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Anastomotic Strictures
Everything in the library about anastomotic strictures — 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
4 items
Prophylactic Acid-suppression Medication to Prevent Anastomotic Strictures After Oesophageal Atresia Surgery
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New article you should know from JPS by Dr. Cecilia Gigena
"Prophylactic Acid-suppression Medication to Prevent Anastomotic Strictures After Oesophageal Atresia Surgery: A Systematic Review and Meta-analysis"
Authors: Thomas Wyllie, Eniol
video · Dec 2023
Supresión ácida profiláctica para prevenir estenosis anastomóticas después de la cirugía de atresia esofágica
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Nuevo artículo que debes conocer de JPS por la Dra. Cecilia Gigena
"Supresión ácida profiláctica para prevenir estenosis anastomóticas después de la cirugía de atresia esofágica: una revisión sistemática y un metanálisis"
Autores: Thomas
video · Dec 2023
Comparison of robotic versus thoracoscopic repair for congenital esophageal atresia
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New article you should know by Cecilia Gigena
"Comparison of robotic versus thoracoscopic repair for congenital esophageal atresia: a propensity score matching analysis "
Authors: Mengxin Zhang, Jinshi Huang, Wei Zhong, Xi Zhang, Yin
video0:56 · Feb 2024
Journal of Pediatric Surgery Article Review: October 2023
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We’re featuring Journal of Pediatric surgery articles to bring you some of the latest news!
This week we are discussing 3 articles from October 2023 issue, with editor Dr. Pablo Laje and authors Thomas Wyllie, and Drs. Mallinath Chakribo
podcast12:59 · Apr 2024
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Every expert statement below comes from the recorded discussions, with its speaker and moment.
Comparison of robotic versus thoracoscopic repair for congenital esophageal atresia
The study is a retrospective multi-center study done in China
host_summaryCecilia Gigena0:10 ↗
After propensity score matching, there were 126 patients total, 63 in each group
host_summaryCecilia Gigena0:21 ↗
Robotic surgery had longer operative time compared to thoracoscopic repair
host_summaryCecilia Gigena0:28 ↗
Robotic surgery had shorter anastomotic time compared to thoracoscopic repair
host_summaryCecilia Gigena0:28 ↗
The robotic group had lower anastomotic strictures compared to thoracoscopic repair
host_summaryCecilia Gigena0:28 ↗
The robotic group had lower unplanned readmissions within 2 years post-op compared to thoracoscopic repair
host_summaryCecilia Gigena0:28 ↗
Robotic surgery appears to be a good option for esophageal atresia repair
host_summaryCecilia Gigena0:46 ↗
Journal of Pediatric Surgery Article Review: October 2023
Acid suppression medicines, particularly proton pump inhibitors (PPIs), have potential harms
clinicalTom Wiley2:03 ↗
There are no randomized controlled trials on prophylactic acid suppression after esophageal atresia repair
epidemiologicalMadina Chakraborty2:30 ↗
Within 1,395 patients across 12 observational studies, 753 received acid suppression medication but this did not reduce the odds of having an esophageal stricture
host_summaryCecilia Gigena2:37 ↗
There was no significant difference in secondary outcomes (gastroesophageal reflux disease, anastomotic leak, esophagitis) between infants receiving prophylactic acid suppression and those who did not
host_summaryEm Gootee3:14 ↗
There is currently no evidence that anti-acid medication reduces the risk of stricture, and there was a tendency toward higher incidence of strictures with treatment
clinicalPablo Laje3:33 ↗
Potential risks of long-term acid suppression therapy include dysbiosis, necrotizing enterocolitis, and increased neonatal infection rates, particularly relevant in preterm and low birth weight infants
host_summaryEm Gootee3:51 ↗
A large prospective study demonstrated that even children with sizable pneumothorax can be safely observed
clinicalElizabeth Speck5:43 ↗
Not every patient with pneumothorax has an active leak; aspiration followed by repeat imaging a few hours later can identify patients who can go home if there is no recurrence
clinicalPablo Laje6:04 ↗
Cross-sectional imaging should not be performed on children with spontaneous pneumothorax to help make clinical decisions; the data support this conclusion
guidelineElizabeth Speck6:22 ↗
If patients reaccumulate air after initial management, they have an ongoing air leak and warrant an operation
clinicalElizabeth Speck6:42 ↗
The data support doing some pleural-based management rather than just staple lobectomy alone for spontaneous pneumothorax
clinicalElizabeth Speck6:51 ↗
Studies are not available to demonstrate that one pleural-based procedure is better than another
epidemiologicalElizabeth Speck7:28 ↗
Some randomized trials showed that doing something to the pleura does not actually reduce recurrences of spontaneous pneumothorax
host_summaryCecilia Gigena7:08 ↗
For the asymptomatic contralateral side in children with spontaneous pneumothorax, do not do anything unless it develops symptoms
host_summaryCecilia Gigena7:40 ↗
For recurrent pneumothorax, whatever procedure was done before, do something more aggressive
opinionElizabeth Speck7:52 ↗
The CPAM study reviewed 110 patients operated over about 5 years, comparing perioperative outcomes between symptomatic and asymptomatic patients
epidemiologicalPablo Laje8:44 ↗
The asymptomatic CPAM group had shorter operating times, shorter postoperative mechanical ventilation, shorter chest tube durations, and shorter hospital stays
host_summaryCecilia Gigena9:00 ↗
Factors associated with symptomatic CPAM lesions include age older than 4 years, postnatal diagnosis, and maximum cyst diameter greater than 39.9 millimeters
host_summaryEm Gootee9:20 ↗
The CPAM study did not enroll patients who accepted conservative treatment compared to asymptomatic patients
host_summaryEm Gootee9:50 ↗
The CPAM study sample size was insufficient and all patients were from a single center
host_summaryEm Gootee10:00 ↗
The CPAM study did not explain why operations were performed in asymptomatic patients, some of whom were several years old (5 to 120 months)
opinionPablo Laje10:09 ↗
The CPAM study excluded patients who underwent thoracotomy, including only thoracoscopic resections
epidemiologicalPablo Laje10:31 ↗
Supresión ácida profiláctica para prevenir estenosis anastomóticas después de la cirugía de atresia esofágica
This is a systematic review that analyzed whether prophylaxis with acid suppression was effective to reduce stricture rates after esophageal atresia repair.
host_summaryCecilia Gigena0:00 ↗
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