Jamie Tung, MD
Clinical Assistant Professor, Surgery - General Surgery
Bio
Dr. Tung is a fellowship-trained surgeon in the Stanford Health Care Chest Wall Surgery Program. He is a clinical instructor in the Stanford Medicine Department of Surgery.
His areas of expertise include trauma, general, and critical care surgery. He excels at the surgical treatment of chest wall injury, including stabilization of rib fractures.
In his research, Dr. Tung has investigated gastrotomy tube complications. He has participated in the American Association for the Surgery of Trauma study of the surgical treatment of liver injury. Other research interests include massive transfusion strategies and education regarding pre-hospital trauma management.
Dr. Tung has co-authored articles on complications of hernia surgery and other topics. His work has been published in The Journal of Trauma and Acute Care Surgery and Case Reports in Surgery. He also co-authored a chapter on chest wall surgery in the Textbook of Emergency General Surgery.
Dr. Tung has made presentations at the American College of Surgeons Annual Meeting, Academic Surgical Congress, and other conferences. Topics include massive transfusions, prehospital trauma care, burn resuscitation, and complications of percutaneous endoscopic gastrostomy (PEG) in trauma patients.
He is a member of the American College of Surgeons, Chest Wall Injury Society, Eastern Association for the Surgery of Trauma, and Association for Academic Surgeons. He is a member of the Stanford Medicine Trauma Committee and other committees. He has worked as and is a certified emergency medical technician (EMT) as well as a tactical physician. He also has served as a “Stop the Bleed” instructor with Stanford Medicine as well as with other institutions where he practiced previously.
Dr. Tung is fluent in English and Cantonese. He is proficient in Mandarin.
Clinical Focus
- General Surgery
- Surgical Stabilization of Rib Fractures
- Disaster Management
- Pre-Hospital Care
- Trauma Surgery
- Critical Care Surgery
Professional Education
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Board Certification: American Board of Surgery, Surgical Critical Care (2021)
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Board Certification: American Board of Surgery, General Surgery (2020)
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Medical Education: Tufts University School of Medicine (2014) MA
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Fellowship: UCSF Fresno Surgical Critical Care Fellowship (2020) CA
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Residency: Maine Medical Center Program (2019) ME
All Publications
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An unknown (and unexpected) cause of septic shock.
Journal of the American College of Emergency Physicians open
2024; 5 (4): e13248
View details for DOI 10.1002/emp2.13248
View details for PubMedID 39076254
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Management of Uncomplicated Appendicitis in Adults: A Nationwide Analysis From 2018 to 2019.
The Journal of surgical research
2024; 298: 307-315
Abstract
Nonoperative management (NOM) of uncomplicated appendicitis (UA) has been increasingly utilized in recent years. The aim of this study was to describe nationwide trends of sociodemographic characteristics, outcomes, and costs of patients undergoing medical versus surgical management for UA.The 2018-2019 National (Nationwide) Inpatient Sample was queried for adults (age ≥18 y) with UA; diagnosis, as well as laparoscopic and open appendectomy, were defined by the International Classification of Diseases, 10th Revision, Clinical Modification codes. We examined several characteristics, including cost of care and length of hospital stay.Among the 167,125 patients with UA, 137,644 (82.4%) underwent operative management and 29,481 (17.6%) underwent NOM. In bivariate analysis, we found that patients who had NOM were older (53 versus 43 y, P < 0.001) and more likely to have Medicare (33.6% versus 16.1%, P < 0.001), with higher prevalence of comorbidities such as diabetes (7.8% versus 5.5%, P < 0.001). The majority of NOM patients were treated at urban teaching hospitals (74.5% versus 66.3%, P < 0.001). They had longer LOS's (5.4 versus 2.3 d, P < 0.001) with higher inpatient costs ($15,584 versus $11,559, P < 0.001) than those who had an appendectomy. Through logistic regression we found that older patients had up to 4.03-times greater odds of undergoing NOM (95% CI: 3.22-5.05, P < 0.001).NOM of UA is more commonly utilized in patients with comorbidities, older age, and those treated in teaching hospitals. This may, however, come at the price of longer length of stay and higher costs. Further guidelines need to be developed to clearly delineate which patients could benefit from NOM.
View details for DOI 10.1016/j.jss.2024.03.017
View details for PubMedID 38640616
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An initiative to assess and improve the resources and patient care processes used among Chest Wall Injury Society collaborative centers (CWIS-CC2).
The journal of trauma and acute care surgery
2023
Abstract
Over the last two decades, the acute management of rib fractures has changed significantly. In 2021, the Chest Wall injury Society (CWIS) began recognizing centers who epitomize their mission as CWIS Collaborative Centers (CWIS-CC). The primary aim of this study was to determine the resources, surgical expertise, access to care, and institutional support that are present among centers.A survey was performed including all CWIS-CC evaluating the resources available at their hospital for the treatment of patients with chest wall injury. Data about each Chest Wall Injury Center (CWIC) care process, availability of resources, institutional support, research support, and educational offerings were recorded.Data was collected from 20 trauma centers resulting in an 80% response rate. These trauma centers were made up of 5 international and 15 US based trauma centers. Eighty percent (16/20) have dedicated care team members for the evaluation and management of rib fractures. Twenty-five percent (5/20) have a dedicated rib fracture service with a separate call schedule. Staffing for chest wall injury clinics consists of a multidisciplinary team: with attending surgeons in all clinics, 80%(8/10) with APPs and 70%(7/10) with care coordinators. Forty percent(8/20) of centers have dedicated rib fracture research support and 35%(7/20) have SSRF-related grants. Forty percent (8/20) of centers have marketing support and 30%(8/20) have a web page support to bring awareness to their center. At these trauma centers, a median of 4(1-9) surgeons perform surgical stabilization of rib fractures (SSRF). In the majority of trauma centers the trauma surgeons perform SSRF.Considerable similarities and differences exist within these CWIS collaborative centers. These differences in resources are hypothesis generating in determining the optimal CWIC. These findings may generate several patient care and team process questions to optimize patient care, patient experience, provider satisfaction, research productivity, education, and outreach.IV Economic & Value-Based Evaluations.
View details for DOI 10.1097/TA.0000000000004158
View details for PubMedID 37889926
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Incidence of surgical rib fixation at chest wall injury society collaborative centers and a guide for expected number of cases (CWIS-CC1).
European journal of trauma and emergency surgery : official publication of the European Trauma Society
2023
Abstract
Surgical stabilization of rib fractures (SSRF) improves outcomes in certain patient populations. The Chest Wall Injury Society (CWIS) began a new initiative to recognize centers who epitomize their mission as CWIS Collaborative Centers (CWIS-CC). We sought to describe incidence and epidemiology of SSRF at our institutions.A retrospective registry evaluation of all patients (age > 15 years) treated at international trauma centers from 1/1/20 to 7/30/2021 was performed. Variables included: age, gender, mechanism of injury, injury severity score, abbreviated injury severity score (AIS), emergency department disposition, length of stay, presence of rib/sternal fractures, and surgical stabilization of rib/sternal fractures. Classification and regression tree analysis (CART) was used for analysis.Data were collected from 9 centers, 26,084 patient encounters. Rib fractures were present in 24% (n = 6294). Overall, 2% of all patients underwent SSRF and 8% of patients with rib fractures underwent SSRF. CART analysis of SSRF by AIS-Chest demonstrated a difference in management by age group. AIS-Chest 3 had an SSRF rate of 3.7, 7.3, and 12.9% based on the age ranges (16-19; 80-110), (20-49; 70-79), and (50-69), respectively (p = 0.003). AIS-Chest > 3 demonstrated an SSRF rate of 9.6, 23.3, and 39.3% for age ranges (16-39; 90-99), (40-49; 80-89), and (50-79), respectively (p = 0.001).Anticipated rate of SSRF can be calculated based on number of rib fractures, AIS-Chest, and age. The disproportionate rate of SSRF in patients age 50-69 with AIS-Chest 3 and age 50-79 with AIS-Chest > 3 should be further investigated, as lower frequency of SSRF in the other age ranges may lead to care inequalities.
View details for DOI 10.1007/s00068-023-02343-4
View details for PubMedID 37624405
View details for PubMedCentralID 5548197
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Rib fracture fixation in a patient on veno-venous extracorporeal membrane oxygenation following a motor vehicle collision.
Trauma surgery & acute care open
2022; 7 (1): e001004
View details for DOI 10.1136/tsaco-2022-001004
View details for PubMedID 36389118
View details for PubMedCentralID PMC9664310
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Management of Uncomplicated Appendicitis in Adults: A Nationwide Analysis of Healthcare Use, Cost, and Outcomes From 2018-2019
LIPPINCOTT WILLIAMS & WILKINS. 2022: S33
View details for Web of Science ID 000867877000081
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Faculty Lead Coaching as a Method to Enhance Feedback Culture and Communication Skills Development in Surgical Education-Needs Assessment (Study in Progress)
LIPPINCOTT WILLIAMS & WILKINS. 2022: S74
View details for Web of Science ID 000867877000185
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Ventriculoperitoneal shunt migration into an inguinal hernia with subsequent laparoscopic reduction and hernia repair.
Trauma surgery & acute care open
2022; 7 (1): e000951
View details for DOI 10.1136/tsaco-2022-000951
View details for PubMedID 35692610
View details for PubMedCentralID PMC9134172
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Ventriculoperitoneal shunt migration into an inguinal hernia with subsequentreduction and hernia repair
TRAUMA SURGERY & ACUTE CARE OPEN
2022; 7 (1)
View details for DOI 10.1136/tsaco-2022-000951
View details for Web of Science ID 000802208900001
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Surgical Infection Society: Chest Wall Injury Society Recommendations for Antibiotic Use during Surgical Stabilization of Traumatic Rib or Sternal Fractures to Reduce Risk of Implant Infection.
Surgical infections
2022; 23 (4): 321-331
Abstract
Background: Surgical stabilization of rib fractures is recommended in patients with flail chest or multiple displaced rib fractures with physiologic compromise. Surgical stabilization of rib fractures (SSRF) and surgical stabilization of sternal fractures (SSSF) involve open reduction and internal fixation of fractures with a plate construct to restore anatomic alignment. Most plate constructs are composed of titanium and presence of this foreign, non-absorbable material presents opportunity for implant infection. Although implant infection rates after SSRF and SSSF are low, they present a challenging clinical entity often requiring prolonged antibiotic therapy, debridement, and potentially implant removal. Methods: The Surgical Infection Society's Therapeutics and Guidelines Committee and Chest Wall Injury Society's Publication Committee convened to develop recommendations for antibiotic use during and after surgical stabilization of traumatic rib and sternal fractures. Clinical scenarios included patients with concomitant infectious processes (sepsis, pneumonia, empyema, cellulitis) or sources of contamination (open chest, gross contamination) incurred as a result of their trauma and present at the time of their surgical stabilization. PubMed, Embase, and Cochrane databases were searched for pertinent studies. Using a process of iterative consensus, all committee members voted to accept or reject each recommendation. Results: For patients undergoing SSRF or SSSF in the absence of pre-existing infectious process, there is insufficient evidence to suggest existing peri-operative guidelines or recommendations are inadequate. For patients undergoing SSRF or SSSF in the presence of sepsis, pneumonia, or an empyema, there is insufficient evidence to provide recommendations on duration and choice of antibiotic. This decision may be informed by existing guidelines for the concomitant infection. For patients undergoing SSRF or SSSF with an open or contaminated chest there is insufficient evidence to provide specific antibiotic recommendations. Conclusions: This guideline document summarizes the current Surgical Infection Society and Chest Wall Injury Society recommendations regarding antibiotic use during and after surgical stabilization of traumatic rib or sternal fractures. Limited evidence exists in the chest wall surgical stabilization literature and further studies should be performed to delineate risk of implant infection among patients undergoing SSSRF or SSSF with concomitant infectious processes.
View details for DOI 10.1089/sur.2022.025
View details for PubMedID 35522129
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Duodenal perforation due to multiple foreign bodies: consideration for operative approach and surgical repair.
Trauma surgery & acute care open
2022; 7 (1): e001063
View details for DOI 10.1136/tsaco-2022-001063
View details for PubMedID 36532693
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Traumatic Injury and Death Among Law Enforcement Officers
ELSEVIER SCIENCE INC. 2021: E94
View details for Web of Science ID 000718306700228
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Surgical Infection Society Guidelines for Total Abdominal Colectomy versus Diverting Loop Ileostomy with Antegrade Intra-Colonic Lavage for the Surgical Management of Severe or Fulminant, Non-Perforated Clostridioides difficile Colitis.
Surgical infections
2021
Abstract
Background: Clostridioides difficile infection (CDI) can result in life-threatening illness requiring surgery. Surgical options for managing severe or fulminant, non-perforated C. difficile colitis include total abdominal colectomy with end ileostomy or creation of a diverting loop ileostomy with antegrade vancomycin lavage. Methods: The Surgical Infection Society's Therapeutics and Guidelines Committee convened to develop guidelines for summarizing the current SIS recommendations for total abdominal colectomy versus diverting loop ileostomy with antegrade lavage for severe or fulminant, non-perforated C. difficile colitis. PubMed, Embase, and the Cochrane database were searched for pertinent studies. Severe infection was defined as laboratory diagnosis of C. difficile infection with leukocytosis (white blood cell count of ≥15,000 cells/mL) or elevated creatinine (serum creatinine level >1.5 mg/dL). Fulminant infection was defined as laboratory diagnosis of C. difficile infection with hypotension or shock, ileus, or megacolon. Perforation was defined as complete disruption of the colon wall. Total abdominal colectomy was defined as resection of the ascending, transverse, descending, and sigmoid colon with end ileostomy. For the purpose of the guideline, the terms subtotal colectomy, total abdominal colectomy, and rectal-sparing total colectomy were used interchangeably. Diverting loop ileostomy with antegrade enema was defined as creation of both a diverting loop ileostomy with intra-operative colonic lavage and post-operative antegrade vancomycin unless otherwise specified. Evaluation of the published evidence was performed using the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system. Using a process of iterative consensus, all committee members voted to accept or reject each recommendation. Results: We recommend that total abdominal colectomy be the procedure of choice for definitive therapy of severe or fulminant, non-perforated C. difficile colitis. In select patients, colon preservation using diverting loop ileostomy with intra-colonic vancomycin may be associated with higher rates of ostomy reversal and restoration of gastrointestinal continuity but may lead to development of recurrent C. difficile colitis. Conclusions: This guideline summarizes the current Surgical Infection Society recommendations regarding use of total abdominal colectomy versus diverting loop ileostomy with antegrade lavage for adults with severe or fulminant, non-perforated C. difficile infection.
View details for DOI 10.1089/sur.2021.126
View details for PubMedID 34619068
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Gastrobronchial Fistula after Robotic Repair of Traumatic Diaphragmatic Hernia
CASE REPORTS IN SURGERY
2020; 2020: 8085425
Abstract
Gastrobronchial fistulas are a rare occurrence in the literature. We report a case of a gastrobronchial fistula after robotic repair of a chronic traumatic diaphragmatic hernia. The patient had severe respiratory symptoms with multiple studies that were inconclusive. The fistula was ultimately discovered after an esophagogastroduodenoscopy (EGD). The patient underwent a left thoracotomy for takedown of his fistula and eventually recovered. Earlier EGD and a lower threshold for differential that included this diagnosis would have led to an earlier identification and treatment of a rare disease process.
View details for DOI 10.1155/2020/8085425
View details for Web of Science ID 000522989600001
View details for PubMedID 32257500
View details for PubMedCentralID PMC7102410
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Empyema commission of 1918-Impact on acute care surgery 100 years later
JOURNAL OF TRAUMA AND ACUTE CARE SURGERY
2019; 86 (2): 321-325
View details for DOI 10.1097/TA.0000000000002088
View details for Web of Science ID 000457577100020
View details for PubMedID 30358766