Emory Surgery Residents Receive Awards at SESC Annual Meeting

February 2017

Cecilia Ethun, MD, and Christopher Nauser, MD, both Emory general surgery residents on research sabbatical, made impressive showings at the 2017 Annual Scientific Meeting of the Southeastern Surgical Congress in Nashville. Dr. Ethun was recognized with the Top Medal Gold Presentation Award, considered a prestigious acknowledgment of excellent research by a young surgeon, and Dr. Nauser received one of three Poster of Distinction Awards, with his abstract being the highest rated.

Dr. Ethun's study was a collaborative effort of the 10-institution investigative partnership known as the U.S. Extrahepatic Biliary Malignancy Consortium. Her co-authors included senior author and Emory surgical oncologist-scientist Shishir Maithel, MD, her faculty mentor; several colleagues from the member institutions (Johns Hopkins, Stanford, Wake Forest, etc.); Emory surgical oncologist Maria Russell, MD; and additional Emory research sabbatical resident Alexandra Lopez-Aguiar, MD.

The study analyzed 445 patients with either incidentally diagnosed gallbladder cancer (IGBC) or non-incidentally diagnosed gallbladder cancer (non-IGBC) who underwent resection at the member institutions from 2000-2015. Two hundred and sixty six patients (60 percent) were IGBC, and 179 (40 percent) were non-IGBC. Dr. Ethun and her team found that the IGBC patients had better overall survival than those with non-IGBC, particularly when the latter group was in Stage III.

"Incidentally diagnosed gallbladder cancer is typically encountered at an earlier stage during cholecystectomy, a procedure that removes the gallbladder, and often carries a better prognosis than non-incidentally diagnosed gallbladder cancer. This study underscores the importance of timing of diagnosis and suggests that these two groups may represent a distinct biology of disease, and the same treatment paradigm may not be appropriate for each," says Dr. Ethun.

Dr. Nauser's abstract was co-authored by his study mentors and Emory trauma and surgical critical care faculty Rachael Williams, MD, and Bryan Morse, MD, and describes the development of an early onset massive pulmonary embolism in a patient with a gunshot wound to the left thoracoabdomen. After being admitted to Grady Memorial Hospital, the patient underwent a left chest tube thoracostomy and exploratory laparotomy. Despite adequate resuscitation and no evidence of postoperative hemorrhage, postoperatively the patient began experiencing respiratory and cardiovascular collapse.

The team suspected pulmonary embolism to be the culprit, even though the appearance of the condition is rare within 24 hours of admission. Subsequent diagnostic studies confirmed their conjecture, and surgical pulmonary embolectomy was performed.

Dr. Nauser's abstract uses the case and its specifics as a means of discussing the anomaly of early onset massive pulmonary emboli following penetrating trauma, and to review the risk factors, etiology, and classic signs and symptoms of this disease process.

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