# Esophageal Atresia — GCMD Library living collection

Everything in the library about esophageal atresia — built automatically from dossiers that name it.

Updated: n/a · 18 episodes · 246 cited statements

## Episodes
### Surgical Management
- [QUAD #1: Cervical Tracheopexy with Dr. Alessandro de Alarcon](https://library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779) — video · 5:26 · [machine version](https://library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779.md)
- [QUAD #2 Thoracoscopic Tracheopexy with Dr. Aaron Garrison](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919) — video · 7:36 · [machine version](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919.md)
- [QUAD #7 Anesthesia for Thoracoscopic Techniques with Dr. Nathaniel Tighe](https://library.globalcastmd.com/watch/quad-7-anesthesia-for-thoracoscopic-techniques-with-dr-nathaniel-tighe-8115) — video · 7:35 · [machine version](https://library.globalcastmd.com/watch/quad-7-anesthesia-for-thoracoscopic-techniques-with-dr-nathaniel-tighe-8115.md)

### Complications
- [Aerodigestive & Esophageal Surgery - Difficult Tracheal Esophageal Fistula](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739) — video · 120:59 · [machine version](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739.md)
- [Tracheobronchopexy to Avoid Tracheostomy in Esophageal Atresia Patients With Severe Life-Threatening Tracheobronchomalacia](https://library.globalcastmd.com/watch/tracheobronchopexy-to-avoid-tracheostomy-in-esophageal-atresia-patients-with-severe-life-threatening-tracheobronchomalacia-10435) — video · 0:50 · [machine version](https://library.globalcastmd.com/watch/tracheobronchopexy-to-avoid-tracheostomy-in-esophageal-atresia-patients-with-severe-life-threatening-tracheobronchomalacia-10435.md)

### Evidence & Research
- [Case Based Journal Review: Esophageal Atresia in 2022](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631) — podcast · 17:55 · [machine version](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631.md)
- [Journal of Pediatric Surgery Article Review: February 2023, BAPS issue](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-february-2023-baps-issue-6580) — podcast · 12:32 · [machine version](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-february-2023-baps-issue-6580.md)
- [Quick Literature Updates Episode 9](https://library.globalcastmd.com/watch/quick-literature-updates-episode-9-6770) — video · [machine version](https://library.globalcastmd.com/watch/quick-literature-updates-episode-9-6770.md)
- [Comparison of robotic versus thoracoscopic repair for congenital esophageal atresia](https://library.globalcastmd.com/watch/comparison-of-robotic-versus-thoracoscopic-repair-for-congenital-esophageal-atresia-7940) — video · 0:56 · [machine version](https://library.globalcastmd.com/watch/comparison-of-robotic-versus-thoracoscopic-repair-for-congenital-esophageal-atresia-7940.md)
- [Journal of Pediatric Surgery Article Review: October 2023](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-october-2023-8504) — podcast · 12:59 · [machine version](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-october-2023-8504.md)
- [Journal of Pediatric Surgery Article Review: Q1 (Jan-Mar) 2024](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-q1-2024-8754) — podcast · 13:34 · [machine version](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-q1-2024-8754.md)
- [Quick Literature Updates Episode 17](https://library.globalcastmd.com/watch/quick-literature-updates-episode-17-9803) — video · 4:28 · [machine version](https://library.globalcastmd.com/watch/quick-literature-updates-episode-17-9803.md)
- [Journal of Pediatric Surgery Article Review: 1st Quarter (Jan-Mar) 2025](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484) — podcast · 16:35 · [machine version](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484.md)
- [Journal of Pediatric Surgery Article Review: 2nd Quarter (Apr-Jun) 2025](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786) — podcast · 16:35 · [machine version](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786.md)
- [Quick Literature Updates Ep 27](https://library.globalcastmd.com/watch/quick-literature-updates-ep-27-11580) — video · 4:20 · [machine version](https://library.globalcastmd.com/watch/quick-literature-updates-ep-27-11580.md)

### In-Depth Reviews
- [Finnish Pediatric Surgery Hub - From Centralization to Collective Learning and Sharing of Expertise](https://library.globalcastmd.com/watch/finnish-pediatric-surgery-hub-from-centralization-to-collective-learning-and-sharing-of-expertise-9951) — video · 0:48 · [machine version](https://library.globalcastmd.com/watch/finnish-pediatric-surgery-hub-from-centralization-to-collective-learning-and-sharing-of-expertise-9951.md)
- [QUAD #27 - Multidisciplinary - How Do Teams Enhance Outcomes by the CCHMC ADEC Team](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201) — video · 10:19 · [machine version](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201.md)

### Long-Term Care
- [Esophageal Surveillance Practices in Esophageal Atresia Patients](https://library.globalcastmd.com/watch/esophageal-surveillance-practices-in-esophageal-atresia-patients-6844) — video · [machine version](https://library.globalcastmd.com/watch/esophageal-surveillance-practices-in-esophageal-atresia-patients-6844.md)

## Chapters
- [0:00](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-q1-2024-8754?t=0) Introduction and Episode Overview (Ep 11)
- [1:22](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-q1-2024-8754?t=82) Article 1: Antibiotic Cessation in Complicated Appendicitis (Ep 11)
- [4:12](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-q1-2024-8754?t=252) Article 2: Esophageal Lengthening Procedures in Complex EA (Ep 11)
- [8:28](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-q1-2024-8754?t=508) Article 3: Long-term Sensory Function After Pectus Repair with Cryoablation (Ep 11)
- [12:01](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-q1-2024-8754?t=721) Summary and Closing (Ep 11)
- [0:00](https://library.globalcastmd.com/watch/finnish-pediatric-surgery-hub-from-centralization-to-collective-learning-and-sharing-of-expertise-9951?t=0) Finnish Pediatric Surgery Hub Overview (Ep 13)
- [0:16](https://library.globalcastmd.com/watch/quick-literature-updates-episode-17-9803?t=16) Introduction and Paper 1: Robotic vs Thoracoscopic EA Repair (Ep 12)
- [1:41](https://library.globalcastmd.com/watch/quick-literature-updates-episode-17-9803?t=101) Paper 2: Delayed Hirschsprung Diagnosis Outcomes (Ep 12)
- [3:01](https://library.globalcastmd.com/watch/quick-literature-updates-episode-17-9803?t=181) Paper 3: Stoma Reversal Closure Techniques and Closing (Ep 12)
- [0:00](https://library.globalcastmd.com/watch/comparison-of-robotic-versus-thoracoscopic-repair-for-congenital-esophageal-atresia-7940?t=0) Robotic vs Thoracoscopic Repair for Esophageal Atresia (Ep 8)
- [0:00](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-october-2023-8504?t=0) Introduction (Ep 10)
- [1:14](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-october-2023-8504?t=74) Prophylactic Acid Suppression After Esophageal Atresia Repair (Ep 10)
- [4:39](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-october-2023-8504?t=279) Management of Primary Spontaneous Pneumothorax (Ep 10)
- [8:08](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-october-2023-8504?t=488) Clinical Symptoms and CPAM Treatment (Ep 10)
- [11:25](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-october-2023-8504?t=685) Summary and Closing (Ep 10)
- [0:00](https://library.globalcastmd.com/watch/quick-literature-updates-episode-9-6770?t=0) Introduction and First Paper Setup (Ep 4)
- [1:10](https://library.globalcastmd.com/watch/quick-literature-updates-episode-9-6770?t=70) Transanastomotic Tubes and Patent Processus Vaginalis Studies (Ep 4)
- [2:13](https://library.globalcastmd.com/watch/quick-literature-updates-episode-9-6770?t=133) Biliary Atresia Transplant Timing (Ep 4)
- [4:14](https://library.globalcastmd.com/watch/quick-literature-updates-episode-9-6770?t=254) Social Risk Screening and Closing (Ep 4)
- [0:00](https://library.globalcastmd.com/watch/esophageal-surveillance-practices-in-esophageal-atresia-patients-6844?t=0) Survey findings on esophageal atresia surveillance practices (Ep 5)
- [0:00](https://library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=0) Introduction and Preoperative Workup (Ep 6)
- [1:14](https://library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=74) Intraoperative Setup and Tools (Ep 6)
- [1:47](https://library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=107) Surgical Technique and Approach (Ep 6)
- [3:24](https://library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=204) Outcomes and Follow-up (Ep 6)
- [4:32](https://library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=272) Summary and Conclusion (Ep 6)
- [0:00](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=0) Introduction and Evolution of Practice (Ep 7)
- [0:58](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=58) Rationale for Repair and Preoperative Imaging (Ep 7)
- [2:02](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=122) Bronchoscopy Classification and Minimally Invasive Advantages (Ep 7)
- [3:21](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=201) Patient Positioning and Aortopexy Technique (Ep 7)
- [4:28](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=268) Posterior Tracheopexy Technique (Ep 7)
- [6:07](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=367) Esophageal Management and Outcomes (Ep 7)
- [6:47](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=407) Summary and Conclusion (Ep 7)
- [0:00](https://library.globalcastmd.com/watch/quad-7-anesthesia-for-thoracoscopic-techniques-with-dr-nathaniel-tighe-8115?t=0) Introduction and Conference Context (Ep 9)
- [0:53](https://library.globalcastmd.com/watch/quad-7-anesthesia-for-thoracoscopic-techniques-with-dr-nathaniel-tighe-8115?t=53) Preoperative Assessment Considerations (Ep 9)
- [1:24](https://library.globalcastmd.com/watch/quad-7-anesthesia-for-thoracoscopic-techniques-with-dr-nathaniel-tighe-8115?t=84) Intraoperative Goals and Techniques for Patient Immobility (Ep 9)
- [2:15](https://library.globalcastmd.com/watch/quad-7-anesthesia-for-thoracoscopic-techniques-with-dr-nathaniel-tighe-8115?t=135) Intraoperative Neuromonitoring and Surgical Exposure via Insufflation (Ep 9)
- [3:10](https://library.globalcastmd.com/watch/quad-7-anesthesia-for-thoracoscopic-techniques-with-dr-nathaniel-tighe-8115?t=190) Lung Isolation Techniques and Airway Anatomy (Ep 9)
- [5:34](https://library.globalcastmd.com/watch/quad-7-anesthesia-for-thoracoscopic-techniques-with-dr-nathaniel-tighe-8115?t=334) Patient Selection and Special Populations (Ep 9)
- [6:32](https://library.globalcastmd.com/watch/quad-7-anesthesia-for-thoracoscopic-techniques-with-dr-nathaniel-tighe-8115?t=392) Summary and Closing (Ep 9)
- [0:00](https://library.globalcastmd.com/watch/tracheobronchopexy-to-avoid-tracheostomy-in-esophageal-atresia-patients-with-severe-life-threatening-tracheobronchomalacia-10435?t=0) Tracheobronchopexy outcomes in esophageal atresia patients with severe tracheobronchomalacia (Ep 15)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- "The study compared two cohorts defined by time frame before and after implementation of stopping antibiotics at discharge" — Scott Short or Katie Russell (clinical) [Ep 11 · 2:07](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-q1-2024-8754?t=127)
- "185 patients were in the home antibiotic group and 121 patients in the no home antibiotic group" — Cecilia Gigena (clinical) [Ep 11 · 2:45](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-q1-2024-8754?t=165)
- "There was no significant difference in deep organ space infection requiring intervention between groups" — Cecilia Gigena (clinical) [Ep 11 · 2:55](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-q1-2024-8754?t=175)
- "There was no difference in length of stay between antibiotic groups" — Cecilia Gigena (clinical) [Ep 11 · 3:03](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-q1-2024-8754?t=183)
- "Secondary outcomes including C. diff infections, superficial site infections, post-operative CT imaging, and readmission showed no difference" — Romeo Ignacio (clinical) [Ep 11 · 3:06](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-q1-2024-8754?t=186)
- "The study was a 25 year experience describing 220 consecutive infants with esophageal atresia in Newcastle" — Mark Davenport (clinical) [Ep 11 · 4:44](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-q1-2024-8754?t=284)
- "13% of the 215 esophageal atresia patients had complex esophageal atresia" — Egodi (epidemiological) [Ep 11 · 5:13](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-q1-2024-8754?t=313)
- "25 patients with complex EA survived the repair: 14 were type A and 11 were type C" — Egodi (clinical) [Ep 11 · 5:24](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-q1-2024-8754?t=324)
- "Type C esophageal atresia is the most common type and means esophageal atresia with a distal fistula" — Cecilia Gigena (clinical) [Ep 11 · 5:43](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-q1-2024-8754?t=343)
- "Type A means pure esophageal atresia with no fistula to the trachea" — Cecilia Gigena (clinical) [Ep 11 · 5:50](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-q1-2024-8754?t=350)
- "Of 25 survivors, 18 had delayed primary anastomosis and 7 had esophageal replacement" — Egodi (clinical) [Ep 11 · 6:00](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-q1-2024-8754?t=360)
- "Two of the esophageal replacements were salvage procedures following failed traction" — Egodi (clinical) [Ep 11 · 6:13](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-q1-2024-8754?t=373)
- "Only 4 patients with esophageal atresia were potentially treatable by traction" — Egodi (clinical) [Ep 11 · 6:13](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-q1-2024-8754?t=373)
- "The esophagus has a great intrinsic blood supply and can be mobilized right down to the diaphragm and up to the thoracic inlet while staying alive" — Bruce Jeffrey (clinical) [Ep 11 · 6:28](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-q1-2024-8754?t=388)
- "Native esophagus was retained in 80% of cases where traction techniques had not been attempted" — Egodi (clinical) [Ep 11 · 6:57](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-q1-2024-8754?t=417)
- "Median time to esophageal continuity was 77 days" — Egodi (clinical) [Ep 11 · 7:02](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-q1-2024-8754?t=422)
- "Management of complex esophageal atresia without lengthening procedures can result in similar rates of native esophagus retention but with significantly less morbidity" — Egodi (clinical) [Ep 11 · 7:12](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-q1-2024-8754?t=432)
- "The pectus study enrolled 47 patients with median bar dwell time of approximately 2.9 years" — Cecilia Gigena (clinical) [Ep 11 · 9:25](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-q1-2024-8754?t=565)
- "Patients had a median of 2 bars placed, with almost 81% secured with pericostal sutures" — Cecilia Gigena (clinical) [Ep 11 · 9:41](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-q1-2024-8754?t=581)
- "About half of the patients had some degree of hypoesthesia" — Cecilia Gigena (clinical) [Ep 11 · 9:51](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-q1-2024-8754?t=591)
- "T5 was the most common dermatome with hypoesthesia" — Cecilia Gigena (clinical) [Ep 11 · 9:56](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-q1-2024-8754?t=596)
- "The area with hypoesthesia was less than 5% of the entire surface treated with cryo" — Cecilia Gigena (clinical) [Ep 11 · 10:00](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-q1-2024-8754?t=600)
- "Neuropathic symptoms were identified by only 13% of patients and none required treatment" — Cecilia Gigena (clinical) [Ep 11 · 10:18](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-q1-2024-8754?t=618)
- "Long-term chest wall hypoesthesia after minimally invasive pectus repair with cryo is limited to one or two dermatomes and chronic symptomatic neuropathic pain is very rare" — Cecilia Gigena (clinical) [Ep 11 · 10:26](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-q1-2024-8754?t=626)
- "Many cases proposed for lengthening may be because surgeons get cold feet about attempting a primary anastomosis" — Bruce Jeffrey (opinion) [Ep 11 · 6:46](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-q1-2024-8754?t=406)
- "The Finnish Pediatric Surgery Hub was established in 2021 by pediatric surgeons from Finland's five neonatal surgery centers." — Lizzie Lee (clinical) [Ep 13 · 0:10](https://library.globalcastmd.com/watch/finnish-pediatric-surgery-hub-from-centralization-to-collective-learning-and-sharing-of-expertise-9951?t=10)
- "The hub performed 34 elective and 6 urgent cases total." — Lizzie Lee (epidemiological) [Ep 13 · 0:18](https://library.globalcastmd.com/watch/finnish-pediatric-surgery-hub-from-centralization-to-collective-learning-and-sharing-of-expertise-9951?t=18)
- "The most frequent diagnoses included anorectal malformations, esophageal atresia, and Hirschsprung disease." — Lizzie Lee (epidemiological) [Ep 13 · 0:18](https://library.globalcastmd.com/watch/finnish-pediatric-surgery-hub-from-centralization-to-collective-learning-and-sharing-of-expertise-9951?t=18)
- "The hub held regular monthly virtual meetings to present new patients, discuss complex cases, and follow up on patients after surgery." — Lizzie Lee (clinical) [Ep 13 · 0:28](https://library.globalcastmd.com/watch/finnish-pediatric-surgery-hub-from-centralization-to-collective-learning-and-sharing-of-expertise-9951?t=28)
- "Findings suggest that the Finnish Pediatric Surgery hub fosters an effective and safe place for sharing surgical expertise and learning." — Lizzie Lee (opinion) [Ep 13 · 0:36](https://library.globalcastmd.com/watch/finnish-pediatric-surgery-hub-from-centralization-to-collective-learning-and-sharing-of-expertise-9951?t=36)
- "The study by Zeng et al. is a retrospective multi-center study done in China comparing robotic repair versus thoracoscopic repair for esophageal atresia" — Cecilia Gigena (clinical) [Ep 12 · 0:58](https://library.globalcastmd.com/watch/quick-literature-updates-episode-17-9803?t=58)
- "After propensity score matching, the study included 126 patients with 63 in each group" — Cecilia Gigena (clinical) [Ep 12 · 1:07](https://library.globalcastmd.com/watch/quick-literature-updates-episode-17-9803?t=67)
- "Robotic surgery had longer operative time but shorter anastomotic time compared to thoracoscopic repair" — Cecilia Gigena (clinical) [Ep 12 · 1:15](https://library.globalcastmd.com/watch/quick-literature-updates-episode-17-9803?t=75)
- "The robotic group had lower anastomotic strictures compared to thoracoscopic repair" — Cecilia Gigena (clinical) [Ep 12 · 1:22](https://library.globalcastmd.com/watch/quick-literature-updates-episode-17-9803?t=82)
- "The robotic group had lower readmissions within 2 years post-op compared to thoracoscopic repair" — Cecilia Gigena (clinical) [Ep 12 · 1:28](https://library.globalcastmd.com/watch/quick-literature-updates-episode-17-9803?t=88)
- "Robotic surgery is a good answer for esophageal atresia repair" — Cecilia Gigena (opinion) [Ep 12 · 1:32](https://library.globalcastmd.com/watch/quick-literature-updates-episode-17-9803?t=92)
- "The Pediatric Colorectal and Pelvic Learning Consortium study included 679 patients with Hirschsprung disease from 14 different sites between 2017 and 2023" — Alex Halpern (clinical) [Ep 12 · 2:05](https://library.globalcastmd.com/watch/quick-literature-updates-episode-17-9803?t=125)
- "Increased age at diagnosis of Hirschsprung disease was associated with a greater likelihood of undergoing fecal diversion after initial pull-through procedure" — Alex Halpern (clinical) [Ep 12 · 2:22](https://library.globalcastmd.com/watch/quick-literature-updates-episode-17-9803?t=142)
- "Increasing age at diagnosis of Hirschsprung disease was associated with an increased risk of constipation or incontinence requiring intervention postoperatively" — Alex Halpern (clinical) [Ep 12 · 2:32](https://library.globalcastmd.com/watch/quick-literature-updates-episode-17-9803?t=152)
- "No association was found between age at diagnosis of Hirschsprung disease and 30-day complication rate after initial pull-through" — Alex Halpern (clinical) [Ep 12 · 2:42](https://library.globalcastmd.com/watch/quick-literature-updates-episode-17-9803?t=162)
- "No association was found between age at diagnosis of Hirschsprung disease and need for pull-through revision" — Alex Halpern (clinical) [Ep 12 · 2:48](https://library.globalcastmd.com/watch/quick-literature-updates-episode-17-9803?t=168)
- "Delayed diagnosis of Hirschsprung disease does affect certain outcomes in these patients" — Alex Halpern (opinion) [Ep 12 · 2:51](https://library.globalcastmd.com/watch/quick-literature-updates-episode-17-9803?t=171)
- "The Children's Hospital in Pakistan conducted a randomized control trial including 124 patients in 2021 to 2022 who needed stoma reversal" — Lizzie Lee (clinical) [Ep 12 · 3:25](https://library.globalcastmd.com/watch/quick-literature-updates-episode-17-9803?t=205)
- "The study aimed to compare surgical site infections and cosmetic outcomes of scars in patients receiving purse-string or linear skin closure techniques for stoma reversal" — Lizzie Lee (clinical) [Ep 12 · 3:35](https://library.globalcastmd.com/watch/quick-literature-updates-episode-17-9803?t=215)
- "The purse-string closure group had way fewer surgical site infections compared to the linear closure group" — Lizzie Lee (clinical) [Ep 12 · 3:44](https://library.globalcastmd.com/watch/quick-literature-updates-episode-17-9803?t=224)
- "The purse-string closure group had much better scar quality compared to the linear closure group" — Lizzie Lee (clinical) [Ep 12 · 3:49](https://library.globalcastmd.com/watch/quick-literature-updates-episode-17-9803?t=229)
- "When reversing a stoma, purse-string closure technique is the best way to do it" — Lizzie Lee (opinion) [Ep 12 · 3:52](https://library.globalcastmd.com/watch/quick-literature-updates-episode-17-9803?t=232)
- "The study is a retrospective multi-center study done in China" — Cecilia Gigena (epidemiological) [Ep 8 · 0:10](https://library.globalcastmd.com/watch/comparison-of-robotic-versus-thoracoscopic-repair-for-congenital-esophageal-atresia-7940?t=10)
- "After propensity score matching, there were 126 patients total, 63 in each group" — Cecilia Gigena (epidemiological) [Ep 8 · 0:21](https://library.globalcastmd.com/watch/comparison-of-robotic-versus-thoracoscopic-repair-for-congenital-esophageal-atresia-7940?t=21)
- "Robotic surgery had longer operative time compared to thoracoscopic repair" — Cecilia Gigena (clinical) [Ep 8 · 0:28](https://library.globalcastmd.com/watch/comparison-of-robotic-versus-thoracoscopic-repair-for-congenital-esophageal-atresia-7940?t=28)
- "Robotic surgery had shorter anastomotic time compared to thoracoscopic repair" — Cecilia Gigena (clinical) [Ep 8 · 0:28](https://library.globalcastmd.com/watch/comparison-of-robotic-versus-thoracoscopic-repair-for-congenital-esophageal-atresia-7940?t=28)
- "The robotic group had lower anastomotic strictures compared to thoracoscopic repair" — Cecilia Gigena (clinical) [Ep 8 · 0:28](https://library.globalcastmd.com/watch/comparison-of-robotic-versus-thoracoscopic-repair-for-congenital-esophageal-atresia-7940?t=28)
- "The robotic group had lower unplanned readmissions within 2 years post-op compared to thoracoscopic repair" — Cecilia Gigena (clinical) [Ep 8 · 0:28](https://library.globalcastmd.com/watch/comparison-of-robotic-versus-thoracoscopic-repair-for-congenital-esophageal-atresia-7940?t=28)
- "Robotic surgery appears to be a good option for esophageal atresia repair" — Cecilia Gigena (opinion) [Ep 8 · 0:46](https://library.globalcastmd.com/watch/comparison-of-robotic-versus-thoracoscopic-repair-for-congenital-esophageal-atresia-7940?t=46)
- "There are no randomized controlled trials on prophylactic acid suppression after esophageal atresia repair" — Madina Chakraborty (epidemiological) [Ep 10 · 2:30](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-october-2023-8504?t=150)
- "In a meta-analysis of 1,395 patients, 753 received acid suppression medication but it did not increase the odds of having an esophageal stricture" — Cecilia Gigena (clinical) [Ep 10 · 2:37](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-october-2023-8504?t=157)
- "There was no evidence to associate prophylactic acid suppression with protection from stricture formation after esophageal atresia repair" — Cecilia Gigena (clinical) [Ep 10 · 2:57](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-october-2023-8504?t=177)
- "No significant differences were found in secondary outcomes including gastroesophageal reflux disease, anastomotic leak, and esophagitis between infants receiving prophylactic acid suppression and those who did not" — Em Gootee (host_summary) [Ep 10 · 3:14](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-october-2023-8504?t=194)
- "There was a tendency toward higher incidence of strictures with anti-acid medication" — Pablo Laje (clinical) [Ep 10 · 3:33](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-october-2023-8504?t=213)
- "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" — Em Gootee (host_summary) [Ep 10 · 3:51](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-october-2023-8504?t=231)
- "The use of anti-acid medication is not without cost and is not as innocent as once thought" — Pablo Laje (opinion) [Ep 10 · 4:20](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-october-2023-8504?t=260)
- "A large prospective study demonstrated that even children with sizable pneumothorax can be safely observed" — Elizabeth Speck (clinical) [Ep 10 · 5:43](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-october-2023-8504?t=343)
- "Not all patients with pneumothorax have an active leak" — Pablo Laje (clinical) [Ep 10 · 6:08](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-october-2023-8504?t=368)
- "Cross-sectional imaging should not be done on children to help make clinical decisions about spontaneous pneumothorax" — Elizabeth Speck (guideline) [Ep 10 · 6:22](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-october-2023-8504?t=382)
- "If air reaccumulates after observation, the patient has an ongoing air leak and warrants an operation" — Elizabeth Speck (clinical) [Ep 10 · 6:42](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-october-2023-8504?t=402)
- "Data support doing some pleural-based management rather than just staple lobectomy for spontaneous pneumothorax" — Elizabeth Speck (clinical) [Ep 10 · 6:51](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-october-2023-8504?t=411)
- "Studies are not available to demonstrate one pleural-based procedure is better than another" — Elizabeth Speck (epidemiological) [Ep 10 · 7:28](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-october-2023-8504?t=448)
- "For the asymptomatic contralateral side in children with pneumothorax, do not do anything unless it develops symptoms" — Cecilia Gigena (guideline) [Ep 10 · 7:40](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-october-2023-8504?t=460)
- "For recurrent pneumothorax, whatever was done before, do something more" — Elizabeth Speck (guideline) [Ep 10 · 7:52](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-october-2023-8504?t=472)
- "In a study of 110 CPAM patients, the asymptomatic group had shorter operating times, shorter post-operative mechanical ventilation, shorter chest tube durations, and shorter hospital stays" — Cecilia Gigena (clinical) [Ep 10 · 8:57](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-october-2023-8504?t=537)
- "Factors associated with symptomatic CPAM lesions include age older than 4 years, postnatal diagnosis, and maximum cyst diameter bigger than 39.9 millimeters" — Em Gootee (host_summary) [Ep 10 · 9:20](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-october-2023-8504?t=560)
- "The CPAM study did not enroll patients who accepted conservative treatment" — Em Gootee (host_summary) [Ep 10 · 9:50](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-october-2023-8504?t=590)
- "The CPAM study had insufficient sample size and was from a single center" — Em Gootee (host_summary) [Ep 10 · 10:00](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-october-2023-8504?t=600)
- "The CPAM study excluded patients who underwent thoracotomy, including only thoracoscopic resections" — Pablo Laje (epidemiological) [Ep 10 · 10:31](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-october-2023-8504?t=631)
- "Patients with a transanastomotic tube had a 2.72 times higher risk of developing a stricture post-operatively after esophageal atresia with tracheoesophageal fistula repair" (clinical) [Ep 4 · 1:10](https://library.globalcastmd.com/watch/quick-literature-updates-episode-9-6770?t=70)
- "The Midwest Pediatric Surgery Consortium study examined every patient who had a laparoscopic pyloric myotomy to identify patent processus vaginalis and followed them annually" (clinical) [Ep 4 · 1:30](https://library.globalcastmd.com/watch/quick-literature-updates-episode-9-6770?t=90)
- "Of 526 patients enrolled in the PPV study, 283 had a patent processus vaginalis (bilateral, right, or left)" (epidemiological) [Ep 4 · 2:00](https://library.globalcastmd.com/watch/quick-literature-updates-episode-9-6770?t=120)
- "Of 208 patients with at least one year follow-up, only three underwent inguinal hernia repair, all within the first year" (clinical) [Ep 4 · 2:13](https://library.globalcastmd.com/watch/quick-literature-updates-episode-9-6770?t=133)
- "Most patent processus vaginalis do not turn into inguinal hernias based on four-year interim analysis data" (clinical) [Ep 4 · 2:35](https://library.globalcastmd.com/watch/quick-literature-updates-episode-9-6770?t=155)
- "Liver transplantation for biliary atresia can be performed as initial treatment (primary) or after failed Kasai hepatoportoenterostomy (salvage)" (clinical) [Ep 4 · 2:45](https://library.globalcastmd.com/watch/quick-literature-updates-episode-9-6770?t=165)
- "The current standard in the US for biliary atresia is Kasai first and liver transplant only if that fails" (guideline) [Ep 4 · 3:05](https://library.globalcastmd.com/watch/quick-literature-updates-episode-9-6770?t=185)
- "Children who had an early salvage liver transplant (before age one) and children who had a primary liver transplant had similar outcomes" (clinical) [Ep 4 · 3:30](https://library.globalcastmd.com/watch/quick-literature-updates-episode-9-6770?t=210)
- "Children who had a late salvage liver transplant had improved graft survival compared to other groups" (clinical) [Ep 4 · 3:45](https://library.globalcastmd.com/watch/quick-literature-updates-episode-9-6770?t=225)
- "Some children who undergo the Kasai procedure will never end up needing a liver transplant" (clinical) [Ep 4 · 4:00](https://library.globalcastmd.com/watch/quick-literature-updates-episode-9-6770?t=240)
- "Social risk screening in pediatrics involves screening for risk factors including food and housing insecurity, financial strain, and unsafe environments" (clinical) [Ep 4 · 4:30](https://library.globalcastmd.com/watch/quick-literature-updates-episode-9-6770?t=270)
- "There is low concordance between screening results showing who might need resources and who is actually asking for more resources" (epidemiological) [Ep 4 · 5:00](https://library.globalcastmd.com/watch/quick-literature-updates-episode-9-6770?t=300)
- "Families may feel uncomfortable with social risk screening and may think there might be downstream repercussions based on their answers" (opinion) [Ep 4 · 5:15](https://library.globalcastmd.com/watch/quick-literature-updates-episode-9-6770?t=315)
- "There may be racial biases in screening practices, with non-white patients potentially being asked social risk questions more often" (epidemiological) [Ep 4 · 5:28](https://library.globalcastmd.com/watch/quick-literature-updates-episode-9-6770?t=328)
- "Current social risk screening protocols may not be effective and may actually lead to more inequities" (opinion) [Ep 4 · 4:50](https://library.globalcastmd.com/watch/quick-literature-updates-episode-9-6770?t=290)
- "The Eastern Pediatric Surgery Network in the US created a survey distributed among pediatric surgeons to understand current practices of esophageal surveillance in esophageal atresia patients" — Cecilia Gigena (host_summary) [Ep 5 · 0:00](https://library.globalcastmd.com/watch/esophageal-surveillance-practices-in-esophageal-atresia-patients-6844?t=0)
- "139 pediatric surgeons responded to the survey" — Cecilia Gigena (host_summary) [Ep 5 · 0:00](https://library.globalcastmd.com/watch/esophageal-surveillance-practices-in-esophageal-atresia-patients-6844?t=0)
- "75% of respondents strongly agree or agree with current guidelines for esophageal atresia surveillance" — Cecilia Gigena (host_summary) [Ep 5 · 0:00](https://library.globalcastmd.com/watch/esophageal-surveillance-practices-in-esophageal-atresia-patients-6844?t=0)
- "Only 37% of respondents reported that their esophageal atresia patients have pre-determined outpatient clinic follow-up schedule" — Cecilia Gigena (host_summary) [Ep 5 · 0:00](https://library.globalcastmd.com/watch/esophageal-surveillance-practices-in-esophageal-atresia-patients-6844?t=0)
- "80% of respondents agree or strongly agree that endoscopy should follow a set schedule" — Cecilia Gigena (host_summary) [Ep 5 · 0:00](https://library.globalcastmd.com/watch/esophageal-surveillance-practices-in-esophageal-atresia-patients-6844?t=0)
- "Only 37% of respondents performed follow-up endoscopy regardless of symptoms" — Cecilia Gigena (host_summary) [Ep 5 · 0:00](https://library.globalcastmd.com/watch/esophageal-surveillance-practices-in-esophageal-atresia-patients-6844?t=0)
- "There is high agreement with current guidelines but weak adherence to them in esophageal atresia surveillance" — Cecilia Gigena (host_summary) [Ep 5 · 0:00](https://library.globalcastmd.com/watch/esophageal-surveillance-practices-in-esophageal-atresia-patients-6844?t=0)
- "Cincinnati Children's typically uses a combined cervical and thoracic approach for esophageal atresia cases." — Alessandro de Alarcon (clinical) [Ep 6 · 0:49](https://library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=49)
- "Preoperative testing includes dynamic CT imaging, pulmonary function tests, microlaryngoscopy and bronchoscopy, and flexible bronchoscopy." — Todd Ponsky (host_summary) [Ep 6 · 0:55](https://library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=55)
- "Required intraoperative equipment includes a neck tray, MLB tray, and Maloney dilators or NG tubes." — Alessandro de Alarcon (clinical) [Ep 6 · 1:15](https://library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=75)
- "Flexible bronchoscopy during the operation is key, and endotracheal tube placement must allow visualization during the procedure." — Alessandro de Alarcon (clinical) [Ep 6 · 1:21](https://library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=81)
- "Nasotracheal intubation is often used with the cuff positioned high, sometimes almost at the glottis." — Alessandro de Alarcon (clinical) [Ep 6 · 1:29](https://library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=89)
- "A NIM tube is preferred when possible to prevent injury to recurrent nerves or provide awareness when approaching them." — Alessandro de Alarcon (clinical) [Ep 6 · 1:39](https://library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=99)
- "The surgical approach uses subplatysmal flaps and addresses anterior compression as needed." — Alessandro de Alarcon (clinical) [Ep 6 · 1:55](https://library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=115)
- "The cervical approach can assist thoracoscopic procedures by removing residual or regrown large thymus tissue." — Todd Ponsky (host_summary) [Ep 6 · 2:01](https://library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=121)
- "Aortopexy and innominate artery pexy can be added at the same time as the cervical procedure." — Alessandro de Alarcon (clinical) [Ep 6 · 2:09](https://library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=129)
- "In the lateral approach, the surgical team works on the side of the airway to find the esophagus." — Todd Ponsky (host_summary) [Ep 6 · 2:19](https://library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=139)
- "Pediatric surgeons identify the recurrent nerve for the ENT team to help prevent injury." — Todd Ponsky (host_summary) [Ep 6 · 2:23](https://library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=143)
- "The Cincinnati team has learned not to be afraid of mobilizing the esophagus, which is important for the procedure." — Alessandro de Alarcon (opinion) [Ep 6 · 2:29](https://library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=149)
- "The esophagus is mobilized above the level where the team aims to perform the pexy, making suture placement easier." — Todd Ponsky (host_summary) [Ep 6 · 2:43](https://library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=163)
- "Stitches are sometimes placed in the trachea to pull it up and out of the way for visualization of the posterior aspect and spine." — Alessandro de Alarcon (clinical) [Ep 6 · 2:54](https://library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=174)
- "A pulmonologist assists with flexible endoscopy through the endotracheal tube to visualize inside the trachea while stitches are placed." — Todd Ponsky (host_summary) [Ep 6 · 3:02](https://library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=182)
- "The team uses 3-0 prolene sutures and places all stitches before securing them down." — Alessandro de Alarcon (clinical) [Ep 6 · 3:15](https://library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=195)
- "Suture placement is performed under spontaneous ventilation conditions." — Alessandro de Alarcon (clinical) [Ep 6 · 3:15](https://library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=195)
- "The combined approach is valuable for complicated cases or patients needing additional operations for symptom relief." — Todd Ponsky (host_summary) [Ep 6 · 3:24](https://library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=204)
- "A patient who had prior thoracoscopic tracheopexy with dysphagia from torqued esophagus underwent the combined approach and became symptom-free." — Alessandro de Alarcon (clinical) [Ep 6 · 3:33](https://library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=213)
- "Outcome measures include follow-up endoscopy, pulmonary function tests when patients are old enough, and imaging." — Alessandro de Alarcon (clinical) [Ep 6 · 4:00](https://library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=240)
- "At 36 months follow-up, imaging may still show tracheomalacia, but patients can be symptomatically better." — Alessandro de Alarcon (clinical) [Ep 6 · 4:09](https://library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=249)
- "The team is still learning what measures should define good versus bad outcomes." — Alessandro de Alarcon (opinion) [Ep 6 · 4:15](https://library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=255)
- "Managing complications including swallowing dysfunction and vocal fold paralysis is part of postoperative care." — Alessandro de Alarcon (clinical) [Ep 6 · 4:26](https://library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=266)
- "Otolaryngology involvement is important both during the procedure and in follow-up due to potential complications." — Todd Ponsky (host_summary) [Ep 6 · 4:32](https://library.globalcastmd.com/watch/quad-1-cervical-tracheopexy-with-dr-alessandro-de-alarcon-7779?t=272)
- "Several years ago, the approach was that patients with tracheomalacia would undergo aortopexy." — Em Gootee (host_summary) [Ep 7 · 0:36](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=36)
- "In the last 4 to 5 years, it has become standard practice to determine which patients will respond best to tracheopexy versus aortopexy." — Em Gootee (host_summary) [Ep 7 · 0:43](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=43)
- "Pediatric surgery trainees were initially told that tracheomalacia is something that kids will grow out of and will get better." — Aaron Garrison (opinion) [Ep 7 · 0:58](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=58)
- "Recent data has shown that there are long term consequences for soiling into the lungs and having chronic lung aspiration, which over time is detrimental." — Aaron Garrison (clinical) [Ep 7 · 1:08](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=68)
- "Preoperative dynamic reconstruction studies give a lot of information for determining which procedure is best for each patient." — Aaron Garrison (clinical) [Ep 7 · 1:26](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=86)
- "Dynamic expiratory films show what you need to see with the airway that inspiratory films alone do not reveal." — Aaron Garrison (clinical) [Ep 7 · 1:31](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=91)
- "Part of the workup is making sure that there is space to anteriorly suspend the aorta so that the trachea diameter can actually be made larger." — Em Gootee (host_summary) [Ep 7 · 1:45](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=105)
- "Surgeons always look for the thymus and make sure that there is enough tissue to remove to be able to bring the trachea up anteriorly." — Aaron Garrison (clinical) [Ep 7 · 1:55](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=115)
- "Preoperative bronchoscopy gives the surgical team an idea of internal anatomy, which can assist in classifying the degree of tracheomalacia prior to surgical intervention." — Em Gootee (host_summary) [Ep 7 · 2:02](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=122)
- "The classification system for tracheomalacia is in evolution, and trying to describe what is mild or severe or moderate is a little bit challenging." — Aaron Garrison (opinion) [Ep 7 · 2:17](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=137)
- "The biggest benefit of minimally invasive approach is visualization and exposure." — Aaron Garrison (opinion) [Ep 7 · 2:34](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=154)
- "Disadvantages of minimally invasive approach include that it takes longer to learn and is more uncomfortable to learn." — Aaron Garrison (opinion) [Ep 7 · 2:39](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=159)
- "Anesthesia colleagues are sometimes hesitant to allow thoracoscopic cases to go on a little bit longer." — Aaron Garrison (opinion) [Ep 7 · 2:42](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=162)
- "A paper in Anesthesiology looked at open, thoracoscopic, and converted patients and found no difference in blood gases and metabolic derangements during surgery." — Aaron Garrison (host_summary) [Ep 7 · 3:03](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=183)
- "The same study found no difference when looking at blood pressure with acidosis and hypoxia between open and thoracoscopic approaches." — Aaron Garrison (host_summary) [Ep 7 · 3:17](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=197)
- "When using a thoracoscopic approach, correct positioning is the key to success." — Em Gootee (host_summary) [Ep 7 · 3:23](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=203)
- "It is best to use gravity to advantage as it aids in retracting the lungs and trachea placement." — Em Gootee (host_summary) [Ep 7 · 3:27](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=207)
- "For anterior mediastinal work, babies are positioned with the arm up and a bump underneath so that there is access to the axilla and anteriorly." — Aaron Garrison (clinical) [Ep 7 · 3:33](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=213)
- "The goal of aortopexy is to suspend the aorta." — Aaron Garrison (clinical) [Ep 7 · 3:51](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=231)
- "The first step in aortopexy is taking out the thymus, finding the innominate junction, and then identifying the arch of the aorta." — Aaron Garrison (clinical) [Ep 7 · 3:54](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=234)
- "Opening the pericardium and finding the area at the pericardial-adventitial junction to suspend is the key point of aortopexy." — Em Gootee (host_summary) [Ep 7 · 4:01](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=241)
- "If you go up too high during aortopexy, then you are doing a pericardiopexy and it is not quite as successful or durable." — Aaron Garrison (clinical) [Ep 7 · 4:10](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=250)
- "Passing suture transternally is preferred with the aortopexy approach, though it can be technically difficult." — Em Gootee (host_summary) [Ep 7 · 4:16](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=256)
- "For tracheopexy, a posterior approach via semiprone position is preferred." — Em Gootee (host_summary) [Ep 7 · 4:23](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=263)
- "Creating a pneumothorax by putting the Veress off the tip of the scapula helps collapse the lung for trocar placement." — Em Gootee (host_summary) [Ep 7 · 4:28](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=268)
- "When operating posteriorly, triangulating your hands gives the best visualization and working space." — Em Gootee (host_summary) [Ep 7 · 4:38](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=278)
- "The goal of posterior tracheopexy is taking the anterior spinal ligament and fixing it to the posterior membranous trachea." — Aaron Garrison (clinical) [Ep 7 · 4:45](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=285)
- "The area of floppy membrane is distal to the dilated pouch usually." — Aaron Garrison (clinical) [Ep 7 · 4:56](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=296)
- "When available, a multidisciplinary team which includes a pulmonologist can allow for internal visualization via bronchoscopy." — Em Gootee (host_summary) [Ep 7 · 4:56](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=296)
- "Bronchoscopic guidance technique is primarily used in non-esophageal atresia patients." — Em Gootee (host_summary) [Ep 7 · 5:05](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=305)
- "Surgeons can make an indent on the posterior wall of the trachea, and pulmonologists can see it pop up on their bronchoscopy to help guide suture placement." — Aaron Garrison (clinical) [Ep 7 · 5:09](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=309)
- "It usually takes about 2 or 3 sutures for posterior tracheopexy, leaving enough space for the esophagus to come through." — Aaron Garrison (clinical) [Ep 7 · 5:43](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=343)
- "Using the knot pusher and tension suture is helpful during tracheopexy." — Aaron Garrison (opinion) [Ep 7 · 5:48](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=348)
- "It is important to create enough tension in the suture to ensure that the pexy is secure." — Em Gootee (host_summary) [Ep 7 · 5:53](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=353)
- "Getting the suture to roll through the anterior spinal ligament is the hardest part and is pretty challenging." — Aaron Garrison (opinion) [Ep 7 · 5:58](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=358)
- "The approach changes for patients without esophageal atresia or with an esophagus in continuity." — Em Gootee (host_summary) [Ep 7 · 6:07](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=367)
- "For patients with esophagus in continuity, the first step is to dissect around the esophagus using a vessel loop for retraction." — Em Gootee (host_summary) [Ep 7 · 6:14](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=374)
- "There are times when the esophagus is put to the left of the trachea, and times when it is put to the right of the trachea." — Aaron Garrison (clinical) [Ep 7 · 6:20](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=380)
- "Dr. Garrison always worries a little bit about dysphagia when repositioning the esophagus, but it is not something he has seen a ton of." — Aaron Garrison (opinion) [Ep 7 · 6:26](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=386)
- "Using pre- and post-operative bronchoscopy allows the surgeon to see the improvement prior to case completion." — Em Gootee (host_summary) [Ep 7 · 6:32](https://library.globalcastmd.com/watch/quad-2-thoracoscopic-tracheopexy-with-dr-aaron-garrison-7919?t=392)
- "Birth history and patient size are important preoperative considerations for esophageal atresia repair." — Nathan Tighe (clinical) [Ep 9 · 0:53](https://library.globalcastmd.com/watch/quad-7-anesthesia-for-thoracoscopic-techniques-with-dr-nathaniel-tighe-8115?t=53)
- "Physiologic status from ventilation and cardiac standpoints is particularly important in preoperative assessment." — Nathan Tighe (clinical) [Ep 9 · 0:57](https://library.globalcastmd.com/watch/quad-7-anesthesia-for-thoracoscopic-techniques-with-dr-nathaniel-tighe-8115?t=57)
- "The association between esophageal atresia and cardiac abnormalities is particularly relevant to anesthetic technique." — Em Gootee (host_summary) [Ep 9 · 1:05](https://library.globalcastmd.com/watch/quad-7-anesthesia-for-thoracoscopic-techniques-with-dr-nathaniel-tighe-8115?t=65)
- "Preoperative visualization of the child's airway allows better decision-making and potentially less time under anesthesia." — Nathan Tighe (clinical) [Ep 9 · 1:13](https://library.globalcastmd.com/watch/quad-7-anesthesia-for-thoracoscopic-techniques-with-dr-nathaniel-tighe-8115?t=73)
- "Akinesis (keeping children still) can be very challenging in small children, especially when intraoperative neuromonitoring is involved." — Nathan Tighe (clinical) [Ep 9 · 1:33](https://library.globalcastmd.com/watch/quad-7-anesthesia-for-thoracoscopic-techniques-with-dr-nathaniel-tighe-8115?t=93)
- "The most common technique for maintaining stillness is short-acting opioid infusions, which result in relatively little hemodynamic instability." — Em Gootee (host_summary) [Ep 9 · 1:42](https://library.globalcastmd.com/watch/quad-7-anesthesia-for-thoracoscopic-techniques-with-dr-nathaniel-tighe-8115?t=102)
- "Volatile anesthetics are especially useful when preservation of spontaneous ventilation is desired." — Em Gootee (host_summary) [Ep 9 · 1:53](https://library.globalcastmd.com/watch/quad-7-anesthesia-for-thoracoscopic-techniques-with-dr-nathaniel-tighe-8115?t=113)
- "Intraoperative neuromonitoring precludes the use of neuromuscular blocking drugs like rocuronium and vecuronium." — Nathan Tighe (clinical) [Ep 9 · 2:25](https://library.globalcastmd.com/watch/quad-7-anesthesia-for-thoracoscopic-techniques-with-dr-nathaniel-tighe-8115?t=145)
- "Insufflation using pneumothorax created by trocar placement can facilitate surgical exposure by overcoming peak inspiratory pressures to allow lung collapse." — Em Gootee (host_summary) [Ep 9 · 2:31](https://library.globalcastmd.com/watch/quad-7-anesthesia-for-thoracoscopic-techniques-with-dr-nathaniel-tighe-8115?t=151)
- "Insufflation is useful for small kids with good lung compliance but not effective in kids with severe bronchopulmonary dysplasia or other compliance abnormalities." — Em Gootee (host_summary) [Ep 9 · 2:48](https://library.globalcastmd.com/watch/quad-7-anesthesia-for-thoracoscopic-techniques-with-dr-nathaniel-tighe-8115?t=168)
- "Patients with compliance abnormalities often require higher peak inspiratory or mean airway pressures, resulting in the need for very high insufflation pressures." — Nathan Tighe (clinical) [Ep 9 · 3:00](https://library.globalcastmd.com/watch/quad-7-anesthesia-for-thoracoscopic-techniques-with-dr-nathaniel-tighe-8115?t=180)
- "Lung isolation utility is restricted by patient size and airway anatomy and requires expertise and specialized equipment." — Nathan Tighe (clinical) [Ep 9 · 3:20](https://library.globalcastmd.com/watch/quad-7-anesthesia-for-thoracoscopic-techniques-with-dr-nathaniel-tighe-8115?t=200)
- "Three dimensions are important for lung isolation: tracheal diameter (particularly AP diameter), bronchial diameters, and the length of the right main stem bronchus between carina and right upper lobe takeoff." — Nathan Tighe (clinical) [Ep 9 · 3:34](https://library.globalcastmd.com/watch/quad-7-anesthesia-for-thoracoscopic-techniques-with-dr-nathaniel-tighe-8115?t=214)
- "Regular endotracheal tube is the most common device for lung isolation in neonates because it is relatively straightforward to mainstem into the left bronchus, which has a good landing zone for the balloon." — Nathan Tighe (clinical) [Ep 9 · 4:05](https://library.globalcastmd.com/watch/quad-7-anesthesia-for-thoracoscopic-techniques-with-dr-nathaniel-tighe-8115?t=245)
- "Endotracheal tube placement is technically easier than placement of other lung isolation devices." — Em Gootee (host_summary) [Ep 9 · 4:19](https://library.globalcastmd.com/watch/quad-7-anesthesia-for-thoracoscopic-techniques-with-dr-nathaniel-tighe-8115?t=259)
- "Bronchial blockers or Fogarty catheters require enough space between the carina and right upper lobe takeoff for balloon placement." — Nathan Tighe (clinical) [Ep 9 · 4:24](https://library.globalcastmd.com/watch/quad-7-anesthesia-for-thoracoscopic-techniques-with-dr-nathaniel-tighe-8115?t=264)
- "In kids with a pig bronchus, bronchial blocker placement becomes very difficult and may require selective lobar blockade." — Nathan Tighe (clinical) [Ep 9 · 4:39](https://library.globalcastmd.com/watch/quad-7-anesthesia-for-thoracoscopic-techniques-with-dr-nathaniel-tighe-8115?t=279)
- "A tracheal bronchus (pig bronchus) is an anatomical variant where an accessory bronchus originates directly from the supracarinal trachea." — Em Gootee (host_summary) [Ep 9 · 4:48](https://library.globalcastmd.com/watch/quad-7-anesthesia-for-thoracoscopic-techniques-with-dr-nathaniel-tighe-8115?t=288)
- "Bronchial blockers can be helpful in kids with abnormal parenchyma when higher ventilatory pressures are needed but higher insufflation pressures should be avoided." — Nathan Tighe (clinical) [Ep 9 · 4:58](https://library.globalcastmd.com/watch/quad-7-anesthesia-for-thoracoscopic-techniques-with-dr-nathaniel-tighe-8115?t=298)
- "In larger kids (usually 8 years or above) with recurrent fistulas, double-lumen tubes can be used and are the easiest device for lung isolation because they allow independent ventilation of the two lungs." — Em Gootee (host_summary) [Ep 9 · 5:17](https://library.globalcastmd.com/watch/quad-7-anesthesia-for-thoracoscopic-techniques-with-dr-nathaniel-tighe-8115?t=317)
- "Early conversations between anesthesiologists and surgeons about patient specifics are part of deciding the best modality for each individual patient." — Em Gootee (host_summary) [Ep 9 · 5:38](https://library.globalcastmd.com/watch/quad-7-anesthesia-for-thoracoscopic-techniques-with-dr-nathaniel-tighe-8115?t=338)
- "Unrepaired single ventricle patients are sensitive to changes in ventilation because they can have swings in circulation direction based on pulmonary vascular resistance." — Nathan Tighe (clinical) [Ep 9 · 5:55](https://library.globalcastmd.com/watch/quad-7-anesthesia-for-thoracoscopic-techniques-with-dr-nathaniel-tighe-8115?t=355)
- "Single ventricle patients may be candidates for open repair or ECMO support to ensure good outcomes." — Em Gootee (host_summary) [Ep 9 · 6:07](https://library.globalcastmd.com/watch/quad-7-anesthesia-for-thoracoscopic-techniques-with-dr-nathaniel-tighe-8115?t=367)
- "Insufflation causes changes in preload, and patients with passive pulmonary circulations are particularly sensitive to this insufflation." — Nathan Tighe (clinical) [Ep 9 · 6:18](https://library.globalcastmd.com/watch/quad-7-anesthesia-for-thoracoscopic-techniques-with-dr-nathaniel-tighe-8115?t=378)
- "Esophageal atresia patients often have tracheobronchomalacia" — Lizzie Lee (host_summary) [Ep 15 · 0:13](https://library.globalcastmd.com/watch/tracheobronchopexy-to-avoid-tracheostomy-in-esophageal-atresia-patients-with-severe-life-threatening-tracheobronchomalacia-10435?t=13)
- "Tracheobronchomalacia can cause serious breathing problems like blue spells in esophageal atresia patients" — Lizzie Lee (host_summary) [Ep 15 · 0:13](https://library.globalcastmd.com/watch/tracheobronchopexy-to-avoid-tracheostomy-in-esophageal-atresia-patients-with-severe-life-threatening-tracheobronchomalacia-10435?t=13)
- "A retrospective observational study reviewed 80 esophageal atresia patients who underwent tracheobronchopexy at two hospitals between 2013 and 2021" — Lizzie Lee (host_summary) [Ep 15 · 0:23](https://library.globalcastmd.com/watch/tracheobronchopexy-to-avoid-tracheostomy-in-esophageal-atresia-patients-with-severe-life-threatening-tracheobronchomalacia-10435?t=23)
- "94% of esophageal atresia patients who underwent tracheobronchopexy were able to avoid a tracheostomy" — Lizzie Lee (host_summary) [Ep 15 · 0:33](https://library.globalcastmd.com/watch/tracheobronchopexy-to-avoid-tracheostomy-in-esophageal-atresia-patients-with-severe-life-threatening-tracheobronchomalacia-10435?t=33)
- "Tracheobronchopexy significantly reduced life-threatening breathing events in esophageal atresia patients" — Lizzie Lee (host_summary) [Ep 15 · 0:38](https://library.globalcastmd.com/watch/tracheobronchopexy-to-avoid-tracheostomy-in-esophageal-atresia-patients-with-severe-life-threatening-tracheobronchomalacia-10435?t=38)
- "Tracheobronchopexy significantly reduced the need for positive pressure ventilation in esophageal atresia patients" — Lizzie Lee (host_summary) [Ep 15 · 0:38](https://library.globalcastmd.com/watch/tracheobronchopexy-to-avoid-tracheostomy-in-esophageal-atresia-patients-with-severe-life-threatening-tracheobronchomalacia-10435?t=38)
- "Tracheobronchopexy significantly reduced ventilator dependence in esophageal atresia patients" — Lizzie Lee (host_summary) [Ep 15 · 0:38](https://library.globalcastmd.com/watch/tracheobronchopexy-to-avoid-tracheostomy-in-esophageal-atresia-patients-with-severe-life-threatening-tracheobronchomalacia-10435?t=38)
- "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." — Lizzie Lee (host_summary) [Ep 14 · 0:15](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=15)
- "Cincinnati Children's has one of the largest aerodigestive centers in the world." — Lizzie Lee (host_summary) [Ep 14 · 0:47](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=47)
- "The expert multidisciplinary team includes speech pathology, otolaryngology, gastroenterology, pulmonology, and pediatric general surgery." — Lizzie Lee (host_summary) [Ep 14 · 0:55](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=55)
- "The vision of the Aerodigestive and Esophageal Center is to improve efficiency and communication between team members and the family." — Claire Miller (clinical) [Ep 14 · 1:28](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=88)
- "The center provides coordinated multidisciplinary care to children with congenital or acquired complex digestive and airway disorders." — Lizzie Lee (host_summary) [Ep 14 · 1:37](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=97)
- "The clinical assessment is a poor predictor when there are airway protection issues." — Claire Miller (clinical) [Ep 14 · 2:44](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=164)
- "Video fluoroscopic swallowing study analyzes different phases of swallowing." — Lizzie Lee (host_summary) [Ep 14 · 2:52](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=172)
- "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." — Lizzie Lee (host_summary) [Ep 14 · 2:59](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=179)
- "High-resolution pharyngeal manometry allows objective assessment of the pressures of the swallow to understand what is underlying a swallowing dysfunction." — Claire Miller (clinical) [Ep 14 · 3:13](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=193)
- "ENT looks at swallowing study results and helps stratify the risk of proceeding with airway reconstruction and decannulation." — Lizzie Lee (host_summary) [Ep 14 · 3:48](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=228)
- "In aerodigestive patients, ENT performs esophageal and airway reconstruction, cleft repair, drool procedures, and manages vocal folds and mobility." — Lizzie Lee (host_summary) [Ep 14 · 3:54](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=234)
- "GERD pathophysiology includes an incompetent lower esophageal sphincter." — Lizzie Lee (host_summary) [Ep 14 · 4:19](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=259)
- "Patients with TEF have a lot of other things other than incompetent lower esophageal sphincters, including motility problems, hernias, and delayed emptying." — Scott Pentik (clinical) [Ep 14 · 4:31](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=271)
- "General signs and symptoms of GERD include regurgitation, vomiting, and heartburn." — Lizzie Lee (host_summary) [Ep 14 · 4:42](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=282)
- "Impedance is a tool used to measure reflux and distinguish between a swallow versus actual reflux." — Scott Pentik (clinical) [Ep 14 · 4:48](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=288)
- "Patients with eosinophilic esophagitis often have procedures performed on them even before their diagnosis." — Scott Pentik (clinical) [Ep 14 · 5:21](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=321)
- "Data shows an increase in airway surgery complications in patients who were later found to have eosinophilic esophagitis." — Lizzie Lee (host_summary) [Ep 14 · 5:28](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=328)
- "The center now performs endoscopy as part of workup prior to even considering surgery." — Scott Pentik (guideline) [Ep 14 · 5:35](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=335)
- "Anatomic issues in aerodigestive patients include strictures that need balloon dilations or stenting." — Lizzie Lee (host_summary) [Ep 14 · 5:40](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=340)
- "Kids will have Nissans and then have hernias later." — Scott Pentik (clinical) [Ep 14 · 5:49](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=349)
- "Motility issues after TEF repairs include narrowing of the esophagus and the esophagus not squeezing, leading to more reflux, more dysphagia, and impactions." — Scott Pentik (clinical) [Ep 14 · 5:58](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=358)
- "When 25 patients in the aerodigestive program were assessed, 76% of them had a feeding disorder." — Lizzie Lee (host_summary) [Ep 14 · 6:13](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=373)
- "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." — Lizzie Lee (host_summary) [Ep 14 · 6:54](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=414)
- "Patients at risk for pulmonary insufficiency typically present with chronic symptoms including tachypnea, shortness of breath, retractions, non-apneic hypoxemia, and in older patients, exercise intolerance." — Sherry Torres Silva (clinical) [Ep 14 · 7:06](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=426)
- "Underlying pulmonary insufficiency should be suspected if patients have had complicated respiratory infections requiring positive pressure ventilation." — Lizzie Lee (host_summary) [Ep 14 · 7:20](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=440)
- "Patients at risk for chronic pulmonary aspiration include preemie babies, those with swallowing dysfunction, GI dysmotility, cardiothoracic esophageal and airway history, and syndromes including CHARGE syndrome, Mobius, Criducha, and trisomy." — Sherry Torres Silva (clinical) [Ep 14 · 7:32](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=452)
- "Risk factors for upper airway obstruction include airway abnormalities like mid-face hypoplasia, skeletal dysplasia, decreased muscle tone, and syndromes associated with airway obstruction." — Lizzie Lee (host_summary) [Ep 14 · 7:48](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=468)
- "Patients with airway obstruction, especially upper airway, will have symptoms with sleep and significant exertion or agitation, and noisy breathing might be one of the most significant symptoms reported." — Sherry Torres Silva (clinical) [Ep 14 · 8:02](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=482)
- "Risk factors for lower airway obstruction include acquired or congenital thoracic deformities and those who had thoracotomies done in the past." — Lizzie Lee (host_summary) [Ep 14 · 8:13](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=493)
- "Tracheomalacia is a very common comorbidity in patients with history of esophageal fistula or atresia." — Sherry Torres Silva (clinical) [Ep 14 · 8:22](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=502)
- "High-resolution CT is the gold standard for diagnosis because it is highly sensitive and detects early changes of the small airways, and 3D reconstructions can be performed." — Sherry Torres Silva (clinical) [Ep 14 · 8:36](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=516)
- "Flexible bronchoscopy is used starting in the nose and ending in the subsegmental bronchi, and bronchoalveolar lavage helps with identification of infections and markers of aspiration." — Sherry Torres Silva (clinical) [Ep 14 · 8:49](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=529)
- "Pulmonologists perform medical management of aspiration including control of sialorrhea, optimization of airway clearance, and use of anti-inflammatory medications for chronic aspiration or inflammation." — Sherry Torres Silva (clinical) [Ep 14 · 9:02](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=542)
- "For patients with ventilatory insufficiency, the pulmonologist determines if the child still needs ventilatory support and whether they are ready for decannulation." — Lizzie Lee (host_summary) [Ep 14 · 9:15](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=555)
- "The pulmonologist assesses how ready the patient is for weaning from the vent and whether they can start or advance feeding." — Lizzie Lee (host_summary) [Ep 14 · 9:26](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=566)
- "In the NICU, general surgeons obtain feeding access, manage anorectal malformations, and perform surgical procedures such as tracheopexies and lung resections." — Lizzie Lee (host_summary) [Ep 14 · 9:41](https://library.globalcastmd.com/watch/quad-27-multidisciplinary-how-do-teams-enhance-outcomes-by-the-cchmc-adec-team-10201?t=581)
- "A subset of children after esophageal atresia repair experience severe airway collapse, leaving them ventilator dependent or suffering repeated cyanotic spells" — Em Gootee (host_summary) [Ep 16 · 1:41](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=101)
- "80 patients with severe airway collapse after esophageal atresia is a huge number; most pediatric surgeons won't see 10 such patients in their career, and many wouldn't see 5" — George W. Holcomb III (epidemiological) [Ep 16 · 2:17](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=137)
- "90% of patients showed complete airway collapse on dynamic bronchoscopy" — George W. Holcomb III (host_summary) [Ep 16 · 2:34](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=154)
- "Three-quarters of tracheobronchopexy procedures used a posterior approach" — George W. Holcomb III (host_summary) [Ep 16 · 2:40](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=160)
- "Tracheobronchopexy was performed on thoracic trachea alone in over half the patients, but had to be extended onto the bronchi in 40%" — George W. Holcomb III (host_summary) [Ep 16 · 2:44](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=164)
- "94% of patients avoided tracheostomy with a mortality rate of 5%, and the procedure significantly reduced pressure ventilation and ventilator dependence" — George W. Holcomb III (host_summary) [Ep 16 · 2:57](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=177)
- "In experienced hands who have done numerous or hundreds of these procedures, tracheobronchopexy can have very good outcomes for patients with severe airway collapse symptoms" — George W. Holcomb III (opinion) [Ep 16 · 3:14](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=194)
- "Canada is the second largest country in the world geographically, though population-wise smaller than California" — Eric Skarsgard (epidemiological) [Ep 16 · 5:28](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=328)
- "The majority of Canada's population lives within 200 kilometers of the US border, but there are definitely lots of children in remote communities where it is not easy to access care" — Eric Skarsgard (epidemiological) [Ep 16 · 5:38](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=338)
- "Outreach services were present in only 7 out of 10 provinces, and only 8 out of 18 children's hospitals (44%) provided outreach services" — Preet Bir (epidemiological) [Ep 16 · 6:43](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=403)
- "A significant number of outreach services are located within 50 kilometers of a children's hospital, leaving vast regions without access to pediatric surgical care" — Em Gootee (host_summary) [Ep 16 · 6:57](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=417)
- "In most places in Canada, no one would transfer a 16 or 17 year old with appendicitis to a children's hospital for surgery; physiologically and every other way they're an adult and do not need the expertise of a pediatric surgeon" — Eric Skarsgard (clinical) [Ep 16 · 7:36](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=456)
- "It's a misconception that the Canadian healthcare system ensures timely care; it actually doesn't, and children wait for surgery beyond their wait time target" — Eric Skarsgard (clinical) [Ep 16 · 8:01](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=481)
- "Newfoundland and Labrador has the best outreach setup with only two pediatric surgeons who have established outreach clinics all over the province, serving as a model to others" — Eric Skarsgard (clinical) [Ep 16 · 8:16](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=496)
- "The population of Newfoundland and Labrador is really rural and spread out, and weather-wise it can be impossible sometimes to access care or financially devastating" — Eric Skarsgard (epidemiological) [Ep 16 · 8:31](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=511)
- "There are measurable costs of living remote to accessible high-quality care in terms of time required to be seen and actual clinical outcomes" — Eric Skarsgard (clinical) [Ep 16 · 9:01](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=541)
- "In the NSQIP database, 5% of all pediatric procedures were G-tube, which is a pretty sizable percent" — Sean Kunisaki (epidemiological) [Ep 16 · 11:56](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=716)
- "The study examined 4,612 G-tube placements from 71 NSQIP-Pediatric hospitals in 2023" — Em Gootee (host_summary) [Ep 16 · 12:38](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=758)
- "77% of G-tube cases were first-time G-tubes as opposed to redos" (epidemiological) [Ep 16 · 12:46](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=766)
- "Upper GI studies were obtained in 45% of first-time G-tube cases with substantial interhospital variability from 0 to 99%" — Em Gootee (host_summary) [Ep 16 · 13:04](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=784)
- "The heterogeneity in use of preoperative upper GIs was extremely broad with no real reason, indicating a potential teaching moment" — Sean Kunisaki (opinion) [Ep 16 · 13:20](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=800)
- "14% of G-tube cases resulted in an ED visit within 0 to 30 days" — Em Gootee (host_summary) [Ep 16 · 13:45](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=825)
- "5.2% of G-tube cases involved dislodgement within 0 to 30 days" — Em Gootee (host_summary) [Ep 16 · 13:45](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=825)
- "An additional 5.5% of G-tubes were dislodged in the 31 to 60 day period" (clinical) [Ep 16 · 13:55](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=835)
- "Dislodgement rates are higher than rates of readmissions or IR interventions, making dislodgements a great QI target" (opinion) [Ep 16 · 13:55](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=835)
- "If you can get dislodgements down, ED visits go down; when dislodgements happen early, patients are told to come back to the ED" (clinical) [Ep 16 · 14:15](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-1st-quarter-2025-10484?t=855)
- "A subset of children after esophageal atresia repair experience severe airway collapse, leaving them ventilator dependent or suffering repeated cyanotic spells" — Em Gootee (host_summary) [Ep 17 · 1:48](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=108)
- "The tracheobronchopexy series included 80 patients, which is a huge number - most pediatric surgeons won't see 10 of these patients in their career, and many wouldn't see 5" — George W. Holcomb III (epidemiological) [Ep 17 · 2:17](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=137)
- "90% of patients on dynamic bronchoscopy showed complete airway collapse" — George W. Holcomb III (host_summary) [Ep 17 · 2:34](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=154)
- "Three-quarters of tracheobronchopexy procedures used a posterior approach" — George W. Holcomb III (host_summary) [Ep 17 · 2:40](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=160)
- "Tracheobronchopexy was performed on thoracic trachea alone in over half the patients, but had to be extended onto the bronchi in 40%" — George W. Holcomb III (host_summary) [Ep 17 · 2:44](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=164)
- "94% of tracheobronchopexy patients avoided tracheostomy with a mortality rate of 5%" — George W. Holcomb III (host_summary) [Ep 17 · 2:57](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=177)
- "Tracheobronchopexy significantly reduced pressure ventilation and ventilator dependence" — George W. Holcomb III (host_summary) [Ep 17 · 2:57](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=177)
- "In experienced hands who have done numerous or hundreds of these type procedures, tracheobronchopexy can have very good outcomes for patients with severe airway collapse symptoms" — George W. Holcomb III (opinion) [Ep 17 · 3:14](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=194)
- "Canada is the 2nd largest country in the world geographically, though population-wise smaller than California" — Eric Skarsgard (epidemiological) [Ep 17 · 5:28](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=328)
- "The majority of Canada's population lives within 200 kilometers of the US border, but there are definitely lots of children in remote communities where it is not easy to access care" — Eric Skarsgard (epidemiological) [Ep 17 · 5:38](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=338)
- "Outreach services were present in only 7 out of 10 provinces, and only 8 out of 18 children's hospitals (44%) provided outreach services" — Preet Bir (epidemiological) [Ep 17 · 6:43](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=403)
- "A significant number of outreach services are located within 50 kilometers of a children's hospital, leaving vast regions without access to pediatric surgical care" — Em Gootee (host_summary) [Ep 17 · 6:57](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=417)
- "In most places in Canada, no one would ever transfer a 16 or 17 year old with appendicitis to a children's hospital for surgery - physiologically and every other way they're an adult and clearly do not need the expertise of a pediatric surgeon" — Eric Skarsgard (opinion) [Ep 17 · 7:36](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=456)
- "Access to surgical care for children in Canada has been in need of improvement for decades" — Eric Skarsgard (opinion) [Ep 17 · 7:51](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=471)
- "It's a misconception that the Canadian healthcare system ensures timely care - it actually doesn't, and children wait for surgery beyond their wait time target" — Eric Skarsgard (clinical) [Ep 17 · 8:01](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=481)
- "Newfoundland and Labrador has the best outreach setup with only two pediatric surgeons who have established outreach clinics all over the province, serving as a model for others" — Eric Skarsgard (opinion) [Ep 17 · 8:16](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=496)
- "The population of Newfoundland and Labrador is really rural and spread out, and geographically and weather-wise it can be impossible sometimes to access care or financially devastating" — Eric Skarsgard (epidemiological) [Ep 17 · 8:31](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=511)
- "There are measurable costs in terms of time required to be seen and actual clinical outcomes for patients living remote from accessible high quality care" — Eric Skarsgard (clinical) [Ep 17 · 9:01](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=541)
- "In the NSQIP database, 5% of all pediatric procedures were G-tube, which is a pretty sizable percent" — Sean Kunisaki (epidemiological) [Ep 17 · 11:56](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=716)
- "The study examined 4,612 G-tube placements from 71 NSQIP-Pediatric hospitals in 2023" — Em Gootee (host_summary) [Ep 17 · 12:38](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=758)
- "77% of G-tube cases were first-time G-tubes as opposed to redos" (epidemiological) [Ep 17 · 12:46](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=766)
- "Upper GI studies were obtained in 45% of first-time G-tube cases with substantial interhospital variability from 0 to 99%" — Em Gootee (host_summary) [Ep 17 · 13:04](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=784)
- "The heterogeneity in use of preoperative upper GIs was extremely broad with no real reason for it, indicating a potential teaching moment" — Sean Kunisaki (opinion) [Ep 17 · 13:23](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=803)
- "14% of G-tube cases resulted in an ED visit within 0 to 30 days" — Em Gootee (host_summary) [Ep 17 · 13:45](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=825)
- "5.2% of G-tube cases involved dislodgement within 0 to 30 days" — Em Gootee (host_summary) [Ep 17 · 13:45](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=825)
- "An additional 5.5% of G-tubes were dislodged in the 31 to 60 day period" (epidemiological) [Ep 17 · 13:55](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=835)
- "Dislodgement rates are higher than rates of readmissions or IR interventions, making them a great QI target" (opinion) [Ep 17 · 13:55](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=835)
- "If you can get dislodgements down, ED visits go down - when dislodgements happen early, patients are told to come back to the ED" (clinical) [Ep 17 · 14:15](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-2nd-quarter-2025-10786?t=855)
- "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." — Lizzie Lee (host_summary) [Ep 18 · 1:04](https://library.globalcastmd.com/watch/quick-literature-updates-ep-27-11580?t=64)
- "Preoperative tracheobronchoscopy for the presence of post-operative tracheomalacia had a sensitivity of 50% and a specificity of 67%." — Lizzie Lee (host_summary) [Ep 18 · 1:24](https://library.globalcastmd.com/watch/quick-literature-updates-ep-27-11580?t=84)
- "Preoperative tracheobronchoscopy, though routine, has limited predictive value for post-operative tracheomalacia in esophageal atresia patients." — Lizzie Lee (host_summary) [Ep 18 · 1:34](https://library.globalcastmd.com/watch/quick-literature-updates-ep-27-11580?t=94)
- "Mina et al. performed a retrospective review of all patients who underwent conservative management of modified Bell stage 2A or greater necrotizing enterocolitis at a single institution from 2011 to 2022." — Alex Halpern (host_summary) [Ep 18 · 2:05](https://library.globalcastmd.com/watch/quick-literature-updates-ep-27-11580?t=125)
- "126 patients underwent conservative management of necrotizing enterocolitis, and 24 of those patients eventually underwent surgery for a post-NEC stricture." — Alex Halpern (host_summary) [Ep 18 · 2:20](https://library.globalcastmd.com/watch/quick-literature-updates-ep-27-11580?t=140)
- "Primary resection and anastomosis was performed in all cases of post-NEC stricture requiring surgery." — Alex Halpern (host_summary) [Ep 18 · 2:29](https://library.globalcastmd.com/watch/quick-literature-updates-ep-27-11580?t=149)
- "Post-NEC strictures are a common occurrence after conservative management of necrotizing enterocolitis." — Alex Halpern (host_summary) [Ep 18 · 2:33](https://library.globalcastmd.com/watch/quick-literature-updates-ep-27-11580?t=153)
- "Huncheid et al. conducted a multi-center non-inferiority trial that compared preterm infants treated with expectant management versus early ibuprofen for patent ductus arteriosus." — Cecilia Gigena (host_summary) [Ep 18 · 3:04](https://library.globalcastmd.com/watch/quick-literature-updates-ep-27-11580?t=184)
- "The trial included 273 infants: 136 treated with expectant management and 137 with early ibuprofen." — Cecilia Gigena (host_summary) [Ep 18 · 3:14](https://library.globalcastmd.com/watch/quick-literature-updates-ep-27-11580?t=194)
- "In the expectant management group for PDA, there was 17.6% necrotizing enterocolitis, 33% bronchopulmonary dysplasia, and 14% death rates." — Cecilia Gigena (host_summary) [Ep 18 · 3:24](https://library.globalcastmd.com/watch/quick-literature-updates-ep-27-11580?t=204)
- "In the ibuprofen group for PDA, there was 15.4% necrotizing enterocolitis, 50% bronchopulmonary dysplasia, and 80% death rates." — Cecilia Gigena (host_summary) [Ep 18 · 3:36](https://library.globalcastmd.com/watch/quick-literature-updates-ep-27-11580?t=216)
- "Expectant management is not inferior to early ibuprofen in preterm patients with patent ductus arteriosus." — Cecilia Gigena (host_summary) [Ep 18 · 3:53](https://library.globalcastmd.com/watch/quick-literature-updates-ep-27-11580?t=233)
- "Most children who aspirate have a functional or neurological problem (cerebral palsy, CHARGE syndrome); some have anatomical problems (TEF, laryngeal cleft, pharyngeal scar, esophageal stenosis)." — Michael Rutter (clinical) [Ep 1 · 4:39](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=279)
- "Lipid-laden macrophages are non-specific markers of aspiration; their recovery depends on the lipid content of aspirated material, the amount aspirated, and time since aspiration." — Bob Wood (clinical) [Ep 1 · 8:05](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=485)
- "Multi-channel intraluminal impedance testing detects reflux but does not diagnose aspiration; it tells you whether something is delivered from the stomach to the esophagus, not what happens after." — Phil Putnam (clinical) [Ep 1 · 9:38](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=578)
- "If a patient is aspirating from above (oropharyngeal or esophageal source), an anti-reflux procedure does not help and may make them worse." — Daniel von Allmen (clinical) [Ep 1 · 9:58](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=598)
- "A 3-French bugbee cautery is a smooth, excellent probe for identifying subtle tracheoesophageal fistulas." — Michael Rutter (clinical) [Ep 1 · 12:10](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=730)
- "A 70-degree endoscope is a difficult tool to use but can visualize TEFs that are otherwise hard to see with standard forward-viewing scopes." — Michael Rutter (clinical) [Ep 1 · 13:21](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=801)
- "Routine bronchoscopy is now standard practice for all type C TEF repairs at Cincinnati Children's, often done in collaboration with ENT colleagues." — Daniel von Allmen (clinical) [Ep 1 · 14:02](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=842)
- "Pediatric surgery fellows at Cincinnati Children's complete a one-month attachment with ENT to perform bronchoscopies and gain airway expertise." — Michael Rutter (clinical) [Ep 1 · 14:51](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=891)
- "Dual scoping (simultaneous bronchoscopy and esophagoscopy) allows scopes to 'shake hands' across a fistula, light transillumination through tissue, and injection of saline or air to reveal subtle openings." — Daniel von Allmen (clinical) [Ep 1 · 19:37](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=1177)
- "A 2.8 mm flexible bronchoscope and a 5.4–6 mm infant gastroscope are the typical scopes used for combined airway-esophageal examination in small children." — Phil Putnam (clinical) [Ep 1 · 21:02](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=1262)
- "Endoscopic TEF closure requires demucosalization of the tract (mucosa is a non-stick surface); the goal is raw-against-raw apposition with minimal fibrin glue (0.1 mL) to seal the tract while scarring occurs." — Michael Rutter (clinical) [Ep 1 · 23:41](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=1421)
- "Endoscopic TEF repair success rate is approximately 80%, typically requiring 2 attempts; after 3–4 failed attempts, open repair should be considered." — Michael Rutter (clinical) [Ep 1 · 37:01](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=2221)
- "Positive-pressure air insufflation (30 cm H₂O) via an endotracheal tube in the esophagus can reveal a TEF by causing air to bubble out of the tracheal opening." — Michael Rutter (clinical) [Ep 1 · 34:20](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=2060)
- "Injection of an inert material (e.g., Radiesse voice gel) into the walls adjacent to a TEF tract can obliterate the potential space and promote raw-on-raw apposition; the material is absorbed over a few weeks." — Michael Rutter (clinical) [Ep 1 · 39:48](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=2388)
- "Slide tracheoplasty for TEF involves transecting the trachea above and below the fistula, beveling the edges, turning in the tracheal wings to repair the esophagus, interposing sternal periosteum, and reconnecting the trachea; it is a three-layer repair." — Michael Rutter (clinical) [Ep 1 · 45:48](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=2748)
- "Sternal periosteum is an excellent interposition graft material: it is abundant, in the surgical field, and extremely strong ('like Kevlar'), though difficult to suture." — Michael Rutter (clinical) [Ep 1 · 46:52](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=2812)
- "Button batteries can cause ongoing tissue injury for weeks after ingestion, even if 'dead' (they retain ~2 volts); institutional protocol mandates removal within 2 hours of identification." — Michael Rutter (guideline) [Ep 1 · 53:37](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=3217)
- "Button battery injuries in the esophagus can progress to aortoesophageal fistula; CT angiography and close follow-up for 6 weeks post-removal are recommended, especially if the battery was at the aortoesophageal junction." — Phil Putnam (guideline) [Ep 1 · 59:02](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=3542)
- "Two slide tracheoplasty repairs for button battery TEF both dehisced (one at 10 days, one at 3 months); both were successfully revised. This may be more than coincidence, suggesting button battery injuries pose unique challenges." — Michael Rutter (clinical) [Ep 1 · 54:02](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=3242)
- "Transtracheal TEF repair is a two-dimensional operation with lower complication risk than slide tracheoplasty; the primary complication is re-fistulization, whereas slide tracheoplasty dehiscence is a more serious event." — Michael Rutter (opinion) [Ep 1 · 69:04](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=4144)
- "Transtracheal repair technique: anterior tracheotomy, identify the fistula from within the trachea, separate tracheal and esophageal layers, three-layer closure (esophageal mucosa with knots in lumen, sternal periosteum, tracheal wall with knots in lumen)." — Michael Rutter (clinical) [Ep 1 · 64:43](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=3883)
- "In patients with retroesophageal subclavian artery, the right recurrent laryngeal nerve is non-recurrent and at higher risk during neck dissection; awareness is critical during transtracheal or slide tracheoplasty approaches." — Michael Rutter (clinical) [Ep 1 · 94:43](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=5683)
- "Flexible bronchoscopy cannot reliably diagnose laryngeal clefts; rigid microlaryngoscopy with active probing is mandatory when posterior glottic pathology is suspected." — Bob Wood (clinical) [Ep 1 · 116:27](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=6987)
- "When examining the cervical trachea and subglottis with a flexible bronchoscope, it is easier to see pathology while slowly withdrawing the scope than while advancing it, due to the need to flex and extend the tip to navigate the glottis." — Bob Wood (clinical) [Ep 1 · 87:43](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=5263)
- "Insufflation with oxygen at 2 L/min through the suction channel of a flexible bronchoscope spreads tissue apart, improves visualization, and does not impair respirations." — Bob Wood (clinical) [Ep 1 · 86:58](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=5218)
- "The degree of angulation at the tip of a flexible bronchoscope is much greater in one direction (retroflexion) than the other; rotating the scope 180° (Sabode maneuver) can reveal posterior tracheal pathology more easily." — Bob Wood (clinical) [Ep 1 · 86:30](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=5190)
- "Endoscopic closure of bronchoesophageal fistulas is feasible but challenging; proximity to large vessels (e.g., pulmonary artery branches) may preclude safe cautery and necessitate surgical resection." — Michael Rutter (clinical) [Ep 1 · 107:43](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=6463)
- "In a patient with multiple bronchoesophageal fistulas and chronic bronchiectasis, lobectomy with resection of the esophageal pseudo-diverticulum can be performed safely; the esophagus can be primarily closed if not strictured." — Daniel von Allmen (clinical) [Ep 1 · 112:36](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=6756)
- "A Y-shaped airway stent from both bronchi into the trachea, with the tracheostomy tube sitting within the stent, can effectively bypass a bronchoesophageal fistula and allow clinical stability when further repair is not feasible." — Michael Rutter (clinical) [Ep 1 · 100:56](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=6056)
- "Tracheal pouches (diverticula) can be marsupialized endoscopically using a Storz ClickLine laparoscopic biopsy forceps with cautery at 40 watts; the technique is quick, well-tolerated, and eliminates the risk of tracheostomy tube misplacement." — Michael Rutter (clinical) [Ep 1 · 118:01](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=7081)
- "When cauterizing in the airway with a bugbee, oxygen concentration should be kept below 30% to minimize fire risk; brief periods of lower oxygen saturation are tolerable." — Michael Rutter (clinical) [Ep 1 · 38:35](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=2315)
- "A 3-French bugbee cautery fits through the 1.2 mm suction channel of a 2.8 mm flexible bronchoscope, allowing precise control and steering of the cautery tip." — Bob Wood (clinical) [Ep 1 · 27:54](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=1674)
- "Trichloroacetic acid (TCA) can be used to demucosalize TEF tracts, but control is less precise than with bugbee cautery; TCA is applied on a pledget and can cause unintended burns if it contacts tissue during insertion." — Todd Ponsky (clinical) [Ep 1 · 25:08](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=1508)
- "Anal fistula plugs (biologic, cone-shaped, made of Surgisis) can theoretically be used to occlude distal airway fistulas; they are wrapped with barbed suture and inserted into the tract to promote collagen matrix formation and scarring." — Todd Ponsky (clinical) [Ep 1 · 110:04](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=6604)
- "Slide tracheoplasty appears to be a learning-curve, surgeon-dependent operation; revision cases have been necessary as experience was gained." — Michael Rutter (opinion) [Ep 1 · 69:59](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=4199)
- "After 7 years of aspiration through a TEF, a child may have significant bronchiectasis; repair of the fistula does not immediately resolve lower airway disease, and ongoing chest physiotherapy and airway clearance are required." — Michael Rutter (clinical) [Ep 1 · 95:23](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=5723)
- "Hearing aid molds are radiolucent and can be missed on chest X-ray; high clinical suspicion is required when a foreign body ingestion is reported but not visualized." — Michael Rutter (clinical) [Ep 1 · 97:35](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=5855)
- "Pectus excavatum can worsen tracheobronchomalacia; placement of a pectus bar can improve airway support and reduce the need for stenting or tracheostomy." — Michael Rutter (clinical) [Ep 1 · 99:49](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=5989)
- "Airway stents can erode into the esophagus, creating secondary fistulas; long-term stent management requires vigilance and may necessitate alternative strategies (e.g., Y-stent with tracheostomy tube within the stent)." — Michael Rutter (clinical) [Ep 1 · 100:32](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=6032)
- "When repairing a high TEF from a thoracic approach, ligation of the fistula on the esophageal side can leave a large tracheal pouch; if the patient has tracheomalacia and requires a tracheostomy, the tube may enter the pouch, causing life-threatening obstruction." — Michael Rutter (clinical) [Ep 1 · 77:21](https://library.globalcastmd.com/watch/aerodigestive-esophageal-surgery-difficult-tracheal-esophageal-fistula-739?t=4641)
- "The azygous vein drains the bronchi, trachea, and esophagus, and its division may lead to impaired function postoperatively and impaired clearance of mucus and debris from the tracheobronchial tree" — Jose Campos (host_summary) [Ep 2 · 3:25](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=205)
- "In a meta-analysis of almost 700 neonates, preserving the azygous vein resulted in significantly lower postoperative pneumonitis compared to division" — Ellen Encisco (host_summary) [Ep 2 · 3:02](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=182)
- "There was no significant difference in anastomotic leak rate or stricture rate between azygous vein preservation and division" — Ellen Encisco (host_summary) [Ep 2 · 3:11](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=191)
- "The endpoint of chest infection in the azygous vein meta-analysis was not clearly defined across studies—some used 'chest infection,' some 'pneumonitis,' some 'pneumonia'—making it a non-homogeneous endpoint" — Jose Campos (clinical) [Ep 2 · 4:45](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=285)
- "In the Quebec study of 244 patients, the overall anastomotic stricture rate at one year was 30%" — Ellen Encisco (host_summary) [Ep 2 · 6:43](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=403)
- "36% of patients with transanastomotic tubes developed strictures compared to 19% without tubes, a difference that remained significant after multivariable analysis" — Ellen Encisco (host_summary) [Ep 2 · 6:50](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=410)
- "Patients with transanastomotic tubes had 2.72 times higher odds of developing a stricture compared to those without" — Ellen Encisco (host_summary) [Ep 2 · 7:06](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=426)
- "The Quebec study adjusted for gestational age, leak, length of gap, and tension, and still found almost 3 times higher stricture rates with transanastomotic tubes" — Jose Campos (host_summary) [Ep 2 · 7:32](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=452)
- "Patients with transanastomotic tubes started feeding on day 2 versus day 10 for those without tubes, but early feeding did not lead to less TPN—duration was 9 days in both groups" — Em Gootee (host_summary) [Ep 2 · 7:54](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=474)
- "Congenital esophageal stenosis is associated with esophageal atresia in 7% to 10% of cases and most are diagnosed really late, sometimes after the anastomosis fails" — Jose Campos (epidemiological) [Ep 2 · 9:44](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=584)
- "Passing a tube through the anastomosis to check for resistance can help identify distal esophageal stenosis intraoperatively" — Jose Campos (clinical) [Ep 2 · 9:58](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=598)
- "In a meta-analysis of about 500 newborns, there was no significant difference in leak occurrence, pneumothorax, or mortality based on whether a chest drain was placed" — Em Gootee (host_summary) [Ep 2 · 12:20](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=740)
- "The group that received a chest drain had a significantly higher chance of returning to the operating room" — Em Gootee (host_summary) [Ep 2 · 12:31](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=751)
- "If a leak occurs, it doesn't always drain through the chest tube" — Todd Ponsky (clinical) [Ep 2 · 11:23](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=683)
- "A chest tube may injure, suck on, or increase the chance of disruption of the anastomosis" — Todd Ponsky (opinion) [Ep 2 · 11:30](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=690)
- "Chest tubes are painful for patients" — Todd Ponsky (clinical) [Ep 2 · 11:39](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=699)
- "Giving acid suppression to neonates increases the risk of necrotizing enterocolitis according to neonatologists' concerns" — Todd Ponsky (host_summary) [Ep 2 · 13:41](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=821)
- "Giving PPIs to neonates can increase pneumonia in different populations, but the risk is very minimal" — Jose Campos (clinical) [Ep 2 · 14:24](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=864)
- "In the Midwest Pediatric Surgery Consortium study, antibiotics for more than 24 hours and acid suppression showed no difference in strictures or leaks" — Ellen Encisco (host_summary) [Ep 2 · 14:54](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=894)
- "Not giving antibiotics postoperatively helps detect complications early rather than having antibiotics cover a complication" — Jose Campos (clinical) [Ep 2 · 14:10](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=850)
- "In Poland, thoracoscopic esophageal atresia repair has been performed exclusively since 2005" — Ellen Encisco (host_summary) [Ep 3 · 1:38](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-february-2023-baps-issue-6580?t=98)
- "The first thoracoscopic esophageal atresia procedure took almost 4 hours, but with experience it became a 1-hour procedure" — Ellen Encisco (host_summary) [Ep 3 · 1:54](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-february-2023-baps-issue-6580?t=114)
- "Dr. Patkowski's team has had no conversions from thoracoscopic to open approach since beginning the technique" — Ellen Encisco (host_summary) [Ep 3 · 1:59](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-february-2023-baps-issue-6580?t=119)
- "All esophageal atresia cases in Dr. Patkowski's center have been managed by one team using only the thoracoscopic approach since the beginning" — Ellen Encisco (host_summary) [Ep 3 · 2:06](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-february-2023-baps-issue-6580?t=126)
- "Centralizing care for esophageal atresia patients is important even if transportation costs are higher, because complication costs are much higher" — Ellen Encisco (host_summary) [Ep 3 · 2:58](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-february-2023-baps-issue-6580?t=178)
- "Dr. Patkowski's center handles 15 to 20 esophageal atresia cases per year, which provides sufficient volume for good experience" — Ellen Encisco (host_summary) [Ep 3 · 3:06](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-february-2023-baps-issue-6580?t=186)
- "The Centre in Rocklaw has become the referral center for esophageal atresia and long gap esophageal atresia cases from the whole of Poland" — Mark Davenport (clinical) [Ep 3 · 3:38](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-february-2023-baps-issue-6580?t=218)
- "Centers of excellence for esophageal atresia are showing better outcomes" — Todd Ponsky (clinical) [Ep 3 · 4:13](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-february-2023-baps-issue-6580?t=253)
- "Centralization of esophageal atresia care would be difficult to implement in the United States healthcare system" — Todd Ponsky (opinion) [Ep 3 · 4:26](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-february-2023-baps-issue-6580?t=266)
- "In the Sheffield study, 47% of Hirschsprung disease patients needed a stoma before primary pull-through" — Govind Murti (epidemiological) [Ep 3 · 5:35](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-february-2023-baps-issue-6580?t=335)
- "In the stoma cohort, 38 patients had ileostomies and the remaining had colostomies" — Ellen Encisco (host_summary) [Ep 3 · 5:41](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-february-2023-baps-issue-6580?t=341)
- "The most common indication for initial stoma in Hirschsprung disease was washout failure, accounting for nearly 40% of cases" — Ellen Encisco (host_summary) [Ep 3 · 5:46](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-february-2023-baps-issue-6580?t=346)
- "Of 20 patients who needed post-pull-through stoma formation, 7 occurred within 30 days and 13 occurred after 30 days" — Govind Murti (epidemiological) [Ep 3 · 6:19](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-february-2023-baps-issue-6580?t=379)
- "Most post-pull-through stomas after 30 days were needed because of constipation or soiling" — Govind Murti (clinical) [Ep 3 · 6:28](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-february-2023-baps-issue-6580?t=388)
- "The Sheffield study represents real life surgical reporting and reflects overall management of Hirschsprung's disease within the UK" — Mark Davenport (opinion) [Ep 3 · 6:35](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-february-2023-baps-issue-6580?t=395)
- "The Sheffield Hirschsprung management sequence does not reflect typical practice in the United States" — Beth Rymeski (opinion) [Ep 3 · 7:09](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-february-2023-baps-issue-6580?t=429)
- "In US practice, most Hirschsprung patients undergo either neonatal pull-through or are sent home on irrigations for pull-through in the first couple of months of life" — Beth Rymeski (clinical) [Ep 3 · 7:20](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-february-2023-baps-issue-6580?t=440)
- "In US practice, pre-pull-through diversion is only done for delayed presentation with perforation or complicated cardiac babies" — Beth Rymeski (clinical) [Ep 3 · 7:39](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-february-2023-baps-issue-6580?t=459)
- "Sheffield primarily performs Duhamel pull-throughs while Cincinnati primarily performs Swenson procedures for Hirschsprung disease" — Ellen Encisco (host_summary) [Ep 3 · 8:10](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-february-2023-baps-issue-6580?t=490)
- "The Tanzania soap bathing study included 252 patients, with 114 receiving a preoperative bath with plain soap" — Cecilia Gigena (host_summary) [Ep 3 · 9:23](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-february-2023-baps-issue-6580?t=563)
- "In the soap bathing group, 11.4% developed surgical site infections compared to 40.6% in the control group" — Cecilia Gigena (host_summary) [Ep 3 · 9:26](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-february-2023-baps-issue-6580?t=566)
- "Preoperative soap bathing reduced the odds of surgical site infections by 80%" — Cecilia Gigena (host_summary) [Ep 3 · 9:43](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-february-2023-baps-issue-6580?t=583)
- "Length of stay in the soap bathing intervention group was 12 days compared to 22 days in the non-intervention group" — Mark Davenport (host_summary) [Ep 3 · 9:53](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-february-2023-baps-issue-6580?t=593)
- "The Tanzania study used trained carers to direct the method of cleansing, concentrating on areas known to harbor commensal and pathogenic bacteria" — Mark Davenport (clinical) [Ep 3 · 9:04](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-february-2023-baps-issue-6580?t=544)
- "Before implementing preoperative bathing in Tanzania, almost every pediatric surgery patient developed a wound infection" — Beth Rymeski (clinical) [Ep 3 · 10:41](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-february-2023-baps-issue-6580?t=641)
- "After implementing preoperative baths in Tanzania, wound infection rates dropped to nearly zero" — Beth Rymeski (clinical) [Ep 3 · 10:56](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-february-2023-baps-issue-6580?t=656)
- "The Tanzania soap bathing trial was well designed, analyzed in substantial detail, and has implications for low to middle income countries where surgical site infections are a major problem" — Mark Davenport (opinion) [Ep 3 · 11:04](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-february-2023-baps-issue-6580?t=664)

## Changelog
- Sep 9: 1 item no longer name esophageal atresia
- Sep 8: 1 item no longer name esophageal atresia
- Sep 7: 6 items added automatically
- Sep 7: 14 items added automatically

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