recognizing that we all have biases and not being defensive when someone says there's bias in that because we all have bias. We know that we all have bias. And so the question is, what are your biases and how do they affect what you do? So I would push everyone. To say, as you're thinking about this work, as you, as you live in this space, you know, what are you doing about it?
recognizing that we all have biases and not being defensive when someone says there's bias in that because we all have bias. We know that we all have bias. And so the question is, what are your biases and how do they affect what you do? So I would push everyone. To say, as you're thinking about this work, as you, as you live in this space, you know, what are you doing about it?
recognizing that we all have biases and not being defensive when someone says there's bias in that because we all have bias. We know that we all have bias. And so the question is, what are your biases and how do they affect what you do? So I would push everyone. To say, as you're thinking about this work, as you, as you live in this space, you know, what are you doing about it?
We were happy that our first procedure was successful. When we did another one, it was much easier. Of course, at the beginning, the first procedure took us almost 4 hours. Right now it's a 1 hour procedure, but of course it's very difficult, but we are very happy to have no conversion.
We were happy that our first procedure was successful. When we did another one, it was much easier. Of course, at the beginning, the first procedure took us almost 4 hours. Right now it's a 1 hour procedure, but of course it's very difficult, but we are very happy to have no conversion.
We were happy that our first procedure was successful. When we did another one, it was much easier. Of course, at the beginning, the first procedure took us almost 4 hours. Right now it's a 1 hour procedure, but of course it's very difficult, but we are very happy to have no conversion.
Intestinal rehabilitation: What is intestinal rehab? - Episode 1
▶Ep 23 · 6:30
host_summaryMucosal defects in enteropathies lead to hypersecretion and profuse fluid losses, preventing nutrient absorption.↗
▶Ep 23 · 7:22
host_summaryGastroschisis can involve all three categories: short bowel from nonviable tissue, inflammation affecting absorption, and motility issues.↗
Quick Literature Updates Episode 6
▶Ep 30 · 0:20
host_summaryTeodoro et al. examined California Department of Public Health data on pediatric gunshot wounds and MVCs from 2006 to 2015.↗
▶Ep 30 · 0:20
host_summaryTeodoro et al. studied pediatric trauma patients presenting to a level one trauma center with gunshot wounds or MVCs between 2009 and 2019.↗
▶Ep 30 · 0:20
host_summaryIn California statewide data, the case fatality rate for gunshot wound victims was higher than that for motor vehicle collisions.↗
▶Ep 30 · 0:20
host_summaryGunshot wound victims were 7.8 times more likely to die than MVC victims.↗
▶Ep 30 · 0:20
host_summaryGunshot wound victims were more likely to require immediate surgery and had increased mortality compared to MVC victims.↗
Quick Literature Updates Episode 11
▶Ep 32 · 0:46
host_summaryIn recent years, the fatality rate for firearms has surpassed the fatality rate for automobiles in children.↗
▶Ep 32 · 0:46
host_summaryStevens et al. used the Gifford's Law Center annual gun law scorecard between 2014 and 2020 to assess state gun law scores.↗
▶Ep 32 · 0:46
host_summaryStevens et al. examined CDC Wonder database data between 1999 and 2020 for pediatric firearm and automobile fatalities.↗
▶Ep 32 · 0:46
quoteThere was a 55% lower firearm fatality rate for the states with the strongest gun laws compared to those with the weakest gun laws.↗
▶Ep 32 · 0:46
quoteAs other recent studies had shown, in the last few years, the fatality rate for firearms has surpassed the fatality rate for automobiles in children.↗
▶Ep 32 · 0:46
host_summaryStronger gun laws were associated with decreased fatality rates, with a 55% lower firearm fatality rate for states with the strongest gun laws compared to those with the weakest gun laws.↗
host_summaryA Texas report described component separation use in nine children aged seven days to 10 years, mostly for omphaloceles and giant defects, achieving fascial closure in the vast majority with some mesh use for bridging↗
▶Ep 49 · 10:26
host_summaryComponent separation technique involves separating tissue at the external oblique about a centimeter beyond the rectus sheath on both sides, dissecting between external and internal oblique, and optionally making an incision on the anterior rectus sheath for another centimeter of space↗
host_summaryThere is literature suggesting a component of psychosocial, psychological dissociation in children on later testing related to anal dilations.↗
▶Ep 44 · 2:55
host_summaryThe number of strictures, number needing anoplasties, and number of redo operations were the same between dilation and no-dilation groups.↗
▶Ep 44 · 3:04
host_summaryThe number of patients who had rectal prolapse is consistent with the literature.↗
▶Ep 44 · 5:20
host_summaryA study of 30-day outcomes for ARM with perineal or rectovaginal fistulas divided patients into early repair (before 6 days old) and late repair (6-8 weeks), with 66 early and 231 late repairs among 291 patients.↗
Quick Literature Updates Episode 14
▶Ep 48 · 1:03
host_summaryThe study by Ahmad et al. examined 384 females with anorectal malformations using the Pediatric Colorectal and Pelvic Learning Consortium database.↗
▶Ep 48 · 1:22
host_summaryAbout 27% of patients with anorectal malformations had a gynecologic anomaly.↗
▶Ep 48 · 1:22
host_summaryAbout 46% of females with anorectal malformations had VACTERL association, defined as having the anorectal malformation plus two of: vertebral, cardiac, tracheoesophageal, renal, or limb anomaly.↗
▶Ep 48 · 1:39
host_summaryHaving VACTERL association was associated with more gynecologic anomalies compared to patients without VACTERL association.↗
▶Ep 48 · 1:49
host_summaryThe association between VACTERL and gynecologic anomalies was especially true when patients had recto vestibular or rectal perineal fistulas.↗
▶Ep 48 · 1:49
host_summaryThe association between VACTERL and gynecologic anomalies was especially true when renal anomalies were found.↗
▶Ep 48 · 1:57
host_summaryFor females with anorectal malformations and VACTERL association, especially renal anomalies, clinicians should look carefully for gynecologic anomalies.↗
▶Ep 48 · 1:57
quoteSo for females with inner rectum malformations and veal association, especially renal anomalies, we should look carefully for gynecologic anomalies.↗
host_summaryIn recent years, the fatality rate for firearms has surpassed the fatality rate for automobiles in children.↗
▶Ep 10 · 0:46
host_summaryStronger gun laws were associated with decreased fatality rates, with a 55% lower firearm fatality rate for states with the strongest gun laws compared to those with the weakest gun laws.↗
▶Ep 10 · 0:46
host_summaryStevens et al. examined CDC Wonder database data between 1999 and 2020 for pediatric firearm and automobile fatalities.↗
▶Ep 10 · 0:46
host_summaryStevens et al. used the Gifford's Law Center annual gun law scorecard between 2014 and 2020 to assess state gun law scores.↗
▶Ep 10 · 0:46
quoteThere was a 55% lower firearm fatality rate for the states with the strongest gun laws compared to those with the weakest gun laws.↗
▶Ep 10 · 0:46
quoteAs other recent studies had shown, in the last few years, the fatality rate for firearms has surpassed the fatality rate for automobiles in children.↗
Outcomes of laparoscopic versus open resection of pediatric choledochal cyst
▶Ep 3 · 0:13
epidemiologicalThe study used the nationwide readmissions database and identified 577 children who underwent choledochal cyst resection between 2016 and 2018.↗
▶Ep 3 · 0:24
clinicalPatients who underwent open resection were more likely to have a Roux-en-Y hepaticojejunostomy.↗
▶Ep 3 · 0:24
clinicalPatients who underwent laparoscopic resection were more likely to have a hepaticoduodenostomy.↗
▶Ep 3 · 0:24
epidemiologicalThe majority of patients underwent open resection.↗
▶Ep 3 · 0:39
clinicalPatients who underwent open resection had higher total costs.↗
▶Ep 3 · 0:39
clinicalPatients who underwent open resection were more likely to have more complications.↗
▶Ep 3 · 0:39
clinicalPatients who underwent open resection were more likely to have a longer length of hospital stay.↗
▶Ep 3 · 0:47
quoteHow do you resect colodocal cysts in pediatric patients?↗
Outcomes of laparoscopic versus open resection of pediatric choledochal cyst
▶Ep 3 · 0:13
epidemiologicalThe study used the nationwide readmissions database and identified 577 children who underwent choledochal cyst resection between 2016 and 2018.↗
▶Ep 3 · 0:24
clinicalPatients who underwent open resection were more likely to have a Roux-en-Y hepaticojejunostomy.↗
▶Ep 3 · 0:24
epidemiologicalThe majority of patients underwent open resection.↗
▶Ep 3 · 0:24
clinicalPatients who underwent laparoscopic resection were more likely to have a hepaticoduodenostomy.↗
▶Ep 3 · 0:39
clinicalPatients who underwent open resection had higher total costs.↗
▶Ep 3 · 0:39
clinicalPatients who underwent open resection were more likely to have more complications.↗
▶Ep 3 · 0:39
clinicalPatients who underwent open resection were more likely to have a longer length of hospital stay.↗
▶Ep 3 · 0:47
quoteHow do you resect colodocal cysts in pediatric patients?↗
Journal of pediatric surgery Article Review: April 2023, IPEG issue
▶Ep 4 · 3:59
host_summaryThe Titanic Index provides an objective way to determine bar number rather than guessing based on eyeballing or age.↗
▶Ep 4 · 3:59
opinionThe Titanic Index provides an objective way to determine bar number rather than guessing based on eyeballing or age.↗
▶Ep 4 · 5:36
clinicalSevere outcomes in button battery ingestion were defined as deep mucosal erosion, perforation, mediastinitis, vascular or airway injury or fistula, or esophageal stricture development.↗
▶Ep 4 · 5:36
host_summarySevere outcomes in button battery ingestion were defined as deep mucosal erosion, perforation, mediastinitis, vascular or airway injury or fistula, or esophageal stricture development.↗
▶Ep 4 · 6:05
host_summaryThe Boston Children's study included 143 patients under 21 years old from 2008 to 2021, with 24 having severe outcomes.↗
▶Ep 4 · 6:05
epidemiologicalThe Boston Children's study included 143 patients under 21 years old from 2008 to 2021, with 24 having severe outcomes.↗
▶Ep 4 · 6:20
clinicalThree predictive factors for severe button battery outcomes are: battery in esophagus at presentation, battery size ≥2cm, and presence of any symptoms.↗
▶Ep 4 · 6:20
host_summaryThree predictive factors for severe button battery outcomes are: battery in esophagus at presentation, battery size ≥2cm, and presence of any symptoms.↗
Quick Literature Updates Episode 15
▶Ep 5 · 2:11
epidemiologicalThe choledochal cyst study used the nationwide readmissions database and identified 577 children who underwent choledochal cyst resection between 2016 and 2018.↗
▶Ep 5 · 2:11
host_summaryThe choledochal cyst study used the nationwide readmissions database and identified 577 children who underwent choledochal cyst resection between 2016 and 2018.↗
▶Ep 5 · 2:21
host_summaryPatients who underwent open choledochal cyst resection were more likely to have a Roux-en-Y hepaticojejunostomy.↗
▶Ep 5 · 2:21
host_summaryThe majority of pediatric choledochal cyst patients underwent open resection.↗
▶Ep 5 · 2:21
host_summaryPatients who underwent laparoscopic choledochal cyst resection were more likely to have a hepaticoduodenostomy.↗
▶Ep 5 · 2:21
clinicalPatients who underwent open choledochal cyst resection were more likely to have a Roux-en-Y hepaticojejunostomy.↗
▶Ep 5 · 2:21
epidemiologicalThe majority of pediatric choledochal cyst patients underwent open resection.↗
▶Ep 5 · 2:21
clinicalPatients who underwent laparoscopic choledochal cyst resection were more likely to have a hepaticoduodenostomy.↗
▶Ep 5 · 2:36
clinicalPatients who underwent open choledochal cyst resection had higher total costs than those who underwent laparoscopic resection.↗
▶Ep 5 · 2:36
clinicalPatients who underwent open choledochal cyst resection were more likely to have a longer length of hospital stay.↗
▶Ep 5 · 2:36
clinicalPatients who underwent open choledochal cyst resection had more complications than those who underwent laparoscopic resection.↗
▶Ep 5 · 2:36
host_summaryPatients who underwent open choledochal cyst resection had higher total costs than those who underwent laparoscopic resection.↗
▶Ep 5 · 2:36
host_summaryPatients who underwent open choledochal cyst resection had more complications than those who underwent laparoscopic resection.↗
▶Ep 5 · 2:36
host_summaryPatients who underwent open choledochal cyst resection were more likely to have a longer length of hospital stay.↗
Journal of Pediatric Surgery Article Review: October 2021
▶Ep 110 · 12:12
host_summaryAfter one year in the bowel management program, 30% of patients still struggled with fecal incontinence despite intensive resources.↗
▶Ep 110 · 14:46
host_summaryThe Italian anorectal malformation study was a retrospective review of 350 patients between 1999 and 2019, representing one of the largest series.↗
▶Ep 110 · 15:29
host_summaryThe Italian study demonstrated a close relationship between spinal cord abnormalities and spinal bone anomalies in anorectal malformation patients.↗
▶Ep 110 · 15:44
host_summaryDespite correlation between spinal bone and cord abnormalities, many patients without sacral or vertebral anomalies still had spinal cord abnormalities, making MRI necessary for screening.↗
▶Ep 110 · 16:01
host_summaryIn typical US practice for anorectal malformations, ultrasound shortly after birth is usually sufficient to look for spinal cord abnormalities, whereas the Italian practice finds MRI necessary.↗
Intestinal rehabilitation: What is intestinal rehab? - Episode 1
▶Ep 112 · 6:30
host_summaryMucosal defects in enteropathies lead to hypersecretion and profuse fluid losses, preventing nutrient absorption.↗
▶Ep 112 · 7:22
host_summaryGastroschisis can involve all three categories: short bowel from nonviable tissue, inflammation affecting absorption, and motility issues.↗
clinicalThere is literature suggesting a component of psychosocial, psychological dissociation in children on later testing related to anal dilations.↗
▶Ep 122 · 1:31
host_summaryThere is literature suggesting a component of psychosocial, psychological dissociation in children on later testing related to anal dilations.↗
▶Ep 122 · 2:55
host_summaryThe number of strictures, number needing anoplasties, and number of redo operations were the same between dilation and no-dilation groups.↗
▶Ep 122 · 2:55
clinicalThe number of strictures, number needing anoplasties, and number of redo operations were the same between dilation and no-dilation groups.↗
▶Ep 122 · 3:04
host_summaryThe number of patients who had rectal prolapse is consistent with the literature.↗
▶Ep 122 · 3:04
clinicalThe number of patients who had rectal prolapse is consistent with the literature.↗
▶Ep 122 · 5:20
clinicalA study of 30-day outcomes for ARM with perineal or rectovaginal fistulas divided patients into early repair (before 6 days old) and late repair (6-8 weeks), with 66 early and 231 late repairs among 291 patients.↗
▶Ep 122 · 5:20
host_summaryA study of 30-day outcomes for ARM with perineal or rectovaginal fistulas divided patients into early repair (before 6 days old) and late repair (6-8 weeks), with 66 early and 231 late repairs among 291 patients.↗
Journal of Pediatric Surgery Article Review: February 2023, BAPS issue
▶Ep 135 · 1:38
clinicalIn Poland, thoracoscopic esophageal atresia repair has been performed exclusively since 2005↗
▶Ep 135 · 1:38
host_summaryIn Poland, thoracoscopic esophageal atresia repair has been performed exclusively since 2005↗
▶Ep 135 · 1:47
quoteWe were happy that our first procedure was successful. When we did another one, it was much easier. Of course, at the beginning, the first procedure took us almost 4 hours. Right now it's a 1 hour procedure, but of course it's very difficult, but we are very happy to have no conversion.↗
▶Ep 135 · 1:47
quoteWe were happy that our first procedure was successful. When we did another one, it was much easier. Of course, at the beginning, the first procedure took us almost 4 hours. Right now it's a 1 hour procedure, but of course it's very difficult, but we are very happy to have no conversion.↗
▶Ep 135 · 1:54
host_summaryThe first thoracoscopic esophageal atresia procedure took almost 4 hours, but with experience it became a 1-hour procedure↗
▶Ep 135 · 1:54
clinicalThe first thoracoscopic esophageal atresia procedure took almost 4 hours, but with experience it became a 1-hour procedure↗
▶Ep 135 · 1:59
clinicalDr. Patkowski's team has had no conversions from thoracoscopic to open approach since beginning the technique↗
▶Ep 135 · 1:59
host_summaryDr. Patkowski's team has had no conversions from thoracoscopic to open approach since beginning the technique↗
▶Ep 135 · 2:06
host_summaryAll esophageal atresia cases in Dr. Patkowski's center have been managed by one team using only the thoracoscopic approach since the beginning↗
▶Ep 135 · 2:06
clinicalAll esophageal atresia cases in Dr. Patkowski's center have been managed by one team using only the thoracoscopic approach since the beginning↗
▶Ep 135 · 2:25
quoteThe first, you need experience in endoscopic surgery. And then just you need time, and you must be very experienced in endoscopic suturing. You must be very slow. If you do it slowly, you will do it fast.↗
▶Ep 135 · 2:25
quoteThe first, you need experience in endoscopic surgery. And then just you need time, and you must be very experienced in endoscopic suturing. You must be very slow. If you do it slowly, you will do it fast.↗
▶Ep 135 · 2:58
quoteEven if this is a higher cost, but probably the costs of complications are much, much more higher than transportation.↗
▶Ep 135 · 2:58
quoteEven if this is a higher cost, but probably the costs of complications are much, much more higher than transportation.↗
▶Ep 135 · 2:58
opinionCentralizing care for esophageal atresia patients is important even if transportation costs are higher, because complication costs are much higher↗
▶Ep 135 · 2:58
host_summaryCentralizing care for esophageal atresia patients is important even if transportation costs are higher, because complication costs are much higher↗
▶Ep 135 · 3:06
host_summaryDr. Patkowski's center handles 15 to 20 esophageal atresia cases per year, which provides sufficient volume for good experience↗
▶Ep 135 · 3:06
clinicalDr. Patkowski's center handles 15 to 20 esophageal atresia cases per year, which provides sufficient volume for good experience↗
▶Ep 135 · 5:41
epidemiologicalIn the stoma cohort, 38 patients had ileostomies and the remaining had colostomies↗
▶Ep 135 · 5:41
host_summaryIn the stoma cohort, 38 patients had ileostomies and the remaining had colostomies↗
▶Ep 135 · 5:46
epidemiologicalThe most common indication for initial stoma in Hirschsprung disease was washout failure, accounting for nearly 40% of cases↗
▶Ep 135 · 5:46
host_summaryThe most common indication for initial stoma in Hirschsprung disease was washout failure, accounting for nearly 40% of cases↗
▶Ep 135 · 6:13
quoteStomma doesn't mean always a failure. Sometimes it's a necessity. Comes with the nature of the disease.↗
▶Ep 135 · 6:13
quoteStomma doesn't mean always a failure. Sometimes it's a necessity. Comes with the nature of the disease.↗
▶Ep 135 · 8:10
host_summarySheffield primarily performs Duhamel pull-throughs while Cincinnati primarily performs Swenson procedures for Hirschsprung disease↗
▶Ep 135 · 8:10
clinicalSheffield primarily performs Duhamel pull-throughs while Cincinnati primarily performs Swenson procedures for Hirschsprung disease↗
Quick Literature Updates Episode 7
▶Ep 138 · 3:35
host_summaryTendon et al. conducted a prospective randomized control trial between 2017 and 2018 comparing three skin closure methods: sutures with tissue adhesive, sutures with adhesive tape, and sutures alone.↗
▶Ep 138 · 3:35
host_summaryWounds were assessed at two weeks, six weeks, and more than six months after operation by surveying clinicians and parents.↗
Quick Literature Updates Episode 14
▶Ep 149 · 1:03
epidemiologicalThe study by Ahmad et al. examined 384 females with anorectal malformations using the Pediatric Colorectal and Pelvic Learning Consortium database.↗
▶Ep 149 · 1:03
host_summaryThe study by Ahmad et al. examined 384 females with anorectal malformations using the Pediatric Colorectal and Pelvic Learning Consortium database.↗
▶Ep 149 · 1:22
host_summaryAbout 27% of patients with anorectal malformations had a gynecologic anomaly.↗
▶Ep 149 · 1:22
epidemiologicalAbout 46% of females with anorectal malformations had VACTERL association, defined as having the anorectal malformation plus two of: vertebral, cardiac, tracheoesophageal, renal, or limb anomaly.↗
▶Ep 149 · 1:22
epidemiologicalAbout 27% of patients with anorectal malformations had a gynecologic anomaly.↗
▶Ep 149 · 1:22
host_summaryAbout 46% of females with anorectal malformations had VACTERL association, defined as having the anorectal malformation plus two of: vertebral, cardiac, tracheoesophageal, renal, or limb anomaly.↗
▶Ep 149 · 1:39
host_summaryHaving VACTERL association was associated with more gynecologic anomalies compared to patients without VACTERL association.↗
▶Ep 149 · 1:39
clinicalHaving VACTERL association was associated with more gynecologic anomalies compared to patients without VACTERL association.↗
▶Ep 149 · 1:49
clinicalThe association between VACTERL and gynecologic anomalies was especially true when renal anomalies were found.↗
▶Ep 149 · 1:49
host_summaryThe association between VACTERL and gynecologic anomalies was especially true when renal anomalies were found.↗
▶Ep 149 · 1:49
clinicalThe association between VACTERL and gynecologic anomalies was especially true when patients had recto vestibular or rectal perineal fistulas.↗
▶Ep 149 · 1:49
host_summaryThe association between VACTERL and gynecologic anomalies was especially true when patients had recto vestibular or rectal perineal fistulas.↗
▶Ep 149 · 1:57
quoteSo for females with inner rectum malformations and veal association, especially renal anomalies, we should look carefully for gynecologic anomalies.↗
▶Ep 149 · 1:57
host_summaryFor females with anorectal malformations and VACTERL association, especially renal anomalies, clinicians should look carefully for gynecologic anomalies.↗
▶Ep 149 · 1:57
guidelineFor females with anorectal malformations and VACTERL association, especially renal anomalies, clinicians should look carefully for gynecologic anomalies.↗
▶Ep 149 · 1:57
quoteSo for females with inner rectum malformations and veal association, especially renal anomalies, we should look carefully for gynecologic anomalies.↗
Quick Literature Updates Episode 15
▶Ep 156 · 2:11
host_summaryThe choledochal cyst study used the nationwide readmissions database and identified 577 children who underwent choledochal cyst resection between 2016 and 2018.↗
▶Ep 156 · 2:11
epidemiologicalThe choledochal cyst study used the nationwide readmissions database and identified 577 children who underwent choledochal cyst resection between 2016 and 2018.↗
▶Ep 156 · 2:21
clinicalPatients who underwent open choledochal cyst resection were more likely to have a Roux-en-Y hepaticojejunostomy.↗
▶Ep 156 · 2:21
clinicalPatients who underwent laparoscopic choledochal cyst resection were more likely to have a hepaticoduodenostomy.↗
▶Ep 156 · 2:21
host_summaryPatients who underwent laparoscopic choledochal cyst resection were more likely to have a hepaticoduodenostomy.↗
▶Ep 156 · 2:21
epidemiologicalThe majority of pediatric choledochal cyst patients underwent open resection.↗
▶Ep 156 · 2:21
host_summaryThe majority of pediatric choledochal cyst patients underwent open resection.↗
▶Ep 156 · 2:21
host_summaryPatients who underwent open choledochal cyst resection were more likely to have a Roux-en-Y hepaticojejunostomy.↗
▶Ep 156 · 2:36
host_summaryPatients who underwent open choledochal cyst resection were more likely to have a longer length of hospital stay.↗
▶Ep 156 · 2:36
host_summaryPatients who underwent open choledochal cyst resection had more complications than those who underwent laparoscopic resection.↗
▶Ep 156 · 2:36
host_summaryPatients who underwent open choledochal cyst resection had higher total costs than those who underwent laparoscopic resection.↗
▶Ep 156 · 2:36
clinicalPatients who underwent open choledochal cyst resection had higher total costs than those who underwent laparoscopic resection.↗
▶Ep 156 · 2:36
clinicalPatients who underwent open choledochal cyst resection were more likely to have a longer length of hospital stay.↗
▶Ep 156 · 2:36
clinicalPatients who underwent open choledochal cyst resection had more complications than those who underwent laparoscopic resection.↗
Journal of Pediatric Surgery Article Review: November 2021
▶Ep 7 · 1:09
epidemiological40% of patients ultimately required a central venous line within 30 days after ECMO decannulation in the University of Michigan study↗
▶Ep 7 · 1:09
host_summary40% of patients ultimately required a central venous line within 30 days after ECMO decannulation in the University of Michigan study↗
▶Ep 7 · 2:27
host_summaryIn neonates (babies less than 28 days), the primary reason for needing a central line after ECMO decannulation was access, with many being CDH babies↗
▶Ep 7 · 2:27
epidemiologicalIn neonates (babies less than 28 days), the primary reason for needing a central line after ECMO decannulation was access, with many being CDH babies↗
▶Ep 7 · 2:41
epidemiologicalIn older children or babies, the primary reason for needing a line after ECMO decannulation was hemodialysis↗
▶Ep 7 · 2:41
host_summaryIn older children or babies, the primary reason for needing a line after ECMO decannulation was hemodialysis↗
▶Ep 7 · 8:40
host_summaryThe Indianapolis partial splenectomy study reviewed cases over 17 years from 2002 to 2019↗
▶Ep 7 · 8:40
epidemiologicalThe Indianapolis partial splenectomy study reviewed cases over 17 years from 2002 to 2019↗
▶Ep 7 · 9:40
host_summaryAbout 29% of patients required completion splenectomy after partial splenectomy↗
▶Ep 7 · 9:40
epidemiologicalAbout 29% of patients required completion splenectomy after partial splenectomy↗
Neonatal Gastric Volvulus with Dr. Jason Frischer
▶Ep 9 · 5:32
clinicalOn upper GI contrast study in gastric volvulus, contrast probably does not go past the stomach if it makes it into the stomach.↗
▶Ep 9 · 5:32
quoteYou would probably see that it doesn't go past the stomach if it makes it into the stomach.↗
▶Ep 9 · 5:53
clinicalIn organoaxial volvulus, if contrast gets past the GE junction into the stomach, the greater curvature appears flipped up.↗
Journal of Pediatric Surgery Article Review: November 2021
▶Ep 26 · 1:09
epidemiological40% of patients ultimately required a central venous line within 30 days after ECMO decannulation in the University of Michigan study↗
▶Ep 26 · 1:09
host_summary40% of patients ultimately required a central venous line within 30 days after ECMO decannulation in the University of Michigan study↗
▶Ep 26 · 2:27
host_summaryIn neonates (babies less than 28 days), the primary reason for needing a central line after ECMO decannulation was access, with many being CDH babies↗
▶Ep 26 · 2:27
epidemiologicalIn neonates (babies less than 28 days), the primary reason for needing a central line after ECMO decannulation was access, with many being CDH babies↗
▶Ep 26 · 2:41
host_summaryIn older children or babies, the primary reason for needing a line after ECMO decannulation was hemodialysis↗
▶Ep 26 · 2:41
epidemiologicalIn older children or babies, the primary reason for needing a line after ECMO decannulation was hemodialysis↗
▶Ep 26 · 8:40
host_summaryThe Indianapolis partial splenectomy study reviewed cases over 17 years from 2002 to 2019↗
▶Ep 26 · 8:40
epidemiologicalThe Indianapolis partial splenectomy study reviewed cases over 17 years from 2002 to 2019↗
▶Ep 26 · 9:40
epidemiologicalAbout 29% of patients required completion splenectomy after partial splenectomy↗
▶Ep 26 · 9:40
host_summaryAbout 29% of patients required completion splenectomy after partial splenectomy↗
Case Based Journal Review - CPAM in 2022
▶Ep 27 · 2:38
clinical57% (68 patients) of the 119 cases were managed conservatively, and none of those who could be followed up became symptomatic↗
▶Ep 27 · 2:38
host_summary57% (68 patients) of the 119 cases were managed conservatively, and none of those who could be followed up became symptomatic↗
▶Ep 27 · 4:36
host_summaryOut of 344 prenatally diagnosed lesions, none had malignant pathology when resected↗
▶Ep 27 · 4:36
clinicalOut of 344 prenatally diagnosed lesions, none had malignant pathology when resected↗
▶Ep 27 · 5:03
epidemiologicalThe risk of malignancy approached 10% for lung masses diagnosed postnatally↗
▶Ep 27 · 5:03
host_summaryThe risk of malignancy approached 10% for lung masses diagnosed postnatally↗
▶Ep 27 · 7:08
host_summaryThe study was retrospective and looked at about 90 patients undergoing thoracoscopic lung resections↗
▶Ep 27 · 7:08
clinicalThe study was retrospective and looked at about 90 patients undergoing thoracoscopic lung resections↗
▶Ep 27 · 10:07
clinicalThere were no differences in major complications, conversion rates, or readmissions between the three age groups↗
▶Ep 27 · 10:07
host_summaryThere were no differences in major complications, conversion rates, or readmissions between the three age groups↗
Case Based Journal Review: Esophageal Atresia in 2022
▶Ep 9 · 3:02
host_summaryIn a meta-analysis of almost 700 neonates, preserving the azygous vein resulted in significantly lower postoperative pneumonitis compared to division↗
▶Ep 9 · 3:11
host_summaryThere was no significant difference in anastomotic leak rate or stricture rate between azygous vein preservation and division↗
▶Ep 9 · 6:43
host_summaryIn the Quebec study of 244 patients, the overall anastomotic stricture rate at one year was 30%↗
▶Ep 9 · 6:50
host_summary36% of patients with transanastomotic tubes developed strictures compared to 19% without tubes, a difference that remained significant after multivariable analysis↗
▶Ep 9 · 7:06
host_summaryPatients with transanastomotic tubes had 2.72 times higher odds of developing a stricture compared to those without↗
▶Ep 9 · 14:54
host_summaryIn the Midwest Pediatric Surgery Consortium study, antibiotics for more than 24 hours and acid suppression showed no difference in strictures or leaks↗
Journal of Pediatric Surgery Article Review: February 2023, BAPS issue
▶Ep 10 · 1:38
host_summaryIn Poland, thoracoscopic esophageal atresia repair has been performed exclusively since 2005↗
▶Ep 10 · 1:47
quoteWe were happy that our first procedure was successful. When we did another one, it was much easier. Of course, at the beginning, the first procedure took us almost 4 hours. Right now it's a 1 hour procedure, but of course it's very difficult, but we are very happy to have no conversion.↗
▶Ep 10 · 1:54
host_summaryThe first thoracoscopic esophageal atresia procedure took almost 4 hours, but with experience it became a 1-hour procedure↗
▶Ep 10 · 1:59
host_summaryDr. Patkowski's team has had no conversions from thoracoscopic to open approach since beginning the technique↗
▶Ep 10 · 2:06
host_summaryAll esophageal atresia cases in Dr. Patkowski's center have been managed by one team using only the thoracoscopic approach since the beginning↗
▶Ep 10 · 2:25
quoteThe first, you need experience in endoscopic surgery. And then just you need time, and you must be very experienced in endoscopic suturing. You must be very slow. If you do it slowly, you will do it fast.↗
▶Ep 10 · 2:58
host_summaryCentralizing care for esophageal atresia patients is important even if transportation costs are higher, because complication costs are much higher↗
▶Ep 10 · 2:58
quoteEven if this is a higher cost, but probably the costs of complications are much, much more higher than transportation.↗
▶Ep 10 · 3:06
host_summaryDr. Patkowski's center handles 15 to 20 esophageal atresia cases per year, which provides sufficient volume for good experience↗
▶Ep 10 · 5:41
host_summaryIn the stoma cohort, 38 patients had ileostomies and the remaining had colostomies↗
▶Ep 10 · 5:46
host_summaryThe most common indication for initial stoma in Hirschsprung disease was washout failure, accounting for nearly 40% of cases↗
▶Ep 10 · 6:13
quoteStomma doesn't mean always a failure. Sometimes it's a necessity. Comes with the nature of the disease.↗
▶Ep 10 · 8:10
host_summarySheffield primarily performs Duhamel pull-throughs while Cincinnati primarily performs Swenson procedures for Hirschsprung disease↗
Journal of Pediatric Surgery Article Review: October 2021
▶Ep 33 · 12:12
host_summaryAfter one year in the bowel management program, 30% of patients still struggled with fecal incontinence despite intensive resources.↗
▶Ep 33 · 14:46
host_summaryThe Italian anorectal malformation study was a retrospective review of 350 patients between 1999 and 2019, representing one of the largest series.↗
▶Ep 33 · 15:29
host_summaryThe Italian study demonstrated a close relationship between spinal cord abnormalities and spinal bone anomalies in anorectal malformation patients.↗
▶Ep 33 · 15:44
host_summaryDespite correlation between spinal bone and cord abnormalities, many patients without sacral or vertebral anomalies still had spinal cord abnormalities, making MRI necessary for screening.↗
▶Ep 33 · 16:01
host_summaryIn typical US practice for anorectal malformations, ultrasound shortly after birth is usually sufficient to look for spinal cord abnormalities, whereas the Italian practice finds MRI necessary.↗
Intestinal rehabilitation: What is intestinal rehab? - Episode 1
▶Ep 34 · 6:30
host_summaryMucosal defects in enteropathies lead to hypersecretion and profuse fluid losses, preventing nutrient absorption.↗
▶Ep 34 · 7:22
host_summaryGastroschisis can involve all three categories: short bowel from nonviable tissue, inflammation affecting absorption, and motility issues.↗
Neonatal Gastric Volvulus with Dr. Jason Frischer
▶Ep 43 · 5:32
quoteYou would probably see that it doesn't go past the stomach if it makes it into the stomach.↗
▶Ep 43 · 5:32
clinicalOn upper GI contrast study in gastric volvulus, contrast probably does not go past the stomach if it makes it into the stomach.↗
▶Ep 43 · 5:53
clinicalIn organoaxial volvulus, if contrast gets past the GE junction into the stomach, the greater curvature appears flipped up.↗
host_summaryGunshot wound victims were more likely to require immediate surgery and had increased mortality compared to MVC victims.↗
▶Ep 49 · 0:20
host_summaryGunshot wound victims were 7.8 times more likely to die than MVC victims.↗
▶Ep 49 · 0:20
host_summaryTeodoro et al. studied pediatric trauma patients presenting to a level one trauma center with gunshot wounds or MVCs between 2009 and 2019.↗
▶Ep 49 · 0:20
host_summaryTeodoro et al. examined California Department of Public Health data on pediatric gunshot wounds and MVCs from 2006 to 2015.↗
▶Ep 49 · 0:20
host_summaryIn California statewide data, the case fatality rate for gunshot wound victims was higher than that for motor vehicle collisions.↗
Quick Literature Updates Episode 11
▶Ep 52 · 0:46
host_summaryStevens et al. examined CDC Wonder database data between 1999 and 2020 for pediatric firearm and automobile fatalities.↗
▶Ep 52 · 0:46
quoteThere was a 55% lower firearm fatality rate for the states with the strongest gun laws compared to those with the weakest gun laws.↗
▶Ep 52 · 0:46
host_summaryIn recent years, the fatality rate for firearms has surpassed the fatality rate for automobiles in children.↗
▶Ep 52 · 0:46
host_summaryStronger gun laws were associated with decreased fatality rates, with a 55% lower firearm fatality rate for states with the strongest gun laws compared to those with the weakest gun laws.↗
▶Ep 52 · 0:46
quoteAs other recent studies had shown, in the last few years, the fatality rate for firearms has surpassed the fatality rate for automobiles in children.↗
▶Ep 52 · 0:46
host_summaryStevens et al. used the Gifford's Law Center annual gun law scorecard between 2014 and 2020 to assess state gun law scores.↗
host_summaryComponent separation technique involves separating tissue at the external oblique about a centimeter beyond the rectus sheath on both sides, dissecting between external and internal oblique, and optionally making an incision on the anterior rectus sheath for another centimeter of space↗
▶Ep 73 · 10:26
host_summaryA Texas report described component separation use in nine children aged seven days to 10 years, mostly for omphaloceles and giant defects, achieving fascial closure in the vast majority with some mesh use for bridging↗
host_summaryGunshot wound victims were 7.8 times more likely to die than MVC victims.↗
▶Ep 7 · 0:20
host_summaryTeodoro et al. studied pediatric trauma patients presenting to a level one trauma center with gunshot wounds or MVCs between 2009 and 2019.↗
▶Ep 7 · 0:20
host_summaryTeodoro et al. examined California Department of Public Health data on pediatric gunshot wounds and MVCs from 2006 to 2015.↗
▶Ep 7 · 0:20
host_summaryGunshot wound victims were more likely to require immediate surgery and had increased mortality compared to MVC victims.↗
▶Ep 7 · 0:20
host_summaryIn California statewide data, the case fatality rate for gunshot wound victims was higher than that for motor vehicle collisions.↗
Quick Literature Updates Episode 11
▶Ep 20 · 0:46
host_summaryStevens et al. examined CDC Wonder database data between 1999 and 2020 for pediatric firearm and automobile fatalities.↗
▶Ep 20 · 0:46
host_summaryStevens et al. used the Gifford's Law Center annual gun law scorecard between 2014 and 2020 to assess state gun law scores.↗
▶Ep 20 · 0:46
host_summaryIn recent years, the fatality rate for firearms has surpassed the fatality rate for automobiles in children.↗
▶Ep 20 · 0:46
host_summaryStronger gun laws were associated with decreased fatality rates, with a 55% lower firearm fatality rate for states with the strongest gun laws compared to those with the weakest gun laws.↗
▶Ep 20 · 0:46
quoteAs other recent studies had shown, in the last few years, the fatality rate for firearms has surpassed the fatality rate for automobiles in children.↗
▶Ep 20 · 0:46
quoteThere was a 55% lower firearm fatality rate for the states with the strongest gun laws compared to those with the weakest gun laws.↗
host_summaryComponent separation technique involves separating tissue at the external oblique about a centimeter beyond the rectus sheath on both sides, dissecting between external and internal oblique, and optionally making an incision on the anterior rectus sheath for another centimeter of space↗
▶Ep 8 · 10:26
host_summaryA Texas report described component separation use in nine children aged seven days to 10 years, mostly for omphaloceles and giant defects, achieving fascial closure in the vast majority with some mesh use for bridging↗
host_summaryIn the Petcova et al. study published in Annals of Surgery 2020, children with uncomplicated appendicitis were randomized to medical management with antibiotics or surgery, with 5-year follow-up.↗
▶Ep 46 · 1:22
host_summaryMedical management of acute uncomplicated appendicitis may be safe but is associated with a high failure rate, with many children ultimately requiring laparoscopic appendectomy.↗
▶Ep 46 · 4:43
host_summaryIndocyanine green (ICG) has become a topic of interest in the last few years for use in pediatric surgery, especially in minimally invasive procedures to improve visualization of structures.↗
▶Ep 46 · 5:20
quoteYou can see very well the biliary anatomy is absolutely. Amazing, as you can see, the main biliary tree, the gallbladder, and then the cystic duct.↗
▶Ep 46 · 5:32
host_summaryFor laparoscopic cholecystectomy, ICG must be administered intravenously 12 to 18 hours prior to surgery to allow time for accumulation in the extrahepatic ducts, or can be injected directly into the gallbladder during surgery.↗
▶Ep 46 · 5:48
host_summaryICG applications in pediatric surgery include laparoscopic cholecystectomies, varicocele repairs, partial nephrectomies, and tumor excisions.↗
▶Ep 46 · 9:48
host_summaryThe double rim sign or halo sign on X-ray indicates a child has swallowed a button battery rather than a coin.↗
▶Ep 46 · 10:00
quoteThis strikes fear at the heart of of uh ENT surgeons, gastroenterologists, and pediatric surgeons.↗
▶Ep 46 · 10:13
host_summaryThe main goal of button battery ingestion treatment is to remove the battery within 2 hours of ingestion.↗
▶Ep 46 · 10:20
host_summarySucralfate or honey can help reduce damage from button batteries on the child's esophagus as temporizing measures.↗
▶Ep 46 · 10:27
quoteWhat you need to do is cut down on the damage, the injury that this is doing. Sucralfate or honey can help.↗
▶Ep 46 · 10:35
host_summaryChildren less than 1 year old should not receive honey due to risk of botulism and should instead receive 10 mL of sucralfate every 10 minutes for up to 3 doses for button battery ingestion.↗
▶Ep 46 · 10:51
host_summaryChildren over age 1 with button battery ingestion should receive honey 10 mL every 10 minutes for up to 6 doses.↗
▶Ep 46 · 14:10
host_summaryGreenwood et al. showed that mortality amongst black newborns is 3 times that of white newborns.↗
▶Ep 46 · 14:19
host_summaryWhen black newborns are treated by black physicians, their mortality is reduced by 58% compared to black newborns treated by white physicians.↗
▶Ep 46 · 14:30
host_summaryBias exists within medicine and can change outcomes; representation matters and can make a difference.↗
▶Ep 46 · 14:57
quoterecognizing that we all have biases and not being defensive when someone says there's bias in that because we all have bias. We know that we all have bias. And so the question is, what are your biases and how do they affect what you do? So I would push everyone. To say, as you're thinking about this work, as you, as you live in this space, you know, what are you doing about it?↗
▶Ep 46 · 15:21
quoteSo let's not just settle to talk about it, but let's figure out what the system level changes are that make a difference and change the outcome.↗
clinicalThere is literature suggesting a component of psychosocial, psychological dissociation in children on later testing related to anal dilations.↗
▶Ep 51 · 2:55
clinicalThe number of strictures, number needing anoplasties, and number of redo operations were the same between dilation and no-dilation groups.↗
▶Ep 51 · 3:04
clinicalThe number of patients who had rectal prolapse is consistent with the literature.↗
▶Ep 51 · 5:20
clinicalA study of 30-day outcomes for ARM with perineal or rectovaginal fistulas divided patients into early repair (before 6 days old) and late repair (6-8 weeks), with 66 early and 231 late repairs among 291 patients.↗
Journal of Pediatric Surgery Article Review: February 2023, BAPS issue
▶Ep 55 · 1:38
clinicalIn Poland, thoracoscopic esophageal atresia repair has been performed exclusively since 2005↗
▶Ep 55 · 1:38
host_summaryIn Poland, thoracoscopic esophageal atresia repair has been performed exclusively since 2005↗
▶Ep 55 · 1:47
quoteWe were happy that our first procedure was successful. When we did another one, it was much easier. Of course, at the beginning, the first procedure took us almost 4 hours. Right now it's a 1 hour procedure, but of course it's very difficult, but we are very happy to have no conversion.↗
▶Ep 55 · 1:47
quoteWe were happy that our first procedure was successful. When we did another one, it was much easier. Of course, at the beginning, the first procedure took us almost 4 hours. Right now it's a 1 hour procedure, but of course it's very difficult, but we are very happy to have no conversion.↗
▶Ep 55 · 1:54
clinicalThe first thoracoscopic esophageal atresia procedure took almost 4 hours, but with experience it became a 1-hour procedure↗
▶Ep 55 · 1:54
host_summaryThe first thoracoscopic esophageal atresia procedure took almost 4 hours, but with experience it became a 1-hour procedure↗
▶Ep 55 · 1:59
clinicalDr. Patkowski's team has had no conversions from thoracoscopic to open approach since beginning the technique↗
▶Ep 55 · 1:59
host_summaryDr. Patkowski's team has had no conversions from thoracoscopic to open approach since beginning the technique↗
▶Ep 55 · 2:06
host_summaryAll esophageal atresia cases in Dr. Patkowski's center have been managed by one team using only the thoracoscopic approach since the beginning↗
▶Ep 55 · 2:06
clinicalAll esophageal atresia cases in Dr. Patkowski's center have been managed by one team using only the thoracoscopic approach since the beginning↗
▶Ep 55 · 2:25
quoteThe first, you need experience in endoscopic surgery. And then just you need time, and you must be very experienced in endoscopic suturing. You must be very slow. If you do it slowly, you will do it fast.↗
▶Ep 55 · 2:25
quoteThe first, you need experience in endoscopic surgery. And then just you need time, and you must be very experienced in endoscopic suturing. You must be very slow. If you do it slowly, you will do it fast.↗
▶Ep 55 · 2:58
quoteEven if this is a higher cost, but probably the costs of complications are much, much more higher than transportation.↗
▶Ep 55 · 2:58
host_summaryCentralizing care for esophageal atresia patients is important even if transportation costs are higher, because complication costs are much higher↗
▶Ep 55 · 2:58
quoteEven if this is a higher cost, but probably the costs of complications are much, much more higher than transportation.↗
▶Ep 55 · 2:58
opinionCentralizing care for esophageal atresia patients is important even if transportation costs are higher, because complication costs are much higher↗
▶Ep 55 · 3:06
clinicalDr. Patkowski's center handles 15 to 20 esophageal atresia cases per year, which provides sufficient volume for good experience↗
▶Ep 55 · 3:06
host_summaryDr. Patkowski's center handles 15 to 20 esophageal atresia cases per year, which provides sufficient volume for good experience↗
▶Ep 55 · 5:41
host_summaryIn the stoma cohort, 38 patients had ileostomies and the remaining had colostomies↗
▶Ep 55 · 5:41
epidemiologicalIn the stoma cohort, 38 patients had ileostomies and the remaining had colostomies↗
▶Ep 55 · 5:46
epidemiologicalThe most common indication for initial stoma in Hirschsprung disease was washout failure, accounting for nearly 40% of cases↗
▶Ep 55 · 5:46
host_summaryThe most common indication for initial stoma in Hirschsprung disease was washout failure, accounting for nearly 40% of cases↗
▶Ep 55 · 6:13
quoteStomma doesn't mean always a failure. Sometimes it's a necessity. Comes with the nature of the disease.↗
▶Ep 55 · 6:13
quoteStomma doesn't mean always a failure. Sometimes it's a necessity. Comes with the nature of the disease.↗
▶Ep 55 · 8:10
host_summarySheffield primarily performs Duhamel pull-throughs while Cincinnati primarily performs Swenson procedures for Hirschsprung disease↗
▶Ep 55 · 8:10
clinicalSheffield primarily performs Duhamel pull-throughs while Cincinnati primarily performs Swenson procedures for Hirschsprung disease↗
Quick Literature Updates Episode 7
▶Ep 58 · 3:35
host_summaryWounds were assessed at two weeks, six weeks, and more than six months after operation by surveying clinicians and parents.↗
▶Ep 58 · 3:35
host_summaryTendon et al. conducted a prospective randomized control trial between 2017 and 2018 comparing three skin closure methods: sutures with tissue adhesive, sutures with adhesive tape, and sutures alone.↗
Quick Literature Updates Episode 15
▶Ep 66 · 2:11
epidemiologicalThe choledochal cyst study used the nationwide readmissions database and identified 577 children who underwent choledochal cyst resection between 2016 and 2018.↗
▶Ep 66 · 2:11
host_summaryThe choledochal cyst study used the nationwide readmissions database and identified 577 children who underwent choledochal cyst resection between 2016 and 2018.↗
▶Ep 66 · 2:21
clinicalPatients who underwent open choledochal cyst resection were more likely to have a Roux-en-Y hepaticojejunostomy.↗
▶Ep 66 · 2:21
host_summaryThe majority of pediatric choledochal cyst patients underwent open resection.↗
▶Ep 66 · 2:21
host_summaryPatients who underwent open choledochal cyst resection were more likely to have a Roux-en-Y hepaticojejunostomy.↗
▶Ep 66 · 2:21
host_summaryPatients who underwent laparoscopic choledochal cyst resection were more likely to have a hepaticoduodenostomy.↗
▶Ep 66 · 2:21
epidemiologicalThe majority of pediatric choledochal cyst patients underwent open resection.↗
▶Ep 66 · 2:21
clinicalPatients who underwent laparoscopic choledochal cyst resection were more likely to have a hepaticoduodenostomy.↗
▶Ep 66 · 2:36
clinicalPatients who underwent open choledochal cyst resection had more complications than those who underwent laparoscopic resection.↗
▶Ep 66 · 2:36
clinicalPatients who underwent open choledochal cyst resection had higher total costs than those who underwent laparoscopic resection.↗
▶Ep 66 · 2:36
clinicalPatients who underwent open choledochal cyst resection were more likely to have a longer length of hospital stay.↗
▶Ep 66 · 2:36
host_summaryPatients who underwent open choledochal cyst resection had higher total costs than those who underwent laparoscopic resection.↗
▶Ep 66 · 2:36
host_summaryPatients who underwent open choledochal cyst resection had more complications than those who underwent laparoscopic resection.↗
▶Ep 66 · 2:36
host_summaryPatients who underwent open choledochal cyst resection were more likely to have a longer length of hospital stay.↗
host_summaryThe choledochal cyst study used the nationwide readmissions database and identified 577 children who underwent choledochal cyst resection between 2016 and 2018.↗
▶Ep 3 · 2:11
epidemiologicalThe choledochal cyst study used the nationwide readmissions database and identified 577 children who underwent choledochal cyst resection between 2016 and 2018.↗
▶Ep 3 · 2:21
epidemiologicalThe majority of pediatric choledochal cyst patients underwent open resection.↗
▶Ep 3 · 2:21
clinicalPatients who underwent laparoscopic choledochal cyst resection were more likely to have a hepaticoduodenostomy.↗
▶Ep 3 · 2:21
clinicalPatients who underwent open choledochal cyst resection were more likely to have a Roux-en-Y hepaticojejunostomy.↗
▶Ep 3 · 2:21
host_summaryPatients who underwent laparoscopic choledochal cyst resection were more likely to have a hepaticoduodenostomy.↗
▶Ep 3 · 2:21
host_summaryThe majority of pediatric choledochal cyst patients underwent open resection.↗
▶Ep 3 · 2:21
host_summaryPatients who underwent open choledochal cyst resection were more likely to have a Roux-en-Y hepaticojejunostomy.↗
▶Ep 3 · 2:36
host_summaryPatients who underwent open choledochal cyst resection had higher total costs than those who underwent laparoscopic resection.↗
▶Ep 3 · 2:36
host_summaryPatients who underwent open choledochal cyst resection were more likely to have a longer length of hospital stay.↗
▶Ep 3 · 2:36
host_summaryPatients who underwent open choledochal cyst resection had more complications than those who underwent laparoscopic resection.↗
▶Ep 3 · 2:36
clinicalPatients who underwent open choledochal cyst resection had higher total costs than those who underwent laparoscopic resection.↗
▶Ep 3 · 2:36
clinicalPatients who underwent open choledochal cyst resection were more likely to have a longer length of hospital stay.↗
▶Ep 3 · 2:36
clinicalPatients who underwent open choledochal cyst resection had more complications than those who underwent laparoscopic resection.↗
Intestinal rehabilitation: What is intestinal rehab? - Episode 1
▶Ep 8 · 6:30
host_summaryMucosal defects in enteropathies lead to hypersecretion and profuse fluid losses, preventing nutrient absorption.↗
▶Ep 8 · 7:22
host_summaryGastroschisis can involve all three categories: short bowel from nonviable tissue, inflammation affecting absorption, and motility issues.↗
Intestinal Rehabilitation, Episode 4: Surgical Management, Part 1
▶Ep 18 · 1:50
host_summaryIn the 1980s and 1990s, babies with intestinal failure had poor outcomes primarily due to liver progression to inflammation and fibrosis associated with parenteral nutrition, lipids, and phytosterols.↗
▶Ep 18 · 9:36
host_summaryAt birth, neonatal bowel is usually not dilated enough to apply the STEP procedure.↗
▶Ep 18 · 15:57
host_summaryIf one part of the stepped bowel becomes dilated, the STEP segments can rotate away from each other separately, causing twisting and functional obstruction.↗
Intestinal Rehabilitation, Episode 4: Surgical Management, Part 1
▶Ep 19 · 1:50
host_summaryIn the 1980s and 1990s, babies with intestinal failure had poor outcomes primarily due to liver progression to inflammation and fibrosis associated with parenteral nutrition, lipids, and phytosterols.↗
▶Ep 19 · 9:36
host_summaryAt birth, neonatal bowel is usually not dilated enough to apply the STEP procedure.↗
▶Ep 19 · 15:57
host_summaryIf one part of the stepped bowel becomes dilated, the STEP segments can rotate away from each other separately, causing twisting and functional obstruction.↗
Intestinal Rehabilitation, Episode 4: Surgical Management, Part 2
▶Ep 20 · 2:04
host_summarySTEP does not create new bowel but redistributes it to reestablish more normal caliber bowel, which helps improve motility overall.↗
▶Ep 20 · 3:33
host_summaryAbout 50% reduction in parental nutrition support can be expected after STEP.↗
▶Ep 20 · 6:32
host_summaryThere is a whole spectrum of findings from ulcers at staple lines, from just having specks of blood in the stool to enough bleeding that kids might have to be transfused every week and a half.↗
▶Ep 20 · 6:47
host_summaryStaple line ulcers can recur after treatment.↗
▶Ep 20 · 7:21
host_summaryTeams have tried enteral omega 3 lipid supplements, bacterial overgrowth management with cycled antibiotics or probiotics, 5ASA, budesonide, and immune modulators like Remicade for staple line bleeding, but none have been the perfect remedy.↗
▶Ep 20 · 7:52
host_summaryThe underlying issue in staple line bleeding is not in the bowel but actually in the mesentery.↗
▶Ep 20 · 8:17
host_summaryMesenteric inflammation causes scarring and obstructs venous outflow, leading to enlarged veins and venous hypertension on the bowel, and even large lymph nodes from lymphatic obstruction.↗
▶Ep 20 · 9:00
host_summaryDr. Helmrath typically revises the staple line with a hand sewn stitch when mesenteric scarring and venous hypertension are present.↗
▶Ep 20 · 10:25
host_summaryDoing things in a staged fashion is typical for the intestinal rehabilitation patient population.↗
▶Ep 20 · 10:45
host_summaryAs intestinal rehabilitation patients grow and develop, more issues might arise requiring additional operations.↗
▶Ep 20 · 11:15
host_summaryIntestinal rehabilitation is a lifelong issue, and surgeons typically follow these patients for a long time.↗
Journal of Pediatric Surgery Article Review: October 2021
▶Ep 45 · 12:12
host_summaryAfter one year in the bowel management program, 30% of patients still struggled with fecal incontinence despite intensive resources.↗
▶Ep 45 · 14:46
host_summaryThe Italian anorectal malformation study was a retrospective review of 350 patients between 1999 and 2019, representing one of the largest series.↗
▶Ep 45 · 15:29
host_summaryThe Italian study demonstrated a close relationship between spinal cord abnormalities and spinal bone anomalies in anorectal malformation patients.↗
▶Ep 45 · 15:44
host_summaryDespite correlation between spinal bone and cord abnormalities, many patients without sacral or vertebral anomalies still had spinal cord abnormalities, making MRI necessary for screening.↗
▶Ep 45 · 16:01
host_summaryIn typical US practice for anorectal malformations, ultrasound shortly after birth is usually sufficient to look for spinal cord abnormalities, whereas the Italian practice finds MRI necessary.↗
Intestinal rehabilitation: What is intestinal rehab? - Episode 1
▶Ep 46 · 6:30
host_summaryMucosal defects in enteropathies lead to hypersecretion and profuse fluid losses, preventing nutrient absorption.↗
▶Ep 46 · 7:22
host_summaryGastroschisis can involve all three categories: short bowel from nonviable tissue, inflammation affecting absorption, and motility issues.↗
Neonatal Gastric Volvulus with Dr. Jason Frischer
▶Ep 59 · 5:32
clinicalOn upper GI contrast study in gastric volvulus, contrast probably does not go past the stomach if it makes it into the stomach.↗
▶Ep 59 · 5:32
quoteYou would probably see that it doesn't go past the stomach if it makes it into the stomach.↗
▶Ep 59 · 5:53
clinicalIn organoaxial volvulus, if contrast gets past the GE junction into the stomach, the greater curvature appears flipped up.↗
Intestinal Rehabilitation, Episode 4: Surgical Management, Part 1
▶Ep 66 · 1:50
host_summaryIn the 1980s and 1990s, babies with intestinal failure had poor outcomes primarily due to liver progression to inflammation and fibrosis associated with parenteral nutrition, lipids, and phytosterols.↗
▶Ep 66 · 9:36
host_summaryAt birth, neonatal bowel is usually not dilated enough to apply the STEP procedure.↗
▶Ep 66 · 15:57
host_summaryIf one part of the stepped bowel becomes dilated, the STEP segments can rotate away from each other separately, causing twisting and functional obstruction.↗
Intestinal Rehabilitation, Episode 4: Surgical Management, Part 1
▶Ep 67 · 1:50
host_summaryIn the 1980s and 1990s, babies with intestinal failure had poor outcomes primarily due to liver progression to inflammation and fibrosis associated with parenteral nutrition, lipids, and phytosterols.↗
▶Ep 67 · 9:36
host_summaryAt birth, neonatal bowel is usually not dilated enough to apply the STEP procedure.↗
▶Ep 67 · 15:57
host_summaryIf one part of the stepped bowel becomes dilated, the STEP segments can rotate away from each other separately, causing twisting and functional obstruction.↗
Intestinal Rehabilitation, Episode 4: Surgical Management, Part 2
▶Ep 68 · 2:04
host_summarySTEP does not create new bowel but redistributes it to reestablish more normal caliber bowel, which helps improve motility overall.↗
▶Ep 68 · 3:33
host_summaryAbout 50% reduction in parental nutrition support can be expected after STEP.↗
▶Ep 68 · 6:32
host_summaryThere is a whole spectrum of findings from ulcers at staple lines, from just having specks of blood in the stool to enough bleeding that kids might have to be transfused every week and a half.↗
▶Ep 68 · 6:47
host_summaryStaple line ulcers can recur after treatment.↗
▶Ep 68 · 7:21
host_summaryTeams have tried enteral omega 3 lipid supplements, bacterial overgrowth management with cycled antibiotics or probiotics, 5ASA, budesonide, and immune modulators like Remicade for staple line bleeding, but none have been the perfect remedy.↗
▶Ep 68 · 7:52
host_summaryThe underlying issue in staple line bleeding is not in the bowel but actually in the mesentery.↗
▶Ep 68 · 8:17
host_summaryMesenteric inflammation causes scarring and obstructs venous outflow, leading to enlarged veins and venous hypertension on the bowel, and even large lymph nodes from lymphatic obstruction.↗
▶Ep 68 · 9:00
host_summaryDr. Helmrath typically revises the staple line with a hand sewn stitch when mesenteric scarring and venous hypertension are present.↗
▶Ep 68 · 10:25
host_summaryDoing things in a staged fashion is typical for the intestinal rehabilitation patient population.↗
▶Ep 68 · 10:45
host_summaryAs intestinal rehabilitation patients grow and develop, more issues might arise requiring additional operations.↗
▶Ep 68 · 11:15
host_summaryIntestinal rehabilitation is a lifelong issue, and surgeons typically follow these patients for a long time.↗
Quick Literature Updates Episode 6
▶Ep 71 · 0:20
host_summaryTeodoro et al. examined California Department of Public Health data on pediatric gunshot wounds and MVCs from 2006 to 2015.↗
▶Ep 71 · 0:20
host_summaryGunshot wound victims were 7.8 times more likely to die than MVC victims.↗
▶Ep 71 · 0:20
host_summaryIn California statewide data, the case fatality rate for gunshot wound victims was higher than that for motor vehicle collisions.↗
▶Ep 71 · 0:20
host_summaryTeodoro et al. studied pediatric trauma patients presenting to a level one trauma center with gunshot wounds or MVCs between 2009 and 2019.↗
▶Ep 71 · 0:20
host_summaryGunshot wound victims were more likely to require immediate surgery and had increased mortality compared to MVC victims.↗
Quick Literature Updates Episode 7
▶Ep 72 · 3:35
host_summaryWounds were assessed at two weeks, six weeks, and more than six months after operation by surveying clinicians and parents.↗
▶Ep 72 · 3:35
host_summaryTendon et al. conducted a prospective randomized control trial between 2017 and 2018 comparing three skin closure methods: sutures with tissue adhesive, sutures with adhesive tape, and sutures alone.↗
Quick Literature Updates Episode 11
▶Ep 76 · 0:46
host_summaryStevens et al. used the Gifford's Law Center annual gun law scorecard between 2014 and 2020 to assess state gun law scores.↗
▶Ep 76 · 0:46
host_summaryIn recent years, the fatality rate for firearms has surpassed the fatality rate for automobiles in children.↗
▶Ep 76 · 0:46
host_summaryStevens et al. examined CDC Wonder database data between 1999 and 2020 for pediatric firearm and automobile fatalities.↗
▶Ep 76 · 0:46
host_summaryStronger gun laws were associated with decreased fatality rates, with a 55% lower firearm fatality rate for states with the strongest gun laws compared to those with the weakest gun laws.↗
▶Ep 76 · 0:46
quoteAs other recent studies had shown, in the last few years, the fatality rate for firearms has surpassed the fatality rate for automobiles in children.↗
▶Ep 76 · 0:46
quoteThere was a 55% lower firearm fatality rate for the states with the strongest gun laws compared to those with the weakest gun laws.↗
host_summaryComponent separation technique involves separating tissue at the external oblique about a centimeter beyond the rectus sheath on both sides, dissecting between external and internal oblique, and optionally making an incision on the anterior rectus sheath for another centimeter of space↗
▶Ep 105 · 10:26
host_summaryA Texas report described component separation use in nine children aged seven days to 10 years, mostly for omphaloceles and giant defects, achieving fascial closure in the vast majority with some mesh use for bridging↗
Journal of Pediatric Surgery Article Review: February 2023, BAPS issue
▶Ep 3 · 1:38
host_summaryIn Poland, thoracoscopic esophageal atresia repair has been performed exclusively since 2005↗
▶Ep 3 · 1:47
quoteWe were happy that our first procedure was successful. When we did another one, it was much easier. Of course, at the beginning, the first procedure took us almost 4 hours. Right now it's a 1 hour procedure, but of course it's very difficult, but we are very happy to have no conversion.↗
▶Ep 3 · 1:54
host_summaryThe first thoracoscopic esophageal atresia procedure took almost 4 hours, but with experience it became a 1-hour procedure↗
▶Ep 3 · 1:59
host_summaryDr. Patkowski's team has had no conversions from thoracoscopic to open approach since beginning the technique↗
▶Ep 3 · 2:06
host_summaryAll esophageal atresia cases in Dr. Patkowski's center have been managed by one team using only the thoracoscopic approach since the beginning↗
▶Ep 3 · 2:25
quoteThe first, you need experience in endoscopic surgery. And then just you need time, and you must be very experienced in endoscopic suturing. You must be very slow. If you do it slowly, you will do it fast.↗
▶Ep 3 · 2:58
quoteEven if this is a higher cost, but probably the costs of complications are much, much more higher than transportation.↗
▶Ep 3 · 2:58
host_summaryCentralizing care for esophageal atresia patients is important even if transportation costs are higher, because complication costs are much higher↗
▶Ep 3 · 3:06
host_summaryDr. Patkowski's center handles 15 to 20 esophageal atresia cases per year, which provides sufficient volume for good experience↗
▶Ep 3 · 5:41
host_summaryIn the stoma cohort, 38 patients had ileostomies and the remaining had colostomies↗
▶Ep 3 · 5:46
host_summaryThe most common indication for initial stoma in Hirschsprung disease was washout failure, accounting for nearly 40% of cases↗
▶Ep 3 · 6:13
quoteStomma doesn't mean always a failure. Sometimes it's a necessity. Comes with the nature of the disease.↗
▶Ep 3 · 8:10
host_summarySheffield primarily performs Duhamel pull-throughs while Cincinnati primarily performs Swenson procedures for Hirschsprung disease↗
Intestinal rehabilitation: What is intestinal rehab? - Episode 1
▶Ep 5 · 6:30
host_summaryMucosal defects in enteropathies lead to hypersecretion and profuse fluid losses, preventing nutrient absorption.↗
▶Ep 5 · 7:22
host_summaryGastroschisis can involve all three categories: short bowel from nonviable tissue, inflammation affecting absorption, and motility issues.↗
Journal of Pediatric Surgery Article Review: October 2021
▶Ep 8 · 12:12
host_summaryAfter one year in the bowel management program, 30% of patients still struggled with fecal incontinence despite intensive resources.↗
▶Ep 8 · 14:46
host_summaryThe Italian anorectal malformation study was a retrospective review of 350 patients between 1999 and 2019, representing one of the largest series.↗
▶Ep 8 · 15:29
host_summaryThe Italian study demonstrated a close relationship between spinal cord abnormalities and spinal bone anomalies in anorectal malformation patients.↗
▶Ep 8 · 15:44
host_summaryDespite correlation between spinal bone and cord abnormalities, many patients without sacral or vertebral anomalies still had spinal cord abnormalities, making MRI necessary for screening.↗
▶Ep 8 · 16:01
host_summaryIn typical US practice for anorectal malformations, ultrasound shortly after birth is usually sufficient to look for spinal cord abnormalities, whereas the Italian practice finds MRI necessary.↗
host_summaryIn the Petcova et al. study published in Annals of Surgery 2020, children with uncomplicated appendicitis were randomized to medical management with antibiotics or surgery, with 5-year follow-up.↗
▶Ep 1 · 1:22
host_summaryMedical management of acute uncomplicated appendicitis may be safe but is associated with a high failure rate, with many children ultimately requiring laparoscopic appendectomy.↗
▶Ep 1 · 4:43
host_summaryIndocyanine green (ICG) has become a topic of interest in the last few years for use in pediatric surgery, especially in minimally invasive procedures to improve visualization of structures.↗
▶Ep 1 · 5:20
quoteYou can see very well the biliary anatomy is absolutely. Amazing, as you can see, the main biliary tree, the gallbladder, and then the cystic duct.↗
▶Ep 1 · 5:32
host_summaryFor laparoscopic cholecystectomy, ICG must be administered intravenously 12 to 18 hours prior to surgery to allow time for accumulation in the extrahepatic ducts, or can be injected directly into the gallbladder during surgery.↗
▶Ep 1 · 5:48
host_summaryICG applications in pediatric surgery include laparoscopic cholecystectomies, varicocele repairs, partial nephrectomies, and tumor excisions.↗
▶Ep 1 · 9:48
host_summaryThe double rim sign or halo sign on X-ray indicates a child has swallowed a button battery rather than a coin.↗
▶Ep 1 · 10:00
quoteThis strikes fear at the heart of of uh ENT surgeons, gastroenterologists, and pediatric surgeons.↗
▶Ep 1 · 10:13
host_summaryThe main goal of button battery ingestion treatment is to remove the battery within 2 hours of ingestion.↗
▶Ep 1 · 10:20
host_summarySucralfate or honey can help reduce damage from button batteries on the child's esophagus as temporizing measures.↗
▶Ep 1 · 10:27
quoteWhat you need to do is cut down on the damage, the injury that this is doing. Sucralfate or honey can help.↗
▶Ep 1 · 10:35
host_summaryChildren less than 1 year old should not receive honey due to risk of botulism and should instead receive 10 mL of sucralfate every 10 minutes for up to 3 doses for button battery ingestion.↗
▶Ep 1 · 10:51
host_summaryChildren over age 1 with button battery ingestion should receive honey 10 mL every 10 minutes for up to 6 doses.↗
▶Ep 1 · 14:10
host_summaryGreenwood et al. showed that mortality amongst black newborns is 3 times that of white newborns.↗
▶Ep 1 · 14:19
host_summaryWhen black newborns are treated by black physicians, their mortality is reduced by 58% compared to black newborns treated by white physicians.↗
▶Ep 1 · 14:30
host_summaryBias exists within medicine and can change outcomes; representation matters and can make a difference.↗
▶Ep 1 · 14:57
quoterecognizing that we all have biases and not being defensive when someone says there's bias in that because we all have bias. We know that we all have bias. And so the question is, what are your biases and how do they affect what you do? So I would push everyone. To say, as you're thinking about this work, as you, as you live in this space, you know, what are you doing about it?↗
▶Ep 1 · 15:21
quoteSo let's not just settle to talk about it, but let's figure out what the system level changes are that make a difference and change the outcome.↗
Novel index to estimate the cephalocaudal extent of the excavation in pectus excavatum - JPS article
▶Ep 29 · 0:11
clinicalThe Haller index and correction index are the currently primarily used indices for pectus excavatum and tell us about the severity of the deformity.↗
▶Ep 29 · 0:19
clinicalThe Titanic index takes into account the extent of the pectus excavatum deformity.↗
▶Ep 29 · 0:25
clinicalThe Titanic index is calculated as the percentage of the sternum that lies behind the anterior costal line as seen on CT scans.↗
▶Ep 29 · 0:35
clinicalThe study was a retrospective review of patients at an institution in Argentina who had undergone minimally invasive repair of pectus excavatum.↗
▶Ep 29 · 0:46
clinicalThe study found a weak correlation between the Titanic index and the other indices (Haller and correction index).↗
▶Ep 29 · 0:46
clinicalThe Titanic index might be more helpful for helping determine how many bars a patient is going to need for repair.↗
▶Ep 29 · 0:57
clinicalThe threshold established was 66.5%, meaning that patients with a higher Titanic index than that probably needed more than 2 bars.↗
▶Ep 29 · 0:57
quoteThe threshold they established here was 66.5%, meaning that patients with a higher titanic index than that probably needed more than 2 bars.↗
Journal of pediatric surgery Article Review: April 2023, IPEG issue
▶Ep 31 · 3:59
opinionThe Titanic Index provides an objective way to determine bar number rather than guessing based on eyeballing or age.↗
▶Ep 31 · 5:36
clinicalSevere outcomes in button battery ingestion were defined as deep mucosal erosion, perforation, mediastinitis, vascular or airway injury or fistula, or esophageal stricture development.↗
▶Ep 31 · 6:05
epidemiologicalThe Boston Children's study included 143 patients under 21 years old from 2008 to 2021, with 24 having severe outcomes.↗
▶Ep 31 · 6:20
clinicalThree predictive factors for severe button battery outcomes are: battery in esophagus at presentation, battery size ≥2cm, and presence of any symptoms.↗
Quick Literature Updates Episode 13
▶Ep 37 · 1:12
host_summaryThe Haller index and correction index are currently primarily used indices for pectus excavatum and tell us about the severity of the deformity.↗
▶Ep 37 · 1:20
host_summaryThe Titanic index is the percentage of the sternum that lies behind the anterior costal line as seen on CT scans.↗
▶Ep 37 · 1:20
quoteThis new index, or the Titanic index as they're calling it, takes into account the extent of the deformity.↗
▶Ep 37 · 1:44
host_summaryThere is a weak correlation between the Titanic index and the other indices (Haller and correction indices).↗
▶Ep 37 · 1:44
host_summaryThe Titanic index might be more helpful for determining how many bars a patient is going to need for pectus excavatum repair.↗
▶Ep 37 · 1:55
host_summaryA Titanic index threshold of 66.5% was established, meaning patients with a higher index than that probably needed more than 2 bars for pectus excavatum repair.↗
host_summaryThe Haller index and correction index are currently primarily used indices for pectus excavatum and tell us about the severity of the deformity.↗
▶Ep 7 · 1:20
quoteThis new index, or the Titanic index as they're calling it, takes into account the extent of the deformity.↗
▶Ep 7 · 1:20
host_summaryThe Titanic index is the percentage of the sternum that lies behind the anterior costal line as seen on CT scans.↗
▶Ep 7 · 1:44
host_summaryThe Titanic index might be more helpful for determining how many bars a patient is going to need for pectus excavatum repair.↗
▶Ep 7 · 1:44
host_summaryThere is a weak correlation between the Titanic index and the other indices (Haller and correction indices).↗
▶Ep 7 · 1:55
host_summaryA Titanic index threshold of 66.5% was established, meaning patients with a higher index than that probably needed more than 2 bars for pectus excavatum repair.↗
clinicalThere is literature suggesting a component of psychosocial, psychological dissociation in children on later testing related to anal dilations.↗
▶Ep 1 · 2:55
clinicalThe number of strictures, number needing anoplasties, and number of redo operations were the same between dilation and no-dilation groups.↗
▶Ep 1 · 3:04
clinicalThe number of patients who had rectal prolapse is consistent with the literature.↗
▶Ep 1 · 5:20
clinicalA study of 30-day outcomes for ARM with perineal or rectovaginal fistulas divided patients into early repair (before 6 days old) and late repair (6-8 weeks), with 66 early and 231 late repairs among 291 patients.↗
host_summaryIn the Petcova et al. study published in Annals of Surgery 2020, children with uncomplicated appendicitis were randomized to medical management with antibiotics or surgery, with 5-year follow-up.↗
▶Ep 13 · 1:22
host_summaryMedical management of acute uncomplicated appendicitis may be safe but is associated with a high failure rate, with many children ultimately requiring laparoscopic appendectomy.↗
▶Ep 13 · 4:43
host_summaryIndocyanine green (ICG) has become a topic of interest in the last few years for use in pediatric surgery, especially in minimally invasive procedures to improve visualization of structures.↗
▶Ep 13 · 5:20
quoteYou can see very well the biliary anatomy is absolutely. Amazing, as you can see, the main biliary tree, the gallbladder, and then the cystic duct.↗
▶Ep 13 · 5:32
host_summaryFor laparoscopic cholecystectomy, ICG must be administered intravenously 12 to 18 hours prior to surgery to allow time for accumulation in the extrahepatic ducts, or can be injected directly into the gallbladder during surgery.↗
▶Ep 13 · 5:48
host_summaryICG applications in pediatric surgery include laparoscopic cholecystectomies, varicocele repairs, partial nephrectomies, and tumor excisions.↗
▶Ep 13 · 9:48
host_summaryThe double rim sign or halo sign on X-ray indicates a child has swallowed a button battery rather than a coin.↗
▶Ep 13 · 10:00
quoteThis strikes fear at the heart of of uh ENT surgeons, gastroenterologists, and pediatric surgeons.↗
▶Ep 13 · 10:13
host_summaryThe main goal of button battery ingestion treatment is to remove the battery within 2 hours of ingestion.↗
▶Ep 13 · 10:20
host_summarySucralfate or honey can help reduce damage from button batteries on the child's esophagus as temporizing measures.↗
▶Ep 13 · 10:27
quoteWhat you need to do is cut down on the damage, the injury that this is doing. Sucralfate or honey can help.↗
▶Ep 13 · 10:35
host_summaryChildren less than 1 year old should not receive honey due to risk of botulism and should instead receive 10 mL of sucralfate every 10 minutes for up to 3 doses for button battery ingestion.↗
▶Ep 13 · 10:51
host_summaryChildren over age 1 with button battery ingestion should receive honey 10 mL every 10 minutes for up to 6 doses.↗
▶Ep 13 · 14:10
host_summaryGreenwood et al. showed that mortality amongst black newborns is 3 times that of white newborns.↗
▶Ep 13 · 14:19
host_summaryWhen black newborns are treated by black physicians, their mortality is reduced by 58% compared to black newborns treated by white physicians.↗
▶Ep 13 · 14:30
host_summaryBias exists within medicine and can change outcomes; representation matters and can make a difference.↗
▶Ep 13 · 14:57
quoterecognizing that we all have biases and not being defensive when someone says there's bias in that because we all have bias. We know that we all have bias. And so the question is, what are your biases and how do they affect what you do? So I would push everyone. To say, as you're thinking about this work, as you, as you live in this space, you know, what are you doing about it?↗
▶Ep 13 · 15:21
quoteSo let's not just settle to talk about it, but let's figure out what the system level changes are that make a difference and change the outcome.↗
Case-Based Journal Review- Intussusception in 2022
▶Ep 14 · 1:48
quoteI would only accept radiology because you have to do an intervention after that. So if it's positive, you have to do an intervention, whether it is enema reduction or surgery.↗
▶Ep 14 · 1:48
quoteI would only accept radiology because you have to do an intervention after that. So if it's positive, you have to do an intervention, whether it is enema reduction or surgery.↗
▶Ep 14 · 3:14
clinicalIn resource-limited settings without 24-hour radiology, unnecessary laparotomies are sometimes performed for intussusception diagnosis in the middle of the night.↗
▶Ep 14 · 3:14
clinicalIn resource-limited settings without 24-hour radiology, unnecessary laparotomies are sometimes performed for intussusception diagnosis in the middle of the night.↗
▶Ep 14 · 6:04
opinionThe 2% difference in success rates between hydrostatic and air reduction is not clinically significant enough to justify changing established practice.↗
▶Ep 14 · 6:04
opinionThe 2% difference in success rates between hydrostatic and air reduction is not clinically significant enough to justify changing established practice.↗
clinicalSedation for pneumatic reduction showed slightly better success rate but higher recurrence rate (5.1% vs 1.3%, non-significant) and more perforations (3 vs 0, non-significant) in a 2017 Pediatric Anesthesia study.↗
▶Ep 14 · 9:54
host_summarySedation for pneumatic reduction showed slightly better success rate but higher recurrence rate (5.1% vs 1.3%, non-significant) and more perforations (3 vs 0, non-significant) in a 2017 Pediatric Anesthesia study.↗
▶Ep 14 · 11:47
opinionIf sedation shows no increased perforation risk compared to no sedation, then sedating children for comfort during reduction is justified.↗
▶Ep 14 · 11:47
opinionIf sedation shows no increased perforation risk compared to no sedation, then sedating children for comfort during reduction is justified.↗
▶Ep 14 · 14:45
quoteI share that same feeling. I feel like I lie when I'm saying the number I have in my mind, but actually my number is 10%. That's the number I tell residents, not the number I tell families, 10%.↗
▶Ep 14 · 14:45
quoteI share that same feeling. I feel like I lie when I'm saying the number I have in my mind, but actually my number is 10%. That's the number I tell residents, not the number I tell families, 10%.↗
▶Ep 14 · 16:17
clinicalBoth recent studies show lower recurrence rates (3.7-13.5%) than the traditionally quoted 15-20% that surgeons have been telling families.↗
▶Ep 14 · 16:17
clinicalBoth recent studies show lower recurrence rates (3.7-13.5%) than the traditionally quoted 15-20% that surgeons have been telling families.↗
▶Ep 14 · 16:59
quoteIncreasing our recurrence or failure tolerance, it benefits the vast majority of children with lower chances of getting a complication.↗
▶Ep 14 · 16:59
quoteIncreasing our recurrence or failure tolerance, it benefits the vast majority of children with lower chances of getting a complication.↗
▶Ep 14 · 16:59
opinionIncreasing tolerance for recurrence risk benefits the vast majority of children by avoiding unnecessary admission and its associated complications.↗
▶Ep 14 · 16:59
opinionIncreasing tolerance for recurrence risk benefits the vast majority of children by avoiding unnecessary admission and its associated complications.↗
Case Based Journal Review - CPAM in 2022
▶Ep 15 · 2:38
clinical57% (68 patients) of the 119 cases were managed conservatively, and none of those who could be followed up became symptomatic↗
▶Ep 15 · 2:38
host_summary57% (68 patients) of the 119 cases were managed conservatively, and none of those who could be followed up became symptomatic↗
▶Ep 15 · 4:36
clinicalOut of 344 prenatally diagnosed lesions, none had malignant pathology when resected↗
▶Ep 15 · 4:36
host_summaryOut of 344 prenatally diagnosed lesions, none had malignant pathology when resected↗
▶Ep 15 · 5:03
epidemiologicalThe risk of malignancy approached 10% for lung masses diagnosed postnatally↗
▶Ep 15 · 5:03
host_summaryThe risk of malignancy approached 10% for lung masses diagnosed postnatally↗
▶Ep 15 · 7:08
clinicalThe study was retrospective and looked at about 90 patients undergoing thoracoscopic lung resections↗
▶Ep 15 · 7:08
host_summaryThe study was retrospective and looked at about 90 patients undergoing thoracoscopic lung resections↗
▶Ep 15 · 10:07
host_summaryThere were no differences in major complications, conversion rates, or readmissions between the three age groups↗
▶Ep 15 · 10:07
clinicalThere were no differences in major complications, conversion rates, or readmissions between the three age groups↗
Case Based Journal Review: Esophageal Atresia in 2022
▶Ep 17 · 3:02
epidemiologicalIn a meta-analysis of almost 700 neonates, preserving the azygous vein resulted in significantly lower postoperative pneumonitis compared to division↗
▶Ep 17 · 3:02
host_summaryIn a meta-analysis of almost 700 neonates, preserving the azygous vein resulted in significantly lower postoperative pneumonitis compared to division↗
▶Ep 17 · 3:11
host_summaryThere was no significant difference in anastomotic leak rate or stricture rate between azygous vein preservation and division↗
▶Ep 17 · 3:11
epidemiologicalThere was no significant difference in anastomotic leak rate or stricture rate between azygous vein preservation and division↗
▶Ep 17 · 6:43
epidemiologicalIn the Quebec study of 244 patients, the overall anastomotic stricture rate at one year was 30%↗
▶Ep 17 · 6:43
host_summaryIn the Quebec study of 244 patients, the overall anastomotic stricture rate at one year was 30%↗
▶Ep 17 · 6:50
host_summary36% of patients with transanastomotic tubes developed strictures compared to 19% without tubes, a difference that remained significant after multivariable analysis↗
▶Ep 17 · 6:50
epidemiological36% of patients with transanastomotic tubes developed strictures compared to 19% without tubes, a difference that remained significant after multivariable analysis↗
▶Ep 17 · 7:06
epidemiologicalPatients with transanastomotic tubes had 2.72 times higher odds of developing a stricture compared to those without↗
▶Ep 17 · 7:06
host_summaryPatients with transanastomotic tubes had 2.72 times higher odds of developing a stricture compared to those without↗
▶Ep 17 · 14:54
host_summaryIn the Midwest Pediatric Surgery Consortium study, antibiotics for more than 24 hours and acid suppression showed no difference in strictures or leaks↗
▶Ep 17 · 14:54
epidemiologicalIn the Midwest Pediatric Surgery Consortium study, antibiotics for more than 24 hours and acid suppression showed no difference in strictures or leaks↗
Intestinal rehabilitation: What is intestinal rehab? - Episode 1
▶Ep 3 · 6:30
host_summaryMucosal defects in enteropathies lead to hypersecretion and profuse fluid losses, preventing nutrient absorption.↗
▶Ep 3 · 7:22
host_summaryGastroschisis can involve all three categories: short bowel from nonviable tissue, inflammation affecting absorption, and motility issues.↗
Intestinal Rehabilitation, Episode 4: Surgical Management, Part 1
▶Ep 5 · 1:50
host_summaryIn the 1980s and 1990s, babies with intestinal failure had poor outcomes primarily due to liver progression to inflammation and fibrosis associated with parenteral nutrition, lipids, and phytosterols.↗
▶Ep 5 · 9:36
host_summaryAt birth, neonatal bowel is usually not dilated enough to apply the STEP procedure.↗
▶Ep 5 · 15:57
host_summaryIf one part of the stepped bowel becomes dilated, the STEP segments can rotate away from each other separately, causing twisting and functional obstruction.↗
Quick Literature Updates Episode 7
▶Ep 6 · 3:35
host_summaryTendon et al. conducted a prospective randomized control trial between 2017 and 2018 comparing three skin closure methods: sutures with tissue adhesive, sutures with adhesive tape, and sutures alone.↗
▶Ep 6 · 3:35
host_summaryWounds were assessed at two weeks, six weeks, and more than six months after operation by surveying clinicians and parents.↗
Case Based Journal Review: Esophageal Atresia in 2022
▶Ep 8 · 3:02
host_summaryIn a meta-analysis of almost 700 neonates, preserving the azygous vein resulted in significantly lower postoperative pneumonitis compared to division↗
▶Ep 8 · 3:11
host_summaryThere was no significant difference in anastomotic leak rate or stricture rate between azygous vein preservation and division↗
▶Ep 8 · 6:43
host_summaryIn the Quebec study of 244 patients, the overall anastomotic stricture rate at one year was 30%↗
▶Ep 8 · 6:50
host_summary36% of patients with transanastomotic tubes developed strictures compared to 19% without tubes, a difference that remained significant after multivariable analysis↗
▶Ep 8 · 7:06
host_summaryPatients with transanastomotic tubes had 2.72 times higher odds of developing a stricture compared to those without↗
▶Ep 8 · 14:54
host_summaryIn the Midwest Pediatric Surgery Consortium study, antibiotics for more than 24 hours and acid suppression showed no difference in strictures or leaks↗
epidemiological384 females with anorectal malformations were studied from the Pediatric Colorectal and Pelvic Learning Consortium database↗
▶Ep 9 · 1:22
epidemiologicalAbout 46% of females with anorectal malformations had VACTERL association (anorectal malformation plus two of: vertebral, cardiac, tracheoesophageal, renal, or limb anomaly)↗
▶Ep 9 · 1:22
epidemiologicalAbout 27% of patients with anorectal malformations had a gynecologic anomaly↗
▶Ep 9 · 1:39
clinicalHaving VACTERL association was associated with more gynecologic anomalies compared to those without VACTERL↗
▶Ep 9 · 1:49
clinicalThe association between VACTERL and gynecologic anomalies was especially true when patients had recto vestibular or rectal perineal fistulas↗
▶Ep 9 · 1:49
clinicalThe association between VACTERL and gynecologic anomalies was especially true when renal anomalies were found↗
▶Ep 9 · 1:57
guidelineFor females with anorectal malformations and VACTERL association, especially renal anomalies, clinicians should look carefully for gynecologic anomalies↗
▶Ep 9 · 1:57
quoteSo for females with inner rectum malformations and veal association, especially renal anomalies, we should look carefully for gynecologic anomalies.↗
