Scholars@Duke
Julie K. Marosky Thacker

Julie K. Marosky Thacker

Associate Professor of Surgery
Surgical Oncology
julie.thacker@duke.edu
DUMC 2829, Durham, NC 27710
Rm. 7678 Hafs,DN, Durham, NC 27710

Selected Publications

Flow Cytometry Characterization of Cerebrospinal Fluid Monocytes in Patients With Postoperative Cognitive Dysfunction: A Pilot Study.

Journal Article Anesth Analg · November 2019 Animal models suggest postoperative cognitive dysfunction may be caused by brain monocyte influx. To study this in humans, we developed a flow cytometry panel to profile cerebrospinal fluid (CSF) samples collected before and after major noncardiac surgery ... Full text Open Access Link to item Cite

American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Perioperative Management of Patients on Preoperative Opioid Therapy.

Journal Article Anesth Analg · August 2019 Enhanced recovery pathways have quickly become part of the standard of care for patients undergoing elective surgery, especially in North America and Europe. One of the central tenets of this multidisciplinary approach is the use of multimodal analgesia wi ... Full text Link to item Cite

American Society for Enhanced Recovery and Perioperative Quality Initiative-4 Joint Consensus Statement on Persistent Postoperative Opioid Use: Definition, Incidence, Risk Factors, and Health Care System Initiatives.

Journal Article Anesth Analg · August 2019 Persistent postoperative opioid use is thought to contribute to the ongoing opioid epidemic in the United States. However, efforts to study and address the issue have been stymied by the lack of a standard definition, which has also hampered efforts to mea ... Full text Link to item Cite

American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Perioperative Opioid Minimization in Opioid-Naïve Patients.

Journal Article Anesth Analg · August 2019 Surgical care episodes place opioid-naïve patients at risk for transitioning to new persistent postoperative opioid use. With one of the central principles being the application of multimodal pain interventions to reduce the reliance on opioid-based medica ... Full text Link to item Cite

Perioperative Quality Initiative consensus statement on the physiology of arterial blood pressure control in perioperative medicine.

Journal Article Br J Anaesth · May 2019 BACKGROUND: Perioperative arterial blood pressure management is a physiologically complex challenge influenced by multiple factors. METHODS: A multidisciplinary, international working subgroup of the Third Perioperative Quality Initiative (POQI) consensus ... Full text Link to item Cite

Perioperative Quality Initiative consensus statement on postoperative blood pressure, risk and outcomes for elective surgery.

Journal Article Br J Anaesth · May 2019 BACKGROUND: Postoperative hypotension and hypertension are frequent events associated with increased risk of adverse outcomes. However, proper assessment and management is often poorly understood. As a part of the PeriOperative Quality Improvement (POQI) 3 ... Full text Link to item Cite

Perioperative Quality Initiative consensus statement on preoperative blood pressure, risk and outcomes for elective surgery.

Journal Article Br J Anaesth · May 2019 BACKGROUND: A multidisciplinary international working subgroup of the third Perioperative Quality Initiative consensus meeting appraised the evidence on the influence of preoperative arterial blood pressure and community cardiovascular medications on perio ... Full text Link to item Cite

Perioperative Quality Initiative consensus statement on intraoperative blood pressure, risk and outcomes for elective surgery.

Journal Article Br J Anaesth · May 2019 BACKGROUND: Intraoperative mortality is now rare, but death within 30 days of surgery remains surprisingly common. Perioperative myocardial infarction is associated with a remarkably high mortality. There are strong associations between hypotension and myo ... Full text Link to item Cite

Adherence to Enhanced Recovery Protocols in NSQIP and Association With Colectomy Outcomes.

Journal Article Ann Surg · March 2019 OBJECTIVE: To evaluate the effect of protocol adherence on length of stay (LOS) and recovery-specific outcomes after colectomy. BACKGROUND: Enhanced recovery protocols (ERPs) may decrease postoperative morbidity and LOS; however, the effect of overall prot ... Full text Link to item Cite

Impact of an enhanced recovery pathway on length of stay and complications in elective radical cystectomy: a before and after cohort study.

Journal Article Perioper Med (Lond) · 2019 BACKGROUND: Enhanced recovery after surgery (ERAS) pathways aim to standardize and integrate perioperative care, incorporating the best available evidence-based practice throughout the perioperative period targeted at attenuating the surgical stress respon ... Full text Open Access Link to item Cite

Overview of Enhanced Recovery After Surgery: The Evolution and Adoption of Enhanced Recovery After Surgery in North America.

Journal Article Surg Clin North Am · December 2018 Enhanced Recovery is broadly defined as the application of evidence based perioperative care elements for improved surgical outcomes. Demonstration of decreasing surgical stress with innovation of surgical technique, in combination with pressure to drive d ... Full text Link to item Cite

Effect of Diagnosis on Outcomes in the Setting of Enhanced Recovery Protocols.

Journal Article Dis Colon Rectum · July 2018 BACKGROUND: Implementation of enhanced recovery protocols in colectomy reduces length of stay and morbidity, but it remains unknown whether benefits vary by clinical diagnosis. OBJECTIVE: Outcomes after colectomy in the setting of enhanced recovery protoco ... Full text Link to item Cite

American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Postoperative Gastrointestinal Dysfunction Within an Enhanced Recovery Pathway for Elective Colorectal Surgery.

Journal Article Anesth Analg · June 2018 The primary driver of length of stay after bowel surgery, particularly colorectal surgery, is the time to return of gastrointestinal (GI) function. Traditionally, delayed GI recovery was thought to be a routine and unavoidable consequence of surgery, but t ... Full text Open Access Link to item Cite

American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Patient-Reported Outcomes in an Enhanced Recovery Pathway.

Journal Article Anesth Analg · June 2018 Patient-reported outcomes (PROs) are measures of health status that come directly from the patient. PROs are an underutilized tool in the perioperative setting. Enhanced recovery pathways (ERPs) have primarily focused on traditional measures of health care ... Full text Open Access Link to item Cite

American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Nutrition Screening and Therapy Within a Surgical Enhanced Recovery Pathway.

Journal Article Anesth Analg · June 2018 Perioperative malnutrition has proven to be challenging to define, diagnose, and treat. Despite these challenges, it is well known that suboptimal nutritional status is a strong independent predictor of poor postoperative outcomes. Although perioperative c ... Full text Open Access Link to item Cite

Association of Integrated Care Coordination With Postsurgical Outcomes in High-Risk Older Adults: The Perioperative Optimization of Senior Health (POSH) Initiative.

Journal Article JAMA Surg · May 1, 2018 IMPORTANCE: Older adults undergoing elective surgery experience higher rates of preventable postoperative complications than younger patients. OBJECTIVE: To assess clinical outcomes for older adults undergoing elective abdominal surgery via a collaborative ... Full text Link to item Cite

Association of an Enhanced Recovery Pilot With Length of Stay in the National Surgical Quality Improvement Program.

Journal Article JAMA Surg · April 1, 2018 IMPORTANCE: Enhanced recovery protocols (ERPs) are standardized care plans of best practices that can decrease morbidity and length of stay (LOS). However, many hospitals need help with implementation. The Enhanced Recovery in National Surgical Quality Imp ... Full text Link to item Cite

Structured reporting of CT enterography for inflammatory bowel disease: effect on key feature reporting, accuracy across training levels, and subjective assessment of disease by referring physicians.

Journal Article Abdom Radiol (NY) · September 2017 PURPOSE: To compare the content and accuracy of structured reporting (SR) versus non-structured reporting (NSR) for computed tomographic enterography (CTE) of inflammatory bowel disease (IBD). MATERIALS AND METHODS: This IRB-approved, HIPAA-compliant, retr ... Full text Link to item Cite

Uptake of enhanced recovery practices by SAGES members: a survey.

Journal Article Surg Endosc · September 2017 BACKGROUND: The SAGES Surgical Multimodal Accelerated Recovery Trajectory (SMART) Enhanced Recovery Task Force aims to increase awareness and provide tools for members to successfully implement enhanced recovery pathways (ERPs) to improve clinical outcomes ... Full text Link to item Cite

Structured Reporting of Magnetic Resonance Enterography for Pediatric Crohn's Disease: Effect on Key Feature Reporting and Subjective Assessment of Disease by Referring Physicians.

Journal Article Curr Probl Diagn Radiol · 2017 PURPOSE: To objectively compare the content of structured reports (SR) vs nonstructured reports (NSR) for magnetic resonance enterography (MRE) of pediatric patients with Crohn's disease, and to evaluate referring clinicians' subjective assessment of repor ... Full text Link to item Cite

American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on optimal analgesia within an enhanced recovery pathway for colorectal surgery: part 1-from the preoperative period to PACU.

Journal Article Perioper Med (Lond) · 2017 BACKGROUND: Within an enhanced recovery pathway (ERP), the approach to treating pain should be multifaceted and the goal should be to deliver "optimal analgesia," which we define in this paper as a technique that optimizes patient comfort and facilitates f ... Full text Open Access Link to item Cite

American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) Joint Consensus Statement on Optimal Analgesia within an Enhanced Recovery Pathway for Colorectal Surgery: Part 2-From PACU to the Transition Home.

Journal Article Perioper Med (Lond) · 2017 BACKGROUND: Within an enhanced recovery pathway (ERP), the approach to treating pain should be multifaceted and the goal should be to deliver "optimal analgesia", which we define in this paper as a technique that optimizes patient comfort and facilitates f ... Full text Open Access Link to item Cite

Intraoperative Frontal Alpha-Band Power Correlates with Preoperative Neurocognitive Function in Older Adults.

Journal Article Front Syst Neurosci · 2017 Each year over 16 million older Americans undergo general anesthesia for surgery, and up to 40% develop postoperative delirium and/or cognitive dysfunction (POCD). Delirium and POCD are each associated with decreased quality of life, early retirement, incr ... Full text Open Access Link to item Cite

Enhanced recovery protocols for colorectal surgery and postoperative renal function: a retrospective review.

Journal Article Perioper Med (Lond) · 2017 BACKGROUND: While enhanced recovery protocols (ERPs) reduce physiologic stress and improve outcomes in general, their effects on postoperative renal function have not been directly studied. METHODS: Patients undergoing major colorectal surgery under ERP (F ... Full text Open Access Link to item Cite

Alvimopan Provides Additional Improvement in Outcomes and Cost Savings in Enhanced Recovery Colorectal Surgery.

Conference Ann Surg · July 2016 OBJECTIVE: To examine the impact of alvimopan on outcomes and costs in a rigorous enhanced recovery colorectal surgery protocol. BACKGROUND: Postoperative ileus remains a major source of morbidity and costs in colorectal surgery. Alvimopan has been shown t ... Full text Link to item Cite

Perioperative Fluid Utilization Variability and Association With Outcomes: Considerations for Enhanced Recovery Efforts in Sample US Surgical Populations.

Journal Article Ann Surg · March 2016 OBJECTIVES: To study current perioperative fluid administration and associated outcomes in common surgical cohorts in the United States. BACKGROUND: An element of enhanced recovery care protocols, optimized perioperative fluid administration may be associa ... Full text Link to item Cite

Enhanced Recovery After Surgery (ERAS) for gastrointestinal surgery, part 2: consensus statement for anaesthesia practice.

Journal Article Acta Anaesthesiol Scand · March 2016 BACKGROUND: The present interdisciplinary consensus review proposes clinical considerations and recommendations for anaesthetic practice in patients undergoing gastrointestinal surgery with an Enhanced Recovery after Surgery (ERAS) programme. METHODS: Stud ... Full text Open Access Link to item Cite

Bleeding hemorrhoids

Chapter · January 1, 2016 Symptomatic hemorrhoid disease is prevalent and can significantly impact a patient’s quality of life. Management options for bleeding hemorrhoid disease are diverse, ranging from conservative measures to a variety of office and operating room procedures, d ... Full text Cite

Improving Outcomes in Colorectal Surgery by Sequential Implementation of Multiple Standardized Care Programs.

Journal Article J Am Coll Surg · August 2015 BACKGROUND: The purpose of this study was to examine the impact of the sequential implementation of the enhanced recovery program (ERP) and surgical site infection bundle (SSIB) on short-term outcomes in colorectal surgery (CRS) to determine if the presenc ... Full text Open Access Link to item Cite

Image-guided percutaneous drainage vs. surgical repair of gastrointestinal anastomotic leaks: is there a difference in hospital course or hospitalization cost?

Journal Article Abdom Imaging · June 2015 PURPOSE: To identify differences in hospital course and hospitalization cost when comparing image-guided percutaneous drainage with surgical repair for gastrointestinal anastomotic leaks. MATERIALS AND METHODS: A retrospective IRB-approved search using key ... Full text Link to item Cite

Contemporary surgical options for metastatic colorectal cancer.

Journal Article Curr Oncol Rep · April 2015 The diagnosis of stage IV colorectal cancer was once associated with a uniformly grim prognosis. Over the last 20 years, advances in chemotherapeutics, surgical technique, and surgical adjuncts have dramatically broadened treatment options and improved out ... Full text Link to item Cite

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Other Anesth Analg · January 2015 Full text Link to item Cite

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Other Anesth Analg · January 2015 Full text Link to item Cite

The preventive surgical site infection bundle in colorectal surgery: an effective approach to surgical site infection reduction and health care cost savings.

Journal Article JAMA Surg · October 2014 IMPORTANCE: Surgical site infections (SSIs) in colorectal surgery are associated with increased morbidity and health care costs. OBJECTIVE: To determine the effect of a preventive SSI bundle (hereafter bundle) on SSI rates and costs in colorectal surgery. ... Full text Link to item Cite

Reduced length of hospital stay in colorectal surgery after implementation of an enhanced recovery protocol.

Journal Article Anesth Analg · May 2014 BACKGROUND: Enhanced recovery after surgery (ERAS) is a multimodal approach to perioperative care that combines a range of interventions to enable early mobilization and feeding after surgery. We investigated the feasibility, clinical effectiveness, and co ... Full text Open Access Link to item Cite

A simple scoring system for risk-stratifying rectal cancer patients prior to radical resection.

Journal Article Tech Coloproctol · May 2014 BACKGROUND: Various predictors of perioperative risk for patients with rectal cancer undergoing radical resection have been well described, but no simple scoring system for surgeons to estimate this risk currently exists. The objective of this study was to ... Full text Link to item Cite

Is follow-up CT imaging of the chest and abdomen necessary after preoperative neoadjuvant therapy in rectal cancer patients without evidence of metastatic disease at diagnosis?

Journal Article Colorectal Dis · November 2013 AIM: Patients with rectal cancer often undergo multiple CT scans prior to surgical resection. We propose that in patients with locally advanced rectal cancer without evidence of metastatic disease at presentation, CT imaging of the chest and abdomen after ... Full text Link to item Cite

Distant Harrington rod migration 35 years after implantation.

Journal Article J Clin Neurosci · October 2013 Harrington rods have been successfully implanted in thousands of patients for the correction of scoliotic deformity since the 1950s. An exceedingly rare complication of Harrington rod placement is loosening with resultant migration. The authors present a 5 ... Full text Open Access Link to item Cite

Guidelines for perioperative care in elective rectal/pelvic surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations.

Journal Article Clin Nutr · December 2012 BACKGROUND: This review aims to present a consensus for optimal perioperative care in rectal/pelvic surgery, and to provide graded recommendations for items for an evidenced-based enhanced recovery protocol. METHODS: Studies were selected with particular a ... Full text Link to item Cite

Exploring predictors of complication in older surgical patients: a deficit accumulation index and the Braden Scale.

Journal Article J Am Geriatr Soc · September 2012 OBJECTIVES: To determine whether readily collected perioperative information might identify older surgical patients at higher risk of complications. DESIGN: Retrospective cohort study. SETTING: Medical chart review at a single academic institution. PARTICI ... Full text Link to item Cite

Advanced age is an independent predictor for increased morbidity and mortality after emergent surgery for diverticulitis.

Journal Article Surgery · September 2012 BACKGROUND: The objectives of our study were to determine the association between age and postoperative outcomes after emergency surgery for diverticulitis and to identify risk factors for postoperative mortality among elderly patients. METHODS: All patien ... Full text Link to item Cite

Diagnosis and management of ileocolic pseudoaneurysms.

Journal Article Perspect Vasc Surg Endovasc Ther · September 2012 Ileocolic pseudoaneurysmal disease is a rare splanchnic aneurysm that affects 3 out of 100 000 patients, and only 7 cases have been described in the past 40 years in patients without preexisting connective tissue disorders. Abdominal pain is the most commo ... Full text Link to item Cite

Impact of anemia on surgical outcomes: innovative interventions in resource-poor settings.

Journal Article World J Surg · September 2012 BACKGROUND: The aim of this work was to study the impact of anemia on surgical outcomes and the impact of instituting appropriate workup and treatment of anemia on surgical outcomes. METHODS: We conducted a case-control retrospective chart review of all he ... Full text Link to item Cite

Worse outcomes in patients undergoing urgent surgery for left-sided diverticulitis admitted on weekends vs weekdays: a population-based study of 31 832 patients.

Journal Article Arch Surg · July 2012 HYPOTHESIS: Among patients undergoing urgent surgery for left-sided diverticulitis, those admitted on weekends vs weekdays have higher rates of Hartmann procedure and adverse outcomes. DESIGN: Analysis of data from the Nationwide Inpatient Sample between J ... Full text Link to item Cite

Detection of intestinal dysplasia using angle-resolved low coherence interferometry.

Journal Article J Biomed Opt · October 2011 Angle-resolved low coherence interferometry (a/LCI) is an optical biopsy technique that allows for depth-resolved, label-free measurement of the average size and optical density of cell nuclei in epithelial tissue to assess the tissue health. a/LCI has pre ... Full text Link to item Cite

Evaluation of pectus bar position and osseous bone formation.

Journal Article J Pediatr Surg · June 2003 PURPOSE: Minimally invasive repair has become a popular approach for pectus excavatum (PE). The bar is secured to the thoracic wall and left for approximately 2 years. The authors have noticed an intense bone formation (BF) around some of these bars at rem ... Full text Link to item Cite

Fibroblast growth factor signaling in the developing tracheoesophageal fistula.

Journal Article J Pediatr Surg · March 2003 BACKGROUND/PURPOSE: The Adriamycin-induced rat model of esophageal atresia and tracheoesophageal fistula (EA/TEF) provides a reliable system for the study of EA/TEF pathogenesis. The authors previously hypothesized that faulty branching lung morphogenesis ... Full text Link to item Cite

A role for sonic hedgehog signaling in the pathogenesis of human tracheoesophageal fistula.

Journal Article J Pediatr Surg · March 2003 BACKGROUND/PURPOSE: Many theories of the pathogenesis of esophageal atresia with tracheoesophageal fistula (EA/TEF) have been proposed, but no specific mechanism has been demonstrated. The authors previously reported data suggesting a respiratory origin of ... Full text Link to item Cite

Organogenesis particularly relevant to fetal surgery.

Journal Article World J Surg · January 2003 In utero surgical intervention is an exciting frontier in medicine. Fetal surgeons strive to treat congenital anomalies definitively while organogenesis is still occurring. Many of these anomalies pose such a threat to the viability of the affected fetus t ... Full text Link to item Cite

Complete discontinuity of the distal fistula tract from the developing gut: direct histologic evidence for the mechanism of tracheoesophageal fistula formation.

Journal Article Anat Rec · July 1, 2002 The embryogenesis of tracheoesophageal anomalies remains controversial. The purpose of this study was to better define the embryogenesis of developing esophageal atresia with tracheoesophageal fistula (EA/TEF), with specific attention to the controversial ... Full text Link to item Cite

Lectin as a marker for staining and purification of embryonic pancreatic epithelium.

Journal Article Biochem Biophys Res Commun · May 3, 2002 The embryonic pancreatic epithelium, and later the ductal epithelium, is known to give rise to the endocrine and exocrine cells of the developing pancreas, but no specific surface marker for these cells has been identified. Here, we utilized Dolichos Biflo ... Full text Link to item Cite