They found that children in the high compliance group had a statistically significant decrease in rates of superficial surgical site infection when compared to children in the low compliance group, showing that standardization of perioperative care may decrease morbidity and improve outcomes in colorectal surgery.
So it seems like both of these options have their pros and cons with the intercostal nerve carablation group having a decreased total opioid use and decreased length of stay in the hospital, but increased operating room times and increased total cost.
So it seems like both of these options have their pros and cons with the intercostal nerve carablation group having a decreased total opioid use and decreased length of stay in the hospital, but increased operating room times and increased total cost.
So it seems like both of these options have their pros and cons with the intercostal nerve co ablation group having a decreased total opioid use and decreased length of stay in the hospital, but increased operating room times and increased total cost.
So it seems like both of these options have their pros and cons with the intercostal nerve carablation group having a decreased total opioid use and decreased length of stay in the hospital, but increased operating room times and increased total cost.
No models of transition care were identified, so it seems like more work is needed to ensure that these children with anorectal malformations and Hirschbung's disease continue to receive optimal care as they grow older.
host_summaryIn the Lascano et al. study, kids who received gabapentin had decreased postoperative opioid use.↗
▶Ep 32 · 2:11
host_summaryIn the Lascano et al. study, kids who received gabapentin had decreased postoperative length of stay.↗
▶Ep 32 · 2:11
host_summaryGabapentin is an anticonvulsant often used off-label as part of multimodal pain control after major surgery.↗
▶Ep 32 · 2:11
quotePain control after appendectomy for perforated appendicitis can be a huge problem in kids.↗
▶Ep 32 · 2:11
quoteCould Gabapentin help with pain control in these kids?↗
▶Ep 32 · 2:11
host_summaryLascano et al. performed a retrospective cohort study at Children's Hospital of LA looking at kids age 2 to 18 who underwent appendectomy for perforated appendicitis between 2014 and 2019.↗
Association of Exclusive Breast Milk Intake and Outcomes in Infants With Uncomplicated Gastroschisis: A National Cohort Study
▶Ep 35 · 0:00
quoteDoes exclusive breast milk intake affect outcomes and uncomplicated gastroschisis?↗
▶Ep 35 · 0:13
host_summaryMcMaster University team performed a retrospective review of infants born between 2014 and 2022 with uncomplicated gastroschisis examining feeding outcomes.↗
▶Ep 35 · 0:24
host_summaryNo significant differences were found between exclusive breast milk and formula groups in rates of necrotizing enterocolitis in infants with uncomplicated gastroschisis.↗
▶Ep 35 · 0:24
host_summaryInfants with exclusive breast milk intake and those with supplemental or exclusive formula intake had similar outcomes in uncomplicated gastroschisis.↗
▶Ep 35 · 0:24
host_summaryNo significant differences were found between exclusive breast milk and formula groups in time to reach full enteral feeds in infants with uncomplicated gastroschisis.↗
▶Ep 35 · 0:24
host_summaryNo significant differences were found between exclusive breast milk and formula groups in duration of parenteral nutrition in infants with uncomplicated gastroschisis.↗
▶Ep 35 · 0:24
host_summaryNo significant differences were found between exclusive breast milk and formula groups in length of hospital stay in infants with uncomplicated gastroschisis.↗
▶Ep 35 · 0:44
host_summaryFormula intake versus exclusive breast milk intake does not appear to affect outcomes in uncomplicated gastroschisis.↗
▶Ep 35 · 0:52
quoteDoes this information change your practice at all?↗
Use of a new vertical traction device for early traction-assisted staged closure of congenital abdominal wall defects: a prospective series of 16 patients
▶Ep 38 · 0:14
host_summaryZiegler et al. performed a prospective study in 10 patients with giant omphalocele and 6 with complicated gastroschisis evaluating a vertical traction device.↗
▶Ep 38 · 0:24
host_summaryThe study utilized Fascia Tenses Pediatric, a traction-assisted abdominal wall closure device.↗
▶Ep 38 · 0:29
host_summaryComplete fascial closure was achieved after a median time of 7 days in children with giant omphalocele.↗
▶Ep 38 · 0:36
host_summaryComplete fascial closure was achieved after a median time of 5 days in children with complicated gastroschisis.↗
▶Ep 38 · 0:39
host_summaryNo patients developed abdominal compartment syndrome in the study.↗
▶Ep 38 · 0:39
host_summaryNo ventral hernias occurred after a median follow-up of 12 months.↗
▶Ep 38 · 0:46
host_summaryFascia Tenses Pediatric helps facilitate early fascial closure in patients with congenital abdominal wall defects.↗
Management of Gastroschisis: Timing of Delivery, Antibiotic Usage, and Closure Considerations
▶Ep 40 · 0:00
quoteWhat is the optimal initial management of an infant with gastroschisis?↗
▶Ep 40 · 0:10
host_summaryThe ABSA Outcomes and Evidence-based Practice Committee performed a systematic review on optimal initial management of gastroschisis.↗
▶Ep 40 · 0:17
host_summaryDelivery after 37 weeks is optimal for infants with gastroschisis.↗
▶Ep 40 · 0:21
host_summaryProphylactic antibiotics covering skin flora are adequate to reduce infection risk until closure in gastroschisis.↗
▶Ep 40 · 0:27
host_summarySutureless repair for gastroschisis is safe and effective.↗
▶Ep 40 · 0:27
host_summaryStudies support primary fascial repair for gastroschisis as long as hemodynamics and abdominal domain permit.↗
▶Ep 40 · 0:37
host_summarySutureless repair does not delay feeding or increase length of stay in gastroschisis patients.↗
▶Ep 40 · 0:41
host_summaryThere is a need for high quality randomized controlled trials to help provide evidence-based care for infants with gastroschisis.↗
▶Ep 40 · 0:50
quoteDoes this information change your practice at all?↗
Quick Literature Updates Episode 16
▶Ep 41 · 2:08
host_summaryThe McMaster University team performed a retrospective review of infants born between 2014 and 2022 with uncomplicated gastroschisis.↗
▶Ep 41 · 2:17
host_summaryInfants with uncomplicated gastroschisis who received exclusive breast milk had similar outcomes to those with supplemental or exclusive formula intake.↗
▶Ep 41 · 2:17
host_summaryIn uncomplicated gastroschisis, there were no significant differences between exclusive breast milk and formula groups in time to reach full enteral feeds, duration of parenteral nutrition, rates of necrotizing enterocolitis, and length of hospital stay.↗
▶Ep 41 · 2:38
quoteSo it seems like formula intake versus exclusive breast milk intake does not really affect outcomes in uncomplicated gastroschisis.↗
Quick Literature Updates Episode 20
▶Ep 43 · 1:58
host_summaryZiegler et al. prospective study included 10 patients with giant omphalocele and 6 with complicated gastroschisis using a traction-assisted abdominal wall closure device (Fascia Tense Pediatric).↗
▶Ep 43 · 1:58
epidemiologicalZiegler et al. prospective study included 10 patients with giant omphalocele and 6 with complicated gastroschisis using a traction-assisted abdominal wall closure device (Fascia Tense Pediatric).↗
▶Ep 43 · 2:13
clinicalComplete fascial closure was achieved after a median of 5 days in children with complicated gastroschisis using the Fascia Tense Pediatric device.↗
▶Ep 43 · 2:13
host_summaryComplete fascial closure was achieved after a median of 7 days in children with giant omphalocele using the Fascia Tense Pediatric device.↗
▶Ep 43 · 2:13
clinicalComplete fascial closure was achieved after a median of 7 days in children with giant omphalocele using the Fascia Tense Pediatric device.↗
▶Ep 43 · 2:13
host_summaryComplete fascial closure was achieved after a median of 5 days in children with complicated gastroschisis using the Fascia Tense Pediatric device.↗
▶Ep 43 · 2:23
host_summaryNo ventral hernias occurred after a median follow-up of 12 months in patients who underwent traction-assisted closure with Fascia Tense Pediatric.↗
▶Ep 43 · 2:23
host_summaryNo patients developed abdominal compartment syndrome after traction-assisted closure with Fascia Tense Pediatric.↗
▶Ep 43 · 2:23
clinicalNo patients developed abdominal compartment syndrome after traction-assisted closure with Fascia Tense Pediatric.↗
▶Ep 43 · 2:23
clinicalNo ventral hernias occurred after a median follow-up of 12 months in patients who underwent traction-assisted closure with Fascia Tense Pediatric.↗
▶Ep 43 · 2:29
quoteSo it seems like fascia tense pediatric helps facilitate early fascial closure in these patients.↗
▶Ep 43 · 2:29
quoteSo it seems like fascia tense pediatric helps facilitate early fascial closure in these patients.↗
Quick Literature Updates Ep 22
▶Ep 44 · 2:11
host_summaryThe APSA Outcomes and Evidence-based Practice Committee systematic review by Slidell et al. found that delivery after 37 weeks is optimal for gastroschisis.↗
▶Ep 44 · 2:21
host_summaryFor gastroschisis, prophylactic antibiotics covering skin flora are adequate to reduce infection risk until closure.↗
▶Ep 44 · 2:28
host_summarySutureless repair for gastroschisis is safe, effective, and does not delay feeding or increase length of stay.↗
▶Ep 44 · 2:28
host_summaryStudies support primary fascial repair for gastroschisis as long as hemodynamics and abdominal domain permit.↗
▶Ep 44 · 2:42
host_summaryThe APSA systematic review concluded that there is a need for high quality randomized controlled trials to help provide evidence-based care for gastroschisis infants.↗
▶Ep 44 · 2:51
quoteDoes this information change your practice at all?↗
host_summaryThoracic epidural and intercostal nerve cryoablation are two options for pain control in patients undergoing a Nuss procedure for pectus excavatum.↗
host_summaryDr. Tsai and his team from Penn State conducted a retrospective chart review of kids who underwent Nuss procedure between 2002 and 2020, comparing outcomes and costs of intercostal nerve cryoablation and epidural.↗
▶Ep 48 · 2:56
host_summaryThe intercostal nerve cryoablation group had lower rates of PCA use compared to thoracic epidural.↗
▶Ep 48 · 2:56
host_summaryThe intercostal nerve cryoablation group had lower total morphine milligram equivalent requirement compared to thoracic epidural.↗
▶Ep 48 · 2:56
host_summaryThe intercostal nerve cryoablation group had shorter length of stay in the hospital compared to thoracic epidural.↗
▶Ep 48 · 3:07
host_summaryThe intercostal nerve cryoablation group had higher total hospitalization cost compared to thoracic epidural.↗
▶Ep 48 · 3:07
host_summaryThe intercostal nerve cryoablation group had longer operative times compared to thoracic epidural.↗
▶Ep 48 · 3:14
quoteSo it seems like both of these options have their pros and cons with the intercostal nerve carablation group having a decreased total opioid use and decreased length of stay in the hospital, but increased operating room times and increased total cost.↗
▶Ep 48 · 3:14
host_summaryBoth intercostal nerve cryoablation and thoracic epidural have pros and cons, with cryoablation showing decreased total opioid use and decreased length of stay but increased operating room times and increased total cost.↗
Transition From Pediatric to Adult Healthcare for Colorectal Conditions: A Systematic Review
▶Ep 52 · 0:00
clinicalPatients with anorectal malformations and Hirschsprung's disease need transfer from pediatric to adult providers to manage their colorectal conditions↗
▶Ep 52 · 0:22
epidemiologicalA team from Melbourne, Australia performed a systematic review and meta-analysis on transition of care for these conditions↗
▶Ep 52 · 0:28
epidemiologicalEight studies were found on the topic of transition care for anorectal malformations and Hirschsprung's disease↗
▶Ep 52 · 0:30
epidemiologicalLittle evidence exists that transfer from pediatric to adult care is happening in a coordinated or timely fashion↗
▶Ep 52 · 0:30
guidelineStudies agreed that transitional care should start early in adolescence↗
▶Ep 52 · 0:40
epidemiologicalNo models of transition care were identified in the systematic review↗
▶Ep 52 · 0:43
opinionMore work is needed to ensure children with anorectal malformations and Hirschsprung's disease continue to receive optimal care as they grow older↗
▶Ep 52 · 0:53
quoteDoes this information change your practice at all?↗
Quick Literature Updates Episode 18
▶Ep 56 · 2:15
host_summaryA systematic review found 8 studies examining transition from pediatric to adult healthcare for colorectal conditions.↗
▶Ep 56 · 2:24
host_summaryStudies found little evidence that transfer from pediatric to adult care for colorectal conditions is happening in a coordinated or timely fashion.↗
▶Ep 56 · 2:24
host_summaryStudies on transition care for colorectal conditions agreed that transitional care should start early in adolescence.↗
▶Ep 56 · 2:33
host_summaryNo models of transition care were identified for children with anorectal malformations and Hirschsprung disease transitioning to adult care.↗
▶Ep 56 · 2:33
quoteNo models of transition care were identified, so it seems like more work is needed to ensure that these children with anorectal malformations and Hirschbung's disease continue to receive optimal care as they grow older.↗
Quick Literature Updates Ep 23
▶Ep 64 · 2:01
host_summaryA working group of pediatric surgeons from Europe created 19 case scenarios with unexpected events to validate the Clavien-Madadi classification.↗
▶Ep 64 · 2:10
host_summarySurgeons within the European Reference Network of inherited and congenital anomalies rated scenarios based on the Clavien-Dindo classification or the Clavien-Madadi classification.↗
▶Ep 64 · 2:23
host_summaryA total of 59 surgeons completed the questionnaire.↗
▶Ep 64 · 2:27
host_summaryThe Clavien-Madadi classification showed significantly better agreement rates and was less frequently considered inaccurate compared to Clavien-Dindo.↗
▶Ep 64 · 2:27
quoteThe Clavian-Matti classification showed significantly better agreement rates and was less frequently considered inaccurate.↗
▶Ep 64 · 2:34
host_summaryMore pediatric surgeons preferred using the Clavien-Madadi classification.↗
▶Ep 64 · 2:38
host_summaryThe Clavien-Madadi classification is both an accurate and useful tool in grading unexpected events in pediatric surgery.↗
▶Ep 64 · 2:38
quoteSo it seems like the Clavian-Matti classification is both an accurate and useful tool in grading unexpected events in pediatric surgery.↗
quoteCould Gabapentin help with pain control in these kids?↗
▶Ep 10 · 2:11
quotePain control after appendectomy for perforated appendicitis can be a huge problem in kids.↗
▶Ep 10 · 2:11
host_summaryIn the Lascano et al. study, kids who received gabapentin had decreased postoperative length of stay.↗
▶Ep 10 · 2:11
host_summaryIn the Lascano et al. study, kids who received gabapentin had decreased postoperative opioid use.↗
▶Ep 10 · 2:11
host_summaryLascano et al. performed a retrospective cohort study at Children's Hospital of LA looking at kids age 2 to 18 who underwent appendectomy for perforated appendicitis between 2014 and 2019.↗
▶Ep 10 · 2:11
host_summaryGabapentin is an anticonvulsant often used off-label as part of multimodal pain control after major surgery.↗
Multi-Institutional Analysis of Choledocholithiasis in Pediatric vs Adult Patients
▶Ep 3 · 0:00
quoteCan a surgery first approach be used for the management of cholodocholithiasis in children?↗
▶Ep 3 · 0:11
epidemiologicalDantes et al. performed a multi-center retrospective review of pediatric and adult patients treated for choledocholithiasis between 2018 and 2024↗
▶Ep 3 · 0:22
epidemiological724 patients were included in the study↗
▶Ep 3 · 0:25
clinicalSurgery first approach with upfront laparoscopic cholecystectomy with intraoperative cholangiogram was performed in 201 pediatric patients and 169 adult patients↗
▶Ep 3 · 0:35
clinicalLaparoscopic common bile duct exploration was attempted in 84 children and 140 adults in the surgery first group↗
▶Ep 3 · 0:43
clinicalCommon bile duct exploration success was higher in pediatric than adult patients↗
▶Ep 3 · 0:43
clinicalComplication rates were similar between pediatric and adult patients in the surgery first approach↗
▶Ep 3 · 0:49
opinionA surgery first approach can be a safe and effective tool for managing choledocholithiasis in pediatric patients↗
Standardized perioperative care reduces colorectal surgical site infection in children
▶Ep 134 · 0:00
epidemiologicalSurgical site infections are a major cause of perioperative morbidity in children undergoing colorectal surgery↗
▶Ep 134 · 0:00
quoteSurgical site infections are a major cause of perioperative morbidity in children undergoing colorectal surgery.↗
▶Ep 134 · 0:20
clinicalThe Western Pediatric Surgery Research Consortium conducted a prospective cohort study on children undergoing colorectal surgery across 10 hospitals in the US↗
▶Ep 134 · 0:32
clinicalThe study utilized an 8-part perioperative care bundle↗
▶Ep 134 · 0:32
clinicalChildren were split into either a high or low compliance group based on adherence to the care bundle↗
▶Ep 134 · 0:41
clinicalChildren in the high compliance group had a statistically significant decrease in rates of superficial surgical site infection when compared to children in the low compliance group↗
▶Ep 134 · 0:41
quoteThey found that children in the high compliance group had a statistically significant decrease in rates of superficial surgical site infection when compared to children in the low compliance group, showing that standardization of perioperative care may decrease morbidity and improve outcomes in colorectal surgery.↗
▶Ep 134 · 0:41
opinionStandardization of perioperative care may decrease morbidity and improve outcomes in colorectal surgery↗
Quick Literature Updates Episode 14
▶Ep 149 · 2:30
host_summaryThoracic epidural and intercostal nerve cryoablation are two options for pain control in patients undergoing a Nuss procedure for pectus excavatum.↗
▶Ep 149 · 2:30
clinicalThoracic epidural and intercostal nerve cryoablation are two options for pain control in patients undergoing a Nuss procedure for pectus excavatum.↗
host_summaryDr. Tsai and his team from Penn State conducted a retrospective chart review of kids who underwent Nuss procedure between 2002 and 2020, comparing outcomes and costs of intercostal nerve cryoablation and epidural.↗
▶Ep 149 · 2:42
epidemiologicalDr. Tsai and his team from Penn State conducted a retrospective chart review of kids who underwent Nuss procedure between 2002 and 2020, comparing outcomes and costs of intercostal nerve cryoablation and epidural.↗
▶Ep 149 · 2:56
host_summaryThe intercostal nerve cryoablation group had shorter length of stay in the hospital compared to thoracic epidural.↗
▶Ep 149 · 2:56
clinicalThe intercostal nerve cryoablation group had shorter length of stay in the hospital compared to thoracic epidural.↗
▶Ep 149 · 2:56
clinicalThe intercostal nerve cryoablation group had lower total morphine milligram equivalent requirement compared to thoracic epidural.↗
▶Ep 149 · 2:56
clinicalThe intercostal nerve cryoablation group had lower rates of PCA use compared to thoracic epidural.↗
▶Ep 149 · 2:56
host_summaryThe intercostal nerve cryoablation group had lower total morphine milligram equivalent requirement compared to thoracic epidural.↗
▶Ep 149 · 2:56
host_summaryThe intercostal nerve cryoablation group had lower rates of PCA use compared to thoracic epidural.↗
▶Ep 149 · 3:07
host_summaryThe intercostal nerve cryoablation group had longer operative times compared to thoracic epidural.↗
▶Ep 149 · 3:07
clinicalThe intercostal nerve cryoablation group had longer operative times compared to thoracic epidural.↗
▶Ep 149 · 3:07
clinicalThe intercostal nerve cryoablation group had higher total hospitalization cost compared to thoracic epidural.↗
▶Ep 149 · 3:07
host_summaryThe intercostal nerve cryoablation group had higher total hospitalization cost compared to thoracic epidural.↗
▶Ep 149 · 3:14
host_summaryBoth intercostal nerve cryoablation and thoracic epidural have pros and cons, with cryoablation showing decreased total opioid use and decreased length of stay but increased operating room times and increased total cost.↗
▶Ep 149 · 3:14
quoteSo it seems like both of these options have their pros and cons with the intercostal nerve carablation group having a decreased total opioid use and decreased length of stay in the hospital, but increased operating room times and increased total cost.↗
▶Ep 149 · 3:14
opinionBoth intercostal nerve cryoablation and thoracic epidural have pros and cons, with cryoablation showing decreased total opioid use and decreased length of stay but increased operating room times and increased total cost.↗
▶Ep 149 · 3:14
quoteSo it seems like both of these options have their pros and cons with the intercostal nerve carablation group having a decreased total opioid use and decreased length of stay in the hospital, but increased operating room times and increased total cost.↗
Transition From Pediatric to Adult Healthcare for Colorectal Conditions: A Systematic Review
▶Ep 163 · 0:00
clinicalPatients with anorectal malformations and Hirschsprung's disease need transfer from pediatric to adult providers to manage their colorectal conditions↗
▶Ep 163 · 0:22
epidemiologicalA team from Melbourne, Australia performed a systematic review and meta-analysis on transition of care for these conditions↗
▶Ep 163 · 0:28
epidemiologicalEight studies were found on the topic of transition care for anorectal malformations and Hirschsprung's disease↗
▶Ep 163 · 0:30
epidemiologicalLittle evidence exists that transfer from pediatric to adult care is happening in a coordinated or timely fashion↗
▶Ep 163 · 0:30
guidelineStudies agreed that transitional care should start early in adolescence↗
▶Ep 163 · 0:40
epidemiologicalNo models of transition care were identified in the systematic review↗
▶Ep 163 · 0:43
opinionMore work is needed to ensure children with anorectal malformations and Hirschsprung's disease continue to receive optimal care as they grow older↗
▶Ep 163 · 0:53
quoteDoes this information change your practice at all?↗
Does Delayed Diagnosis of Hirschsprung Disease Impact Post-operative and Functional Outcomes? A Multi-Center Review From the Pediatric Colorectal and Pelvic Learning Consortium
▶Ep 165 · 0:00
quoteDoes delayed diagnosis of Hirschrung disease affect postoperative and functional outcomes?↗
▶Ep 165 · 0:12
clinicalThe Pediatric Colorectal and Pelvic Learning Consortium conducted a multi-center retrospective review from 2017 to 2023 examining the relationship between delayed diagnosis of Hirschsprung disease and postoperative/functional outcomes.↗
▶Ep 165 · 0:23
epidemiologicalThe study included 679 patients with Hirschsprung disease from 14 different sites.↗
▶Ep 165 · 0:29
clinicalIncreased age at diagnosis was associated with a greater likelihood of undergoing fecal diversion after initial pull-through procedure.↗
▶Ep 165 · 0:39
clinicalIncreased age at diagnosis was associated with an increased risk of constipation or incontinence requiring intervention postoperatively.↗
▶Ep 165 · 0:49
clinicalNo association was found between age at diagnosis and 30-day complication rate after initial pull-through.↗
▶Ep 165 · 0:49
clinicalNo association was found between age at diagnosis and need for pull-through revision.↗
▶Ep 165 · 0:58
clinicalDelayed diagnosis of Hirschsprung disease affects certain postoperative and functional outcomes in patients.↗
▶Ep 165 · 1:04
quoteDoes this information change your practice at all?↗
Quick Literature Updates Episode 17
▶Ep 172 · 2:05
host_summaryThe Pediatric Colorectal and Pelvic Learning Consortium conducted a multi-center retrospective review from 2017 to 2023 examining delayed diagnosis of Hirschsprung disease.↗
▶Ep 172 · 2:05
clinicalThe Pediatric Colorectal and Pelvic Learning Consortium conducted a multi-center retrospective review from 2017 to 2023 examining delayed diagnosis of Hirschsprung disease.↗
▶Ep 172 · 2:16
clinicalThe Hirschsprung study included 679 patients from 14 different sites.↗
▶Ep 172 · 2:16
host_summaryThe Hirschsprung study included 679 patients from 14 different sites.↗
▶Ep 172 · 2:22
host_summaryIncreased age at diagnosis of Hirschsprung disease was associated with a greater likelihood of undergoing fecal diversion after initial pull-through procedure.↗
▶Ep 172 · 2:22
clinicalIncreased age at diagnosis of Hirschsprung disease was associated with a greater likelihood of undergoing fecal diversion after initial pull-through procedure.↗
▶Ep 172 · 2:32
clinicalIncreasing age at diagnosis of Hirschsprung disease was associated with an increased risk of constipation or incontinence requiring intervention postoperatively.↗
▶Ep 172 · 2:32
host_summaryIncreasing age at diagnosis of Hirschsprung disease was associated with an increased risk of constipation or incontinence requiring intervention postoperatively.↗
▶Ep 172 · 2:42
host_summaryThe Hirschsprung study did not find an association between age at diagnosis and 30-day complication rate after initial pull-through.↗
▶Ep 172 · 2:42
host_summaryThe Hirschsprung study did not find an association between age at diagnosis and need for pull-through revision.↗
▶Ep 172 · 2:42
clinicalThe Hirschsprung study did not find an association between age at diagnosis and need for pull-through revision.↗
▶Ep 172 · 2:42
clinicalThe Hirschsprung study did not find an association between age at diagnosis and 30-day complication rate after initial pull-through.↗
▶Ep 172 · 2:51
quoteSo, it seems like delayed diagnosis of Hirschrung's disease does affect certain outcomes in these patients.↗
▶Ep 172 · 2:51
opinionDelayed diagnosis of Hirschsprung disease does affect certain outcomes in these patients.↗
▶Ep 172 · 2:51
opinionDelayed diagnosis of Hirschsprung disease does affect certain outcomes in these patients.↗
▶Ep 172 · 2:51
quoteSo, it seems like delayed diagnosis of Hirschrung's disease does affect certain outcomes in these patients.↗
Quick Literature Updates Episode 18
▶Ep 174 · 2:15
epidemiologicalA systematic review found 8 studies examining transition from pediatric to adult healthcare for colorectal conditions.↗
▶Ep 174 · 2:24
clinicalStudies found little evidence that transfer from pediatric to adult care for colorectal conditions is happening in a coordinated or timely fashion.↗
▶Ep 174 · 2:24
guidelineStudies on transition care for colorectal conditions agreed that transitional care should start early in adolescence.↗
▶Ep 174 · 2:33
quoteNo models of transition care were identified, so it seems like more work is needed to ensure that these children with anorectal malformations and Hirschbung's disease continue to receive optimal care as they grow older.↗
▶Ep 174 · 2:33
clinicalNo models of transition care were identified for children with anorectal malformations and Hirschsprung disease transitioning to adult care.↗
Quick Literature Updates Ep 22
▶Ep 184 · 2:11
host_summaryThe APSA Outcomes and Evidence-based Practice Committee systematic review by Slidell et al. found that delivery after 37 weeks is optimal for gastroschisis.↗
▶Ep 184 · 2:21
host_summaryFor gastroschisis, prophylactic antibiotics covering skin flora are adequate to reduce infection risk until closure.↗
▶Ep 184 · 2:28
host_summarySutureless repair for gastroschisis is safe, effective, and does not delay feeding or increase length of stay.↗
▶Ep 184 · 2:28
host_summaryStudies support primary fascial repair for gastroschisis as long as hemodynamics and abdominal domain permit.↗
▶Ep 184 · 2:42
host_summaryThe APSA systematic review concluded that there is a need for high quality randomized controlled trials to help provide evidence-based care for gastroschisis infants.↗
▶Ep 184 · 2:51
quoteDoes this information change your practice at all?↗
Quick Literature Updates Ep 23
▶Ep 185 · 2:01
clinicalA working group of pediatric surgeons from Europe created 19 case scenarios with unexpected events to validate the Clavien-Madadi classification.↗
▶Ep 185 · 2:10
clinicalSurgeons within the European Reference Network of inherited and congenital anomalies rated scenarios based on the Clavien-Dindo classification or the Clavien-Madadi classification.↗
▶Ep 185 · 2:23
epidemiologicalA total of 59 surgeons completed the questionnaire.↗
▶Ep 185 · 2:27
clinicalThe Clavien-Madadi classification showed significantly better agreement rates and was less frequently considered inaccurate compared to Clavien-Dindo.↗
▶Ep 185 · 2:27
quoteThe Clavian-Matti classification showed significantly better agreement rates and was less frequently considered inaccurate.↗
▶Ep 185 · 2:34
clinicalMore pediatric surgeons preferred using the Clavien-Madadi classification.↗
▶Ep 185 · 2:38
quoteSo it seems like the Clavian-Matti classification is both an accurate and useful tool in grading unexpected events in pediatric surgery.↗
▶Ep 185 · 2:38
opinionThe Clavien-Madadi classification is both an accurate and useful tool in grading unexpected events in pediatric surgery.↗
Quick Literature Updates Ep 26
▶Ep 188 · 2:16
clinicalZoo et al. used the PHIS database and performed a multi-institutional cohort study of all ARM patients between 2016 and 2022↗
▶Ep 188 · 2:25
epidemiologicalIn ARM patients, the rates of actual diagnoses across all hospital encounters were 45.4% vertebral spinal, 77.4% cardiac, 10.2% TEF, 39.9% renal and 15.7% limb↗
▶Ep 188 · 2:40
epidemiological25.8% of female patients with anorectal malformations had a congenital gynecologic malformation diagnosed↗
▶Ep 188 · 2:45
clinicalThe most common anomalies associated with ARMs are cardiac, vertebrospinal, renal, and gynecologic↗
▶Ep 188 · 2:45
quoteSo it seems like the most common anomalies associated with ARMs are cardiac, vertebrospinal, renal, and gynecologic.↗
▶Ep 188 · 2:53
opinionThe authors of the ARM screening study suggest changing the VACTERL acronym to VACTERL-GS↗
host_summaryZiegler et al. prospective study included 10 patients with giant omphalocele and 6 with complicated gastroschisis using a traction-assisted abdominal wall closure device (Fascia Tense Pediatric).↗
▶Ep 12 · 2:13
host_summaryComplete fascial closure was achieved after a median of 7 days in children with giant omphalocele using the Fascia Tense Pediatric device.↗
▶Ep 12 · 2:13
host_summaryComplete fascial closure was achieved after a median of 5 days in children with complicated gastroschisis using the Fascia Tense Pediatric device.↗
▶Ep 12 · 2:23
host_summaryNo ventral hernias occurred after a median follow-up of 12 months in patients who underwent traction-assisted closure with Fascia Tense Pediatric.↗
▶Ep 12 · 2:23
host_summaryNo patients developed abdominal compartment syndrome after traction-assisted closure with Fascia Tense Pediatric.↗
▶Ep 12 · 2:29
quoteSo it seems like fascia tense pediatric helps facilitate early fascial closure in these patients.↗
host_summaryA systematic review found 8 studies examining transition from pediatric to adult healthcare for colorectal conditions.↗
▶Ep 32 · 2:15
epidemiologicalA systematic review found 8 studies examining transition from pediatric to adult healthcare for colorectal conditions.↗
▶Ep 32 · 2:24
host_summaryStudies on transition care for colorectal conditions agreed that transitional care should start early in adolescence.↗
▶Ep 32 · 2:24
guidelineStudies on transition care for colorectal conditions agreed that transitional care should start early in adolescence.↗
▶Ep 32 · 2:24
host_summaryStudies found little evidence that transfer from pediatric to adult care for colorectal conditions is happening in a coordinated or timely fashion.↗
▶Ep 32 · 2:24
clinicalStudies found little evidence that transfer from pediatric to adult care for colorectal conditions is happening in a coordinated or timely fashion.↗
▶Ep 32 · 2:33
clinicalNo models of transition care were identified for children with anorectal malformations and Hirschsprung disease transitioning to adult care.↗
▶Ep 32 · 2:33
quoteNo models of transition care were identified, so it seems like more work is needed to ensure that these children with anorectal malformations and Hirschbung's disease continue to receive optimal care as they grow older.↗
▶Ep 32 · 2:33
host_summaryNo models of transition care were identified for children with anorectal malformations and Hirschsprung disease transitioning to adult care.↗
▶Ep 32 · 2:33
quoteNo models of transition care were identified, so it seems like more work is needed to ensure that these children with anorectal malformations and Hirschbung's disease continue to receive optimal care as they grow older.↗
Does Delayed Diagnosis of Hirschsprung Disease Impact Post-operative and Functional Outcomes? A Multi-Center Review From the Pediatric Colorectal and Pelvic Learning Consortium
▶Ep 6 · 0:00
quoteDoes delayed diagnosis of Hirschrung disease affect postoperative and functional outcomes?↗
▶Ep 6 · 0:12
clinicalThe Pediatric Colorectal and Pelvic Learning Consortium conducted a multi-center retrospective review from 2017 to 2023 examining the relationship between delayed diagnosis of Hirschsprung disease and postoperative/functional outcomes.↗
▶Ep 6 · 0:23
epidemiologicalThe study included 679 patients with Hirschsprung disease from 14 different sites.↗
▶Ep 6 · 0:29
clinicalIncreased age at diagnosis was associated with a greater likelihood of undergoing fecal diversion after initial pull-through procedure.↗
▶Ep 6 · 0:39
clinicalIncreased age at diagnosis was associated with an increased risk of constipation or incontinence requiring intervention postoperatively.↗
▶Ep 6 · 0:49
clinicalNo association was found between age at diagnosis and 30-day complication rate after initial pull-through.↗
▶Ep 6 · 0:49
clinicalNo association was found between age at diagnosis and need for pull-through revision.↗
▶Ep 6 · 0:58
clinicalDelayed diagnosis of Hirschsprung disease affects certain postoperative and functional outcomes in patients.↗
▶Ep 6 · 1:04
quoteDoes this information change your practice at all?↗
host_summaryThe Pediatric Colorectal and Pelvic Learning Consortium conducted a multi-center retrospective review from 2017 to 2023 examining delayed diagnosis of Hirschsprung disease.↗
▶Ep 19 · 2:16
host_summaryThe Hirschsprung study included 679 patients from 14 different sites.↗
▶Ep 19 · 2:22
host_summaryIncreased age at diagnosis of Hirschsprung disease was associated with a greater likelihood of undergoing fecal diversion after initial pull-through procedure.↗
▶Ep 19 · 2:32
host_summaryIncreasing age at diagnosis of Hirschsprung disease was associated with an increased risk of constipation or incontinence requiring intervention postoperatively.↗
▶Ep 19 · 2:42
host_summaryThe Hirschsprung study did not find an association between age at diagnosis and need for pull-through revision.↗
▶Ep 19 · 2:42
host_summaryThe Hirschsprung study did not find an association between age at diagnosis and 30-day complication rate after initial pull-through.↗
▶Ep 19 · 2:51
opinionDelayed diagnosis of Hirschsprung disease does affect certain outcomes in these patients.↗
▶Ep 19 · 2:51
quoteSo, it seems like delayed diagnosis of Hirschrung's disease does affect certain outcomes in these patients.↗
Quick Literature Updates Ep 27
▶Ep 26 · 2:05
host_summaryMina et al. performed a retrospective review of all patients who underwent conservative management of modified Bell stage 2A or greater necrotizing enterocolitis at a single institution from 2011 to 2022.↗
▶Ep 26 · 2:20
host_summary126 patients underwent conservative management of necrotizing enterocolitis, and 24 of those patients eventually underwent surgery for a post-NEC stricture.↗
▶Ep 26 · 2:29
host_summaryPrimary resection and anastomosis was performed in all cases of post-NEC stricture requiring surgery.↗
▶Ep 26 · 2:33
host_summaryPost-NEC strictures are a common occurrence after conservative management of necrotizing enterocolitis.↗
▶Ep 26 · 2:33
quoteSo it seems like post-neck strictures are a common occurrence after conservative management of neck.↗
host_summaryIn the Lascano et al. study, kids who received gabapentin had decreased postoperative opioid use.↗
▶Ep 52 · 2:11
host_summaryGabapentin is an anticonvulsant often used off-label as part of multimodal pain control after major surgery.↗
▶Ep 52 · 2:11
host_summaryIn the Lascano et al. study, kids who received gabapentin had decreased postoperative length of stay.↗
▶Ep 52 · 2:11
host_summaryLascano et al. performed a retrospective cohort study at Children's Hospital of LA looking at kids age 2 to 18 who underwent appendectomy for perforated appendicitis between 2014 and 2019.↗
▶Ep 52 · 2:11
quoteCould Gabapentin help with pain control in these kids?↗
▶Ep 52 · 2:11
quotePain control after appendectomy for perforated appendicitis can be a huge problem in kids.↗
Association of Exclusive Breast Milk Intake and Outcomes in Infants With Uncomplicated Gastroschisis: A National Cohort Study
▶Ep 55 · 0:00
quoteDoes exclusive breast milk intake affect outcomes and uncomplicated gastroschisis?↗
▶Ep 55 · 0:13
host_summaryMcMaster University team performed a retrospective review of infants born between 2014 and 2022 with uncomplicated gastroschisis examining feeding outcomes.↗
▶Ep 55 · 0:24
host_summaryNo significant differences were found between exclusive breast milk and formula groups in length of hospital stay in infants with uncomplicated gastroschisis.↗
▶Ep 55 · 0:24
host_summaryNo significant differences were found between exclusive breast milk and formula groups in rates of necrotizing enterocolitis in infants with uncomplicated gastroschisis.↗
▶Ep 55 · 0:24
host_summaryNo significant differences were found between exclusive breast milk and formula groups in duration of parenteral nutrition in infants with uncomplicated gastroschisis.↗
▶Ep 55 · 0:24
host_summaryNo significant differences were found between exclusive breast milk and formula groups in time to reach full enteral feeds in infants with uncomplicated gastroschisis.↗
▶Ep 55 · 0:24
host_summaryInfants with exclusive breast milk intake and those with supplemental or exclusive formula intake had similar outcomes in uncomplicated gastroschisis.↗
▶Ep 55 · 0:44
host_summaryFormula intake versus exclusive breast milk intake does not appear to affect outcomes in uncomplicated gastroschisis.↗
▶Ep 55 · 0:52
quoteDoes this information change your practice at all?↗
Use of a new vertical traction device for early traction-assisted staged closure of congenital abdominal wall defects: a prospective series of 16 patients
▶Ep 58 · 0:14
host_summaryZiegler et al. performed a prospective study in 10 patients with giant omphalocele and 6 with complicated gastroschisis evaluating a vertical traction device.↗
▶Ep 58 · 0:24
host_summaryThe study utilized Fascia Tenses Pediatric, a traction-assisted abdominal wall closure device.↗
▶Ep 58 · 0:29
host_summaryComplete fascial closure was achieved after a median time of 7 days in children with giant omphalocele.↗
▶Ep 58 · 0:36
host_summaryComplete fascial closure was achieved after a median time of 5 days in children with complicated gastroschisis.↗
▶Ep 58 · 0:39
host_summaryNo patients developed abdominal compartment syndrome in the study.↗
▶Ep 58 · 0:39
host_summaryNo ventral hernias occurred after a median follow-up of 12 months.↗
▶Ep 58 · 0:46
host_summaryFascia Tenses Pediatric helps facilitate early fascial closure in patients with congenital abdominal wall defects.↗
Management of Gastroschisis: Timing of Delivery, Antibiotic Usage, and Closure Considerations
▶Ep 60 · 0:00
quoteWhat is the optimal initial management of an infant with gastroschisis?↗
▶Ep 60 · 0:10
host_summaryThe ABSA Outcomes and Evidence-based Practice Committee performed a systematic review on optimal initial management of gastroschisis.↗
▶Ep 60 · 0:17
host_summaryDelivery after 37 weeks is optimal for infants with gastroschisis.↗
▶Ep 60 · 0:21
host_summaryProphylactic antibiotics covering skin flora are adequate to reduce infection risk until closure in gastroschisis.↗
▶Ep 60 · 0:27
host_summaryStudies support primary fascial repair for gastroschisis as long as hemodynamics and abdominal domain permit.↗
▶Ep 60 · 0:27
host_summarySutureless repair for gastroschisis is safe and effective.↗
▶Ep 60 · 0:37
host_summarySutureless repair does not delay feeding or increase length of stay in gastroschisis patients.↗
▶Ep 60 · 0:41
host_summaryThere is a need for high quality randomized controlled trials to help provide evidence-based care for infants with gastroschisis.↗
▶Ep 60 · 0:50
quoteDoes this information change your practice at all?↗
Quick Literature Updates Episode 16
▶Ep 61 · 2:08
host_summaryThe McMaster University team performed a retrospective review of infants born between 2014 and 2022 with uncomplicated gastroschisis.↗
▶Ep 61 · 2:17
host_summaryIn uncomplicated gastroschisis, there were no significant differences between exclusive breast milk and formula groups in time to reach full enteral feeds, duration of parenteral nutrition, rates of necrotizing enterocolitis, and length of hospital stay.↗
▶Ep 61 · 2:17
host_summaryInfants with uncomplicated gastroschisis who received exclusive breast milk had similar outcomes to those with supplemental or exclusive formula intake.↗
▶Ep 61 · 2:38
quoteSo it seems like formula intake versus exclusive breast milk intake does not really affect outcomes in uncomplicated gastroschisis.↗
Conservative Management of Necrotizing Enterocolitis in Newborns: Incidence and Management of Intestinal Strictures
▶Ep 62 · 0:00
quoteHow big of a problem are intestinal strictures after conservative management of necrotizing enterocolitis?↗
▶Ep 62 · 0:13
host_summaryA retrospective review by Men et al examined all patients who underwent conservative management of modified Bell stage 2A or greater NEC at a single institution from 2011 to 2022.↗
▶Ep 62 · 0:27
host_summary126 patients underwent conservative management of NEC in the study period.↗
▶Ep 62 · 0:27
host_summary24 of 126 patients (19%) who underwent conservative management of NEC eventually required surgery for a post-NEC stricture.↗
▶Ep 62 · 0:36
host_summaryPrimary resection and anastomosis was performed in all cases of post-NEC stricture requiring surgery.↗
▶Ep 62 · 0:40
host_summaryPost-NEC strictures are a common occurrence after conservative management of NEC.↗
▶Ep 62 · 0:40
quoteSo, it seems like post neck strictures are a common occurrence after conservative management of neck.↗
▶Ep 62 · 0:46
quoteDoes this information change your practice at all?↗
Remote Ischemic Conditioning (RIC) Decreases the Incidence and Severity of Necrotizing Enterocolitis (NEC) - Validation in a Large Animal Model
▶Ep 64 · 0:00
host_summaryRIC has been shown to decrease rates of necrotizing enterocolitis in a rat model.↗
▶Ep 64 · 0:16
host_summaryGadal used an established piglet NEC model to test RIC.↗
▶Ep 64 · 0:20
host_summaryPiglets were randomly assigned to receive RIC or serve as controls.↗
▶Ep 64 · 0:24
host_summaryRIC was initiated at 24 hours of life and consisted of 4 cycles of 4 minutes of arterial occlusion followed by reperfusion.↗
▶Ep 64 · 0:31
host_summaryCycles were repeated every 24 hours in the low frequency group and every 12 hours in the high frequency group.↗
▶Ep 64 · 0:37
host_summary38 piglets were randomized into the control group, 26 into the low frequency group, and 22 into the high frequency group.↗
▶Ep 64 · 0:45
host_summaryHigh frequency RIC significantly reduced the incidence of NEC when compared to controls.↗
▶Ep 64 · 0:50
host_summaryLow frequency RIC did not significantly reduce the incidence of NEC.↗
▶Ep 64 · 0:53
quoteSo it seems like high frequency Rick protects against neck in a piglet model.↗
▶Ep 64 · 0:53
host_summaryHigh frequency RIC protects against NEC in a piglet model.↗
Quick Literature Updates Ep 22
▶Ep 68 · 2:11
host_summaryThe APSA Outcomes and Evidence-based Practice Committee systematic review by Slidell et al. found that delivery after 37 weeks is optimal for gastroschisis.↗
▶Ep 68 · 2:21
host_summaryFor gastroschisis, prophylactic antibiotics covering skin flora are adequate to reduce infection risk until closure.↗
▶Ep 68 · 2:28
host_summarySutureless repair for gastroschisis is safe, effective, and does not delay feeding or increase length of stay.↗
▶Ep 68 · 2:28
host_summaryStudies support primary fascial repair for gastroschisis as long as hemodynamics and abdominal domain permit.↗
▶Ep 68 · 2:42
host_summaryThe APSA systematic review concluded that there is a need for high quality randomized controlled trials to help provide evidence-based care for gastroschisis infants.↗
▶Ep 68 · 2:51
quoteDoes this information change your practice at all?↗
Quick Literature Updates Ep 27
▶Ep 69 · 2:05
host_summaryMina et al. performed a retrospective review of all patients who underwent conservative management of modified Bell stage 2A or greater necrotizing enterocolitis at a single institution from 2011 to 2022.↗
▶Ep 69 · 2:20
host_summary126 patients underwent conservative management of necrotizing enterocolitis, and 24 of those patients eventually underwent surgery for a post-NEC stricture.↗
▶Ep 69 · 2:29
host_summaryPrimary resection and anastomosis was performed in all cases of post-NEC stricture requiring surgery.↗
▶Ep 69 · 2:33
host_summaryPost-NEC strictures are a common occurrence after conservative management of necrotizing enterocolitis.↗
▶Ep 69 · 2:33
quoteSo it seems like post-neck strictures are a common occurrence after conservative management of neck.↗
host_summaryGabapentin is an anticonvulsant often used off-label as part of multimodal pain control after major surgery.↗
▶Ep 20 · 2:11
host_summaryIn the Lascano et al. study, kids who received gabapentin had decreased postoperative opioid use.↗
▶Ep 20 · 2:11
host_summaryIn the Lascano et al. study, kids who received gabapentin had decreased postoperative length of stay.↗
▶Ep 20 · 2:11
quotePain control after appendectomy for perforated appendicitis can be a huge problem in kids.↗
▶Ep 20 · 2:11
quoteCould Gabapentin help with pain control in these kids?↗
▶Ep 20 · 2:11
host_summaryLascano et al. performed a retrospective cohort study at Children's Hospital of LA looking at kids age 2 to 18 who underwent appendectomy for perforated appendicitis between 2014 and 2019.↗
Management of Gastroschisis: Timing of Delivery, Antibiotic Usage, and Closure Considerations
▶Ep 24 · 0:00
quoteWhat is the optimal initial management of an infant with gastroschisis?↗
▶Ep 24 · 0:10
host_summaryThe ABSA Outcomes and Evidence-based Practice Committee performed a systematic review on optimal initial management of gastroschisis.↗
▶Ep 24 · 0:17
host_summaryDelivery after 37 weeks is optimal for infants with gastroschisis.↗
▶Ep 24 · 0:21
host_summaryProphylactic antibiotics covering skin flora are adequate to reduce infection risk until closure in gastroschisis.↗
▶Ep 24 · 0:27
host_summaryStudies support primary fascial repair for gastroschisis as long as hemodynamics and abdominal domain permit.↗
▶Ep 24 · 0:27
host_summarySutureless repair for gastroschisis is safe and effective.↗
▶Ep 24 · 0:37
host_summarySutureless repair does not delay feeding or increase length of stay in gastroschisis patients.↗
▶Ep 24 · 0:41
host_summaryThere is a need for high quality randomized controlled trials to help provide evidence-based care for infants with gastroschisis.↗
▶Ep 24 · 0:50
quoteDoes this information change your practice at all?↗
Quick Literature Updates Episode 16
▶Ep 25 · 2:08
host_summaryThe McMaster University team performed a retrospective review of infants born between 2014 and 2022 with uncomplicated gastroschisis.↗
▶Ep 25 · 2:17
host_summaryInfants with uncomplicated gastroschisis who received exclusive breast milk had similar outcomes to those with supplemental or exclusive formula intake.↗
▶Ep 25 · 2:17
host_summaryIn uncomplicated gastroschisis, there were no significant differences between exclusive breast milk and formula groups in time to reach full enteral feeds, duration of parenteral nutrition, rates of necrotizing enterocolitis, and length of hospital stay.↗
▶Ep 25 · 2:38
quoteSo it seems like formula intake versus exclusive breast milk intake does not really affect outcomes in uncomplicated gastroschisis.↗
Quick Literature Updates Ep 22
▶Ep 27 · 2:11
host_summaryThe APSA Outcomes and Evidence-based Practice Committee systematic review by Slidell et al. found that delivery after 37 weeks is optimal for gastroschisis.↗
▶Ep 27 · 2:21
host_summaryFor gastroschisis, prophylactic antibiotics covering skin flora are adequate to reduce infection risk until closure.↗
▶Ep 27 · 2:28
host_summarySutureless repair for gastroschisis is safe, effective, and does not delay feeding or increase length of stay.↗
▶Ep 27 · 2:28
host_summaryStudies support primary fascial repair for gastroschisis as long as hemodynamics and abdominal domain permit.↗
▶Ep 27 · 2:42
host_summaryThe APSA systematic review concluded that there is a need for high quality randomized controlled trials to help provide evidence-based care for gastroschisis infants.↗
▶Ep 27 · 2:51
quoteDoes this information change your practice at all?↗
Use of a new vertical traction device for early traction-assisted staged closure of congenital abdominal wall defects: a prospective series of 16 patients
▶Ep 5 · 0:14
host_summaryZiegler et al. performed a prospective study in 10 patients with giant omphalocele and 6 with complicated gastroschisis evaluating a vertical traction device.↗
▶Ep 5 · 0:24
host_summaryThe study utilized Fascia Tenses Pediatric, a traction-assisted abdominal wall closure device.↗
▶Ep 5 · 0:29
host_summaryComplete fascial closure was achieved after a median time of 7 days in children with giant omphalocele.↗
▶Ep 5 · 0:36
host_summaryComplete fascial closure was achieved after a median time of 5 days in children with complicated gastroschisis.↗
▶Ep 5 · 0:39
host_summaryNo ventral hernias occurred after a median follow-up of 12 months.↗
▶Ep 5 · 0:39
host_summaryNo patients developed abdominal compartment syndrome in the study.↗
▶Ep 5 · 0:46
host_summaryFascia Tenses Pediatric helps facilitate early fascial closure in patients with congenital abdominal wall defects.↗
Quick Literature Updates Episode 20
▶Ep 6 · 1:58
epidemiologicalZiegler et al. prospective study included 10 patients with giant omphalocele and 6 with complicated gastroschisis using a traction-assisted abdominal wall closure device (Fascia Tense Pediatric).↗
▶Ep 6 · 2:13
clinicalComplete fascial closure was achieved after a median of 5 days in children with complicated gastroschisis using the Fascia Tense Pediatric device.↗
▶Ep 6 · 2:13
clinicalComplete fascial closure was achieved after a median of 7 days in children with giant omphalocele using the Fascia Tense Pediatric device.↗
▶Ep 6 · 2:23
clinicalNo ventral hernias occurred after a median follow-up of 12 months in patients who underwent traction-assisted closure with Fascia Tense Pediatric.↗
▶Ep 6 · 2:23
clinicalNo patients developed abdominal compartment syndrome after traction-assisted closure with Fascia Tense Pediatric.↗
▶Ep 6 · 2:29
quoteSo it seems like fascia tense pediatric helps facilitate early fascial closure in these patients.↗
Transition From Pediatric to Adult Healthcare for Colorectal Conditions: A Systematic Review
▶Ep 70 · 0:00
clinicalPatients with anorectal malformations and Hirschsprung's disease need transfer from pediatric to adult providers to manage their colorectal conditions↗
▶Ep 70 · 0:22
epidemiologicalA team from Melbourne, Australia performed a systematic review and meta-analysis on transition of care for these conditions↗
▶Ep 70 · 0:28
epidemiologicalEight studies were found on the topic of transition care for anorectal malformations and Hirschsprung's disease↗
▶Ep 70 · 0:30
epidemiologicalLittle evidence exists that transfer from pediatric to adult care is happening in a coordinated or timely fashion↗
▶Ep 70 · 0:30
guidelineStudies agreed that transitional care should start early in adolescence↗
▶Ep 70 · 0:40
epidemiologicalNo models of transition care were identified in the systematic review↗
▶Ep 70 · 0:43
opinionMore work is needed to ensure children with anorectal malformations and Hirschsprung's disease continue to receive optimal care as they grow older↗
▶Ep 70 · 0:53
quoteDoes this information change your practice at all?↗
Does Delayed Diagnosis of Hirschsprung Disease Impact Post-operative and Functional Outcomes? A Multi-Center Review From the Pediatric Colorectal and Pelvic Learning Consortium
▶Ep 72 · 0:00
quoteDoes delayed diagnosis of Hirschrung disease affect postoperative and functional outcomes?↗
▶Ep 72 · 0:12
clinicalThe Pediatric Colorectal and Pelvic Learning Consortium conducted a multi-center retrospective review from 2017 to 2023 examining the relationship between delayed diagnosis of Hirschsprung disease and postoperative/functional outcomes.↗
▶Ep 72 · 0:23
epidemiologicalThe study included 679 patients with Hirschsprung disease from 14 different sites.↗
▶Ep 72 · 0:29
clinicalIncreased age at diagnosis was associated with a greater likelihood of undergoing fecal diversion after initial pull-through procedure.↗
▶Ep 72 · 0:39
clinicalIncreased age at diagnosis was associated with an increased risk of constipation or incontinence requiring intervention postoperatively.↗
▶Ep 72 · 0:49
clinicalNo association was found between age at diagnosis and 30-day complication rate after initial pull-through.↗
▶Ep 72 · 0:49
clinicalNo association was found between age at diagnosis and need for pull-through revision.↗
▶Ep 72 · 0:58
clinicalDelayed diagnosis of Hirschsprung disease affects certain postoperative and functional outcomes in patients.↗
▶Ep 72 · 1:04
quoteDoes this information change your practice at all?↗
Quick Literature Updates Episode 17
▶Ep 75 · 2:05
host_summaryThe Pediatric Colorectal and Pelvic Learning Consortium conducted a multi-center retrospective review from 2017 to 2023 examining delayed diagnosis of Hirschsprung disease.↗
▶Ep 75 · 2:05
clinicalThe Pediatric Colorectal and Pelvic Learning Consortium conducted a multi-center retrospective review from 2017 to 2023 examining delayed diagnosis of Hirschsprung disease.↗
▶Ep 75 · 2:16
host_summaryThe Hirschsprung study included 679 patients from 14 different sites.↗
▶Ep 75 · 2:16
clinicalThe Hirschsprung study included 679 patients from 14 different sites.↗
▶Ep 75 · 2:22
host_summaryIncreased age at diagnosis of Hirschsprung disease was associated with a greater likelihood of undergoing fecal diversion after initial pull-through procedure.↗
▶Ep 75 · 2:22
clinicalIncreased age at diagnosis of Hirschsprung disease was associated with a greater likelihood of undergoing fecal diversion after initial pull-through procedure.↗
▶Ep 75 · 2:32
clinicalIncreasing age at diagnosis of Hirschsprung disease was associated with an increased risk of constipation or incontinence requiring intervention postoperatively.↗
▶Ep 75 · 2:32
host_summaryIncreasing age at diagnosis of Hirschsprung disease was associated with an increased risk of constipation or incontinence requiring intervention postoperatively.↗
▶Ep 75 · 2:42
clinicalThe Hirschsprung study did not find an association between age at diagnosis and 30-day complication rate after initial pull-through.↗
▶Ep 75 · 2:42
clinicalThe Hirschsprung study did not find an association between age at diagnosis and need for pull-through revision.↗
▶Ep 75 · 2:42
host_summaryThe Hirschsprung study did not find an association between age at diagnosis and 30-day complication rate after initial pull-through.↗
▶Ep 75 · 2:42
host_summaryThe Hirschsprung study did not find an association between age at diagnosis and need for pull-through revision.↗
▶Ep 75 · 2:51
opinionDelayed diagnosis of Hirschsprung disease does affect certain outcomes in these patients.↗
▶Ep 75 · 2:51
quoteSo, it seems like delayed diagnosis of Hirschrung's disease does affect certain outcomes in these patients.↗
▶Ep 75 · 2:51
opinionDelayed diagnosis of Hirschsprung disease does affect certain outcomes in these patients.↗
▶Ep 75 · 2:51
quoteSo, it seems like delayed diagnosis of Hirschrung's disease does affect certain outcomes in these patients.↗
Quick Literature Updates Ep 22
▶Ep 79 · 2:11
host_summaryThe APSA Outcomes and Evidence-based Practice Committee systematic review by Slidell et al. found that delivery after 37 weeks is optimal for gastroschisis.↗
▶Ep 79 · 2:21
host_summaryFor gastroschisis, prophylactic antibiotics covering skin flora are adequate to reduce infection risk until closure.↗
▶Ep 79 · 2:28
host_summarySutureless repair for gastroschisis is safe, effective, and does not delay feeding or increase length of stay.↗
▶Ep 79 · 2:28
host_summaryStudies support primary fascial repair for gastroschisis as long as hemodynamics and abdominal domain permit.↗
▶Ep 79 · 2:42
host_summaryThe APSA systematic review concluded that there is a need for high quality randomized controlled trials to help provide evidence-based care for gastroschisis infants.↗
▶Ep 79 · 2:51
quoteDoes this information change your practice at all?↗
Quick Literature Updates Ep 23
▶Ep 80 · 2:01
clinicalA working group of pediatric surgeons from Europe created 19 case scenarios with unexpected events to validate the Clavien-Madadi classification.↗
▶Ep 80 · 2:10
clinicalSurgeons within the European Reference Network of inherited and congenital anomalies rated scenarios based on the Clavien-Dindo classification or the Clavien-Madadi classification.↗
▶Ep 80 · 2:23
epidemiologicalA total of 59 surgeons completed the questionnaire.↗
▶Ep 80 · 2:27
clinicalThe Clavien-Madadi classification showed significantly better agreement rates and was less frequently considered inaccurate compared to Clavien-Dindo.↗
▶Ep 80 · 2:27
quoteThe Clavian-Matti classification showed significantly better agreement rates and was less frequently considered inaccurate.↗
▶Ep 80 · 2:34
clinicalMore pediatric surgeons preferred using the Clavien-Madadi classification.↗
▶Ep 80 · 2:38
opinionThe Clavien-Madadi classification is both an accurate and useful tool in grading unexpected events in pediatric surgery.↗
▶Ep 80 · 2:38
quoteSo it seems like the Clavian-Matti classification is both an accurate and useful tool in grading unexpected events in pediatric surgery.↗
host_summaryIn the Lascano et al. study, kids who received gabapentin had decreased postoperative opioid use.↗
▶Ep 76 · 2:11
host_summaryGabapentin is an anticonvulsant often used off-label as part of multimodal pain control after major surgery.↗
▶Ep 76 · 2:11
host_summaryIn the Lascano et al. study, kids who received gabapentin had decreased postoperative length of stay.↗
▶Ep 76 · 2:11
host_summaryLascano et al. performed a retrospective cohort study at Children's Hospital of LA looking at kids age 2 to 18 who underwent appendectomy for perforated appendicitis between 2014 and 2019.↗
▶Ep 76 · 2:11
quotePain control after appendectomy for perforated appendicitis can be a huge problem in kids.↗
▶Ep 76 · 2:11
quoteCould Gabapentin help with pain control in these kids?↗
Association of Exclusive Breast Milk Intake and Outcomes in Infants With Uncomplicated Gastroschisis: A National Cohort Study
▶Ep 84 · 0:00
quoteDoes exclusive breast milk intake affect outcomes and uncomplicated gastroschisis?↗
▶Ep 84 · 0:13
host_summaryMcMaster University team performed a retrospective review of infants born between 2014 and 2022 with uncomplicated gastroschisis examining feeding outcomes.↗
▶Ep 84 · 0:24
host_summaryNo significant differences were found between exclusive breast milk and formula groups in length of hospital stay in infants with uncomplicated gastroschisis.↗
▶Ep 84 · 0:24
host_summaryNo significant differences were found between exclusive breast milk and formula groups in rates of necrotizing enterocolitis in infants with uncomplicated gastroschisis.↗
▶Ep 84 · 0:24
host_summaryInfants with exclusive breast milk intake and those with supplemental or exclusive formula intake had similar outcomes in uncomplicated gastroschisis.↗
▶Ep 84 · 0:24
host_summaryNo significant differences were found between exclusive breast milk and formula groups in time to reach full enteral feeds in infants with uncomplicated gastroschisis.↗
▶Ep 84 · 0:24
host_summaryNo significant differences were found between exclusive breast milk and formula groups in duration of parenteral nutrition in infants with uncomplicated gastroschisis.↗
▶Ep 84 · 0:44
host_summaryFormula intake versus exclusive breast milk intake does not appear to affect outcomes in uncomplicated gastroschisis.↗
▶Ep 84 · 0:52
quoteDoes this information change your practice at all?↗
Use of a new vertical traction device for early traction-assisted staged closure of congenital abdominal wall defects: a prospective series of 16 patients
▶Ep 87 · 0:14
host_summaryZiegler et al. performed a prospective study in 10 patients with giant omphalocele and 6 with complicated gastroschisis evaluating a vertical traction device.↗
▶Ep 87 · 0:24
host_summaryThe study utilized Fascia Tenses Pediatric, a traction-assisted abdominal wall closure device.↗
▶Ep 87 · 0:29
host_summaryComplete fascial closure was achieved after a median time of 7 days in children with giant omphalocele.↗
▶Ep 87 · 0:36
host_summaryComplete fascial closure was achieved after a median time of 5 days in children with complicated gastroschisis.↗
▶Ep 87 · 0:39
host_summaryNo patients developed abdominal compartment syndrome in the study.↗
▶Ep 87 · 0:39
host_summaryNo ventral hernias occurred after a median follow-up of 12 months.↗
▶Ep 87 · 0:46
host_summaryFascia Tenses Pediatric helps facilitate early fascial closure in patients with congenital abdominal wall defects.↗
Management of Gastroschisis: Timing of Delivery, Antibiotic Usage, and Closure Considerations
▶Ep 90 · 0:00
quoteWhat is the optimal initial management of an infant with gastroschisis?↗
▶Ep 90 · 0:10
host_summaryThe ABSA Outcomes and Evidence-based Practice Committee performed a systematic review on optimal initial management of gastroschisis.↗
▶Ep 90 · 0:17
host_summaryDelivery after 37 weeks is optimal for infants with gastroschisis.↗
▶Ep 90 · 0:21
host_summaryProphylactic antibiotics covering skin flora are adequate to reduce infection risk until closure in gastroschisis.↗
▶Ep 90 · 0:27
host_summaryStudies support primary fascial repair for gastroschisis as long as hemodynamics and abdominal domain permit.↗
▶Ep 90 · 0:27
host_summarySutureless repair for gastroschisis is safe and effective.↗
▶Ep 90 · 0:37
host_summarySutureless repair does not delay feeding or increase length of stay in gastroschisis patients.↗
▶Ep 90 · 0:41
host_summaryThere is a need for high quality randomized controlled trials to help provide evidence-based care for infants with gastroschisis.↗
▶Ep 90 · 0:50
quoteDoes this information change your practice at all?↗
Quick Literature Updates Episode 16
▶Ep 91 · 2:08
host_summaryThe McMaster University team performed a retrospective review of infants born between 2014 and 2022 with uncomplicated gastroschisis.↗
▶Ep 91 · 2:17
host_summaryIn uncomplicated gastroschisis, there were no significant differences between exclusive breast milk and formula groups in time to reach full enteral feeds, duration of parenteral nutrition, rates of necrotizing enterocolitis, and length of hospital stay.↗
▶Ep 91 · 2:17
host_summaryInfants with uncomplicated gastroschisis who received exclusive breast milk had similar outcomes to those with supplemental or exclusive formula intake.↗
▶Ep 91 · 2:38
quoteSo it seems like formula intake versus exclusive breast milk intake does not really affect outcomes in uncomplicated gastroschisis.↗
Conservative Management of Necrotizing Enterocolitis in Newborns: Incidence and Management of Intestinal Strictures
▶Ep 92 · 0:00
quoteHow big of a problem are intestinal strictures after conservative management of necrotizing enterocolitis?↗
▶Ep 92 · 0:13
host_summaryA retrospective review by Men et al examined all patients who underwent conservative management of modified Bell stage 2A or greater NEC at a single institution from 2011 to 2022.↗
▶Ep 92 · 0:27
host_summary126 patients underwent conservative management of NEC in the study period.↗
▶Ep 92 · 0:27
host_summary24 of 126 patients (19%) who underwent conservative management of NEC eventually required surgery for a post-NEC stricture.↗
▶Ep 92 · 0:36
host_summaryPrimary resection and anastomosis was performed in all cases of post-NEC stricture requiring surgery.↗
▶Ep 92 · 0:40
quoteSo, it seems like post neck strictures are a common occurrence after conservative management of neck.↗
▶Ep 92 · 0:40
host_summaryPost-NEC strictures are a common occurrence after conservative management of NEC.↗
▶Ep 92 · 0:46
quoteDoes this information change your practice at all?↗
Remote Ischemic Conditioning (RIC) Decreases the Incidence and Severity of Necrotizing Enterocolitis (NEC) - Validation in a Large Animal Model
▶Ep 95 · 0:00
host_summaryRIC has been shown to decrease rates of necrotizing enterocolitis in a rat model.↗
▶Ep 95 · 0:16
host_summaryGadal used an established piglet NEC model to test RIC.↗
▶Ep 95 · 0:20
host_summaryPiglets were randomly assigned to receive RIC or serve as controls.↗
▶Ep 95 · 0:24
host_summaryRIC was initiated at 24 hours of life and consisted of 4 cycles of 4 minutes of arterial occlusion followed by reperfusion.↗
▶Ep 95 · 0:31
host_summaryCycles were repeated every 24 hours in the low frequency group and every 12 hours in the high frequency group.↗
▶Ep 95 · 0:37
host_summary38 piglets were randomized into the control group, 26 into the low frequency group, and 22 into the high frequency group.↗
▶Ep 95 · 0:45
host_summaryHigh frequency RIC significantly reduced the incidence of NEC when compared to controls.↗
▶Ep 95 · 0:50
host_summaryLow frequency RIC did not significantly reduce the incidence of NEC.↗
▶Ep 95 · 0:53
host_summaryHigh frequency RIC protects against NEC in a piglet model.↗
▶Ep 95 · 0:53
quoteSo it seems like high frequency Rick protects against neck in a piglet model.↗
Quick Literature Updates Ep 22
▶Ep 99 · 2:11
host_summaryThe APSA Outcomes and Evidence-based Practice Committee systematic review by Slidell et al. found that delivery after 37 weeks is optimal for gastroschisis.↗
▶Ep 99 · 2:21
host_summaryFor gastroschisis, prophylactic antibiotics covering skin flora are adequate to reduce infection risk until closure.↗
▶Ep 99 · 2:28
host_summarySutureless repair for gastroschisis is safe, effective, and does not delay feeding or increase length of stay.↗
▶Ep 99 · 2:28
host_summaryStudies support primary fascial repair for gastroschisis as long as hemodynamics and abdominal domain permit.↗
▶Ep 99 · 2:42
host_summaryThe APSA systematic review concluded that there is a need for high quality randomized controlled trials to help provide evidence-based care for gastroschisis infants.↗
▶Ep 99 · 2:51
quoteDoes this information change your practice at all?↗
Quick Literature Updates Ep 27
▶Ep 100 · 2:05
host_summaryMina et al. performed a retrospective review of all patients who underwent conservative management of modified Bell stage 2A or greater necrotizing enterocolitis at a single institution from 2011 to 2022.↗
▶Ep 100 · 2:20
host_summary126 patients underwent conservative management of necrotizing enterocolitis, and 24 of those patients eventually underwent surgery for a post-NEC stricture.↗
▶Ep 100 · 2:29
host_summaryPrimary resection and anastomosis was performed in all cases of post-NEC stricture requiring surgery.↗
▶Ep 100 · 2:33
quoteSo it seems like post-neck strictures are a common occurrence after conservative management of neck.↗
▶Ep 100 · 2:33
host_summaryPost-NEC strictures are a common occurrence after conservative management of necrotizing enterocolitis.↗
Association of Exclusive Breast Milk Intake and Outcomes in Infants With Uncomplicated Gastroschisis: A National Cohort Study
▶Ep 15 · 0:00
quoteDoes exclusive breast milk intake affect outcomes and uncomplicated gastroschisis?↗
▶Ep 15 · 0:13
host_summaryMcMaster University team performed a retrospective review of infants born between 2014 and 2022 with uncomplicated gastroschisis examining feeding outcomes.↗
▶Ep 15 · 0:24
host_summaryInfants with exclusive breast milk intake and those with supplemental or exclusive formula intake had similar outcomes in uncomplicated gastroschisis.↗
▶Ep 15 · 0:24
host_summaryNo significant differences were found between exclusive breast milk and formula groups in duration of parenteral nutrition in infants with uncomplicated gastroschisis.↗
▶Ep 15 · 0:24
host_summaryNo significant differences were found between exclusive breast milk and formula groups in time to reach full enteral feeds in infants with uncomplicated gastroschisis.↗
▶Ep 15 · 0:24
host_summaryNo significant differences were found between exclusive breast milk and formula groups in rates of necrotizing enterocolitis in infants with uncomplicated gastroschisis.↗
▶Ep 15 · 0:24
host_summaryNo significant differences were found between exclusive breast milk and formula groups in length of hospital stay in infants with uncomplicated gastroschisis.↗
▶Ep 15 · 0:44
host_summaryFormula intake versus exclusive breast milk intake does not appear to affect outcomes in uncomplicated gastroschisis.↗
▶Ep 15 · 0:52
quoteDoes this information change your practice at all?↗
Conservative Management of Necrotizing Enterocolitis in Newborns: Incidence and Management of Intestinal Strictures
▶Ep 16 · 0:00
quoteHow big of a problem are intestinal strictures after conservative management of necrotizing enterocolitis?↗
▶Ep 16 · 0:13
host_summaryA retrospective review by Men et al examined all patients who underwent conservative management of modified Bell stage 2A or greater NEC at a single institution from 2011 to 2022.↗
▶Ep 16 · 0:27
host_summary24 of 126 patients (19%) who underwent conservative management of NEC eventually required surgery for a post-NEC stricture.↗
▶Ep 16 · 0:27
host_summary126 patients underwent conservative management of NEC in the study period.↗
▶Ep 16 · 0:36
host_summaryPrimary resection and anastomosis was performed in all cases of post-NEC stricture requiring surgery.↗
▶Ep 16 · 0:40
quoteSo, it seems like post neck strictures are a common occurrence after conservative management of neck.↗
▶Ep 16 · 0:40
host_summaryPost-NEC strictures are a common occurrence after conservative management of NEC.↗
▶Ep 16 · 0:46
quoteDoes this information change your practice at all?↗
Remote Ischemic Conditioning (RIC) Decreases the Incidence and Severity of Necrotizing Enterocolitis (NEC) - Validation in a Large Animal Model
▶Ep 18 · 0:00
host_summaryRIC has been shown to decrease rates of necrotizing enterocolitis in a rat model.↗
▶Ep 18 · 0:16
host_summaryGadal used an established piglet NEC model to test RIC.↗
▶Ep 18 · 0:20
host_summaryPiglets were randomly assigned to receive RIC or serve as controls.↗
▶Ep 18 · 0:24
host_summaryRIC was initiated at 24 hours of life and consisted of 4 cycles of 4 minutes of arterial occlusion followed by reperfusion.↗
▶Ep 18 · 0:31
host_summaryCycles were repeated every 24 hours in the low frequency group and every 12 hours in the high frequency group.↗
▶Ep 18 · 0:37
host_summary38 piglets were randomized into the control group, 26 into the low frequency group, and 22 into the high frequency group.↗
▶Ep 18 · 0:45
host_summaryHigh frequency RIC significantly reduced the incidence of NEC when compared to controls.↗
▶Ep 18 · 0:50
host_summaryLow frequency RIC did not significantly reduce the incidence of NEC.↗
▶Ep 18 · 0:53
quoteSo it seems like high frequency Rick protects against neck in a piglet model.↗
▶Ep 18 · 0:53
host_summaryHigh frequency RIC protects against NEC in a piglet model.↗
Multi-Institutional Analysis of Choledocholithiasis in Pediatric vs Adult Patients
▶Ep 22 · 0:00
quoteCan a surgery first approach be used for the management of cholodocholithiasis in children?↗
▶Ep 22 · 0:11
epidemiologicalDantes et al. performed a multi-center retrospective review of pediatric and adult patients treated for choledocholithiasis between 2018 and 2024↗
▶Ep 22 · 0:22
epidemiological724 patients were included in the study↗
▶Ep 22 · 0:25
clinicalSurgery first approach with upfront laparoscopic cholecystectomy with intraoperative cholangiogram was performed in 201 pediatric patients and 169 adult patients↗
▶Ep 22 · 0:35
clinicalLaparoscopic common bile duct exploration was attempted in 84 children and 140 adults in the surgery first group↗
▶Ep 22 · 0:43
clinicalCommon bile duct exploration success was higher in pediatric than adult patients↗
▶Ep 22 · 0:43
clinicalComplication rates were similar between pediatric and adult patients in the surgery first approach↗
▶Ep 22 · 0:49
opinionA surgery first approach can be a safe and effective tool for managing choledocholithiasis in pediatric patients↗
Cost and outcomes of intercostal nerve cryoablation versus thoracic epidural following the Nuss procedure
▶Ep 32 · 0:00
quoteThoracic epidural and intercostal nerve coagabulations are two options for pain control in patients undergoing a NUS procedure for pectus excavatum.↗
▶Ep 32 · 0:00
clinicalThoracic epidural and intercostal nerve cryoablation are two options for pain control in patients undergoing a Nuss procedure for pectus excavatum↗
▶Ep 32 · 0:19
clinicalDr. Tsai and his team from Penn State conducted a retrospective chart review looking at kids who underwent a Nuss procedure between 2002 and 2020↗
▶Ep 32 · 0:21
clinicalThe intercostal nerve cryoablation group had shorter length of stay in the hospital compared to thoracic epidural↗
▶Ep 32 · 0:21
clinicalThe intercostal nerve cryoablation group had lower total morphine milligram equivalent requirement compared to thoracic epidural↗
▶Ep 32 · 0:21
clinicalThe intercostal nerve cryoablation group had lower rates of PCA use compared to thoracic epidural↗
▶Ep 32 · 0:44
clinicalThe intercostal nerve cryoablation group had higher total hospitalization cost than the thoracic epidural group↗
▶Ep 32 · 0:44
clinicalThe intercostal nerve cryoablation group had longer operative times compared to thoracic epidural↗
▶Ep 32 · 0:51
opinionBoth intercostal nerve cryoablation and thoracic epidural have pros and cons for pain control following Nuss procedure↗
▶Ep 32 · 0:51
quoteSo it seems like both of these options have their pros and cons with the intercostal nerve co ablation group having a decreased total opioid use and decreased length of stay in the hospital, but increased operating room times and increased total cost.↗
Quick Literature Updates Episode 13
▶Ep 37 · 2:35
host_summaryEarly initiation of peritoneal dialysis was associated with decreased post-operative mortality in infants after pediatric cardiac surgery.↗
▶Ep 37 · 2:41
host_summaryEarly initiation of peritoneal dialysis shortened length of stay in the ICU in infants after pediatric cardiac surgery.↗
▶Ep 37 · 2:41
host_summaryEarly initiation of peritoneal dialysis shortened duration of mechanical ventilation in infants after pediatric cardiac surgery.↗
▶Ep 37 · 2:49
quoteSo it seems that early initiation of peritoneal dialysis may benefit infants after pediatric cardiac surgery.↗
Vacuum Bell Therapy for Pectus Excavatum: Long-term Experience at a Single Center
▶Ep 48 · 0:00
quoteWhat factors affect outcomes in patients with pectus excavatum treated with vacuum valve therapy?↗
▶Ep 48 · 0:13
clinicalThe study was a single institution retrospective chart review conducted from 2012 to 2023↗
▶Ep 48 · 0:20
epidemiological278 patients were included in the analysis↗
▶Ep 48 · 0:23
clinical247 patients had non-excellent corrections with vacuum bell therapy↗
▶Ep 48 · 0:23
clinical31 patients had excellent corrections with vacuum bell therapy↗
▶Ep 48 · 0:29
clinicalChest wall flexibility is a predictor of positive outcomes↗
▶Ep 48 · 0:29
clinicalInitial chest depth less than 1.5 centimeters is a predictor of positive outcomes↗
▶Ep 48 · 0:29
clinicalExcellent correction was more common in children 8 to 12.9 years old↗
▶Ep 48 · 0:41
opinionExcellent correction in children with pectus excavatum treated with vacuum bell therapy is uncommon↗
▶Ep 48 · 0:41
clinicalImproved outcomes are seen in younger patients with more mild defects and greater chest wall flexibility↗
Early Peritoneal Dialysis and Postoperative Outcomes in Infants After Pediatric Cardiac Surgery
▶Ep 6 · 0:00
quoteCan early initiation of peritoneal dialysis after pediatric cardiac surgery improve outcomes?↗
▶Ep 6 · 0:14
clinicalDr. Dudike and his team performed a systematic review and meta-analysis on early peritoneal dialysis after pediatric cardiac surgery↗
▶Ep 6 · 0:19
clinicalFive studies were included in the meta-analysis↗
▶Ep 6 · 0:24
clinicalEarly initiation of peritoneal dialysis was associated with decreased postoperative mortality↗
▶Ep 6 · 0:30
clinicalEarly initiation of peritoneal dialysis shortened duration of mechanical ventilation↗
▶Ep 6 · 0:30
opinionEarly initiation of peritoneal dialysis may benefit infants after pediatric cardiac surgery↗
▶Ep 6 · 0:30
clinicalEarly initiation of peritoneal dialysis shortened length of stay in the ICU↗
Quick Literature Updates Episode 13
▶Ep 7 · 2:35
host_summaryEarly initiation of peritoneal dialysis was associated with decreased post-operative mortality in infants after pediatric cardiac surgery.↗
▶Ep 7 · 2:41
host_summaryEarly initiation of peritoneal dialysis shortened length of stay in the ICU in infants after pediatric cardiac surgery.↗
▶Ep 7 · 2:41
host_summaryEarly initiation of peritoneal dialysis shortened duration of mechanical ventilation in infants after pediatric cardiac surgery.↗
▶Ep 7 · 2:49
quoteSo it seems that early initiation of peritoneal dialysis may benefit infants after pediatric cardiac surgery.↗
Female Fertility Cryopreservation Outcomes in Childhood Cancer: A Systematic Review
▶Ep 27 · 0:00
quoteWhat does the current literature say about outcomes of female fertility cryopreservation in children with cancer?↗
▶Ep 27 · 0:13
clinicalGillippelli et al. performed a systematic retrospective review of female fertility cryopreservation outcomes in children with cancer↗
▶Ep 27 · 0:19
clinical12 studies were included in the final systematic review↗
▶Ep 27 · 0:19
clinicalThe review initially examined 104 abstracts and 34 full text articles↗
▶Ep 27 · 0:27
epidemiological5.9% of patients who underwent ovarian tissue cryopreservation later received ovarian tissue transplantation↗
▶Ep 27 · 0:27
epidemiologicalOvarian tissue cryopreservation was performed in 501 patients across the included studies↗
▶Ep 27 · 0:38
clinical33% of patients who underwent ovarian tissue transplantation were able to become pregnant↗
▶Ep 27 · 0:44
quoteSo, it seems like ovarian tissue cryopreservation has great advantages for pediatric cancer patients, but needs to be studied further.↗
▶Ep 27 · 0:44
opinionOvarian tissue cryopreservation has great advantages for pediatric cancer patients but needs to be studied further↗
▶Ep 27 · 0:52
quoteDoes this information change your practice at all?↗
Same-Day Discharge for Elective Pediatric Laparoscopic Gastrostomy Tube Insertion is Safe and Increasing in Frequency; A NSQIP Pediatric Retrospective Review 2017 to 2021
▶Ep 29 · 0:00
quoteWhat are the trends and outcomes of same-day discharge after pediatric elective laparoscopic gastrostomy?↗
▶Ep 29 · 0:13
clinicalThe study analyzed the ACS NSQIP Pediatric database from 2017 to 2021↗
▶Ep 29 · 0:21
epidemiological5,947 pediatric patients underwent elective laparoscopic gastrostomy tube placement in the study period↗
▶Ep 29 · 0:29
epidemiological4.7% of patients were discharged the same day after laparoscopic gastrostomy tube placement↗
▶Ep 29 · 0:33
clinicalThere were no significant differences in reoperations between same-day discharge and 1-2 day discharge patients↗
▶Ep 29 · 0:33
clinicalThere were no significant differences in any other complications between same-day discharge and 1-2 day discharge patients↗
▶Ep 29 · 0:33
clinicalThere were no significant differences in 30-day unplanned readmissions between same-day discharge and 1-2 day discharge patients↗
▶Ep 29 · 0:46
epidemiologicalSame-day discharge after pediatric laparoscopic gastrostomy is not commonly done↗
▶Ep 29 · 0:46
quoteSo, it seems like same day discharge for pediatric patients after elective laparoscopic gastrostomy is safe, but not commonly done.↗
▶Ep 29 · 0:46
opinionSame-day discharge for pediatric patients after elective laparoscopic gastrostomy appears to be safe↗
host_summaryMina et al. performed a retrospective review of all patients who underwent conservative management of modified Bell stage 2A or greater necrotizing enterocolitis at a single institution from 2011 to 2022.↗
▶Ep 7 · 2:20
host_summary126 patients underwent conservative management of necrotizing enterocolitis, and 24 of those patients eventually underwent surgery for a post-NEC stricture.↗
▶Ep 7 · 2:29
host_summaryPrimary resection and anastomosis was performed in all cases of post-NEC stricture requiring surgery.↗
▶Ep 7 · 2:33
host_summaryPost-NEC strictures are a common occurrence after conservative management of necrotizing enterocolitis.↗
▶Ep 7 · 2:33
quoteSo it seems like post-neck strictures are a common occurrence after conservative management of neck.↗
clinicalThoracic epidural and intercostal nerve cryoablation are two options for pain control in patients undergoing Nuss procedure for pectus excavatum↗
▶Ep 9 · 2:42
epidemiologicalThe study was a retrospective chart review of kids who underwent Nuss procedure between 2002 and 2020↗
▶Ep 9 · 2:56
clinicalThe intercostal nerve cryoablation group had shorter length of stay in the hospital compared to thoracic epidural↗
▶Ep 9 · 2:56
clinicalThe intercostal nerve cryoablation group had lower total morphine milligram equivalent requirement compared to thoracic epidural↗
▶Ep 9 · 2:56
clinicalThe intercostal nerve cryoablation group had lower rates of PCA use compared to thoracic epidural↗
▶Ep 9 · 3:07
clinicalThe intercostal nerve cryoablation group had higher total hospitalization cost compared to thoracic epidural↗
▶Ep 9 · 3:07
clinicalThe intercostal nerve cryoablation group had longer operative times compared to thoracic epidural↗
▶Ep 9 · 3:14
quoteSo it seems like both of these options have their pros and cons with the intercostal nerve carablation group having a decreased total opioid use and decreased length of stay in the hospital, but increased operating room times and increased total cost.↗
host_summaryGillielli et al. reviewed 104 abstracts and 34 full text articles, ultimately including 12 studies in their systematic review of female fertility cryopreservation in childhood cancer.↗
▶Ep 16 · 2:04
epidemiologicalGillielli et al. reviewed 104 abstracts and 34 full text articles, ultimately including 12 studies in their systematic review of female fertility cryopreservation in childhood cancer.↗
▶Ep 16 · 2:16
epidemiologicalOvarian tissue cryopreservation was performed in 501 pediatric cancer patients, with 5.9% undergoing ovarian tissue transplantation.↗
▶Ep 16 · 2:16
host_summaryOvarian tissue cryopreservation was performed in 501 pediatric cancer patients, with 5.9% undergoing ovarian tissue transplantation.↗
▶Ep 16 · 2:27
host_summaryAfter ovarian tissue transplantation, 33% of pediatric cancer patients were able to become pregnant.↗
▶Ep 16 · 2:27
clinicalAfter ovarian tissue transplantation, 33% of pediatric cancer patients were able to become pregnant.↗
▶Ep 16 · 2:33
opinionOvarian tissue cryopreservation has great advantages for pediatric cancer patients but needs to be studied further.↗
▶Ep 16 · 2:33
host_summaryOvarian tissue cryopreservation has great advantages for pediatric cancer patients but needs to be studied further.↗
▶Ep 16 · 2:41
quoteDoes this information change your practice at all?↗
▶Ep 16 · 2:41
quoteDoes this information change your practice at all?↗
