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Stephanie Chao, MD

  • Stephanie D Chao

Especialidades

Surgery

Trabajo y Educación

Formación Profesional

University of California San Francisco, San Francisco, CA, 6/30/2006

Residencia

Stanford University School of Medicine, Stanford, CA, 6/30/2013

Compañerismo

Stanford University School of Medicine, Palo Alto, CA, 6/30/2015

Certificaciones Médicas

General Surgery, American Board of Surgery

Pediatric Surgery, American Board of Surgery

Condiciones Tratadas

Biliary Disorders

Chest Wall Anomalies

Congenital Diaphragmatic Hernia (CDH)

Disorders of the Spleen

GERD

Hernias

Intestinal Disorders

Minimally invasive surgery

Neonatal Congenital Anomalies

Neonatal Surgery

Pectus Carinatum

Pectus Excavatum

Pediatric Trauma

Pediatric Tumors

Todo Publicaciones

Pleomorphic myxoid liposarcoma in an adolescent with Li-Fraumeni syndrome. Pediatric surgery international Sinclair, T. J., Thorson, C. M., Alvarez, E., Tan, S., Spunt, S. L., Chao, S. D. 2017

Abstract

We present the case of a 15-year-old female with a right perineal mass that was found to be pleomorphic myxoid liposarcoma, a recently recognized, rare subtype of liposarcoma. The patient had a strong family history of malignancy and genetic screening revealed a pathogenic TP53 mutation consistent with Li-Fraumeni syndrome.

View details for DOI 10.1007/s00383-017-4063-x

View details for PubMedID 28160093

Endoscopic Division of Duodenal Web Causing Near Obstruction in 2-Year-Old with Trisomy 21 JOURNAL OF LAPAROENDOSCOPIC & ADVANCED SURGICAL TECHNIQUES Wood, L. S., Kastenberg, Z., Sinclair, T., Chao, S., Wall, J. K. 2016; 26 (5): 413-417

Abstract

Surgical intervention for duodenal atresia most commonly entails duodenoduodenostomy in the neonatal period. Occasionally, type I duodenal atresia with incomplete obstruction may go undiagnosed until later in life. Endoscopic approach to dividing intestinal webs has been reported as successful in patients as young as 7 days of age, and can be a useful modality particularly in patients with comorbidities who may not tolerate open or laparoscopic surgery.A 2-year-old female with a history of trisomy 21 and tetralogy of Fallot underwent laparoscopic and endoscopic exploration of intestinal obstruction as seen on upper gastrointestinal series for symptoms of recurrent emesis and weight loss. After laparoscopy confirmed a duodenal web as the cause of intestinal obstruction, endoscopic division of the membrane was carried out with a triangle tip electrocautery knife and 15mm radially dilating balloon.The patient tolerated the procedure well, and also tolerated full age-appropriate diet by time of discharge on postoperative day 2. She remains asymptomatic as of 6 months postoperatively.This report describes a successful endoscopic approach for definitive treatment of a duodenal web in a 2-year-old girl with trisomy 21, and laparoscopy confirmed no intraabdominal obstructive process or complication from endoscopy. Endoscopy enables minimal recovery time and suggests an improved method of duodenal web division over pure surgical intervention.

View details for DOI 10.1089/lap.2015.0462

View details for Web of Science ID 000376469600014

View details for PubMedID 26913816

Multimodality Renal Failure in a Patient with OEIS Complex. AJP reports Santoro, J. D., Chao, S., Hsieh, M. H., Lee, H. C. 2015; 5 (2): e161-4

Abstract

Omphalocele-exstrophy of the bladder-imperforate anus-spinal defect (OEIS) complex is a rare constellation of clinical abnormalities with wide phenotypic presentation. We describe a case of a preterm neonate with OEIS complex with acute renal failure, and the challenges in diagnosis and management of this patient as renal failure can be a multifactorial process when encountered with this rare complex.

View details for DOI 10.1055/s-0035-1554799

View details for PubMedID 26495176

Medical training fails to prepare providers to care for patients with chronic hepatitis B infection. World journal of gastroenterology Chao, S. D., Wang, B., Chang, E. T., Ma, L., So, S. K. 2015; 21 (22): 6914-6923

Abstract

To investigate physicians' knowledge including chronic hepatitis B (CHB) diagnosis, screening, and management in various stages of their training.A voluntary 20-question survey was administered in Santa Clara County, CA where Asian and Pacific Islanders (API) account for a third of the population. Among the 219 physician participants, there were 63 interns, 60 second-year residents, 26 chief residents and 70 attending physicians. The survey asked questions regarding respondents' demographics, general hepatitis B virus knowledge questions (i.e., transmission, prevalence, diagnostic testing, prevention, and treatment options), as well as, self-reported practice behavior and confidence in knowledge.Knowledge about screening and managing patients with CHB was poor: only 24% identified the correct tests to screen for CHB, 13% knew the next steps for patients testing positive for CHB, 18% knew the high prevalence rate among API, and 31% knew how to screen for liver cancer. Wald chi-square analysis determined the effect of training level on knowledge; in all cases except for knowledge of liver cancer screening (P = 0.0032), knowledge did not significantly increase with length in residency training or completion of residency.Even in a high-risk region, both medical school and residency training have not adequately prepared physicians in the screening and management of CHB.

View details for DOI 10.3748/wjg.v21.i22.6914

View details for PubMedID 26078568

Initial Results of Endoscopic Gastrocutaneous Fistula Closure in Children Using an Over-the-Scope Clip. Journal of laparoendoscopic & advanced surgical techniques. Part A Wright, R., Abrajano, C., Koppolu, R., Stevens, M., Nyznyk, S., Chao, S., Bruzoni, M., Wall, J. 2015; 25 (1): 69-72

Abstract

Gastrocutaneous fistula (GCF) occurs commonly in pediatric patients after removal of long-term gastrostomy tubes. Although open repair is generally successful, endoscopic approaches may offer benefits in terms of incisional complications, postoperative pain, and procedure time. In addition, endoscopic approaches may offer particular benefit in patients with varied degrees of skin irritation or erosion surrounding a GCF, making surgical repair difficult, or patients with significant comorbidities, making minimal intervention and anesthesia time preferable. Over-the-scope (OSC) clips are a new technology that enables endoscopic closure of intestinal fistulas up to 2cm in diameter. Six pediatric patients underwent endoscopic GCF closure using OSC clips under Institutional Review Board approval. The procedure was technically successful in 5 of 6 cases with an average operating time of 29 minutes. The technical failure required an open revision, whereas all other patients reported full healing of the GCF site at 1 month. All successful cases were performed as outpatients without postoperative narcotics. In addition, all patients reported high satisfaction with the procedure and cosmetic results. Endoscopic GCF closure using an OSC clip is technically feasible in the pediatric population. Based on limited cases with a 1-month follow-up, the functional and cosmetic results of technically successful cases are excellent. Endoscopic GCF closure is a potential alternative to standard surgical closure in patients with skin irritation or erosion and/or significant comorbidities.

View details for DOI 10.1089/lap.2014.0379

View details for PubMedID 25531644

Introduction of the Per-Oral Endoscopic Myotomy Technique to Pediatric Surgical Practice J Pediatr Surg Case Rep Chao, S. D., Russo, M., Wright, R., Rivas, H., Wall, J. K. 2014; 2 (6)
Intraoperative functional luminal imaging to assess esophagogastric junction distensibility during per-oral endoscopic myotomy in pediatric patients J Gastroint Dig Syst Wright, R., Chao, S. D., Wall, J. K. 2014; 4 (4)
Education and counseling of pregnant patients with chronic hepatitis B: perspectives from obstetricians and perinatal nurses in santa clara county, california. Asian Pacific journal of cancer prevention Yang, E. J., Cheung, C. M., So, S. K., Chang, E. T., Chao, S. D. 2013; 14 (3): 1707-1713

Abstract

Background: This study aimed to better understand the barriers to perinatal hepatitis B prevention and to identify the reasons for poor hepatitis B knowledge and delivery of education to hepatitis B surface-antigen- positive pregnant women among healthcare providers in Santa Clara County, California. Materials and Methods: Qualitative interviews were conducted with 16 obstetricians and 17 perinatal nurses in Santa Clara County, California, which has one of the largest populations in the United States at high risk for perinatal hepatitis B transmission. Results: Most providers displayed a lack of self-efficacy attributed to insufficient hepatitis B training and education. They felt discouraged from counseling and educating their patients because of a lack of resources and discouraging patient attitudes such as stigma and apathy. Providers called for institutional changes from the government, hospitals, and nonprofit organizations to improve care for patients with chronic hepatitis B. Conclusions: Early and continuing provider training, increased public awareness, and development of comprehensive resources and new programs may contribute to reducing the barriers for health care professionals to provide counseling and education to pregnant patients with chronic hepatitis B infection.

View details for PubMedID 23679261

Low Levels of Knowledge and Preventive Practices Regarding Vertical Hepatitis B Transmission among Perinatal Nurses JOGNN-JOURNAL OF OBSTETRIC GYNECOLOGIC AND NEONATAL NURSING Chao, S. D., Cheung, C. M., Yang, E. J., So, S. K., Chang, E. T. 2012; 41 (4): 494-505

Abstract

To evaluate current levels of hepatitis-B-related knowledge and clinical practice among perinatal nurses.Cross-sectional study.Santa Clara County, California, home to one of the largest U.S. populations at risk of perinatal hepatitis B transmission.Perinatal nurses (N = 518) from eight birthing hospitals.In 2008-2010, nurses completed a baseline survey evaluating existing hepatitis-B-related knowledge and preventive clinical practices, participated in an educational seminar, received instructional materials about hepatitis B, and completed a follow-up knowledge survey.Eighty percent of perinatal nurses had provided health care to a pregnant woman with chronic hepatitis B, but only 51% routinely provided patients with educational information about hepatitis B. While 75% routinely informed patients about effective methods to prevent mother-to-child transmission, only a small minority (17-34%) educated infected women about standard recommendations for protecting themselves and household members. One fourth or fewer nurses correctly answered most questions about hepatitis B prevalence, risks, and symptoms. After the educational seminar, knowledge increased statistically significantly.Existing knowledge about hepatitis B is limited, and nationally recommended preventive clinical practices are commonly overlooked by perinatal nurses. This lack of knowledge and preventive care represents a noteworthy gap and an opportunity for targeted training and education to improve perinatal hepatitis B prevention and medical management of infected mothers.

View details for DOI 10.1111/j.1552-6909.2012.01379.x

View details for Web of Science ID 000306476300006

View details for PubMedID 22697047

The Jade Ribbon Campaign: A systematic, evidence-based public awareness campaign to improve Asian and Pacific Islander health J Comm in Healthcare Chao, S. D., So, S. K. 2011; 4 (1)
The Jade Ribbon Campaign: A Model Program for Community Outreach and Education to Prevent Liver Cancer in Asian Americans JOURNAL OF IMMIGRANT AND MINORITY HEALTH Chao, S. D., Chang, E. T., Le, P. V., Prapong, W., Kiernan, M., So, S. K. 2009; 11 (4): 281-290

Abstract

The Jade Ribbon Campaign (JRC) is a culturally targeted, community-based outreach program to promote the prevention, early detection, and management of chronic hepatitis B virus (HBV) infection and liver cancer among Asian Americans. In 2001, 476 Chinese American adults from the San Francisco Bay Area attended an HBV screening clinic and educational seminar. The prevalence of chronic HBV infection was 13%; only 8% of participants showed serologic evidence of protective antibody from prior vaccination. Participants reported low preventive action before the clinic, but after one year, 67% of those with chronic HBV infection had consulted a physician for liver cancer screening, and 78% of all participants had encouraged family members to be tested for HBV. The increase in HBV awareness, screening, and physician follow-up suggests that culturally aligned interventions similar to the JRC may help reduce the disproportionate burden of disease to chronic HBV infection among Asian Americans.

View details for DOI 10.1007/s10903-007-9094-2

View details for Web of Science ID 000281505100005

View details for PubMedID 17990118

Eliminating the Threat of Chronic Hepatitis B in the Asian and Pacific Islander Community: A Call to Action ASIAN PACIFIC JOURNAL OF CANCER PREVENTION Chao, S. D., Chang, E. T., So, S. K. 2009; 10 (3): 507-512

Abstract

Chronic hepatitis B in the Asian and Pacific Islander (API) population is among our nation's greatest ethnic and racial health disparities. Despite comprising 4.3% of the population, API make up a disproportionate half of the 1.2-2 million Americans living with chronic hepatitis B. As many as two-thirds of API are not aware of their infection because they have not been tested. This lack of knowledge prevents them from undergoing life-saving liver cancer screening and potential treatment. Likewise, those not protected are unaware that they should be vaccinated. Instead, there is a pervasive lack of awareness among API and healthcare providers. New concerted public health actions are needed to eliminate this major health disparity.

View details for Web of Science ID 000270750100033

View details for PubMedID 19640200

Short waitlist time does not adversely impact outcome following liver transplantation for hepatocellular carcinoma AMERICAN JOURNAL OF TRANSPLANTATION Chao, S. D., Roberts, J. P., Farr, M., Yao, F. Y. 2007; 7 (6): 1594-1600

Abstract

It has been suggested that patients with hepatocellular carcinoma (HCC) undergoing living donor liver transplantation (LDLT) have worse recurrence-free survival compared to deceased donor liver transplantation (CLT), leading to the hypothesis that short waitlist time or fast-tracking may include more aggressive tumors that would have been selected out by traditionally longer waitlist time. The primary aim of the present study was to evaluate the impact of waitlist time on HCC recurrence. The study cohort included 100 patients meeting T2 criteria by imaging before undergoing CLT (n = 90) or LDLT (n = 10). The 5-year recurrence-free probability was 89.9% for the entire cohort, and 91.9%, 90.5% and 86.6%, respectively, for waitlist time of 3 months or less, 3-6 months and > 6 months (p = 0.81). In the Cox proportional hazards model, waitlist time was also not a significant predictor of HCC recurrence. Tumor under-staging was observed in 20.5% of patients with waitlist time 3 months or less and 23.0% for waitlist time > 3 months (p = 0.81). In conclusion, our results failed to show an association between waitlist time and outcome after CLT or LDLT for HCC, and provided evidence disputing a significant role of waitlist time in the selection against HCC with unfavorable tumor biology.

View details for DOI 10.1111/j.1600-6143.2007.01800.x

View details for Web of Science ID 000246576700020

View details for PubMedID 17430396

Anomalies of the corpus callosum: An MR analysis of the phenotypic spectrum of associated malformations AMERICAN JOURNAL OF ROENTGENOLOGY Hetts, S. W., Sherr, E. H., Chao, S., Gobuty, S., Barkovich, A. J. 2006; 187 (5): 1343-1348

Abstract

We sought to categorize the structural brain anomalies associated with abnormalities of the corpus callosum and anterior and hippocampal commissures in a large cohort.Brain MR images of adult and pediatric patients from our institution and from a national support organization (the ACC Network) were retrospectively evaluated for the type and severity of commissural anomalies and the presence and type of other structural abnormalities.Of 142 cases that were reviewed, 82 patients had agenesis of the corpus callosum (ACC), while 60 had hypogenesis of the corpus callosum (HCC). Of the overall cohort, almost all had reduced white matter volume outside the commissures, the majority had malformations of cortical development (most commonly heterotopia or abnormal sulcation), many had noncallosal midline anomalies (including abnormal anterior or hippocampal commissures and interhemispheric cysts and lipomas), and several patients had abnormalities of the cerebellum or brainstem. Sixty-six patients had Probst bundles, which were more common in patients with ACC than in those with HCC. Probst bundles were present in all four patients who had ACC or HCC but no other midline, cortical, or posterior fossa anomalies.Isolated commissural anomalies were rare in the populations of patients examined. Most cases of ACC and HCC were associated with complex telencephalic, diencephalic, or rhombencephalic malformations. Reduced cerebral hemispheric white matter volume and malformations of cortical development were seen in more than half of the patients, suggesting that many commissural anomalies are part of an overall cerebral dysgenesis. ACC and HCC appear to lie along a dysgenetic spectrum, as opposed to representing distinct disorders.

View details for DOI 10.2214/AJR.05.0146

View details for Web of Science ID 000241510800035

View details for PubMedID 17056927

Single infusion of myeloid progenitors reduces death from Aspergillus fumigatus following chemotherapy-induced neutropenia BLOOD Bitmansour, A., Cao, T. M., Chao, S., Shashidhar, S., Brown, J. M. 2005; 105 (9): 3535-3537

Abstract

Hematopoietic progenitors committed to the myeloid lineage, the common myeloid and granulocyte-monocyte progenitors (CMP/GMP), have been shown to protect against opportunistic pathogens following myeloablative radiation; however, the efficacy of this approach has not been studied in the setting of chemotherapy-induced neutropenia. In this mouse model, the infusion of CMP/GMP on the day after 5-fluorouracil (5-FU) administration (D+1) resulted in a significant increase in the number of splenic neutrophils by D+8 when compared with 5-FU-only controls (P = .02), the majority of which were CMP/GMP-derived (54%). Moreover, 19% and 28% of neutrophils in the blood and bone marrow, respectively, were CMP/GMP-derived. Survival following intranasal challenge with the fungus Aspergillus fumigatus was significantly higher in CMP/GMP-infused mice than the controls (56% and 33% respectively; P = .019). Thus, a single infusion of CMP/GMP enhances tissue neutrophil content and increases survival against a lethal challenge with A fumigatus in the setting of chemotherapy-induced neutropenia.

View details for DOI 10.1182/blood-2004-2004-07-2676

View details for Web of Science ID 000228797400029

View details for PubMedID 15576478

Central nervous system aspergillosis in an immunocompetent patient: cure in a hospice setting with very high-dose itraconazole. The American journal of hospice & palliative care Palanisamy, A., Chao, S. D., Fouts, M., Kerr, D. 2005; 22 (2): 139-144

Abstract

Aspergillosis of the central nervous system (CNS) is a rare condition with exceedingly high mortality. This study describes the case of an immunocompetent 42-year-old man with a history of intravenous drug use and hepatitis C who developed multiple Aspergillus lesions in the cerebellum. Despite neurosurgery and antifungal therapy with amphotericin B, he had a protracted hospital course with multiple complications, eventually developing cognitive and motor impairment due to progressive cerebellar lesions. After transfer to hospice and palliative care service, oral itraconazole was escalated to 1600 mg/day with the hope of palliating headache, nausea, and cognitive impairment. Remarkably, the patient stabilized and improved over time. After 14 months, this unprecedented high-dose regimen was discontinued, and the patient was discharged home with only mild cerebellar motor impairment.

View details for PubMedID 15853093

Lack of drug interaction conformity in commonly used drug compendia for selected at-risk dermatologic drugs AMERICAN JOURNAL OF CLINICAL DERMATOLOGY Chao, S. D., Maibach, H. I. 2005; 6 (2): 105-111

Abstract

Systemic treatments that have significant efficacy for dermatologic conditions can often cause severe adverse reactions when improperly combined with interacting drugs. We have noted discrepancies in the reporting of such drug-drug interactions among major drug compendia used in hospitals and physicians' offices.The aim of this study was to compare the consistency of drug-drug interaction listings among four of the most widely used English language drug compendia in the US.Drug monographs from Mosby's GenRx, USP DI, AHFS Drug Information, and the Physicians' Desk Reference were compared. The respective drug-drug interactions provided by the various compendia for four systemic agents -- dapsone, erythromycin, methotrexate and prednisone -- commonly prescribed for dermatologic purposes were compiled.We found considerable discrepancies among the compendia with respect to the number of drug interactions listed. Agreement among the compendia was especially poor when more than two sources were compared.There is a need for a drug compendium that reconciles drug-drug interaction reporting discrepancies under standardized criteria based on the scientific literature and clinical significance.

View details for Web of Science ID 000228512000005

View details for PubMedID 15799682