Osteosarcoma
Everything in the library about osteosarcoma — built automatically from the recorded discussions that name it
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Content of this collection
Evidence & Research
2 items
Update Course Rewind: 2021 Top Ten Key Takeaways
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The 9th annual Pediatric Surgery Update Course was held as a webinar on August 27, 2021. We had a lot of lively discussion and engaging presentations on the latest updates in pediatric surgery. In this video we are reviewing the top ten key
video16:02 · Oct 2021
Bailey Roberts, MD - Best of the Best in Pediatric Surgery 2024
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Watch IPSO's Dr. Bailey Roberts's presentation on “Extracellular vesicles from metastatic osteosarcoma contribute to creation of a pre-metastatic nich” at the 2024 Best of the Best in Pediatric Surgery event!
Moderators: Todd Ponsky, Cec
video8:39 · Feb 2024
Case-Based Learning
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Update Course Rewind: Thoracotomy vs VATS for Lung Metastases
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There are recent updates about the management of lung metastases in osteosarcoma and deciding thoracotomy vs VATS is our topic for today. At the recent 2021 Pediatric Surgery Update Course, Dr. Anusua "Roshni" Dasgupta reviewed the latest l
video9:40 · Aug 2022
Update Course Rewind: Chest Wall Reconstruction 2024
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In this session from the 12th Annual Update Course in Pediatric Surgery, Dr. Margaret Mutch from Australia walks through the complexities of chest wall reconstruction following thoracic osteosarcoma resection in a pediatric patient.Key High
video5:32 · Aug 2025
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Every expert statement below comes from the recorded discussions, with its speaker and moment.
Update Course Rewind: 2021 Top Ten Key Takeaways
In the Petcova et al. study published in Annals of Surgery 2020, children with uncomplicated appendicitis were randomized to medical management with antibiotics or surgery, with 5-year follow-up.
host_summaryEllen Encisco0:43 ↗
In the Petcova et al. appendicitis study, the surgery group had no complications, while 46% of patients in the non-surgical management group required appendectomy during follow-up.
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Medical management of acute uncomplicated appendicitis may be safe but is associated with a high failure rate, with many children ultimately requiring laparoscopic appendectomy.
host_summaryEllen Encisco1:22 ↗
Metastectomy for osteosarcoma lung metastases improves survival and can make patients long-term survivors.
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Approximately 10% of 1 millimeter lung nodules in osteosarcoma patients contain malignant disease.
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The Children's Oncology Group is starting a study to determine whether thoracotomy or thoracoscopy is superior for resection of pulmonary metastases in osteosarcoma, with enrollment expected late 2021 or early 2022.
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The Flourish device is a catheter-based device that places magnets in proximal and distal esophageal pouches to create a compression anastomosis by causing ischemia of tissue between the magnets, which then sloughs off.
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Inclusion criteria for the Flourish device are: atretic gap less than 4 centimeters long, fistula repaired or absent, and G-tube able to accommodate an 18 French catheter.
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The Flourish device is associated with a high stricture rate and known serious life-threatening complications, and should only be used by centers with capabilities to treat the many issues associated with esophageal atresia.
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Indocyanine green (ICG) has become a topic of interest in the last few years for use in pediatric surgery, especially in minimally invasive procedures to improve visualization of structures.
host_summaryEllen Encisco4:43 ↗
For laparoscopic cholecystectomy, ICG must be administered intravenously 12 to 18 hours prior to surgery to allow time for accumulation in the extrahepatic ducts, or can be injected directly into the gallbladder during surgery.
host_summaryEllen Encisco5:32 ↗
ICG applications in pediatric surgery include laparoscopic cholecystectomies, varicocele repairs, partial nephrectomies, and tumor excisions.
host_summaryEllen Encisco5:48 ↗
For anorectal malformations with rectal-perineal or rectal-vestibular fistula, outcomes including complications are similar whether the procedure is done before or after 14 days of life.
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A PCPLC consortium study comparing endorectal pull-through for Hirschsprung disease at less than 31 days versus greater than 31 days found that preoperative enterocolitis, postoperative enterocolitis, constipation, and incontinence were the same between both groups.
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Delayed pull-through with irrigations is a safe alternative to an operation in the neonatal period for Hirschsprung disease.
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Cryoanalgesia is probably effective at improving post-operative pain and decreasing length of stay for pectus patients, with length of stay reduced from 4 days to 1 day.
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There are no long-term studies on the effects of cryoanalgesia for pectus repair.
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The double rim sign or halo sign on X-ray indicates a child has swallowed a button battery rather than a coin.
host_summaryEllen Encisco9:48 ↗
The main goal of button battery ingestion treatment is to remove the battery within 2 hours of ingestion.
host_summaryEllen Encisco10:13 ↗
Sucralfate or honey can help reduce damage from button batteries on the child's esophagus as temporizing measures.
host_summaryEllen Encisco10:20 ↗
Children less than 1 year old should not receive honey due to risk of botulism and should instead receive 10 mL of sucralfate every 10 minutes for up to 3 doses for button battery ingestion.
host_summaryEllen Encisco10:35 ↗
Children over age 1 with button battery ingestion should receive honey 10 mL every 10 minutes for up to 6 doses.
host_summaryEllen Encisco10:51 ↗
New ATLS recommendations for pediatric trauma patients in hemorrhagic shock call for earlier transfusion: after 1 bolus of 20 cc per kilogram of crystalloid fluid, blood should be given.
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Balanced transfusion protocol for pediatric hemorrhagic shock typically includes 10 to 20 mLs per kilogram of packed red blood cells, plus inclusion of FFP and platelets.
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Earlier transfusion in pediatric trauma was associated with shorter median time to transfusion and a decrease in total fluid volume administered.
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Whole blood in trauma patients requires less volume compared to component therapy.
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Research shows that observation of spontaneous pneumothorax in adults is non-inferior to immediate intervention with tube thoracostomy.
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The Midwest Pediatric Surgery Consortium study on spontaneous pneumothorax management with simple aspiration showed 48% success rate, but 44% of patients in the simple aspiration group recurred.
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83% of patients who failed simple aspiration for spontaneous pneumothorax ultimately ended up with VATS or blebectomy.
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Greenwood et al. showed that mortality amongst black newborns is 3 times that of white newborns.
host_summaryEllen Encisco14:10 ↗
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