From
StayCurrentMD
Quick Literature Updates Episode 17
With Dr. Alex Halpern · hosted by Dr. Em Gootee & Dr. Cecilia Gigena & Lizzy Lee, PA-C
Chapter 1 of 3 · Evidence & Research
Robotic EA repair
Introduction and Robotic vs Thoracoscopic EA Repair
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Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
Delayed diagnosis of Hirschsprung disease does affect certain outcomes in these patients.
The Zeng et al. study was a retrospective multi-center study done in China comparing robotic repair versus thoracoscopic repair for esophageal atresia.
After propensity score matching, the study included 126 patients with 63 in each group (robotic vs thoracoscopic).
Robotic surgery for esophageal atresia had longer operative time but shorter anastomotic time compared to thoracoscopic repair.
The robotic group had lower anastomotic strictures and lower readmissions within 2 years post-op compared to thoracoscopic repair.
Robotic surgery is a good answer for esophageal atresia repair.
The Pediatric Colorectal and Pelvic Learning Consortium conducted a multi-center retrospective review from 2017 to 2023 examining delayed diagnosis of Hirschsprung disease.
The Hirschsprung study included 679 patients from 14 different sites.
Increased age at diagnosis of Hirschsprung disease was associated with a greater likelihood of undergoing fecal diversion after initial pull-through procedure.
Increasing age at diagnosis of Hirschsprung disease was associated with an increased risk of constipation or incontinence requiring intervention postoperatively.
The Hirschsprung study did not find an association between age at diagnosis and 30-day complication rate after initial pull-through.
The Hirschsprung study did not find an association between age at diagnosis and need for pull-through revision.
The Children's Hospital in Pakistan conducted a randomized control trial including 124 patients in 2021 to 2022 who needed stoma reversal.
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.
The purse-string closure group had way fewer surgical site infections compared to the linear closure group for stoma reversal.
The purse-string closure group had much better scar quality compared to the linear closure group for stoma reversal.
When reversing a stoma, purse-string closure technique is the best way to do it.