# Ovarian Teratoma — GCMD Library living collection

Everything in the library about ovarian teratoma — built automatically from dossiers that name it.

Updated: n/a · 3 episodes · 78 cited statements

## Episodes
### Evidence & Research
- [What's New in Pediatric Surgery 2020 - FULL SHOW](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217) — video · 57:41 · [machine version](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217.md)

### In-Depth Reviews
- [Ovarian Teratoma - Ovarian Torsion - Soft Tissue Sarcoma: Update Course 2015](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672) — video · 34:37 · [machine version](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672.md)
- [Compiled Hayes Jordan Rapid Fire Sessions: Update Course 2015](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995) — video · 33:36 · [machine version](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995.md)

## Chapters
- [0:00](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=0) Ovarian Teratomas and Germ Cell Tumors: Staging and Treatment Updates (Ep 1)
- [5:58](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=358) Surgical Technique Discussion for Ovarian Masses (Ep 1)
- [12:40](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=760) Ovarian Torsion: Preservation Strategies and Timing (Ep 1)
- [18:16](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1096) Ovarian Torsion: Ultrasound Reliability and Surgical Decision-Making (Ep 1)
- [25:26](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1526) Rhabdomyosarcoma: Staging, Grouping, and Sentinel Node Requirements (Ep 1)
- [31:00](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1860) Non-Rhabdo Soft Tissue Sarcomas: Grade-Based Treatment (Ep 1)
- [0:00](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=0) Ovarian Germ Cell Tumors: Case Presentation and Staging Updates (Ep 2)
- [5:14](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=314) Ovarian Teratoma Management: Surgical Approach and Technique (Ep 2)
- [11:52](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=712) Ovarian Torsion: Preservation Strategies and Timing (Ep 2)
- [17:28](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1048) Ovarian Torsion: Operative Timing and Oophoropexy Debate (Ep 2)
- [25:07](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1507) Rhabdomyosarcoma: Staging, Grouping, and Sentinel Node Requirements (Ep 2)
- [29:40](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1780) Non-Rhabdomyosarcoma Soft Tissue Sarcomas: Grade-Based Treatment (Ep 2)
- [0:03](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=3) Introduction and Spontaneous Pneumothorax Management (Ep 3)
- [9:15](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=555) Ovarian Teratoma Follow-up and Appendectomy Opioid Use (Ep 3)
- [16:32](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=992) Pyloromyotomy Feeding Protocols (Ep 3)
- [19:54](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=1194) Stoma Takedown Antibiotic Selection (Ep 3)
- [23:11](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=1391) Umbilical Hernia Repair Timing (Ep 3)
- [27:02](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=1622) Appendix and Ulcerative Colitis (Ep 3)
- [28:49](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=1729) Circumcision Technique and Penile Necrosis (Ep 3)
- [33:25](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=2005) Pilonidal Disease Management: Gips Procedure (Ep 3)
- [38:35](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=2315) Airway Foreign Body: CT vs Bronchoscopy (Ep 3)
- [44:35](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=2675) Intussusception Re-reduction and Trauma Resuscitation (Ep 3)
- [52:31](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=3151) Central Line Radiography, TEF Leak Treatment, and OR Headgear (Ep 3)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- 80% of ovarian masses are teratomas — Andrea Hayes-Jordan (epidemiological) [Ep 1 · 1:25](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=85)
- In the year 2000, girls with ovarian germ cell tumors have almost 100% survival — Andrea Hayes-Jordan (epidemiological) [Ep 1 · 1:50](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=110)
- Stage one ovarian tumors limited to the ovary now receive only oophorectomy without chemotherapy — Andrea Hayes-Jordan (guideline) [Ep 1 · 2:14](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=134)
- Microscopic residual and lymph node involvement in ovarian tumors require chemotherapy — Andrea Hayes-Jordan (guideline) [Ep 1 · 2:26](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=146)
- 25% of girls with ovarian germ cell tumors will be missed if peritoneal cytology and washings are not performed — Andrea Hayes-Jordan (epidemiological) [Ep 1 · 3:16](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=196)
- If staging procedures are omitted from the operative report, oncologists will treat ovarian tumors as stage 2 — Andrea Hayes-Jordan (clinical) [Ep 1 · 3:54](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=234)
- Gliomatosis peritonei is a benign disease appearance associated with ovarian teratomas with nearly 100% survival — Andrea Hayes-Jordan (clinical) [Ep 1 · 4:41](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=281)
- In bilateral ovarian disease, tumors larger than 10 cm should definitely be biopsied — Andrea Hayes-Jordan (guideline) [Ep 1 · 5:37](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=337)
- If an ovarian tumor is ruptured during laparoscopic removal, the patient is committed to chemotherapy including platinum — Dan (clinical) [Ep 1 · 7:11](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=431)
- 15% of ovarian tumors in adolescents are epithelial tumors with different staging criteria than germ cell tumors — Dan (epidemiological) [Ep 1 · 7:19](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=439)
- If alpha-fetoprotein and beta-HCG levels are normal preoperatively, there is some comfort about draining a cyst without contamination — Andrea Hayes-Jordan (clinical) [Ep 1 · 8:07](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=487)
- The salvage rate for recurrent ovarian germ cell tumors is almost 100% because chemotherapy is very effective — Dan (clinical) [Ep 1 · 12:15](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=735)
- Ovarian torsion is an urgent but not emergent situation if the goal is to preserve the ovary — Andrea Hayes-Jordan (guideline) [Ep 1 · 13:40](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=820)
- Many black-colored ovaries from torsion have viable follicles and ovarian preservation should be the goal — Andrea Hayes-Jordan (clinical) [Ep 1 · 13:40](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=820)
- 76% of ovaries removed for torsion had normal ovarian tissue, only 13% had no ovarian tissue, and only 11% were completely necrotic — Andrea Hayes-Jordan (epidemiological) [Ep 1 · 15:44](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=944)
- Pain after oophoropexy is usually short-lived and resolves in about a week — Andrea Hayes-Jordan (clinical) [Ep 1 · 16:34](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=994)
- The ability to preserve ovarian function after torsion is related to age, with pediatric patients having more active follicles than older adults — Andrea Hayes-Jordan (clinical) [Ep 1 · 16:58](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1018)
- Ultrasound Doppler for ovarian torsion has sensitivity and specificity in the 50-60% range — Andrea Hayes-Jordan (clinical) [Ep 1 · 21:03](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1263)
- Half of soft tissue sarcomas are rhabdomyosarcomas and half are non-rhabdo sarcomas — Andrea Hayes-Jordan (epidemiological) [Ep 1 · 25:58](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1558)
- Abdominal, pelvic, and retroperitoneal rhabdomyosarcomas have the worst survival while orbital rhabdomyosarcomas have the best survival — Andrea Hayes-Jordan (epidemiological) [Ep 1 · 26:22](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1582)
- Even small tumors in the extremity or abdomen can only achieve stage 2 at best (not stage 1) in rhabdomyosarcoma staging — Andrea Hayes-Jordan (clinical) [Ep 1 · 27:04](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1624)
- Surgical extent determines clinical group in rhabdomyosarcoma: group 1 is complete resection, group 2 is microscopic residual, group 3 is biopsy only — Andrea Hayes-Jordan (guideline) [Ep 1 · 27:15](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1635)
- Group 1 and 2 rhabdomyosarcoma patients have excellent prognosis while group 3 patients do more poorly — Andrea Hayes-Jordan (clinical) [Ep 1 · 27:27](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1647)
- Inability to resect a large rhabdomyosarcoma is a biologic determination, not a reflection of surgical skill, and aggressive resection with high morbidity will not improve outcome — Andrea Hayes-Jordan (opinion) [Ep 1 · 27:44](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1664)
- Sentinel lymph node biopsy is now required for all trunk and extremity rhabdomyosarcomas — Andrea Hayes-Jordan (guideline) [Ep 1 · 29:15](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1755)
- For rhabdomyosarcoma, completion node dissection is not performed for positive sentinel nodes; radiation therapy is given instead — Andrea Hayes-Jordan (guideline) [Ep 1 · 29:31](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1771)
- Sentinel lymph node mapping for rhabdomyosarcoma should be performed at the time of re-excision if initial excisional biopsy had positive margins — Andrea Hayes-Jordan (guideline) [Ep 1 · 30:10](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1810)
- 40-50% of biopsied lymph nodes are positive in rhabdomyosarcoma, and clinically negative nodes may also be positive — Andrea Hayes-Jordan (epidemiological) [Ep 1 · 30:36](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1836)
- Histologic grade is now critical in non-rhabdo soft tissue sarcomas, not just the diagnosis — Andrea Hayes-Jordan (guideline) [Ep 1 · 31:00](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1860)
- Low-grade soft tissue sarcomas require only resection with observation, no chemotherapy or radiation — Andrea Hayes-Jordan (guideline) [Ep 1 · 31:27](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1887)
- Low-grade soft tissue sarcomas with positive margins receive adjuvant radiation therapy — Andrea Hayes-Jordan (guideline) [Ep 1 · 31:34](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1894)
- Unresectable soft tissue sarcomas should receive both preoperative radiation and chemotherapy (previously only chemotherapy was recommended) — Andrea Hayes-Jordan (guideline) [Ep 1 · 31:49](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1909)
- Chemotherapy-sensitive soft tissue sarcomas include synovial sarcoma and undifferentiated sarcoma — Andrea Hayes-Jordan (clinical) [Ep 1 · 32:07](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1927)
- Chemotherapy-insensitive soft tissue sarcomas include alveolar soft part sarcoma, malignant epithelioid sarcoma, and clear cell sarcoma, which are primarily treated with surgery and radiation — Andrea Hayes-Jordan (clinical) [Ep 1 · 32:25](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1945)
- A 5 cm tumor in a child less than 3 years old is equivalent to a 3 cm tumor in a larger patient, so 3 cm should be the cutoff for excision versus biopsy in toddlers — Andrea Hayes-Jordan (clinical) [Ep 1 · 32:51](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1971)
- Low-grade non-rhabdo sarcomas with negative margins can be cured with surgery alone without chemotherapy — Andrea Hayes-Jordan (clinical) [Ep 1 · 33:22](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=2002)
- Core needle biopsies are acceptable for soft tissue sarcomas if 3-4 good non-necrotic cores are obtained — Andrea Hayes-Jordan (guideline) [Ep 1 · 34:07](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=2047)
- 80% of ovarian masses in children are teratomas — Andrea Hayes-Jordan (epidemiological) [Ep 2 · 0:37](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=37)
- By the year 2000, girls with ovarian germ cell tumors have almost 100% survival — Andrea Hayes-Jordan (epidemiological) [Ep 2 · 1:03](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=63)
- Stage 1 ovarian germ cell tumors (limited to ovary) now receive only oophorectomy without chemotherapy — Andrea Hayes-Jordan (guideline) [Ep 2 · 1:22](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=82)
- Peritoneal cytology/washings will miss approximately 25% of girls with disease if not performed — Andrea Hayes-Jordan (clinical) [Ep 2 · 2:28](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=148)
- If staging procedures are omitted from the operative report, oncologists will treat the patient as stage 2 — Andrea Hayes-Jordan (clinical) [Ep 2 · 3:06](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=186)
- Gliomatosis peritonei is a benign disease with 100% survival, typically associated with ovarian teratomas — Andrea Hayes-Jordan (clinical) [Ep 2 · 3:53](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=233)
- For bilateral ovarian disease, tumors larger than 10 centimeters should be biopsied, with lower threshold for bilateral oophorectomy on first operation — Andrea Hayes-Jordan (clinical) [Ep 2 · 4:38](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=278)
- 15% of ovarian tumors in the teenage age range are actually epithelial tumors with different staging criteria than germ cell tumors — Dan (epidemiological) [Ep 2 · 6:31](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=391)
- If a presumed teratoma is ruptured during laparoscopic removal, the patient is committed to chemotherapy including platinum — Dan (clinical) [Ep 2 · 6:12](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=372)
- If preoperative AFP and beta-HCG levels are normal, there is increased comfort (though not 100%) about draining a cystic ovarian mass — Andrea Hayes-Jordan (clinical) [Ep 2 · 7:18](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=438)
- The salvage rate for patients with recurrent ovarian germ cell tumors is almost 100% because chemotherapy is very effective — Dan (clinical) [Ep 2 · 11:28](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=688)
- Ovarian torsion should be considered an urgent rather than emergent situation if the goal is ovarian preservation — Andrea Hayes-Jordan (clinical) [Ep 2 · 12:52](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=772)
- Many black-colored ovaries from torsion actually contain viable follicles and ovarian preservation should be the goal — Andrea Hayes-Jordan (clinical) [Ep 2 · 13:25](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=805)
- 76% of ovaries removed for torsion (that surgeons judged to be dead) contained normal ovarian tissue on pathology; only 11% were completely necrotic — Andrea Hayes-Jordan (clinical) [Ep 2 · 14:56](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=896)
- The ability to preserve ovarian function after torsion is related to patient age, with pediatric patients having more active follicles than older adults — Andrea Hayes-Jordan (clinical) [Ep 2 · 16:10](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=970)
- The current recommendation is detorsion without complete oophorectomy for ovarian torsion — Andrea Hayes-Jordan (guideline) [Ep 2 · 17:17](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1037)
- Ultrasound Doppler has only 50-60% sensitivity and specificity for diagnosing ovarian torsion — Andrea Hayes-Jordan (clinical) [Ep 2 · 20:10](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1210)
- Half of soft tissue sarcomas are rhabdomyosarcomas and half are non-rhabdomyosarcomas — Andrea Hayes-Jordan (epidemiological) [Ep 2 · 25:10](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1510)
- In rhabdomyosarcoma, prognosis varies by site, with abdominal/pelvic/retroperitoneal tumors having the worst survival and orbital tumors having the best — Andrea Hayes-Jordan (clinical) [Ep 2 · 25:27](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1527)
- The surgeon determines the clinical group in rhabdomyosarcoma based on surgical extent: group 1 is complete resection, group 2 is microscopic residual, group 3 is biopsy only — Andrea Hayes-Jordan (clinical) [Ep 2 · 26:27](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1587)
- Group 1 and 2 rhabdomyosarcoma patients have excellent prognosis; group 3 patients do more poorly — Andrea Hayes-Jordan (clinical) [Ep 2 · 26:39](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1599)
- Attempting to resect a large unresectable rhabdomyosarcoma with high morbidity will not improve the patient's outcome; this is a biologic determination, not a reflection of surgical skill — Andrea Hayes-Jordan (opinion) [Ep 2 · 27:01](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1621)
- A 4-centimeter mass in the forearm of a 5-year-old is relatively huge and should probably be biopsied rather than resected initially — Andrea Hayes-Jordan (clinical) [Ep 2 · 28:08](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1688)
- Sentinel lymph node biopsy is now required for all trunk and extremity rhabdomyosarcomas — Andrea Hayes-Jordan (guideline) [Ep 2 · 28:27](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1707)
- For rhabdomyosarcoma, completion lymph node dissection is not performed for positive sentinel nodes; patients receive radiation therapy instead — Andrea Hayes-Jordan (guideline) [Ep 2 · 28:43](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1723)
- 40-50% of biopsied lymph nodes are positive in rhabdomyosarcoma, and clinically negative nodes may also be positive — Andrea Hayes-Jordan (epidemiological) [Ep 2 · 29:48](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1788)
- For non-rhabdomyosarcoma soft tissue sarcomas, histologic grade is now critical and determines treatment — Andrea Hayes-Jordan (guideline) [Ep 2 · 30:03](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1803)
- Low-grade soft tissue sarcomas require only resection and observation; no chemotherapy or radiation unless margins are positive — Andrea Hayes-Jordan (guideline) [Ep 2 · 30:39](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1839)
- For unresectable soft tissue sarcomas, preoperative radiation therapy and chemotherapy are now recommended (previously only chemotherapy) — Andrea Hayes-Jordan (guideline) [Ep 2 · 31:01](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1861)
- Chemosensitive soft tissue sarcomas include synovial sarcoma and undifferentiated sarcoma — Andrea Hayes-Jordan (clinical) [Ep 2 · 31:19](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1879)
- Chemoinsensitive soft tissue sarcomas include alveolar soft part sarcoma, malignant epithelioid, and clear cell sarcoma; surgery and radiation are the primary treatments — Andrea Hayes-Jordan (clinical) [Ep 2 · 31:37](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1897)
- A 5-centimeter tumor in a child less than 3 years old is equivalent to a 3-centimeter tumor in a larger patient, so 3 centimeters should be the cutoff for excision in toddlers — Andrea Hayes-Jordan (clinical) [Ep 2 · 32:03](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1923)
- Low-grade non-rhabdomyosarcoma soft tissue sarcomas with negative margins can be cured with surgery alone and do not need chemotherapy — Andrea Hayes-Jordan (clinical) [Ep 2 · 32:34](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1954)
- Core biopsies are acceptable for soft tissue sarcomas if 3-4 good non-necrotic cores are obtained, confirmed by pathologist during the procedure — Andrea Hayes-Jordan (clinical) [Ep 2 · 33:19](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1999)
- Most spontaneous pneumothorax patients presenting to the emergency department have already sealed the pleural defect by the time of evaluation. — Todd Ponsky (clinical) [Ep 3 · 7:00](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=420)
- Incarceration rate of umbilical hernias in children is incredibly low. — Todd Ponsky (clinical) [Ep 3 · 26:10](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=1570)
- Approximately 80% of umbilical hernias in children resolve spontaneously. — Todd Ponsky (epidemiological) [Ep 3 · 26:40](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=1600)
- The penis is a highly vascular organ, and unless the dorsal artery is damaged, necrosis should not occur with proper technique. (clinical) [Ep 3 · 30:50](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=1850)
- Wrapping the base of the penis with saline-soaked gauze during monopolar electrocautery use can help prevent complications. (clinical) [Ep 3 · 29:50](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=1790)
- The Gips procedure takes approximately 3 to 5 minutes to perform. — Todd Ponsky (clinical) [Ep 3 · 36:40](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=2200)
- Airway instrumentation in a patient with reactive airway disease carries higher real risk than the negligible radiation from a targeted chest CT. — Todd Ponsky (opinion) [Ep 3 · 45:00](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=2700)

## Host summaries
Recaps by a host of what the experts said — not the host's own clinical position.
- Blood flow on ultrasound does not exclude torsion because the ovary may be twisted but not completely occluded at that moment in time — Todd Ponsky summarizing the discussion [Ep 1 · 22:35](https://qa.library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1355)
- Good blood flow on ultrasound does not rule out torsion because the ovary may be intermittently twisted — Todd Ponsky summarizing the discussion [Ep 2 · 21:50](https://qa.library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1310)
- In the Midwest Pediatric Surgery Consortium prospective trial of spontaneous pneumothorax, 83% of patients who failed initial aspiration eventually required VATS procedure. — Todd Ponsky summarizing the discussion [Ep 3 · 3:30](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=210)
- Among spontaneous pneumothorax patients sent home after successful aspiration, the recurrence rate was 44% with no episodes of tension pneumothorax. — Todd Ponsky summarizing the discussion [Ep 3 · 3:44](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=224)
- In a 12-center UK retrospective review, the recurrence rate of mature and immature ovarian teratomas and serous cystadenomas was 8%. — Todd Ponsky summarizing the discussion [Ep 3 · 10:40](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=640)
- After uncomplicated appendectomy, 84% of patients require no opioids on post-operative day one, 95% by day two, and 100% by day three. — Todd Ponsky summarizing the discussion [Ep 3 · 14:10](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=850)
- A Riley Hospital RCT found that ad-lib feeding after pyloromyotomy decreased time to goal feeds and length of stay compared to incremental feeding protocols, without increasing post-operative vomiting or readmissions. — Todd Ponsky summarizing the discussion [Ep 3 · 17:30](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=1050)
- Patients with serum chloride less than 100 on admission for pyloric stenosis took significantly longer to reach feeding goals. — Todd Ponsky summarizing the discussion [Ep 3 · 18:00](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=1080)
- Nationwide Children's Hospital reduced stoma takedown wound infection rate from 21% to 8% with a perioperative bundle, then to 2.2% by switching antibiotics from cefoxitin to unasyn. — Todd Ponsky summarizing the discussion [Ep 3 · 21:00](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=1260)
- Enterococcus was the predominant pathogen in stoma takedown infections, and unasyn provides better enterococcal coverage than cefoxitin. — Todd Ponsky summarizing the discussion [Ep 3 · 22:20](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=1340)
- Changing gloves and instruments when performing fascial and skin closures during stoma takedown is believed to be the most impactful element of the infection-reduction bundle. — Todd Ponsky summarizing the discussion [Ep 3 · 21:40](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=1300)
- Multi-state cohort study showed umbilical hernia repair before age 4 doubles both recurrence rate and readmission rate. — Todd Ponsky summarizing the discussion [Ep 3 · 24:40](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=1480)
- A 1960s study of African-American children found that very large umbilical hernia defects had lower spontaneous closure rates than smaller defects. — Todd Ponsky summarizing the discussion [Ep 3 · 25:40](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=1540)
- In a Journal of Crohn's and Colitis multicenter study, appendectomy in patients with refractory ulcerative colitis resulted in sustained symptomatic improvement in 30%, pathologic improvement in 50%, and complete endoscopic remission in 17%. — Todd Ponsky summarizing the discussion [Ep 3 · 28:20](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=1700)
- In a Pediatric Surgery International retrospective of 24 penile necrosis cases after circumcision, monopolar electrocautery use was identified as the primary predictive factor. — Todd Ponsky summarizing the discussion [Ep 3 · 30:00](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=1800)
- Other predictive factors for penile necrosis after circumcision include post-circumcision infection, compartment syndrome, local anesthetic agent use, and methemoglobinemia. — Todd Ponsky summarizing the discussion [Ep 3 · 30:20](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=1820)
- The Gips procedure for pilonidal disease involves coring out pits with a trephine, extracting granulation tissue and hair, curettage, and flushing, with wounds left open and unpacked. — Todd Ponsky summarizing the discussion [Ep 3 · 35:50](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=2150)
- Volumetric chest CT for suspected airway foreign body has nearly 100% sensitivity and can detect radiolucent foreign bodies. — Todd Ponsky summarizing the discussion [Ep 3 · 40:50](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=2450)
- In a 133-patient series using CT triage for suspected airway foreign bodies, CT excluded foreign body in 30% of patients, avoiding unnecessary bronchoscopy. — Todd Ponsky summarizing the discussion [Ep 3 · 43:20](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=2600)
- When CT showed a foreign body, bronchoscopy confirmed findings in 94% of cases, compared to 61% yield with bronchoscopy alone without CT. — Todd Ponsky summarizing the discussion [Ep 3 · 43:40](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=2620)
- Modern pediatric CT scans deliver radiation equivalent to approximately 1 to 10 millisieverts, comparable to natural background radiation exposure over one year. — Todd Ponsky summarizing the discussion [Ep 3 · 42:20](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=2540)
- Repeat contrast enema after initial intussusception reduction failure that reached the cecum succeeds in 50% to 64% of cases. — Todd Ponsky summarizing the discussion [Ep 3 · 47:00](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=2820)
- The ATOMIC data from eight children's hospitals showed that pediatric trauma patients do better with earlier blood transfusion after only one crystalloid bolus, rather than the traditional two-bolus approach. — Todd Ponsky summarizing the discussion [Ep 3 · 49:10](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=2950)
- In pediatric trauma, total transfusion of 40 cc/kg of blood or 4 units is a strong predictor that non-operative management will fail and the patient should go to the operating room. — Todd Ponsky summarizing the discussion [Ep 3 · 50:20](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=3020)
- For stable pediatric solid organ injury patients who never require blood transfusion, hospital discharge can occur as early as the next day. — Todd Ponsky summarizing the discussion [Ep 3 · 51:20](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=3080)
- Kansas City study of 622 central venous catheters showed that obtaining chest radiographs only for symptomatic patients is safe, with no critically ill patients and only one requiring intervention. — Todd Ponsky summarizing the discussion [Ep 3 · 52:40](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=3160)
- In an RCT of glycopyrrolate for esophageal anastomotic leaks after EA repair, the treatment group had 76% leak resolution vs 29% in placebo, with chest tube output of 124 mL vs 370 mL. — Todd Ponsky summarizing the discussion [Ep 3 · 54:10](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=3250)
- Glycopyrrolate treatment enabled oral feeding in 71% of esophageal anastomotic leak patients compared to only 14% in the placebo group. — Todd Ponsky summarizing the discussion [Ep 3 · 54:40](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=3280)
- Riley Hospital environmental study found cloth skull caps had the lowest permeability and lowest microbial shedding in the surgical field. — Todd Ponsky summarizing the discussion [Ep 3 · 56:20](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=3380)
- Disposable bouffant caps had the highest particle and microbial shedding onto the surgical field of all three headgear types tested. — Todd Ponsky summarizing the discussion [Ep 3 · 56:40](https://qa.library.globalcastmd.com/watch/what-s-new-in-pediatric-surgery-2020-full-show-3217?t=3400)

---
Educational content from recorded physician discussions — not medical advice. Cite the canonical URL or the ?t= deep link. Policy: https://qa.library.globalcastmd.com/ai