Stephanie G Worrell

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Journals/Publications

• Alvarado, C. E., & Worrell, S. G. (2023). Proceed With Caution, Benign Is Not Always Benign. The Annals of thoracic surgery, 116(2), 437-438.
• Alvarado, C. E., Worrell, S. G., Sarode, A. L., Bassiri, A., Jiang, B., Linden, P. A., & Towe, C. W. (2023). Disparities and access to thoracic surgeons among esophagectomy patients in the United States. Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus, 36(11).
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  Esophagectomy is a complex operation with significant morbidity and mortality. Previous studies have shown that sub-specialization is associated with improved esophagectomy outcomes. We hypothesized that disparities would exist among esophagectomy patients regarding access to thoracic surgeons based on demographic, geographic, and hospital factors. The Premier Healthcare Database was used to identify adult inpatients receiving esophagectomy for esophageal and gastric cardia cancer, Barrett's esophagus, and achalasia from 2015 to 2019 using ICD-10 codes. Patients were categorized as receiving their esophagectomy from a thoracic versus non-thoracic provider. Survey methodology was used to correct for sampling error. Backwards selection from bivariable analysis was used in a survey-weighted multivariable logistic regression to determine predictors of esophagectomy provider specialization. During the study period, 960 patients met inclusion criteria representing an estimated population size of 3894 patients. Among them, 1696 (43.5%) were performed by a thoracic surgeon and 2199 (56.5%) were performed by non-thoracic providers. On multivariable analysis, factors associated with decreased likelihood of receiving care from a thoracic provider included Black (OR 0.41, p 
• Conrad, H., & Worrell, S. G. (2023). Commentary: A universal patient-reported outcome measure. The Journal of thoracic and cardiovascular surgery.
• Conrad, H., Young, C., Alvarado, C., Rao, R., & Worrell, S. (2023). Dissuasion in women surgical trainees pursuing cardiothoracic surgery. American journal of surgery.
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  The reasons for persistent gender disparity in cardiothoracic surgery (CTS) are multifaceted. The objective of this paper is to understand if and why women surgical trainees are dissuaded from pursuing CTS.
• Fairbairn, K., & Worrell, S. G. (2023). Esophageal Perforation: Is Surgery Still Necessary?. Thoracic surgery clinics, 33(2), 117-123.
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  Esophageal perforation is a rare but fatal disease process that requires prompt diagnosis and treatment. Surgery has historically been required for treatment; however, there is currently a shift toward endoscopic management. Although no randomized controlled trials exist to compare patient outcomes, many case series and systematic analyses describe their indications, efficacy, and safety profile. Endoscopic stenting and endoscopic vacuum therapy are the 2 therapies most widely described across a diverse patient population and appear to be safe and effective when treating esophageal perforation, in the proper clinical setting. Guidelines and scoring systems exist to help direct management and stratify patient risk.
• Kanagasegar, N., Alvarado, C. E., Lyons, J. L., Rivero, M. J., Vekstein, C., Levine, I., Towe, C. W., Worrell, S. G., & Marks, J. M. (2023). Risk factors for adverse outcomes following paraesophageal hernia repair among obese patients. Surgical endoscopy, 37(9), 6791-6797.
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  Although obesity is an established risk factor for adverse outcomes after paraesophageal hernia repair (PEHR), many obese patients nonetheless receive PEHR. The purpose of this study was to explore risk factors for adverse outcomes of PEHR among this high-risk cohort. We hypothesized that obese patients may have other risk factors for adverse outcomes following PEHR.
• Papageorge, M. V., Alvarado, C. E., Kane, L., Worrell, S. G., & Antonoff, M. B. (2023). Seeking mentors: Experience with the Women in Thoracic Surgery mentorship program. JTCVS open, 13, 468-472.
• Riall, T. S., & Worrell, S. G. (2023). Communication in your department and beyond. Surgery.
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  Technical skills and clinical acumen are necessary for success in a surgical career. However, these skills alone are not sufficient. A surgeon's emotional intelligence and ability to communicate, manage conflict, and cultivate relationships may be even more critical to success. Health care environments are increasingly complex. An individual surgeon's or surgical department's success depends highly on the teams around them, including anesthesia, nursing, hospital administration, clinic teams, and many more. The surgeon's ability to communicate across the organization and lead by influence is critical.
• Towe, C. W., Servais, E. L., Brown, L. M., Blasberg, J. D., Mitchell, J. D., Worrell, S. G., Seder, C. W., & David, E. A. (2023). The Society of Thoracic Surgeons General Thoracic Surgery Database: 2023 Update on Outcomes and Research. The Annals of thoracic surgery.
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  The Society of Thoracic Surgeons General Thoracic Surgery Database (STS GTSD) continues its trajectory of growth and enhancement, solidifying its stature as a premier global thoracic surgical database. The past year witnessed a notable expansion with the inclusion of 10 additional participating sites, now totaling 287, augmenting the database's repository to over 800,000 procedures. A significant stride was made in refining the data audit process, elevating the accuracy and completeness metrics, a testament to the relentless pursuit of data integrity. The GTSD further broadened its research apparatus, with 15 scholarly publications, a 50% uptick from the preceding year. These publications underscore the database's instrumental role in advancing thoracic surgical knowledge. In a concerted effort to alleviate data entry exigencies, the GTSD Task Force instituted also streamlined data submission protocols, a move lauded by participant sites. This report delineates the recent advancements, volume trajectories, outcome metrics, and encapsulates the prolific research output emanating from the GTSD, reflecting a year of substantial progress and academic fecundity.
• Wang, K. J., & Worrell, S. G. (2023). Invited Commentary: Disparity and Variation in Esophageal Cancer Surgery. Journal of the American College of Surgeons, 237(5), 785-787.
• Worrell, S. G., & Molena, D. (2023). Controversies in the surgical management of esophageal adenocarcinoma. Journal of gastrointestinal oncology, 14(4), 1919-1926.
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  The incidence of esophageal adenocarcinoma (EAC) has risen dramatically over the last decade. Over this same period, our understanding and treatments have been revolutionized. Just over a decade ago, the majority of patients with locally advanced esophageal cancer went directly to surgery and our overall survival was bleak. Our current strategy for locally advanced esophageal adenocarcinoma is a multi-disciplinary approach. This approach consists of chemotherapy plus or minus radiation followed by surgical resection followed by adjuvant immunotherapy with the presence of any residual disease. Therefore, now more than ever, the goals of surgery are to minimize morbidity, provide aggressive local control and allow patients to receive to quickly recover so they can receive adjuvant systemic therapy. Surgery continues to play a crucial role in the multi-disciplinary approach to EAC. This review will highlight the on-going areas of controversy in surgical treatment. These controversies are around surgical selection, perioperative decision making and the role of surgery. Specifically, there are controversies in the type of surgical approach offered. This review will discuss the benefits of minimally invasive versus open esophagectomy. The indications for gastrectomy versus esophagectomy in patients with gastroesophageal junction EAC. Further, at the time of operation, there is still debate and on-going trials addressing the addition of a pyloric intervention. Lastly, as we push the limits of systemic therapy, there are those who may not even need a surgical resection. This review will cover the most recent data on selective esophageal resection and the concerns regarding this approach.
• Worrell, S. G., Goodman, K. A., Altorki, N. K., Ashman, J. B., Crabtree, T. D., Dorth, J., Firestone, S., Harpole, D. H., Hofstetter, W. L., Hong, T. S., Kissoon, K., Ku, G. Y., Molena, D., Tepper, J. E., Watson, T. J., Williams, T., & Willett, C. (2023). The Society of Thoracic Surgeons/American Society for Radiation Oncology Updated Clinical Practice Guidelines on Multimodality Therapy for Locally Advanced Cancer of the Esophagus or Gastroesophageal Junction. Practical radiation oncology.
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  Outcomes for patients with esophageal cancer have improved over the last decade with the implementation of multimodality therapy. There are currently no comprehensive guidelines addressing multidisciplinary management of esophageal cancer that have incorporated the input of surgeons, radiation oncologists, and medical oncologists. To address the need for multidisciplinary input in the management of esophageal cancer and to meet current best practices for clinical practice guidelines, the current guidelines were created as a collaboration between The Society of Thoracic Surgeons (STS), American Society for Radiation Oncology (ASTRO), and the American Society of Clinical Oncology (ASCO). Physician representatives chose 8 key clinical questions pertinent to the care of patients with locally advanced, resectable thoracic esophageal cancer (excluding cervical location). A comprehensive literature review was performed identifying 227 articles that met the inclusion criteria covering the use of induction chemotherapy, chemotherapy vs chemoradiotherapy before surgery, optimal radiation dose, the value of esophagectomy, timing of esophagectomy, the approach and extent of lymphadenectomy, the use of minimally invasive esophagectomy, and the value of adjuvant therapy after resection. The relevant data were reviewed and voted on by the panel with 80% of the authors, with 75% agreement on class and level of evidence. These data were then complied into the guidelines document.
• Worrell, S. G., Goodman, K. A., Altorki, N. K., Ashman, J. B., Crabtree, T. D., Dorth, J., Firestone, S., Harpole, D. H., Hofstetter, W. L., Hong, T. S., Kissoon, K., Ku, G. Y., Molena, D., Tepper, J. E., Watson, T. J., Williams, T., & Willett, C. (2023). The Society of Thoracic Surgeons/American Society for Radiation Oncology Updated Clinical Practice Guidelines on Multimodality Therapy for Locally Advanced Cancer of the Esophagus or Gastroesophageal Junction. The Annals of thoracic surgery.
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  Outcomes for patients with esophageal cancer have improved over the last decade with the implementation of multimodality therapy. There are currently no comprehensive guidelines addressing multidisciplinary management of esophageal cancer that have incorporated the input of surgeons, radiation oncologists, and medical oncologists. To address the need for multidisciplinary input in the management of esophageal cancer and to meet current best practices for clinical practice guidelines, the current guidelines were created as a collaboration between The Society of Thoracic Surgeons (STS), American Society for Radiation Oncology (ASTRO), and the American Society of Clinical Oncology (ASCO). Physician representatives chose 8 key clinical questions pertinent to the care of patients with locally advanced, resectable thoracic esophageal cancer (excluding cervical location). A comprehensive literature review was performed identifying 227 articles that met the inclusion criteria covering the use of induction chemotherapy, chemotherapy vs chemoradiotherapy before surgery, optimal radiation dose, the value of esophagectomy, timing of esophagectomy, the approach and extent of lymphadenectomy, the use of minimally invasive esophagectomy, and the value of adjuvant therapy after resection. The relevant data were reviewed and voted on by the panel with 80% of the authors, with 75% agreement on class and level of evidence. These data were then complied into the guidelines document.
• Alvarado, C. E., & Worrell, S. G. (2022). Commentary: A "Watch"Ful Eye On The Future. Seminars in thoracic and cardiovascular surgery, 34(3), 1140-1141.
• Alvarado, C. E., & Worrell, S. G. (2022). Commentary: How far would you go?. The Journal of thoracic and cardiovascular surgery, 163(5), 1698-1699.
• Alvarado, C. E., Kapcio, K. C., Lada, M. J., Linden, P. A., Towe, C. W., & Worrell, S. G. (2022). The Effect of Diabetes on Pathologic Complete Response Among Patients With Esophageal Cancer. Seminars in thoracic and cardiovascular surgery.
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  Diabetes is a common comorbidity in the U.S. and is associated with adverse outcomes in a variety of disease processes. Other cancer specialties have shown an association of diabetes with poor oncologic outcomes. We hypothesized that pathologic complete response (pCR) would be less likely among diabetic patients with esophageal cancer who underwent neoadjuvant chemoradiation therapy followed by esophagectomy resulting in worse overall survival (OS). We performed a retrospective chart review at 2 high-volume academic hospitals of all patients with esophageal cancer who received neoadjuvant chemoradiation therapy followed by esophagectomy from 2010-2019. Patients were excluded if they had histology other than squamous cell carcinoma or adenocarcinoma, did not receive multi-agent chemotherapy or received a radiation dose
• Alvarado, C. E., Worrell, S. G., Bachman, K. C., Jiang, B., Janko, M., Gray, K. E., Argote-Greene, L. M., Linden, P. A., & Towe, C. W. (2022). Robotic Approach Has Improved Outcomes for Minimally Invasive Resection of Mediastinal Tumors. The Annals of thoracic surgery, 113(6), 1853-1858.
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  The optimal minimally invasive surgical approach to mediastinal tumors is unknown. There are limited reports comparing the outcomes of resection with robotic-assisted thoracoscopic surgery (RATS) and video-assisted thoracoscopic surgery (VATS) surgery. We hypothesized that patients who underwent RATS would have improved outcomes.
• Alvarado, C. E., Worrell, S. G., Sarode, A. L., Jiang, B., Halloran, S. J., Argote-Greene, L. M., Linden, P. A., & Towe, C. W. (2022). Comparing Thoracoscopic and Robotic Lobectomy Using a Nationally Representative Database. The American surgeon, 31348221148347.
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  Studies of robotic lobectomy (Robot-L) have been performed using data from high-volume, specialty centers which may not be generalizable. The purpose of this study was to compare mortality, length of stay (LOS), and cost between Robot-L and thoracoscopic lobectomy (VATS-L) using a nationally representative database hypothesizing they would be similar.
• Bachman, K. C., Worrell, S. G., Linden, P. A., Gray, K. E., Argote-Greene, L. M., & Towe, C. W. (2022). Wedge Resection Offers Similar Survival to Segmentectomy for Typical Carcinoid Tumors. Seminars in thoracic and cardiovascular surgery, 34(1), 293-298.
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  Current guidelines recommend anatomic lung resection of typical bronchopulmonary carcinoids. Typical carcinoid tumors have excellent prognosis and sublobar resection has been associated with noninferior long-term survival. It's unclear whether wedge resection is acceptable for small typical carcinoid tumors. We hypothesize there is no difference in survival between wedge resection and segmentectomy for Stage I typical bronchopulmonary carcinoid tumors. Using the National Cancer Database from 2010 to 2016, we identified clinical T1N0M0 typical bronchopulmonary carcinoid tumors by wedge resection or segmentectomy. Short-term outcomes included length of stay, lymph nodes evaluated, pathologic node status, positive margin status, and 90-day mortality. Primary outcome was overall survival and estimated using Kaplan-Meier survival analysis. 821 patients were identified: 677 receiving wedge resection, 144 receiving segmentectomy. Segmentectomy was more commonly performed in an academic setting (70.0% vs 57.3%, P = 0.005). The mean tumor size for segmentectomy was 1.7 cm versus 1.4 cm for wedge resection (P < 0.001). There was no difference in LOS, positive margin status, and 90-day mortality between groups. There were significantly more lymph nodes evaluated in segmentectomy patients (median 4 vs 0, P < 0.001), but there was no difference in positive lymph node status (5.3% vs 2.6%, P = 0.165). The OS was similar between wedge and segmental resection (P = 0.613): 3-year survival (93.5% vs 92.8%) and 5-year survival (83.8% vs 84.9%). Wedge resection and segmentectomy have similar survival for Stage I typical bronchopulmonary carcinoids in a large national database. This analysis suggests nonanatomic, parenchymal-sparing resection should be considered an appropriate alternative for Stage I typical bronchopulmonary carcinoids.
• Cao, L., Linden, P. A., Biswas, T., Worrell, S. G., Sinopoli, J. N., Miller, M. E., Shenk, R., Montero, A. J., & Towe, C. W. (2022). Modeling the COVID Pandemic: Do Delays in Surgery Justify Using SBRT to Treat Low-Risk Early Stage NSCLC?. The Journal of surgical research, 283, 532-539.
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  It was suggested that stereotactic radiation (SBRT) is an "alternative if no surgical capacity is available" for non-small cell lung cancer (NSCLC) care during the COVID-19 pandemic. The purpose of this study was to compare the oncologic outcomes of delayed surgical resection and early SBRT among operable patients with early stage lung cancer.
• Ceppa, D. P., Antonoff, M. B., Tong, B. C., Timsina, L., Ikonomidis, J. S., Worrell, S. G., Stephens, E. H., Gillaspie, E. A., Schumacher, L., Molena, D., Kane, L. C., Blackmon, S., & Donington, J. S. (2022). 2020 Women in Thoracic Surgery Update on the Status of Women in Cardiothoracic Surgery. The Annals of thoracic surgery, 113(3), 918-925.
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  Women in Thoracic Surgery (WTS) has previously reported on the status of women in cardiothoracic (CT) surgery. We sought to provide a 10-year update on women in CT surgery.
• Chang, C., Linden, P. A., Jiang, B., Sarode, A., Bachman, K., Towe, C. W., Argote-Greene, L., & Worrell, S. G. (2022). Monitoring for Recurrence After Esophagectomy. The Annals of thoracic surgery, 114(1), 211-217.
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  Current guidelines for follow-up after esophagectomy suggest only history and physical examination (HPE). With recent advances in chemotherapy and immunotherapy for patients with recurrent esophageal cancer, we hypothesized that surveillance imaging (SI) would identify patients with cancer recurrence earlier and improve long-term survival.
• Coffey, M. R., Bachman, K. C., Ho, V. P., Worrell, S. G., Moorman, M. L., Linden, P. A., & Towe, C. W. (2022). Iatrogenic rib fractures and the associated risks of mortality. European journal of trauma and emergency surgery : official publication of the European Trauma Society, 48(1), 231-241.
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  Rib fractures, though typically associated with blunt trauma, can also result from complications of medical or surgical care, including cardiopulmonary resuscitation. The purpose of this study is to describe the demographics and outcomes of iatrogenic rib fractures.
• Fairbairn, K., Rice, J., & Worrell, S. G. (2023). Robotic Lobectomy. Thoracic surgery clinics, 33(1), 33-41.
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  Robotic lobectomy volume in the United States has increased dramatically in the past 10 years. Improved perioperative outcomes and increased public demand for minimally invasive techniques continue to drive its popularity. Preoperative workup is similar to VATs lobectomy and includes appropriate tumor staging, pulmonary function tests, and imaging. Severe intraoperative complications are rare but can be catastrophic; individualized response to each is required.
• Gerber, M. H., & Worrell, S. G. (2022). Indocyanine Green Use During Esophagectomy. Surgical oncology clinics of North America, 31(4), 609-629.
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  During an esophagectomy, many factors influence the anastomosis. Surgical factors include anastomotic tension, location of the anastomosis, surgical technique, and perfusion of the conduit. The use of fluorescent angiography is a possible avenue for more objective evaluation of the gastric conduit. There is a lot of variability in the way this tool has been used and what the results indicate. This article will discuss the various methods of fluorescent angiography to determine intestinal perfusion using indocyanine green and fluorescent imaging and the data on the association with clinical outcomes.
• Gray, K. E., Sarode, A., Jiang, B., Alvarado, C. E., Sinopoli, J., Linden, P. A., Worrell, S. G., Ho, V. P., Argote-Green, L. M., & Towe, C. W. (2022). Surgical Repair Versus Stent for Esophageal Perforation: A Multi-Institutional Database Analysis. The Annals of thoracic surgery.
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  Endoscopic esophageal stenting is utilized as an alternative to surgical repair for esophageal perforation (EP). Multi-institutional studies supporting stenting are lacking. The purpose of this study was to compare the outcomes of surgical repair and esophageal stenting in patients with EP using a nationally representative database. We hypothesized that mortality between these approaches would not be different.
• Jiang, B., & Worrell, S. G. (2022). Commentary: Test drive in cardiothoracic surgery. The Journal of thoracic and cardiovascular surgery, 163(4), 1429-1430.
• Linden, P. A., Block, M. I., Perry, Y., Gaissert, H. A., Worrell, S. J., Grau-Sepulveda, M. V., Kosinski, A. S., Jawitz, O. K., Hartwig, M. G., & Towe, C. W. (2022). Risk of Each of the Five Lung Lobectomies: A Society of Thoracic Surgeons Database Analysis. The Annals of thoracic surgery, 114(5), 1871-1877.
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  The perioperative risk of pulmonary lobectomy as a solitary procedure has been extensively studied, yet the differences in outcomes between lobes, which have unique anatomy and a different amount of lung parenchyma, are entirely unknown. The purpose of this study was to define the risk of each of the 5 lobectomies.
• Linden, P. A., Towe, C. W., Worrell, S. G., Jiang, B., Ho, V. P., Argote-Greene, L., Bachman, K., & Perry, Y. (2022). Drain Amylase: A Simple and Versatile Method of Detecting Esophageal Anastomotic Leaks. The Annals of thoracic surgery, 113(6), 1794-1800.
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  Anastomotic leak after esophagectomy is a significant cause of morbidity. Perianastomotic drain amylase is accurate in detecting leaks, but it is unclear whether its accuracy is affected by comorbid conditions, anastomotic method, or anastomotic location. We hypothesized that drain amylase would accurately discriminate leak in a variety of settings.
• Odetoyinbo, K., Bachman, K., Worrell, S., Gray, K., Linden, P., & Towe, C. (2022). Factors influencing quality of lymphadenectomy in minimally invasive esophagectomy: a US-based analysis. Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus, 35(10).
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  NCCN guidelines suggest that at least 15 lymph nodes (LN) should be evaluated at the time of esophagectomy to consider the lymphadenectomy 'adequate'. Despite these guidelines, this may not always be achieved in practice. The purpose of this study was to determine factors associated with adequate lymphadenectomy among patients receiving minimally invasive esophagectomy (MIE). Patients receiving MIE in the National Cancer Database from 2010 to 2016 were identified. Patients with metastatic disease were excluded. The primary endpoint was adequate lymphadenectomy, defined as >15 or greater LN evaluated. Factors associated with adequate lymphadenectomy and overall survival were evaluated in univariable and multivariable analyses. Categorical variables were assessed using chi-squared, and continuous variables were assessed with rank-sum test. Survival was evaluated using the Kaplan-Meier method. A total of 6,539 patients underwent MIE between 2010 and 2016 (5,024 thoracoscopic-laparoscopic MIE and 1,515 robotic-assisted MIE). A total of 3,527 patients (53.9%) received adequate lymphadenectomy. Receiving MIE at an academic center (odds ratio [OR] 1.37, 95% confidence interval [CI] 1.15-1.63, P 
• Slater, B. J., Collings, A., Dirks, R., Gould, J. C., Qureshi, A. P., Juza, R., Rodríguez-Luna, M. R., Wunker, C., Kohn, G. P., Kothari, S., Carslon, E., Worrell, S., Abou-Setta, A. M., Ansari, M. T., Athanasiadis, D. I., Daly, S., Dimou, F., Haskins, I. N., Hong, J., , Krishnan, K., et al. (2022). Multi-society consensus conference and guideline on the treatment of gastroesophageal reflux disease (GERD). Surgical endoscopy.
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  Gastroesophageal reflux disease (GERD) is one of the most common diseases in North America and globally. The aim of this guideline is to provide evidence-based recommendations regarding the most utilized and available endoscopic and surgical treatments for GERD.
• Towe, C. W., Worrell, S. G., & Finley, D. J. (2022). One Day Is Here to Stay. The Annals of thoracic surgery, 113(1), 380.
• Worrell, S. (2022). Does achalasia subtype lll need to be treated differently than type l and ll? CON.. Foregut., online ahead of print..
• Worrell, S. (2022). The Effect of Diabetes on Pathologic Complete Response Among Patients With Esophageal Cancer. Seminars of Thoracic and Cardiovascular Surgery. doi:10.1053/j.semtcvs.2021.10.016
• Worrell, S. G., Alvarado, C. E., Thibault, D., Towe, C. W., Mitchell, J. D., Vekstein, A., Kosinski, A. S., Hartwig, M. G., & Linden, P. A. (2022). Impact of Diabetes on Pathologic Response to Multimodality Therapy for Esophageal Cancer. The Annals of thoracic surgery.
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  The incidence of esophageal cancer has increased faster than that of most cancers. Evidence from other malignant neoplasms suggests that diabetic patients have a worse response to multimodality therapy. We hypothesized that diabetic patients with esophageal cancer will have a decreased response to neoadjuvant chemotherapy and radiation therapy compared with nondiabetic patients.
• Worrell, S. G., Gupta, S., Alvarado, C. E., Sarode, A., Luo, X., Towe, C. W., & Linden, P. A. (2022). Morbidity After Esophagectomy Is Higher for Benign Than Malignant Disease. The Annals of thoracic surgery.
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  Esophagectomy carries a high risk of morbidity and mortality. The most common indication for esophagectomy is esophageal cancer, with fewer than 5% of esophagectomies performed for benign disease. We hypothesized that esophagectomy for benign disease is associated with a higher risk of operative and postoperative complications.
• Worrell, S., & Katz, P. (2022). Quality of a Surgery with Low Quantity, commentary on "Long-term quality of life in achalasia patients after esophagectomy:. A single center experience. Foregut., online ahead of print..
• Worrell, S., Alvarado, C. E., Sarode, A. L., Jiang, B., Halloran, S., Argote-Greene, L. M., Linden, P. A., & Towe, C. W. (2022). Comparing thoracoscopic and robotic lobectomy using a nationally representative database.. The American Surgeon..
• Worrell, S., Alvarado, C., Luo, X., Bachman, K., Linden, P., Towe, C., Sarode, A., Argote-Greene, L., & Perry, Y. (2022). How long is long enough? Acloser look at proximal margin length for esophageal adenocarcinoma. . Foregut. Epub ahead of print.
• Worrell, S., Mack, S., Till, B., Thosani, D., Rahman, U., Grenda, T., Evans, N., & Okusanya, O. (2022). Does Age Impact Risk of Morbidity and Mortality for Elective Paraesophageal Hernia Repair  the Era of Minimally-Invasive Repair?. Foregut. Epub ahead of print.
• Worrell, S., Papageorge, M., Alvarado, C. E., Kane, L., & Antonoff, M. (2022). Seeking Mentors: Experience with the Women in Thoracic Surgery Mentorship Program. 
  
  
  . JTCVS Open..
• Ali, A. M., Bachman, K. C., Worrell, S. G., Gray, K. E., Perry, Y., Linden, P. A., & Towe, C. W. (2021). Robotic minimally invasive esophagectomy provides superior surgical resection. Surgical endoscopy, 35(11), 6329-6334.
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  Robotic minimally invasive esophagectomy (RMIE) and "traditional" minimally invasive esophagectomy techniques (tMIE) have reported superior outcomes relative to open techniques. Differences in the outcomes of these two approaches have not been examined. We hypothesized that short-term outcomes of RMIE would be superior to tMIE.
• Alvarado, C. E., Worrell, S. G., Bachman, K. C., Gray, K., Perry, Y., Linden, P. A., & Towe, C. W. (2021). Surgery following neoadjuvant chemoradiation therapy in clinical N3 esophageal cancer results in improved survival: a propensity-matched analysis. Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus, 34(7).
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  Esophageal cancer patients with extensive nodal metastases have poor survival, and benefit of surgery in this population is unclear. The aim of this study is to determine if surgery after neoadjuvant chemoradiotherapy (nCRT) improves overall survival (OS) in patients with clinical N3 (cN3) esophageal cancer relative to chemoradiation therapy (CRT) alone. The National Cancer Database was queried for all patients with cN3 esophageal cancer between 2010 and 2016. Patients who met inclusion criteria (received multiagent chemotherapy and radiation dose ≥30 Gy) were divided into two cohorts: CRT alone and nCRT + surgery. 769 patients met inclusion criteria, including 560 patients who received CRT alone, and 209 patients who received nCRT + surgery. The overall 5-year survival was significantly lower in the CRT alone group compared to the nCRT + surgery group (11.8% vs 18.0%, P < 0.001). A 1:1 propensity matched cohort of CRT alone and nCRT + surgery patients also demonstrated improved survival associated with surgery (13.11 mo vs 23.1 mo, P < 0.001). Predictors of survival were analyzed in the surgery cohort, and demonstrated that lymphovascular invasion was associated with worse survival (HR 2.07, P = 0.004). Despite poor outcomes of patients with advanced nodal metastases, nCRT + surgery is associated with improved OS. Of those with cN3 disease, only 27% underwent esophagectomy. Given the improved OS, patients with advanced nodal disease should be considered for surgery. Further investigation is warranted to determine which patients with cN3 disease would benefit most from esophagectomy, as 5-year survival remains low (18.0%).
• Alvarado, C., & Worrell, S. G. (2021). Commentary: A shot through the heart and perc to blame-an atrioesophageal fistula. JTCVS techniques, 6, 170-171.
• Chang, C., Watt, T. M., Fiedler, A. G., & Worrell, S. G. (2021). Women mentoring women. The Journal of thoracic and cardiovascular surgery.
• Coffey, M. R., Bachman, K. C., Worrell, S. G., Argote-Greene, L. M., Linden, P. A., & Towe, C. W. (2021). Concurrent diagnosis of anxiety increases postoperative length of stay among patients receiving esophagectomy for esophageal cancer. Psycho-oncology, 30(9), 1514-1524.
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  Psychiatric comorbidities disproportionately affect patients with cancer. While identified risk factors for prolonged length of stay (LOS) after esophagectomy are primarily medical comorbidities, the impact of psychiatric comorbidities on perioperative outcomes is unclear. We hypothesized that psychiatric comorbidities would prolong LOS in patients with esophageal cancer.
• Coffey, M. R., Bachman, K. C., Worrell, S. G., Argote-Greene, L. M., Linden, P. A., & Towe, C. W. (2021). Palliative Surgery Outcomes for Patients with Esophageal Cancer: An National Cancer Database Analysis. The Journal of surgical research, 267, 229-234.
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  Many patients with esophageal cancer are not candidates for surgical resection with curative intent, given the advanced stage of disease at presentation. Palliative surgery is one treatment option, but relative survival of palliative surgery has not been described. This study aims to describe the outcomes of palliative surgery in patients with esophageal cancer.
• Firestone, S., Wyler von Ballmoos, M., Kissoon, K., Goldberg, J., Worrell, S., Lawton, J., & , S. o. (2021). An Update From The Society of Thoracic Surgeons Workforce on Evidence-Based Surgery: Improving the Implementation of Clinical Practice Guidelines. The Annals of thoracic surgery, 112(3), 691-692.
• Hue, J. J., Bachman, K. C., Gray, K. E., Linden, P. A., Worrell, S. G., & Towe, C. W. (2021). Does Timing of Robotic Esophagectomy Adoption Impact Short-Term Postoperative Outcomes?. The Journal of surgical research, 260, 220-228.
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  Robotic esophagectomies are increasingly common and are reported to have superior outcomes compared with an open approach; however, it is unclear if all institutions can achieve such outcomes. We hypothesize that early adopters of robotic technique would have improved short-term outcomes.
• Hue, J. J., Bachman, K. C., Worrell, S. G., Gray, K. E., Linden, P. A., & Towe, C. W. (2021). Outcomes of robotic esophagectomies for esophageal cancer by hospital volume: an analysis of the national cancer database. Surgical endoscopy, 35(7), 3802-3810.
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  Robotic minimally invasive esophagectomies (RMIE) have been associated with superior outcomes; however, it is unclear if these are specific to robotic technique or are present only at high-volume institutions. We hypothesize that low-volume RMIE centers would have inferior outcomes.
• Kishawi, S. K., Ho, V. P., Bachman, K. C., Alvarado, C. E., Worrell, S. G., Argote-Greene, L. M., Linden, P. A., & Towe, C. W. (2021). Are We Underestimating the Morbidity of Single Rib Fractures?. The Journal of surgical research, 268, 174-180.
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  Previous studies suggest that patients with multiple rib fractures have poor outcomes, but it is unknown how isolated single rib fractures (SRF) are associated with morbidity or mortality. We hypothesized that patients with poor outcomes after SRF can be identified by demographics and comorbidities. The purpose of this study was to model adverse outcome after single rib fractures.
• Towe, C. W., Srinivasan, S., Ho, V. P., Bachmann, K., Worrell, S. G., Perry, Y., Argote-Green, L. M., & Linden, P. A. (2021). Antibiotic Resistance Is Associated With Morbidity and Mortality After Decortication for Empyema. The Annals of thoracic surgery, 111(1), 206-213.
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  Previous studies of decortication for empyema demonstrated that patient characteristics are associated with mortality, but the relationship of infectious pathogen to outcome has not been described. Our objective was to analyze the association of microbiology and antibiotic resistance with postoperative mortality after decortication for empyema. We hypothesized that bacterial pathogens, antibiotic resistance, and patient characteristics would all contribute to perioperative morbidity and mortality.
• Towe, C. W., Thibault, D. P., Worrell, S. G., Bachman, K. C., Perry, Y., Kosinski, A. S., & Linden, P. A. (2021). Factors Associated With Successful Postoperative Day One Discharge After Anatomic Lung Resection. The Annals of thoracic surgery, 112(1), 221-227.
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  There are no criteria to estimate the risk of early discharge after anatomic lung resection. We hypothesized that demographic, clinical, and surgical variables could be used to predict successful postoperative day 1 (POD1) discharge after anatomic lung resection.
• Towe, C. W., Worrell, S. G., Bachman, K., Sarode, A. L., Perry, Y., & Linden, P. A. (2021). Neoadjuvant Treatment Is Associated With Superior Outcomes in T4 Lung Cancers With Local Extension. The Annals of thoracic surgery, 111(2), 448-455.
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  Neoadjuvant chemoradiation is associated with improved survival of superior sulcus cancers, but little data exists regarding clinical T4 lung cancers with mediastinal invasion. We hypothesized that neoadjuvant treatment would be associated with improved survival in T4 lung cancer patients with mediastinal invasion.
• Wang, N., Bachman, K. C., Linden, P. A., Ho, V. P., Moorman, M. L., Worrell, S. G., Argote-Greene, L. M., & Towe, C. W. (2021). Age as a Barrier to Surgical Stabilization of Rib Fractures in Patients with Flail Chest. The American surgeon, 31348211047490.
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  Although randomized trials demonstrate a benefit to surgical stabilization of rib fractures (SSRF), SSRF is rarely performed. We hypothesized older patients were less likely to receive SSRF nationally.
• Worrell, S. (2021). Commentary: The Increasing Presence of Women Cardiothoracic Surgeons.

  . Semin Thorac Cardiovasc Surg. Epub ahead of print.

• Worrell, S. (2021). Nissen: How I do it.. Foregut. Epub ahead of print,.
• Worrell, S. G. (2021). Commentary: The Increasing Presence of Women Cardiothoracic Surgeons. Seminars in thoracic and cardiovascular surgery, 33(2), 625-626.
• Worrell, S., & Alvarado, C. (2021). Commentary: A "watchful" eye on the future.. Semin Thorac Cardiovasc Surg. /online ahead of print.
• Worrell, S., & Jiang, B. (2021). Commentary: Test Drive in Cardiothoracic Surgery.. J Thorac Cardiovasc Surg./ online ahead of print, 01264-2.
• Worrell, S., & Towe, C. (2021). One day is here to stay.. Annals of Thoracic Surgery. Epub ahead of print.
• Worrell, S., Bachman, K. C., Towe, C. W., & Linden, P. A. (2021). Wedge Resection Offers Similar Survival to Segmentectomy for Typical Carcinoid Tumor.. Semin Thorac Cardiovasc Surg.
• Worrell, S., Ceppa, D. P., Antonoff, M. B., Tong, B. C., Timsina, L., Ikonomidis, J., Stephens, E. H., Gillaspie, E. A., Schumacher, L., Molena, D., Kane, L. C., Blackmon, S., & Donington, J. S. (2021). 2020 Women in Thoracic Surgery update on the status of women in cardiothoracic surgery.. Annals of Thoracic./Epub ahead of print..
• Worrell, S., Chang, C., Linden, P. A., Jiang, B., Sarode, A., Bachman, K., Towe, C. W., & Argote-Green, L. (2021). Monitoring for Recurrence Following Esophagectomy.. Annals of Thoracic Surgery./ Epub ahead of print.
• Worrell, S., Chang, C., Watt, T., & Fiedler, A. (2021). Women Mentorin Women.. The Journal of Thoracic and Cardiovascular Surgery. Epub ahead of print.
• Worrell, S., Firestone, S., Wyler, M. v., Kissoon, K., Goldberg, J., & Lawton, J. (2021). An Update from The Society of Thoracic Surgeons Workforce on Evidence-Based Surgery: Improving the Implementation of Clinical Practice Guidelines.. Ann Thorac Surg., 112((3)), 691-692.
• Worrell, S., Gardner, R., Tipton, A., Janko, M., Usman, M., Linden, P., Towe, C., & Argote-Green, L. (2021). Management of bilateral spontaneous pneumothorax related to COVID-19 infection.. Journal of Clinical Surgery and Research, 2((3)). doi:10.31579/2768-2757/022
• Worrell, S., Jiang, B., Linden, P., Oliu, A., Towe, C., & Perry, Y. (2021). Low Embolic Risk from Short Duration Atrial Fibrillation following Anatomic Lung Resection.. Int. J Drug Reg Affairs, 9((1)), 73-78.
• Worrell, S., Linden, P. A., Towe, C. W., Jiang, B., Ho, V. P., Argote-Green, L., Bachmann, K., & Perry, Y. (2021). Drain Amylase: A Simple and Versatile Method of Detecing Esophageal Anastomotic Leaks.. Annals of Thoracic Surgery./Epub ahead of print..
• Worrell, S., Randall, A., & O'Donnell, B. (2021). Cervicothoracic Neurenteric Cyst With Contralateral Diaphragmatic Hernia: An Unusual Combination. Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society, 24(5), 467-470.
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  We describe a premature male infant who died from complications resulting from two malformations: a large left-sided diaphragmatic hernia and a right-sided cervicothoracic neurenteric cyst. The findings of the first limited prenatal ultrasound led to the incorrect diagnosis of right-sided diaphragmatic hernia. Vertebral anomalies, commonly associated with neurenteric cysts, and an intrathoracic stomach, were not identified until autopsy examination. A literature review describes only one partly similar case relating a neurenteric cyst to the jejunum associated with an ipsilateral diaphragmatic defect identified on prenatal ultrasound. The second report of this combination raises the question of a developmental relationship.
• Worrell, S., Wang, N., Bachman, K. C., Linden, P. A., Ho, V. P., Moorman, M. L., Argote-Green, L. M., & Towe, C. W. (2021). Age is a barrier to surgical stabilization of Rib fractures in patients with flail chest.. The American Journal of Surgery./ Epub ahead of print.
• Worrell, S., Worrell, S., Coffey, M., Coffey, M., Bachman, K. C., Bachman, K. C., Linden, P. A., Linden, P. A., Towe, C. W., & Towe, C. W. (2021). Concurrent Diagnosis of Anxiety Increases Postoperative Length of Stay Among Patinets Receiving Esophagectomy for Esophageal Cancer.. Psycho-Oncology./Epub ahead of print.
• Chang, C., & Worrell, S. G. (2020). Viruses and esophageal cancer. Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus, 33(12).
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  Esophageal adenocarcinoma (EAC) has had the fastest increasing incidence of any solid tumor in the United States in the last 30 years. Long standing gastroesophageal reflux disease is a well-established risk factor with strong associations with obesity, alcohol and tobacco. However, there are likely additional contributing factors. Viruses such as human papillomavirus, ebstein-barr virus and herpes simplex virus have been implicated in the pathogenesis of esophageal cancer. This review will discuss the known literature linking viruses to esophageal adenocarcinoma and consider future relationships such as identifying prognostic and predictive molecular biomarkers to guide therapies.
• Fiedler, A. G., Emerson, D., Gillaspie, E. A., Hermsen, J. L., Levack, M. M., McCarthy, D. P., Sihag, S., Worrell, S. G., & Antonoff, M. B. (2020). Multi-institutional collaborative mock oral (mICMO) examination for cardiothoracic surgery trainees: Results from the pilot experience. JTCVS open, 3, 128-135.
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  The American Board of Thoracic Surgery-certifying examination is challenging for applicants. Single institutions have reported good results with a mock oral examination (MOE) for trainees. General surgery literature has demonstrated success with in-person multi-institutional MOE examinations. Due to small numbers of cardiothoracic training programs and significant geographic variability, we hypothesized that a multi-institutional, collaborative remotely administered MOE (mICMO) pairing faculty with trainees from different institutions would provide an important educational experience.
• Hue, J. J., Linden, P. A., Bachman, K. C., Worrell, S. G., Gray, K. E., & Towe, C. W. (2020). Conversion from thoracoscopic to open pneumonectomy is not associated with short- or long-term mortality. Surgery, 168(5), 948-952.
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  Thoracoscopic pneumonectomy commonly requires conversion to thoracotomy. We hypothesize that conversion would lead to worse short- and long-term outcomes compared with operations completed thoracoscopically.
• Jiang, B., Linden, P. A., Gupta, A., Jarrett, C., Worrell, S. G., Ho, V. P., Perry, Y., Towe, C. W., & , U. H. (2020). Conventional Computed Tomographic Calcium Scoring vs full chest CTCS for lung cancer screening: a cost-effectiveness analysis. BMC pulmonary medicine, 20(1), 187.
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  Conventional CTCS images the mid/lower chest for coronary artery disease (CAD). Because many CAD patients are also at risk for lung malignancy, CTCS often discovers incidental pulmonary nodules (IPN). CTCS excludes the upper chest, where malignancy is common. Full-chest CTCS (FCT) may be a cost-effective screening tool for IPN.
• Linden, P. A., Perry, Y., Worrell, S., Wallace, A., Argote-Greene, L., Ho, V. P., & Towe, C. W. (2020). Postoperative day 1 discharge after anatomic lung resection: A Society of Thoracic Surgeons database analysis. The Journal of thoracic and cardiovascular surgery, 159(2), 667-678.e2.
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  Although minimally invasive techniques have led to shorter hospitalizations, discharge on postoperative day 1 is still uncommon. We hypothesized that day 1 discharge could be performed safely and that there might be significant variation in day 1 discharge rates between hospitals.
• Worrell, S. (2020). Esophageal Cancer and Surgical Margins: When a Positive is a Negative. . Annals of surgical oncology. Epud ahead of print.
• Worrell, S. G. (2020). Esophageal Cancer and Surgical Margins: When a Positive Is a Negative. Annals of surgical oncology, 27(5), 1316-1317.
• Worrell, S. G., & Linden, P. A. (2020). ASO Author Reflections: More May Not Be Better. Annals of surgical oncology, 27(2), 509-510.
• Worrell, S. G., Bachman, K. C., Sarode, A. L., Perry, Y., Linden, P. A., & Towe, C. W. (2020). Minimally invasive esophagectomy is associated with superior survival, lymphadenectomy and surgical margins: propensity matched analysis of the National Cancer Database. Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus, 33(10).
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  Despite excellent short-term outcomes of minimally invasive esophagectomy (MIE), there is minimal data on long-term outcomes compared to open esophagectomy. MIE's superior visualization may have improved lymphadenectomy and complete resection rate and therefore improved long-term outcomes. We hypothesized that MIE would have superior long-term survival. Patients undergoing an esophagectomy for cancer between 2010 and 2016 were identified in the National Cancer Database. MIE included laparoscopic/robotic approach, and conversions were categorized as open. A 1:1 propensity match was performed. Lymphadenectomy and margin status were compared between MIE and open using Stuart Maxwell marginal homogeneity and Wilcoxon matched-pair signed-rank test. Survival was compared using log-rank test. 13,083 patients were identified: 8,906 (68%) open and 4,177 (32%) MIE. Propensity matching identified 3,659 'pairs' of MIE and open esophagectomy patients. Among them, MIE was associated with higher number lymph nodes examined (16 vs. 14, P 
• Worrell, S. G., Haug, K., Dubovoy, A., Lin, J., & Engoren, M. (2020). Is Lactic Acidosis After Lung Transplantation Associated With Worse Outcomes?. The Annals of thoracic surgery, 110(2), 434-440.
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  Elevated lactate levels may be caused by increased production suggestive of tissue ischemia; however, they may also occur without evidence of ischemia, by catecholamine activation of beta receptors. The purpose of this study was to determine the factors associated with increased lactate levels during and after lung transplantation and to evaluate whether lactate levels were associated with increased time to extubation and postoperative complications.
• Worrell, S. G., Towe, C. W., A Dorth, J., Machtay, M., Perry, Y., & Linden, P. A. (2020). Higher Doses of Neoadjuvant Radiation for Esophageal Cancer Do Not Affect the Pathologic Complete Response Rate or Survival: A Propensity-Matched Analysis. Annals of surgical oncology, 27(2), 500-508.
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  Traditional neoadjuvant therapy for esophageal cancer has used chemoradiation doses greater than 45 Gy. This study aimed to examine the dose of preoperative radiation in relation to the pathologic complete response (pCR) rate and overall survival (OS) for patients with resectable esophageal cancer.
• Worrell, S., & Alvarado, C. (2020). Commentary: A shot through the hearty and perc to blame- an atrioesophageal fistula.. JTCVS Techniques, 25(6), 170-171.
• Towe, C. W., Wu, K., Khil, A., Perry, Y., Worrell, S. G., Ho, V. P., & Linden, P. A. (2019). Desaturation during Six-Minute Walk Testing Predicts Major Morbidity Following Anatomic Lung Resection among Patients with COPD. Healthcare (Basel, Switzerland), 7(1).
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  Pulmonary function testing (PFT) is commonly used to risk-stratify patients prior to lung resection. Guidelines recommend that patients with reduced lung function, due to chronic lung conditions such as Chronic Obstructive Pulmonary Disease (COPD), should receive additional physiologic testing to determine fitness for resection. We reviewed our experience with six-minute walk testing (SMWT) to determine the association of test results and post-operative complications.
• Worrell, S. G., Dedhia, P., Gilbert, C., James, C., Chang, A. C., Lin, J., & Reddy, R. M. (2019). The cost and quality of life outcomes in developing a robotic lobectomy program. Journal of robotic surgery, 13(2), 239-243.
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  The use of the robotic platform is increasingly being utilized for lung resections. Our aim was to compare outcomes of thoracoscopic (VATS) versus robotic-assisted thoracoscopic (RATS) lobectomy early in a program's adoption of robotic surgery, including perioperative outcomes, cost, and long-term quality of life. A prospective database was retrospectively reviewed for all patients undergoing minimally invasive lobectomy by either VATS or RATS techniques from 2010 to 2012. Patients' operative, post-operative complications, cost (operating room and hospital) and quality of life were compared between the two resection techniques. Long-term follow-up including assessment using the European Organization for Research and Treatment of Cancer quality of life questionnaire was documented. During the first 25 RATS lobectomies, there were 73 VATS lobectomies performed, for a total of 98 cases. There was no significant difference in cancer stage, operative time, estimated blood loss, lymph node count, or hospital length of stay. The RATS resections had significantly higher operative and total hospital cost (p 
• Worrell, S., & Chang, A. C. (2019). Pulmonary Nodules. In "TSRA Decision Algorithms in Cardiothoracic Surgery." Eds. Louis C, Vardas P, Chen P, Dixon J, Amin PB.. Thoracic Surgery Residents Association.
• Worrell, S., & Linden, P. A. (2019). ASO Author reflections: More may not be better. 

  . Annals of surgical oncology. Epub ahead of print..

• Worrell, S., Boys, J. A., & DeMeester, S. R. (2019). Collis gastroplasty for foreshortened esophagus. . Eds. Yeo, CJ. Elsevier Inc. Shackelford's 8th edition,.
• Worrell, S., Lagisetty, K. H., & Reddy, R. M. (2019). A bronchogenic cyst masquerading as a paraesophageal hiatal hernia.. Thoracic Surgery: 50 Challenging Cases./Eds. Vigneswaran WT. CRC Press.
• Worrell, S. (2018). Editorial Comment on "Survival Impact of Total Resected Lymph Nodes in Esophageal Cancer Patients with and without Neoadjuvant Chemoradiation.. Annals of Surgical Oncology. Epub ahead of print.
• Worrell, S. G. (2018). Editorial Comment on "Survival Impact of Total Resected Lymph Nodes in Esophageal Cancer Patients with and without Neoadjuvant Chemoradiation". Annals of surgical oncology, 25(13), 3783-3784.
• Worrell, S. G., & Chang, A. C. (2018). Silencing the bird: Should surgical thoracic duct ligation shuffle off this mortal coil?. The Journal of thoracic and cardiovascular surgery, 156(2), 844.
• Worrell, S., & Chang, A. (2017). "Risk Adjustment and Performance Measurement for Esophageal Cancer Resection.". Thoracic Surgery Clinics, Quality in Thoracic Surgery., 27((3)), 221-226.
• Worrell, S., & DeMeester, S. R. (2016). "Antireflux Surgery." Diagnosis and Treatment of Gastroesophageal Reflux Disease.. Ed Michael F. Vaezi. Springer International Publishing Switzerland, 145-160 Print.
• Worrell, S., & DeMeester, S. R. (2016). "Endoscopic Resection and Ablation for Early-Stage Esophageal Cancer." . Thoracic Surgery Clinics, 26((2)), 173-176.
• Worrell, S., Boys, J. A., & DeMeester, S. R. (2016). "Identification and Management of a Short Esophagus and a Complex Hiatus." Fundoplication Surgery: A Clinical Guide to Optimizing Results.. Ed Ralph W Aye and John G Hunter. Springer Publishing, 31-37 print.
• Worrell, S., Bonavina, L., Saino, G., & DeMeester, S. R. (2015). "Magnetic LES Augmentation: The LINX Procedure." Antireflux Surgery. . Ed Lee L Swanstrom and Christy M. Dunst. Springer Publishing, 139-148. print.
• Worrell, S., & DeMeester, S. R. (2014). "Thoracic Emergencies." Surgical Clinics of North America: Acute Care Surgery.. Ed George C. Velmahos., 94((1)), 183-191.
• Baydala, L. T., Worrell, S., Fletcher, F., Letendre, S., Letendre, L., Ruttan, L., Baydala, L. T., Worrell, S., Fletcher, F., Letendre, S., Letendre, L., & Ruttan, L. (2013). "Making a place of respect": lessons learned in carrying out consent protocol with First Nations elders. Progress in community health partnerships : research, education, and action, 7(2), 135-43.
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  This article explores the issue of informed consent by First Nations Elders modifying and implementing a substance abuse prevention program for youth, Nimi Icinohabi, among the Alexis Nakota Sioux Nation. The Elders who approved and guided the research maintained that informed consent procedures carried out by the Western academic institutions were redundant given adherence to their own culturally based protocol.
• Greene, C. L., DeMeester, S. R., Zehetner, J., Worrell, S. G., Oh, D. S., & Hagen, J. A. (2013). Diaphragmatic relaxing incisions during laparoscopic paraesophageal hernia repair. Surgical endoscopy, 27(12), 4532-8.
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  Laparoscopic paraesophageal hernia (PEH) repair is associated with an objective recurrence rate exceeding 50% at 5 years. Minimizing tension is a critical factor in preventing hernia recurrence. This study aimed to evaluate the outcomes of crural relaxing incisions in patients undergoing PEH repair.
• Worrell, S. G., DeMeester, S. R., Greene, C. L., Oh, D. S., & Hagen, J. A. (2013). Pharyngeal pH monitoring better predicts a successful outcome for extraesophageal reflux symptoms after antireflux surgery. Surgical endoscopy, 27(11), 4113-8.
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  Gastroesophageal reflux disease can be associated with extraesophageal symptoms (hoarseness, cough, asthma, and globus). However, these symptoms may have a multifactorial etiology. Proximal pH monitoring has been proposed as a means of identifying patients where reflux is the cause of the extraesophageal symptoms. The aim of this study was to determine whether proximal esophageal or pharyngeal pH monitoring better identified patients with extraesophageal symptoms that improved after antireflux surgery.
• Willer, B. L., Mittal, S. K., Worrell, S. G., Mumtaz, S., & Lee, T. H. (2010). Applicability and feasibility of incorporating minimally invasive esophagectomy at a high volume center. Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 14(8), 1201-6.
• Worrell, S., Mumtaz, S., Tsuboi, K., Lee, T. H., & Mittal, S. K. (2010). Anastomotic complications associated with stapled versus hand-sewn anastomosis. The Journal of surgical research, 161(1), 9-12.
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  To compare anastomotic complications of stapled versus hand-sewn cervical esophago-gastric anastomosis.

Presentations

• Worrell, S. (2024, Feb). LINX: the good, bad and the ugly. Esophageal symposium. Phoenix, AZ.
• Worrell, S. (2024, Feb). Thoracic surgery for the General surgeon. Arizona chapter of the American College of Surgeons. Phoenix, AZ.
• Worrell, S. (2024, Feb). Updates on advances in foregut surgery. Arizona chapter of the American College of Surgeons. Phoenix, AZ.
• Worrell, S. (2024, June). Endoscopic wound vacuum placement. Western Thoracic Surgical Association. Vail, CO: Western Thoracic Surgical Association.
• Worrell, S. (2024, March). Fungus in the chest: when, how and why to operate . University of Arizona Internal Medicine, Infectious Disease Grand Rounds. Tucson, AZ.
• Worrell, S. (2024, May). Everything you wanted to know about esophageal cancer. Allegheny Hospital Department of Surgery Grand Rounds.Pittsburgh, PA.
• Worrell, S. (2024, May). Lung Cancer, Exercise and the Tumor Microenvironment. University of Arizona Department of Surgery Research DayUniversity of Arizona.
• Worrell, S. (2024, Oct). Everything you wanted to know about Stage III esophageal cancer. UPMC Department of Surgery Grand Rounds.
• Worrell, S. (2024, October). Advances in Lung Cancer Surgery. Desert Lung CME. Tucson, AZ: University of Arizona.
• Worrell, S. (2024, October). Building a program: starting a new practice. Society of Thoracic surgeons Leadership institute webinar series. virtual.
• Worrell, S. (2024, Sept). Early Lung cancer diagnosis and treatment. Primary care panel. Tucson, AZ.
• Worrell, S. (2024, Sept). Post-Antireflux surgery abnormal findings. American Foregut Society. Denver, CO: American Foregut Society.
• Worrell, S. (2024, Sept). Robotic minimally invasive esophagectomy: how I do it. International Thoracic Surgical Oncology Summit.