Jill Knepprath
0 statements · 0 topics · summaries given as host listed separately
Abdominal Wall Defects
· episode host
Aerodigestive / ENT
· episode host
Colorectal / ARM & Hirschsprung
· series host
Fetal Surgery
· episode host
Inguinal Hernia
· episode host
Liver Tumors (Hepatoblastoma/HCC)
· episode host
Neurofibromatosis
· episode host
Pediatric Robotic Surgery
· episode host
Peritoneal Dialysis Access
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Wilms Tumor
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Summaries Jill gave as host · 360 summaries
Recaps of other experts' statements, not Jill's own clinical position.
Summaries Jill gave as host · Abdominal Wall Defects 7 summaries
Open the Abdominal Wall Defects collection →
Surgeon annual volume impacts recurrence rates of pediatric inguinal hernia repairs: A multi-institutional study
Host summary
Jill Knepprath summarizing a resource: Heller et al. published a multi-institutional study in the Journal of Pediatric Surgery in 2025 exploring the impact of surgeon volume on patients with inguinal hernias.
Open
Host summary
Jill Knepprath summarizing a resource: The authors found that inguinal hernias repaired by lower volume surgeons had a 1.5 fold increase in the odds of recurrence.
Open
Host summary
Jill Knepprath summarizing a resource: Inguinal hernias repaired by lower volume surgeons had a 1.5 fold increase in the odds of recurrence.
Open
Host summary
Jill Knepprath summarizing a resource: When broken down by surgical approach, there was no difference in recurrence rates for open inguinal hernia repairs based on surgeon volume.
Open
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Jill Knepprath summarizing a resource: Laparoscopic inguinal hernia repairs done by lower volume surgeons had a 3.3 fold increase in the odds of recurrence.
Open
Host summary
Jill Knepprath summarizing a resource: However, laparoscopic repairs done by lower volume surgeons had a 3.3 fold increase in the odds of recurrence.
Open
Host summary
Jill Knepprath summarizing a resource: The authors of the Heller et al. study recommend maintaining a high volume of laparoscopic repairs, and if that's not possible, to seek help from a higher volume surgeon.
Open
Summaries Jill gave as host · Aerodigestive / ENT 7 summaries
Open the Aerodigestive / ENT collection →
Surgeon annual volume impacts recurrence rates of pediatric inguinal hernia repairs: A multi-institutional study
Host summary
Jill Knepprath summarizing a resource: Heller et al. published a multi-institutional study in the Journal of Pediatric Surgery in 2025 exploring the impact of surgeon volume on patients with inguinal hernias.
Open
Host summary
Jill Knepprath summarizing a resource: Inguinal hernias repaired by lower volume surgeons had a 1.5 fold increase in the odds of recurrence.
Open
Host summary
Jill Knepprath summarizing a resource: The authors found that inguinal hernias repaired by lower volume surgeons had a 1.5 fold increase in the odds of recurrence.
Open
Host summary
Jill Knepprath summarizing a resource: When broken down by surgical approach, there was no difference in recurrence rates for open inguinal hernia repairs based on surgeon volume.
Open
Host summary
Jill Knepprath summarizing a resource: Laparoscopic inguinal hernia repairs done by lower volume surgeons had a 3.3 fold increase in the odds of recurrence.
Open
Host summary
Jill Knepprath summarizing a resource: However, laparoscopic repairs done by lower volume surgeons had a 3.3 fold increase in the odds of recurrence.
Open
Host summary
Jill Knepprath summarizing a resource: The authors of the Heller et al. study recommend maintaining a high volume of laparoscopic repairs, and if that's not possible, to seek help from a higher volume surgeon.
Open
Summaries Jill gave as host · Anorectal Malformation 40 summaries
Open the Anorectal Malformation collection →
Patient-reported outcomes of Children with an Anorectal Malformation
Host summary
Jill Knepprath summarizing a resource: Are you using the sacral ratio to counsel them?
Open
Host summary
Jill Knepprath summarizing a resource: A 2024 survey by Witt et al. at Nationwide Children's was published in the Annals of Surgery examining patients with anorectal malformation
Open
Host summary
Jill Knepprath summarizing a resource: The survey looked at over 900 patients with anorectal malformation
Open
Host summary
Jill Knepprath summarizing a resource: There was no difference in continence for patients based on sacral ratio alone in regards to quality of life
Open
Host summary
Jill Knepprath summarizing a resource: Patients who are incontinent had a 20-point lower quality of life compared to patients who were continent or clean on enemas
Open
Host summary
Jill Knepprath summarizing a resource: Bowel management may actually matter more than sacral ratio in predicting continence outcomes
Open
Host summary
Jill Knepprath summarizing a resource: The sacral ratio may not be as strong a predictor of continence as patients age
Open
Host summary
Jill Knepprath summarizing a resource: Quality of life is significantly lower for patients with incontinence compared to those clean on enemas
Open
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Jill Knepprath summarizing a resource: Does this change this change your practice?
Open
Update Course Rewind 2025: Do We Still Need Routine Anal Dilations After PSARP?
Host summary
Jill Knepprath summarizing the discussion: For decades, every child received anal dilations after PSARP.
Open
Host summary
Jill Knepprath summarizing the discussion: For decades, every child received anal dilations after PSARP.
Open
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Jill Knepprath summarizing the discussion: A study from Spain followed the historical dilation protocol starting two weeks after PSARP, performing dilations twice a day, with the Hagar size increased by 1 millimeter each week until reaching the optimal size.
Open
Host summary
Jill Knepprath summarizing the discussion: A study from Spain followed the historical dilation protocol starting two weeks after PSARP, performing dilations twice a day, with the Hagar size increased by 1 millimeter each week until reaching the optimal size.
Open
Host summary
Jill Knepprath summarizing the discussion: The Heineke-Mikulicz anoplasty is a procedure for skin-level strictures in PSARP patients.
Open
Host summary
Jill Knepprath summarizing the discussion: The Heineke-Mikulicz anoplasty is a procedure for skin-level strictures in PSARP patients.
Open
Host summary
Jill Knepprath summarizing the discussion: Heineke-Mikulicz anoplasty is done by making incisions at the 12, 3, 6, and 9 o'clock positions, making a rhomboid shape that opens up the strictured area.
Open
Host summary
Jill Knepprath summarizing the discussion: Heineke-Mikulicz anoplasty is done by making incisions at the 12, 3, 6, and 9 o'clock positions, making a rhomboid shape that opens up the strictured area.
Open
Host summary
Jill Knepprath summarizing the discussion: Heineke-Mikulicz anoplasty does not require flaps or any mobilization of the rectum.
Open
Host summary
Jill Knepprath summarizing the discussion: Heineke-Mikulicz anoplasty does not require flaps or any mobilization of the rectum.
Open
Host summary
Jill Knepprath summarizing the discussion: Heineke-Mikulicz anoplasty is safe, effective, and minimally invasive.
Open
Host summary
Jill Knepprath summarizing the discussion: Heineke-Mikulicz anoplasty is safe, effective, and minimally invasive.
Open
Host summary
Jill Knepprath summarizing the discussion: Heineke-Mikulicz anoplasty can be done outpatient as an alternative to long-term dilations after PSARP.
Open
Host summary
Jill Knepprath summarizing the discussion: Heineke-Mikulicz anoplasty can be done outpatient as an alternative to long-term dilations after PSARP.
Open
Host summary
Jill Knepprath summarizing the discussion: Anal dilation after PSARP can cause stress for families.
Open
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Jill Knepprath summarizing the discussion: There isn't strong evidence to support mandatory anal dilation after PSARP.
Open
Host summary
Jill Knepprath summarizing the discussion: Anal dilation after PSARP can cause stress for families.
Open
Host summary
Jill Knepprath summarizing the discussion: There isn't strong evidence to support mandatory anal dilation after PSARP.
Open
Host summary
Jill Knepprath summarizing the discussion: Age of the patient and access to returning for an outpatient procedure are things to consider when making decisions about anal dilation after PSARP.
Open
Host summary
Jill Knepprath summarizing the discussion: Age of the patient and access to returning for an outpatient procedure are things to consider when making decisions about anal dilation after PSARP.
Open
Update Course Rewind 2025: Hirschsprung + ARM: Rare but Real
Host summary
Jill Knepprath summarizing the discussion: The rate of Hirschsprung disease and anorectal malformation occurring together is less than 2%
Open
Host summary
Jill Knepprath summarizing the discussion: It's rare, but something to keep in mind for patients with trisomy 21.
Open
Host summary
Jill Knepprath summarizing the discussion: The co-occurrence of Hirschsprung disease and ARM is something to keep in mind for patients with trisomy 21
Open
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Jill Knepprath summarizing the discussion: Ganglion cells were found in 91% of rectal fistula specimens
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Host summary
Jill Knepprath summarizing the discussion: Hypo or absent ganglion cells were found in the remaining rectal fistula specimens
Open
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Jill Knepprath summarizing the discussion: But absent cells in fistula tissue doesn't necessarily mean it's Hirschsprung's disease.
Open
Host summary
Jill Knepprath summarizing the discussion: Absent ganglion cells in fistula tissue does not necessarily mean the patient has Hirschsprung disease
Open
Host summary
Jill Knepprath summarizing the discussion: Three patients (4% of the study cohort) had both Hirschsprung disease and anorectal malformation
Open
Host summary
Jill Knepprath summarizing the discussion: Two of the three patients with both conditions had trisomy 21
Open
Host summary
Jill Knepprath summarizing the discussion: Complex anorectal malformation patients with chromosomal anomalies who do not respond to laxatives or enemas should be worked up for Hirschsprung disease
Open
Summaries Jill gave as host · Colorectal / ARM & Hirschsprung 66 summaries
Open the Colorectal / ARM & Hirschsprung collection →
Patient-reported outcomes of Children with an Anorectal Malformation
Host summary
Jill Knepprath summarizing a resource: Are you using the sacral ratio to counsel them?
Open
Host summary
Jill Knepprath summarizing a resource: A 2024 survey by Witt et al. at Nationwide Children's was published in the Annals of Surgery examining patients with anorectal malformation
Open
Host summary
Jill Knepprath summarizing a resource: The survey looked at over 900 patients with anorectal malformation
Open
Host summary
Jill Knepprath summarizing a resource: There was no difference in continence for patients based on sacral ratio alone in regards to quality of life
Open
Host summary
Jill Knepprath summarizing a resource: Patients who are incontinent had a 20-point lower quality of life compared to patients who were continent or clean on enemas
Open
Host summary
Jill Knepprath summarizing a resource: Bowel management may actually matter more than sacral ratio in predicting continence outcomes
Open
Host summary
Jill Knepprath summarizing a resource: The sacral ratio may not be as strong a predictor of continence as patients age
Open
Host summary
Jill Knepprath summarizing a resource: Quality of life is significantly lower for patients with incontinence compared to those clean on enemas
Open
Host summary
Jill Knepprath summarizing a resource: Does this change this change your practice?
Open
Update Course Rewind 2025: Timing of PSARP: Early vs. Delayed—Does It Really Matter?
Host summary
Jill Knepprath summarizing the discussion: For patients with rectal vestibular fistulas, some surgeons perform anal rectoplasties immediately while others wait until after discharge.
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Jill Knepprath summarizes what Dr. Jamie Harris said: Dr. Jamie Harris presents a case of a full-term newborn baby girl with rectal vestibular fistula weighing 3 kg with completely negative VACTERL workup.
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Jill Knepprath summarizing the discussion: The panel agreed that it's safe to perform the PSARP either early before discharge or later around 1 to 3 months of age.
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Jill Knepprath summarizing the discussion: The NSQIP study defined early repair as 7 days and delayed repair as between 6 weeks and 8 months.
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Jill Knepprath summarizing the discussion: The NSQIP study found no difference in overall outcomes, including re-operations and readmissions, between early and delayed PSARP.
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Jill Knepprath summarizing the discussion: Wound breakdown and dehiscence was the most common complication for both early and delayed repair groups in the PCPLC study.
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Jill Knepprath summarizing the discussion: There was no significant difference in postoperative complications between early and delayed repair groups in the PCPLC study.
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Jill Knepprath summarizing the discussion: Early repair during the newborn period avoids an additional admission for the surgery.
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Jill Knepprath summarizing the discussion: Both early and delayed PSARP repairs are safe for patients with rectal vestibular fistulas.
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Jill Knepprath summarizing the discussion: What matters most in timing PSARP is the circumstances, family access to care, patient size, and the surgeon's comfort and experience.
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Laparoscopic modified percutaneous internal ring suturing - a mesh-free alternative for indirect inguinal hernia repair in adults. a pilot prospective cohort study
Host summary
Jill Knepprath summarizing a resource: High ligation hernia repair, that's for kids.
Open
Host summary
Jill Knepprath summarizing a resource: The study was published in the International Journal of Surgery.
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Jill Knepprath summarizing a resource: The study used the modified percutaneous internal ring suturing technique to evaluate whether a laparoscopic non-mesh repair works on indirect inguinal hernias in adults.
Open
Host summary
Jill Knepprath summarizing a resource: No patients had hernia recurrence on follow-up, with a median follow-up of 79 months.
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Host summary
Jill Knepprath summarizing a resource: Patients reported a decrease in pain and an improved activity post-operatively.
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Jill Knepprath summarizing a resource: The study shows success with the modified PIRS technique in adults.
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Jill Knepprath summarizing a resource: Would you offer this to your hernia patients?
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Update Course Rewind 2025: Do We Still Need Routine Anal Dilations After PSARP?
Host summary
Jill Knepprath summarizing the discussion: For decades, every child received anal dilations after PSARP.
Open
Host summary
Jill Knepprath summarizing the discussion: A study from Spain followed the historical dilation protocol starting two weeks after PSARP, performing dilations twice a day, with the Hagar size increased by 1 millimeter each week until reaching the optimal size.
Open
Host summary
Jill Knepprath summarizing the discussion: The Heineke-Mikulicz anoplasty is a procedure for skin-level strictures in PSARP patients.
Open
Host summary
Jill Knepprath summarizing the discussion: Heineke-Mikulicz anoplasty is done by making incisions at the 12, 3, 6, and 9 o'clock positions, making a rhomboid shape that opens up the strictured area.
Open
Host summary
Jill Knepprath summarizing the discussion: Heineke-Mikulicz anoplasty does not require flaps or any mobilization of the rectum.
Open
Host summary
Jill Knepprath summarizing the discussion: Heineke-Mikulicz anoplasty is safe, effective, and minimally invasive.
Open
Host summary
Jill Knepprath summarizing the discussion: Heineke-Mikulicz anoplasty can be done outpatient as an alternative to long-term dilations after PSARP.
Open
Host summary
Jill Knepprath summarizing the discussion: There isn't strong evidence to support mandatory anal dilation after PSARP.
Open
Host summary
Jill Knepprath summarizing the discussion: Anal dilation after PSARP can cause stress for families.
Open
Host summary
Jill Knepprath summarizing the discussion: Age of the patient and access to returning for an outpatient procedure are things to consider when making decisions about anal dilation after PSARP.
Open
Update Course Rewind 2025: Hirschsprung’s Pull-Through: Why Family Training May Save Lives
Host summary
Jill Knepprath summarizing the discussion: The median age of the neonatal pull-through group was 11 days at time of surgery.
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Jill Knepprath summarizing the discussion: The median age of the delayed pull-through group was 98 days at time of surgery.
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Host summary
Jill Knepprath summarizing the discussion: The median age of the neonatal pull-through group was 11 days at time of surgery.
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Jill Knepprath summarizing the discussion: The median age of the delayed pull-through group was 98 days at time of surgery.
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Host summary
Jill Knepprath summarizing the discussion: The PCPLC study found no difference in postoperative enterocolitis between neonatal and delayed pull-through groups.
Open
Host summary
Jill Knepprath summarizing the discussion: The PCPLC study found no difference in preoperative enterocolitis between neonatal and delayed pull-through groups.
Open
Host summary
Jill Knepprath summarizing the discussion: The PCPLC study found no difference in postoperative enterocolitis between neonatal and delayed pull-through groups.
Open
Host summary
Jill Knepprath summarizing the discussion: The PCPLC study found no difference in fecal incontinence at follow-up between neonatal and delayed pull-through groups.
Open
Host summary
Jill Knepprath summarizing the discussion: The PCPLC study found no difference in preoperative enterocolitis between neonatal and delayed pull-through groups.
Open
Host summary
Jill Knepprath summarizing the discussion: The PCPLC study found no difference in fecal incontinence at follow-up between neonatal and delayed pull-through groups.
Open
Update Course Rewind 2025: Botox for Hirschsprung’s: Where, When, and Why
Host summary
Jill Knepprath summarizing the discussion: A 2022 multi-center study found that 24% of patients undergoing pull-through procedure also received Botox
Open
Host summary
Jill Knepprath summarizing the discussion: Patients that received Botox had a higher chance of diaper rash
Open
Host summary
Jill Knepprath summarizing the discussion: Injecting Botox during pull-through procedure for Hirschsprung's disease has been shown to reduce enterocolitis risk
Open
Host summary
Jill Knepprath summarizing the discussion: Dosing and guidance for Botox injection varies widely
Open
Update Course Rewind 2025: Hirschsprung + ARM: Rare but Real
Host summary
Jill Knepprath summarizing the discussion: The rate of Hirschsprung disease and anorectal malformation occurring together is less than 2%
Open
Host summary
Jill Knepprath summarizing the discussion: It's rare, but something to keep in mind for patients with trisomy 21.
Open
Host summary
Jill Knepprath summarizing the discussion: The co-occurrence of Hirschsprung disease and ARM is something to keep in mind for patients with trisomy 21
Open
Host summary
Jill Knepprath summarizing the discussion: Hypo or absent ganglion cells were found in the remaining rectal fistula specimens
Open
Host summary
Jill Knepprath summarizing the discussion: Ganglion cells were found in 91% of rectal fistula specimens
Open
Host summary
Jill Knepprath summarizing the discussion: Absent ganglion cells in fistula tissue does not necessarily mean the patient has Hirschsprung disease
Open
Host summary
Jill Knepprath summarizing the discussion: But absent cells in fistula tissue doesn't necessarily mean it's Hirschsprung's disease.
Open
Host summary
Jill Knepprath summarizing the discussion: Three patients (4% of the study cohort) had both Hirschsprung disease and anorectal malformation
Open
Host summary
Jill Knepprath summarizing the discussion: Two of the three patients with both conditions had trisomy 21
Open
Host summary
Jill Knepprath summarizing the discussion: Complex anorectal malformation patients with chromosomal anomalies who do not respond to laxatives or enemas should be worked up for Hirschsprung disease
Open
Summaries Jill gave as host · Congenital Diaphragmatic Hernia 13 summaries
Open the Congenital Diaphragmatic Hernia collection →
Improving Outcomes for Congenital Diaphragmatic Hernia (CDH): Protocol Changes at Cincinnati Children's
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Jill Knepprath summarizes what Dr. Paul Kingma said: Protocol changes began in August 2023 and were implemented in spring of 2024
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Jill Knepprath summarizes what Dr. Paul Kingma said: Previously, peak pressures were limited to 25 to 26 cmH2O and mean airway pressures to less than 16 to 17 cmH2O
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Jill Knepprath summarizes what Dr. Paul Kingma said: Previously, babies were fed once they had return of bowel function after repair
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Jill Knepprath summarizes what Dr. Paul Kingma said: Previously, babies received as-needed sedation
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Jill Knepprath summarizes what Dr. Paul Kingma said: ECMO use increased from 14% to 22% in the new cohort
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Jill Knepprath summarizes what Dr. Paul Kingma said: The new cohort had 36 babies compared to 99 in the previous cohort
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Jill Knepprath summarizes what Dr. Paul Kingma said: Survival for ECMO patients increased from 39% to 55%
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Jill Knepprath summarizes what Dr. Paul Kingma said: ECMO use was around 41% in the old cohort versus 45% in the new cohort
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Inside a FETO Procedure: Fetoscopic Balloon Tracheal Occlusion with Dr. Beth Rymeski
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Jill Knepprath summarizes what Dr. Beth Rymeski said: The goal of FETO is to allow fluid to stay in the lungs and allow the lungs to expand and grow.
Open
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Jill Knepprath summarizes what Dr. Beth Rymeski said: FETO helps prevent pulmonary hypoplasia, which is a big factor in poor outcomes for CDH babies.
Open
Host summary
Jill Knepprath summarizes what Dr. Beth Rymeski said: The balloon is filled with around 0.65 to 0.8 mL of water, depending on the size of the trachea.
Open
Host summary
Jill Knepprath summarizes what Dr. Beth Rymeski said: Sometimes the trocar advances into the mouth during the procedure and needs to be backed out.
Open
Host summary
Jill Knepprath summarizes what Dr. Beth Rymeski said: Final confirmation includes advancing the scope one more time to verify the balloon is below the vocal cords and in the main trachea.
Open
Summaries Jill gave as host · Enterocolitis 4 summaries
Open the Enterocolitis collection →
Update Course Rewind 2025: Botox for Hirschsprung’s: Where, When, and Why
Host summary
Jill Knepprath summarizing the discussion: A 2022 multi-center study found that 24% of patients undergoing pull-through procedure also received Botox
Open
Host summary
Jill Knepprath summarizing the discussion: Patients that received Botox had a higher chance of diaper rash
Open
Host summary
Jill Knepprath summarizing the discussion: Injecting Botox during pull-through procedure for Hirschsprung's disease has been shown to reduce enterocolitis risk
Open
Host summary
Jill Knepprath summarizing the discussion: Dosing and guidance for Botox injection varies widely
Open
Summaries Jill gave as host · Esophageal Atresia 21 summaries
Open the Esophageal Atresia collection →
Update Course Rewind 2025: The Recurrent TEF Problem
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Jill Knepprath summarizes what Dr. Douglas von Allmen said: Recurrent tracheoesophageal fistulas can develop years after initial TEF repair.
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Jill Knepprath summarizes what Dr. Douglas von Allmen said: Esophageal dilations were performed without improvement.
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Jill Knepprath summarizes what Dr. Douglas von Allmen said: Bronchoscopy revealed granulation tissue along the back wall of the airway.
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Jill Knepprath summarizes what Dr. Douglas von Allmen said: The recurrent laryngeal nerve is at risk of damage during repair of recurrent TEFs.
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Jill Knepprath summarizes what Dr. Douglas von Allmen said: A transtracheal approach provides better surgical exposure and reduces risk to the recurrent laryngeal nerve.
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Jill Knepprath summarizes what Dr. Douglas von Allmen said: The transtracheal approach helps minimize injury to the recurrent laryngeal nerve.
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Esophageal Atresia & Tracheoesophageal Fistula (EA/TEF) Types Explained for Pediatric Surgery
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Jill Knepprath summarizing a resource: Today I'm going to walk through esophageal atresia and tracheoesophageal fistula, or TEF.
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Jill Knepprath summarizing a resource: EA/TEF is a basic concept in pediatric surgery.
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Jill Knepprath summarizing a resource: In normal anatomy, the esophagus goes straight down to the stomach with no atresia or interruptions, and the trachea goes straight down to the lungs with no connections between the two.
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Jill Knepprath summarizing a resource: Type A EA/TEF consists of esophageal atresia proximally and distally in the esophagus, preventing solids and liquids from reaching the stomach, with no connection between esophagus and trachea.
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Jill Knepprath summarizing a resource: Type B EA/TEF has distal esophageal atresia and a proximal fistula, allowing solids and liquids to enter the trachea while the stomach remains empty.
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Jill Knepprath summarizing a resource: Type C EA/TEF has proximal esophageal atresia and a distal fistula, allowing air to reach both lungs and stomach while solids and liquids cannot reach the stomach.
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Jill Knepprath summarizing a resource: Type D EA/TEF has both a distal fistula and a proximal fistula, allowing solids and liquids into the trachea and air into both lungs and stomach.
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Jill Knepprath summarizing a resource: Type E EA/TEF has no atresia but does have a tracheoesophageal fistula, which is often pretty high.
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Jill Knepprath summarizing a resource: Type E EA/TEF is also known as H-type because of its anatomical appearance.
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Jill Knepprath summarizing a resource: This is also known as H. You can see the H right here.
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Jill Knepprath summarizing a resource: And this is the one with the best results and usually the easiest to fix.
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Jill Knepprath summarizing a resource: Type E (H-type) EA/TEF has the best results and is usually the easiest to fix.
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Jill Knepprath summarizing a resource: Children with Type E (H-type) EA/TEF may present with symptoms later because they are still able to get solids and liquids down to the stomach and air to the lungs.
Open
Summaries Jill gave as host · Fecal Incontinence 7 summaries
Open the Fecal Incontinence collection →
Update Course Rewind 2025: Sacral Nerve Stimulation for Refractory Pediatric Fecal Incontinence
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Jill Knepprath summarizes what Dr. Ben Hamm said: What do you do when nothing is working for a child with severe fecal incontinence?
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Jill Knepprath summarizes what Dr. Ben Hamm said: Contrast enema showed an elongated sigmoid colon, but a previous rectal biopsy was normal.
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Jill Knepprath summarizes what Dr. Ben Hamm said: Anti-grade colonic enema procedures or sycostomy tubes are a reasonable next step for refractory pediatric fecal incontinence.
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Jill Knepprath summarizes what Dr. Ben Hamm said: Overnight, the rate of the child needing a diaper went from 33% to 11% with sacral nerve stimulation.
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Jill Knepprath summarizes what Dr. Ben Hamm said: A 2023 study showed an improvement in involuntary daytime and nighttime bowel movements with sacral nerve stimulation.
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Jill Knepprath summarizes what Dr. Ben Hamm said: How is the stimulator placed and how does it work?
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Jill Knepprath summarizes what Dr. Ben Hamm said: If symptoms improve during the trial, the stimulator can be implanted long term with a battery.
Open
Summaries Jill gave as host · Fetal Surgery 10 summaries
Open the Fetal Surgery collection →
Inside a FETO Procedure: Fetoscopic Balloon Tracheal Occlusion with Dr. Beth Rymeski
Host summary
Jill Knepprath summarizes what Dr. Beth Rymeski said: The goal of FETO is to allow fluid to stay in the lungs and allow the lungs to expand and grow.
Open
Host summary
Jill Knepprath summarizes what Dr. Beth Rymeski said: The goal of FETO is to allow fluid to stay in the lungs and allow the lungs to expand and grow.
Open
Host summary
Jill Knepprath summarizes what Dr. Beth Rymeski said: FETO helps prevent pulmonary hypoplasia, which is a big factor in poor outcomes for CDH babies.
Open
Host summary
Jill Knepprath summarizes what Dr. Beth Rymeski said: FETO helps prevent pulmonary hypoplasia, which is a big factor in poor outcomes for CDH babies.
Open
Host summary
Jill Knepprath summarizes what Dr. Beth Rymeski said: The balloon is filled with around 0.65 to 0.8 mL of water, depending on the size of the trachea.
Open
Host summary
Jill Knepprath summarizes what Dr. Beth Rymeski said: The balloon is filled with around 0.65 to 0.8 mL of water, depending on the size of the trachea.
Open
Host summary
Jill Knepprath summarizes what Dr. Beth Rymeski said: Sometimes the trocar advances into the mouth during the procedure and needs to be backed out.
Open
Host summary
Jill Knepprath summarizes what Dr. Beth Rymeski said: Sometimes the trocar advances into the mouth during the procedure and needs to be backed out.
Open
Host summary
Jill Knepprath summarizes what Dr. Beth Rymeski said: Final confirmation includes advancing the scope one more time to verify the balloon is below the vocal cords and in the main trachea.
Open
Host summary
Jill Knepprath summarizes what Dr. Beth Rymeski said: Final confirmation includes advancing the scope one more time to verify the balloon is below the vocal cords and in the main trachea.
Open
Summaries Jill gave as host · Hepatoblastoma 16 summaries
Open the Hepatoblastoma collection →
Characteristics of Transfusion and Association With Oncologic Outcomes in Hepatoblastoma Resection
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Jill Knepprath summarizing a resource: It is not uncommon for a patient with hepatoblastoma to need a transfusion during resection
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Jill Knepprath summarizing a resource: It's not uncommon for a patient with hepatoblastoma to need a transfusion during resection.
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Jill Knepprath summarizing a resource: The study was multi-institutional and published in Pediatric Blood and Cancer in 2025
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Jill Knepprath summarizing a resource: The study examined how intraoperative transfusion may affect recurrence and survival in hepatoblastoma resection patients
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Jill Knepprath summarizing a resource: Only 11% of transfused patients received platelets
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Jill Knepprath summarizing a resource: Of those transfused, the majority received red blood cells
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Jill Knepprath summarizing a resource: Intraoperative blood transfusions had no effect on recurrence, however, they were associated with increased death.
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Jill Knepprath summarizing a resource: Intraoperative blood transfusions were associated with increased death
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Jill Knepprath summarizing a resource: Intraoperative blood transfusions had no effect on recurrence
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Jill Knepprath summarizing a resource: There were instances of unnecessary blood transfusions
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Jill Knepprath summarizing a resource: Patients who were transfused had higher post-op hemoglobin
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Jill Knepprath summarizing a resource: Transfused patients still required more plasma and platelets postoperatively
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Jill Knepprath summarizing a resource: The authors think that blood transfusions were mostly red blood cells, and that is what contributed to the post-op coagulopathy.
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Jill Knepprath summarizing a resource: The authors think that blood transfusions were mostly red blood cells, and that is what contributed to the post-op coagulopathy
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Jill Knepprath summarizing a resource: The authors recommend more careful patient selection for intraoperative transfusions
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Jill Knepprath summarizing a resource: The authors recommend a balanced transfusion approach
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Summaries Jill gave as host · Hirschsprung disease 20 summaries
Open the Hirschsprung disease collection →
Update Course Rewind 2025: Hirschsprung’s Pull-Through: Why Family Training May Save Lives
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Jill Knepprath summarizing the discussion: The median age of the neonatal pull-through group was 11 days at time of surgery.
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Jill Knepprath summarizing the discussion: The median age of the delayed pull-through group was 98 days at time of surgery.
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Jill Knepprath summarizing the discussion: The PCPLC study found no difference in fecal incontinence at follow-up between neonatal and delayed pull-through groups.
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Jill Knepprath summarizing the discussion: The PCPLC study found no difference in preoperative enterocolitis between neonatal and delayed pull-through groups.
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Jill Knepprath summarizing the discussion: The PCPLC study found no difference in postoperative enterocolitis between neonatal and delayed pull-through groups.
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Update Course Rewind 2025: Botox for Hirschsprung’s: Where, When, and Why
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Jill Knepprath summarizing the discussion: A 2022 multi-center study found that 24% of patients undergoing pull-through procedure also received Botox
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Jill Knepprath summarizing the discussion: Patients that received Botox had a higher chance of diaper rash
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Jill Knepprath summarizing the discussion: Injecting Botox during pull-through procedure for Hirschsprung's disease has been shown to reduce enterocolitis risk
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Jill Knepprath summarizing the discussion: Dosing and guidance for Botox injection varies widely
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Update Course Rewind 2025: Hirschsprung + ARM: Rare but Real
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Jill Knepprath summarizing the discussion: The rate of Hirschsprung disease and anorectal malformation occurring together is less than 2%
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Jill Knepprath summarizing the discussion: The co-occurrence of Hirschsprung disease and ARM is something to keep in mind for patients with trisomy 21
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Jill Knepprath summarizing the discussion: It's rare, but something to keep in mind for patients with trisomy 21.
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Jill Knepprath summarizing the discussion: Hypo or absent ganglion cells were found in the remaining rectal fistula specimens
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Jill Knepprath summarizing the discussion: Ganglion cells were found in 91% of rectal fistula specimens
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Jill Knepprath summarizing the discussion: Absent ganglion cells in fistula tissue does not necessarily mean the patient has Hirschsprung disease
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Jill Knepprath summarizing the discussion: But absent cells in fistula tissue doesn't necessarily mean it's Hirschsprung's disease.
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Jill Knepprath summarizing the discussion: Three patients (4% of the study cohort) had both Hirschsprung disease and anorectal malformation
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Jill Knepprath summarizing the discussion: Two of the three patients with both conditions had trisomy 21
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Jill Knepprath summarizing the discussion: Complex anorectal malformation patients with chromosomal anomalies who do not respond to laxatives or enemas should be worked up for Hirschsprung disease
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Summaries Jill gave as host · Inguinal Hernia 19 summaries
Open the Inguinal Hernia collection →
Surgeon annual volume impacts recurrence rates of pediatric inguinal hernia repairs: A multi-institutional study
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Jill Knepprath summarizing a resource: Heller et al. published a multi-institutional study in the Journal of Pediatric Surgery in 2025 exploring the impact of surgeon volume on patients with inguinal hernias.
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Jill Knepprath summarizing a resource: The authors found that inguinal hernias repaired by lower volume surgeons had a 1.5 fold increase in the odds of recurrence.
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Jill Knepprath summarizing a resource: Inguinal hernias repaired by lower volume surgeons had a 1.5 fold increase in the odds of recurrence.
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Jill Knepprath summarizing a resource: When broken down by surgical approach, there was no difference in recurrence rates for open inguinal hernia repairs based on surgeon volume.
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Jill Knepprath summarizing a resource: However, laparoscopic repairs done by lower volume surgeons had a 3.3 fold increase in the odds of recurrence.
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Jill Knepprath summarizing a resource: Laparoscopic inguinal hernia repairs done by lower volume surgeons had a 3.3 fold increase in the odds of recurrence.
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Jill Knepprath summarizing a resource: The authors of the Heller et al. study recommend maintaining a high volume of laparoscopic repairs, and if that's not possible, to seek help from a higher volume surgeon.
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Laparoscopic modified percutaneous internal ring suturing - a mesh-free alternative for indirect inguinal hernia repair in adults. a pilot prospective cohort study
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Jill Knepprath summarizing a resource: High ligation hernia repair, that's for kids.
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Jill Knepprath summarizing a resource: The study was published in the International Journal of Surgery.
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Jill Knepprath summarizing a resource: The study used the modified percutaneous internal ring suturing technique to evaluate whether a laparoscopic non-mesh repair works on indirect inguinal hernias in adults.
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Jill Knepprath summarizing a resource: No patients had hernia recurrence on follow-up, with a median follow-up of 79 months.
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Jill Knepprath summarizing a resource: Patients reported a decrease in pain and an improved activity post-operatively.
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Jill Knepprath summarizing a resource: The study shows success with the modified PIRS technique in adults.
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Jill Knepprath summarizing a resource: Would you offer this to your hernia patients?
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Summaries Jill gave as host · Liver Tumors (Hepatoblastoma/HCC) 16 summaries
Open the Liver Tumors (Hepatoblastoma/HCC) collection →
Characteristics of Transfusion and Association With Oncologic Outcomes in Hepatoblastoma Resection
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Jill Knepprath summarizing a resource: It's not uncommon for a patient with hepatoblastoma to need a transfusion during resection.
Open
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Jill Knepprath summarizing a resource: It is not uncommon for a patient with hepatoblastoma to need a transfusion during resection
Open
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Jill Knepprath summarizing a resource: The study was multi-institutional and published in Pediatric Blood and Cancer in 2025
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Jill Knepprath summarizing a resource: The study examined how intraoperative transfusion may affect recurrence and survival in hepatoblastoma resection patients
Open
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Jill Knepprath summarizing a resource: Of those transfused, the majority received red blood cells
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Jill Knepprath summarizing a resource: Only 11% of transfused patients received platelets
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Jill Knepprath summarizing a resource: Intraoperative blood transfusions had no effect on recurrence, however, they were associated with increased death.
Open
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Jill Knepprath summarizing a resource: Intraoperative blood transfusions were associated with increased death
Open
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Jill Knepprath summarizing a resource: Intraoperative blood transfusions had no effect on recurrence
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Jill Knepprath summarizing a resource: There were instances of unnecessary blood transfusions
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Jill Knepprath summarizing a resource: Transfused patients still required more plasma and platelets postoperatively
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Jill Knepprath summarizing a resource: Patients who were transfused had higher post-op hemoglobin
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Jill Knepprath summarizing a resource: The authors think that blood transfusions were mostly red blood cells, and that is what contributed to the post-op coagulopathy
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Jill Knepprath summarizing a resource: The authors think that blood transfusions were mostly red blood cells, and that is what contributed to the post-op coagulopathy.
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Jill Knepprath summarizing a resource: The authors recommend more careful patient selection for intraoperative transfusions
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Jill Knepprath summarizing a resource: The authors recommend a balanced transfusion approach
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Summaries Jill gave as host · Lymphatic Malformation 4 summaries
Open the Lymphatic Malformation collection →
Update Course Rewind 2025: Neck Pathologies - The Diagnostic Challenge
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Jill Knepprath summarizes what Dr. Douglas von Allmen said: A ranula is a benign cyst that forms under the tongue caused by saliva leaking from a blocked sublingual gland.
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Jill Knepprath summarizes what Dr. Douglas von Allmen said: Lymphatic malformations are clusters of lymph vessels that are often present at birth.
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Jill Knepprath summarizes what Dr. Douglas von Allmen said: For lymphatic malformations, there are 3 procedural treatments: laser, sclerotherapy, and excision.
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Jill Knepprath summarizes what Dr. Douglas von Allmen said: There are 3 medical therapies for lymphatic malformations that are still undergoing clinical trials.
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Summaries Jill gave as host · Metastatic Disease 15 summaries
Open the Metastatic Disease collection →
Malignant peripheral nerve sheath tumors: a report from Children’s Oncology Group study ARST0332
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Jill Knepprath summarizing a resource: Is there a role for chemo radiation in peripheral nerve sheath tumors, or is excision all that is needed?
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Jill Knepprath summarizing a resource: The Children's Oncology Group published a prospective trial on malignant peripheral nerve sheath tumors in the Journal of the National Cancer Institute in 2025.
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Jill Knepprath summarizing a resource: Patients were assigned to four treatment groups: observation, adjuvant radiation, adjuvant chemoradiation, and neoadjuvant chemoradiation.
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Jill Knepprath summarizing a resource: Overall results confirmed that resection has a major influence on survival for these patients.
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Jill Knepprath summarizing a resource: Resection has a major influence on survival for patients with malignant peripheral nerve sheath tumors.
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Jill Knepprath summarizing a resource: Patients without metastatic disease had improved outcomes.
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Jill Knepprath summarizing a resource: Female patients with malignant peripheral nerve sheath tumors had improved outcomes.
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Jill Knepprath summarizing a resource: In patients receiving neoadjuvant therapy, 23% showed a response.
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Jill Knepprath summarizing a resource: In patients receiving neoadjuvant therapy, 45% were stable.
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Jill Knepprath summarizing a resource: In patients receiving neoadjuvant therapy, 32% had progressive disease.
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Jill Knepprath summarizing a resource: There was no difference in survival based on the response to neoadjuvant therapy among patients who went on to have resection.
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Jill Knepprath summarizing a resource: There was no difference in survival based on the response to neoadjuvant therapy.
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Jill Knepprath summarizing a resource: Resection should be done for patients with malignant peripheral nerve sheath tumors whenever possible, even if they show a good response to chemoradiation.
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Jill Knepprath summarizing a resource: Overall, this study confirms that resection should be done for these patients whenever possible, even if they show a good response to chemo radiation.
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Summaries Jill gave as host · Neurofibromatosis 15 summaries
Open the Neurofibromatosis collection →
Malignant peripheral nerve sheath tumors: a report from Children’s Oncology Group study ARST0332
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Jill Knepprath summarizing a resource: Is there a role for chemo radiation in peripheral nerve sheath tumors, or is excision all that is needed?
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Jill Knepprath summarizing a resource: The Children's Oncology Group published a prospective trial on malignant peripheral nerve sheath tumors in the Journal of the National Cancer Institute in 2025.
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Jill Knepprath summarizing a resource: Patients were assigned to four treatment groups: observation, adjuvant radiation, adjuvant chemoradiation, and neoadjuvant chemoradiation.
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Jill Knepprath summarizing a resource: Resection has a major influence on survival for patients with malignant peripheral nerve sheath tumors.
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Jill Knepprath summarizing a resource: Overall results confirmed that resection has a major influence on survival for these patients.
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Jill Knepprath summarizing a resource: Patients without metastatic disease had improved outcomes.
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Jill Knepprath summarizing a resource: Female patients with malignant peripheral nerve sheath tumors had improved outcomes.
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Jill Knepprath summarizing a resource: In patients receiving neoadjuvant therapy, 32% had progressive disease.
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Jill Knepprath summarizing a resource: In patients receiving neoadjuvant therapy, 45% were stable.
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Jill Knepprath summarizing a resource: In patients receiving neoadjuvant therapy, 23% showed a response.
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Jill Knepprath summarizing a resource: There was no difference in survival based on the response to neoadjuvant therapy.
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Jill Knepprath summarizing a resource: There was no difference in survival based on the response to neoadjuvant therapy among patients who went on to have resection.
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Jill Knepprath summarizing a resource: Resection should be done for patients with malignant peripheral nerve sheath tumors whenever possible, even if they show a good response to chemoradiation.
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Jill Knepprath summarizing a resource: Overall, this study confirms that resection should be done for these patients whenever possible, even if they show a good response to chemo radiation.
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Summaries Jill gave as host · Pediatric Robotic Surgery 13 summaries
Open the Pediatric Robotic Surgery collection →
Update Course Rewind 2025: Robotics in Pediatric Surgery: Which indications benefit the most?
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Jill Knepprath summarizing the discussion: All pediatric surgical patients are good candidates for robotic surgery.
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Jill Knepprath summarizing the discussion: Robotic surgery reduces postoperative pain and infection risk, leading to faster recovery.
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Jill Knepprath summarizing the discussion: Robotic surgery improves depth perception compared to laparoscopic surgery.
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Jill Knepprath summarizing the discussion: Robotic surgery reduces surgeon fatigue compared to laparoscopic surgery.
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Jill Knepprath summarizing the discussion: In colorectal surgery, robotic operative time is longer than laparoscopic.
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Jill Knepprath summarizing the discussion: Laparoscopy has a higher conversion rate to open surgery than robotic surgery in colorectal cases.
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Jill Knepprath summarizing the discussion: Both robotic and laparoscopic surgery have comparable oncologic results.
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Jill Knepprath summarizing the discussion: It takes half the number of cases to become proficient in robotic surgery versus laparoscopy.
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Jill Knepprath summarizing the discussion: Robotics can be indicated for surgeries in the chest, pelvic reconstruction, abdominal tumors, and urology.
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Jill Knepprath summarizing the discussion: In smaller patients, ports should be measured 3 centimeters apart.
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Jill Knepprath summarizing the discussion: Robotic surgery in pediatric patients is ideal in select cases including adrenal masses, polyoco cysts, and nephrectomies.
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Jill Knepprath summarizing the discussion: Reported cons of robotic surgery include cost, setup time, the size of the ports, and a steep learning curve.
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Jill Knepprath summarizing the discussion: Once proficiency is achieved, operative times and conversions to open surgery are lower for robotic surgery compared to laparoscopy.
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Summaries Jill gave as host · Peritoneal Dialysis Access 7 summaries
Open the Peritoneal Dialysis Access collection →
Surgeon annual volume impacts recurrence rates of pediatric inguinal hernia repairs: A multi-institutional study
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Jill Knepprath summarizing a resource: Heller et al. published a multi-institutional study in the Journal of Pediatric Surgery in 2025 exploring the impact of surgeon volume on patients with inguinal hernias.
Open
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Jill Knepprath summarizing a resource: The authors found that inguinal hernias repaired by lower volume surgeons had a 1.5 fold increase in the odds of recurrence.
Open
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Jill Knepprath summarizing a resource: Inguinal hernias repaired by lower volume surgeons had a 1.5 fold increase in the odds of recurrence.
Open
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Jill Knepprath summarizing a resource: When broken down by surgical approach, there was no difference in recurrence rates for open inguinal hernia repairs based on surgeon volume.
Open
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Jill Knepprath summarizing a resource: Laparoscopic inguinal hernia repairs done by lower volume surgeons had a 3.3 fold increase in the odds of recurrence.
Open
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Jill Knepprath summarizing a resource: However, laparoscopic repairs done by lower volume surgeons had a 3.3 fold increase in the odds of recurrence.
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Jill Knepprath summarizing a resource: The authors of the Heller et al. study recommend maintaining a high volume of laparoscopic repairs, and if that's not possible, to seek help from a higher volume surgeon.
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Summaries Jill gave as host · Thrombosis 6 summaries
Open the Thrombosis collection →
Update Course Rewind 2025: New Technologies for Central Line Management
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Jill Knepprath summarizes what Dr. Nathan Fagan said: The Surfacer requires an open femoral vein, preferably on the right side, to be effective.
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Jill Knepprath summarizes what Dr. Nathan Fagan said: The Surfacer technique is suitable for acute pediatric cases as opposed to the chronic scarring seen in adult cases.
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Jill Knepprath summarizes what Dr. Nathan Fagan said: Transhepatic and translumbar access are last resorts when all traditional central access is lost.
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Jill Knepprath summarizes what Dr. Nathan Fagan said: Transhepatic access involves a catheter being directly placed through the liver into the inferior vena cava.
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Jill Knepprath summarizes what Dr. Nathan Fagan said: Transhepatic access is a more complicated procedure and has higher risk for thrombosis.
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Jill Knepprath summarizes what Dr. Nathan Fagan said: Translumbar access involves accessing the inferior vena cava from the back.
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Summaries Jill gave as host · Thyroid Nodules 10 summaries
Open the Thyroid Nodules collection →
Update Course Rewind 2025: Nerve Monitoring in Pediatric Thyroid Surgery
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Jill Knepprath summarizing the discussion: Thyroid nodules are more common in adults than in children, so there are not many centers with pediatric surgeons who have high volume of these cases
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Jill Knepprath summarizing the discussion: If biopsy comes back as cancer, completing thyroidectomy is the next recommended step
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Jill Knepprath summarizing the discussion: In thyroid surgery, intraoperative nerve monitoring is a technique to localize the recurrent laryngeal nerves which control the vocal cords using an electric probe that stimulates the nerve while EMG electrodes monitor vocal cord movement
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Jill Knepprath summarizing the discussion: In a recent survey, 80% of pediatric thyroid surgeons use nerve monitoring
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Jill Knepprath summarizing the discussion: Nerve monitoring detects injury early, allowing surgeons to stage the operation and avoid bilateral injury, paralysis, and subsequent tracheotomy
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Jill Knepprath summarizing the discussion: Nerve monitoring devices were often too big for pediatric patients in the past
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Jill Knepprath summarizing the discussion: Nerve monitoring can be considered in all pediatric thyroid surgeries because adhesive electrodes can be applied to even a 3.0 endotracheal tube
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Jill Knepprath summarizing the discussion: Radiologists say that TIRRADS is not really reliable for pediatrics since it was originally developed for adults
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Jill Knepprath summarizing the discussion: When criteria was based on the size of the thyroid relative to the size of the patient, no malignancies were missed
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Jill Knepprath summarizing the discussion: Dr. Aldrin's 2025 study showed that the PES-TIRRADS eliminated unnecessary biopsies while not missing a single thyroid malignancy compared to adult and 2015 pediatric guidelines
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Summaries Jill gave as host · Tracheoesophageal Fistula 21 summaries
Open the Tracheoesophageal Fistula collection →
Update Course Rewind 2025: The Recurrent TEF Problem
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Jill Knepprath summarizes what Dr. Douglas von Allmen said: Recurrent tracheoesophageal fistulas can develop years after initial TEF repair.
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Jill Knepprath summarizes what Dr. Douglas von Allmen said: Esophageal dilations were performed without improvement.
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Jill Knepprath summarizes what Dr. Douglas von Allmen said: Bronchoscopy revealed granulation tissue along the back wall of the airway.
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Jill Knepprath summarizes what Dr. Douglas von Allmen said: The recurrent laryngeal nerve is at risk of damage during repair of recurrent TEFs.
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Jill Knepprath summarizes what Dr. Douglas von Allmen said: A transtracheal approach provides better surgical exposure and reduces risk to the recurrent laryngeal nerve.
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Jill Knepprath summarizes what Dr. Douglas von Allmen said: The transtracheal approach helps minimize injury to the recurrent laryngeal nerve.
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Esophageal Atresia & Tracheoesophageal Fistula (EA/TEF) Types Explained for Pediatric Surgery
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Jill Knepprath summarizing a resource: Today I'm going to walk through esophageal atresia and tracheoesophageal fistula, or TEF.
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Jill Knepprath summarizing a resource: EA/TEF is a basic concept in pediatric surgery.
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Jill Knepprath summarizing a resource: In normal anatomy, the esophagus goes straight down to the stomach with no atresia or interruptions, and the trachea goes straight down to the lungs with no connections between the two.
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Jill Knepprath summarizing a resource: Type A EA/TEF consists of esophageal atresia proximally and distally in the esophagus, preventing solids and liquids from reaching the stomach, with no connection between esophagus and trachea.
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Jill Knepprath summarizing a resource: Type B EA/TEF has distal esophageal atresia and a proximal fistula, allowing solids and liquids to enter the trachea while the stomach remains empty.
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Jill Knepprath summarizing a resource: Type C EA/TEF has proximal esophageal atresia and a distal fistula, allowing air to reach both lungs and stomach while solids and liquids cannot reach the stomach.
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Jill Knepprath summarizing a resource: Type D EA/TEF has both a distal fistula and a proximal fistula, allowing solids and liquids into the trachea and air into both lungs and stomach.
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Jill Knepprath summarizing a resource: Type E EA/TEF has no atresia but does have a tracheoesophageal fistula, which is often pretty high.
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Jill Knepprath summarizing a resource: This is also known as H. You can see the H right here.
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Jill Knepprath summarizing a resource: Type E EA/TEF is also known as H-type because of its anatomical appearance.
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Jill Knepprath summarizing a resource: Type E (H-type) EA/TEF has the best results and is usually the easiest to fix.
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Jill Knepprath summarizing a resource: And this is the one with the best results and usually the easiest to fix.
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Jill Knepprath summarizing a resource: Children with Type E (H-type) EA/TEF may present with symptoms later because they are still able to get solids and liquids down to the stomach and air to the lungs.
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Summaries Jill gave as host · Wilms Tumor 23 summaries
Open the Wilms Tumor collection →
Impact of Pulmonary Tumor Burden in Favorable Histology Wilms Tumor Outcomes: A Report From the Children's Oncology Group Study AREN053
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Jill Knepprath summarizing a resource: Your patient has a Wilms tumor with favorable histology, but workup shows that they also have lung metastases.
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Jill Knepprath summarizing a resource: Dick et al. published a report from a Children's Oncology Group study in the Journal of Clinical Oncology in 2025
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Jill Knepprath summarizing a resource: The study examined factors in patients with favorable histology Wilms tumor and pulmonary metastases and how those factors may affect outcomes
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Jill Knepprath summarizing a resource: Factors studied included the number of metastases, the size of the metastases, and different biological markers
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Jill Knepprath summarizing a resource: There was no difference in survival based on the number of metastases
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Jill Knepprath summarizing a resource: Patients with larger nodules and rapid response to chemotherapy showed no changes in overall survival
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Jill Knepprath summarizing a resource: Patients who had a rapid response to chemotherapy with larger nodules showed worse event-free survival
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Jill Knepprath summarizing a resource: In multivariable models, neither the size nor the number of nodules had any effect on survival
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Jill Knepprath summarizing a resource: 1q gain was associated with worse event-free survival
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Jill Knepprath summarizing a resource: 1q gain was associated with worse overall survival
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Jill Knepprath summarizing a resource: One cue gain is the superior prognostic factor when compared to size and number of nodules in patients with favorable histology Wilms and pulmonary metastases.
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Jill Knepprath summarizing a resource: 1q gain is the superior prognostic factor when compared to size and number of nodules in patients with favorable histology Wilms tumor and pulmonary metastases
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Updated Favorable histology Wilms tumor risk stratification: Rationale for future Children’s Oncology Group clinical trials
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Jill Knepprath summarizing a resource: Risk stratification for Wilms tumor has evolved many times over the years.
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Jill Knepprath summarizing a resource: Risk stratification for Wilm's tumor has evolved many times over the years, so let's catch up.
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Jill Knepprath summarizing a resource: The Children's Oncology Group published updated risk stratification for patients with favorable histology Wilms tumor in Nature in June 2025.
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Jill Knepprath summarizing a resource: The new risk stratification model includes biological and clinical features that were not in the first generation risk stratification.
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Jill Knepprath summarizing a resource: The new model changes some of the older features or gets rid of them altogether.
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Jill Knepprath summarizing a resource: Factors being added are loss of heterozygosity of 11P15, 1Q gain, and lymph node involvement.
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Jill Knepprath summarizing a resource: Factors that are being added are loss of heterozygosity of 11P15C, 1Q gain. And lymph node involvement.
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Jill Knepprath summarizing a resource: Tumor nephrectomy weight is no longer included in the risk stratification.
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Jill Knepprath summarizing a resource: Tumor nephrectomy weight is no longer included.
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Jill Knepprath summarizing a resource: The model modified how histology and age are used to stratify certain patients.
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Jill Knepprath summarizing a resource: More changes are expected in the future as ongoing COG trials produce more results.
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