare Jennifer F. Tseng, MD, MPH the Department of Surgery System, a relationship that James Utley Professor and Chair of Surgery, throughout the ensuing decades extends back to the 1950s. The Boston University School of Medicine are Drs. Richard Egdahl, John departments of Surgery at both Surgeon-in-Chief, Boston Medical Center Mannick, Lester Williams,Peter hospitals are well-integrated, Mozden, Robert Hobson, collaborating not only on the Edward Spatz, James Becker, training of medical students,

2 bumc.bu.edu/surgery BUSM/BMC Department of Surgery Annual Report 2018 3 Faculty

Department Leadership Division and Section Leadership Faculty

Jennifer F. Tseng, MD, MPH Peter Burke, MD Karl Karlson, MD DEPARTMENT OF Aaron Richman, MD James Utley Professor and Chair of Surgery, Chief, Section of Acute Care and Trauma Surgery Chief, Division of Cardiac Surgery SURGERY FACULTY Assistant Professor of Surgery, Boston University School of Medicine Jennifer F. Tseng, MD, MPH Boston University School Surgeon-in-Chief, Boston Medical Center James Utley Professor and of Medicine* Chair of Surgery, Boston University School of Medicine Sabrina E. Sanchez, MD, MPH Surgeon-in-Chief Assistant Professor of Surgery, David McAneny, MD Catherine Chen, MD, MPH Virginia R. Litle, MD Boston University School Vice Chair of Surgery, Boston University Chief, Section of Pediatric Surgery Chief, Division of Thoracic Surgery Acute Care and Trauma Surgery/ of Medicine School of Medicine Surgical Critical Care Chief Surgical Officer, Boston Medical Center Peter Burke, MD Cardiac Surgery Section Chief, Acute Care and Trauma Surgery Karl Karlson, MD Professor of Surgery, Boston Division Chief Alik Farber, MD Cullen Carter, MD David McAneny, MD University School of Medicine Assistant Professor of Surgery, Surgery Clerkship Director Chief, Division of Vascular and Endovascular Surgery Chief, Division of General Surgery Boston University School Chief, Section of Surgical Endocrinology Robert Schulze, MD, MBA of Medicine Chief, Section of Surgical Oncology Section Chief, Surgical Critical Care Clinical Associate Professor of Nikola Dobrilovic, MD, MBA Surgery, Boston University School Associate Professor of Surgery, of Medicine* Boston University School Tracey Dechert, MD Matthew Nuhn, MD of Medicine* Associate Chair, Faculty Development Geoffrey Habershaw, DPM Chief, Division of Transplant Surgery Lisa Allee, MSW, LICSW and Diversity Chief, Division of Podiatry Surgery Instructor of Surgery, Boston Colon and Rectal Surgery University School of Medicine Jason F. Hall, MD, MPH Section Chief Tejal Brahmbhatt, MD Associate Professor of Surgery, Assistant Professor of Surgery, Boston University School Alik Farber, MD Robert Schulze, MD, MBA Boston University School of Medicine Associate Chair, Clinical Operations Jason F. Hall, MD, MPH Chief, Section of Surgical Critical Care of Medicine Chief, Section of Colon and Rectal Surgery Associate Director, Angela Kuhnen, MD Surgery Clerkship Assistant Professor of Surgery, Boston University School Tracey Dechert, MD of Medicine Assistant Professor of Surgery, Tony Godfrey, PhD Jaromir Slama, MD Boston University School Uma R. Phatak, MD Associate Chair, Research Donald Hess, MD Chief, Division of Plastic and Reconstructive Surgery of Medicine Assistant Professor of Surgery, Chief, Section of Minimally Invasive and Boston University School Weight Loss Surgery Andrew Glantz, MD of Medicine Associate Professor of Surgery, Boston University School of Medicine Donald Hess, MD Associate Chair, Education George Kasotakis, MD, MPH Program Director, Surgery Residency (through 8/2018) * Recommended for Assistant Professor of Surgery, Boston University School of Medicine

4 bumc.bu.edu/surgery BUSM/BMC Department of Surgery Annual Report 2018 5 Faculty

Minimally Invasive and Plastic and Surgical Endocrinology Transplant Surgery Surgical Research ROGER WILLIAMS Patrick B. O’Neal, MD James McPhee, MD Weight Loss Sugery Reconstructive Surgery MEDICAL CENTER Assistant Professor of Surgery, Assistant Professor of Surgery, David McAneny, MD Matthew Nuhn, MD Tony Godfrey, PhD Boston University School Boston University School Donald Hess, MD Jaromir Slama, MD Section Chief Division Chief Associate Chair of Research N. Joseph Espat, MD, MS of Medicine of Medicine Section Chief Division Chief Professor of Surgery, Boston Assistant Professor of Surgery, Professor of Surgery and Chairman, Department of Assistant Director, Boston Assistant Professor of Surgery, Assistant Professor of Surgery, University School of Medicine Boston University School Computational Biomedicine, Surgery, Roger Williams University School of Medicine Research Boston University School Boston University School of Medicine Boston University School Medical Center Surgery Clerkship of Medicine of Medicine F. Thurston Drake, MD, MPH of Medicine Professor of Surgery, Boston Qi Chen, MD, PhD Laszlo N. Tauber Assistant Amitabh Gautam, MD University School of Medicine Vivian E. Sanchez, MD Assistant Professor, Boston Brian Carmine, MD Nilton Medina, MD Professor of Surgery, Boston Assistant Professor of Surgery, Marina Malikova, PhD, MSci, Assistant Professor of Surgery, University School of Medicine Assistant Professor of Surgery, Assistant Professor of Surgery, University School of Medicine Boston University School MA, CCRA, RAC Abdul Saeid Calvino, MD Boston University School Boston University School Boston University School of Medicine Executive Director, Surgical Assistant Professor of Surgery, of Medicine Hillary Mull, PhD of Medicine of Medicine Surgical Oncology Translational Research Boston University School Director, Boston University Research Assistant Professor, Vascular and Operations and Compliance of Medicine Anesthesia/Surgery Internship Boston University School Cullen Carter, MD Smita Ramanadham, MD David McAneny, MD Endovascular Surgery Assistant Director, Boston of Medicine Assistant Professor of Surgery, Assistant Professor of Surgery, Section Chief Amy Rosen, PhD University School of Medicine Cardiac Surgery Boston University School Boston University School Professor of Surgery, Boston Alik Farber, MD Professor of Surgery, Boston Surgery Clerkship Amy Rosen, PhD of Medicine of Medicine University School of Medicine Division Chief University School of Medicine Miguel Haime, MD Professor of Surgery, Boston Professor of Surgery, Boston Steven Katz, MD Assistant Professor of Surgery, University School of Medicine Luise I. Pernar, MD Podiatry Surgery Michael R. Cassidy, MD University School of Medicine Pamela Rosenkranz, RN, Associate Professor of Surgery, Boston University School Assistant Professor of Surgery, Assistant Professor of Surgery, BSN, MEd Boston University School of Medicine Jinghua Yang, PhD Boston University School Geoffrey Habershaw, DPM Boston University School Douglas W. Jones, MD Instructor of Surgery, Boston of Medicine Associate Professor, Boston of Medicine Division Chief of Medicine Assistant Professor of Surgery, University School of Medicine Vascular Surgery University School of Medicine Assistant Professor of Surgery, Boston University School Ponnandai Somasundar, MD Pediatric Surgery Boston University School Maureen Kavanah, MD of Medicine Sing Chau Ng, MS Associate Professor of Surgery, Sarah Carlson, MD of Medicine Associate Professor of Surgery, Staff biostatistician Boston University School Assistant Professor of Surgery, Catherine Chen, MD, MPH Boston University School Jeffrey Kalish, MD Administrative Director, SOAR of Medicine Boston University School Section Chief Ewald Ray Mendeszoon Jr., DPM of Medicine Associate Professor of Surgery, of Medicine Assistant Professor of Surgery, Instructor of Surgery, Boston Boston University School Emeritus Ting Zhao, MD Harvard Medical School University School of Medicine Teviah Sachs, MD, MPH of Medicine Associate Professor of Surgery, Assistant Professor of Surgery, Robert Beazley, MD Boston University School Thomas Hamilton, MD David Negron, DPM, MBA Boston University School Jeffrey Siracuse, MD, RPVI Professor Emeritus of Surgery of Medicine Assistant Professor of Surgery, Instructor of Surgery, Boston of Medicine Associate Professor of Surgery, Boston University School Harvard Medical School University School of Medicine Boston University School of Medicine VETERANS AFFAIRS (VA) Jennifer F. Tseng, MD, MPH of Medicine BOSTON HEALTHCARE Konstantinos Papadakis, MD Justin Ogbonna, DPM James Utley Professor and Chair Benedict Daly, MD SYSTEM Assistant Professor of Surgery, Instructor of Surgery, Boston of Surgery, Boston University Jonathan Woodson, MD Professor Emeritus of Surgery Harvard Medical School University School of Medicine School of Medicine Professor of Surgery, Boston Boston University School General Surgery University School of Medicine of Medicine Jason Smithers, MD Hau Pham, DPM Thoracic Surgery Dr. Woodson is director of the Kamal Itani, MD Assistant Professor of Surgery, Assistant Professor of Surgery, Boston University-wide Institute CAPE COD HOSPITAL Chief of Surgery, Veterans Affairs Harvard Medical School Boston University School Virginia R. Litle, MD for Health System Innovation and (CAPE COD HEALTHCARE) Boston Healthcare System of Medicine Division Chief Policy; Lars Anderson Professor Professor of Surgery, Boston Jay Wilson, MD Professor of Surgery, Boston in Management and Professor Lawrence Novak, MD University School of Medicine Associate Professor of Surgery, Wei Tseng, DPM University School of Medicine of the Practice, BU Questrom Surgery Residency Harvard Medical School Instructor of Surgery, Boston School of Business; and Professor Program Director P. Marco Fisichella, MD, MBA University School of Medicine Kei Suzuki, MD of Health Law, Policy and Associate Professor of Surgery, Assistant Professor of Surgery, Management, BU School of Stephen Brooks, MD Harvard Medical School Vitaliy Volansky, DPM Boston University School Public Health. Clinical Assistant Professor, Instructor of Surgery, Boston of Medicine Boston University School Jason S. Gold, MD University School of Medicine of Medicine Associate Professor of Surgery, Harvard Medical School

6 bumc.bu.edu/surgery BUSM/BMC Department of Surgery Annual Report 2018 7 Faculty

Faculty News

TEJAL BRAHMBHATT, F. THURSTON DRAKE, N. JOSEPH ESPAT, MD, STEVEN KATZ, MD, Roger MD, Acute Care and New Faculty MD, MPH, Surgical MS, Chair of Surgery at Williams Medical Center, Trauma Surgery/Surgical AARON RICHMAN, MD Endocrinology, had five Roger Williams Medical presented at the American Critical Care, was Assistant Professor of Surgery, peer-reviewed papers Center, presented at Association of Immunology inducted as a Fellow of Boston University School of Medicine* published or accepted for Grand Rounds at the and the annual meeting the American College Acute Care and Trauma Surgery/Surgical Critical Care publication as of press University of Tennessee, of the Society of Surgical of Surgeons (FACS) in date. During the previous Boston University, and the Oncology during the October 2017. During the previous year, A graduate of the BUSM/BMC General Surgery Residency, Dr. year, he and his research colleagues gave University of Maryland during the previous previous year. Dr. Katz had papers published Dr. Brahmbhatt gave or participated in more Richman will join the Department of Surgery as a member of the eight poster presentations and three podium year. He also was the keynote speaker at or accepted for publication in the following than 10 oral presentations at conferences faculty in October 2018. Dr. Richman graduated from the University presentations at major national meetings. the Mexican chapter of the International journals: Annals of Oncology, Journal of throughout the U.S. and Europe, including of Colorado Boulder and received his medical degree from the These included a podium presentation at the Hepato-Pancreato-Biliary Association Vascular and Interventional Radiology, Journal at the American College of Surgeons, the University of California San Diego. After completing his general American Association of Endocrine Surgeons (IHPBA) annual meeting in Cancun. of the National Comprehensive Cancer Eastern Association for the Surgery of (AAES) annual meeting with David McAneny, Network, Journal of Leukocyte Biology, and the surgery residency in 2017, Dr. Richman did a fellowship in surgical Trauma, the Surgical Infection Society, MD, and resident co-author Stephanie Journal of Surgical Oncology. Dr. Katz serves critical care and trauma at the University of Colorado/Denver Health the Radiological Society of North America, Talutis, MD, MS, which presented the first ALIK FARBER, MD, on several committees of the American Medical Center. and the World Congress of Surgery. data from the Collaborative Endocrine Chief of Vascular and Board of Surgery and is Associate Editor of Dr. Richman’s main clinical interests are trauma and emergency Dr. Brahmbhatt co-authored a chapter Surgery Quality Improvement Project Endovascular Surgery, Oncogene. In addition, he is the principal general surgery. His primary research interests are surgical education, in the gold standard textbook for adult (CESQIP), a national quality improvement had numerous papers investigator of two clinical trials of CAR-T critical care ultrasound, and minimally invasive techniques in trauma. fractures, “Rockwood and Wilkins’ Fractures initiative of the AAES. Dr. Drake also had published, including one therapy for patients with metastatic liver in Adults” 9th edition (Wolters Kluwer posters selected for presentation at meetings in the Clinical Practice cancer and myeloma. Health; in press), and had papers published of the New England Surgical Society, the section of the New or accepted for publication in the following ABDUL SAIED CALVINO, CULLEN CARTER, MD, American College of Surgeons 2018 Clinical England Journal of Medicine on “Chronic peer-reviewed journals: Journal of Trauma MD, Roger Williams Minimally Invasive and Congress, and the American Thyroid Limb-threatening Ischemia” and another ANGELA KUHNEN, MD, and Acute Care Surgery, American Journal Medical Center, was an Weight Loss Surgery Association. in the Journal of Vascular Surgery entitled Colon and Rectal Surgery, of Emergency Medicine, and Insights of invited speaker at the and Surgery Clerkship With Sabrina Sanchez, MD, MPH, Dr. “The BEST-CLI Trial Has Crossed the was invited to design Biomedical Research. Rhode Island Department Director, was a recipient Drake is co-principal investigator at BUSM/ Halfway Mark — and Promises to be Worth and moderate a new In addition, Dr. Brahmbhatt was named of Health 2018 Health of a 2018 Educator BMC for the Comparing Outcomes of Drugs the Wait.” Dr. Farber reports that since symposium at the 2018 local arrangements chair for the 2019 Equity Summit last fall, of the Year Award in and Appendectomy (CODA) Trial (see page 28). September 2017, faculty in the Division of American Society for annual national conference of the Society where he addressed “Decreasing racial Clinical Sciences at BMC, presented by the Enrollment for this prospective, randomized Vascular and Endovascular Surgery had Colon and Rectal Surgeons of Asian Academic Surgeons, and became cancer care disparities through population- Committee on Faculty Affairs of BU School trial with nearly 20 sites nationwide began 27 papers published, in press, or accepted (ASCRS) national meeting entitled “Pathogen a member of the Graduate Surgical centered interventions.” In June, Dr. Calvino of Medicine in May. The awards, which are at BMC in early 2018. In addition, Dr. Drake’s for publication in the following journals: or Partner? The Role of the Gut Microbiome Education Committee of the Association presented “Increasing cancer screenings: presented annually, recognize BU School of team was awarded a two-year, BMC Patient New England Journal of Medicine, Journal of in the Colorectal Surgical Patient.” for Surgical Education and the Emergency Closing the gap in health disparities” at a Medicine educators who provide excellence Safety Award to implement and evaluate Vascular Surgery, Journal of Cardiovascular Dr. Kuhnen was also a panel speaker in General Surgery Committee of the Eastern clinical forum organized by the American in teaching and mentoring in the areas of a pilot project to improve communication Surgery, Annals of Vascular Surgery, American a symposium moderated by Colon and Association for the Surgery of Trauma. Cancer Society and the Rhode Island pre-clinical sciences, clinical sciences, and and evaluation of incidental adrenal gland Journal of Surgery, Stroke, Vascular and Rectal Surgery Chief Jason Hall, MD, MPH, Dr. Brahmbhatt also is the site principal Department of Health. Dr. Calvino also gave graduate medical sciences. findings with the goal of improving the Endovascular Surgery, and Advances in on the “Difficulties Surrounding investigator of these multi-center studies: oral presentations at the American College management of a broad spectrum of Surgery. Also during the previous year, Dr. the Management of Diverticulitis.” Prospective Observational Study of of Surgeons Clinical Congress and the incidental findings. Farber was inducted as a faculty member Temporary Vascular Shunts in Trauma, and Society of Surgical Oncology (SSO) annual TRACEY DECHERT, MD, During the previous year, Dr. Drake into Alpha Omega Alpha, the national Pelvic Angioembolization: A Prospective meeting, as well as a poster presentation Acute Care and Trauma was co-author (with Quan-Yang Duh, medical honor society. LUISE PERNAR, MD, Multi-Institutional Study. at the BU Health Equity Symposium (which Surgery/Surgical Critical MD, of the University of California San Minimally Invasive and received honorable mention) and the SSO. Care, was inducted into Francisco) of a chapter on adrenal surgery in Weight Loss Surgery, the Boston University “Comprehensive General Surgical Oncology” DONALD HESS, MD, Chief was appointed Director Medical Group (BUMG) (Decker). He was also accepted as a full of Minimally Invasive and of Surgical Education. Clinical Excellence member of the AAES, and was appointed Weight Loss Surgery, was In this new role, Society at the group’s first annual awards to the Fellowship Committee, where he will named Associate Chair for Dr. Pernar collaborates event. Dr. Dechert is chair of the BUMG spearhead a research project on the burdens Education. In this role, with department leadership, the Surgery Boston University School of Medicine Promotions Education Committee, which developed and of fellowship interviews for applicants, Dr. Hess, who is also Program Education Office, the Director of Surgical JEFFREY SIRACUSE, MD, RPVI implemented the awards program. the findings of which are expected to be Director for the General Simulation, BMC, BUSM, and the Boston Vascular and Endovascular Surgery presented at the 2019 AAES annual meeting. Surgery Residency Program, is responsible University Medical Group to design Associate Professor of Surgery In addition, Dr. Drake will be admitted as a for the administration of the residency and implement useful, innovative, and and Radiology Fellow of the American College of Surgeons program as well as other educational effective educational programs for this fall (2018). * Recommended for initiatives in the department and BMC. faculty and trainees.

8 bumc.bu.edu/surgery BUSM/BMC Department of Surgery Annual Report 2018 9 Faculty

Dr. Pernar and resident Rumbidzayi TEVIAH SACHS, MD, Interventional Oncology Conference, and at MAUREEN TEDESCO, In addition, the Society of Surgical Oncology Nzara, MD, gave a poster presentation MPH, Surgical Oncology, Grand Rounds at the University of Kansas. MD, of Kaiser Permanente (SSO) nominated Dr. Tseng to the SSO’s at the 2018 Society of American was named an Associate Dr. Somasundar had articles published in Santa Clara Medical Center Executive Council, which serves as the Gastrointestinal and Endoscopic Surgeons Program Director of the following journals: European Journal (California), an Adjunct governing body of the organization. SSO (SAGES) annual meeting on complications the Surgery Residency of Surgical Oncology, Hepatobiliary Surgery Clinical Assistant Professor leaders are selected from among those after open ventral hernia repair stratified Program. Nutrition, Tumor Journal, and the Journal of Surgery at BUSM, whose careers have shown a devotion to by BMI. Research conducted by Dr. Pernar of Leukocyte Biology. Dr. Somasundar was named an Assistant advancing and promoting the science and and resident Alaina Geary, MD, resulted was recognized by peers in Rhode Island Director of the BUSM/BMC Surgery treatment of cancer. If approved, Dr. Tseng in two oral presentations at this year’s JEFFREY SIRACUSE, Magazine as a “Top Doctor.” Clerkship in May. will serve on the Executive Council from Association for Surgical Education (ASE) MD, RPVI, Vascular and 2019 to 2022. annual meeting; both were on Resident- Endovascular Surgery, as-Teacher programs in general surgery was among 10 BUSM KEI SUZUKI, MD, Thoracic JENNIFER TSENG, MD, Top Docs training. In collaboration with Donald Hess, faculty inducted into the Surgery, received a MPH, Surgical Oncology Congratulations to the following MD, Chief of Minimally Invasive and Weight Boston University Medical research award from and Chair of Surgery, was Department of Surgery faculty Loss Surgery, Dr. Pernar also led a workshop Group (BUMG) Clinical the Thoracic Surgery appointed Deputy Editor members cited as “tops” in their at the ASE annual meeting on how to set Excellence Society at the group’s first Foundation for his project of JAMA Surgery, effective specialties in Boston Magazine’s up a Resident-as-Teacher program within annual awards event. During the previous “Utilization of nasal January 2018. Dr. Tseng 2017 “Top Docs” issue. a surgical residency. In addition, Dr. Pernar year, Dr. Siracuse received an Early Career biomarkers as screening was also asked to serve PETER BURKE, MD had a chapter published in “Shackleford’s Faculty Research Award from the Vascular tools for lung cancer.” See article on page 14. as Councilor for the Boston Surgical Society Acute Care and Trauma Surgery Surgery of the Alimentary Tract,” 8th edition and Endovascular Surgery Society, where he and is the President-Elect of the Society of (Saunders Elsevier) and a chapter published serves on the Executive Council and chairs Asian Academic Surgeons. ALIK FARBER, MD in “Scientific American Medicine.” the Membership Development Committee. Vascular and Endovascular Surgery Dr. Siracuse was also selected as chair of JASON HALL, MD, MPH the Appropriateness Committee of the Colon and Rectal Surgery MARINA MALIKOVA, Society for Vascular Surgery (SVS), and is a PhD, MSci, MA, CCRA, member of the SVS Guidelines on Popliteal DONALD HESS, MD RAC, Surgical Research, Aneurysms Writing Committee. Minimally Invasive and Weight Loss ALUMNI AND OTHER FRIENDS: PLEASE KEEP IN TOUCH! was appointed chair of the During the previous year, Dr. Siracuse also Surgery Clinical Trial Forecasting became a reviewer for JAMA Surgery and JEFFREY KALISH, MD and Budgeting Symposium was appointed to the editorial board of the Please send us your current/preferred contact information (e-mail and mailing address, please) so we can Vascular and Endovascular Surgery at the 9th Annual Clinical journal Vascular and Endovascular Surgery. keep you informed about your fellow alumni and other news, and invite you to special alumni events. MAUREEN KAVANAH, MD Operations Executives (SCOPE) Summit in Dr. Siracuse gave 12 regional and national We will use this information only for items of interest, such as newsletters and invitations, and will not share Surgical Oncology Florida, where she also gave two invited presentations, including at the SVS annual it. In addition, please send us news and contact information about your current or former colleagues with a presentations. During the previous year, meeting plenary session; and had 25 papers BU/BMC surgery connection, whether from medical school, residency, fellowship, or faculty years. VIRGINIA LITLE, MD Dr. Malikova had eight papers published in published or accepted for publication Thoracic Surgery seven peer-reviewed journals: Future Science in peer-reviewed journals, including the DAVID McANENY, MD OA, Clinics in Surgery, Journal of Clinical Trials Journal of Vascular Surgery, Annals of Vascular General Surgery, Surgical and Regulatory Affairs, Surgical Cases, World Surgery, and the Journal of the American Endocrinology, Surgical Oncology Journal of Surgery and Surgical Research, Heart Association. JAROMIR SLAMA, MD and Pharmaceutical Outsourcing Magazine. Plastic and Reconstructive Surgery Dr. Malikova also serves on the editorial board of Surgical Case Reports and Reviews, PONNANDAI and is a panel reviewer for the National SOMASUNDAR, MD, Institute of Allergy and Infectious Diseases MPH, Roger Williams (NIAID): NIAID Clinical Site Monitoring and Medical Center, gave two Vaccine Research Center General Clinical invited lectures in India Research Support Services. during the previous year, and will be an abstract reviewer for the upcoming International Society of Geriatric Oncology conference in the Netherlands. He also presented at Reach us at: [email protected]. conferences in the U.S., including the Rhode And be sure to follow us on Twitter @BMCSurgery. Island Cancer Summit and the Synergy

10 bumc.bu.edu/surgery BUSM/BMC Department of Surgery Annual Report 2018 11 Alumni

During his residency, Dr. Shemin decided to specialize in cardiac Division of Cardiothoracic Surgery at UCLA Medical Center, one of surgery, which at the time was undergoing many exciting advances. the top academic hospitals in the nation, he could not resist. In 2007, He spent two years during his residency as a clinical associate in Dr. Shemin and his wife, Susan — their three children now grown cardiac surgery at the National Heart, Lung, and Blood Institute, and — moved to California to start a new chapter. Among many other following his graduation in 1980 from the Brigham, completed a accomplishments, Dr. Shemin brought minimally invasive and robotic fellowship in cardiothoracic surgery at New York University Medical cardiac surgery to UCLA and grew its heart transplantation program, Center. Acceptance into both programs was highly competitive. now one of the busiest and most respected in the nation. In addition to his busy schedule at UCLA, which includes patient Bringing heart transplantation to New England care, research, teaching, and administrative responsibilities, In 1982, Dr. Shemin joined the faculty at Brigham and Women’s Dr. Shemin holds leadership positions in many professional societies. Hospital, taking a year in 1983 to complete a heart transplantation He served as former Chair of the American Board of Thoracic Surgery fellowship at Stanford University. Dr. Shemin, who was Medical and is currently a governor of the American College of Surgeons, Director of the Cardiac Surgical ICU, convinced the leadership representing cardiothoracic surgery. that Brigham and Women’s should develop a program in heart transplantation. At the time, heart transplants were being done at Alumni awards among many honors only three hospitals nationwide, none of which was in New England. Dr. Shemin also serves on numerous editorial boards, including Dr. Shemin succeeded and, in 1984, he was part of the team that the prestigious Journal of Thoracic and Cardiovascular Surgery and Circulation. He has authored more than 370 articles and abstracts as well as 28 book “I support the BU School of Medicine because I am chapters, and is frequently invited to lecture worldwide. Among his many honors, Dr. Shemin very grateful for the education I received there, has received the BU School of Medicine and the BU College of Liberal Arts Alumni Achievement — Richard J. Shemin, MD which was second to none.” Award. A longtime generous supporter of the BU School of Medicine, he is a lifetime member of the Chester S. Keefer, MD Society. performed the first successful heart transplant in New England. Dr. Shemin considers BU School of Medicine the foundation Richard J. Shemin, MD, is a 1974 graduate of the BU School of Medicine and former Chair of Cardiothoracic Surgery at BUSM/BMC. Dr. Shemin Another highlight of Dr. Shemin’s career was a case in 1983, which upon which he built his illustrious career, which is why he recently is now Chief of Cardiothoracic Surgery at UCLA Medical Center, and Executive Vice Chairman of its Department of Surgery. at the time received national media attention, involving a woman who established the Richard J. Shemin, MD, and Saul Shemin, DVM, was 30 weeks pregnant with a ruptured aorta who went into cardiac Academic Surgical Award, which is given to outstanding BU School arrest. Neither she nor the baby were expected to survive. Dr. Shemin, of Medicine students. “I support the BU School of Medicine because who fortunately had chosen to assist with a number of cesarean I am very grateful for the education I received there, which was Alumni Profile: Richard J. Shemin, MD, Class of 1974 sections during his surgical training, delivered the infant safely and second to none.” then saved the mother. ver since he was a young boy growing up in Little Rock, and religion, graduating magna cum laude] and be with classmates “This was a situation where one patient near death went into the E Arkansas, Richard Shemin knew he wanted to be a doctor, who were also academically strong and focused on a career in OR and two people came out alive,” says Dr. Shemin, noting that and most likely a surgeon. medicine,” says Dr. Shemin. He was elected into the Phi Beta Kapa he advises surgical trainees to learn as much as possible about all His inspiration was his father, Saul, a veterinarian and Society and, as a junior medical student, elected to Alpha Omega specialties during their training. “I tell them it will make them better cattle rancher who sometimes let his eager and curious son help out Alpha. doctors. You never know when the knowledge or surgical skills learned under his watchful eye: once letting him set a dog’s leg and another Dr. Shemin matched with his first choice of surgical residencies: years before may make a difference in the life of a patient.” time assist in an operation on a cat. When his father told him, “You’ve the Harvard-affiliated Peter Bent Brigham Hospital in Boston. (In got good hands,” Richard, whose great uncle was also a doctor, knew 1980, Peter Bent Brigham Hospital, Robert Breck Brigham Hospital, World-class cardiothoracic surgery service he had found his calling in life. and Boston Hospital for Women merged to form Brigham and In 1987, Dr. Shemin, then only 36, was recruited to BU School Indeed, decades later, Dr. Shemin, one of the nation’s top Women’s Hospital.) He was the first BU School of Medicine graduate of Medicine as Professor and Chair of Cardiothoracic Surgery. academic cardiac surgeons, Robert and Kelly Day Professor and to be accepted into the elite surgical training program. During his 20-year career at BU, Dr. Shemin served in many senior Chief of Cardiothoracic Surgery at UCLA Medical Center, Executive leadership roles, including Vice Chair of Surgery and Co-Director of Vice Chairman of the Department of Surgery, and Co-Director of the Prepared for success the Cardiovascular Center at Boston Medical Center, a center he was Cardiac Vascular Center, says, “I still wake up every day excited to “The education that BU School of Medicine provided — and still instrumental in creating. During his tenure, he built a world-class go to work.” provides — was as good as or better than any other medical school cardiothoracic surgery service that performed more than 1,000 in the country,” says Dr. Shemin, who is also Program Director of the operations a year with outcomes as good as or better than other Highly selective program UCLA Cardiothoracic Surgery Residency Program at the David Geffen top academic hospitals in the region. “We were a coveted training After graduating from high school, Dr. Shemin was thrilled to be School of Medicine at UCLA. “BU School of Medicine’s core values of program internationally and a highly productive basic science and accepted to Boston University’s six-year BA/MD program, from which humanism, compassion, and professionalism, as well as its emphasis clinical research center,” he says. On Match Day 2018, Richard J. Shemin, MD (center), presented the inaugural he graduated, cum laude, in 1974. “This highly selective program on teamwork and communication skills, prepared its graduates then, Although Dr. Shemin enjoyed his position at BU School of Medicine Richard J. Shemin, MD, and Saul Shemin, DVM, Academic Surgical Award to enabled me to earn a liberal arts degree [he majored in philosophy as now, for success in today’s complex healthcare environment.” and considered Boston home, when he was recruited to lead the (from left) graduating medical students Kevin Arndt and Matthew Peacock.

12 bumc.bu.edu/surgery BUSM/BMC Department of Surgery Annual Report 2018 13 Highlight: Research

ung cancer is the leading cause of cancer deaths in both Nasal Biomarkers: L women and men in the United States, responsible for killing nearly 156,000 Americans in 2017 alone. The vast majority of lung cancers are caused by cigarette smoking, and the A Potential New more and longer one smokes the greater the odds of developing the disease. Unfortunately, at the time of diagnosis, almost seven in 10 Tool for Lung Cancer patients have locally advanced or metastatic disease, when treatment is far less likely to be effective and the outlook is often Screening bleak. Early diagnosis and treatment is therefore essential for improving patients’ odds of beating lung cancer. In 2011, the National Lung Screening Trial recommended that heavy smokers (30-plus pack years*) between the ages of 55 and 74 (later expanded to 80) undergo screening for lung cancer with low-dose computed tomography (CT). This recommendation was based on evidence that CT screening in this population reduced lung cancer deaths. In 2013, the United States Preventive Services Task Force also recommended these screening guidelines.

Arbitrary screening criteria But CT screening is imperfect and not without risks. The lung cancer detection rate (yield) is very low — in the range of 0.6 to 3.7 percent — largely because the screening criteria are somewhat arbitrary. Moreover, it is estimated that approximately one cancer death is caused by radiation from imaging for every 2,500 patients screened. Thoracic surgeon Kei Suzuki, MD, has long focused his research on lung cancer, first as a resident and later during his fellowship at Memorial Sloan Kettering Cancer Center in New York. When he joined the BUSM/BMC Surgery faculty in 2016, he was eager to continue his research in this domain. Dr. Suzuki is especially grateful to Thoracic surgeon Kei Suzuki, MD “In the ongoing battle against lung cancer we need a Thoracic Surgery Chief Virginia Litle, MD, and Associate Chair of Research simple, non-radiation tool to help us identify patients Tony Godfrey, PhD, for their support and mentorship of his research. at high risk so we are screening those most likely to of Medicine. Dr. Spira’s research focuses on genomic changes care office setting, could be developed into a biomarker that will benefit. We are hopeful that this research will bring Sparing lower-risk patients associated with smoking-related lung disease, and is based on provide a simple way to determine which patients should undergo “We need a way to biologically the paradigm that smoking creates a “field of molecular injury” CT screening for lung cancer. us closer toward that goal.” — Kei Suzuki, MD identify individuals at high risk of in epithelial cells that line the airway. These changes, Dr. Spira Initially Dr. Suzuki will evaluate the nasal genetic changes in developing lung cancer so that established, are also seen in the nasal lining. patients who fit the current age and smoking history criteria. If this we screen them with CT while Dr. Spira’s work has led to a biomarker, now in clinical use, that approach proves successful, it would later be evaluated in other sparing people at lower risk from distinguishes which patients who have had a suspicious lung nodule individuals, including those who are younger and/or have a smoking unnecessary and potentially harmful scans,” says Dr. Suzuki, who detected by CT are at high risk of lung cancer and should undergo history of fewer pack years, and developed into a biomarker. treats many patients with lung cancer. Such a biomarker would also further intervention, such as a biopsy. The biomarker cells are “In the ongoing battle against lung cancer we need a simple, be able to identify people who do not fit the current criteria, but acquired via a bronchoscope from the patient’s airway. non-radiation tool to help us identify patients at high risk so we nonetheless have a high risk of lung cancer and should also are screening those most likely to benefit,” says Dr. Suzuki. “We are undergo screening. Research takes a new direction hopeful that this research will bring us closer toward that goal.” As it turns out, BUSM/BMC is the ideal place for Dr. Suzuki With recent funding from the Thoracic Surgery Foundation, to pursue this goal. Shortly after he arrived, he connected with Dr. Suzuki is taking this research in a new direction. He is * Pack years are the number of packs of cigarettes smoked per day pulmonologist and BUSM-BMC Cancer Center Director Avrum investigating whether genetic changes in the cells of the nasal multiplied by the number of years the person has smoked. Spira, MD, chief of Computational Medicine in the Department lining, which could be easily acquired with a swab in a primary

14 bumc.bu.edu/surgery BUSM/BMC Department of Surgery Annual Report 2018 15 Highlight: Patient Care

very second and fourth Monday of the month, a Colon and Rectal E multidisciplinary team of clinicians at Boston Medical Center gathers together to discuss the case of every patient who will undergo surgery for colorectal cancer, both before Surgery Provides and after the patient’s operation. Regularly participating in this conference are, of course, BMC’s three colorectal surgeons: Chief Jason Hall, MD, MPH, Angela Leading-Edge Kuhnen, MD, and Uma Phatak, MD. They are joined by others involved in colorectal cancer patients’ care, including specialists Treatments from medical oncology, radiation oncology, radiology, and pathology, as well as physician assistants. Established last year by Dr. Hall, who joined the Department of Surgery in 2016, this conference “ensures that each of our patients with cancer receives the best, most appropriate treatment in a well-coordinated manner,” says Dr. Hall.

“Our team is deeply committed to providing each and every patient with excellent care. There is nothing we find more rewarding than having a positive impact on our patients’ lives.” — Jason Hall, MD, MPH

This commitment to providing the best possible treatment extends to all patients who receive care from the Colon and Rectal Surgery team (see sidebar). Patients include people from nearby communities, many of whom who rely on BMC as their safety-net hospital. Others travel long distances for access to the excellent medical and surgical care for inflammatory bowel disease (IBD) offered at BMC’s Dempsey Center for Digestive Disorders, which is Jason Hall, MD, MPH, Chief of Colon and Rectal Surgery co-led by Dr. Hall and BMC gastroenterologist Francis Farraye, MD.

Cutting-edge treatments Colon and Rectal Surgery provides the entire breadth of the most Dr. Hall notes that in complex cases, at Boston Medical Center that better pain control on the first post-operative day results in The Colon and Rectal effective, cutting-edge surgical treatments, including minimally it is common for two attending colorectal surgeons to participate faster recovery and shorter length of stay. Surgery Team invasive and robotic surgery, for common and complex disorders in an operation to ensure the best possible outcome. Indeed, Several other projects are investigating some of the social Jason Hall, MD, MPH of the colon and rectum. The types of conditions treated include outcomes achieved by the section reflect a consistently high quality determinants of outcomes, including the effect of patients’ Chief colon and rectal cancer; IBD (Crohn’s disease and ulcerative colitis); of care. The latest quarterly data (as of press time) from the National primary languages on readmissions. The section is also the first Angela Kuhnen, MD familial adenomatous polyposis; diverticulitis; and hemorrhoids, Surgical Quality Improvement Program (NSQIP), a voluntary program to participate in a department-wide project to create standardized Uma Phatak, MD fissures and fistulas. The division also excels at complex re- of the American College of Surgeons that provides data on a range discharge instructions in several languages (Spanish, Portuguese, Sandy Falcon, PA-C operations and offers screening colonoscopies. of post-operative outcomes, indicates that the section’s outcomes and Haitian Creole) for non-English-speaking surgical patients, were outstanding. with the goal of reducing preventable readmissions or Emergency Daniel Kent, PA-C BMC is one of only a few hospitals in the region to offer transanal Department visits and improving patient satisfaction (see article, Samuel Lajoie, PA-C endoscopic microsurgery (TEMS) for selected patients with early- stage rectal cancer (with or without chemotherapy or radiation), Research on enhanced recovery page 20). Veronica Frett and certain rectal polyps. This minimally invasive technique, Faculty in the section are also engaged in research, with a particular “Our team is deeply committed to providing each and every Humu Marah which enables surgeons to visualize and remove tumors using focus on enhanced recovery following colorectal surgery. One patient with excellent care,” says Dr. Hall. “There is nothing we find Latoya Moorer a proctoscope inserted through the anus, avoids the need for project is looking at the role of certain adjuvant medications to more rewarding than having a positive impact on our patients’ lives.” Natasha Sanchez-Lopez an incision and its potential complications. Importantly, it also encourage return to bowel function after surgery. Another is preserves the function of the rectum, thus avoiding the need for a evaluating the use of transversus abdominis plane (TAP) blocks to permanent colostomy. improve pain control following surgery, based on the knowledge FOR APPOINTMENTS OR REFERRALS, CALL: 617-414-8054

16 bumc.bu.edu/surgery BUSM/BMC Department of Surgery Annual Report 2018 17 Highlight: Equity

urgical skill obviously plays an important role in the Investigations Seek S outcomes of patients being treated for a serious disease like cancer. But long before many patients are on the operating table, the cards may already be stacked against them to Understand and by virtue of their race, ethnicity, socioeconomic status, insurance coverage, country of origin, primary language, and the distance they must travel for tertiary-level treatment. Reduce Inequities Understanding the root causes of inequities in surgical care with the goal of reducing or eliminating them has long been a in Surgical Care major priority of the Department of Surgery. As part of an urban safety-net hospital serving a racially/ethnically diverse and largely economically disadvantaged patient population, the Department of Surgery is especially well-positioned to conduct research aimed at understanding disparities in surgical care and implementing and evaluating measures to address them. This important work is enhanced by the existence of SOAR (Surgical Outcomes Analysis & Research), a research initiative founded years ago by Surgery Chair Jennifer Tseng, MD, MPH, with a mandate to investigate and promulgate best practices and eradicate disparities in all aspects of surgery. In collaboration with Dr. Tseng and other faculty at Boston Medical Center and Johns Hopkins Medical Center, surgical oncologist Teviah Sachs, MD, MPH, is engaged in numerous research projects looking at disparities in the surgical care of patients with gastric (stomach) cancer and cancers of the pancreas and liver. Research collaborators (from left) Teviah Sachs, MD, MPH, Susanna de Geus, MD, PhD, Jennifer Tseng, MD, MPH, Rodney Bruno, BS, Need for early diagnosis of gastric cancer and Sing Chau Ng, MS. Other collaborators (not pictured) are Ryan Morgan, BS, Michael Cassidy, MD, and David McAneny, MD. While the incidence of and mortality from gastric cancer has decreased in the U.S. and other developed nations during the past century, the disease remains a major cause of death around with world. For U.S. hospitals that treat large immigrant populations, born outside the U.S. or Canada (predominantly the Caribbean, Collaboration with Johns Hopkins Africa, and Central America/Mexico), lived in poorer neighborhoods, Another area of investigation Dr. Sachs is pursuing involves and were insured through federal programs. disparities in hepato-pancreato-biliary (HPB) cancer surgery. “The goal of our research is to identify where we can make Among the many other findings of this research, which will He recently teamed up with faculty of the Department of Surgery improvements to ensure that all patients, regardless of be published in the Journal of Gastrointestinal Surgery, was that at Johns Hopkins Hospital, where he did his fellowship, to conduct the patient’s stage of cancer at presentation was the strongest a study on disparities in HPB surgery. their race or ethnicity, birthplace, or circumstances, have predictor of survival. Unfortunately, the research found that patients This retrospective observational study, which is currently under of Hispanic ethnicity, individuals born in regions such as Central IRB review, will investigate how racial/ethnic, socioeconomic, and equal access to the best surgical care resulting in the best America, and those living in the most impoverished communities insurance status impact the treatment and outcomes of patients frequently present with later stage disease — often too late for with benign or malignant tumors originating from the pancreas or possible outcomes.” — Teviah Sachs, MD, MPH surgical intervention or a chance at cure. Other authors of the paper liver. The co-principal investigator is Christopher Wolfgang, MD, were Dr. Tseng, Ryan Morgan, BS, Michael Cassidy, MD, Susanna de PhD, Director of Hepatobiliary and Pancreatic Surgery at Johns Geus, MD, PhD, and David McAneny, MD. Hopkins; other members of the research team are research fellows “These findings focus attention on the importance of early Heidi Overton, MD, at Johns Hopkins, and Dr. de Geus at BUSM/ it is imperative to know how to identify and manage patients at risk diagnosis, as patients with early-stage gastric cancer can benefit BMC, along with Dr. Tseng and biostatician and SOAR Administrative of gastric cancer to ensure that they receive the best possible care. from surgical intervention,” says Dr. Sachs, adding that prevention Director Sing Chau Ng, MS. With this goal in mind, Dr. Sachs conducted a retrospective study programs aimed at reducing risk factors, as well as targeted “The goal of this and other research we are engaged in is aimed at identifying the presentation and survival of gastric cancer screening of high-risk populations in the U.S., would help improve to identify where we can make improvements to ensure that patients treated between 2004 and 2017 at Boston Medical Center. survival. Dr. Sachs has submitted proposals for grants to continue all patients, regardless of their race or ethnicity, birthplace, or Of the 249 patients, 40 percent were African-American, most were work in this area. economic circumstances, have equal access to the best surgical care resulting in the best possible outcomes,” says Dr. Sachs.

18 bumc.bu.edu/surgery BUSM/BMC Department of Surgery Annual Report 2018 19 Highlight: Quality and Safety

is always a special day when a patient goes home from Resident’s Research It the hospital following surgery. But recovering from an operation safely at home requires strict adherence to written post-operative discharge instructions on everything from Focuses on Quality wound care and medications to when to seek medical attention. Not following these instructions can lead to readmissions and potentially serious harm to the patient. and Safety But what if the patient does not understand the discharge instructions because he is not proficient in English? This is an important question at Boston Medical Center, where nearly one- third of patients speak a primary language other than English. Stephanie Talutis, MD, MPH, is a resident who recently completed her second year of dedicated research time under the mentorship of David McAneny, MD, Vice Chair of Surgery and Chief Surgical Officer. “The Department of Surgery treats about 1,300 non- Dr. Talutis has focused much of English-speaking patients a year, so it is important that her research on projects aimed at improving quality and patient safety, we evaluate whether we are addressing their needs to with a particular focus on the issues affecting non-English-speaking ensure the best possible outcomes.” — Stephanie Talutis, MD, MPH patients at BMC. “The Department of Surgery alone treats about 1,300 non- English-speaking patients a year, so it is important that we evaluate whether we are addressing their needs to ensure the best possible outcomes,” says Dr. Talutis.

Effect of primary language One research project instigated by Dr. Talutis evaluated the effect of primary language on readmission after colorectal surgery at BMC. “We hypothesized that patients whose primary language was not Surgery resident Stephanie Talutis, MD, MPH English were readmitted more frequently,” says Dr. Talutis. In fact, her research, a retrospective review that compared the outcomes of nearly 600 patients, 25 percent of whom were non- English speakers, found that this was not the case. However, among patient populations. Dr. Talutis notes that not having standardized will be translated into Spanish, Portuguese, and Haitian Creole, the patients who were readmitted to the hospital, non-English speakers instructions leads to confusion among care providers, and the lack languages most commonly spoken by BMC’s non-English speaking were readmitted sooner than their English-speaking counterparts. of multilingual discharge instructions can potentially harm patients. patient population. This work led to a poster presentation at the American Society of In 2014, for example, a Spanish-speaking BMC surgical patient A plan is in place for educating faculty, residents, and other Colon and Rectal Surgeons national scientific meeting in May, and delayed contacting his doctor about symptoms he was experiencing providers about the new instructions and the materials will be put a podium presentation at the New England Society of Colon and after leaving the hospital because he did not understand his in the electronic medical record and shared drive for easy access. Rectal Surgeons in June. discharge instructions, and suffered complications as a result. Dr. Talutis says the anticipated outcomes of this initiative are to “Fortunately, he was not permanently harmed, but this was entirely reduce preventable Emergency Department visits and hospital Standardized multilingual instructions preventable,” says Dr. Talutis, noting that this is likely just one of readmissions and improve patients’ experiences, all of which will be Another of Dr. Talutis’s projects, which is still ongoing, aims to many incidents in which patients whose primary language is not evaluated over time. improve quality and safety through the creation of standardized English may have been put at risk. “Everyone in the department appreciates the need for these multilingual discharge instructions for surgical patients. Supported steps to improve patient safety and quality, and is very excited to by a two-year BMC Patient Safety grant, this work is being Spanish, Portuguese, and Haitian Creole see them coming to fruition,” says Dr. Talutis, who will continue her conducted in collaboration with co-principal investigators This multi-faceted project involves developing standardized involvement in the project during her clinical training. Dr. Talutis Stephanie Talutis, MD, MPH, with faculty members hopes that in the future additional funding will become available to David McAneny, MD (left), and Thurston Drake, MD, MPH, Pamela Rosenkranz, RN, BSN, MEd, and Dr. McAneny. discharge instructions for the most commonly performed operations at the 2018 American Association of Endocrine Surgeons This project was borne out of a recognition that written discharge for seven surgical divisions, starting with Colon and Rectal Surgery. translate the discharge instructions into additional languages, and annual meeting, where she gave a poster presentation. instructions in the Department of Surgery were not standardized A multidisciplinary team was formed to provide input. Once that this initiative will be adopted by other BMC departments and — even within a division — and were also not available in the approved by the division chief, the discharge instructions, which will perhaps other medical centers nationwide. languages most commonly spoken by BMC’s non-English speaking be written at a fifth-grade reading level and accompanied by images,

20 bumc.bu.edu/surgery BUSM/BMC Department of Surgery Annual Report 2018 21 Education

Surgery Education Office Current Residents PGY 2 PGY4 Categorical Maunil Bhatt, MD SURGERY RESIDENCY PROGRAM SURGERY RESIDENCY PROGRAM PGY1 Sherif Aly, MD Virginia Commonwealth University School Categorical Boston University School of Medicine of Medicine Donald Hess, MD, he department offers a highly competitive, five-year Accreditation Council for Nicole Cimbak, MD Rebecca Hasley, MD Joshua Davies, MD Associate Chair for Education, T Graduate Medical Education (ACGME)-accredited Surgery Residency Program. Sidney Kimmel Medical College at Thomas Drexel University College of Medicine Pennsylvania State University College of Program Director Led by Donald Hess, MD, the program provides residents with the range and depth of experience and academic exposure to develop superior surgical skills and Jefferson University Olivia Humbarger, MD Medicine Tracey Dechert, MD, to make mature, informed, independent judgments. Graduates of the program are well- Loreski Collado, MD Boston University School of Medicine Matthew Egyud, MD Associate Program Director prepared to become outstanding general surgeons or surgical specialists. The majority of Cooper Medical School of Rowan University Lenee Plauche, MD Boston University School of Medicine Teviah Sachs, MD, MPH, residents pursue additional fellowship training after graduation, and many have gone on to Allan Stolarksi, MD Boston University School of Medicine Krista Hachey, MD, MPH Associate Program Director assume leadership positions in academic surgery. Albany Medical College Michael Poulson, MD The Warren Alpert Medical School at Lana Ketlere, Residency Program Coordinator The Surgery Residency Program is based at Boston University Medical Center, a modern, Spencer Wilson, MD Georgetown University School of Medicine Brown University vibrant medical complex located in the heart of Boston’s South End. The medical center University of North Carolina at Chapel Hill Jian Zheng, MD SURGERY FELLOWSHIP PROGRAMS includes Boston University School of Medicine, the Boston University School of Public School of Medicine Preliminary USF Health Morsani College of Medicine Surgical Critical Care Fellowship Health, and the Boston University Goldman School of Dental Medicine, as well as Boston Mark Zapata, MD Juan Munoz, MD Medical Center. Medical College of Georgia at Augusta Pontificia Universidad Javeriana Bogotá PGY5 Robert Schulze, MD, MBA, Program Director Our program leads to American Board of Surgery Certification within an environment University Facultad de Medicina Olga Beresneva, MD Vascular and Endovascular Surgery Fellowship designed to encourage clinical and basic scientific research experience. Residents PGY3 Drexel University College of Medicine Alik Farber, MD, Program Director interested in careers in academic surgery are encouraged to develop the necessary skills in Preliminary Aldana Blanco, MD Christopher Graham, MD research, education, and/or administration through a broad range of research fellowship William Biche, MD Universidad de Buenos Aires Facultad de SUNY Downstate Medical Center College of SURGICAL EDUCATION opportunities. Clinical research is also encouraged among residents during their clinical Yale School of Medicine Medicina Medicine years of training. In fact, most residents have contributed to at least one paper being Luise I. Pernar, MD, Director Kenneth Briley, MD Andrea Madiedo, MD Elica Inagaki, MD published in a peer-reviewed journal by graduation, and many have given award-winning Tulane University School of Medicine University of Miami Leonard M. Miller Medical College of Wisconsin presentations (see Resident News, page 26). PODIATRY RESIDENCY PROGRAM Curtis Hon, MD School of Medicine Andrew McChesney, MD The principal goal of our program is clinical excellence. We believe that exposure to a Geoffrey Habershaw, DPM, Program Director Boston University School of Medicine Benjamin Nelson, MD University of Iowa Roy J. and Lucille A. large, diverse patient population and broad experience in complex open and minimally Carver College of Medicine David Negron, DPM, MBA, Patrick Mota, MD Boston University School of Medicine invasive surgery are essential elements in the training of outstanding surgeons. Rumbidzayi Nzara, MD Associate Program Director St. George’s University School of Medicine Praveen Sridhar, MD The department also has a unique program that links Boston University School of University of Minnesota Medical School Medicine students who are interested in surgical research with resident mentors, who Boston University School of Medicine SURGERY CLERKSHIP connect the students with faculty members conducting research in the students’ areas Stephanie Talutis, MD, MPH Cullen Carter, MD, Director of interest. This program provides residents with mentoring experience and has led to New York Medical College Tejal Brahmbhatt, MD, Associate Director numerous award-winning presentations by medical students. Abdul Saied Calvino, MD, Assistant Director, Roger Williams Medical Center Patrick B. O’Neal, MD, Assistant Director, 2018 Surgery Residency Graduates Visiting Professors Veterans Affairs (VA) Boston Healthcare System The Department of Surgery was honored to welcome the following surgical leaders as Visiting Professors during the previous year. Maureen Tedesco, MD, Assistant Director, Ryan Macht, MD, MS Kaiser Permanente Bariatric and Minimally Invasive Grasberger Research Boston Medical Center George H. Clowes, Jr. MD, Peter J. Mozden Visiting Surgery Fellowship, University of Symposium Lecture and Visiting Professorship Trauma Lecture and Visiting Professorship in Surgical California San Francisco Visiting Professorship in Vascular Surgery Professorship Oncology Feroze Sidhwa, MD Mary T. Hawn, MD, MPH (Spring 2018) John B. Holcomb, MD Vernon K. Sondak, MD Surgical Critical Care Fellowship, Professor and Chair of Richard F. Neville, MD Director, Center for Chair, Cutaneous Oncology, Cooper University Hospital Surgery, Stanford School Associate Director, INOVA Translational Injury Research H. Lee Moffitt Cancer Center of Medicine Heart and Vascular Institute and Research Institute SURGERY RESIDENCY Kathryn Van Orden, MD Chief, Division of Acute PROGRAM VIDEO Surgical Critical Care Fellowship, Vice-Chairman, Department of Care Surgery; Vice Chair, Professor of Oncologic Boston Medical Center Learn about the unique opportunities Brigham and Women’s Hospital Surgery; Director of Vascular Department of Surgery Sciences and Surgery, offered by the Boston University Visiting Professorship in Services Professor of Surgery, University of South Florida Kimberly Zamor, MD, MS 2018 Surgery Residency graduates (from left): School of Medicine Surgery Residency Vascular Surgery (Fall 2017) Clinical Professor of Surgery, University of Texas Medical Morsani College of Medicine Vascular Surgery Fellowship, Drs. Macht, Zamor, Van Orden, and Sidhwa, Program by watching our informative Thomas Forbes, MD George Washington University School at Houston online video. Go to: bumc.bu.edu/ Dartmouth-Hitchcock with Surgery Residency Program Director Professor of Surgery and surgery/training/residency. Medical Center Donald Hess, MD (far left), and Surgery Chair Chair, Division of Vascular Jennifer Tseng, MD, MPH (far right). Surgery, University of Toronto

22 bumc.bu.edu/surgery BUSM/BMC Department of Surgery Annual Report 2018 23 Education

Residents on Research Area of Research: Building a Research Mentors: Alik Farber, Massachusetts General Hospital “Socially responsible Resident-as-Teacher program MD, Jeffrey Siracuse, MD Institute for Technology Residents have the option to specific to general surgery Area of Research: Study Assessment). surgery is becoming spend two years conducting residents and suitable for of institutional, provider, Current Fellows laboratory or translational publication and national and patient-related factors an increasingly research, typically after their dissemination. (Site: Boston associated with disparities Surgical Critical Care Fellowship important part of the second year, to pursue their University School of Medicine). in critical limb ischemia Tara Dinitto, MD academic development. Jeannette Zhang, MD national conversation Megan Janeway, MD presentation, treatment, and Often this research is done Boston University School of outcomes among a diverse, low- in collaboration with other Vascular and Endovascular about reducing Medicine income, multilingual population departments at Boston Medical Surgery Fellowship Research Mentor: Tracey at a single academic, urban disparities in care, Center and other schools at Scott Hardouin, MD Dechert, MD safety-net hospital (Site: Boston Boston University, as well as Brad Oriel, MD and we are proud to Area of Research: Surgical University School of Medicine). other institutions, providing outcomes and quality Miriam Neufeld, MD be at the forefront of residents with a wealth of improvement as they relate to Indiana University School of Current Podiatry Residents opportunities to pursue their socioeconomic disparities and Medicine this movement.” interests, develop as academic social determinants of health Research Mentors: Chaitan PGY1 surgeons, and make significant — Megan Janeway, MD of the Boston Medical Center Narsule, MD, Michael Siegel, MD Ankit Desai, DPM contributions. Dr. William M. Scholl College patient population (Site: Boston (BU School of Public Health) of Podiatric Medicine at the Nkiruka Arinze, MD University School of Medicine). Area of Research: Examining Vanderbilt University School of Rosalind Franklin University of Na Eun Kim, MD firearm-related injury among SRS members participated in the 2018 “March for Our Lives” against gun violence. Medicine Medicine and Science Rutgers Robert Wood Johnson children and the presence, Research Mentors: Alik Farber, Medical School implementation, or relaxation Daniel Reubens, DPM MD, Vipul Chitalia, MD, PhD Western University of Health Research Mentors: Sabrina of relevant gun legislation. (Site: (Department of Medicine) Sciences College of Podiatric Sanchez, MD, MPH, Andrew Boston University School of Area of Research: Determining Medicine says Dr. Janeway, who is now in the first year of her research Mike Capuano to discuss issues of importance such as gun violence Leather, MD (King’s College Medicine). the role of newly defined fellowship, focusing on the impact of socioeconomic factors on research, the opioid crisis, and trauma system preparedness. London) Jacob Nudel, MD PGY2 mediators of uremic toxicity in surgical outcomes. Area of Research: Factors for Harvard Medical School Maria Bolla, DPM patients with chronic kidney During the previous year, six SRS members attended the national Service projects and research delayed emergency surgical care Research Mentors: Donald Hess, New York College of Podiatric disease and peripheral artery meeting of the Association for Surgical Education in Austin, Texas, Two of SRS’s service projects also made significant headway in the in Puebla, Mexico (Sites: Boston MD, Amy Rosen, PhD, Chin Hur, Medicine disease (Site: Boston University giving five presentations that sparked a great deal of interest. The previous year. Now in its third year, the SRS Service Learning Project University School of Medicine, MD (Massachusetts General School of Medicine). Heidi Fuller, DPM presenters were residents Ryan Macht, MD, MS (“Improving Nutrition provides first-year medical students on the Acute Care/Trauma King’s College London, Centro Hospital) Des Moines University in Perioperative Patients”), Michael Poulson, MD (“Advocacy and Surgery service with the opportunity to address inpatients’ unmet Alaina Geary, MD de Salud, Puebla Mexico) Area of Research: Computational Policy Training Program for Residents and Medical Students”), needs by helping them understand their procedures and screening Tufts University School PGY3 Scott Levin, MD approaches to surgical Megan Janeway, MD (“Socially Responsible Surgery: A Model them for social determinants of health. Another project integrates of Medicine Amy Wong, DPM Organization for Implementing Socially Responsible Practice in The Warren Alpert Medical decision making (Sites: Boston food insecurity screening on surgical services, leading to improved Research Mentor: Western University Training Programs” and “The Service Learning Project: A Unique School of Brown University University School of Medicine, patient access to nutrition resources during the perioperative period. Luise Pernar, MD Model for Patient Education and Advocacy Training in Early Medical In the previous year, SRS also expanded it research program, which Education”) and Praveen Sridhar, MD (“Holidays are for Patients, Too: now includes five residents and 20 medical students working on more Using a Pulpectomy to Serve Patients and Engage Medical Students”). than 15 unique projects. One, for example, is focused on assessing whether there are disparities in post-hospitalization care placement Advocacy Program based on injury type and social determinants of health. Others are Socially Responsible Surgery Group Has a Productive Year Last year also marked the development of the SRS Advocacy Program, evaluating patients’ experiences within the referral system for elective led by Dr. Poulson, which hosts monthly advocacy roundtables surgery and how to improve access to early surgical intervention for to educate residents and medical students about advocacy and gallbladder disease. ecognizing social responsibility as a core value of surgical and Lisa Allee, MSW, LICSW. political policy work. Advocacy activities organized by SRS included SRS also secured several grants from multiple sources for pilot R practice and an essential component of health, in 2014 the According to SRS resident Megan Janeway, MD, a founding participation in events such as the anti-gun violence “March for Our projects and the development of existing projects. In addition, Department of Surgery launched its Socially Responsible member of SRS, last year was an especially busy and productive year Lives” in 2018 and the annual Mother’s Day Walk for Peace, and members of SRS gave 14 regional and national podium and poster Surgery (SRS) group under the leadership of trauma surgeon for the group, which now includes some 60 residents and medical co-organizing the first annual Health Equity Symposium at Boston presentations at meetings throughout the nation. Tracey Dechert, MD. students, including residents from other institutions. Medical Center. “Socially responsible surgery is becoming an increasingly Through its innovative work in the areas of education, research, As members of the Advocacy Program, Drs. Janeway and Poulson important part of the national conversation about reducing disparities advocacy, and service, SRS has expanded in size and scope to Many successes both received grants to attend the American College of Surgeons in care, and we are proud to be at the forefront of this movement,” become an influential national leader in the domain of socially “We have had many successes in the past year, with lots of Leadership and Advocacy Summit in Washington, DC in May. There, says Dr. Janeway. responsible surgery. In addition to Dr. Dechert, the group’s other momentum and interest from many other surgery programs around they met with Senators Edward Markey and Elizabeth Warren and faculty advisors are Sabrina Sanchez, MD, MPH, Angela Kuhnen, MD, the country, who have approached us and want to learn from us,” Representatives William Keating, Catherine Clark, Seth Moulton, and MORE INFORMATION ABOUT SRS IS AVAILABLE ON OUR WEBSITE.

24 bumc.bu.edu/surgery BUSM/BMC Department of Surgery Annual Report 2018 25 Education

Resident News

NKIRUKA CHRISTOPHER GRAHAM, MD, MATTHEW EGYUD, MD, and OLIVIA at the Society for Vascular MICHAEL Third-year F. Thurston Drake, MD, MPH). ARINZE, MD, was chosen KRISTA HACHEY, MD, MPH, HUMBARGER, Surgery 2018 annual meeting, POULSON, medical During the previous year, will present an as a finalist in were selected MD, will and had a manuscript accepted MD, was students Dr. Talutis also presented 13 abstract at the the national by third-year present an for publication in the Journal of named selected posters and gave 10 podium New England American medical abstract at the Learning through the Arts. Director of FEROZE presentations, including one at Society for College of students for New England Advocacy SIDHWA, the 2018 American Association Vascular Surgeons the annual Society for and Policy MD, for of Endocrine Surgeons (AAES) Surgery in October entitled Committee senior Vascular Surgery in October ANDREW for BMC’s Socially Responsible the annual Lester Williams annual meeting in North “Outcomes after Open and on Trauma (ACS-COT) Resident resident entitled “Broad Variation in McCHESNEY, Surgery group (see article, page teaching award, which is given Carolina. Her presentation, Endovascular Treatment of Research Competition (in teaching Prosthetic Conduit Utilization MD, matched 24). Dr. Poulson presented at to a graduating chief resident. entitled “Postoperative Infrainguinal Occlusive Disease basic science research) for award. “His for Femoral-Popliteal Bypass to the the Association for Surgical The students also voted to have Hematoma Evacuation after in Morbid and Super Obese “Histone Deacetylase 7 teaching is Not Justified Based on fellowship Education meeting in Austin, Dr. Sidhwa receive two other Thyroid and Parathyroid Patients.” Dr. Arinze’s research and Lung Inflammation in extended Contemporary Outcomes program Texas on “Advocacy and Policy honors: the Arnold P. Gold Surgery: An Analysis of the mentor is Alik Farber, MD. Acute Respiratory Distress outside the Favoring Autologous Great in vascular Training Program for Residents Foundation Humanism and CESQIP Database,” was the Syndrome,” with George realm of Saphenous Vein.” surgery at Eastern Virginia and Medical Students.” He also Excellence in Teaching Award, first presentation of the Kasotakis, MD, serving as academics Medical College. received a grant to attend the and induction into the BUSM Collaborative Endocrine OLGA principal investigator and and into the American College of Surgeons Robert Russell, MD Chapter Surgery Quality Improvement BERESNEVA, resident mentor. This research social aspect of patient care; ELICA Leadership and Advocacy of the Gold Humanism Honor Program (CESQIP) data at MD, gave also received first prize at I learned so many interesting INAGAKI, MD, RUMBIDZAYI Summit in Washington, DC, Society. Said one student a national meeting. This a poster the regional (New England) lessons over a short span of matched to NZARA, MD, where he and research resident about Dr. Sidhwa, “He was not work was also accepted for presentation and state (Massachusetts) time with him,” said a student the fellowship gave a poster Megan Janeway, MD, met only knowledgeable, but also publication in Surgery. on the “Utility ACS-COT Resident Research about Dr. Egyud. Said another program presentation with legislators to discuss generous with his time. He In addition, Dr. Talutis had of Flexible competitions. student about Dr. Hachey, “Her in Vascular at the 2018 increasing funding for gun made the OR a comfortable three papers accepted for Upper passion for her work is palpable Surgery at Society of violence research, solutions place to learn, and made you publication and contributed Endoscopy in Early and makes her teaching all the the University of Pittsburgh American for the opioid epidemic, and feel like you matter.” to a book chapter in “Essential Postoperative Period after ALAINA more effective.” Medical Center (UPMC). Gastrointestinal and Endoscopic trauma system preparedness. Principles in Patient Safety: RYGB” during Obesity Week GEARY, MD, Surgeons (SAGES) annual In addition, the BUSM class of An Illustrated Manual for the 2017. At the American Society presented meeting on complications 2019 nominated Dr. Poulson STEPHANIE Health Care Team” (publication of Colon and Rectal Surgeons two abstracts Third-year SCOTT LEVIN, after open ventral hernia repair to be inducted into the BUSM TALUTIS, pending) with David McAneny, annual meeting in 2018, at the medical MD, received stratified by BMI. Following her Robert Russell, MD Chapter MD, MPH, MD, and Pamela Rosenkranz, Dr. Beresneva gave a poster Association students a two-year BU graduation in 2019, Dr. Nzara of the Gold Humanism Honor received the RN, BSN, MEd. presentation on the “Influence for Surgical selected Medical Center will be doing a fellowship in Society. The class of 2019 Grasberger of Obesity on Surgery for Education annual meeting in REBECCA Primary Care minimally invasive and bariatric also selected Dr. Poulson to Research Diverticulitis.” She also gave May: “Teaching Attitudes and HASLEY, Academic surgery at the University of receive the Arnold P. Gold Award for a podium presentation on Resident-as-Teacher Programs MD, for the Fellowship Maryland. Foundation Humanism and the best poster presentation JIAN ZHENG, this topic at the New England in General Surgery Residency annual junior teaching award. funded by a Health Resources Excellence in Teaching Award, at this year’s Grasberger MD, had Society of Colon and Rectal Programs” and “The Surgical Students described Dr. Hasley & Services Administration which reflects his teaching and Research Symposium. Her three papers Surgeons in June 2018. Resident as Teacher: A Review as “incredibly proactive about National Research Service compassionate treatment of poster was entitled “The Use published in of Published Curricula.” Dr. teaching, approachable, kind, Award T32 training grant. As the patients, families, students, of a Discharge Readiness collaboration Geary’s research mentor is and made us feel comfortable inaugural surgery fellow in the and colleagues. Assessment to Identify Barriers with her Luise Pernar, MD. asking questions every day.” program, Dr. Levin will pursue to Discharge in a Safety Net research a Masters of Health Services Hospital.” Dr. Talutis is the co- colleagues at Memorial Sloan and Systems Research at the principal investigator of a BMC Kettering Cancer Center, where BU School of Public Health Patient Safety Grant, “Creation she completed a surgical and conduct research in health of Standardized Multilingual oncology clinical research disparities in vascular surgery Discharge Instructions for fellowship in June 2017. The Surgical Patients” (see page papers were published in the with mentors Alik Farber, MD, 2018 Surgery Residency Program and Jeffrey Siracuse, MD. Dr. graduates Kimberly Zamor, MD, 20) and is participating in a Journal of the American College Levin gave a poster presentation MS, and Ryan Macht, MD, MS. second BMC Patient Safety of Surgeons, HPB, and Annals of Grant on the “Management Surgical Oncology. of Adrenal Incidenalomas” (PI:

26 bumc.bu.edu/surgery BUSM/BMC Department of Surgery Annual Report 2018 27 Research

Research underway in the Prognostic Immune Score for Stage I Lung Selected Grants Adenocarcinoma Clinical Research DEPARTMENT OF SURGERY PORTFOLIO OF CLINICAL RESEARCH PROJECTS Department of Surgery reflects a (N=162), FY 2018 Early and Adequate Protein Feeding Principal Investigator: Kei Suzuki, MD Projects major commitment to advancing Co-Investigator (on CHEST Foundation study): knowledge and improving Post-Traumatic Injury Principal Investigator: Peter Burke, MD Tony Godfrey, PhD (Mentor) As of press time, there are 162 patient care and outcomes. The Sponsors: CHEST Foundation; Boston Sponsor: National Institutes of Health/ active clinical research projects in Investigator-initiated studies University Clinical and Translational Science 130 | department’s faculty and trainees National Institute of Diabetes and Digestive the Department of Surgery. The and Kidney Diseases Institute are engaged in all aspects of 17 | Clinical trials sponsored by Grant amount: $478,500 Grant amounts: $80,000 (CHEST chart at right indicates the wide research, from explorations at the Foundation: $60,000; Boston University range of research conducted pharmaceutical industry basic science level to translating Bone Metabolism in Adolescents Clinical and Translational Science Institute: in the department. 9 | Federally-sponsored studies discoveries into treatments that Undergoing Bariatric Surgery $20,000) 6 | Non-governmental organizations improve human health. Site Principal Investigator: Brian Carmine, MD Clinical Trials Sponsor: National Institutes of Health/ Utilization of Nasal Biomarkers as (NGOs), foundations Screening Tools for Lung Cancer Currently Open for Enrollment Ongoing work in the department includes National Institute of Diabetes and Digestive and Kidney Diseases (subcontract through Principal Investigator: Kei Suzuki, MD basic and translational research in diverse Early and Adequate Protein Feeding Massachusetts General Hospital, PI: Sponsor: The Thoracic Surgery Foundation areas that include the following: Post-Traumatic Injury A Randomized, Multicenter, Controlled A Phase 1 Multi-Center, Randomized, Madhusmita Misra, MD) Grant amount: $80,000 • Cancer biomarkers Principal Investigator: Peter Burke, MD, Trial to Compare Best Endovascular Versus Double-Blind, Placebo-Controlled, Grant amount: $67,153 Dose-Escalation Study of Vonapanitase • Clinical outcomes Acute Care and Trauma Surgery/Surgical Best Surgical Therapy in Patients with Critical Care Critical Limb Ischemia Administered Following Angioplasty of a The Comparison of Outcomes of Antibiotic • Comparative effectiveness Sponsor: National Institutes of Health/ BMC Site Principal Investigator: Distal Popliteal, Tibial, or Peroneal Artery Drugs and Appendectomy (CODA) Trial Office of Surgical National Institute of Diabetes and Digestive , Vascular and in Patients with Peripheral Artery Disease • Global surgery and access to surgical care Principal Investigators: F. Thurston Drake, Jeffrey Kalish, MD Translational and Kidney Diseases Endovascular Surgery Principal Investigator: Jeffrey Siracuse, MD, • Health care disparities MD, MPH; Sabrina Sanchez, MD, MPH Vascular and Endovascular Surgery Sponsor: Patient-Centered Outcomes Research Executive Chair: Alik Farber, MD, Vascular • Health services Research Institute (subcontract through the Comparison of Outcomes of Antibiotic and Endovascular Surgery Sponsor: Proteon • Nutritional needs of trauma and critically University of Washington, Seattle, PI: David The Office of Surgical Translational Drugs and Appendectomy (CODA) Trial Sponsor: National Institutes of Health/ ill patients R. Flum, MD, MPH) Research: Operations and Compliance in Principal Investigators: Thurston Drake, National Heart, Lung, and Blood Institute Perioperative Nutritional Optimization in the Department of Surgery, led by Marina MD, MPH, Surgical Endocrinology; Sabrina Patients with Critical Limb Ischemia • P athophysiology of acute respiratory Grant amount: $236,500 (est.) Malikova, PhD, MSci, MA, CCRA, RAC, is Sanchez, MD, MPH, Acute Care and Prospective, Multi-Center, Randomized, Principal Investigator: Jeffrey Siracuse, MD, distress syndrome (ARDS) Development of Diagnostic and Prognostic responsible for clinical trials and basic Trauma Surgery/Surgical Critical Care Controlled Trial Evaluating the Use of Vascular and Endovascular Surgery • Prisoners’ access to medical care Tests for Esophageal Adenocarcinoma biomedical research operations, macro- Sponsor: Patient-Centered Outcomes PriMatrix Dermal Repair Scaffold for the Sponsor: Vascular & Endovascular Surgery • Quality improvement Principal Investigator: Tony Godfrey, PhD management of research programs, and Research Institute (PCORI) Management of Diabetic Foot Ulcers Society providing guidance and oversight to project Principal Investigator: Hau Pham, DPM, • Surgical education Co-Investigators: Virginia R. Litle, MD, Lincoln Stein, MD, PhD, James Luketich, MD, managers, research coordinators, and A Multi-Center Prospective Study to Podiatry Surgery A Randomized Phase III Study of Sublobar • Venous thromboembolism prevention and Arjun Pennathur, MD, Zhongren Zhou, MD, PhD laboratory staff. The office also provides Evaluate the Safety and Effectiveness Sponsor: Integra Life Sciences Resection Versus Stereotactic Ablative risk assessment Sponsor: National Institutes of Health/ assistance to investigators with protocol of the Vasq External Support for Radiotherapy in High-Risk Patients with and informed consent writing, regulatory • Violence- and accident-related injury and National Cancer Institute Arteriovenous Fistula Standard Versus Negative Pressure Stage I Non-Small Cell Lung Cancer submissions, clinical trial agreements, epidemiology Grant amount: $2,456,723 Principal Investigator: Alik Farber, MD, Vaccum Dressings in Lower-Extremity Principal Investigator: Kei Suzuki, MD, budget development, and post-award Vascular and Endovascular Surgery Bypass Patients Thoracic Surgery Collaborations with colleagues at the financial management. In addition, the Creation of Standardized Multilingual Sponsor: Laminate, Inc. Principal Investigator: Jeffrey Siracuse, MD, Sponsor: Jolt Coalition Boston University schools of medicine, office develops and implements systems Discharge Instructions for Surgical Patients Vascular and Endovascular Surgery engineering, public health, and business and procedures to ensure research quality Principal Investigator: Pamela Rosenkranz, Bovine Versus Porcine Acellular Dermal Sponsor: Smith and Nephew, Inc. Prognostic Immune Markers in Lung enhance projects in the clinical, health control and compliance as well as efficient RN, BSN, MEd Matrix for Abdominal Wall Herniorrhaphy Adenocarcinoma services, and education research arenas. Our day-to-day research operations. Sponsor: Boston Medical Center Patient Principal Investigator: , investigators also increasingly collaborate on or Bridging Parallel-Group, Placebo-Controlled Kei Suzuki, MD Safety Grant projects with researchers at other academic Principal Investigator: George Kasotakis, Randomized Study Investigating the Effect Thoracic Surgery Grant amount: $50,000 institutions around the region and the nation. MD, MPH, Acute Care and Trauma Surgery/ of Intravenous Iso-osmolar Iodinated Sponsor: Chest Foundation Surgical Critical Care Contrast Material Iodixanol (Visipaque Sponsor: Integra Life Sciences Injection 320 mgI/mL) on Renal Function in Adults with Chronic Kidney Disease trūFreeze® Spray Cryotherapy Stage III or Stage IV Who Have Undergone FOR MORE INFORMATION ABOUT OUR RESEARCH ACTIVITIES, Patient Registry Endovascular Aneurysm Repair PLEASE VISIT OUR WEBSITE: BUMC.BU.EDU/SURGERY (SURGICAL RESEARCH). Principal Investigator: Virginia R. Litle, MD, Principal Investigator: Jeffrey Siracuse, MD, Thoracic Surgery Vascular and Endovascular Surgery Sponsor: CSA Medical Sponsor: General Electric

28 bumc.bu.edu/surgery BUSM/BMC Department of Surgery Annual Report 2018 29 Research

Publications Research conducted by faculty and trainees of the Department of Surgery is published widely in leading journals and textbooks. During the previous academic year, the department had 153 articles published in peer-reviewed journals and 22 published books or book chapters.

Selected Publications Eslami MH, Reitz KM, Rybin DV, Doros G, Farber A. Arinze N, Farber A, Sachs Improved access to health T, Patts G, Kalish J, Kuhnen care in Massachusetts A, Kasotakis G, Siracuse after 2006 Massachusetts JJ. The effect of statin use Healthcare Reform Law is and intensity on stroke and associated with a significant myocardial infarction after decrease in mortality among carotid endarterectomy. J Vasc vascular surgery patients. J Surg 2018; Apr 20 (Epub ahead Vasc Surg 2018; Mar 31 (Epub of print). ahead of print).

Cassidy MR, Stempel M, Zabor Eslami MH, Rybin DV, Doros G, E, Mehrara B, Gemignani M. Siracuse JJ, Farber A. External Does response to neoadjuvant validation of Vascular Study Group Muñoz-Largacha JA, Steiling KA, Tan TW, Eslami M, Rybin D, chemotherapy impact breast of New England risk predictive Kathuria H, Charlot M, Fitzgerald Doros G, Zhang WW, Farber A. reconstruction? Breast J 2018; model of mortality after elective C, Suzuki K, Litle VR. Initial Outcomes of endovascular and Jan 8 (Epub ahead of print). abdominal aorta aneurysm surgical experience following open surgical repair of ruptured repair in the Vascular Quality implementation of lung cancer abdominal aortic aneurysms Chan S, Sridhar P, Kirchner R, Initiative and comparison against screening at an urban safety net in elderly patients. J Vasc Surg Lock YJ, Herbert Z, Buonamici S, established models. J Vasc Surg hospital. J Thorac Cardiovasc 2017; Jul; 66(1):64-70. Smith P, Lieberman J, Petrocca 2018; Jan; 67(1):143-150. Surg 2018; Feb 9 (Epub ahead F. Basal-A triple-negative breast of print). Van Orden K, Farber A, cancer cells selectively rely Kasotakis G, Galvan MD, Schermerhorn ML, Goodney PP, on RNA splicing for survival. Osathanugrah P, Dharia N, Bufe Sterbling HM, Rosen AK, Hachey Kalish JA, Jones DW, Rybin D, Mol Cancer Ther 2017; Dec; L, Breed Z, Mizgerd JP, Remick KJ, Vellanki NS, Hewes PD, Rao Siracuse JJ; Vascular Quality Help Us Build a Healthier Future for All 16(12):2849-2861. DG. Timing of valproic acid in SR, Pinjic E, Fernando HC, Litle Initiative. Local anesthesia for acute lung injury: Prevention VR. Caprini Risk Model decreases percutaneous endovascular Philanthropic gifts can make a significant difference in the lives of those we serve through patient care, de Geus SWL, Kasumova GG, is the best therapy? J Surg Res venous thromboembolism abdominal aortic aneurysm research, and education. Our goal is to build a healthier future for all. Eskander MF, , Kent TS, 2017; Dec; 220:206-212. rates in thoracic surgery cancer repair is associated with fewer Ng SC We need your support to help fund: Moser AJ, Vahrmeijer AL, Callery patients. Ann Thorac Surg 2018; pulmonary complications. J Vasc MP, Tseng JF. Is neoadjuvant Litle VR. Imaging and scopes? Mar; 105(3):879-885. Surg 2018; Mar 27 (Epub ahead • clinical services that meet the needs of all our patients, including those who are underserved therapy sufficient in resected It’s bloody time for another of print). • pioneering basic and clinical research that will improve outcomes and save lives pancreatic cancer patients? A branch in the decision tree. J Talutis SD, Drake FT. national study. Gastrointest Surg Thorac Cardiovasc Surg 2018; Comparative effectiveness of Zuriaga MA, Fuster JJ, Farb MG, • innovative educational initiatives to prepare surgeons for a rapidly changing world 2018; Feb; 22(2):214-225. May; 55(5):2243-2244. surgery versus antibiotics in MacLauchlan S, Bretón-Romero • research and initiatives to understand and reduce disparities in surgical care acute appendicitis: A systematic R, Karki S, Hess DT, Apovian CM, de Geus SWL, Eskander MF, Muñoz-Largacha JA, Gower review. J Comp Eff Res 2017; Jul; Hamburg NM, Gokce N, Walsh Please support us by making a gift to the Department of Surgery. Kasumova GG, Ng SC, Kent AC, Sridhar P, Deshpande A, 6(5):471-482. K. Activation of non-canonical Either use the enclosed postage-paid envelope to mail your gift, or give online at: TS, Mancias JD, Callery MP, O’Hara CJ, Yamada E, Godfrey WNT signaling in human visceral bu.edu/ Mahadevan A, Tseng JF. TE, Fernando HC, Litle VR. Talutis SD, Drake FT, Sachs adipose tissue contributes to supportingbusm. When giving online, please select the “Department of Surgery Discretionary Fund” to Stereotactic body radiotherapy miRNA profiling of primary lung T, Rao SR, McAneny D. local and systemic inflammation. make sure your gift is directed to us. and head and neck squamous Postoperative hematoma Sci Rep 2017; Dec 11; 7(1):17326. for unresected pancreatic For more information about supporting the Department of Surgery, contact the Boston University Writer/Editor: Hilary F. Bennett cell carcinomas: Addressing a evacuation after thyroid and Highlights Photography: Matthew Morris, BMC cancer: A nationwide School of Medicine Development Office at 617.358.9535 or [email protected]. review. Cancer 2017; Nov 1; diagnostic dilemma. J Thorac parathyroid surgery: An analysis Design: Korzenowski Design 123(21):4158-4167. Cardiovasc Surg 2017; Aug; of the CESQIP database. Surgery 154(2):714-727. 2018 (accepted for publication).

30 bumc.bu.edu/surgery BUSM/BMC Department of Surgery Annual Report 2018 31 Boston University School of Medicine/Boston Medical Center Department of Surgery

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