Jeff Choi

All Publications

• Safety of Foregoing Operation for Small Bowel Obstruction in the Virgin Abdomen: Systematic Review and Meta-Analysis. Journal of the American College of Surgeons Choi, J., Fisher, A. T., Mulaney, B., Anand, A., Carlos, G., Stave, C. D., Spain, D. A., Weiser, T. G. 2020

  Abstract

  Our objective was to assess the safety of foregoing surgery in patients without abdominopelvic surgery history presenting with small bowel obstruction (SBO). Classic dogma has counseled early surgical intervention for small bowel obstruction (SBO) in the virgin abdomen - patients without abdominopelvic surgery history - given their presumed higher risk of malignant or potentially catastrophic etiologies compared to those who underwent prior abdominal operations. The term virgin abdomen was coined before widespread use of computed tomography, which now elucidates many SBO etiologies. Despite recent efforts to re-evaluate clinical management standards, the prevalence of SBO etiologies in the virgin abdomen and the current management landscape (non-operative vs operative) in these patients remain unclear. Our random-effects meta-analysis of six studies including 442 patients found the prevalence of malignant etiologies in patients without abdominopelvic surgery history presenting with SBO varied from 7.7% [95% CI:3.0-14.1] to 13.4% [95% CI:7.6-20.3] on sensitivity analysis. Most malignant etiologies were not suspected prior to surgery. De novo adhesions (54%) were the most common etiology. Over half of patients underwent a trial of non-operative management, which often failed. Subgroups of patients likely have variable risk profiles for underlying malignant etiologies, yet no study had consistent follow-up data and we did not find convincing evidence that foregoing operative management altogether in this population can be generally recommended.

  View details for DOI 10.1016/j.jamcollsurg.2020.06.010

  View details for PubMedID 32574687

• Pain Scores in Geriatric vs Nongeriatric Patients With Rib Fractures. JAMA surgery Choi, J., Khan, S., Zamary, K., Tennakoon, L., Spain, D. A. 2020

  View details for DOI 10.1001/jamasurg.2020.1933

  View details for PubMedID 32609366

• Evidenced-Based Practice Among Trainees: A Survey on Facial Trauma Wound Management. Journal of surgical education Choi, J., Traboulsi, A. A., Okland, T. S., Sadauskas, V., Perrault, D., Spain, D. A., Lorenz, H. P., Weiser, T. G. 2020

  Abstract

  Assess whether facial trauma wound care and antibiotic use recommendations are guided by evidence-based practice (EBP) or practice patterns, and investigate strategies to improve EBP adoption among surgical trainees.We conducted a survey of all trainees who manage facial trauma (general surgery, emergency medicine, plastic surgery, otolaryngology) to assess clinical knowledge and sources of treatment recommendations. Clinical questions were based on Oxford Center for Evidence-Based Medicine Level 1 or 2 evidence. We measured internal validity of questions using Cronbach's ?. Results were weight-adjusted for nonresponse and then analyzed using Welch t test and descriptive statistics.Stanford Hospital and Clinics, a Level I trauma center.Response rate was 50.3% overall (78/155). For recommendations on facial trauma wound and antibiotic use, nonspecialty junior residents most frequently relied on their own senior or specialty residents (79.1%); nonspecialty senior residents relied on specialty residents (67.9%). Specialty junior residents most often relied on their own senior residents (51.0%), the majority of whom made recommendations based on their own knowledge (73.2%). Questions assessing EBP knowledge had Cronbach's ? of 0.98; response accuracy was similar between specialty and nonspecialty residents (54.6% vs 55.5%, p?=?0.96). When provided recommendations that conflict with EBP, both nonspecialty and specialty residents more frequently followed recommendations rather than EBP; junior residents reported doing so to avoid conflict with superiors. Total 92.6% of surveyed residents felt cross-departmental EBP guidelines would improve patient care.Facial trauma wound care and antibiotic recommendations disseminate down seniority and from craniofacial specialty to nonspecialty residents, yet knowledge of EBP among senior specialty and nonspecialty residents was weak. EBP may be difficult to adopt in the absence of consensus society guidelines. To address this gap, we published a review of EBP for facial trauma and plan to update our trauma manual with cross-departmental guidelines to facilitate EBP adoption among trainees.

  View details for DOI 10.1016/j.jsurg.2020.03.015

  View details for PubMedID 32461098

• A Novel Approach to Deliver Therapeutic Extracellular Vesicles Directly into the Mouse Kidney Cells Ullah, M., Liu, D. D., Rai, S., Razavi, M., Choi, J., Wang, J., Concepcion, W., Thakor, A. S. 2020; 9 (4): 937

  View details for DOI 10.3390/cells9040937

• Review of Facial Trauma Management. The journal of trauma and acute care surgery Choi, J., Lorenz, H. P., Spain, D. A. 2020

  Abstract

  Facial trauma afflicts significant morbidity and mortality with potential to compromise critical adjacent structures. Facial trauma management is often entrusted to the hands of the craniofacial surgeon; evidence-based practice may be difficult to distinguish from outdated practice for the non-craniofacial trauma surgeon. We review up-to-date evidence in facial trauma management relevant for trauma surgeons, and highlight areas needing further research.Review.

  View details for DOI 10.1097/TA.0000000000002589

  View details for PubMedID 31972757

• Necessity of routine chest radiograph in blunt trauma resuscitation: time to evaluate dogma with evidence. The journal of trauma and acute care surgery Choi, J., Forrester, J. D., Spain, D. A. 2020

  View details for DOI 10.1097/TA.0000000000002793

  View details for PubMedID 32467468

• Surgical Infection Society Guidelines for Antibiotic Use in Patients with Traumatic Facial Fractures. Surgical infections Forrester, J. D., Wolff, C. J., Choi, J., Colling, K. P., Huston, J. M. 2020

  Abstract

  Background: Facial fractures are common in traumatic injury. Antibiotic administration practices for traumatic facial fractures differ widely. Methods: The Surgical Infection Society's (SIS's) Therapeutics and Guidelines Committee convened to develop guidelines for antibiotic administration in the management of traumatic facial fractures. PubMed, Embase, and the Cochrane database were searched for pertinent studies. Pre-operative antibiotics were defined as those administered more than 1 hour before surgery. Peri-operative antibiotics were those administered within 1 hour of the start of surgery depending on the type of antibiotic and as late as ?24 hours after surgery. Post-operative antibiotics were defined as those administered >24 hours after surgery. Prophylactic antibiotics were those administered for >24 hours without a documented infection. Evaluation of the published evidence was performed with the GRADE system. Using a process of iterative consensus, all committee members voted to accept or reject each recommendation. Results: We recommend that in adult patients with non-operative upper face, midface, or mandibular fractures, prophylactic antibiotics not be prescribed and that in adult patients with operative, non-mandibular fractures, pre-operative antibiotics likewise not be prescribed. We recommend that in adult patients with operative, mandibular fractures, pre-operative antibiotics not be prescribed; and in adult patients with operative, non-mandibular facial fractures, post-operative (>24 hours) antibiotics again not be prescribed. We recommend that in adult patients with operative, mandibular facial fractures, post-operative antibiotics (> 24 hours) not be prescribed. Conclusions: This guideline summarizes the current SIS recommendations regarding antibiotic management of patients with traumatic facial fractures.

  View details for DOI 10.1089/sur.2020.107

  View details for PubMedID 32598227

• Altered Mental Status and Hypercalcemia with a Splenic Mass. The journal of trauma and acute care surgery Khan, S., Choi, J., Patel, S. A., Spain, D. A. 2019

  View details for DOI 10.1097/TA.0000000000002534

  View details for PubMedID 31688787

• Atraumatic acute forearm compartment syndrome due to systemic heparin. Trauma surgery & acute care open Chavez, G., Choi, J., Fogel, N., Jaramillo, J. D., Murphy, M., Spain, D. 2019; 4 (1): e000399

  View details for DOI 10.1136/tsaco-2019-000399

  View details for PubMedID 31799418

  View details for PubMedCentralID PMC6861105

• Meckel's Diverticulum Fistulization: Another Complication to Consider. Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract Choi, J., Hawn, M. 2019

  View details for DOI 10.1007/s11605-019-04378-8

  View details for PubMedID 31468335

• LAPRA-TY for laparoscopic repair of traumatic diaphragmatic hernia without intracorporeal knot tying. Trauma surgery & acute care open Choi, J., Pan, J., Forrester, J. D., Spain, D., Browder, T. D. 2019; 4 (1): e000334

  Abstract

  A 38-year-old man was brought in by ambulance as a trauma activation after sustaining a self-inflicted stab wound in the left upper quadrant with a kitchen knife. His primary survey was unremarkable and his vital signs were normal. Secondary survey revealed a 2 cm transverse stab wound inferior and medial to the left nipple. Extended focused assessment with sonography for trauma (FAST) did not show intra-abdominal or pericardial fluid and chest X-ray did not show a definite pneumothorax or hemothorax.Wound exploration at bedside.Admit for observation and serial examinations.Exploratory laparotomy and open repair of traumatic diaphragmatic injury (TDI).Thoracotomy and open repair of TDI.Diagnostic laparoscopy and laparoscopic repair of TDI.

  View details for DOI 10.1136/tsaco-2019-000334

  View details for PubMedID 31321313

  View details for PubMedCentralID PMC6606065

• Perianal Extramammary Paget's Disease: More Than Meets the Eye. Digestive diseases and sciences Choi, J., Zemek, A., Lee, G. K., Kin, C. 2018

  View details for PubMedID 29696480

• A Novel Approach for Therapeutic Delivery to the Rodent Pancreas Via Its Arterial Blood Supply. Pancreas Choi, J., Wang, J., Ren, G., Thakor, A. S. 2018; 47 (7): 910?15

  Abstract

  Endovascular techniques can now access the arterial blood supply of the pancreas in humans to enable therapeutics to reach the gland in high concentrations while concurrently avoiding issues related to non-targeted delivery. However, there is no way to replicate this in small animals. In a rat model, we therefore developed a novel non-terminal technique to deliver therapeutics to different regions of the pancreas, via its arterial blood supply.In female Wistar rats, selective branches of the celiac artery were temporarily ligated, depending on the region of the pancreas being targeted. Trypan blue dye was then administered as a surrogate marker for a therapeutic agent, via the celiac artery, and its staining/distribution throughout the pancreas determined. Postoperatively, animals were monitored daily, and serum was evaluated for markers of pancreatitis, liver, and metabolic function.Using this technique, we could selectively target the head, body/tail, or entire gland of the pancreas, via its arterial blood supply, with minimal nontarget staining. Following the procedure, all animals recovered with no evidence of pancreatitis or liver/metabolic dysfunction.Our study demonstrates a novel technique that can be used to selectively deliver therapeutics directly to the rat pancreas in a safe manner with full recovery of the animal.

  View details for PubMedID 29975350

• Systems approach to uncover signaling networks in primary immunodeficiency diseases. journal of allergy and clinical immunology Choi, J., Fernandez, R., Maecker, H. T., Butte, M. J. 2017

  View details for DOI 10.1016/j.jaci.2017.03.025

  View details for PubMedID 28412396