Lizzie Lee

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

▶ Ep 42 · 0:00

quote Do children born with gastroschisis perform worse in school compared to age-matched peers without the condition? ↗

▶ Ep 42 · 0:11

host_summary This is a retrospective study using educational data from children born between 1991 and 2022. ↗

▶ Ep 42 · 0:18

host_summary 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. ↗

▶ Ep 42 · 0:33

quote They found that children with gastroschisis, even those with the simpler form, were significantly more likely to fail middle school assessments. ↗

▶ Ep 42 · 0:33

host_summary Children with gastroschisis, even those with the simpler form, were significantly more likely to fail middle school assessments. ↗

▶ Ep 42 · 0:41

quote This suggests that children with gastroschisis may face long-term learning challenges and could benefit from early educational support. ↗

▶ Ep 42 · 0:41

host_summary Children with gastroschisis may face long-term learning challenges and could benefit from early educational support. ↗

Quick Literature Updates Episode 20

▶ Ep 43 · 1:03

host_summary 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. ↗

▶ Ep 43 · 1:03

epidemiological 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. ↗

▶ Ep 43 · 1:11

quote They wanted to know whether thoracoscopic repair has a higher recurrence rate and longer operating room time compared to open repair. ↗

▶ Ep 43 · 1:11

quote They wanted to know whether thoracoscopic repair has a higher recurrence rate and longer operating room time compared to open repair. ↗

▶ Ep 43 · 1:18

clinical Thoracoscopic repair for congenital diaphragmatic hernia has higher recurrence rates compared to open repair. ↗

▶ Ep 43 · 1:18

clinical Thoracoscopic repair for congenital diaphragmatic hernia has longer operative times compared to open repair. ↗

▶ Ep 43 · 1:18

host_summary Thoracoscopic repair for congenital diaphragmatic hernia has longer operative times compared to open repair. ↗

▶ Ep 43 · 1:18

host_summary Thoracoscopic repair for congenital diaphragmatic hernia has higher recurrence rates compared to open repair. ↗

▶ Ep 43 · 1:25

host_summary Thoracoscopic repair for congenital diaphragmatic hernia has a lower incidence of postoperative bowel obstruction compared to open repair. ↗

▶ Ep 43 · 1:25

clinical Thoracoscopic repair for congenital diaphragmatic hernia has a lower incidence of postoperative bowel obstruction compared to open repair. ↗

Quick Literature Updates Ep 22

▶ Ep 44 · 1:03

host_summary 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. ↗

▶ Ep 44 · 1:14

host_summary In the Beotti study, patients were assigned to a new non-dilation protocol group or a traditional dilation group. ↗

▶ Ep 44 · 1:20

host_summary The Beotti study primary outcomes were anastomotic complications, enterocolitis, and constipation. ↗

▶ Ep 44 · 1:26

quote What did they find? ↗

▶ Ep 44 · 1:27

host_summary 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. ↗

▶ Ep 44 · 1:36

host_summary Choosing not to do postoperative anal dilations after Hirschsprung pull-through may be a good alternative with benefits like lower constipation and enterocolitis. ↗

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

▶ Ep 45 · 0:00

quote What's the best way to manage a giantombalocele? ↗

▶ Ep 45 · 0:07

clinical Four treatment approaches were compared: paint-and-wait, operative silos, compression techniques, and Duoderm silo. ↗

▶ Ep 45 · 0:07

epidemiological The study examined 117 infants with giant omphalocele. ↗

▶ Ep 45 · 0:19

quote Babies treated with the duoderm silo were most likely to have their abdomen closed in one surgery. ↗

▶ Ep 45 · 0:19

clinical Babies treated with Duoderm silo were most likely to have their abdomen closed in one surgery. ↗

▶ Ep 45 · 0:24

quote About 8 out of 10 did. ↗

▶ Ep 45 · 0:24

clinical Approximately 80% of infants treated with Duoderm silo achieved single-stage abdominal closure. ↗

▶ Ep 45 · 0:25

clinical Some babies treated with operative silos achieved closure sooner than other methods. ↗

▶ Ep 45 · 0:25

clinical The overall chance of complications was similar across all four treatment methods. ↗

▶ Ep 45 · 0:32

clinical Almost half of the infants required six months or more before complete abdominal closure could be achieved. ↗

▶ Ep 45 · 0:32

quote Almost half of the babies needed 6 months or more before the abdomen could be fully closed. ↗

▶ Ep 45 · 0:38

opinion Duoderm silos may be a particularly good option when the goal is single-stage abdominal closure. ↗

▶ Ep 45 · 0:38

opinion There is no one-size-fits-all treatment for giant omphalocele. ↗

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

▶ Ep 46 · 0:00

quote What's the best way to manage a giantombalocele? ↗

▶ Ep 46 · 0:07

epidemiological The study examined 117 infants with giant omphalocele ↗

▶ Ep 46 · 0:07

clinical Four treatment approaches were compared: paint-and-wait, operative silos, compression techniques, and Duoderm silo ↗

▶ Ep 46 · 0:19

quote Babies treated with the duoderm silo were most likely to have their abdomen closed in one surgery. ↗

▶ Ep 46 · 0:19

clinical Babies treated with Duoderm silo were most likely to have their abdomen closed in one surgery ↗

▶ Ep 46 · 0:24

quote About 8 out of 10 did. ↗

▶ Ep 46 · 0:24

clinical Approximately 80% of infants treated with Duoderm silo achieved single-surgery abdominal closure ↗

▶ Ep 46 · 0:25

clinical Complication rates were similar across all four management methods ↗

▶ Ep 46 · 0:25

clinical Some babies treated with operative silos achieved closure sooner than other methods ↗

▶ Ep 46 · 0:32

clinical Almost half of infants required 6 months or more before complete abdominal closure could be achieved ↗

▶ Ep 46 · 0:38

opinion There is no universal best treatment approach for giant omphalocele ↗

▶ Ep 46 · 0:38

quote 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. ↗

▶ Ep 46 · 0:38

opinion Duoderm silos may be particularly beneficial when the goal is single-stage abdominal closure ↗

Acute Recurrent Pancreatitis 10 entries

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

▶ Ep 4 · 0:00

quote What if curing a rare pancreatic tumor sets the stage for chronic pancreatitis? ↗

▶ Ep 4 · 0:09

epidemiological Solid pseudopapillary neoplasms are one of the most frequent pancreatic tumors in pediatric patients ↗

▶ Ep 4 · 0:15

clinical Surgery for solid pseudopapillary neoplasms is usually curative and outcomes are excellent ↗

▶ Ep 4 · 0:22

clinical In a single center study, 10 adolescent girls underwent surgical resection for solid pseudopapillary neoplasms ↗

▶ Ep 4 · 0:25

clinical 3 out of 10 patients developed acute recurrent or chronic pancreatitis after resection ↗

▶ Ep 4 · 0:32

quote Every patient who developed ongoing pancreatitis had genetic risk factors like the CFTR gene variant, or they had pancreas divisum. ↗

▶ Ep 4 · 0:32

clinical Every patient who developed ongoing pancreatitis had genetic risk factors like CFTR gene variants or pancreas divisum ↗

▶ Ep 4 · 0:40

clinical Some patients with post-resection pancreatitis ultimately required completion pancreatectomy ↗

▶ Ep 4 · 0:45

quote Even low grade tumors can carry high stakes consequences. ↗

▶ Ep 4 · 0:48

opinion Identifying genetic and anatomic risk factors before surgery may change management of patients with solid pseudopapillary neoplasms ↗

Aerodigestive / ENT 28 entries

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

▶ Ep 25 · 0:15

host_summary 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. ↗

▶ Ep 25 · 0:47

host_summary Cincinnati Children's has one of the largest aerodigestive centers in the world. ↗

▶ Ep 25 · 0:55

host_summary The expert multidisciplinary team includes speech pathology, otolaryngology, gastroenterology, pulmonology, and pediatric general surgery. ↗

▶ Ep 25 · 1:37

host_summary The center provides coordinated multidisciplinary care to children with congenital or acquired complex digestive and airway disorders. ↗

▶ Ep 25 · 2:52

host_summary Video fluoroscopic swallowing study analyzes different phases of swallowing. ↗

▶ Ep 25 · 2:59

host_summary 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. ↗

▶ Ep 25 · 3:48

host_summary ENT looks at swallowing study results and helps stratify the risk of proceeding with airway reconstruction and decannulation. ↗

▶ Ep 25 · 3:54

host_summary In aerodigestive patients, ENT performs esophageal and airway reconstruction, cleft repair, drool procedures, and manages vocal folds and mobility. ↗

▶ Ep 25 · 4:19

host_summary GERD pathophysiology includes an incompetent lower esophageal sphincter. ↗

▶ Ep 25 · 4:42

host_summary General signs and symptoms of GERD include regurgitation, vomiting, and heartburn. ↗

▶ Ep 25 · 5:28

host_summary Data shows an increase in airway surgery complications in patients who were later found to have eosinophilic esophagitis. ↗

▶ Ep 25 · 5:40

host_summary Anatomic issues in aerodigestive patients include strictures that need balloon dilations or stenting. ↗

▶ Ep 25 · 6:13

host_summary When 25 patients in the aerodigestive program were assessed, 76% of them had a feeding disorder. ↗

▶ Ep 25 · 6:54

host_summary 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. ↗

▶ Ep 25 · 7:20

host_summary Underlying pulmonary insufficiency should be suspected if patients have had complicated respiratory infections requiring positive pressure ventilation. ↗

▶ Ep 25 · 7:48

host_summary Risk factors for upper airway obstruction include airway abnormalities like mid-face hypoplasia, skeletal dysplasia, decreased muscle tone, and syndromes associated with airway obstruction. ↗

▶ Ep 25 · 8:13

host_summary Risk factors for lower airway obstruction include acquired or congenital thoracic deformities and those who had thoracotomies done in the past. ↗

▶ Ep 25 · 9:15

host_summary For patients with ventilatory insufficiency, the pulmonologist determines if the child still needs ventilatory support and whether they are ready for decannulation. ↗

▶ Ep 25 · 9:26

host_summary The pulmonologist assesses how ready the patient is for weaning from the vent and whether they can start or advance feeding. ↗

▶ Ep 25 · 9:41

host_summary In the NICU, general surgeons obtain feeding access, manage anorectal malformations, and perform surgical procedures such as tracheopexies and lung resections. ↗

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

▶ Ep 26 · 0:00

quote Can performing a tracheobronchopexy help oesophageal atresia patients with severe tracheobronchoalacia avoid getting a tracheostomy? ↗

▶ Ep 26 · 0:13

host_summary Tracheobronchomalacia can cause serious breathing problems like blue spells in esophageal atresia patients ↗

▶ Ep 26 · 0:13

host_summary Esophageal atresia patients often have tracheobronchomalacia ↗

▶ Ep 26 · 0:23

host_summary A retrospective observational study reviewed 80 esophageal atresia patients who underwent tracheobronchopexy at two hospitals between 2013 and 2021 ↗

▶ Ep 26 · 0:33

host_summary 94% of esophageal atresia patients who underwent tracheobronchopexy were able to avoid a tracheostomy ↗

▶ Ep 26 · 0:38

host_summary Tracheobronchopexy significantly reduced the need for positive pressure ventilation in esophageal atresia patients ↗

▶ Ep 26 · 0:38

host_summary Tracheobronchopexy significantly reduced life-threatening breathing events in esophageal atresia patients ↗

▶ Ep 26 · 0:38

host_summary Tracheobronchopexy significantly reduced ventilator dependence in esophageal atresia patients ↗

Anorectal Malformation 36 entries

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

▶ Ep 55 · 0:00

quote Does creating a collaborative initiative help with providing high quality pediatric surgical care? ↗

▶ Ep 55 · 0:10

clinical The Finnish Pediatric Surgery Hub was established in 2021 by pediatric surgeons from Finland's five neonatal surgery centers. ↗

▶ Ep 55 · 0:18

epidemiological The hub performed 34 elective and 6 urgent cases total. ↗

▶ Ep 55 · 0:18

epidemiological The most frequent diagnoses included anorectal malformations, esophageal atresia, and Hirschsprung disease. ↗

▶ Ep 55 · 0:28

clinical The hub held regular monthly virtual meetings to present new patients, discuss complex cases, and follow up on patients after surgery. ↗

▶ Ep 55 · 0:36

quote Their findings suggest that the Finnish Pediatric Surgery hub fosters an effective and safe place for sharing surgical expertise and learning. ↗

▶ Ep 55 · 0:36

opinion Findings suggest that the Finnish Pediatric Surgery hub fosters an effective and safe place for sharing surgical expertise and learning. ↗

Quick Literature Updates Episode 18

▶ Ep 56 · 1:10

host_summary 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. ↗

▶ Ep 56 · 1:10

quote 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. ↗

▶ Ep 56 · 1:34

host_summary 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. ↗

▶ Ep 56 · 1:43

host_summary The ERAS Society did not have enough data to make recommendations about nasogastric tubes and central lines in neonatal surgical care. ↗

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

▶ Ep 58 · 0:01

quote Which colostomy is best in pediatric patients with anorectal malformation? ↗

▶ Ep 58 · 0:10

clinical The systematic review and meta-analysis compared clinical outcomes of loop colostomies versus divided colostomies in neonates with anorectal malformations ↗

▶ Ep 58 · 0:19

epidemiological The review included 11 retrospective cohort studies ↗

▶ Ep 58 · 0:23

quote There were no significant differences between the two colostomy types in terms of complications such as stoma prolapse, urinary tract infections, and wound infections. ↗

▶ Ep 58 · 0:23

clinical There were no significant differences between the two colostomy types in terms of complications such as stoma prolapse, urinary tract infections, and wound infections ↗

▶ Ep 58 · 0:31

opinion Both colostomies are good options for fecal diversion, with the choice depending on individual patient factors and surgical expertise ↗

Morbidity of Rectal Prolapse Repair After Surgery for Anorectal Malformation

▶ Ep 61 · 0:00

quote What if the safest move for rectal prolapse after anorectal malformation surgery is not to repair it? ↗

▶ Ep 61 · 0:11

epidemiological A study examined 85 children treated for rectal prolapse after anorectal malformation surgery ↗

▶ Ep 61 · 0:16

epidemiological Approximately 30% of children had recurrence of prolapse requiring another repair ↗

▶ Ep 61 · 0:20

clinical Children without symptoms from prolapse at initial presentation were more likely to develop stricture later ↗

▶ Ep 61 · 0:26

opinion Surgical repair of asymptomatic rectal prolapse may not be indicated because the treatment itself carries risks ↗

▶ Ep 61 · 0:26

quote surgeons need to think twice before rushing into repair if the prolapse isn't causing big symptoms, because the treatment itself can carry risks ↗

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

▶ Ep 62 · 0:00

quote After reconstructive surgery for anorectal malformations, dilatations are routine, but are they actually necessary? ↗

▶ Ep 62 · 0:11

clinical Routine anal dilatations after surgery for anorectal malformations have been standard since the 1980s ↗

▶ Ep 62 · 0:18

epidemiological Stricture rates after anorectal malformation surgery range from 0 to almost 40%, even with the classic Pena protocol ↗

▶ Ep 62 · 0:25

clinical Alternative methods like weekly dilatations or skipping dilatations altogether showed similar outcomes to standard protocols ↗

▶ Ep 62 · 0:32

opinion There is insufficient high quality evidence proving that dilatations after anorectal malformation surgery are actually necessary ↗

▶ Ep 62 · 0:37

quote Bottom line, we might have been doing this for decades without really needing to, and we need more randomized trials to settle the debate. ↗

▶ Ep 62 · 0:37

opinion More randomized trials are needed to determine whether post-operative anal dilatations are necessary ↗

Quick Literature Updates Ep 23

▶ Ep 64 · 1:02

host_summary APSA published best practices for locum tenens surgeons, hospitals and agencies stressing the importance of patient safety and support for surgeons. ↗

▶ Ep 64 · 1:02

quote The American P Paediatric Surgical Association, APSA published best practices for locum tendon surgeons, hospitals and agencies in this review article. ↗

▶ Ep 64 · 1:17

host_summary Locum tenens can help prevent burnout by offering flexible work options for a better work-life balance. ↗

▶ Ep 64 · 1:23

host_summary Hospitals should avoid relying solely on locum tenens pediatric surgeons without any full-time surgeons, because this may cause patients to slip through handoffs. ↗

▶ Ep 64 · 1:23

quote 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. ↗

▶ Ep 64 · 1:32

host_summary Locum tenens agencies should sponsor CME and conduct formal exit interviews. ↗

Appendicitis 8 entries

Quick Literature Updates Ep 24

▶ Ep 11 · 1:03

host_summary The Donnati et al. study was an observational prospective study in Italy from 2013 to 2022 on 468 patients around 15 years old. ↗

▶ Ep 11 · 1:13

host_summary Surgeons placed 733 pectus bars total across the 468 patients in the Donnati study. ↗

▶ Ep 11 · 1:21

host_summary Bar dislocation is defined as when a pectus bar rotates more than 30 degrees out of place. ↗

▶ Ep 11 · 1:28

quote Bridge fixation was significantly more stable than single bar fixation. ↗

▶ Ep 11 · 1:28

host_summary Bridge fixation was significantly more stable than single bar fixation for pectus repair. ↗

▶ Ep 11 · 1:33

host_summary None of the patients with bridge fixation had dislocated bars compared to those who underwent the single bar technique. ↗

▶ Ep 11 · 1:33

quote None of the patients with bridge fixation had dislocated bars compared to those who underwent the single bar technique. ↗

▶ Ep 11 · 1:39

host_summary Bridge fixation is the best technique for preventing bar dislocation in pectus excavatum patients. ↗

CHARGE Syndrome 20 entries

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

▶ Ep 4 · 0:15

host_summary 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. ↗

▶ Ep 4 · 0:47

host_summary Cincinnati Children's has one of the largest aerodigestive centers in the world. ↗

▶ Ep 4 · 0:55

host_summary The expert multidisciplinary team includes speech pathology, otolaryngology, gastroenterology, pulmonology, and pediatric general surgery. ↗

▶ Ep 4 · 1:37

host_summary The center provides coordinated multidisciplinary care to children with congenital or acquired complex digestive and airway disorders. ↗

▶ Ep 4 · 2:52

host_summary Video fluoroscopic swallowing study analyzes different phases of swallowing. ↗

▶ Ep 4 · 2:59

host_summary 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. ↗

▶ Ep 4 · 3:48

host_summary ENT looks at swallowing study results and helps stratify the risk of proceeding with airway reconstruction and decannulation. ↗

▶ Ep 4 · 3:54

host_summary In aerodigestive patients, ENT performs esophageal and airway reconstruction, cleft repair, drool procedures, and manages vocal folds and mobility. ↗

▶ Ep 4 · 4:19

host_summary GERD pathophysiology includes an incompetent lower esophageal sphincter. ↗

▶ Ep 4 · 4:42

host_summary General signs and symptoms of GERD include regurgitation, vomiting, and heartburn. ↗

▶ Ep 4 · 5:28

host_summary Data shows an increase in airway surgery complications in patients who were later found to have eosinophilic esophagitis. ↗

▶ Ep 4 · 5:40

host_summary Anatomic issues in aerodigestive patients include strictures that need balloon dilations or stenting. ↗

▶ Ep 4 · 6:13

host_summary When 25 patients in the aerodigestive program were assessed, 76% of them had a feeding disorder. ↗

▶ Ep 4 · 6:54

host_summary 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. ↗

▶ Ep 4 · 7:20

host_summary Underlying pulmonary insufficiency should be suspected if patients have had complicated respiratory infections requiring positive pressure ventilation. ↗

▶ Ep 4 · 7:48

host_summary Risk factors for upper airway obstruction include airway abnormalities like mid-face hypoplasia, skeletal dysplasia, decreased muscle tone, and syndromes associated with airway obstruction. ↗

▶ Ep 4 · 8:13

host_summary Risk factors for lower airway obstruction include acquired or congenital thoracic deformities and those who had thoracotomies done in the past. ↗

▶ Ep 4 · 9:15

host_summary For patients with ventilatory insufficiency, the pulmonologist determines if the child still needs ventilatory support and whether they are ready for decannulation. ↗

▶ Ep 4 · 9:26

host_summary The pulmonologist assesses how ready the patient is for weaning from the vent and whether they can start or advance feeding. ↗

▶ Ep 4 · 9:41

host_summary In the NICU, general surgeons obtain feeding access, manage anorectal malformations, and perform surgical procedures such as tracheopexies and lung resections. ↗

Chronic Pancreatitis 10 entries

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

▶ Ep 9 · 0:00

quote What if curing a rare pancreatic tumor sets the stage for chronic pancreatitis? ↗

▶ Ep 9 · 0:09

epidemiological Solid pseudopapillary neoplasms are one of the most frequent pancreatic tumors in pediatric patients ↗

▶ Ep 9 · 0:15

clinical Surgery for solid pseudopapillary neoplasms is usually curative and outcomes are excellent ↗

▶ Ep 9 · 0:22

clinical In a single center study, 10 adolescent girls underwent surgical resection for solid pseudopapillary neoplasms ↗

▶ Ep 9 · 0:25

clinical 3 out of 10 patients developed acute recurrent or chronic pancreatitis after resection ↗

▶ Ep 9 · 0:32

quote Every patient who developed ongoing pancreatitis had genetic risk factors like the CFTR gene variant, or they had pancreas divisum. ↗

▶ Ep 9 · 0:32

clinical Every patient who developed ongoing pancreatitis had genetic risk factors like CFTR gene variants or pancreas divisum ↗

▶ Ep 9 · 0:40

clinical Some patients with post-resection pancreatitis ultimately required completion pancreatectomy ↗

▶ Ep 9 · 0:45

quote Even low grade tumors can carry high stakes consequences. ↗

▶ Ep 9 · 0:48

opinion Identifying genetic and anatomic risk factors before surgery may change management of patients with solid pseudopapillary neoplasms ↗

CICU / Post-op CHD Care 58 entries

Early Tricuspid Valve Surgery for Heart Failure in Congenital Heart Disease

▶ Ep 3 · 0:00

quote What if fixing a heart valve earlier could prevent heart failure and congenital heart disease? ↗

▶ Ep 3 · 0:08

clinical The right ventricle was not built to pump blood to the whole body. ↗

▶ Ep 3 · 0:08

clinical In adults with transposition of the great arteries, the right ventricle sometimes has to pump blood to the whole body. ↗

▶ Ep 3 · 0:16

clinical Over time, many patients with transposition of the great arteries develop severe tricuspid regurgitation and worsening heart function. ↗

▶ Ep 3 · 0:25

clinical Patients with moderate to severe tricuspid valve leakage but only mild to moderate ventricular dysfunction had better outcomes after surgery. ↗

▶ Ep 3 · 0:33

clinical If the right ventricle was already severely weak, tricuspid valve surgery did not make a difference in outcomes. ↗

▶ Ep 3 · 0:37

quote Bottom line, in patients with transposition of the great arteries, earlier valve surgery can improve their outcomes. ↗

▶ Ep 3 · 0:37

clinical In patients with transposition of the great arteries, earlier tricuspid valve surgery can improve outcomes. ↗

Practice Patterns and Outcomes of Hemodialysis in Infants Undergoing Congenital Heart Surgery in th

▶ Ep 4 · 0:00

quote Does it matter where a baby receives care after heart surgery? ↗

▶ Ep 4 · 0:07

epidemiological 1% of infants can develop severe acute kidney injury and require dialysis after congenital heart surgery ↗

▶ Ep 4 · 0:14

epidemiological For infants that needed hemodialysis after congenital heart surgery, one-year survival was 46% ↗

▶ Ep 4 · 0:14

epidemiological For infants that did not need hemodialysis after congenital heart surgery, one-year survival was 94% ↗

▶ Ep 4 · 0:23

clinical Most infants requiring dialysis after congenital heart surgery received continuous renal replacement therapy rather than intermittent dialysis ↗

▶ Ep 4 · 0:30

quote Where the baby was treated mattered a lot. ↗

▶ Ep 4 · 0:33

epidemiological Hospitals that use dialysis more frequently had 3 times higher hospital survival for infants after congenital heart surgery ↗

▶ Ep 4 · 0:33

epidemiological Hospitals that use dialysis more frequently had double the 1-year survival rate for infants after congenital heart surgery ↗

▶ Ep 4 · 0:39

epidemiological Dialysis after infant heart surgery is rare ↗

▶ Ep 4 · 0:44

opinion Outcomes may improve when infants requiring dialysis after heart surgery are treated at a center with more experience in using dialysis ↗

Practice Patterns and Outcomes of Hemodialysis in Infants Undergoing Congenital Heart Surgery in the

▶ Ep 5 · 0:00

quote Does it matter where a baby receives care after heart surgery? ↗

▶ Ep 5 · 0:07

epidemiological 1% of infants can develop severe acute kidney injury and require dialysis after congenital heart surgery ↗

▶ Ep 5 · 0:14

clinical For infants not needing hemodialysis after congenital heart surgery, one-year survival was 94% ↗

▶ Ep 5 · 0:14

clinical For infants needing hemodialysis after congenital heart surgery, one-year survival was 46% ↗

▶ Ep 5 · 0:23

clinical Most infants requiring dialysis after congenital heart surgery received continuous renal replacement therapy rather than intermittent dialysis ↗

▶ Ep 5 · 0:30

quote Where the baby was treated mattered a lot. ↗

▶ Ep 5 · 0:33

clinical Hospitals that use dialysis more frequently had double the 1-year survival rate for infants after congenital heart surgery ↗

▶ Ep 5 · 0:33

clinical Hospitals that use dialysis more frequently had 3 times higher hospital survival for infants after congenital heart surgery ↗

▶ Ep 5 · 0:39

epidemiological Dialysis after infant heart surgery is rare ↗

▶ Ep 5 · 0:44

opinion Outcomes may improve when infants requiring dialysis after heart surgery are treated at a center with more experience in using dialysis ↗

Practice Patterns and Outcomes of Hemodialysis in Infants Undergoing Congenital Heart Surgery in the

▶ Ep 6 · 0:00

quote Does it matter where a baby receives care after heart surgery? ↗

▶ Ep 6 · 0:07

epidemiological 1% of infants can develop severe acute kidney injury and require dialysis after congenital heart surgery ↗

▶ Ep 6 · 0:14

clinical For infants not needing hemodialysis after congenital heart surgery, one-year survival was 94% ↗

▶ Ep 6 · 0:14

clinical For infants needing hemodialysis after congenital heart surgery, one-year survival was 46% ↗

▶ Ep 6 · 0:23

clinical Most infants requiring dialysis after congenital heart surgery received continuous renal replacement therapy rather than intermittent dialysis ↗

▶ Ep 6 · 0:30

quote Where the baby was treated mattered a lot. ↗

▶ Ep 6 · 0:33

clinical Hospitals that use dialysis more frequently had double the 1-year survival rate for infants after congenital heart surgery ↗

▶ Ep 6 · 0:33

clinical Hospitals that use dialysis more frequently had 3 times higher hospital survival for infants after congenital heart surgery ↗

▶ Ep 6 · 0:39

epidemiological Dialysis after infant heart surgery is rare ↗

▶ Ep 6 · 0:44

opinion Outcomes may improve when infants requiring dialysis after heart surgery are treated at a center with more experience in using dialysis ↗

Practice Patterns and Outcomes of Hemodialysis in Infants Undergoing Congenital Heart Surgery...

▶ Ep 7 · 0:00

quote Does it matter where a baby receives care after heart surgery? ↗

▶ Ep 7 · 0:07

epidemiological 1% of infants develop severe acute kidney injury requiring dialysis after congenital heart surgery ↗

▶ Ep 7 · 0:14

epidemiological One-year survival for infants requiring hemodialysis after congenital heart surgery is 46% ↗

▶ Ep 7 · 0:14

epidemiological One-year survival for infants not requiring hemodialysis after congenital heart surgery is 94% ↗

▶ Ep 7 · 0:23

clinical Most infants requiring dialysis after congenital heart surgery received continuous renal replacement therapy rather than intermittent dialysis ↗

▶ Ep 7 · 0:30

quote Where the baby was treated mattered a lot. ↗

▶ Ep 7 · 0:33

epidemiological Hospitals that use dialysis more frequently had 3 times higher hospital survival for infants after congenital heart surgery ↗

▶ Ep 7 · 0:33

epidemiological Hospitals that use dialysis more frequently had double the 1-year survival rate for infants after congenital heart surgery ↗

▶ Ep 7 · 0:39

epidemiological Dialysis after infant heart surgery is rare ↗

▶ Ep 7 · 0:44

clinical Outcomes for infants requiring dialysis after heart surgery may improve when treated at centers with more experience in using dialysis ↗

Surgical and Catheter-Based Intervention in Pediatric Pulmonary Vein Stenosis

▶ Ep 8 · 0:00

quote Can you ever truly fix pulmonary vein stenosis? ↗

▶ Ep 8 · 0:06

clinical Pulmonary vein stenosis is a rare but serious condition where the veins from the lungs to the heart become narrowed ↗

▶ Ep 8 · 0:12

epidemiological A study from Cincinnati Children's examined 56 children comparing surgery versus catheter-based interventions for pulmonary vein stenosis ↗

▶ Ep 8 · 0:23

clinical Over time, catheter-based treatments became the preferred first option for pulmonary vein stenosis ↗

▶ Ep 8 · 0:28

clinical Surgery was reserved for complex cases involving multiple severely affected veins or other heart defects ↗

▶ Ep 8 · 0:34

epidemiological 92% of children with pulmonary vein stenosis needed another intervention after initial treatment ↗

▶ Ep 8 · 0:34

epidemiological Most reinterventions for pulmonary vein stenosis occurred within the first year after initial treatment ↗

▶ Ep 8 · 0:34

clinical Recurrence of pulmonary vein stenosis remained common regardless of the initial intervention type ↗

▶ Ep 8 · 0:45

quote So pulmonary vein stenosis isn't a one-time fix. ↗

▶ Ep 8 · 0:48

clinical Pulmonary vein stenosis requires ongoing surveillance, repeated interventions, and a long-term multidisciplinary approach ↗

Cleft Lip and Palate 11 entries

Optimal Outcome Reporting 5 and 8 Years Following Cleft Palate Repair

▶ Ep 1 · 0:00

quote How do we actually define a successful outcome after cleft palate surgical repair? ↗

▶ Ep 1 · 0:09

clinical There has not been a standardized way to measure outcomes after cleft palate repair ↗

▶ Ep 1 · 0:14

clinical Optimal outcome reporting (OOR) is a new metric for measuring cleft palate repair outcomes ↗

▶ Ep 1 · 0:20

quote Basically, the best case surgical outcome means one operation, no unintended fistula, and normal speech function. ↗

▶ Ep 1 · 0:20

clinical Best case surgical outcome for cleft palate repair is defined as one operation, no unintended fistula, and normal speech function ↗

▶ Ep 1 · 0:28

epidemiological About 70% of patients achieve optimal outcome 5 years after cleft palate repair ↗

▶ Ep 1 · 0:28

epidemiological Nearly 75% of patients achieve optimal outcome 8 years after cleft palate repair ↗

▶ Ep 1 · 0:39

clinical Younger age at surgery is associated with better long-term outcomes after cleft palate repair ↗

▶ Ep 1 · 0:39

clinical Specific cleft types are associated with better long-term outcomes after cleft palate repair ↗

▶ Ep 1 · 0:39

clinical Absence of underlying syndromes is associated with better long-term outcomes after cleft palate repair ↗

▶ Ep 1 · 0:47

opinion Optimal outcome reporting provides surgeons a clear, measurable way to track success ↗

Colorectal / ARM & Hirschsprung 82 entries

The use of postoperative calibrations in Hirschsprung disease

▶ Ep 168 · 0:00

quote For patients with Hirschsprung disease who undergo endorectal pull-through surgeries, are daily postoperative anal dilations necessary and effective? ↗

▶ Ep 168 · 0:13

clinical The study was prospective and took place from 2021 to 2023 ↗

▶ Ep 168 · 0:13

clinical The study included 33 patients under six months old who underwent endorectal pull-through surgeries ↗

▶ Ep 168 · 0:24

clinical Patients were assigned to either a new non-dilation protocol group or a traditional dilation group ↗

▶ Ep 168 · 0:30

clinical The primary outcomes measured were anastomotic complications, enterocolitis, and constipation ↗

▶ Ep 168 · 0:37

clinical There was no significant difference in anastomotic complications between the two groups ↗

▶ Ep 168 · 0:37

clinical The non-dilation group had less enterocolitis compared to the traditional dilation group ↗

▶ Ep 168 · 0:37

clinical The non-dilation group had less constipation compared to the traditional dilation group ↗

▶ Ep 168 · 0:46

quote This means that choosing not to do postoperative anal dilations may be a good alternative with benefits like lower constipation and enterocolitis. ↗

▶ Ep 168 · 0:46

opinion Choosing not to do postoperative anal dilations may be a good alternative with benefits like lower constipation and enterocolitis ↗

Quick Literature Updates Episode 17

▶ Ep 172 · 3:25

host_summary The Children's Hospital in Pakistan conducted a randomized control trial including 124 patients in 2021 to 2022 who needed stoma reversal. ↗

▶ Ep 172 · 3:25

clinical The Children's Hospital in Pakistan conducted a randomized control trial including 124 patients in 2021 to 2022 who needed stoma reversal. ↗

▶ Ep 172 · 3:35

host_summary The Pakistani stoma reversal trial aimed to compare surgical site infections and cosmetic outcomes of scars in patients receiving purse-string or linear skin closure techniques. ↗

▶ Ep 172 · 3:35

clinical The Pakistani stoma reversal trial aimed to compare surgical site infections and cosmetic outcomes of scars in patients receiving purse-string or linear skin closure techniques. ↗

▶ Ep 172 · 3:44

host_summary The purse-string closure group had way fewer surgical site infections compared to the linear closure group for stoma reversal. ↗

▶ Ep 172 · 3:44

clinical The purse-string closure group had much better scar quality compared to the linear closure group for stoma reversal. ↗

▶ Ep 172 · 3:44

host_summary The purse-string closure group had much better scar quality compared to the linear closure group for stoma reversal. ↗

▶ Ep 172 · 3:44

clinical The purse-string closure group had way fewer surgical site infections compared to the linear closure group for stoma reversal. ↗

▶ Ep 172 · 3:52

opinion When reversing a stoma, purse-string closure technique is the best way to do it. ↗

▶ Ep 172 · 3:52

opinion When reversing a stoma, purse-string closure technique is the best way to do it. ↗

▶ Ep 172 · 3:52

quote So when reversing a stoma, purse string closure technique is the best way to do it. ↗

▶ Ep 172 · 3:52

quote So when reversing a stoma, purse string closure technique is the best way to do it. ↗

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

▶ Ep 173 · 0:00

quote Does creating a collaborative initiative help with providing high quality pediatric surgical care? ↗

▶ Ep 173 · 0:10

clinical The Finnish Pediatric Surgery Hub was established in 2021 by pediatric surgeons from Finland's five neonatal surgery centers. ↗

▶ Ep 173 · 0:18

epidemiological The most frequent diagnoses included anorectal malformations, esophageal atresia, and Hirschsprung disease. ↗

▶ Ep 173 · 0:18

epidemiological The hub performed 34 elective and 6 urgent cases total. ↗

▶ Ep 173 · 0:28

clinical The hub held regular monthly virtual meetings to present new patients, discuss complex cases, and follow up on patients after surgery. ↗

▶ Ep 173 · 0:36

opinion Findings suggest that the Finnish Pediatric Surgery hub fosters an effective and safe place for sharing surgical expertise and learning. ↗

▶ Ep 173 · 0:36

quote Their findings suggest that the Finnish Pediatric Surgery hub fosters an effective and safe place for sharing surgical expertise and learning. ↗

Quick Literature Updates Episode 18

▶ Ep 174 · 1:10

quote 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. ↗

▶ Ep 174 · 1:10

guideline 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. ↗

▶ Ep 174 · 1:34

guideline 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. ↗

▶ Ep 174 · 1:43

guideline The ERAS Society did not have enough data to make recommendations about nasogastric tubes and central lines in neonatal surgical care. ↗

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

▶ Ep 176 · 0:01

quote Which colostomy is best in pediatric patients with anorectal malformation? ↗

▶ Ep 176 · 0:10

clinical The systematic review and meta-analysis compared clinical outcomes of loop colostomies versus divided colostomies in neonates with anorectal malformations ↗

▶ Ep 176 · 0:19

epidemiological The review included 11 retrospective cohort studies ↗

▶ Ep 176 · 0:23

clinical There were no significant differences between the two colostomy types in terms of complications such as stoma prolapse, urinary tract infections, and wound infections ↗

▶ Ep 176 · 0:23

quote There were no significant differences between the two colostomy types in terms of complications such as stoma prolapse, urinary tract infections, and wound infections. ↗

▶ Ep 176 · 0:31

opinion Both colostomies are good options for fecal diversion, with the choice depending on individual patient factors and surgical expertise ↗

Morbidity of Rectal Prolapse Repair After Surgery for Anorectal Malformation

▶ Ep 181 · 0:00

quote What if the safest move for rectal prolapse after anorectal malformation surgery is not to repair it? ↗

▶ Ep 181 · 0:11

epidemiological A study examined 85 children treated for rectal prolapse after anorectal malformation surgery ↗

▶ Ep 181 · 0:16

epidemiological Approximately 30% of children had recurrence of prolapse requiring another repair ↗

▶ Ep 181 · 0:20

clinical Children without symptoms from prolapse at initial presentation were more likely to develop stricture later ↗

▶ Ep 181 · 0:26

opinion Surgical repair of asymptomatic rectal prolapse may not be indicated because the treatment itself carries risks ↗

▶ Ep 181 · 0:26

quote surgeons need to think twice before rushing into repair if the prolapse isn't causing big symptoms, because the treatment itself can carry risks ↗

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

▶ Ep 182 · 0:00

quote After reconstructive surgery for anorectal malformations, dilatations are routine, but are they actually necessary? ↗

▶ Ep 182 · 0:11

clinical Routine anal dilatations after surgery for anorectal malformations have been standard since the 1980s ↗

▶ Ep 182 · 0:18

epidemiological Stricture rates after anorectal malformation surgery range from 0 to almost 40%, even with the classic Pena protocol ↗

▶ Ep 182 · 0:25

clinical Alternative methods like weekly dilatations or skipping dilatations altogether showed similar outcomes to standard protocols ↗

▶ Ep 182 · 0:32

opinion There is insufficient high quality evidence proving that dilatations after anorectal malformation surgery are actually necessary ↗

▶ Ep 182 · 0:37

quote Bottom line, we might have been doing this for decades without really needing to, and we need more randomized trials to settle the debate. ↗

▶ Ep 182 · 0:37

opinion More randomized trials are needed to determine whether post-operative anal dilatations are necessary ↗

Quick Literature Updates Ep 22

▶ Ep 184 · 1:03

host_summary 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. ↗

▶ Ep 184 · 1:14

host_summary In the Beotti study, patients were assigned to a new non-dilation protocol group or a traditional dilation group. ↗

▶ Ep 184 · 1:20

host_summary The Beotti study primary outcomes were anastomotic complications, enterocolitis, and constipation. ↗

▶ Ep 184 · 1:26

quote What did they find? ↗

▶ Ep 184 · 1:27

host_summary 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. ↗

▶ Ep 184 · 1:36

host_summary Choosing not to do postoperative anal dilations after Hirschsprung pull-through may be a good alternative with benefits like lower constipation and enterocolitis. ↗

Quick Literature Updates Ep 23

▶ Ep 185 · 1:02

quote The American P Paediatric Surgical Association, APSA published best practices for locum tendon surgeons, hospitals and agencies in this review article. ↗

▶ Ep 185 · 1:02

guideline APSA published best practices for locum tenens surgeons, hospitals and agencies stressing the importance of patient safety and support for surgeons. ↗

▶ Ep 185 · 1:17

opinion Locum tenens can help prevent burnout by offering flexible work options for a better work-life balance. ↗

▶ Ep 185 · 1:23

guideline Hospitals should avoid relying solely on locum tenens pediatric surgeons without any full-time surgeons, because this may cause patients to slip through handoffs. ↗

▶ Ep 185 · 1:23

quote 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. ↗

▶ Ep 185 · 1:32

guideline Locum tenens agencies should sponsor CME and conduct formal exit interviews. ↗

Sacrococcygeal Teratomas in Currarino Syndrome: A Multicenter Review of Tumor Characteristics, Surgical Outcomes, and Recurrence

▶ Ep 186 · 0:00

quote What if the sacrococcygeal teratomas that we worry most about are actually the least aggressive ones? ↗

▶ Ep 186 · 0:10

epidemiological A multicenter review examined over 200 sacrococcygeal teratoma cases comparing children with Currarino syndrome to those without it. ↗

▶ Ep 186 · 0:19

clinical Tumors in Currarino patients are almost exclusively Altman type 4, buried deep in the pelvis. ↗

▶ Ep 186 · 0:19

clinical Currarino patients were almost always diagnosed after birth. ↗

▶ Ep 186 · 0:27

clinical Every tumor in the Currarino group was a mature one with no immature or malignant components at all. ↗

▶ Ep 186 · 0:27

quote Every tumor in the curorinal group was a mature one. There were no immature or malignant components at all. ↗

▶ Ep 186 · 0:33

clinical Currarino-associated tumors were much smaller, around 3 centimeters instead of 8 centimeters. ↗

▶ Ep 186 · 0:36

clinical Recurrence was almost nonexistent in Currarino cases and not significantly different from non-Currarino cases. ↗

▶ Ep 186 · 0:41

opinion Currarino-associated sacrococcygeal teratomas behave incredibly well oncologically, suggesting potential for less aggressive long-term follow-up. ↗

▶ Ep 186 · 0:41

quote So the message here is that curorino associated sacrococcygeal teratomas behave incredibly well oncologically, which means we may be able to rethink how aggressively we follow these kids long term. ↗

Quick Literature Updates Ep 26

▶ Ep 188 · 1:07

quote Recent literature has been supporting treating appendicitis with antibiotics rather than surgery. ↗

▶ Ep 188 · 1:07

opinion Recent literature has been supporting treating appendicitis with antibiotics rather than surgery ↗

▶ Ep 188 · 1:12

clinical The Saint Peter et al. study was a multi-center randomized trial in Canada, the US, Finland, Sweden, and Singapore investigating whether antibiotic treatment is inferior to appendicectomy ↗

▶ Ep 188 · 1:24

clinical 34% of children treated with antibiotics for appendicitis eventually required surgery within a year compared to only 7% in the surgery group ↗

▶ Ep 188 · 1:32

clinical There were no deaths in either the antibiotic or surgery group for appendicitis treatment ↗

▶ Ep 188 · 1:32

clinical Children in the antibiotic group had a higher risk of mild to moderate adverse events compared to the surgery group ↗

▶ Ep 188 · 1:39

clinical Antibiotics were not as effective as surgery for treating non-perforated appendicitis in children, as it did not meet the threshold for non-inferiority ↗

▶ Ep 188 · 1:39

quote The key takeaway is that antibiotics were not as effective as surgery for treating non-perforated appendicitis in children, as it did not meet the threshold for non-inferiority. ↗

Congenital Diaphragmatic Hernia 5 entries

Quick Literature Updates Episode 20

▶ Ep 12 · 1:03

host_summary 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. ↗

▶ Ep 12 · 1:11

quote They wanted to know whether thoracoscopic repair has a higher recurrence rate and longer operating room time compared to open repair. ↗

▶ Ep 12 · 1:18

host_summary Thoracoscopic repair for congenital diaphragmatic hernia has longer operative times compared to open repair. ↗

▶ Ep 12 · 1:18

host_summary Thoracoscopic repair for congenital diaphragmatic hernia has higher recurrence rates compared to open repair. ↗

▶ Ep 12 · 1:25

host_summary Thoracoscopic repair for congenital diaphragmatic hernia has a lower incidence of postoperative bowel obstruction compared to open repair. ↗

Congenital Heart Disease 48 entries

Early Tricuspid Valve Surgery for Heart Failure in Congenital Heart Disease

▶ Ep 1 · 0:00

quote What if fixing a heart valve earlier could prevent heart failure and congenital heart disease? ↗

▶ Ep 1 · 0:08

clinical The right ventricle was not built to pump blood to the whole body. ↗

▶ Ep 1 · 0:08

clinical In adults with transposition of the great arteries, the right ventricle sometimes has to pump blood to the whole body. ↗

▶ Ep 1 · 0:16

clinical Over time, many patients with transposition of the great arteries develop severe tricuspid regurgitation and worsening heart function. ↗

▶ Ep 1 · 0:25

clinical Patients with moderate to severe tricuspid valve leakage but only mild to moderate ventricular dysfunction had better outcomes after surgery. ↗

▶ Ep 1 · 0:33

clinical If the right ventricle was already severely weak, tricuspid valve surgery did not make a difference in outcomes. ↗

▶ Ep 1 · 0:37

clinical In patients with transposition of the great arteries, earlier tricuspid valve surgery can improve outcomes. ↗

▶ Ep 1 · 0:37

quote Bottom line, in patients with transposition of the great arteries, earlier valve surgery can improve their outcomes. ↗

Practice Patterns and Outcomes of Hemodialysis in Infants Undergoing Congenital Heart Surgery in th

▶ Ep 2 · 0:00

quote Does it matter where a baby receives care after heart surgery? ↗

▶ Ep 2 · 0:07

epidemiological 1% of infants can develop severe acute kidney injury and require dialysis after congenital heart surgery ↗

▶ Ep 2 · 0:14

epidemiological For infants that did not need hemodialysis after congenital heart surgery, one-year survival was 94% ↗

▶ Ep 2 · 0:14

epidemiological For infants that needed hemodialysis after congenital heart surgery, one-year survival was 46% ↗

▶ Ep 2 · 0:23

clinical Most infants requiring dialysis after congenital heart surgery received continuous renal replacement therapy rather than intermittent dialysis ↗

▶ Ep 2 · 0:30

quote Where the baby was treated mattered a lot. ↗

▶ Ep 2 · 0:33

epidemiological Hospitals that use dialysis more frequently had 3 times higher hospital survival for infants after congenital heart surgery ↗

▶ Ep 2 · 0:33

epidemiological Hospitals that use dialysis more frequently had double the 1-year survival rate for infants after congenital heart surgery ↗

▶ Ep 2 · 0:39

epidemiological Dialysis after infant heart surgery is rare ↗

▶ Ep 2 · 0:44

opinion Outcomes may improve when infants requiring dialysis after heart surgery are treated at a center with more experience in using dialysis ↗

Practice Patterns and Outcomes of Hemodialysis in Infants Undergoing Congenital Heart Surgery in the

▶ Ep 3 · 0:00

quote Does it matter where a baby receives care after heart surgery? ↗

▶ Ep 3 · 0:07

epidemiological 1% of infants can develop severe acute kidney injury and require dialysis after congenital heart surgery ↗

▶ Ep 3 · 0:14

clinical For infants not needing hemodialysis after congenital heart surgery, one-year survival was 94% ↗

▶ Ep 3 · 0:14

clinical For infants needing hemodialysis after congenital heart surgery, one-year survival was 46% ↗

▶ Ep 3 · 0:23

clinical Most infants requiring dialysis after congenital heart surgery received continuous renal replacement therapy rather than intermittent dialysis ↗

▶ Ep 3 · 0:30

quote Where the baby was treated mattered a lot. ↗

▶ Ep 3 · 0:33

clinical Hospitals that use dialysis more frequently had double the 1-year survival rate for infants after congenital heart surgery ↗

▶ Ep 3 · 0:33

clinical Hospitals that use dialysis more frequently had 3 times higher hospital survival for infants after congenital heart surgery ↗

▶ Ep 3 · 0:39

epidemiological Dialysis after infant heart surgery is rare ↗

▶ Ep 3 · 0:44

opinion Outcomes may improve when infants requiring dialysis after heart surgery are treated at a center with more experience in using dialysis ↗

Practice Patterns and Outcomes of Hemodialysis in Infants Undergoing Congenital Heart Surgery in the

▶ Ep 4 · 0:00

quote Does it matter where a baby receives care after heart surgery? ↗

▶ Ep 4 · 0:07

epidemiological 1% of infants can develop severe acute kidney injury and require dialysis after congenital heart surgery ↗

▶ Ep 4 · 0:14

clinical For infants needing hemodialysis after congenital heart surgery, one-year survival was 46% ↗

▶ Ep 4 · 0:14

clinical For infants not needing hemodialysis after congenital heart surgery, one-year survival was 94% ↗

▶ Ep 4 · 0:23

clinical Most infants requiring dialysis after congenital heart surgery received continuous renal replacement therapy rather than intermittent dialysis ↗

▶ Ep 4 · 0:30

quote Where the baby was treated mattered a lot. ↗

▶ Ep 4 · 0:33

clinical Hospitals that use dialysis more frequently had 3 times higher hospital survival for infants after congenital heart surgery ↗

▶ Ep 4 · 0:33

clinical Hospitals that use dialysis more frequently had double the 1-year survival rate for infants after congenital heart surgery ↗

▶ Ep 4 · 0:39

epidemiological Dialysis after infant heart surgery is rare ↗

▶ Ep 4 · 0:44

opinion Outcomes may improve when infants requiring dialysis after heart surgery are treated at a center with more experience in using dialysis ↗

Practice Patterns and Outcomes of Hemodialysis in Infants Undergoing Congenital Heart Surgery...

▶ Ep 5 · 0:00

quote Does it matter where a baby receives care after heart surgery? ↗

▶ Ep 5 · 0:07

epidemiological 1% of infants develop severe acute kidney injury requiring dialysis after congenital heart surgery ↗

▶ Ep 5 · 0:14

epidemiological One-year survival for infants requiring hemodialysis after congenital heart surgery is 46% ↗

▶ Ep 5 · 0:14

epidemiological One-year survival for infants not requiring hemodialysis after congenital heart surgery is 94% ↗

▶ Ep 5 · 0:23

clinical Most infants requiring dialysis after congenital heart surgery received continuous renal replacement therapy rather than intermittent dialysis ↗

▶ Ep 5 · 0:30

quote Where the baby was treated mattered a lot. ↗

▶ Ep 5 · 0:33

epidemiological Hospitals that use dialysis more frequently had 3 times higher hospital survival for infants after congenital heart surgery ↗

▶ Ep 5 · 0:33

epidemiological Hospitals that use dialysis more frequently had double the 1-year survival rate for infants after congenital heart surgery ↗

▶ Ep 5 · 0:39

epidemiological Dialysis after infant heart surgery is rare ↗

▶ Ep 5 · 0:44

clinical Outcomes for infants requiring dialysis after heart surgery may improve when treated at centers with more experience in using dialysis ↗

Congenital Lung Lesions (CPAM) 8 entries

Quick Literature Updates Episode 18

▶ Ep 32 · 1:10

quote 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. ↗

▶ Ep 32 · 1:10

guideline 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. ↗

▶ Ep 32 · 1:10

quote 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. ↗

▶ Ep 32 · 1:10

host_summary 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. ↗

▶ Ep 32 · 1:34

host_summary 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. ↗

▶ Ep 32 · 1:34

guideline 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. ↗

▶ Ep 32 · 1:43

host_summary The ERAS Society did not have enough data to make recommendations about nasogastric tubes and central lines in neonatal surgical care. ↗

▶ Ep 32 · 1:43

guideline The ERAS Society did not have enough data to make recommendations about nasogastric tubes and central lines in neonatal surgical care. ↗

Congenital Pulmonary Airway Malformation 4 entries

Quick Literature Updates Episode 18

▶ Ep 9 · 1:10

quote 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. ↗

▶ Ep 9 · 1:10

guideline The ERAS Society used a modified Delphi technique with a multidisciplinary group of experts to reach more than 70% consensus ↗

▶ Ep 9 · 1:34

guideline The ERAS Society agreed on 16 recommendations covering 11 topics including team communication, pre-surgery fasting, temperature control, and antibiotic use ↗

▶ Ep 9 · 1:43

guideline The ERAS Society did not have enough data to make recommendations about nasogastric tubes and central lines ↗

Enterocolitis 10 entries

The use of postoperative calibrations in Hirschsprung disease

▶ Ep 21 · 0:00

quote For patients with Hirschsprung disease who undergo endorectal pull-through surgeries, are daily postoperative anal dilations necessary and effective? ↗

▶ Ep 21 · 0:13

clinical The study was prospective and took place from 2021 to 2023 ↗

▶ Ep 21 · 0:13

clinical The study included 33 patients under six months old who underwent endorectal pull-through surgeries ↗

▶ Ep 21 · 0:24

clinical Patients were assigned to either a new non-dilation protocol group or a traditional dilation group ↗

▶ Ep 21 · 0:30

clinical The primary outcomes measured were anastomotic complications, enterocolitis, and constipation ↗

▶ Ep 21 · 0:37

clinical The non-dilation group had less constipation compared to the traditional dilation group ↗

▶ Ep 21 · 0:37

clinical The non-dilation group had less enterocolitis compared to the traditional dilation group ↗

▶ Ep 21 · 0:37

clinical There was no significant difference in anastomotic complications between the two groups ↗

▶ Ep 21 · 0:46

quote This means that choosing not to do postoperative anal dilations may be a good alternative with benefits like lower constipation and enterocolitis. ↗

▶ Ep 21 · 0:46

opinion Choosing not to do postoperative anal dilations may be a good alternative with benefits like lower constipation and enterocolitis ↗

Esophageal Atresia 45 entries

Quick Literature Updates Episode 17

▶ Ep 19 · 3:25

host_summary The Children's Hospital in Pakistan conducted a randomized control trial including 124 patients in 2021 to 2022 who needed stoma reversal. ↗

▶ Ep 19 · 3:35

host_summary The Pakistani stoma reversal trial aimed to compare surgical site infections and cosmetic outcomes of scars in patients receiving purse-string or linear skin closure techniques. ↗

▶ Ep 19 · 3:44

host_summary The purse-string closure group had much better scar quality compared to the linear closure group for stoma reversal. ↗

▶ Ep 19 · 3:44

host_summary The purse-string closure group had way fewer surgical site infections compared to the linear closure group for stoma reversal. ↗

▶ Ep 19 · 3:52

quote So when reversing a stoma, purse string closure technique is the best way to do it. ↗

▶ Ep 19 · 3:52

opinion When reversing a stoma, purse-string closure technique is the best way to do it. ↗

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

▶ Ep 20 · 0:00

quote Does creating a collaborative initiative help with providing high quality pediatric surgical care? ↗

▶ Ep 20 · 0:10

clinical The Finnish Pediatric Surgery Hub was established in 2021 by pediatric surgeons from Finland's five neonatal surgery centers. ↗

▶ Ep 20 · 0:18

epidemiological The hub performed 34 elective and 6 urgent cases total. ↗

▶ Ep 20 · 0:18

epidemiological The most frequent diagnoses included anorectal malformations, esophageal atresia, and Hirschsprung disease. ↗

▶ Ep 20 · 0:28

clinical The hub held regular monthly virtual meetings to present new patients, discuss complex cases, and follow up on patients after surgery. ↗

▶ Ep 20 · 0:36

quote Their findings suggest that the Finnish Pediatric Surgery hub fosters an effective and safe place for sharing surgical expertise and learning. ↗

▶ Ep 20 · 0:36

opinion Findings suggest that the Finnish Pediatric Surgery hub fosters an effective and safe place for sharing surgical expertise and learning. ↗

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

▶ Ep 21 · 0:15

host_summary 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. ↗

▶ Ep 21 · 0:47

host_summary Cincinnati Children's has one of the largest aerodigestive centers in the world. ↗

▶ Ep 21 · 0:55

host_summary The expert multidisciplinary team includes speech pathology, otolaryngology, gastroenterology, pulmonology, and pediatric general surgery. ↗

▶ Ep 21 · 1:37

host_summary The center provides coordinated multidisciplinary care to children with congenital or acquired complex digestive and airway disorders. ↗

▶ Ep 21 · 2:52

host_summary Video fluoroscopic swallowing study analyzes different phases of swallowing. ↗

▶ Ep 21 · 2:59

host_summary 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. ↗

▶ Ep 21 · 3:48

host_summary ENT looks at swallowing study results and helps stratify the risk of proceeding with airway reconstruction and decannulation. ↗

▶ Ep 21 · 3:54

host_summary In aerodigestive patients, ENT performs esophageal and airway reconstruction, cleft repair, drool procedures, and manages vocal folds and mobility. ↗

▶ Ep 21 · 4:19

host_summary GERD pathophysiology includes an incompetent lower esophageal sphincter. ↗

▶ Ep 21 · 4:42

host_summary General signs and symptoms of GERD include regurgitation, vomiting, and heartburn. ↗

▶ Ep 21 · 5:28

host_summary Data shows an increase in airway surgery complications in patients who were later found to have eosinophilic esophagitis. ↗

▶ Ep 21 · 5:40

host_summary Anatomic issues in aerodigestive patients include strictures that need balloon dilations or stenting. ↗

▶ Ep 21 · 6:13

host_summary When 25 patients in the aerodigestive program were assessed, 76% of them had a feeding disorder. ↗

▶ Ep 21 · 6:54

host_summary 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. ↗

▶ Ep 21 · 7:20

host_summary Underlying pulmonary insufficiency should be suspected if patients have had complicated respiratory infections requiring positive pressure ventilation. ↗

▶ Ep 21 · 7:48

host_summary Risk factors for upper airway obstruction include airway abnormalities like mid-face hypoplasia, skeletal dysplasia, decreased muscle tone, and syndromes associated with airway obstruction. ↗

▶ Ep 21 · 8:13

host_summary Risk factors for lower airway obstruction include acquired or congenital thoracic deformities and those who had thoracotomies done in the past. ↗

▶ Ep 21 · 9:15

host_summary For patients with ventilatory insufficiency, the pulmonologist determines if the child still needs ventilatory support and whether they are ready for decannulation. ↗

▶ Ep 21 · 9:26

host_summary The pulmonologist assesses how ready the patient is for weaning from the vent and whether they can start or advance feeding. ↗

▶ Ep 21 · 9:41

host_summary In the NICU, general surgeons obtain feeding access, manage anorectal malformations, and perform surgical procedures such as tracheopexies and lung resections. ↗

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

▶ Ep 22 · 0:00

quote Can performing a tracheobronchopexy help oesophageal atresia patients with severe tracheobronchoalacia avoid getting a tracheostomy? ↗

▶ Ep 22 · 0:13

host_summary Tracheobronchomalacia can cause serious breathing problems like blue spells in esophageal atresia patients ↗

▶ Ep 22 · 0:13

host_summary Esophageal atresia patients often have tracheobronchomalacia ↗

▶ Ep 22 · 0:23

host_summary A retrospective observational study reviewed 80 esophageal atresia patients who underwent tracheobronchopexy at two hospitals between 2013 and 2021 ↗

▶ Ep 22 · 0:33

host_summary 94% of esophageal atresia patients who underwent tracheobronchopexy were able to avoid a tracheostomy ↗

▶ Ep 22 · 0:38

host_summary Tracheobronchopexy significantly reduced life-threatening breathing events in esophageal atresia patients ↗

▶ Ep 22 · 0:38

host_summary Tracheobronchopexy significantly reduced the need for positive pressure ventilation in esophageal atresia patients ↗

▶ Ep 22 · 0:38

host_summary Tracheobronchopexy significantly reduced ventilator dependence in esophageal atresia patients ↗

Quick Literature Updates Ep 27

▶ Ep 26 · 1:04

host_summary Van Haal et al. conducted a retrospective cohort study in the Netherlands that included 79 patients who had rigid tracheobronchoscopy done before and after esophageal atresia surgery. ↗

▶ Ep 26 · 1:24

host_summary Preoperative tracheobronchoscopy for the presence of post-operative tracheomalacia had a sensitivity of 50% and a specificity of 67%. ↗

▶ Ep 26 · 1:34

host_summary Preoperative tracheobronchoscopy, though routine, has limited predictive value for post-operative tracheomalacia in esophageal atresia patients. ↗

▶ Ep 26 · 1:34

quote This shows that pre-op TBS, though routine, has limited predictive value for post-op tracheomalacia. ↗

Etiologies (Gastroschisis/NEC/Atresia/Volvulus) 41 entries

STAT trial: stoma or intestinal anastomosis for necrotizing enterocolitis: a multicentre randomized controlled trial

▶ Ep 65 · 0:00

quote What's the best surgical approach for infants needing laparotomy, for necrotizing enterocolitis, anastomosis, or stoma formation? ↗

▶ Ep 65 · 0:13

host_summary The STAT trial looked at newborns who underwent laparotomy for necrotizing enterocolitis requiring intestinal resection from 2010 to 2020. ↗

▶ Ep 65 · 0:13

host_summary The STAT trial was a randomized controlled trial in 12 centers worldwide. ↗

▶ Ep 65 · 0:26

host_summary Infants were randomized to two surgical approaches: either anastomosis or stoma formation. ↗

▶ Ep 65 · 0:31

host_summary There was no difference in unplanned surgeries between primary anastomosis and stoma formation groups. ↗

▶ Ep 65 · 0:31

host_summary There was no difference in mortality between primary anastomosis and stoma formation groups. ↗

▶ Ep 65 · 0:31

host_summary Infants undergoing primary anastomosis had a significantly less duration of requiring parenteral nutrition compared to those with stoma formation. ↗

▶ Ep 65 · 0:43

host_summary Primary anastomosis is superior for enhancing recovery from necrotizing enterocolitis in infants and does not increase adverse outcomes. ↗

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

▶ Ep 66 · 0:00

quote Do children born with gastroschisis perform worse in school compared to age-matched peers without the condition? ↗

▶ Ep 66 · 0:11

host_summary This is a retrospective study using educational data from children born between 1991 and 2022. ↗

▶ Ep 66 · 0:18

host_summary 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. ↗

▶ Ep 66 · 0:33

quote They found that children with gastroschisis, even those with the simpler form, were significantly more likely to fail middle school assessments. ↗

▶ Ep 66 · 0:33

host_summary Children with gastroschisis, even those with the simpler form, were significantly more likely to fail middle school assessments. ↗

▶ Ep 66 · 0:41

host_summary Children with gastroschisis may face long-term learning challenges and could benefit from early educational support. ↗

▶ Ep 66 · 0:41

quote This suggests that children with gastroschisis may face long-term learning challenges and could benefit from early educational support. ↗

Quick Literature Updates Ep 22

▶ Ep 68 · 1:03

host_summary 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. ↗

▶ Ep 68 · 1:14

host_summary In the Beotti study, patients were assigned to a new non-dilation protocol group or a traditional dilation group. ↗

▶ Ep 68 · 1:20

host_summary The Beotti study primary outcomes were anastomotic complications, enterocolitis, and constipation. ↗

▶ Ep 68 · 1:26

quote What did they find? ↗

▶ Ep 68 · 1:27

host_summary 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. ↗

▶ Ep 68 · 1:36

host_summary Choosing not to do postoperative anal dilations after Hirschsprung pull-through may be a good alternative with benefits like lower constipation and enterocolitis. ↗

Quick Literature Updates Ep 27

▶ Ep 69 · 1:04

host_summary Van Haal et al. conducted a retrospective cohort study in the Netherlands that included 79 patients who had rigid tracheobronchoscopy done before and after esophageal atresia surgery. ↗

▶ Ep 69 · 1:24

host_summary Preoperative tracheobronchoscopy for the presence of post-operative tracheomalacia had a sensitivity of 50% and a specificity of 67%. ↗

▶ Ep 69 · 1:34

host_summary Preoperative tracheobronchoscopy, though routine, has limited predictive value for post-operative tracheomalacia in esophageal atresia patients. ↗

▶ Ep 69 · 1:34

quote This shows that pre-op TBS, though routine, has limited predictive value for post-op tracheomalacia. ↗

Availability, utilization, and barriers to bowel ultrasound for necrotizing enterocolitis...

▶ Ep 74 · 0:08

host_summary Bowel ultrasound is becoming an important tool for diagnosing necrotizing enterocolitis (NEC). ↗

▶ Ep 74 · 0:19

host_summary A national survey included more than 100 neonatologists, surgeons, and radiologists from 42 children's hospitals. ↗

▶ Ep 74 · 0:26

quote While bowel ultrasound was available in 83% of level 4 NICUs, clinicians reported using it inconsistently, most often only when X-rays. ↗

▶ Ep 74 · 0:26

host_summary Bowel ultrasound was available in 83% of level 4 NICUs. ↗

▶ Ep 74 · 0:26

host_summary Clinicians reported using bowel ultrasound inconsistently, most often only when X-rays were inconclusive. ↗

▶ Ep 74 · 0:36

host_summary The biggest barriers to bowel ultrasound use were lack of standardized protocols, limited provider training, and uncertainty about how bowel ultrasound should guide treatment decisions. ↗

▶ Ep 74 · 0:36

quote The biggest barriers weren't the technology itself, they were the lack of standardized protocols, limited provider training, and uncertainty about how bowel ultrasound should guide treatment decisions. ↗

▶ Ep 74 · 0:46

host_summary Wider adoption of bowel ultrasound for NEC will depend on better evidence, standardized guidelines, and improved clinician training. ↗

Update Course Rewind 2025: Updates in NEC Management

▶ Ep 75 · 2:06

host_summary For every 10 babies with surgical NEC, an X-ray might only catch one or two in the early stages (based on 13% sensitivity) ↗

▶ Ep 75 · 2:15

host_summary A 2023 study in Pediatric Radiology suggests ultrasound can detect bowel wall thinning, perfusion abnormalities, and silent fluid collections that X-ray misses ↗

▶ Ep 75 · 5:00

host_summary The benefit of primary anastomosis may not be seen in immediate survival but appears in the long run ↗

▶ Ep 75 · 5:18

host_summary In clip-and-drop technique, surgeon removes necrotic segment, staples the ends, and returns in 24-48 hours to check gut hemodynamics before committing to stoma or anastomosis ↗

▶ Ep 75 · 6:55

host_summary In the SAT trial, mortality was similar between primary anastomosis and stoma groups ↗

▶ Ep 75 · 6:56

host_summary Babies who received primary anastomosis got off parenteral nutrition significantly sooner than those with stoma ↗

▶ Ep 75 · 7:06

host_summary Babies with primary anastomosis were able to return to enteral feeds more quickly and had fewer intestinal complications than those with stoma ↗

▶ Ep 75 · 7:52

host_summary Mucous fistula refeeding involves recycling upper stoma output into the lower bowel to keep it healthy ↗

Fetal Surgery 38 entries

Quick Literature Updates Ep 19

▶ Ep 25 · 1:00

guideline APSA created a peer support program for pediatric surgeons in 2020. ↗

▶ Ep 25 · 1:00

quote The American Pediatric Surgical Association or the APSA created a peer support program for pediatric surgeons in 2020. ↗

▶ Ep 25 · 1:00

quote The American Pediatric Surgical Association or the APSA created a peer support program for pediatric surgeons in 2020. ↗

▶ Ep 25 · 1:00

host_summary APSA created a peer support program for pediatric surgeons in 2020. ↗

▶ Ep 25 · 1:12

host_summary The goal of the APSA peer support program was to support surgeons after traumatic events. ↗

▶ Ep 25 · 1:12

quote Their goal was to support surgeons after traumatic events. ↗

▶ Ep 25 · 1:12

quote Their goal was to support surgeons after traumatic events. ↗

▶ Ep 25 · 1:12

guideline The goal of the APSA peer support program was to support surgeons after traumatic events. ↗

▶ Ep 25 · 1:16

quote The most common referral reasons were toxic work environments and adverse events. ↗

▶ Ep 25 · 1:16

epidemiological The most common referral reasons for the peer support program were toxic work environments and adverse events. ↗

▶ Ep 25 · 1:16

quote The most common referral reasons were toxic work environments and adverse events. ↗

▶ Ep 25 · 1:16

host_summary The most common referral reasons for the peer support program were toxic work environments and adverse events. ↗

▶ Ep 25 · 1:20

host_summary 50 surgeons total agreed to receive training on how to be a supporter in the APSA program. ↗

▶ Ep 25 · 1:20

epidemiological 50 surgeons total agreed to receive training on how to be a supporter in the APSA program. ↗

▶ Ep 25 · 1:25

epidemiological Over 80% of trained peer supporters were able to use these peer support skills informally with colleagues, partners, and trainees. ↗

▶ Ep 25 · 1:25

host_summary Over 80% of trained peer supporters were able to use these peer support skills informally with colleagues, partners, and trainees. ↗

▶ Ep 25 · 1:31

opinion The peer support program shows that this type of support system can work really well to help surgeons heal from traumatic experiences and toxic work environments. ↗

▶ Ep 25 · 1:31

host_summary The peer support program shows that this type of support system can work really well to help surgeons heal from traumatic experiences and toxic work environments. ↗

The fetal frontier: A review of current and emerging fetal therapies for genetic diseases

▶ Ep 27 · 0:00

quote What if we could treat genetic diseases before a baby is even born? ↗

▶ Ep 27 · 0:14

clinical Faster prenatal diagnosis enables detection of many genetic conditions early ↗

▶ Ep 27 · 0:18

clinical Enzyme replacement therapy can be delivered directly to the fetus ↗

▶ Ep 27 · 0:18

clinical Medications can be given to the mother that cross the placenta ↗

▶ Ep 27 · 0:24

clinical Protein therapy can be delivered to the fetus ↗

▶ Ep 27 · 0:24

clinical Stem cells can be delivered to the fetus ↗

▶ Ep 27 · 0:27

quote The fetus actually has some advantages for treatment, a more tolerant immune system and a more permissive blood-brain barrier. ↗

▶ Ep 27 · 0:27

clinical The fetus has a more tolerant immune system compared to postnatal life ↗

▶ Ep 27 · 0:27

clinical The fetus has a more permissive blood-brain barrier compared to postnatal life ↗

▶ Ep 27 · 0:34

clinical Most fetal therapies for genetic diseases are still experimental ↗

▶ Ep 27 · 0:38

quote Intervene during fetal development to prevent lifelong disease. ↗

▶ Ep 27 · 0:38

clinical Fetal intervention aims to prevent lifelong disease by treating during fetal development ↗

Utility of Fluorescence In Situ Hybridization as a Fetal Surgery Eligibility Criterion for....

▶ Ep 28 · 0:00

quote What if invasive genetic testing before fetal surgery might not actually change your decision? ↗

▶ Ep 28 · 0:09

clinical Many centers require genetic testing to rule out chromosome abnormalities before fetal surgery, even when ultrasounds and blood tests already look reassuring ↗

▶ Ep 28 · 0:20

quote Are we adding risk without adding information? ↗

▶ Ep 28 · 0:23

clinical When imaging and cell-free DNA screening showed low risk for aneuploidy, the FISH test matched those results 100% of the time ↗

▶ Ep 28 · 0:23

epidemiological A study reviewed nearly 1000 pregnancies evaluated for fetal surgery ↗

▶ Ep 28 · 0:36

clinical For low-risk pregnancies, FISH did not provide any new information that changed surgery candidacy ↗

▶ Ep 28 · 0:36

quote In other words, for low-risk pregnancies, fish didn't provide any new information that changed surgery candidacy. ↗

▶ Ep 28 · 0:42

opinion In carefully selected low-risk cases, non-invasive screening may be enough, potentially avoiding the FISH procedure ↗

Gastroschisis 13 entries

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

▶ Ep 26 · 0:00

quote Do children born with gastroschisis perform worse in school compared to age-matched peers without the condition? ↗

▶ Ep 26 · 0:11

host_summary This is a retrospective study using educational data from children born between 1991 and 2022. ↗

▶ Ep 26 · 0:18

host_summary 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. ↗

▶ Ep 26 · 0:33

quote They found that children with gastroschisis, even those with the simpler form, were significantly more likely to fail middle school assessments. ↗

▶ Ep 26 · 0:33

host_summary Children with gastroschisis, even those with the simpler form, were significantly more likely to fail middle school assessments. ↗

▶ Ep 26 · 0:41

host_summary Children with gastroschisis may face long-term learning challenges and could benefit from early educational support. ↗

▶ Ep 26 · 0:41

quote This suggests that children with gastroschisis may face long-term learning challenges and could benefit from early educational support. ↗

Quick Literature Updates Ep 22

▶ Ep 27 · 1:03

host_summary 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. ↗

▶ Ep 27 · 1:14

host_summary In the Beotti study, patients were assigned to a new non-dilation protocol group or a traditional dilation group. ↗

▶ Ep 27 · 1:20

host_summary The Beotti study primary outcomes were anastomotic complications, enterocolitis, and constipation. ↗

▶ Ep 27 · 1:26

quote What did they find? ↗

▶ Ep 27 · 1:27

host_summary 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. ↗

▶ Ep 27 · 1:36

host_summary Choosing not to do postoperative anal dilations after Hirschsprung pull-through may be a good alternative with benefits like lower constipation and enterocolitis. ↗

Giant Omphalocele 31 entries

Quick Literature Updates Episode 20

▶ Ep 6 · 1:03

epidemiological 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. ↗

▶ Ep 6 · 1:11

quote They wanted to know whether thoracoscopic repair has a higher recurrence rate and longer operating room time compared to open repair. ↗

▶ Ep 6 · 1:18

clinical Thoracoscopic repair for congenital diaphragmatic hernia has longer operative times compared to open repair. ↗

▶ Ep 6 · 1:18

clinical Thoracoscopic repair for congenital diaphragmatic hernia has higher recurrence rates compared to open repair. ↗

▶ Ep 6 · 1:25

clinical Thoracoscopic repair for congenital diaphragmatic hernia has a lower incidence of postoperative bowel obstruction compared to open repair. ↗

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

▶ Ep 6 · 0:00

quote What's the best way to manage a giantombalocele? ↗

▶ Ep 6 · 0:07

epidemiological The study examined 117 infants with giant omphalocele. ↗

▶ Ep 6 · 0:07

clinical Four treatment approaches were compared: paint-and-wait, operative silos, compression techniques, and Duoderm silo. ↗

▶ Ep 6 · 0:19

clinical Babies treated with Duoderm silo were most likely to have their abdomen closed in one surgery. ↗

▶ Ep 6 · 0:19

quote Babies treated with the duoderm silo were most likely to have their abdomen closed in one surgery. ↗

▶ Ep 6 · 0:24

quote About 8 out of 10 did. ↗

▶ Ep 6 · 0:24

clinical Approximately 80% of infants treated with Duoderm silo achieved single-stage abdominal closure. ↗

▶ Ep 6 · 0:25

clinical The overall chance of complications was similar across all four treatment methods. ↗

▶ Ep 6 · 0:25

clinical Some babies treated with operative silos achieved closure sooner than other methods. ↗

▶ Ep 6 · 0:32

quote Almost half of the babies needed 6 months or more before the abdomen could be fully closed. ↗

▶ Ep 6 · 0:32

clinical Almost half of the infants required six months or more before complete abdominal closure could be achieved. ↗

▶ Ep 6 · 0:38

opinion Duoderm silos may be a particularly good option when the goal is single-stage abdominal closure. ↗

▶ Ep 6 · 0:38

opinion There is no one-size-fits-all treatment for giant omphalocele. ↗

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

▶ Ep 7 · 0:00

quote What's the best way to manage a giantombalocele? ↗

▶ Ep 7 · 0:07

clinical Four treatment approaches were compared: paint-and-wait, operative silos, compression techniques, and Duoderm silo ↗

▶ Ep 7 · 0:07

epidemiological The study examined 117 infants with giant omphalocele ↗

▶ Ep 7 · 0:19

quote Babies treated with the duoderm silo were most likely to have their abdomen closed in one surgery. ↗

▶ Ep 7 · 0:19

clinical Babies treated with Duoderm silo were most likely to have their abdomen closed in one surgery ↗

▶ Ep 7 · 0:24

quote About 8 out of 10 did. ↗

▶ Ep 7 · 0:24

clinical Approximately 80% of infants treated with Duoderm silo achieved single-surgery abdominal closure ↗

▶ Ep 7 · 0:25

clinical Some babies treated with operative silos achieved closure sooner than other methods ↗

▶ Ep 7 · 0:25

clinical Complication rates were similar across all four management methods ↗

▶ Ep 7 · 0:32

clinical Almost half of infants required 6 months or more before complete abdominal closure could be achieved ↗

▶ Ep 7 · 0:38

opinion Duoderm silos may be particularly beneficial when the goal is single-stage abdominal closure ↗

▶ Ep 7 · 0:38

quote 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. ↗

▶ Ep 7 · 0:38

opinion There is no universal best treatment approach for giant omphalocele ↗

Hirschsprung disease 41 entries

The use of postoperative calibrations in Hirschsprung disease

▶ Ep 74 · 0:00

quote For patients with Hirschsprung disease who undergo endorectal pull-through surgeries, are daily postoperative anal dilations necessary and effective? ↗

▶ Ep 74 · 0:13

clinical The study was prospective and took place from 2021 to 2023 ↗

▶ Ep 74 · 0:13

clinical The study included 33 patients under six months old who underwent endorectal pull-through surgeries ↗

▶ Ep 74 · 0:24

clinical Patients were assigned to either a new non-dilation protocol group or a traditional dilation group ↗

▶ Ep 74 · 0:30

clinical The primary outcomes measured were anastomotic complications, enterocolitis, and constipation ↗

▶ Ep 74 · 0:37

clinical The non-dilation group had less constipation compared to the traditional dilation group ↗

▶ Ep 74 · 0:37

clinical There was no significant difference in anastomotic complications between the two groups ↗

▶ Ep 74 · 0:37

clinical The non-dilation group had less enterocolitis compared to the traditional dilation group ↗

▶ Ep 74 · 0:46

quote This means that choosing not to do postoperative anal dilations may be a good alternative with benefits like lower constipation and enterocolitis. ↗

▶ Ep 74 · 0:46

opinion Choosing not to do postoperative anal dilations may be a good alternative with benefits like lower constipation and enterocolitis ↗

Quick Literature Updates Episode 17

▶ Ep 75 · 3:25

host_summary The Children's Hospital in Pakistan conducted a randomized control trial including 124 patients in 2021 to 2022 who needed stoma reversal. ↗

▶ Ep 75 · 3:25

clinical The Children's Hospital in Pakistan conducted a randomized control trial including 124 patients in 2021 to 2022 who needed stoma reversal. ↗

▶ Ep 75 · 3:35

clinical The Pakistani stoma reversal trial aimed to compare surgical site infections and cosmetic outcomes of scars in patients receiving purse-string or linear skin closure techniques. ↗

▶ Ep 75 · 3:35

host_summary The Pakistani stoma reversal trial aimed to compare surgical site infections and cosmetic outcomes of scars in patients receiving purse-string or linear skin closure techniques. ↗

▶ Ep 75 · 3:44

host_summary The purse-string closure group had much better scar quality compared to the linear closure group for stoma reversal. ↗

▶ Ep 75 · 3:44

host_summary The purse-string closure group had way fewer surgical site infections compared to the linear closure group for stoma reversal. ↗

▶ Ep 75 · 3:44

clinical The purse-string closure group had way fewer surgical site infections compared to the linear closure group for stoma reversal. ↗

▶ Ep 75 · 3:44

clinical The purse-string closure group had much better scar quality compared to the linear closure group for stoma reversal. ↗

▶ Ep 75 · 3:52

opinion When reversing a stoma, purse-string closure technique is the best way to do it. ↗

▶ Ep 75 · 3:52

quote So when reversing a stoma, purse string closure technique is the best way to do it. ↗

▶ Ep 75 · 3:52

quote So when reversing a stoma, purse string closure technique is the best way to do it. ↗

▶ Ep 75 · 3:52

opinion When reversing a stoma, purse-string closure technique is the best way to do it. ↗

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

▶ Ep 76 · 0:00

quote Does creating a collaborative initiative help with providing high quality pediatric surgical care? ↗

▶ Ep 76 · 0:10

clinical The Finnish Pediatric Surgery Hub was established in 2021 by pediatric surgeons from Finland's five neonatal surgery centers. ↗

▶ Ep 76 · 0:18

epidemiological The most frequent diagnoses included anorectal malformations, esophageal atresia, and Hirschsprung disease. ↗

▶ Ep 76 · 0:18

epidemiological The hub performed 34 elective and 6 urgent cases total. ↗

▶ Ep 76 · 0:28

clinical The hub held regular monthly virtual meetings to present new patients, discuss complex cases, and follow up on patients after surgery. ↗

▶ Ep 76 · 0:36

quote Their findings suggest that the Finnish Pediatric Surgery hub fosters an effective and safe place for sharing surgical expertise and learning. ↗

▶ Ep 76 · 0:36

opinion Findings suggest that the Finnish Pediatric Surgery hub fosters an effective and safe place for sharing surgical expertise and learning. ↗

Quick Literature Updates Ep 22

▶ Ep 79 · 1:03

host_summary 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. ↗

▶ Ep 79 · 1:14

host_summary In the Beotti study, patients were assigned to a new non-dilation protocol group or a traditional dilation group. ↗

▶ Ep 79 · 1:20

host_summary The Beotti study primary outcomes were anastomotic complications, enterocolitis, and constipation. ↗

▶ Ep 79 · 1:26

quote What did they find? ↗

▶ Ep 79 · 1:27

host_summary 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. ↗

▶ Ep 79 · 1:36

host_summary Choosing not to do postoperative anal dilations after Hirschsprung pull-through may be a good alternative with benefits like lower constipation and enterocolitis. ↗

Quick Literature Updates Ep 23

▶ Ep 80 · 1:02

guideline APSA published best practices for locum tenens surgeons, hospitals and agencies stressing the importance of patient safety and support for surgeons. ↗

▶ Ep 80 · 1:02

quote The American P Paediatric Surgical Association, APSA published best practices for locum tendon surgeons, hospitals and agencies in this review article. ↗

▶ Ep 80 · 1:17

opinion Locum tenens can help prevent burnout by offering flexible work options for a better work-life balance. ↗

▶ Ep 80 · 1:23

quote 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. ↗

▶ Ep 80 · 1:23

guideline Hospitals should avoid relying solely on locum tenens pediatric surgeons without any full-time surgeons, because this may cause patients to slip through handoffs. ↗

▶ Ep 80 · 1:32

guideline Locum tenens agencies should sponsor CME and conduct formal exit interviews. ↗

Hypoplastic Left Heart Syndrome 12 entries

Outcomes of Fontan Patients Undergoing Combined Heart - Liver Transplantation in Pediatric Hospitals Across the U.S.

▶ Ep 3 · 0:00

quote What happens when kids who underwent Fontan procedure don't just need a new heart, but a new liver as well. ↗

▶ Ep 3 · 0:11

epidemiological Liver disease is becoming a rising issue in Fontan patients ↗

▶ Ep 3 · 0:11

epidemiological Combined heart-liver transplantation is happening more often in Fontan patients ↗

▶ Ep 3 · 0:11

epidemiological More Fontan patients are surviving into adolescence and adulthood ↗

▶ Ep 3 · 0:21

clinical The study examined children and young adults undergoing combined heart-liver transplant at hospitals across the US in the last few years ↗

▶ Ep 3 · 0:28

clinical Many of the patients in the study had hypoplastic left heart syndrome ↗

▶ Ep 3 · 0:36

clinical About 85% of patients survived at 1 year after combined heart-liver transplant ↗

▶ Ep 3 · 0:36

clinical Long-term outcomes after combined heart-liver transplant were excellent ↗

▶ Ep 3 · 0:41

clinical Three-year survival after combined heart-liver transplant was basically identical to patients who received heart transplant alone ↗

▶ Ep 3 · 0:48

epidemiological Combined heart-liver transplant is increasingly common for Fontan patients with advanced liver disease ↗

▶ Ep 3 · 0:48

quote The big takeaway, combined heart liver transplant is effective and increasingly common for Fontan patients with advanced liver disease. ↗

▶ Ep 3 · 0:48

clinical Combined heart-liver transplant is effective for Fontan patients with advanced liver disease ↗

Inguinal Hernia 37 entries

The Use of Laryngeal Mask Airway Versus Endotracheal Intubation in Pediatric Laparoscopic Inguinal Hernia Repair: A Randomized Controlled Trial

▶ Ep 18 · 0:01

quote When kids need laparoscopic surgery, do they really need a breathing tube, or could a less invasive airway work just as well? ↗

▶ Ep 18 · 0:11

host_summary In laparoscopic surgery, the traditional airway approach is using endotracheal intubation. ↗

▶ Ep 18 · 0:21

host_summary A randomized trial studied 50 kids having laparoscopic hernia repair comparing LMA to endotracheal intubation. ↗

▶ Ep 18 · 0:26

host_summary There was no difference in tidal carbon dioxide levels between LMA and endotracheal intubation groups in pediatric laparoscopic hernia repair. ↗

▶ Ep 18 · 0:26

host_summary There was no difference in oxygen saturation between LMA and endotracheal intubation groups in pediatric laparoscopic hernia repair. ↗

▶ Ep 18 · 0:33

host_summary There was only one desaturation event in the LMA group and one in the endotracheal intubation group. ↗

▶ Ep 18 · 0:37

host_summary For certain laparoscopic surgeries in children, an LMA might be just as safe as a traditional endotracheal tube. ↗

▶ Ep 18 · 0:37

quote The takeaway is that for certain laparoscopic surgeries in children, an LMA might be just as safe as a traditional endotracheal tube. ↗

Effect of a Pediatric Surgeon's Primarily Performed Technique on Inguinal Hernia Recurrence Rates: A Multicenter Retrospective Cohort Study

▶ Ep 19 · 0:00

quote Does a surgeon's preferred technique actually affect hernia outcome? This study suggests that yes, it can. ↗

▶ Ep 19 · 0:09

host_summary The study examined pediatric inguinal hernia repairs across 21 children's hospitals. ↗

▶ Ep 19 · 0:15

host_summary When laparoscopic repair was done by surgeons who primarily use that approach, the hernia recurrence rate was 1.7%. ↗

▶ Ep 19 · 0:15

host_summary When surgeons who mostly do open repairs performed a laparoscopic repair, the hernia recurrence rate was 3.6%. ↗

▶ Ep 19 · 0:27

host_summary Surgeons who primarily do laparoscopic repairs had similar low recurrence rates whether they operated laparoscopically or open. ↗

▶ Ep 19 · 0:35

host_summary Surgeons tend to get the best results with the technique they use most often. ↗

▶ Ep 19 · 0:35

quote This means that surgeons tend to get the best results with the technique they use most often. ↗

▶ Ep 19 · 0:39

host_summary If surgeons split their practice between open and laparoscopic hernia repairs, it is important to maintain strong skills in both so that outcomes can stay consistent. ↗

A Retrospective Nationwide Comparison of Laparoscopic vs Open Inguinal Hernia Repair in Children

▶ Ep 20 · 0:00

quote Open or laparoscopic hernia repair, which is better for kids? ↗

▶ Ep 20 · 0:06

host_summary A nationwide study examined over 53,000 children who had inguinal hernia repair across the United States. ↗

▶ Ep 20 · 0:13

host_summary Approximately 16% of pediatric inguinal hernia repairs in the study were performed laparoscopically. ↗

▶ Ep 20 · 0:15

host_summary The majority of pediatric inguinal hernia repairs in the study were open repairs. ↗

▶ Ep 20 · 0:23

host_summary Laparoscopic inguinal hernia repair had more than 3 times the risk of same-side recurrence compared to open surgery. ↗

▶ Ep 20 · 0:30

host_summary Laparoscopic inguinal hernia repair was linked to fewer future surgeries on the opposite side (metachronous hernias). ↗

▶ Ep 20 · 0:36

host_summary The findings comparing laparoscopic and open inguinal hernia repair held up after adjusting for hospital differences and patient factors. ↗

▶ Ep 20 · 0:40

host_summary Laparoscopic inguinal hernia repair may reduce the chance of needing surgery on the contralateral side. ↗

▶ Ep 20 · 0:40

quote Bottom line, open repair has a lower risk of recurrence, while laparoscopic repair may reduce the chance of needing surgery on the other side. ↗

▶ Ep 20 · 0:40

host_summary Open inguinal hernia repair has a lower risk of same-side recurrence compared to laparoscopic repair. ↗

A Retrospective Nationwide Comparison of Laparoscopic vs Open Inguinal Hernia Repair in Children

▶ Ep 21 · 0:00

quote Open or laparoscopic hernia repair, which is better for kids? ↗

▶ Ep 21 · 0:06

host_summary A nationwide study examined over 53,000 children who had inguinal hernia repair across the United States. ↗

▶ Ep 21 · 0:13

host_summary Approximately 16% of the pediatric inguinal hernia repairs in the study were performed laparoscopically. ↗

▶ Ep 21 · 0:15

host_summary The majority of pediatric inguinal hernia repairs in the study were open repairs. ↗

▶ Ep 21 · 0:17

host_summary The study compared two key outcomes: hernia recurrence on the same side and the need for a second hernia operation later on. ↗

▶ Ep 21 · 0:23

host_summary Laparoscopic inguinal hernia repair had more than 3 times the risk of same-side recurrence compared to open surgery. ↗

▶ Ep 21 · 0:30

host_summary Laparoscopic inguinal hernia repair was linked to fewer future surgeries on the opposite side (metachronous hernias). ↗

▶ Ep 21 · 0:36

host_summary The findings comparing laparoscopic and open inguinal hernia repair held up even after adjusting for hospital differences and patient factors. ↗

▶ Ep 21 · 0:40

quote Bottom line, open repair has a lower risk of recurrence, while laparoscopic repair may reduce the chance of needing surgery on the other side. ↗

▶ Ep 21 · 0:40

host_summary Laparoscopic inguinal hernia repair may reduce the chance of needing surgery on the contralateral side. ↗

▶ Ep 21 · 0:40

host_summary Open inguinal hernia repair has a lower risk of same-side recurrence compared to laparoscopic repair. ↗

Intestinal Failure 27 entries

Outcomes of Children With Short Bowel Syndrome: Experiences in a Multidisciplinary Intestinal Rehabilitation Unit Over Two Decades

▶ Ep 26 · 0:10

host_summary This retrospective study examined 64 pediatric patients with short bowel syndrome managed by a multidisciplinary intestinal rehab program between 2001 and 2022. ↗

▶ Ep 26 · 0:22

host_summary 89% of patients with short bowel syndrome in the study survived. ↗

▶ Ep 26 · 0:22

host_summary 78% of patients with short bowel syndrome were able to wean off parenteral nutrition. ↗

▶ Ep 26 · 0:22

host_summary Survival rates of children with short bowel syndrome improved over time in the study period. ↗

▶ Ep 26 · 0:31

host_summary Presence of intestinal failure associated liver disease affected survival in pediatric short bowel syndrome patients. ↗

▶ Ep 26 · 0:31

host_summary Introduction of fish oil-based parenteral nutrition in 2007 improved survival in pediatric short bowel syndrome patients. ↗

Advancements in Pediatric Intestinal Failure: Innovative Therapies and Improved Outcomes

▶ Ep 28 · 1:24

clinical Chronic intestinal inflammation resembling Crohn's disease is now being observed in intestinal failure patients, requiring management with inflammatory bowel disease therapies like biologics. ↗

▶ Ep 28 · 3:19

epidemiological A 2012 Pediatric Intestinal Failure Consortium study showed 50% of intestinal failure patients achieved enteral autonomy, while 25% either died or had intestinal transplant. ↗

▶ Ep 28 · 3:51

epidemiological Studies from Canada, Michigan, and Spain show that multidisciplinary intestinal rehabilitation teams improve survival. ↗

▶ Ep 28 · 9:26

clinical Second-generation lipid emulsions attempt to reduce omega-6 exposure by diluting the soybean component. ↗

▶ Ep 28 · 9:43

clinical Omega-6 fatty acids promote inflammation while omega-3 fatty acids lead to a more anti-inflammatory response. ↗

▶ Ep 28 · 11:12

clinical In utero, babies receive significant amounts of DHA and arachidonic acid through the placenta, but standard lipid emulsions in TPN fall short of providing these. ↗

▶ Ep 28 · 13:09

clinical Kitelock addresses three issues of central line complications: organisms, clot/thrombosis, and biofilm. ↗

▶ Ep 28 · 14:19

clinical Patients with Type 3 short bowel syndrome have the best prognosis because they still have residual ileum. ↗

▶ Ep 28 · 14:36

clinical The ileum is where GLP-2 is naturally produced. ↗

▶ Ep 28 · 14:39

clinical Without an ileum, infants cannot generate the necessary GLP-2 hormone surge to drive their own intestinal adaptation. ↗

▶ Ep 28 · 16:54

clinical Children have much greater adaptive potential than adults because of their inherent gut growth capacity. ↗

▶ Ep 28 · 17:00

epidemiological The proportion of children reaching enteral autonomy has improved over the past 20 years. ↗

▶ Ep 28 · 17:06

clinical Controlling liver disease buys time for intestinal adaptation. ↗

Impact of social determinants of health on outcomes in pediatric short bowel syndrome...

▶ Ep 29 · 0:00

quote Can a child's zip code actually change their short bowel syndrome outcomes? ↗

▶ Ep 29 · 0:07

host_summary This was a retrospective cohort study of children with short bowel syndrome in an intestinal rehabilitation program, followed from 2006 to 2019. ↗

▶ Ep 29 · 0:16

host_summary The study asked whether social determinants of health predict outcomes like bloodstream infections, liver disease, and achieving enteral autonomy. ↗

▶ Ep 29 · 0:24

host_summary Social determinants of health do predict outcomes in pediatric short bowel syndrome in real ways. ↗

▶ Ep 29 · 0:24

quote And the answer was yes, in very real ways. ↗

▶ Ep 29 · 0:27

host_summary Distance from the hospital was associated with higher risks of serious complications in children with short bowel syndrome. ↗

▶ Ep 29 · 0:33

host_summary Parental education was linked with fewer central line infections in children with short bowel syndrome. ↗

▶ Ep 29 · 0:37

host_summary Social determinants need to be considered to support families of children with short bowel syndrome better. ↗

Intestinal Rehab 81 entries

Outcomes of Children With Short Bowel Syndrome: Experiences in a Multidisciplinary Intestinal Rehabilitation Unit Over Two Decades

▶ Ep 93 · 0:10

host_summary This retrospective study examined 64 pediatric patients with short bowel syndrome managed by a multidisciplinary intestinal rehab program between 2001 and 2022. ↗

▶ Ep 93 · 0:22

host_summary Survival rates of children with short bowel syndrome improved over time in the study period. ↗

▶ Ep 93 · 0:22

host_summary 78% of patients with short bowel syndrome were able to wean off parenteral nutrition. ↗

▶ Ep 93 · 0:22

host_summary 89% of patients with short bowel syndrome in the study survived. ↗

▶ Ep 93 · 0:31

host_summary Introduction of fish oil-based parenteral nutrition in 2007 improved survival in pediatric short bowel syndrome patients. ↗

▶ Ep 93 · 0:31

host_summary Presence of intestinal failure associated liver disease affected survival in pediatric short bowel syndrome patients. ↗

STAT trial: stoma or intestinal anastomosis for necrotizing enterocolitis: a multicentre randomized controlled trial

▶ Ep 96 · 0:00

quote What's the best surgical approach for infants needing laparotomy, for necrotizing enterocolitis, anastomosis, or stoma formation? ↗

▶ Ep 96 · 0:13

host_summary The STAT trial looked at newborns who underwent laparotomy for necrotizing enterocolitis requiring intestinal resection from 2010 to 2020. ↗

▶ Ep 96 · 0:13

host_summary The STAT trial was a randomized controlled trial in 12 centers worldwide. ↗

▶ Ep 96 · 0:26

host_summary Infants were randomized to two surgical approaches: either anastomosis or stoma formation. ↗

▶ Ep 96 · 0:31

host_summary There was no difference in mortality between primary anastomosis and stoma formation groups. ↗

▶ Ep 96 · 0:31

host_summary Infants undergoing primary anastomosis had a significantly less duration of requiring parenteral nutrition compared to those with stoma formation. ↗

▶ Ep 96 · 0:31

host_summary There was no difference in unplanned surgeries between primary anastomosis and stoma formation groups. ↗

▶ Ep 96 · 0:43

host_summary Primary anastomosis is superior for enhancing recovery from necrotizing enterocolitis in infants and does not increase adverse outcomes. ↗

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

▶ Ep 97 · 0:00

quote Do children born with gastroschisis perform worse in school compared to age-matched peers without the condition? ↗

▶ Ep 97 · 0:11

host_summary This is a retrospective study using educational data from children born between 1991 and 2022. ↗

▶ Ep 97 · 0:18

host_summary 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. ↗

▶ Ep 97 · 0:33

host_summary Children with gastroschisis, even those with the simpler form, were significantly more likely to fail middle school assessments. ↗

▶ Ep 97 · 0:33

quote They found that children with gastroschisis, even those with the simpler form, were significantly more likely to fail middle school assessments. ↗

▶ Ep 97 · 0:41

host_summary Children with gastroschisis may face long-term learning challenges and could benefit from early educational support. ↗

▶ Ep 97 · 0:41

quote This suggests that children with gastroschisis may face long-term learning challenges and could benefit from early educational support. ↗

Quick Literature Updates Ep 22

▶ Ep 99 · 1:03

host_summary 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. ↗

▶ Ep 99 · 1:14

host_summary In the Beotti study, patients were assigned to a new non-dilation protocol group or a traditional dilation group. ↗

▶ Ep 99 · 1:20

host_summary The Beotti study primary outcomes were anastomotic complications, enterocolitis, and constipation. ↗

▶ Ep 99 · 1:26

quote What did they find? ↗

▶ Ep 99 · 1:27

host_summary 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. ↗

▶ Ep 99 · 1:36

host_summary Choosing not to do postoperative anal dilations after Hirschsprung pull-through may be a good alternative with benefits like lower constipation and enterocolitis. ↗

Quick Literature Updates Ep 27

▶ Ep 100 · 1:04

host_summary Van Haal et al. conducted a retrospective cohort study in the Netherlands that included 79 patients who had rigid tracheobronchoscopy done before and after esophageal atresia surgery. ↗

▶ Ep 100 · 1:24

host_summary Preoperative tracheobronchoscopy for the presence of post-operative tracheomalacia had a sensitivity of 50% and a specificity of 67%. ↗

▶ Ep 100 · 1:34

host_summary Preoperative tracheobronchoscopy, though routine, has limited predictive value for post-operative tracheomalacia in esophageal atresia patients. ↗

▶ Ep 100 · 1:34

quote This shows that pre-op TBS, though routine, has limited predictive value for post-op tracheomalacia. ↗

Availability, utilization, and barriers to bowel ultrasound for necrotizing enterocolitis...

▶ Ep 106 · 0:08

host_summary Bowel ultrasound is becoming an important tool for diagnosing necrotizing enterocolitis (NEC). ↗

▶ Ep 106 · 0:19

host_summary A national survey included more than 100 neonatologists, surgeons, and radiologists from 42 children's hospitals. ↗

▶ Ep 106 · 0:26

host_summary Bowel ultrasound was available in 83% of level 4 NICUs. ↗

▶ Ep 106 · 0:26

quote While bowel ultrasound was available in 83% of level 4 NICUs, clinicians reported using it inconsistently, most often only when X-rays. ↗

▶ Ep 106 · 0:26

host_summary Clinicians reported using bowel ultrasound inconsistently, most often only when X-rays were inconclusive. ↗

▶ Ep 106 · 0:36

host_summary The biggest barriers to bowel ultrasound use were lack of standardized protocols, limited provider training, and uncertainty about how bowel ultrasound should guide treatment decisions. ↗

▶ Ep 106 · 0:36

quote The biggest barriers weren't the technology itself, they were the lack of standardized protocols, limited provider training, and uncertainty about how bowel ultrasound should guide treatment decisions. ↗

▶ Ep 106 · 0:46

host_summary Wider adoption of bowel ultrasound for NEC will depend on better evidence, standardized guidelines, and improved clinician training. ↗

Update Course Rewind 2025: Updates in NEC Management

▶ Ep 107 · 2:06

host_summary For every 10 babies with surgical NEC, an X-ray might only catch one or two in the early stages (based on 13% sensitivity) ↗

▶ Ep 107 · 2:15

host_summary A 2023 study in Pediatric Radiology suggests ultrasound can detect bowel wall thinning, perfusion abnormalities, and silent fluid collections that X-ray misses ↗

▶ Ep 107 · 5:00

host_summary The benefit of primary anastomosis may not be seen in immediate survival but appears in the long run ↗

▶ Ep 107 · 5:18

host_summary In clip-and-drop technique, surgeon removes necrotic segment, staples the ends, and returns in 24-48 hours to check gut hemodynamics before committing to stoma or anastomosis ↗

▶ Ep 107 · 6:55

host_summary In the SAT trial, mortality was similar between primary anastomosis and stoma groups ↗

▶ Ep 107 · 6:56

host_summary Babies who received primary anastomosis got off parenteral nutrition significantly sooner than those with stoma ↗

▶ Ep 107 · 7:06

host_summary Babies with primary anastomosis were able to return to enteral feeds more quickly and had fewer intestinal complications than those with stoma ↗

▶ Ep 107 · 7:52

host_summary Mucous fistula refeeding involves recycling upper stoma output into the lower bowel to keep it healthy ↗

Advancements in Pediatric Intestinal Failure: Innovative Therapies and Improved Outcomes

▶ Ep 108 · 1:24

host_summary Chronic intestinal inflammation resembling Crohn's disease is now being observed in intestinal failure patients, requiring management with inflammatory bowel disease therapies like biologics. ↗

▶ Ep 108 · 1:24

clinical Chronic intestinal inflammation resembling Crohn's disease is now being observed in intestinal failure patients, requiring management with inflammatory bowel disease therapies like biologics. ↗

▶ Ep 108 · 3:19

epidemiological A 2012 Pediatric Intestinal Failure Consortium study showed 50% of intestinal failure patients achieved enteral autonomy, while 25% either died or had intestinal transplant. ↗

▶ Ep 108 · 3:19

host_summary A 2012 Pediatric Intestinal Failure Consortium study showed 50% of intestinal failure patients achieved enteral autonomy, while 25% either died or had intestinal transplant. ↗

▶ Ep 108 · 3:51

host_summary Studies from Canada, Michigan, and Spain show that multidisciplinary intestinal rehabilitation teams improve survival. ↗

▶ Ep 108 · 3:51

epidemiological Studies from Canada, Michigan, and Spain show that multidisciplinary intestinal rehabilitation teams improve survival. ↗

▶ Ep 108 · 9:26

clinical Second-generation lipid emulsions attempt to reduce omega-6 exposure by diluting the soybean component. ↗

▶ Ep 108 · 9:26

host_summary Second-generation lipid emulsions attempt to reduce omega-6 exposure by diluting the soybean component. ↗

▶ Ep 108 · 9:43

host_summary Omega-6 fatty acids promote inflammation while omega-3 fatty acids lead to a more anti-inflammatory response. ↗

▶ Ep 108 · 9:43

clinical Omega-6 fatty acids promote inflammation while omega-3 fatty acids lead to a more anti-inflammatory response. ↗

▶ Ep 108 · 11:12

clinical In utero, babies receive significant amounts of DHA and arachidonic acid through the placenta, but standard lipid emulsions in TPN fall short of providing these. ↗

▶ Ep 108 · 11:12

host_summary In utero, babies receive significant amounts of DHA and arachidonic acid through the placenta, but standard lipid emulsions in TPN fall short of providing these. ↗

▶ Ep 108 · 13:09

host_summary Kitelock addresses three issues of central line complications: organisms, clot/thrombosis, and biofilm. ↗

▶ Ep 108 · 13:09

clinical Kitelock addresses three issues of central line complications: organisms, clot/thrombosis, and biofilm. ↗

▶ Ep 108 · 14:19

clinical Patients with Type 3 short bowel syndrome have the best prognosis because they still have residual ileum. ↗

▶ Ep 108 · 14:19

host_summary Patients with Type 3 short bowel syndrome have the best prognosis because they still have residual ileum. ↗

▶ Ep 108 · 14:36

host_summary The ileum is where GLP-2 is naturally produced. ↗

▶ Ep 108 · 14:36

clinical The ileum is where GLP-2 is naturally produced. ↗

▶ Ep 108 · 14:39

host_summary Without an ileum, infants cannot generate the necessary GLP-2 hormone surge to drive their own intestinal adaptation. ↗

▶ Ep 108 · 14:39

clinical Without an ileum, infants cannot generate the necessary GLP-2 hormone surge to drive their own intestinal adaptation. ↗

▶ Ep 108 · 16:54

host_summary Children have much greater adaptive potential than adults because of their inherent gut growth capacity. ↗

▶ Ep 108 · 16:54

clinical Children have much greater adaptive potential than adults because of their inherent gut growth capacity. ↗

▶ Ep 108 · 17:00

epidemiological The proportion of children reaching enteral autonomy has improved over the past 20 years. ↗

▶ Ep 108 · 17:00

host_summary The proportion of children reaching enteral autonomy has improved over the past 20 years. ↗

▶ Ep 108 · 17:06

host_summary Controlling liver disease buys time for intestinal adaptation. ↗

▶ Ep 108 · 17:06

clinical Controlling liver disease buys time for intestinal adaptation. ↗

Impact of social determinants of health on outcomes in pediatric short bowel syndrome...

▶ Ep 109 · 0:00

quote Can a child's zip code actually change their short bowel syndrome outcomes? ↗

▶ Ep 109 · 0:07

host_summary This was a retrospective cohort study of children with short bowel syndrome in an intestinal rehabilitation program, followed from 2006 to 2019. ↗

▶ Ep 109 · 0:16

host_summary The study asked whether social determinants of health predict outcomes like bloodstream infections, liver disease, and achieving enteral autonomy. ↗

▶ Ep 109 · 0:24

host_summary Social determinants of health do predict outcomes in pediatric short bowel syndrome in real ways. ↗

▶ Ep 109 · 0:24

quote And the answer was yes, in very real ways. ↗

▶ Ep 109 · 0:27

host_summary Distance from the hospital was associated with higher risks of serious complications in children with short bowel syndrome. ↗

▶ Ep 109 · 0:33

host_summary Parental education was linked with fewer central line infections in children with short bowel syndrome. ↗

▶ Ep 109 · 0:37

host_summary Social determinants need to be considered to support families of children with short bowel syndrome better. ↗

Islet Cell / TPIAT 10 entries

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

▶ Ep 4 · 0:00

quote What if curing a rare pancreatic tumor sets the stage for chronic pancreatitis? ↗

▶ Ep 4 · 0:09

epidemiological Solid pseudopapillary neoplasms are one of the most frequent pancreatic tumors in pediatric patients ↗

▶ Ep 4 · 0:15

clinical Surgery for solid pseudopapillary neoplasms is usually curative and outcomes are excellent ↗

▶ Ep 4 · 0:22

clinical In a single center study, 10 adolescent girls underwent surgical resection for solid pseudopapillary neoplasms ↗

▶ Ep 4 · 0:25

clinical 3 out of 10 patients developed acute recurrent or chronic pancreatitis after resection ↗

▶ Ep 4 · 0:32

clinical Every patient who developed ongoing pancreatitis had genetic risk factors like CFTR gene variants or pancreas divisum ↗

▶ Ep 4 · 0:32

quote Every patient who developed ongoing pancreatitis had genetic risk factors like the CFTR gene variant, or they had pancreas divisum. ↗

▶ Ep 4 · 0:40

clinical Some patients with post-resection pancreatitis ultimately required completion pancreatectomy ↗

▶ Ep 4 · 0:45

quote Even low grade tumors can carry high stakes consequences. ↗

▶ Ep 4 · 0:48

opinion Identifying genetic and anatomic risk factors before surgery may change management of patients with solid pseudopapillary neoplasms ↗

Necrotizing Enterocolitis 24 entries

STAT trial: stoma or intestinal anastomosis for necrotizing enterocolitis: a multicentre randomized controlled trial

▶ Ep 19 · 0:00

quote What's the best surgical approach for infants needing laparotomy, for necrotizing enterocolitis, anastomosis, or stoma formation? ↗

▶ Ep 19 · 0:13

host_summary The STAT trial was a randomized controlled trial in 12 centers worldwide. ↗

▶ Ep 19 · 0:13

host_summary The STAT trial looked at newborns who underwent laparotomy for necrotizing enterocolitis requiring intestinal resection from 2010 to 2020. ↗

▶ Ep 19 · 0:26

host_summary Infants were randomized to two surgical approaches: either anastomosis or stoma formation. ↗

▶ Ep 19 · 0:31

host_summary Infants undergoing primary anastomosis had a significantly less duration of requiring parenteral nutrition compared to those with stoma formation. ↗

▶ Ep 19 · 0:31

host_summary There was no difference in mortality between primary anastomosis and stoma formation groups. ↗

▶ Ep 19 · 0:31

host_summary There was no difference in unplanned surgeries between primary anastomosis and stoma formation groups. ↗

▶ Ep 19 · 0:43

host_summary Primary anastomosis is superior for enhancing recovery from necrotizing enterocolitis in infants and does not increase adverse outcomes. ↗

Availability, utilization, and barriers to bowel ultrasound for necrotizing enterocolitis...

▶ Ep 20 · 0:08

host_summary Bowel ultrasound is becoming an important tool for diagnosing necrotizing enterocolitis (NEC). ↗

▶ Ep 20 · 0:19

host_summary A national survey included more than 100 neonatologists, surgeons, and radiologists from 42 children's hospitals. ↗

▶ Ep 20 · 0:26

quote While bowel ultrasound was available in 83% of level 4 NICUs, clinicians reported using it inconsistently, most often only when X-rays. ↗

▶ Ep 20 · 0:26

host_summary Bowel ultrasound was available in 83% of level 4 NICUs. ↗

▶ Ep 20 · 0:26

host_summary Clinicians reported using bowel ultrasound inconsistently, most often only when X-rays were inconclusive. ↗

▶ Ep 20 · 0:36

host_summary The biggest barriers to bowel ultrasound use were lack of standardized protocols, limited provider training, and uncertainty about how bowel ultrasound should guide treatment decisions. ↗

▶ Ep 20 · 0:36

quote The biggest barriers weren't the technology itself, they were the lack of standardized protocols, limited provider training, and uncertainty about how bowel ultrasound should guide treatment decisions. ↗

▶ Ep 20 · 0:46

host_summary Wider adoption of bowel ultrasound for NEC will depend on better evidence, standardized guidelines, and improved clinician training. ↗

Update Course Rewind 2025: Updates in NEC Management

▶ Ep 21 · 2:06

host_summary For every 10 babies with surgical NEC, an X-ray might only catch one or two in the early stages (based on 13% sensitivity) ↗

▶ Ep 21 · 2:15

host_summary A 2023 study in Pediatric Radiology suggests ultrasound can detect bowel wall thinning, perfusion abnormalities, and silent fluid collections that X-ray misses ↗

▶ Ep 21 · 5:00

host_summary The benefit of primary anastomosis may not be seen in immediate survival but appears in the long run ↗

▶ Ep 21 · 5:18

host_summary In clip-and-drop technique, surgeon removes necrotic segment, staples the ends, and returns in 24-48 hours to check gut hemodynamics before committing to stoma or anastomosis ↗

▶ Ep 21 · 6:55

host_summary In the SAT trial, mortality was similar between primary anastomosis and stoma groups ↗

▶ Ep 21 · 6:56

host_summary Babies who received primary anastomosis got off parenteral nutrition significantly sooner than those with stoma ↗

▶ Ep 21 · 7:06

host_summary Babies with primary anastomosis were able to return to enteral feeds more quickly and had fewer intestinal complications than those with stoma ↗

▶ Ep 21 · 7:52

host_summary Mucous fistula refeeding involves recycling upper stoma output into the lower bowel to keep it healthy ↗

Neuroblastoma 18 entries

Quick Literature Updates Ep 19

▶ Ep 21 · 1:00

guideline APSA created a peer support program for pediatric surgeons in 2020. ↗

▶ Ep 21 · 1:00

quote The American Pediatric Surgical Association or the APSA created a peer support program for pediatric surgeons in 2020. ↗

▶ Ep 21 · 1:00

quote The American Pediatric Surgical Association or the APSA created a peer support program for pediatric surgeons in 2020. ↗

▶ Ep 21 · 1:00

host_summary APSA created a peer support program for pediatric surgeons in 2020. ↗

▶ Ep 21 · 1:12

host_summary The goal of the APSA peer support program was to support surgeons after traumatic events. ↗

▶ Ep 21 · 1:12

quote Their goal was to support surgeons after traumatic events. ↗

▶ Ep 21 · 1:12

guideline The goal of the APSA peer support program was to support surgeons after traumatic events. ↗

▶ Ep 21 · 1:12

quote Their goal was to support surgeons after traumatic events. ↗

▶ Ep 21 · 1:16

epidemiological The most common referral reasons for the peer support program were toxic work environments and adverse events. ↗

▶ Ep 21 · 1:16

quote The most common referral reasons were toxic work environments and adverse events. ↗

▶ Ep 21 · 1:16

quote The most common referral reasons were toxic work environments and adverse events. ↗

▶ Ep 21 · 1:16

host_summary The most common referral reasons for the peer support program were toxic work environments and adverse events. ↗

▶ Ep 21 · 1:20

host_summary 50 surgeons total agreed to receive training on how to be a supporter in the APSA program. ↗

▶ Ep 21 · 1:20

epidemiological 50 surgeons total agreed to receive training on how to be a supporter in the APSA program. ↗

▶ Ep 21 · 1:25

epidemiological Over 80% of trained peer supporters were able to use these peer support skills informally with colleagues, partners, and trainees. ↗

▶ Ep 21 · 1:25

host_summary Over 80% of trained peer supporters were able to use these peer support skills informally with colleagues, partners, and trainees. ↗

▶ Ep 21 · 1:31

host_summary The peer support program shows that this type of support system can work really well to help surgeons heal from traumatic experiences and toxic work environments. ↗

▶ Ep 21 · 1:31

opinion The peer support program shows that this type of support system can work really well to help surgeons heal from traumatic experiences and toxic work environments. ↗

Obesity 37 entries

Clinical Research Facilitators, Barriers, and Preferences of Parents of Children With Overweight...

▶ Ep 8 · 0:00

quote Why is it so hard to enroll families in childhood obesity research? ↗

▶ Ep 8 · 0:07

epidemiological Researchers surveyed more than 100 parents of children with overweight or obesity to understand what influences their decision to participate in research ↗

▶ Ep 8 · 0:15

epidemiological Mistrust, time demands, and social pressure are barriers that make it harder for parents to participate in childhood obesity research ↗

▶ Ep 8 · 0:15

epidemiological Parents reported more reasons to participate in childhood obesity research than reasons not to participate ↗

▶ Ep 8 · 0:26

epidemiological Research perceptions varied by family characteristics ↗

▶ Ep 8 · 0:30

opinion To improve childhood obesity research, studies need to be easier to join, reduce participation burden, and build trust with families from the beginning ↗

▶ Ep 8 · 0:30

quote The takeaway, if we want better childhood obesity research, we need to make studies easier to join, reduce participation burden, and build trust with families from the very beginning. ↗

Identifying & Managing Eating Disorders in Pediatric Obesity Treatment: Current Practices in Weight

▶ Ep 9 · 0:00

quote Are we actually missing diagnosing eating disorders in kids being treated for obesity? ↗

▶ Ep 9 · 0:08

epidemiological A national survey examined pediatric weight management programs across the US regarding eating disorder screening practices ↗

▶ Ep 9 · 0:14

epidemiological Most programs are screening for eating disorders but not in a standardized way ↗

▶ Ep 9 · 0:14

quote Most programs are screening for eating disorders, but not in a very standardized way. ↗

▶ Ep 9 · 0:19

clinical Much of the screening is informal, using homegrown questionnaires or clinical judgment rather than validated tools ↗

▶ Ep 9 · 0:19

quote About 3/5% are doing some form of screening, but a lot of it is informal, Homegrown questionnaires or just clinical judgment rather than validated tools. ↗

▶ Ep 9 · 0:19

epidemiological About 60% of programs perform some form of eating disorder screening ↗

▶ Ep 9 · 0:29

epidemiological Medical providers lag behind behavioral health specialists by a wide margin when diagnosing conditions like binge eating disorder ↗

▶ Ep 9 · 0:29

quote Providers are generally comfortable screening, but when it comes to actually diagnosing things like binge eating disorder, medical providers lag behind behavioral health specialists by a wide margin. ↗

▶ Ep 9 · 0:29

epidemiological Providers are generally comfortable with screening for eating disorders ↗

▶ Ep 9 · 0:39

quote The biggest barriers, clinicians report not being trained enough, not knowing how to manage what they find, and lacking clear treatment pathways. ↗

▶ Ep 9 · 0:39

epidemiological Clinicians report not knowing how to manage eating disorders they identify as a barrier ↗

▶ Ep 9 · 0:39

epidemiological Clinicians report not being trained enough as a barrier to eating disorder management ↗

▶ Ep 9 · 0:39

epidemiological Clinicians report lacking clear treatment pathways for eating disorders as a barrier ↗

▶ Ep 9 · 0:47

opinion Medical providers may need more training for diagnosis and treatment of eating disorders in pediatric obesity settings ↗

Identifying & Managing Eating Disorders in Pediatric Obesity Treatment: Current Practices in Weight

▶ Ep 10 · 0:00

quote Are we actually missing diagnosing eating disorders in kids being treated for obesity? ↗

▶ Ep 10 · 0:08

epidemiological A national survey of pediatric weight management programs across the US was conducted ↗

▶ Ep 10 · 0:14

quote Most programs are screening for eating disorders, but not in a very standardized way. ↗

▶ Ep 10 · 0:14

epidemiological Most programs are screening for eating disorders, but not in a very standardized way ↗

▶ Ep 10 · 0:19

epidemiological About 60% of programs are doing some form of screening ↗

▶ Ep 10 · 0:19

epidemiological A lot of screening uses informal, homegrown questionnaires or just clinical judgment rather than validated tools ↗

▶ Ep 10 · 0:19

quote About 3/5% are doing some form of screening, but a lot of it is informal, Homegrown questionnaires or just clinical judgment rather than validated tools. ↗

▶ Ep 10 · 0:29

quote Providers are generally comfortable screening, but when it comes to actually diagnosing things like binge eating disorder, medical providers lag behind behavioral health specialists by a wide margin. ↗

▶ Ep 10 · 0:29

epidemiological Providers are generally comfortable screening for eating disorders ↗

▶ Ep 10 · 0:29

epidemiological When it comes to diagnosing binge eating disorder, medical providers lag behind behavioral health specialists by a wide margin ↗

▶ Ep 10 · 0:39

epidemiological Clinicians report not knowing how to manage eating disorders they find as a barrier ↗

▶ Ep 10 · 0:39

epidemiological Clinicians report not being trained enough as a barrier to eating disorder diagnosis and management ↗

▶ Ep 10 · 0:39

quote The biggest barriers, clinicians report not being trained enough, not knowing how to manage what they find, and lacking clear treatment pathways. ↗

▶ Ep 10 · 0:39

epidemiological Clinicians report lacking clear treatment pathways for eating disorders as a barrier ↗

▶ Ep 10 · 0:47

opinion Medical providers may need more training for diagnosis and treatment of eating disorders ↗

Osteosarcoma 8 entries

Update Course Rewind: Chest Wall Reconstruction 2024

▶ Ep 4 · 0:00

quote Would you know how to reconstruct a chest wall if you needed to? ↗

▶ Ep 4 · 0:51

clinical The histopathology report confirmed an aggressive osteosarcoma. ↗

▶ Ep 4 · 1:45

guideline There is a lack of clear evidence-based guidelines for reconstructive materials, but the priority is long-term durability, aesthetics, function, and accommodating future growth. ↗

▶ Ep 4 · 3:05

clinical Instead of using screws that came packaged with the plates, they used a K-wire drill to drill through the remaining ribs and then used Prolene sutures to secure the implant. ↗

▶ Ep 4 · 3:29

clinical Permacol is a surgical implant made of a porcine dermal collagen matrix that allows device placement. ↗

▶ Ep 4 · 4:12

clinical Doctor Mutch performed a further chest wall reconstruction where they excised the entire sternum, costochondral cartilages, and anterior ribs and replaced it with a cement mesh. ↗

▶ Ep 4 · 4:45

clinical There was one case of minor scoliosis on follow-up, which is being followed by the spinal team and so far has not needed intervention. ↗

▶ Ep 4 · 5:17

opinion Bioengineering of tissue replacement and 3D printing may be the way of the future in chest wall reconstructions. ↗

Pancreatitis 10 entries

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

▶ Ep 25 · 0:00

quote What if curing a rare pancreatic tumor sets the stage for chronic pancreatitis? ↗

▶ Ep 25 · 0:09

epidemiological Solid pseudopapillary neoplasms are one of the most frequent pancreatic tumors in pediatric patients ↗

▶ Ep 25 · 0:15

clinical Surgery for solid pseudopapillary neoplasms is usually curative and outcomes are excellent ↗

▶ Ep 25 · 0:22

clinical In a single center study, 10 adolescent girls underwent surgical resection for solid pseudopapillary neoplasms ↗

▶ Ep 25 · 0:25

clinical 3 out of 10 patients developed acute recurrent or chronic pancreatitis after resection ↗

▶ Ep 25 · 0:32

quote Every patient who developed ongoing pancreatitis had genetic risk factors like the CFTR gene variant, or they had pancreas divisum. ↗

▶ Ep 25 · 0:32

clinical Every patient who developed ongoing pancreatitis had genetic risk factors like CFTR gene variants or pancreas divisum ↗

▶ Ep 25 · 0:40

clinical Some patients with post-resection pancreatitis ultimately required completion pancreatectomy ↗

▶ Ep 25 · 0:45

quote Even low grade tumors can carry high stakes consequences. ↗

▶ Ep 25 · 0:48

opinion Identifying genetic and anatomic risk factors before surgery may change management of patients with solid pseudopapillary neoplasms ↗

Pectus Excavatum 102 entries

Pectus Bar Dislocation: Comparison Between Three Different Stabilization Techniques Adopted in a Single Centre

▶ Ep 45 · 0:13

epidemiological The study was an observational perspective study conducted in Italy from 2013 to 2022. ↗

▶ Ep 45 · 0:13

epidemiological The study included 468 patients around 15 years old. ↗

▶ Ep 45 · 0:23

epidemiological Surgeons placed 733 bars total across the patient cohort. ↗

▶ Ep 45 · 0:31

clinical Bar dislocation is defined as when a bar rotates more than 30 degrees out of place. ↗

▶ Ep 45 · 0:31

quote Dislocation is when a bar rotates more than 30 degrees out of place. ↗

▶ Ep 45 · 0:43

clinical None of the patients with bridge fixation had dislocated bars. ↗

▶ Ep 45 · 0:43

quote None of the patients with bridge fixation had dislocated bars compared to those who underwent the single bar technique. ↗

Update Course Rewind: Cryoanalgesia in Pectus Cases 2024

▶ Ep 46 · 0:57

host_summary Cryoanalgesia is a minimally invasive procedure to repair pectus excavatum or alleviate pain during surgery on the chest wall that temporarily blocks nerve conduction along peripheral nerve pathways and relieves pain by freezing the affected nerve. ↗

▶ Ep 46 · 0:57

clinical Cryoanalgesia is a minimally invasive procedure to repair pectus excavatum or alleviate pain during surgery on the chest wall that temporarily blocks nerve conduction along peripheral nerve pathways and relieves pain by freezing the affected nerve. ↗

▶ Ep 46 · 1:30

host_summary The freeze point is in the posterior axillary line, 4 centimeters from the vertebral column. ↗

▶ Ep 46 · 1:30

clinical The freeze point is in the posterior axillary line, 4 centimeters from the vertebral column. ↗

▶ Ep 46 · 1:36

clinical With the original cryoprobe, it's a 2-minute freeze cycle. ↗

▶ Ep 46 · 1:36

host_summary With the original cryoprobe, it's a 2-minute freeze cycle. ↗

▶ Ep 46 · 2:02

host_summary Subpleural injection with 0.25% marcaine with epinephrine works immediately, as opposed to the 8 to 10 hour delay with the cryo nerve block. ↗

▶ Ep 46 · 2:02

clinical Subpleural injection with 0.25% marcaine with epinephrine works immediately, as opposed to the 8 to 10 hour delay with the cryo nerve block. ↗

▶ Ep 46 · 2:13

clinical Subpleural injection takes only 15 seconds per interspace. ↗

▶ Ep 46 · 2:13

host_summary Subpleural injection takes only 15 seconds per interspace. ↗

▶ Ep 46 · 2:26

epidemiological 50% of the update course audience has never used cryoanalgesia. ↗

▶ Ep 46 · 2:26

host_summary 50% of the update course audience has never used cryoanalgesia. ↗

▶ Ep 46 · 2:33

epidemiological About 40% of the update course responders answered that cost is the main reason they don't use cryoanalgesia. ↗

▶ Ep 46 · 2:33

host_summary About 40% of the update course responders answered that cost is the main reason they don't use cryoanalgesia. ↗

▶ Ep 46 · 2:55

host_summary Doing T3 to T8 bilaterally with the new probe saves almost 30 minutes. ↗

▶ Ep 46 · 2:55

clinical Doing T3 to T8 bilaterally with the new probe saves almost 30 minutes. ↗

▶ Ep 46 · 3:10

host_summary The new probe has improved shaft insulation so that it can actually touch the lung, since it only reaches room temperature. ↗

▶ Ep 46 · 3:10

clinical The new probe has improved shaft insulation so that it can actually touch the lung, since it only reaches room temperature. ↗

▶ Ep 46 · 3:48

clinical The Chicago study was limited because they did not measure pain scores or compare the 1 minute freeze cycle directly to 2-minute freeze cycles. ↗

▶ Ep 46 · 3:48

host_summary The Chicago study was limited because they did not measure pain scores or compare the 1 minute freeze cycle directly to 2-minute freeze cycles. ↗

▶ Ep 46 · 4:13

clinical There is a risk of pneumothorax from the lung tearing after inadvertent adhesion to the cryoprobe. ↗

▶ Ep 46 · 4:13

host_summary There is a risk of pneumothorax from the lung tearing after inadvertent adhesion to the cryoprobe. ↗

▶ Ep 46 · 4:19

host_summary The double lumen endotracheal tube helps minimize pneumothorax risk by deflating the lung and maximizing working space so that the cryoprobe does not touch the lung. ↗

▶ Ep 46 · 4:19

clinical The double lumen endotracheal tube helps minimize pneumothorax risk by deflating the lung and maximizing working space so that the cryoprobe does not touch the lung. ↗

▶ Ep 46 · 4:39

clinical A major advantage of the double lumen tube over the single lumen tube is that it helps prevent the nerve block from being done too far anteriorly, which will make the nerve block ineffective. ↗

▶ Ep 46 · 4:39

host_summary A major advantage of the double lumen tube over the single lumen tube is that it helps prevent the nerve block from being done too far anteriorly, which will make the nerve block ineffective. ↗

▶ Ep 46 · 5:13

host_summary Doctor Sung Kim did a cadaver study at UCSF showing that 18% of the lateral cutaneous branch nerves are posterior to the mid axillary line. ↗

▶ Ep 46 · 5:13

clinical Doctor Sung Kim did a cadaver study at UCSF showing that 18% of the lateral cutaneous branch nerves are posterior to the mid axillary line. ↗

▶ Ep 46 · 5:31

clinical Some surgeons have success with using a single lumen tube doing a mediastinal dissection, going across from the right to the left side. ↗

▶ Ep 46 · 5:31

host_summary Some surgeons have success with using a single lumen tube doing a mediastinal dissection, going across from the right to the left side. ↗

▶ Ep 46 · 5:58

host_summary In a small group of patients, Doctor Kim cryoablated the main intercostal nerve at the bottom of the rib and the collateral branch at the top of the rib below it. ↗

▶ Ep 46 · 5:58

clinical In a small group of patients, Doctor Kim cryoablated the main intercostal nerve at the bottom of the rib and the collateral branch at the top of the rib below it. ↗

▶ Ep 46 · 6:12

host_summary As you move down toward T7 and T8, the interspace will widen enough to freeze both the main nerve and collateral branch. ↗

▶ Ep 46 · 6:12

clinical As you move down toward T7 and T8, the interspace will widen enough to freeze both the main nerve and collateral branch. ↗

▶ Ep 46 · 6:32

host_summary In the UCSF study, when they did 2 freeze points per interspace on 22 patients, the length of stay decreased from 2 days to 1 day. ↗

▶ Ep 46 · 6:32

clinical In the UCSF study, when they did 2 freeze points per interspace on 22 patients, the length of stay decreased from 2 days to 1 day. ↗

▶ Ep 46 · 6:42

clinical In the UCSF study, 9 out of the 22 patients reported pain scores of 0. ↗

▶ Ep 46 · 6:42

host_summary In the UCSF study, 9 out of the 22 patients reported pain scores of 0. ↗

▶ Ep 46 · 7:00

host_summary Cryoanalgesia controls pain and decreases hospital length of stay with few short-term complications. ↗

▶ Ep 46 · 7:00

clinical Cryoanalgesia controls pain and decreases hospital length of stay with few short-term complications. ↗

Six Years of Quality Improvement in Pectus Excavatum Repair: Implementation of Intercostal Nerve Cryoablation and ERAS Protocols for Patients Undergoing Nuss Procedure

▶ Ep 47 · 0:00

quote How do intercostal nerve cryoablation and enhanced recovery after surgery, also known as ARIS protocols, affect pain management, opioid use, length of stay, and recovery in pectus excavatum patients undergoing the NES procedure? ↗

▶ Ep 47 · 0:19

epidemiological The study was a retrospective cohort study that looked at 62 patients from 2017 to 2023 ↗

▶ Ep 47 · 0:25

clinical Intercostal nerve cryoablation slightly increased surgery time in pectus excavatum patients undergoing the Nuss procedure ↗

▶ Ep 47 · 0:25

clinical Intercostal nerve cryoablation slightly increased early postoperative pain in pectus excavatum patients undergoing the Nuss procedure ↗

▶ Ep 47 · 0:25

clinical Intercostal nerve cryoablation significantly reduced hospital stays in pectus excavatum patients undergoing the Nuss procedure ↗

▶ Ep 47 · 0:25

clinical Intercostal nerve cryoablation significantly reduced opioid use in pectus excavatum patients undergoing the Nuss procedure ↗

▶ Ep 47 · 0:36

clinical Adding ERAS protocols to cryoablation further reduced opioid needs in pectus excavatum patients undergoing the Nuss procedure ↗

▶ Ep 47 · 0:36

clinical Adding ERAS protocols to cryoablation further reduced early pain scores in pectus excavatum patients undergoing the Nuss procedure ↗

▶ Ep 47 · 0:40

opinion Combining cryoablation and ERAS protocols leads to better outcomes and pain management in pectus excavatum patients undergoing the Nuss procedure ↗

▶ Ep 47 · 0:40

quote These findings suggest that combining cryoablation and ARR protocols leads to better outcomes and pain management. ↗

Cardiopulmonary Impact of the Minimally Invasive Repair of Pectus Excavatum in Pediatric Patients: A Prospective Pilot Study

▶ Ep 49 · 0:00

quote Does minimally invasive repair of pectus excavatum improve heart and lung function during exercise in pediatric patients? ↗

▶ Ep 49 · 0:12

clinical This was a prospective pilot study ↗

▶ Ep 49 · 0:12

clinical Study included patients under 18 who had cardiopulmonary exercise testing before minimally invasive repair of pectus excavatum and then after removal of their pectus bar ↗

▶ Ep 49 · 0:24

clinical Results showed a significant improvement in O2 pulse after the repair ↗

▶ Ep 49 · 0:24

clinical O2 pulse is a measure of how much oxygen the heart pumps per beat ↗

▶ Ep 49 · 0:24

clinical Improved O2 pulse suggests better heart function after the repair ↗

▶ Ep 49 · 0:24

clinical 25 patients total completed both tests ↗

▶ Ep 49 · 0:37

opinion The improvement may reflect relief of cardiac compression that was present preoperatively due to pectus excavatum ↗

▶ Ep 49 · 0:43

quote The main takeaway is that minimally invasive repair of pectus excavatum does appear to improve heart performance during exercise. ↗

▶ Ep 49 · 0:43

clinical Minimally invasive repair of pectus excavatum does appear to improve heart performance during exercise ↗

Update Course Rewind: Part 1 Non-Pectus Uses of Cryoanalgesia 2024

▶ Ep 52 · 1:02

clinical Cryoanalgesia temporarily blocks nerve conduction along peripheral nerve pathways by freezing the affected nerve ↗

▶ Ep 52 · 1:02

host_summary Cryoanalgesia temporarily blocks nerve conduction along peripheral nerve pathways by freezing the affected nerve ↗

▶ Ep 52 · 1:25

clinical When fibrous outer neural structures remain intact, axons can regenerate in 4 to 6 weeks ↗

▶ Ep 52 · 1:25

host_summary When fibrous outer neural structures remain intact, axons can regenerate in 4 to 6 weeks ↗

▶ Ep 52 · 1:57

host_summary Epidurals usually only give pain relief for a few days ↗

▶ Ep 52 · 1:57

host_summary Cryoanalgesia can help with pain control all through the recovery period ↗

▶ Ep 52 · 1:57

clinical Epidurals usually only give pain relief for a few days ↗

▶ Ep 52 · 1:57

clinical Cryoanalgesia can help with pain control all through the recovery period ↗

▶ Ep 52 · 2:23

clinical At T10 level or lower, cryoanalgesia can cause pseudohernias on the abdominal wall from affecting motor branches ↗

▶ Ep 52 · 2:23

host_summary At T10 level or lower, cryoanalgesia can cause pseudohernias on the abdominal wall from affecting motor branches ↗

▶ Ep 52 · 2:44

clinical A cardiac probe used for ablations can be used in smaller children ↗

▶ Ep 52 · 2:44

host_summary A cardiac probe used for ablations can be used in smaller children ↗

▶ Ep 52 · 2:58

host_summary The newest probe has shaft insulation that only reaches room temperature, eliminating skin freeze risk as only the probe tip gets cold ↗

▶ Ep 52 · 2:58

clinical The newest probe has shaft insulation that only reaches room temperature, eliminating skin freeze risk as only the probe tip gets cold ↗

▶ Ep 52 · 3:21

clinical Patients were able to be discharged home without any narcotic prescriptions ↗

▶ Ep 52 · 3:21

host_summary Patients were able to be discharged home without any narcotic prescriptions ↗

▶ Ep 52 · 3:24

host_summary With cryoanalgesia, surgeons do not have to wait for a regional anesthesia team ↗

▶ Ep 52 · 3:24

clinical With cryoanalgesia, surgeons do not have to wait for a regional anesthesia team ↗

▶ Ep 52 · 3:40

clinical The intercostal nerve cryoablation group used 137 oral morphine equivalents during hospital stay compared to 533 in the regional nerve block group ↗

▶ Ep 52 · 3:40

host_summary The intercostal nerve cryoablation group used 137 oral morphine equivalents during hospital stay compared to 533 in the regional nerve block group ↗

Update Course Rewind: Part 2 Non-Pectus Uses of Cryoanalgesia 2024

▶ Ep 53 · 0:56

clinical Cryoablation is not limited to thoracotomy or thoracoscopy; there are novel ways to use cryotherapy in a percutaneous approach. ↗

▶ Ep 53 · 1:21

clinical Slipping rib syndrome is a condition with cartilaginous union at the end of the ribs, particularly for floating ribs but also for false ribs. ↗

▶ Ep 53 · 1:58

epidemiological Slipping rib syndrome is more common in teenage girls than boys. ↗

▶ Ep 53 · 2:01

clinical Patients with slipping rib syndrome often present with somatic tenderness of the abdominal wall that can be elicited by asking them to flex or crunch their abdominal muscles, but they really won't have a visceral type tenderness. ↗

▶ Ep 53 · 2:25

clinical If patients get pain relief from the intercostal block with ropivacaine and dexamethasone, the next step is to refer them to interventional radiology for ultrasound-guided cryotherapy. ↗

▶ Ep 53 · 3:13

clinical Outcomes from using cryoablation for slipping rib syndrome included reduced pain scores, reduced narcotic use, and shorter length of stay in the hospital. ↗

▶ Ep 53 · 3:19

clinical Patients treated with cryoablation for slipping rib syndrome were able to resume normal activities much earlier. ↗

Quick Literature Updates Ep 24

▶ Ep 54 · 1:03

epidemiological The Donnati et al. study was an observational prospective study in Italy from 2013 to 2022 on 468 patients around 15 years old. ↗

▶ Ep 54 · 1:13

epidemiological Surgeons placed 733 pectus bars total across the 468 patients in the Donnati study. ↗

▶ Ep 54 · 1:21

clinical Bar dislocation is defined as when a pectus bar rotates more than 30 degrees out of place. ↗

▶ Ep 54 · 1:28

quote Bridge fixation was significantly more stable than single bar fixation. ↗

▶ Ep 54 · 1:28

clinical Bridge fixation was significantly more stable than single bar fixation for pectus repair. ↗

▶ Ep 54 · 1:33

clinical None of the patients with bridge fixation had dislocated bars compared to those who underwent the single bar technique. ↗

▶ Ep 54 · 1:33

quote None of the patients with bridge fixation had dislocated bars compared to those who underwent the single bar technique. ↗

▶ Ep 54 · 1:39

opinion Bridge fixation is the best technique for preventing bar dislocation in pectus excavatum patients. ↗

Peritoneal Dialysis Access 40 entries

Practice Patterns and Outcomes of Hemodialysis in Infants Undergoing Congenital Heart Surgery in th

▶ Ep 9 · 0:00

quote Does it matter where a baby receives care after heart surgery? ↗

▶ Ep 9 · 0:07

epidemiological 1% of infants can develop severe acute kidney injury and require dialysis after congenital heart surgery ↗

▶ Ep 9 · 0:14

epidemiological For infants that needed hemodialysis after congenital heart surgery, one-year survival was 46% ↗

▶ Ep 9 · 0:14

epidemiological For infants that did not need hemodialysis after congenital heart surgery, one-year survival was 94% ↗

▶ Ep 9 · 0:23

clinical Most infants requiring dialysis after congenital heart surgery received continuous renal replacement therapy rather than intermittent dialysis ↗

▶ Ep 9 · 0:30

quote Where the baby was treated mattered a lot. ↗

▶ Ep 9 · 0:33

epidemiological Hospitals that use dialysis more frequently had 3 times higher hospital survival for infants after congenital heart surgery ↗

▶ Ep 9 · 0:33

epidemiological Hospitals that use dialysis more frequently had double the 1-year survival rate for infants after congenital heart surgery ↗

▶ Ep 9 · 0:39

epidemiological Dialysis after infant heart surgery is rare ↗

▶ Ep 9 · 0:44

opinion Outcomes may improve when infants requiring dialysis after heart surgery are treated at a center with more experience in using dialysis ↗

Practice Patterns and Outcomes of Hemodialysis in Infants Undergoing Congenital Heart Surgery in the

▶ Ep 10 · 0:00

quote Does it matter where a baby receives care after heart surgery? ↗

▶ Ep 10 · 0:07

epidemiological 1% of infants can develop severe acute kidney injury and require dialysis after congenital heart surgery ↗

▶ Ep 10 · 0:14

clinical For infants not needing hemodialysis after congenital heart surgery, one-year survival was 94% ↗

▶ Ep 10 · 0:14

clinical For infants needing hemodialysis after congenital heart surgery, one-year survival was 46% ↗

▶ Ep 10 · 0:23

clinical Most infants requiring dialysis after congenital heart surgery received continuous renal replacement therapy rather than intermittent dialysis ↗

▶ Ep 10 · 0:30

quote Where the baby was treated mattered a lot. ↗

▶ Ep 10 · 0:33

clinical Hospitals that use dialysis more frequently had double the 1-year survival rate for infants after congenital heart surgery ↗

▶ Ep 10 · 0:33

clinical Hospitals that use dialysis more frequently had 3 times higher hospital survival for infants after congenital heart surgery ↗

▶ Ep 10 · 0:39

epidemiological Dialysis after infant heart surgery is rare ↗

▶ Ep 10 · 0:44

opinion Outcomes may improve when infants requiring dialysis after heart surgery are treated at a center with more experience in using dialysis ↗

Practice Patterns and Outcomes of Hemodialysis in Infants Undergoing Congenital Heart Surgery in the

▶ Ep 11 · 0:00

quote Does it matter where a baby receives care after heart surgery? ↗

▶ Ep 11 · 0:07

epidemiological 1% of infants can develop severe acute kidney injury and require dialysis after congenital heart surgery ↗

▶ Ep 11 · 0:14

clinical For infants needing hemodialysis after congenital heart surgery, one-year survival was 46% ↗

▶ Ep 11 · 0:14

clinical For infants not needing hemodialysis after congenital heart surgery, one-year survival was 94% ↗

▶ Ep 11 · 0:23

clinical Most infants requiring dialysis after congenital heart surgery received continuous renal replacement therapy rather than intermittent dialysis ↗

▶ Ep 11 · 0:30

quote Where the baby was treated mattered a lot. ↗

▶ Ep 11 · 0:33

clinical Hospitals that use dialysis more frequently had double the 1-year survival rate for infants after congenital heart surgery ↗

▶ Ep 11 · 0:33

clinical Hospitals that use dialysis more frequently had 3 times higher hospital survival for infants after congenital heart surgery ↗

▶ Ep 11 · 0:39

epidemiological Dialysis after infant heart surgery is rare ↗

▶ Ep 11 · 0:44

opinion Outcomes may improve when infants requiring dialysis after heart surgery are treated at a center with more experience in using dialysis ↗

Practice Patterns and Outcomes of Hemodialysis in Infants Undergoing Congenital Heart Surgery...

▶ Ep 12 · 0:00

quote Does it matter where a baby receives care after heart surgery? ↗

▶ Ep 12 · 0:07

epidemiological 1% of infants develop severe acute kidney injury requiring dialysis after congenital heart surgery ↗

▶ Ep 12 · 0:14

epidemiological One-year survival for infants requiring hemodialysis after congenital heart surgery is 46% ↗

▶ Ep 12 · 0:14

epidemiological One-year survival for infants not requiring hemodialysis after congenital heart surgery is 94% ↗

▶ Ep 12 · 0:23

clinical Most infants requiring dialysis after congenital heart surgery received continuous renal replacement therapy rather than intermittent dialysis ↗

▶ Ep 12 · 0:30

quote Where the baby was treated mattered a lot. ↗

▶ Ep 12 · 0:33

epidemiological Hospitals that use dialysis more frequently had double the 1-year survival rate for infants after congenital heart surgery ↗

▶ Ep 12 · 0:33

epidemiological Hospitals that use dialysis more frequently had 3 times higher hospital survival for infants after congenital heart surgery ↗

▶ Ep 12 · 0:39

epidemiological Dialysis after infant heart surgery is rare ↗

▶ Ep 12 · 0:44

clinical Outcomes for infants requiring dialysis after heart surgery may improve when treated at centers with more experience in using dialysis ↗

Rectal Prolapse 6 entries

Morbidity of Rectal Prolapse Repair After Surgery for Anorectal Malformation

▶ Ep 4 · 0:00

quote What if the safest move for rectal prolapse after anorectal malformation surgery is not to repair it? ↗

▶ Ep 4 · 0:11

epidemiological A study examined 85 children treated for rectal prolapse after anorectal malformation surgery ↗

▶ Ep 4 · 0:16

epidemiological Approximately 30% of children had recurrence of prolapse requiring another repair ↗

▶ Ep 4 · 0:20

clinical Children without symptoms from prolapse at initial presentation were more likely to develop stricture later ↗

▶ Ep 4 · 0:26

opinion Surgical repair of asymptomatic rectal prolapse may not be indicated because the treatment itself carries risks ↗

▶ Ep 4 · 0:26

quote surgeons need to think twice before rushing into repair if the prolapse isn't causing big symptoms, because the treatment itself can carry risks ↗

Sarcoma (Ewing/Rhabdo) 16 entries

Update Course Rewind: Chest Wall Reconstruction 2024

▶ Ep 30 · 0:00

quote Would you know how to reconstruct a chest wall if you needed to? ↗

▶ Ep 30 · 0:00

quote Would you know how to reconstruct a chest wall if you needed to? ↗

▶ Ep 30 · 0:51

clinical The histopathology report confirmed an aggressive osteosarcoma. ↗

▶ Ep 30 · 0:51

host_summary The histopathology report confirmed an aggressive osteosarcoma. ↗

▶ Ep 30 · 1:45

host_summary There is a lack of clear evidence-based guidelines for reconstructive materials, but the priority is long-term durability, aesthetics, function, and accommodating future growth. ↗

▶ Ep 30 · 1:45

guideline There is a lack of clear evidence-based guidelines for reconstructive materials, but the priority is long-term durability, aesthetics, function, and accommodating future growth. ↗

▶ Ep 30 · 3:05

host_summary Instead of using screws that came packaged with the plates, they used a K-wire drill to drill through the remaining ribs and then used Prolene sutures to secure the implant. ↗

▶ Ep 30 · 3:05

clinical Instead of using screws that came packaged with the plates, they used a K-wire drill to drill through the remaining ribs and then used Prolene sutures to secure the implant. ↗

▶ Ep 30 · 3:29

clinical Permacol is a surgical implant made of a porcine dermal collagen matrix that allows device placement. ↗

▶ Ep 30 · 3:29

host_summary Permacol is a surgical implant made of a porcine dermal collagen matrix that allows device placement. ↗

▶ Ep 30 · 4:12

host_summary Doctor Mutch performed a further chest wall reconstruction where they excised the entire sternum, costochondral cartilages, and anterior ribs and replaced it with a cement mesh. ↗

▶ Ep 30 · 4:12

clinical Doctor Mutch performed a further chest wall reconstruction where they excised the entire sternum, costochondral cartilages, and anterior ribs and replaced it with a cement mesh. ↗

▶ Ep 30 · 4:45

host_summary There was one case of minor scoliosis on follow-up, which is being followed by the spinal team and so far has not needed intervention. ↗

▶ Ep 30 · 4:45

clinical There was one case of minor scoliosis on follow-up, which is being followed by the spinal team and so far has not needed intervention. ↗

▶ Ep 30 · 5:17

host_summary Bioengineering of tissue replacement and 3D printing may be the way of the future in chest wall reconstructions. ↗

▶ Ep 30 · 5:17

opinion Bioengineering of tissue replacement and 3D printing may be the way of the future in chest wall reconstructions. ↗

Short Bowel Syndrome 14 entries

Outcomes of Children With Short Bowel Syndrome: Experiences in a Multidisciplinary Intestinal Rehabilitation Unit Over Two Decades

▶ Ep 8 · 0:10

host_summary This retrospective study examined 64 pediatric patients with short bowel syndrome managed by a multidisciplinary intestinal rehab program between 2001 and 2022. ↗

▶ Ep 8 · 0:22

host_summary Survival rates of children with short bowel syndrome improved over time in the study period. ↗

▶ Ep 8 · 0:22

host_summary 78% of patients with short bowel syndrome were able to wean off parenteral nutrition. ↗

▶ Ep 8 · 0:22

host_summary 89% of patients with short bowel syndrome in the study survived. ↗

▶ Ep 8 · 0:31

host_summary Introduction of fish oil-based parenteral nutrition in 2007 improved survival in pediatric short bowel syndrome patients. ↗

▶ Ep 8 · 0:31

host_summary Presence of intestinal failure associated liver disease affected survival in pediatric short bowel syndrome patients. ↗

Impact of social determinants of health on outcomes in pediatric short bowel syndrome...

▶ Ep 10 · 0:00

quote Can a child's zip code actually change their short bowel syndrome outcomes? ↗

▶ Ep 10 · 0:07

host_summary This was a retrospective cohort study of children with short bowel syndrome in an intestinal rehabilitation program, followed from 2006 to 2019. ↗

▶ Ep 10 · 0:16

host_summary The study asked whether social determinants of health predict outcomes like bloodstream infections, liver disease, and achieving enteral autonomy. ↗

▶ Ep 10 · 0:24

host_summary Social determinants of health do predict outcomes in pediatric short bowel syndrome in real ways. ↗

▶ Ep 10 · 0:24

quote And the answer was yes, in very real ways. ↗

▶ Ep 10 · 0:27

host_summary Distance from the hospital was associated with higher risks of serious complications in children with short bowel syndrome. ↗

▶ Ep 10 · 0:33

host_summary Parental education was linked with fewer central line infections in children with short bowel syndrome. ↗

▶ Ep 10 · 0:37

host_summary Social determinants need to be considered to support families of children with short bowel syndrome better. ↗

Single Ventricle / HLHS 22 entries

Outcomes of Fontan Patients Undergoing Combined Heart - Liver Transplantation in Pediatric Hospitals Across the U.S.

▶ Ep 35 · 0:00

quote What happens when kids who underwent Fontan procedure don't just need a new heart, but a new liver as well. ↗

▶ Ep 35 · 0:11

epidemiological Combined heart-liver transplantation is happening more often in Fontan patients ↗

▶ Ep 35 · 0:11

epidemiological Liver disease is becoming a rising issue in Fontan patients ↗

▶ Ep 35 · 0:11

epidemiological More Fontan patients are surviving into adolescence and adulthood ↗

▶ Ep 35 · 0:21

clinical The study examined children and young adults undergoing combined heart-liver transplant at hospitals across the US in the last few years ↗

▶ Ep 35 · 0:28

clinical Many of the patients in the study had hypoplastic left heart syndrome ↗

▶ Ep 35 · 0:36

clinical About 85% of patients survived at 1 year after combined heart-liver transplant ↗

▶ Ep 35 · 0:36

clinical Long-term outcomes after combined heart-liver transplant were excellent ↗

▶ Ep 35 · 0:41

clinical Three-year survival after combined heart-liver transplant was basically identical to patients who received heart transplant alone ↗

▶ Ep 35 · 0:48

quote The big takeaway, combined heart liver transplant is effective and increasingly common for Fontan patients with advanced liver disease. ↗

▶ Ep 35 · 0:48

clinical Combined heart-liver transplant is effective for Fontan patients with advanced liver disease ↗

▶ Ep 35 · 0:48

epidemiological Combined heart-liver transplant is increasingly common for Fontan patients with advanced liver disease ↗

Surgical and Catheter-Based Intervention in Pediatric Pulmonary Vein Stenosis

▶ Ep 37 · 0:00

quote Can you ever truly fix pulmonary vein stenosis? ↗

▶ Ep 37 · 0:06

clinical Pulmonary vein stenosis is a rare but serious condition where the veins from the lungs to the heart become narrowed ↗

▶ Ep 37 · 0:12

epidemiological A study from Cincinnati Children's examined 56 children comparing surgery versus catheter-based interventions for pulmonary vein stenosis ↗

▶ Ep 37 · 0:23

clinical Over time, catheter-based treatments became the preferred first option for pulmonary vein stenosis ↗

▶ Ep 37 · 0:28

clinical Surgery was reserved for complex cases involving multiple severely affected veins or other heart defects ↗

▶ Ep 37 · 0:34

clinical Recurrence of pulmonary vein stenosis remained common regardless of the initial intervention type ↗

▶ Ep 37 · 0:34

epidemiological 92% of children with pulmonary vein stenosis needed another intervention after initial treatment ↗

▶ Ep 37 · 0:34

epidemiological Most reinterventions for pulmonary vein stenosis occurred within the first year after initial treatment ↗

▶ Ep 37 · 0:45

quote So pulmonary vein stenosis isn't a one-time fix. ↗

▶ Ep 37 · 0:48

clinical Pulmonary vein stenosis requires ongoing surveillance, repeated interventions, and a long-term multidisciplinary approach ↗

Soft Tissue Sarcoma (lymph nodes) 18 entries

Update Course Rewind: Chest Wall Reconstruction 2024

▶ Ep 13 · 0:00

quote Would you know how to reconstruct a chest wall if you needed to? ↗

▶ Ep 13 · 0:51

clinical The histopathology report confirmed an aggressive osteosarcoma. ↗

▶ Ep 13 · 1:45

guideline There is a lack of clear evidence-based guidelines for reconstructive materials, but the priority is long-term durability, aesthetics, function, and accommodating future growth. ↗

▶ Ep 13 · 3:05

clinical Instead of using screws that came packaged with the plates, they used a K-wire drill to drill through the remaining ribs and then used Prolene sutures to secure the implant. ↗

▶ Ep 13 · 3:29

clinical Permacol is a surgical implant made of a porcine dermal collagen matrix that allows device placement. ↗

▶ Ep 13 · 4:12

clinical Doctor Mutch performed a further chest wall reconstruction where they excised the entire sternum, costochondral cartilages, and anterior ribs and replaced it with a cement mesh. ↗

▶ Ep 13 · 4:45

clinical There was one case of minor scoliosis on follow-up, which is being followed by the spinal team and so far has not needed intervention. ↗

▶ Ep 13 · 5:17

opinion Bioengineering of tissue replacement and 3D printing may be the way of the future in chest wall reconstructions. ↗

Appendectomy vs Right Hemicolectomy for Pediatric Neuroendocrine Tumor of the Appendix

▶ Ep 14 · 0:00

quote What if I told you kids with appendix tumors might not need the big surgery that doctors have been doing for decades? ↗

▶ Ep 14 · 0:06

clinical The speaker is affiliated with Cincinnati Children's Hospital ↗

▶ Ep 14 · 0:10

clinical Traditionally, children with neuroendocrine appendix tumors have been treated the same way as adults with right hemicolectomy ↗

▶ Ep 14 · 0:10

quote Traditionally, kids with neuroendocrine appendix tumors have been treated the same way as adults with a right hemicolectomy. ↗

▶ Ep 14 · 0:19

epidemiological A new national study examined over 1,300 children with neuroendocrine appendix tumors ↗

▶ Ep 14 · 0:24

clinical Survival rates were approximately 99% whether patients had appendectomy or right hemicolectomy, even with larger tumors or positive margins ↗

▶ Ep 14 · 0:24

quote Even when the tumors were larger or had positive margins, survival rates were almost perfect, like 99%, whether they just had an appendectomy or the bigger colectomy surgery. ↗

▶ Ep 14 · 0:35

opinion Appendectomy avoids putting pediatric patients through a much bigger operation with no added survival benefit compared to right hemicolectomy ↗

▶ Ep 14 · 0:35

opinion For pediatric patients, appendectomy alone is safe and effective for neuroendocrine tumors of the appendix ↗

▶ Ep 14 · 0:35

quote So the big takeaway, for kids, appendectomy alone is not only enough, it's safe, effective, and avoids putting them through a much bigger operation for no added benefit. ↗

Tracheoesophageal Fistula 20 entries

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

▶ Ep 11 · 0:15

host_summary 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. ↗

▶ Ep 11 · 0:47

host_summary Cincinnati Children's has one of the largest aerodigestive centers in the world. ↗

▶ Ep 11 · 0:55

host_summary The expert multidisciplinary team includes speech pathology, otolaryngology, gastroenterology, pulmonology, and pediatric general surgery. ↗

▶ Ep 11 · 1:37

host_summary The center provides coordinated multidisciplinary care to children with congenital or acquired complex digestive and airway disorders. ↗

▶ Ep 11 · 2:52

host_summary Video fluoroscopic swallowing study analyzes different phases of swallowing. ↗

▶ Ep 11 · 2:59

host_summary 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. ↗

▶ Ep 11 · 3:48

host_summary ENT looks at swallowing study results and helps stratify the risk of proceeding with airway reconstruction and decannulation. ↗

▶ Ep 11 · 3:54

host_summary In aerodigestive patients, ENT performs esophageal and airway reconstruction, cleft repair, drool procedures, and manages vocal folds and mobility. ↗

▶ Ep 11 · 4:19

host_summary GERD pathophysiology includes an incompetent lower esophageal sphincter. ↗

▶ Ep 11 · 4:42

host_summary General signs and symptoms of GERD include regurgitation, vomiting, and heartburn. ↗

▶ Ep 11 · 5:28

host_summary Data shows an increase in airway surgery complications in patients who were later found to have eosinophilic esophagitis. ↗

▶ Ep 11 · 5:40

host_summary Anatomic issues in aerodigestive patients include strictures that need balloon dilations or stenting. ↗

▶ Ep 11 · 6:13

host_summary When 25 patients in the aerodigestive program were assessed, 76% of them had a feeding disorder. ↗

▶ Ep 11 · 6:54

host_summary 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. ↗

▶ Ep 11 · 7:20

host_summary Underlying pulmonary insufficiency should be suspected if patients have had complicated respiratory infections requiring positive pressure ventilation. ↗

▶ Ep 11 · 7:48

host_summary Risk factors for upper airway obstruction include airway abnormalities like mid-face hypoplasia, skeletal dysplasia, decreased muscle tone, and syndromes associated with airway obstruction. ↗

▶ Ep 11 · 8:13

host_summary Risk factors for lower airway obstruction include acquired or congenital thoracic deformities and those who had thoracotomies done in the past. ↗

▶ Ep 11 · 9:15

host_summary For patients with ventilatory insufficiency, the pulmonologist determines if the child still needs ventilatory support and whether they are ready for decannulation. ↗

▶ Ep 11 · 9:26

host_summary The pulmonologist assesses how ready the patient is for weaning from the vent and whether they can start or advance feeding. ↗

▶ Ep 11 · 9:41

host_summary In the NICU, general surgeons obtain feeding access, manage anorectal malformations, and perform surgical procedures such as tracheopexies and lung resections. ↗

Tracheomalacia 22 entries

Quick Literature Updates Ep 19

▶ Ep 6 · 1:00

quote The American Pediatric Surgical Association or the APSA created a peer support program for pediatric surgeons in 2020. ↗

▶ Ep 6 · 1:00

host_summary APSA created a peer support program for pediatric surgeons in 2020. ↗

▶ Ep 6 · 1:00

quote The American Pediatric Surgical Association or the APSA created a peer support program for pediatric surgeons in 2020. ↗

▶ Ep 6 · 1:00

guideline APSA created a peer support program for pediatric surgeons in 2020. ↗

▶ Ep 6 · 1:12

quote Their goal was to support surgeons after traumatic events. ↗

▶ Ep 6 · 1:12

guideline The goal of the APSA peer support program was to support surgeons after traumatic events. ↗

▶ Ep 6 · 1:12

host_summary The goal of the APSA peer support program was to support surgeons after traumatic events. ↗

▶ Ep 6 · 1:12

quote Their goal was to support surgeons after traumatic events. ↗

▶ Ep 6 · 1:16

host_summary The most common referral reasons for the peer support program were toxic work environments and adverse events. ↗

▶ Ep 6 · 1:16

quote The most common referral reasons were toxic work environments and adverse events. ↗

▶ Ep 6 · 1:16

epidemiological The most common referral reasons for the peer support program were toxic work environments and adverse events. ↗

▶ Ep 6 · 1:16

quote The most common referral reasons were toxic work environments and adverse events. ↗

▶ Ep 6 · 1:20

epidemiological 50 surgeons total agreed to receive training on how to be a supporter in the APSA program. ↗

▶ Ep 6 · 1:20

host_summary 50 surgeons total agreed to receive training on how to be a supporter in the APSA program. ↗

▶ Ep 6 · 1:25

host_summary Over 80% of trained peer supporters were able to use these peer support skills informally with colleagues, partners, and trainees. ↗

▶ Ep 6 · 1:25

epidemiological Over 80% of trained peer supporters were able to use these peer support skills informally with colleagues, partners, and trainees. ↗

▶ Ep 6 · 1:31

opinion The peer support program shows that this type of support system can work really well to help surgeons heal from traumatic experiences and toxic work environments. ↗

▶ Ep 6 · 1:31

host_summary The peer support program shows that this type of support system can work really well to help surgeons heal from traumatic experiences and toxic work environments. ↗

Quick Literature Updates Ep 27

▶ Ep 7 · 1:04

host_summary Van Haal et al. conducted a retrospective cohort study in the Netherlands that included 79 patients who had rigid tracheobronchoscopy done before and after esophageal atresia surgery. ↗

▶ Ep 7 · 1:24

host_summary Preoperative tracheobronchoscopy for the presence of post-operative tracheomalacia had a sensitivity of 50% and a specificity of 67%. ↗

▶ Ep 7 · 1:34

host_summary Preoperative tracheobronchoscopy, though routine, has limited predictive value for post-operative tracheomalacia in esophageal atresia patients. ↗

▶ Ep 7 · 1:34

quote This shows that pre-op TBS, though routine, has limited predictive value for post-op tracheomalacia. ↗

Wilms Tumor 22 entries

Update Course Rewind: Updates in Wilms Management 2024

▶ Ep 15 · 0:09

quote Hello pediatric surgery family. I'm Lizzie Lee from Cincinnati Children's Hospital Medical Center. ↗

▶ Ep 15 · 0:09

quote Hello pediatric surgery family. I'm Lizzie Lee from Cincinnati Children's Hospital Medical Center. ↗

▶ Ep 15 · 1:54

clinical Loss of heterozygosity is the loss of genetic diversity in tumor cells and can indicate more aggressive disease in Wilms tumor. ↗

▶ Ep 15 · 1:54

host_summary Loss of heterozygosity is the loss of genetic diversity in tumor cells and can indicate more aggressive disease in Wilms tumor. ↗

▶ Ep 15 · 2:02

clinical Gain of 1Q refers to an extra copy of a section of chromosome 1, which is linked to worse outcomes in some cancers. ↗

▶ Ep 15 · 2:02

host_summary Gain of 1Q refers to an extra copy of a section of chromosome 1, which is linked to worse outcomes in some cancers. ↗

▶ Ep 15 · 3:15

guideline According to Children's Oncology Group updates, adverse biologic factors are associated with worse prognosis in stage 2 patients, but not in stage 1 favorable histology Wilms tumor patients. ↗

▶ Ep 15 · 3:15

host_summary According to Children's Oncology Group updates, adverse biologic factors are associated with worse prognosis in stage 2 patients, but not in stage 1 favorable histology Wilms tumor patients. ↗

▶ Ep 15 · 3:30

host_summary The North American COG approach often involves immediate surgery, while the European SIOP approach typically starts with chemotherapy before surgery. ↗

▶ Ep 15 · 3:30

guideline The North American COG approach often involves immediate surgery, while the European SIOP approach typically starts with chemotherapy before surgery. ↗

▶ Ep 15 · 3:49

clinical Genetic markers like loss of heterozygosity at specific chromosomes can indicate a higher risk of cancer recurrence and guide decisions about adding chemotherapy treatments. ↗

▶ Ep 15 · 3:49

host_summary Genetic markers like loss of heterozygosity at specific chromosomes can indicate a higher risk of cancer recurrence and guide decisions about adding chemotherapy treatments. ↗

Quick Literature Updates Ep 21

▶ Ep 16 · 1:02

clinical Pediatric trauma patients are at high risk for developing venous thromboembolism (VTE). ↗

▶ Ep 16 · 1:02

host_summary Pediatric trauma patients are at high risk for developing venous thromboembolism (VTE). ↗

▶ Ep 16 · 1:09

host_summary The Wita et al. cohort study was conducted from 2019 to 2022 in eight pediatric trauma centers and included patients younger than 18 years old. ↗

▶ Ep 16 · 1:09

epidemiological The Wita et al. cohort study was conducted from 2019 to 2022 in eight pediatric trauma centers and included patients younger than 18 years old. ↗

▶ Ep 16 · 1:18

epidemiological Among 460 high-risk pediatric trauma patients, more than half received chemical VTE prophylaxis. ↗

▶ Ep 16 · 1:18

host_summary Among 460 high-risk pediatric trauma patients, more than half received chemical VTE prophylaxis. ↗

▶ Ep 16 · 1:25

host_summary Delaying blood thinners beyond 24 hours of hospital arrival increases the risk of blood clots in pediatric trauma patients. ↗

▶ Ep 16 · 1:25

clinical Delaying blood thinners beyond 24 hours of hospital arrival increases the risk of blood clots in pediatric trauma patients. ↗

▶ Ep 16 · 1:32

clinical VTE prophylaxis is safe and effective for pediatric trauma patients and needs to be started within 24 hours of admission. ↗

▶ Ep 16 · 1:32

host_summary VTE prophylaxis is safe and effective for pediatric trauma patients and needs to be started within 24 hours of admission. ↗

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