Lizzy Lee

Summaries Lizzy gave as host · Abdominal Wall Defects 44 summaries

Open the Abdominal Wall Defects collection →

Educational Outcomes in School-Aged Children With a History of Simple and Complex Gastroschisis are Poor Compared to Controls

Host summary Lizzy Lee summarizing a resource: Do children born with gastroschisis perform worse in school compared to age-matched peers without the condition? Open

Host summary Lizzy Lee summarizing a resource: This is a retrospective study using educational data from children born between 1991 and 2022. Open

Host summary Lizzy Lee summarizing a resource: Researchers used odds ratio and subgroup analysis to compare school performance using the Early Development Instrument or EDI and grade level assessments between 208 children with gastroschisis and over 2000 age-matched controls. Open

Host summary Lizzy Lee summarizing a resource: Children with gastroschisis, even those with the simpler form, were significantly more likely to fail middle school assessments. Open

Host summary Lizzy Lee summarizing a resource: They found that children with gastroschisis, even those with the simpler form, were significantly more likely to fail middle school assessments. Open

Host summary Lizzy Lee summarizing a resource: This suggests that children with gastroschisis may face long-term learning challenges and could benefit from early educational support. Open

Host summary Lizzy Lee summarizing a resource: Children with gastroschisis may face long-term learning challenges and could benefit from early educational support. Open

Quick Literature Updates Episode 20

Host summary Lizzy Lee summarizes what Dr. Alex Halpern said: Meta-analysis by Shibuya et al. included 709 patients from 15 research studies across multiple international centers comparing thoracoscopic versus open repair for congenital diaphragmatic hernia. Open

Host summary Lizzy Lee summarizes what Dr. Alex Halpern said: They wanted to know whether thoracoscopic repair has a higher recurrence rate and longer operating room time compared to open repair. Open

Host summary Lizzy Lee summarizes what Dr. Alex Halpern said: Thoracoscopic repair for congenital diaphragmatic hernia has longer operative times compared to open repair. Open

Host summary Lizzy Lee summarizes what Dr. Alex Halpern said: Thoracoscopic repair for congenital diaphragmatic hernia has higher recurrence rates compared to open repair. Open

Host summary Lizzy Lee summarizes what Dr. Alex Halpern said: Thoracoscopic repair for congenital diaphragmatic hernia has a lower incidence of postoperative bowel obstruction compared to open repair. Open

Quick Literature Updates Ep 22

Host summary Lizzy Lee summarizing a resource: The Beotti et al. prospective study on postoperative calibrations in Hirschsprung disease took place 2021 to 2023 and included 33 patients under six months old who underwent endorectal pull-through surgeries. Open

Host summary Lizzy Lee summarizing a resource: In the Beotti study, patients were assigned to a new non-dilation protocol group or a traditional dilation group. Open

Host summary Lizzy Lee summarizing a resource: The Beotti study primary outcomes were anastomotic complications, enterocolitis, and constipation. Open

Host summary Lizzy Lee summarizing a resource: What did they find? Open

Host summary Lizzy Lee summarizing a resource: In the Beotti study, there was no significant difference in anastomotic complications between the two groups, but the non-dilation group had less enterocolitis and less constipation. Open

Host summary Lizzy Lee summarizing a resource: Choosing not to do postoperative anal dilations after Hirschsprung pull-through may be a good alternative with benefits like lower constipation and enterocolitis. Open

A multi-institutional comparison of management techniques for infants with giant omphalocele

Host summary Lizzy Lee summarizing a resource: What's the best way to manage a giantombalocele? Open

Host summary Lizzy Lee summarizing a resource: The study examined 117 infants with giant omphalocele. Open

Host summary Lizzy Lee summarizing a resource: Four treatment approaches were compared: paint-and-wait, operative silos, compression techniques, and Duoderm silo. Open

Host summary Lizzy Lee summarizing a resource: Babies treated with the duoderm silo were most likely to have their abdomen closed in one surgery. Open

Host summary Lizzy Lee summarizing a resource: Babies treated with Duoderm silo were most likely to have their abdomen closed in one surgery. Open

Host summary Lizzy Lee summarizing a resource: About 8 out of 10 did. Open

Host summary Lizzy Lee summarizing a resource: Approximately 80% of infants treated with Duoderm silo achieved single-stage abdominal closure. Open

Host summary Lizzy Lee summarizing a resource: Some babies treated with operative silos achieved closure sooner than other methods. Open

Host summary Lizzy Lee summarizing a resource: The overall chance of complications was similar across all four treatment methods. Open

Host summary Lizzy Lee summarizing a resource: Almost half of the babies needed 6 months or more before the abdomen could be fully closed. Open

Host summary Lizzy Lee summarizing a resource: Almost half of the infants required six months or more before complete abdominal closure could be achieved. Open

Host summary Lizzy Lee summarizing a resource: There is no one-size-fits-all treatment for giant omphalocele. Open

Host summary Lizzy Lee summarizing a resource: Duoderm silos may be a particularly good option when the goal is single-stage abdominal closure. Open

A multi-institutional comparison of management techniques for infants with giant omphalocele

Host summary Lizzy Lee summarizing a resource: What's the best way to manage a giantombalocele? Open

Host summary Lizzy Lee summarizing a resource: Four treatment approaches were compared: paint-and-wait, operative silos, compression techniques, and Duoderm silo Open

Host summary Lizzy Lee summarizing a resource: The study examined 117 infants with giant omphalocele Open

Host summary Lizzy Lee summarizing a resource: Babies treated with the duoderm silo were most likely to have their abdomen closed in one surgery. Open

Host summary Lizzy Lee summarizing a resource: Babies treated with Duoderm silo were most likely to have their abdomen closed in one surgery Open

Host summary Lizzy Lee summarizing a resource: Approximately 80% of infants treated with Duoderm silo achieved single-surgery abdominal closure Open

Host summary Lizzy Lee summarizing a resource: About 8 out of 10 did. Open

Host summary Lizzy Lee summarizing a resource: Complication rates were similar across all four management methods Open

Host summary Lizzy Lee summarizing a resource: Some babies treated with operative silos achieved closure sooner than other methods Open

Host summary Lizzy Lee summarizing a resource: Almost half of infants required 6 months or more before complete abdominal closure could be achieved Open

Host summary Lizzy Lee summarizing a resource: There's no one size fits all treatment, but Duoderm silos may be a really good option for certain babies, especially when the goal is closing the abdomen in one step. Open

Host summary Lizzy Lee summarizing a resource: Duoderm silos may be particularly beneficial when the goal is single-stage abdominal closure Open

Host summary Lizzy Lee summarizing a resource: There is no universal best treatment approach for giant omphalocele Open

Summaries Lizzy gave as host · Acute Recurrent Pancreatitis 10 summaries

Open the Acute Recurrent Pancreatitis collection →

Pancreatitis in pediatric patients with pancreatic solid pseudopapillary neoplasms- a single center experience

Host summary Lizzy Lee summarizing a resource: What if curing a rare pancreatic tumor sets the stage for chronic pancreatitis? Open

Host summary Lizzy Lee summarizing a resource: Solid pseudopapillary neoplasms are one of the most frequent pancreatic tumors in pediatric patients Open

Host summary Lizzy Lee summarizing a resource: Surgery for solid pseudopapillary neoplasms is usually curative and outcomes are excellent Open

Host summary Lizzy Lee summarizing a resource: In a single center study, 10 adolescent girls underwent surgical resection for solid pseudopapillary neoplasms Open

Host summary Lizzy Lee summarizing a resource: 3 out of 10 patients developed acute recurrent or chronic pancreatitis after resection Open

Host summary Lizzy Lee summarizing a resource: Every patient who developed ongoing pancreatitis had genetic risk factors like the CFTR gene variant, or they had pancreas divisum. Open

Host summary Lizzy Lee summarizing a resource: Every patient who developed ongoing pancreatitis had genetic risk factors like CFTR gene variants or pancreas divisum Open

Host summary Lizzy Lee summarizing a resource: Some patients with post-resection pancreatitis ultimately required completion pancreatectomy Open

Host summary Lizzy Lee summarizing a resource: Even low grade tumors can carry high stakes consequences. Open

Host summary Lizzy Lee summarizing a resource: Identifying genetic and anatomic risk factors before surgery may change management of patients with solid pseudopapillary neoplasms Open

Summaries Lizzy gave as host · Aerodigestive / ENT 28 summaries

Open the Aerodigestive / ENT collection →

QUAD #27 - Multidisciplinary - How Do Teams Enhance Outcomes by the CCHMC ADEC Team

Host summary Lizzy Lee summarizing the discussion: Cincinnati Children's Hospital hosted the Quad Conference in October 2022, combining four conferences: International Organization for Esophageal Atresia, Aerodigestive Society Conference, Cincinnati Children's Airway Course, and Cincinnati Children's Pediatric Dysphagia Series. Open

Host summary Lizzy Lee summarizing the discussion: Cincinnati Children's has one of the largest aerodigestive centers in the world. Open

Host summary Lizzy Lee summarizing the discussion: The expert multidisciplinary team includes speech pathology, otolaryngology, gastroenterology, pulmonology, and pediatric general surgery. Open

Host summary Lizzy Lee summarizing the discussion: The center provides coordinated multidisciplinary care to children with congenital or acquired complex digestive and airway disorders. Open

Host summary Lizzy Lee summarizing the discussion: Video fluoroscopic swallowing study analyzes different phases of swallowing. Open

Host summary Lizzy Lee summarizing the discussion: FEES (fiber optic endoscopic evaluation of swallowing study) allows visualization of pharyngeal and laryngeal structures and assessment of function, aspiration, and residual after each swallow. Open

Host summary Lizzy Lee summarizing the discussion: ENT looks at swallowing study results and helps stratify the risk of proceeding with airway reconstruction and decannulation. Open

Host summary Lizzy Lee summarizing the discussion: In aerodigestive patients, ENT performs esophageal and airway reconstruction, cleft repair, drool procedures, and manages vocal folds and mobility. Open

Host summary Lizzy Lee summarizing the discussion: GERD pathophysiology includes an incompetent lower esophageal sphincter. Open

Host summary Lizzy Lee summarizing the discussion: General signs and symptoms of GERD include regurgitation, vomiting, and heartburn. Open

Host summary Lizzy Lee summarizing the discussion: Data shows an increase in airway surgery complications in patients who were later found to have eosinophilic esophagitis. Open

Host summary Lizzy Lee summarizing the discussion: Anatomic issues in aerodigestive patients include strictures that need balloon dilations or stenting. Open

Host summary Lizzy Lee summarizing the discussion: When 25 patients in the aerodigestive program were assessed, 76% of them had a feeding disorder. Open

Host summary Lizzy Lee summarizing the discussion: Patients at risk for pulmonary insufficiency include preemies with chronic lung disease, patients with restrictive lung disease, congenital or acquired abnormalities, and heart disease like pulmonary hypertension. Open

Host summary Lizzy Lee summarizing the discussion: Underlying pulmonary insufficiency should be suspected if patients have had complicated respiratory infections requiring positive pressure ventilation. Open

Host summary Lizzy Lee summarizing the discussion: Risk factors for upper airway obstruction include airway abnormalities like mid-face hypoplasia, skeletal dysplasia, decreased muscle tone, and syndromes associated with airway obstruction. Open

Host summary Lizzy Lee summarizing the discussion: Risk factors for lower airway obstruction include acquired or congenital thoracic deformities and those who had thoracotomies done in the past. Open

Host summary Lizzy Lee summarizing the discussion: For patients with ventilatory insufficiency, the pulmonologist determines if the child still needs ventilatory support and whether they are ready for decannulation. Open

Host summary Lizzy Lee summarizing the discussion: The pulmonologist assesses how ready the patient is for weaning from the vent and whether they can start or advance feeding. Open

Host summary Lizzy Lee summarizing the discussion: In the NICU, general surgeons obtain feeding access, manage anorectal malformations, and perform surgical procedures such as tracheopexies and lung resections. Open

Tracheobronchopexy to Avoid Tracheostomy in Esophageal Atresia Patients With Severe Life-Threatening Tracheobronchomalacia

Host summary Lizzy Lee summarizing a resource: Can performing a tracheobronchopexy help oesophageal atresia patients with severe tracheobronchoalacia avoid getting a tracheostomy? Open

Host summary Lizzy Lee summarizing a resource: Tracheobronchomalacia can cause serious breathing problems like blue spells in esophageal atresia patients Open

Host summary Lizzy Lee summarizing a resource: Esophageal atresia patients often have tracheobronchomalacia Open

Host summary Lizzy Lee summarizing a resource: A retrospective observational study reviewed 80 esophageal atresia patients who underwent tracheobronchopexy at two hospitals between 2013 and 2021 Open

Host summary Lizzy Lee summarizing a resource: 94% of esophageal atresia patients who underwent tracheobronchopexy were able to avoid a tracheostomy Open

Host summary Lizzy Lee summarizing a resource: Tracheobronchopexy significantly reduced ventilator dependence in esophageal atresia patients Open

Host summary Lizzy Lee summarizing a resource: Tracheobronchopexy significantly reduced the need for positive pressure ventilation in esophageal atresia patients Open

Host summary Lizzy Lee summarizing a resource: Tracheobronchopexy significantly reduced life-threatening breathing events in esophageal atresia patients Open

Summaries Lizzy gave as host · Anorectal Malformation 36 summaries

Open the Anorectal Malformation collection →

Finnish Pediatric Surgery Hub - From Centralization to Collective Learning and Sharing of Expertise

Host summary Lizzy Lee summarizing a resource: Does creating a collaborative initiative help with providing high quality pediatric surgical care? Open

Host summary Lizzy Lee summarizing a resource: The Finnish Pediatric Surgery Hub was established in 2021 by pediatric surgeons from Finland's five neonatal surgery centers. Open

Host summary Lizzy Lee summarizing a resource: The hub performed 34 elective and 6 urgent cases total. Open

Host summary Lizzy Lee summarizing a resource: The most frequent diagnoses included anorectal malformations, esophageal atresia, and Hirschsprung disease. Open

Host summary Lizzy Lee summarizing a resource: The hub held regular monthly virtual meetings to present new patients, discuss complex cases, and follow up on patients after surgery. Open

Host summary Lizzy Lee summarizing a resource: Their findings suggest that the Finnish Pediatric Surgery hub fosters an effective and safe place for sharing surgical expertise and learning. Open

Host summary Lizzy Lee summarizing a resource: Findings suggest that the Finnish Pediatric Surgery hub fosters an effective and safe place for sharing surgical expertise and learning. Open

Quick Literature Updates Episode 18

Host summary Lizzy Lee summarizes what Dr. Alex Halpern said: The ERAS Society used a modified Delphi technique to develop recommendations for neonatal perioperative care, requiring more than 70% consensus from a multidisciplinary group of experts. Open

Host summary Lizzy Lee summarizes what Dr. Alex Halpern said: The ERAS, or the Enhanced Recovery after Surgery Society, used a modified Delphi technique, which is a fancy way of saying that a multidisciplinary group of experts gathered together to reach more than a 70% consensus. Open

Host summary Lizzy Lee summarizes what Dr. Alex Halpern said: The ERAS Society agreed on 16 recommendations covering 11 topics including team communication, pre-surgery fasting, temperature control, and antibiotic use for neonatal surgical patients. Open

Host summary Lizzy Lee summarizes what Dr. Alex Halpern said: The ERAS Society did not have enough data to make recommendations about nasogastric tubes and central lines in neonatal surgical care. Open

Comparing Loop and Divided Colostomy for Anorectal Malformation: A Systematic Review and Meta-Analysis

Host summary Lizzy Lee summarizing a resource: Which colostomy is best in pediatric patients with anorectal malformation? Open

Host summary Lizzy Lee summarizing a resource: The systematic review and meta-analysis compared clinical outcomes of loop colostomies versus divided colostomies in neonates with anorectal malformations Open

Host summary Lizzy Lee summarizing a resource: The review included 11 retrospective cohort studies Open

Host summary Lizzy Lee summarizing a resource: There were no significant differences between the two colostomy types in terms of complications such as stoma prolapse, urinary tract infections, and wound infections. Open

Host summary Lizzy Lee summarizing a resource: There were no significant differences between the two colostomy types in terms of complications such as stoma prolapse, urinary tract infections, and wound infections Open

Host summary Lizzy Lee summarizing a resource: Both colostomies are good options for fecal diversion, with the choice depending on individual patient factors and surgical expertise Open

Morbidity of Rectal Prolapse Repair After Surgery for Anorectal Malformation

Host summary Lizzy Lee summarizing a resource: What if the safest move for rectal prolapse after anorectal malformation surgery is not to repair it? Open

Host summary Lizzy Lee summarizing a resource: A study examined 85 children treated for rectal prolapse after anorectal malformation surgery Open

Host summary Lizzy Lee summarizing a resource: Approximately 30% of children had recurrence of prolapse requiring another repair Open

Host summary Lizzy Lee summarizing a resource: Children without symptoms from prolapse at initial presentation were more likely to develop stricture later Open

Host summary Lizzy Lee summarizing a resource: surgeons need to think twice before rushing into repair if the prolapse isn't causing big symptoms, because the treatment itself can carry risks Open

Host summary Lizzy Lee summarizing a resource: Surgical repair of asymptomatic rectal prolapse may not be indicated because the treatment itself carries risks Open

Post Operative Anal Dilatations for the Prevention of Anal Strictures in Children With Anorectal Malformation: A Systematic Review

Host summary Lizzy Lee summarizing a resource: After reconstructive surgery for anorectal malformations, dilatations are routine, but are they actually necessary? Open

Host summary Lizzy Lee summarizing a resource: Routine anal dilatations after surgery for anorectal malformations have been standard since the 1980s Open

Host summary Lizzy Lee summarizing a resource: Stricture rates after anorectal malformation surgery range from 0 to almost 40%, even with the classic Pena protocol Open

Host summary Lizzy Lee summarizing a resource: Alternative methods like weekly dilatations or skipping dilatations altogether showed similar outcomes to standard protocols Open

Host summary Lizzy Lee summarizing a resource: There is insufficient high quality evidence proving that dilatations after anorectal malformation surgery are actually necessary Open

Host summary Lizzy Lee summarizing a resource: Bottom line, we might have been doing this for decades without really needing to, and we need more randomized trials to settle the debate. Open

Host summary Lizzy Lee summarizing a resource: More randomized trials are needed to determine whether post-operative anal dilatations are necessary Open

Quick Literature Updates Ep 23

Host summary Lizzy Lee summarizes what Dr. Alex Halpern said: APSA published best practices for locum tenens surgeons, hospitals and agencies stressing the importance of patient safety and support for surgeons. Open

Host summary Lizzy Lee summarizes what Dr. Alex Halpern said: The American P Paediatric Surgical Association, APSA published best practices for locum tendon surgeons, hospitals and agencies in this review article. Open

Host summary Lizzy Lee summarizes what Dr. Alex Halpern said: Locum tenens can help prevent burnout by offering flexible work options for a better work-life balance. Open

Host summary Lizzy Lee summarizes what Dr. Alex Halpern said: Hospitals should avoid relying solely on locum tenens pediatric surgeons without any full-time surgeons, because this may cause patients to slip through handoffs. Open

Host summary Lizzy Lee summarizes what Dr. Alex Halpern said: However, hospitals should avoid relying solely on locum tenants pediatric surgeons without any full-time surgeons, because this may cause patients to slip through handoffs. Open

Host summary Lizzy Lee summarizes what Dr. Alex Halpern said: Locum tenens agencies should sponsor CME and conduct formal exit interviews. Open

Summaries Lizzy gave as host · Appendicitis 8 summaries

Open the Appendicitis collection →

Quick Literature Updates Ep 24

Host summary Lizzy Lee summarizes what Dr. Carlos Colunga said: The Donnati et al. study was an observational prospective study in Italy from 2013 to 2022 on 468 patients around 15 years old. Open

Host summary Lizzy Lee summarizes what Dr. Carlos Colunga said: Surgeons placed 733 pectus bars total across the 468 patients in the Donnati study. Open

Host summary Lizzy Lee summarizes what Dr. Carlos Colunga said: Bar dislocation is defined as when a pectus bar rotates more than 30 degrees out of place. Open

Host summary Lizzy Lee summarizes what Dr. Carlos Colunga said: Bridge fixation was significantly more stable than single bar fixation. Open

Host summary Lizzy Lee summarizes what Dr. Carlos Colunga said: Bridge fixation was significantly more stable than single bar fixation for pectus repair. Open

Host summary Lizzy Lee summarizes what Dr. Carlos Colunga said: None of the patients with bridge fixation had dislocated bars compared to those who underwent the single bar technique. Open

Host summary Lizzy Lee summarizes what Dr. Carlos Colunga said: Bridge fixation is the best technique for preventing bar dislocation in pectus excavatum patients. Open

Summaries Lizzy gave as host · CHARGE Syndrome 20 summaries

Open the CHARGE Syndrome collection →