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BOB in Ped Surg 2023 - PAPSA Winner - Mohamad Mahmoud Qinawy, MD
With Dr. Mohammad Mahmoud Qinawy · hosted by Dr. Em Gootee
Chapter 1 of 3 · Evidence & Research
Competition intro
Introduction and PAPSA competition setup
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Host summaries · secondary, not cited in answers
Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
Video
BOB Ped Surg 2023 - Mohamad Qinawy, PAPSA - Presentation
8 min · Published Feb 2023
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Gastroesophageal Reflux Disease
Jeffrey Ponsky · 33 min · Published Jun 2016
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GERD - (GastroEsophageal) REFLUX (Disease) in Esophageal Atresia Patients: An ERNICA animation
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Gastroesopheal Reflux Disease
33 min · Published Dec 2016
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Top Themes From The Stay Current App
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Esophagogastric Dissociation for GERD in Severe Neurodisability
Dr. Todd Ponsky · 2 min · Published Oct 2016
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What the experts said
Nissen fundoplication is the most commonly adopted procedure for GERD all over the world
Post-operative dysphagia and bloating are frequently encountered after Nissen fundoplication, creating the necessity for a more facilitative design
Recurrent GERD after fundoplication has been reported to occur in up to 15% of children requiring re-operation
The study was a prospective single-blinded randomized comparative study conducted from October 2018 to February 2020 with 40 patients divided into two groups
The Hill-Snow procedure involves excision of the distal abdominal esophagus to the phrenic incision with non-absorbable suture
In the Hill-Snow procedure, the esophagogastric angle is established by suturing the fundus of the stomach to the distal third of the esophagus with running 2-0 suture
Study inclusion criteria included patients with GERD with failure of medical treatment, symptomatic hiatus hernia, obstruction, and life-threatening symptoms like apnea
Recurrent cases, giant hiatus hernia, and hernia were excluded from the study
Operative time was significantly longer in the Hill-Snow group when compared to the Nissen group
Early post-operative bloating was lower in the Hill-Snow group: 3 cases versus 15 cases in the Nissen group
Early dysphagia was lower in the Hill-Snow group: 2 cases versus 7 cases in the Nissen group
Early vomiting was encountered more in the Hill-Snow group: 6 cases versus 2 cases in the Nissen group
No late post-operative bloating was found in the Hill-Snow group, while 11 cases from the Nissen group suffered from bloating
Recurrent vomiting and need for drugs was found in 8 cases in the Hill-Snow group versus 6 cases in the Nissen group
There were 3 recurrent Hill-Snow cases versus 2 recurrent Nissen cases
The recurrent Hill-Snow cases were found in the first 10 cases, attributed to the learning curve
When evaluating reflux disease surgery, you need to differentiate neurologically normal versus neurologically abnormal patients because their responses to surgery are very different
The study had only a very small group that were neurologically abnormal
After this study, the presenter's group does not use or take sutures between the esophagus and the crura
A recent study from the Midwest Pediatric Surgery Consortium or Kansas City Group showed that anterior gastropexy is ineffective and has worse outcomes
According to most recent literature, there is no importance of fixation of the esophagus to the crura