# Sarcoma (Ewing/Rhabdo) — GCMD Library living collection

Also covered as: osteosarcoma · esophageal atresia · pyloric stenosis · ovarian torsion · rhabdomyosarcoma · synovial sarcoma · melanoma · inguinal hernia

Experts: Dr. Todd Ponsky, Dr. Rod Gerardo, Dr. Ellen Encisco, Dr. Jose Campos

Updated: n/a · 36 episodes · 802 cited statements

## Episodes
### Foundations
- [StayCurrent Forums Trailer](https://library.globalcastmd.com/watch/staycurrent-forums-trailer-13734) — video · [machine version](https://library.globalcastmd.com/watch/staycurrent-forums-trailer-13734.md)
- [Commercial Audio Only (1080p)](https://library.globalcastmd.com/watch/commercial-audio-only-13743) — podcast · 0:37 · [machine version](https://library.globalcastmd.com/watch/commercial-audio-only-13743.md)

### Diagnosis & Workup
- [Pediatric and Young Adult Image-Guided Percutaneous Bone Biopsy-A New Standard of Care?](https://library.globalcastmd.com/watch/pediatric-and-young-adult-image-guided-percutaneous-bone-biopsy-a-new-standard-of-care-11545) — video · 1:05 · [machine version](https://library.globalcastmd.com/watch/pediatric-and-young-adult-image-guided-percutaneous-bone-biopsy-a-new-standard-of-care-11545.md)
- [Indocyanine green assists with sentinel lymph node mapping in pediatric and adolescent patients](https://library.globalcastmd.com/watch/indocyanine-green-assists-with-sentinel-lymph-node-mapping-in-pediatric-and-adolescent-patients-12056) — video · 1:13 · [machine version](https://library.globalcastmd.com/watch/indocyanine-green-assists-with-sentinel-lymph-node-mapping-in-pediatric-and-adolescent-patients-12056.md)

### Evidence & Research
- [Nonmetastatic Nonrhabdomyosarcoma Soft Tissue Sarcoma](https://library.globalcastmd.com/watch/nonmetastatic-nonrhabdomyosarcoma-soft-tissue-sarcoma-326) — video · 3:50 · [machine version](https://library.globalcastmd.com/watch/nonmetastatic-nonrhabdomyosarcoma-soft-tissue-sarcoma-326.md)
- [Case-Based Journal Review- Intussusception in 2022](https://library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092) — podcast · 20:19 · [machine version](https://library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092.md)
- [Case Based Journal Review - CPAM in 2022](https://library.globalcastmd.com/watch/case-based-journal-review-cpam-in-2022-5319) — podcast · 12:23 · [machine version](https://library.globalcastmd.com/watch/case-based-journal-review-cpam-in-2022-5319.md)
- [Update Course 2021: THORACOTOMY VS VATS FOR OSTEO METS](https://library.globalcastmd.com/watch/update-course-2021-thoracotomy-vs-vats-for-osteo-mets-5417) — video · [machine version](https://library.globalcastmd.com/watch/update-course-2021-thoracotomy-vs-vats-for-osteo-mets-5417.md)
- [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)
- [Update Course Rewind: Thoracotomy vs VATS for Lung Metastases](https://library.globalcastmd.com/watch/update-course-rewind-thoracotomy-vs-vats-for-lung-metastases-5632) — video · 9:40 · [machine version](https://library.globalcastmd.com/watch/update-course-rewind-thoracotomy-vs-vats-for-lung-metastases-5632.md)
- [Bailey Roberts, MD - Best of the Best in Pediatric Surgery 2024](https://library.globalcastmd.com/watch/bailey-roberts-md-best-of-the-best-in-pediatric-surgery-2024-8011) — video · 8:39 · [machine version](https://library.globalcastmd.com/watch/bailey-roberts-md-best-of-the-best-in-pediatric-surgery-2024-8011.md)
- [Heat 2 Winner: Matthew Urichuk, PhD - Best of the Best in Pediatric Surgery 2024](https://library.globalcastmd.com/watch/heat-2-winner-matthew-urichuk-phd-best-of-the-best-in-pediatric-surgery-2024-8013) — video · 1:52 · [machine version](https://library.globalcastmd.com/watch/heat-2-winner-matthew-urichuk-phd-best-of-the-best-in-pediatric-surgery-2024-8013.md)
- [Female Fertility Cryopreservation Outcomes in Childhood Cancer: A Systematic Review](https://library.globalcastmd.com/watch/female-fertility-cryopreservation-outcomes-in-childhood-cancer-a-systematic-review-8647) — video · 0:59 · [machine version](https://library.globalcastmd.com/watch/female-fertility-cryopreservation-outcomes-in-childhood-cancer-a-systematic-review-8647.md)
- [Resultados de la criopreservación de la fertilidad femenina en el cáncer infantil: una revisión sistemática](https://library.globalcastmd.com/watch/resultados-de-la-criopreservaci-n-de-la-fertilidad-femenina-en-el-c-ncer-infantil-una-revisi-n-sistem-tica-8648) — video · 0:57 · [machine version](https://library.globalcastmd.com/watch/resultados-de-la-criopreservaci-n-de-la-fertilidad-femenina-en-el-c-ncer-infantil-una-revisi-n-sistem-tica-8648.md)
- [Female Fertility Cryopreservation Outcomes in Childhood Cancer: A Systematic Review](https://library.globalcastmd.com/watch/female-fertility-cryopreservation-outcomes-in-childhood-cancer-a-systematic-review-9521) — video · 0:56 · [machine version](https://library.globalcastmd.com/watch/female-fertility-cryopreservation-outcomes-in-childhood-cancer-a-systematic-review-9521.md)
- [Case-Based Journal Review: Inguinal Hernia 2025](https://library.globalcastmd.com/watch/case-based-journal-review-inguinal-hernia-2025-10168) — podcast · 19:13 · [machine version](https://library.globalcastmd.com/watch/case-based-journal-review-inguinal-hernia-2025-10168.md)
- [Same-Day Discharge for Elective Pediatric Laparoscopic Gastrostomy Tube Insertion is Safe and Increasing in Frequency; A NSQIP Pediatric Retrospective Review 2017 to 2021](https://library.globalcastmd.com/watch/same-day-discharge-for-elective-pediatric-laparoscopic-gastrostomy-tube-insertion-is-safe-and-increasing-in-frequency-a-nsqip-pediatric-retrospective-review-2017-to-2021-10299) — video · 0:58 · [machine version](https://library.globalcastmd.com/watch/same-day-discharge-for-elective-pediatric-laparoscopic-gastrostomy-tube-insertion-is-safe-and-increasing-in-frequency-a-nsqip-pediatric-retrospective-review-2017-to-2021-10299.md)
- [Current management of pulmonary relapse in Ewing sarcoma: A report from the Pediatric Surgical Oncology Research Collaborative](https://library.globalcastmd.com/watch/current-management-of-pulmonary-relapse-in-ewing-sarcoma-a-report-from-the-pediatric-surgical-oncology-research-collaborative-11335) — video · 1:14 · [machine version](https://library.globalcastmd.com/watch/current-management-of-pulmonary-relapse-in-ewing-sarcoma-a-report-from-the-pediatric-surgical-oncology-research-collaborative-11335.md)
- [Early Postoperative Fever in Pediatric Oncology Patients Undergoing Solid Tumor Resection](https://library.globalcastmd.com/watch/early-postoperative-fever-in-pediatric-oncology-patients-undergoing-solid-tumor-resection-11354) — video · 0:51 · [machine version](https://library.globalcastmd.com/watch/early-postoperative-fever-in-pediatric-oncology-patients-undergoing-solid-tumor-resection-11354.md)

### Case-Based Learning
- [Difficult Cases of Lung Lesions: Pediatric Thoracic Surgery Part 1-Lung...](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085) — video · 21:56 · [machine version](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085.md)
- [Update Course Rewind: Chest Wall Reconstruction 2024](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839) — video · 5:32 · [machine version](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839.md)

### In-Depth Reviews
- [Rapid Fire and Conclusion: Pediatric Obesity 2017](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373) — video · 23:37 · [machine version](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373.md)
- [Ovarian Teratoma - Ovarian Torsion - Soft Tissue Sarcoma: Update Course 2015](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672) — video · 34:37 · [machine version](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672.md)
- [Soft Tissue Sarcoma Rapid Fire: Update Course 2015](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980) — video · 8:27 · [machine version](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980.md)
- [Compiled Hayes Jordan Rapid Fire Sessions: Update Course 2015](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995) — video · 33:36 · [machine version](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995.md)
- [Lymphatic Anomalies](https://library.globalcastmd.com/watch/lymphatic-anomalies-290) — podcast · 43:16 · [machine version](https://library.globalcastmd.com/watch/lymphatic-anomalies-290.md)
- [Urology Part I](https://library.globalcastmd.com/watch/urology-part-i-1980) — podcast · 69:50 · [machine version](https://library.globalcastmd.com/watch/urology-part-i-1980.md)
- [Inguinal Hernia: Adult](https://library.globalcastmd.com/watch/inguinal-hernia-adult-3441) — podcast · 31:02 · [machine version](https://library.globalcastmd.com/watch/inguinal-hernia-adult-3441.md)
- [Thyroid Disorders](https://library.globalcastmd.com/watch/thyroid-disorders-302) — podcast · 45:51 · [machine version](https://library.globalcastmd.com/watch/thyroid-disorders-302.md)
- [Wilms Tumor: Audio Chapter](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487) — podcast · 64:03 · [machine version](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487.md)
- [Update Course Rewind: 2021 Top Ten Key Takeaways](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578) — video · 16:02 · [machine version](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578.md)
- [Update Course Rewind: 2022 Top Ten Key Takeaways](https://library.globalcastmd.com/watch/update-course-rewind-2022-top-ten-key-takeaways-6766) — video · [machine version](https://library.globalcastmd.com/watch/update-course-rewind-2022-top-ten-key-takeaways-6766.md)
- [Pyloric Stenosis with Dr. Alex Bondoc](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728) — podcast · 16:20 · [machine version](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728.md)
- [Update Course Rewind: 2023 Top Ten Key Takeaways](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758) — video · 16:22 · [machine version](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758.md)
- [Choledocholithiasis with Drs. David Vitale & Lucas Neff](https://library.globalcastmd.com/watch/choledocholithiasis-with-drs-david-vitale-lucas-neff-8884) — podcast · 15:27 · [machine version](https://library.globalcastmd.com/watch/choledocholithiasis-with-drs-david-vitale-lucas-neff-8884.md)

### Emerging & Future Directions
- [#APSA50: Artificial Intelligence](https://library.globalcastmd.com/watch/apsa50-artificial-intelligence-1445) — podcast · 15:04 · [machine version](https://library.globalcastmd.com/watch/apsa50-artificial-intelligence-1445.md)

## Chapters
- [0:00](https://library.globalcastmd.com/watch/pediatric-and-young-adult-image-guided-percutaneous-bone-biopsy-a-new-standard-of-care-11545?t=0) Image-Guided Percutaneous Biopsy for Pediatric Bone Tumors (Ep 33)
- [0:00](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=0) Introduction and Background (Ep 11)
- [2:51](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=171) Initial Evaluation of Thyroid Nodules (Ep 11)
- [6:57](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=417) Diagnostic Workup and Imaging (Ep 11)
- [11:40](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=700) Surgical Management of Papillary Thyroid Cancer (Ep 11)
- [17:40](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1060) Postoperative Management and Risk Stratification (Ep 11)
- [22:53](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1373) Management of Follicular Lesions (Ep 11)
- [27:53](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1673) Benign Nodules and Medullary Thyroid Cancer Introduction (Ep 11)
- [33:32](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2012) Multiple Endocrine Neoplasia Syndromes (Ep 11)
- [39:46](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2386) Medullary Cancer Follow-up and Special Considerations (Ep 11)
- [44:23](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2663) Closing Remarks (Ep 11)
- [0:00](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=0) Introduction and Case Presentation (Ep 24)
- [3:05](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=185) Epidemiology, Risk Factors, and Diagnosis (Ep 24)
- [6:14](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=374) Medical Management and Resuscitation (Ep 24)
- [8:07](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=487) Surgical Technique and Intraoperative Considerations (Ep 24)
- [13:47](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=827) Post-operative Care and Long-term Outcomes (Ep 24)
- [0:00](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=0) Introduction and #10: POEM for Achalasia (Ep 25)
- [1:52](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=112) #9: Blunt Cerebrovascular Injury Screening (Ep 25)
- [3:12](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=192) #8: Early Discharge After Pyloromyotomy (Ep 25)
- [4:36](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=276) #7: ICG for Sentinel Node Identification (Ep 25)
- [6:21](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=381) #6: Anal Dilation After PSARP (Ep 25)
- [7:58](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=478) #5: Fertility Preservation in Pediatric Oncology (Ep 25)
- [9:40](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=580) #4: Massive Transfusion Protocol (Ep 25)
- [11:24](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=684) #3: Management of Ovarian Torsion (Ep 25)
- [12:54](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=774) #2: Total Pancreatectomy with Islet Autotransplantation (Ep 25)
- [14:22](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=862) #1: Non-Operative Management of Blunt Liver and Spleen Trauma (Ep 25)
- [0:00](https://library.globalcastmd.com/watch/choledocholithiasis-with-drs-david-vitale-lucas-neff-8884?t=0) Introduction and Risk Stratification (Ep 26)
- [2:38](https://library.globalcastmd.com/watch/choledocholithiasis-with-drs-david-vitale-lucas-neff-8884?t=158) Pediatric Predictors and Treatment Approaches (Ep 26)
- [5:17](https://library.globalcastmd.com/watch/choledocholithiasis-with-drs-david-vitale-lucas-neff-8884?t=317) Surgery-First Paradigm (Ep 26)
- [9:37](https://library.globalcastmd.com/watch/choledocholithiasis-with-drs-david-vitale-lucas-neff-8884?t=577) Technical Details of Laparoscopic CBD Exploration (Ep 26)
- [13:47](https://library.globalcastmd.com/watch/choledocholithiasis-with-drs-david-vitale-lucas-neff-8884?t=827) Learning Curve and Summary (Ep 26)
- [0:00](https://library.globalcastmd.com/watch/apsa50-artificial-intelligence-1445?t=0) Introduction and Background (Ep 7)
- [1:20](https://library.globalcastmd.com/watch/apsa50-artificial-intelligence-1445?t=80) Current AI Applications in Healthcare (Ep 7)
- [4:34](https://library.globalcastmd.com/watch/apsa50-artificial-intelligence-1445?t=274) Future Applications in Surgery and ICU (Ep 7)
- [7:41](https://library.globalcastmd.com/watch/apsa50-artificial-intelligence-1445?t=461) Limitations of AI and Data Requirements (Ep 7)
- [10:47](https://library.globalcastmd.com/watch/apsa50-artificial-intelligence-1445?t=647) Cloud Infrastructure and Ethical Considerations (Ep 7)
- [0:00](https://library.globalcastmd.com/watch/female-fertility-cryopreservation-outcomes-in-childhood-cancer-a-systematic-review-9521?t=0) Systematic Review of Female Fertility Cryopreservation Outcomes (Ep 27)
- [0:00](https://library.globalcastmd.com/watch/urology-part-i-1980?t=0) Introduction and Circumcision Indications (Ep 9)
- [8:43](https://library.globalcastmd.com/watch/urology-part-i-1980?t=523) Circumcision Technique and Anesthesia (Ep 9)
- [20:25](https://library.globalcastmd.com/watch/urology-part-i-1980?t=1225) Operating Room Circumcision and Dressing (Ep 9)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- "The study evaluated 169 biopsies in 141 patients over a 10-year period at a single institution." — Sophia Schermerhorn (clinical) [Ep 33 · 0:13](https://library.globalcastmd.com/watch/pediatric-and-young-adult-image-guided-percutaneous-bone-biopsy-a-new-standard-of-care-11545?t=13)
- "Nearly 90% of the biopsies were core-needle biopsies." — Sophia Schermerhorn (clinical) [Ep 33 · 0:19](https://library.globalcastmd.com/watch/pediatric-and-young-adult-image-guided-percutaneous-bone-biopsy-a-new-standard-of-care-11545?t=19)
- "All biopsies were performed with image guidance, most commonly CT, sometimes combined with fluoroscopy and ultrasound." — Sophia Schermerhorn (clinical) [Ep 33 · 0:22](https://library.globalcastmd.com/watch/pediatric-and-young-adult-image-guided-percutaneous-bone-biopsy-a-new-standard-of-care-11545?t=22)
- "All biopsies were performed by interventional radiologists." — Sophia Schermerhorn (clinical) [Ep 33 · 0:28](https://library.globalcastmd.com/watch/pediatric-and-young-adult-image-guided-percutaneous-bone-biopsy-a-new-standard-of-care-11545?t=28)
- "97.9% of biopsies were diagnostic." — Sophia Schermerhorn (clinical) [Ep 33 · 0:33](https://library.globalcastmd.com/watch/pediatric-and-young-adult-image-guided-percutaneous-bone-biopsy-a-new-standard-of-care-11545?t=33)
- "Only 3 patients required repeat biopsy." — Sophia Schermerhorn (clinical) [Ep 33 · 0:33](https://library.globalcastmd.com/watch/pediatric-and-young-adult-image-guided-percutaneous-bone-biopsy-a-new-standard-of-care-11545?t=33)
- "There was one patient with transient sciatic nerve paresis, which resolved." — Sophia Schermerhorn (clinical) [Ep 33 · 0:40](https://library.globalcastmd.com/watch/pediatric-and-young-adult-image-guided-percutaneous-bone-biopsy-a-new-standard-of-care-11545?t=40)
- "The complication rate was 0.7%." — Sophia Schermerhorn (clinical) [Ep 33 · 0:43](https://library.globalcastmd.com/watch/pediatric-and-young-adult-image-guided-percutaneous-bone-biopsy-a-new-standard-of-care-11545?t=43)
- "The approach provided sufficient tissue for histology, immunostains, and molecular studies." — Sophia Schermerhorn (clinical) [Ep 33 · 0:46](https://library.globalcastmd.com/watch/pediatric-and-young-adult-image-guided-percutaneous-bone-biopsy-a-new-standard-of-care-11545?t=46)
- "Immunostains and molecular studies are increasingly essential for modern risk stratification and targeted therapy." — Sophia Schermerhorn (clinical) [Ep 33 · 0:46](https://library.globalcastmd.com/watch/pediatric-and-young-adult-image-guided-percutaneous-bone-biopsy-a-new-standard-of-care-11545?t=46)
- "Image-guided percutaneous biopsy should be strongly considered the diagnostic modality of choice for pediatric bone and soft tissue tumors." — Sophia Schermerhorn (opinion) [Ep 33 · 0:56](https://library.globalcastmd.com/watch/pediatric-and-young-adult-image-guided-percutaneous-bone-biopsy-a-new-standard-of-care-11545?t=56)
- "Thyroid nodules are less common in children than adults, but when detected in children they are more likely to be malignant" — Diana Deason (epidemiological) [Ep 11 · 6:23](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=383)
- "When children present with thyroid cancer, they are more likely to have extension outside of the thyroid, regional lymph node involvement, and distant metastasis compared to adults" — Diana Deason (clinical) [Ep 11 · 6:31](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=391)
- "Risk factors for thyroid nodules and cancer include previous exposure to radiation or alkylating agents, such as treatment for Hodgkin's lymphoma, leukemia, or CNS tumors" — Diana Deason (clinical) [Ep 11 · 4:08](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=248)
- "Thyroid conditions and cancers have familial predisposition including MEN syndromes, PTEN hamartoma tumor syndromes, and APC-associated polyposis syndromes" — Diana Deason (clinical) [Ep 11 · 4:27](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=267)
- "Current ATA recommendations state that hyperfunctioning nodules (hot nodules) do not need to be biopsied if they are going to be resected" — Diana Deason (guideline) [Ep 11 · 8:08](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=488)
- "Ultrasound features suspicious for thyroid malignancy include hypoechoic mass, irregular margins, increased blood flow, and microcalcifications" — Diana Deason (clinical) [Ep 11 · 9:57](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=597)
- "In adults, lesions less than 1 centimeter are not biopsied, but in pediatric patients size cutoffs cannot be used as in adults; ultrasound characteristics and clinical context determine biopsy indication" — Diana Deason (guideline) [Ep 11 · 11:12](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=672)
- "Papillary thyroid cancer in children shows bilateral disease in up to 30% of patients and multifocal disease in up to 65% of pediatric patients" — Diana Deason (epidemiological) [Ep 11 · 15:00](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=900)
- "Current recommendations for papillary thyroid cancer are total or near-total thyroidectomy due to risk of bilateral disease, multifocal disease, increased recurrence risk with lobectomy alone, and ability to optimize for radioactive iodine therapy" — Diana Deason (guideline) [Ep 11 · 15:00](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=900)
- "Nerve monitoring is used routinely during thyroidectomy; while it does not decrease risk of nerve injury, it is helpful in identifying the recurrent laryngeal nerve, especially in patients with bulky cervical disease" — Diana Deason (opinion) [Ep 11 · 17:07](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1027)
- "There is no evidence to support prophylactic lateral neck dissection in pediatric thyroid cancer" — Diana Deason (guideline) [Ep 11 · 18:33](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1113)
- "After total thyroidectomy, PTH level less than 10-15 in recovery indicates higher risk for hypocalcemia and warrants starting calcium replacement or calcitriol" — Diana Deason (clinical) [Ep 11 · 19:37](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1177)
- "Low-risk papillary thyroid cancer (disease confined to thyroid with no metastatic lymph nodes) requires only postoperative thyroglobulin monitoring with TSH goal of 0.5-1, ultrasound at 6 months then annually for 5 years, and no radioactive iodine" — Diana Deason (guideline) [Ep 11 · 21:12](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1272)
- "Intermediate-risk patients (extensive central neck disease or any lateral neck disease) and high-risk patients (extensive regional disease, local invasion, or distant metastasis) receive radioactive iodine postoperatively" — Diana Deason (guideline) [Ep 11 · 21:48](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1308)
- "High-risk papillary thyroid cancer patients have TSH suppression goal of less than 0.1, while low-risk patients have goal of 0.5-1" — Diana Deason (guideline) [Ep 11 · 27:31](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1651)
- "Follicular lesions are indeterminate specimens representing about one-third of FNA results, with three subtypes: follicular lesion of undetermined significance, follicular lesion concerning for neoplasm, and suspicious/suggestive of malignancy with follicular component" — Diana Deason (clinical) [Ep 11 · 23:05](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1385)
- "Follicular lesions of undetermined significance have 5-15% malignancy risk in adults but approximately 28% in pediatric literature" — Diana Deason (epidemiological) [Ep 11 · 24:07](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1447)
- "Follicular neoplasms have reported malignancy rate of 15-30% but more recent data suggests 50-60% in pediatric patients" — Diana Deason (epidemiological) [Ep 11 · 24:18](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1458)
- "Most recent ATA recommendations are that all indeterminate lesions in children be resected due to higher malignancy risk compared to adults" — Diana Deason (guideline) [Ep 11 · 23:50](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1430)
- "Frozen section cannot distinguish follicular adenoma from follicular carcinoma but can identify papillary component" — Diana Deason (clinical) [Ep 11 · 25:04](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1504)
- "Follicular carcinoma with significant vascular invasion or tumor greater than 4 centimeters requires completion thyroidectomy; minimal vascular invasion with smaller tumor can be monitored" — Diana Deason (guideline) [Ep 11 · 26:10](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1570)
- "After lobectomy for benign disease, approximately 30% of patients may develop hypothyroidism at some point, requiring thyroid function monitoring" — Diana Deason (epidemiological) [Ep 11 · 27:01](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1621)
- "For thyroid masses greater than 4 centimeters, the sensitivity and specificity of FNA is decreased, requiring careful follow-up even if benign" — Diana Deason (clinical) [Ep 11 · 28:49](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1729)
- "Benign FNA results should be followed with repeat ultrasound in 6-12 months with repeat biopsy if the mass is enlarging or develops suspicious features" — Diana Deason (guideline) [Ep 11 · 29:02](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1742)
- "Inadequate FNA specimens occur in roughly 1-3% of cases and should be repeated in 3-6 months to avoid picking up atypia from trauma of initial FNA" — Diana Deason (clinical) [Ep 11 · 29:49](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1789)
- "Sporadic medullary thyroid cancer is unusual in children, so routine calcitonin monitoring is not recommended for every pediatric patient with a thyroid nodule" — Diana Deason (guideline) [Ep 11 · 31:34](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1894)
- "Patients with medullary thyroid cancer and calcitonin level greater than 500 at presentation require imaging to exclude metastatic disease including CT neck, CT chest, MRI or CT abdomen, and possibly bone scan" — Diana Deason (guideline) [Ep 11 · 33:01](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=1981)
- "MEN 2A patients can develop medullary thyroid cancer, pheochromocytomas, and hyperparathyroidism" — Diana Deason (clinical) [Ep 11 · 33:36](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2016)
- "MEN 2B patients can develop medullary thyroid cancer, pheochromocytomas, mucosal neuromas, and Marfanoid habitus with elongated features and joint laxity" — Diana Deason (clinical) [Ep 11 · 33:47](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2027)
- "MEN 2B patients with RET 918 mutation present with thyroid cancer very early, in infancy, with reported cases as young as 3 months" — Diana Deason (clinical) [Ep 11 · 34:11](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2051)
- "MEN 2B patients with 918 mutation should have thyroidectomy before one year of age" — Diana Deason (guideline) [Ep 11 · 34:31](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2071)
- "De novo RET mutations are more likely to be MEN 2B than 2A" — Diana Deason (epidemiological) [Ep 11 · 35:13](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2113)
- "MEN 2A patients are classified as high-risk or moderate-risk based on specific RET codon mutations, with different timing recommendations for prophylactic thyroidectomy" — Diana Deason (guideline) [Ep 11 · 35:42](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2142)
- "MEN 2A high-risk patients (most commonly RET 634 mutation) should have total thyroidectomy before age 5, with surveillance starting at age 3 including calcitonin, CEA, and ultrasounds" — Diana Deason (guideline) [Ep 11 · 36:03](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2163)
- "If calcitonin levels exceed 40 in MEN 2A surveillance, central neck dissection is recommended at time of thyroidectomy" — Diana Deason (guideline) [Ep 11 · 36:27](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2187)
- "Children under age 10 have increased risk of complications from thyroidectomy including hypoparathyroidism and nerve injury due to smaller anatomy" — Diana Deason (clinical) [Ep 11 · 36:36](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2196)
- "MEN 2A moderate-risk patients have thyroidectomy when serum calcitonin becomes elevated or if parents decline frequent surveillance" — Diana Deason (guideline) [Ep 11 · 36:59](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2219)
- "MEN 2A high-risk patients begin pheochromocytoma screening at age 11; moderate-risk patients begin at age 16" — Diana Deason (guideline) [Ep 11 · 37:55](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2275)
- "Central lymph node dissection for medullary thyroid cancer is not necessary if prophylactic thyroidectomy is performed before calcitonin levels exceed 40" — Diana Deason (guideline) [Ep 11 · 39:03](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2343)
- "After medullary thyroid cancer surgery, if calcitonin levels are greater than 150, imaging is needed to detect metastasis including CT neck, CT chest, MRI or CT abdomen, bone scan, and MRI of pelvis and axial skeleton" — Diana Deason (guideline) [Ep 11 · 40:22](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2422)
- "Systemic therapy for medullary thyroid cancer (tyrosine kinase inhibitors and external beam radiation) has significant side effects and is reserved for progressive disease not treatable with surgery, not used routinely for elevated calcitonin alone" — Diana Deason (guideline) [Ep 11 · 41:38](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2498)
- "In young children with Graves' disease, surgery is often preferred over radioactive iodine due to concerns about risks of secondary malignancies from radioactive iodine" — Diana Deason (opinion) [Ep 11 · 42:29](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2549)
- "Diffuse infiltration of the thyroid (rather than discrete nodule) is a characteristic of papillary thyroid cancer that is more common in children and should prompt biopsy especially if suspicious lymph nodes are present" — Diana Deason (clinical) [Ep 11 · 43:52](https://library.globalcastmd.com/watch/thyroid-disorders-302?t=2632)
- "Pyloric stenosis occurs when the pyloric muscle becomes thickened or hypertrophied, creating a narrower passage between stomach and small intestine that blocks food passage." — Em Gootee (clinical) [Ep 24 · 0:21](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=21)
- "The classic symptom of pyloric stenosis is projectile vomiting after feeding followed by signs of hunger, which can lead to severe dehydration and weight loss." — Em Gootee (clinical) [Ep 24 · 0:40](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=40)
- "Bilious vomiting should be considered an emergency in an infant." — Em Gootee (guideline) [Ep 24 · 2:19](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=139)
- "Risk factors for pyloric stenosis include being first-born, male sex, family history, maternal diabetes, bottle-feeding, prematurity, C-section birth, and exposure to erythromycin." — Kim Pribbin (epidemiological) [Ep 24 · 2:33](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=153)
- "Pyloric stenosis usually affects babies between 2 and 8 weeks of age but can occur anytime from birth to 6 months." — Em Gootee (epidemiological) [Ep 24 · 2:56](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=176)
- "Pyloric stenosis occurs in about 4 to 5 in 1000 live births with heavy male preponderance." — Alex Bondoc (epidemiological) [Ep 24 · 3:05](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=185)
- "A 2017 Journal of Pediatric Surgery study of 584 patients found African American infants with pyloric stenosis presented with higher bicarbonate and lower chloride levels." — Em Gootee (epidemiological) [Ep 24 · 3:24](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=204)
- "Uninsured families' babies had lower chloride and higher bicarbonate levels at presentation and longer times between diagnosis and operating room." — Kim Pribbin (epidemiological) [Ep 24 · 3:44](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=224)
- "A large-scale study from Denmark and Holland found pyloric stenosis is 87% heritable." — Kim Pribbin (epidemiological) [Ep 24 · 4:13](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=253)
- "Researchers have identified specific genetic changes that may indicate risk for pyloric stenosis as a molecular diagnostic marker." — Em Gootee (clinical) [Ep 24 · 4:25](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=265)
- "A key physical exam finding is a palpable olive in the upper right quadrant, which is the palpable stenosed muscle." — Kim Pribbin (clinical) [Ep 24 · 4:41](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=281)
- "Laboratory findings typically include hyperbilirubinemia, hypochloremia, and elevated bicarbonate levels." — Em Gootee (clinical) [Ep 24 · 5:22](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=322)
- "Loss of chloride and hydrogen ions from vomiting leads to hypochloremic metabolic alkalosis." — Kim Pribbin (clinical) [Ep 24 · 5:35](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=335)
- "Elevated bicarbonate is excreted in urine, which obligates sodium loss to maintain electroneutrality; water loss follows sodium excretion, making the patient more hemodynamically unstable." — Em Gootee (clinical) [Ep 24 · 5:46](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=346)
- "There is an association between Gilbert's syndrome and pyloric stenosis; some patients are incidentally diagnosed with Gilbert's when labs are checked for pyloric stenosis." — Alex Bondoc (clinical) [Ep 24 · 6:01](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=361)
- "Ultrasound diagnostic criteria for pyloric stenosis are muscle thickness greater than 4 millimeters and pyloric channel length greater than 15 millimeters." — Kim Pribbin (clinical) [Ep 24 · 6:23](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=383)
- "A 2008 and 2016 Journal of Pediatric Surgery study identified specific fluid resuscitation pathways that reduced blood draws and did not delay time to surgery." — Kim Pribbin (clinical) [Ep 24 · 6:46](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=406)
- "Recommended fluid resuscitation is a bolus of isotonic saline followed by maintenance IV fluids of D5 half-normal saline with 20 milliequivalents per liter of potassium chloride added." — Em Gootee (guideline) [Ep 24 · 7:04](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=424)
- "Nasogastric decompression should be avoided to prevent exacerbation of metabolic alkalosis." — Kim Pribbin (guideline) [Ep 24 · 7:18](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=438)
- "Atropine is traditional medical management for pyloric stenosis but has fallen out of favor because pediatric anesthetists are skilled and there is not high concordance between congenital anomalies that would make a baby high anesthetic risk." — Alex Bondoc (opinion) [Ep 24 · 7:34](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=454)
- "Pyloromyotomy is a 45-minute curative operation that can be done safely and quickly." — Em Gootee (clinical) [Ep 24 · 7:53](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=473)
- "According to a 2023 Journal of Pediatric Surgery study, antibiotic prophylaxis may be unnecessary for pyloromyotomy and may carry unnecessary long-term side effects." — Em Gootee (clinical) [Ep 24 · 8:12](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=492)
- "The first pyloromyotomy was done the year before Ramstedt, but Ramstedt popularized it and the spreader bears his name; he used a coffee spoon and intended to do pyloroplasty but ended up doing myotomy only because the baby became unstable." — Alex Bondoc (clinical) [Ep 24 · 8:40](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=520)
- "Gastric suction prior to induction is essential; anesthetists suction the baby while awake in three positions (head down, turn right, turn left) to empty the atonic stomach and prevent aspiration during induction." — Alex Bondoc (guideline) [Ep 24 · 9:09](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=549)
- "For laparoscopic pyloromyotomy, the baby is positioned perpendicular to the bed's long axis and the surgeon operates from the baby's feet using 3-millimeter instruments." — Kim Pribbin (clinical) [Ep 24 · 9:57](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=597)
- "The surgeon should know the channel length from ultrasound because a 3-millimeter Maryland grasper when fully opened is 13 millimeters; if the channel is 15-18 millimeters and only a 13-millimeter myotomy is made, it will be incomplete." — Alex Bondoc (clinical) [Ep 24 · 10:57](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=657)
- "The technique involves scoring the serosal surface, finding entry with the bovie blade, twisting to crack the muscle, then using a serrated spreader to grip and separate the muscle; both ends should move independently when complete." — Alex Bondoc (clinical) [Ep 24 · 11:23](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=683)
- "If the myotomy is incomplete, there will be resistance when gripping the muscle or the ends may still move as if connected." — Kim Pribbin (clinical) [Ep 24 · 11:49](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=709)
- "The anesthetist can put air down a suction catheter to look for bubbles if mucosal violation is suspected; a piece of omentum is laid on top of the myotomy." — Alex Bondoc (clinical) [Ep 24 · 12:05](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=725)
- "Open pyloromyotomy can be done through a periumbilical incision with tunneling up to the right upper quadrant by stretching the baby's skin." — Alex Bondoc (clinical) [Ep 24 · 12:27](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=747)
- "Risks of pyloromyotomy include incomplete myotomy, mucosal perforation, aspiration, and wound infection." — Em Gootee (clinical) [Ep 24 · 12:52](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=772)
- "Incisional hernias can occur because the fascia on stab incisions in the left and right upper quadrant is typically not closed; omental hernias have been observed." — Alex Bondoc (clinical) [Ep 24 · 13:06](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=786)
- "Complication rates after pyloromyotomy are equivalent or better with open approach because laparoscopic pyloromyotomy is an experience and feel operation." — Alex Bondoc (opinion) [Ep 24 · 13:23](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=803)
- "Post-operative vomiting is very common and does not necessarily mean the operation did not work; the stomach is still atonic and will not remodel immediately." — Alex Bondoc (clinical) [Ep 24 · 13:54](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=834)
- "Complete intolerance of feeds lasting into days post-operatively raises concern for incomplete myotomy." — Alex Bondoc (clinical) [Ep 24 · 14:13](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=853)
- "A flexible feeding protocol that reduces formula volume if a baby vomits 6 times but continues smaller feeds and increases as tolerated allows greater flexibility and decreases length of hospital stay." — Em Gootee (clinical) [Ep 24 · 14:30](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=870)
- "Adults who had pyloromyotomy as children do not tend to have major issues like nausea, vomiting, reflux, or other GI problems later in life, suggesting long-term follow-up is usually not necessary." — Kim Pribbin (clinical) [Ep 24 · 15:08](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=908)
- "POEM procedure allows 360 degrees of myotomy options versus approximately 180 degrees with laparoscopic Heller myotomy" (clinical) [Ep 25 · 1:06](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=66)
- "POEM can be performed after a failed Heller or prior POEM by choosing a different dissection plane" (clinical) [Ep 25 · 1:22](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=82)
- "POEM does not require hiatal dissection, reducing reflux risk" (clinical) [Ep 25 · 1:32](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=92)
- "Blunt cerebrovascular injury (BCVI) occurs in 1.3% of all pediatric head trauma" (epidemiological) [Ep 25 · 2:02](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=122)
- "Nearly one third of pediatric BCVI patients will have a stroke, increasing mortality up to 20%" (epidemiological) [Ep 25 · 2:02](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=122)
- "The Memphis score is the most sensitive scoring system for BCVI screening" — Meera Kotagal (guideline) [Ep 25 · 2:51](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=171)
- "Patients under 37 weeks gestational age or younger than 4 weeks old should be monitored overnight post-pyloromyotomy" (guideline) [Ep 25 · 4:18](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=258)
- "Full-term babies over 4 weeks old may be eligible for discharge from PACU after pyloromyotomy" (guideline) [Ep 25 · 3:56](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=236)
- "NSQIP data show only 1.5% of pyloromyotomy patients were discharged on day of surgery with no difference in readmission or complication odds" (epidemiological) [Ep 25 · 4:01](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=241)
- "ICG technique for sentinel node identification is real-time and uses equipment standard in laparoscopic towers" (clinical) [Ep 25 · 5:20](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=320)
- "ICG travels to the sentinel node over 45 to 75 seconds after injection into the tumor" (clinical) [Ep 25 · 5:52](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=352)
- "Recent studies show lack of firm correlation between anal dilations and stricture development after PSARP" (clinical) [Ep 25 · 6:39](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=399)
- "Many PSARP patients require colostomy closure, providing opportunity for strictureplasty if needed" (clinical) [Ep 25 · 7:02](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=422)
- "Fertility preservation counseling is emphasized by every professional society even when surgery is not planned" (guideline) [Ep 25 · 8:20](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=500)
- "Prepubertal ovary is approximately 2 centimeters in size, about the size of a grape" (clinical) [Ep 25 · 9:08](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=548)
- "Laparoscopic oophorectomy is recommended for prepubertal ovarian tissue preservation to reduce hemorrhage risk and preserve remaining ovarian tissue" (guideline) [Ep 25 · 9:13](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=553)
- "Massive transfusion protocol should be activated after administering 20 mL per kilogram of blood in the trauma bay" (guideline) [Ep 25 · 11:08](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=668)
- "Blood products in massive transfusion should be given in 1:1:1 ratio (packed red blood cells:FFP:platelets)" — Meera Kotagal (guideline) [Ep 25 · 10:34](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=634)
- "Most trauma coolers do not contain platelets; they must be specifically ordered or obtained via MTP activation" — Meera Kotagal (clinical) [Ep 25 · 10:58](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=658)
- "In ovarian torsion, avoid oophorectomy even if ovary appears black because it may regain functionality" (clinical) [Ep 25 · 12:23](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=743)
- "Do not perform oophoropexy after detorsion of ovarian torsion; recommend detorsion and monitoring only" (guideline) [Ep 25 · 12:31](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=751)
- "After TPIAT, all patients are on insulin in the ICU to allow islet cells to engraft without metabolic stress" — Juan Gurria (clinical) [Ep 25 · 13:27](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=807)
- "Many chronic pancreatitis patients have gene mutations triggering recurrent attacks that replace normal pancreatic cells with fibrosis" (clinical) [Ep 25 · 13:45](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=825)
- "APSA 2023 guidelines support treating blunt liver and spleen trauma based on hemodynamic stability and clinical signs rather than injury grade alone" (guideline) [Ep 25 · 16:04](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=964)
- "Grade 1 and 2 blunt liver and spleen injuries in hemodynamically stable patients can be considered for discharge from the emergency department" (guideline) [Ep 25 · 15:13](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=913)
- "Hemodynamically stable pediatric trauma patients with normal initial hemoglobin do not require repeat CBC unless clinical status changes" — Meera Kotagal (guideline) [Ep 25 · 15:36](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=936)
- "Initial hemoglobin less than 9.25 g/dL predicts higher likelihood of non-operative management failure in blunt abdominal trauma" — Meera Kotagal (clinical) [Ep 25 · 15:46](https://library.globalcastmd.com/watch/update-course-rewind-2023-top-ten-key-takeaways-8758?t=946)
- "Choledocholithiasis is more common in older children, children with higher BMI, and patients of Hispanic ethnicity" — David Vitale (epidemiological) [Ep 26 · 1:03](https://library.globalcastmd.com/watch/choledocholithiasis-with-drs-david-vitale-lucas-neff-8884?t=63)
- "Risk factors for choledocholithiasis include metabolic diseases, hemolysis such as sickle cell, and congenital biliary anomalies like choledochal cysts" — David Vitale (clinical) [Ep 26 · 0:55](https://library.globalcastmd.com/watch/choledocholithiasis-with-drs-david-vitale-lucas-neff-8884?t=55)
- "According to ASGE guidelines, patients with high probability of common bile duct stones (common bile duct stones seen on ultrasound, ascending cholangitis, or quite high bilirubin) should go straight to ERCP" — David Vitale (guideline) [Ep 26 · 1:52](https://library.globalcastmd.com/watch/choledocholithiasis-with-drs-david-vitale-lucas-neff-8884?t=112)
- "Patients with intermediate risk (abnormal liver biochemical tests or dilated common bile ducts) can undergo endoscopic ultrasound, MRCP, laparoscopic cholangiogram, or intraoperative ultrasound" — Cecilia Gigena (guideline) [Ep 26 · 2:11](https://library.globalcastmd.com/watch/choledocholithiasis-with-drs-david-vitale-lucas-neff-8884?t=131)
- "In pediatric patients, direct bilirubin or conjugated bilirubin more than 2 was the most predictive factor for common bile duct stones" — David Vitale (clinical) [Ep 26 · 2:40](https://library.globalcastmd.com/watch/choledocholithiasis-with-drs-david-vitale-lucas-neff-8884?t=160)
- "Common bile duct diameter greater than 6 millimeters was most sensitive for predicting common bile duct stones in children, although without statistical significance" — Cecilia Gigena (clinical) [Ep 26 · 2:50](https://library.globalcastmd.com/watch/choledocholithiasis-with-drs-david-vitale-lucas-neff-8884?t=170)
- "The pediatric duct score (published in Journal of American College of Surgeons with 10 centers) found that ducts greater than 6 millimeters, common bile duct stones on ultrasound, or total bilirubin greater than 1.8 were the most predictive risk factors" — David Vitale (clinical) [Ep 26 · 3:03](https://library.globalcastmd.com/watch/choledocholithiasis-with-drs-david-vitale-lucas-neff-8884?t=183)
- "Pediatric literature with small sample size shows that doing same anesthesia laparoscopic cholecystectomy with ERCP in stone disease led to less anesthesia time and lower length of stay" — David Vitale (clinical) [Ep 26 · 3:41](https://library.globalcastmd.com/watch/choledocholithiasis-with-drs-david-vitale-lucas-neff-8884?t=221)
- "Retrospective data comparing ERCP versus laparoscopic common bile duct exploration is conflicted and the choice is probably institution and provider dependent based on expertise" — David Vitale (opinion) [Ep 26 · 4:03](https://library.globalcastmd.com/watch/choledocholithiasis-with-drs-david-vitale-lucas-neff-8884?t=243)
- "Randomized trials from 2013 show no significant difference in morbidity, mortality, retained stones, or failure rates between ERCP and laparoscopic common bile duct exploration" — Cecilia Gigena (clinical) [Ep 26 · 4:18](https://library.globalcastmd.com/watch/choledocholithiasis-with-drs-david-vitale-lucas-neff-8884?t=258)
- "Stones above the cystic duct pose a problem because they can float up during attempted laparoscopic removal, making the procedure more difficult" — David Vitale (clinical) [Ep 26 · 4:39](https://library.globalcastmd.com/watch/choledocholithiasis-with-drs-david-vitale-lucas-neff-8884?t=279)
- "Local expertise and availability is probably the most important factor in deciding between ERCP and laparoscopic common bile duct exploration" — David Vitale (opinion) [Ep 26 · 5:00](https://library.globalcastmd.com/watch/choledocholithiasis-with-drs-david-vitale-lucas-neff-8884?t=300)
- "Most free-standing children's hospitals do not have ERCP capabilities" — Cecilia Gigena (epidemiological) [Ep 26 · 9:12](https://library.globalcastmd.com/watch/choledocholithiasis-with-drs-david-vitale-lucas-neff-8884?t=552)
- "The mantra for laparoscopic common bile duct exploration is all stones go forward, using balloons to dilate the sphincter and flush stones antegrade into the duodenum" — Luke Neff (clinical) [Ep 26 · 6:42](https://library.globalcastmd.com/watch/choledocholithiasis-with-drs-david-vitale-lucas-neff-8884?t=402)
- "If you're having to open up the common bile duct to extract the stone and you had ERCP capability, that's probably not the right thing to do in most cases" — Luke Neff (opinion) [Ep 26 · 7:30](https://library.globalcastmd.com/watch/choledocholithiasis-with-drs-david-vitale-lucas-neff-8884?t=450)
- "A 12 gauge angiocath is used for laparoscopic common bile duct exploration, with a new incision made to achieve a flat angle of entry into the cystic ductotomy" — Luke Neff (clinical) [Ep 26 · 9:37](https://library.globalcastmd.com/watch/choledocholithiasis-with-drs-david-vitale-lucas-neff-8884?t=577)
- "A 6 French ureteral stent cut down shorter for better flow is used with a glide wire, employing a cylinder technique to navigate the valves" — Luke Neff (clinical) [Ep 26 · 9:57](https://library.globalcastmd.com/watch/choledocholithiasis-with-drs-david-vitale-lucas-neff-8884?t=597)
- "An angioplasty balloon of 6 or 8 millimeters (but definitely not more than that) is used to dilate the sphincter" — Luke Neff (clinical) [Ep 26 · 10:37](https://library.globalcastmd.com/watch/choledocholithiasis-with-drs-david-vitale-lucas-neff-8884?t=637)
- "The balloon is inflated in the duct and pulled back to provide tactile feedback to locate the sphincter, then partially deflated to straddle the ampulla, then inflated to full profile under fluoroscopy and held for about 5 minutes" — Luke Neff (clinical) [Ep 26 · 11:02](https://library.globalcastmd.com/watch/choledocholithiasis-with-drs-david-vitale-lucas-neff-8884?t=662)
- "Never use a balloon larger than the dilated common bile duct because literature shows a higher rate of pancreatitis with ampullary dilation without sphincterotomy" — David Vitale (clinical) [Ep 26 · 11:23](https://library.globalcastmd.com/watch/choledocholithiasis-with-drs-david-vitale-lucas-neff-8884?t=683)
- "If the pancreatic duct is seen on fluoroscopy during the procedure, stop because that has a higher risk for pancreatitis" — Cecilia Gigena (clinical) [Ep 26 · 12:24](https://library.globalcastmd.com/watch/choledocholithiasis-with-drs-david-vitale-lucas-neff-8884?t=744)
- "The prevalence of stone disease is increasing" — Luke Neff (epidemiological) [Ep 26 · 12:34](https://library.globalcastmd.com/watch/choledocholithiasis-with-drs-david-vitale-lucas-neff-8884?t=754)
- "The learning curve for laparoscopic common bile duct exploration is around 5 to 10 cases, though this is person-specific" — Luke Neff (clinical) [Ep 26 · 13:40](https://library.globalcastmd.com/watch/choledocholithiasis-with-drs-david-vitale-lucas-neff-8884?t=820)
- "The position of the 12-gauge angiocath is really important, and the ability to manipulate the catheter and wire in the duct depends on the initial setup and how flat the angle of entry is into the cystic duct" — Luke Neff (clinical) [Ep 26 · 13:24](https://library.globalcastmd.com/watch/choledocholithiasis-with-drs-david-vitale-lucas-neff-8884?t=804)
- "Radiology has been thought of as one of the first fields where artificial intelligence will make an impact in healthcare" — Michael Muley (opinion) [Ep 7 · 1:39](https://library.globalcastmd.com/watch/apsa50-artificial-intelligence-1445?t=99)
- "At the Radiological Society of North America annual meeting, there are about 100 to 150 startups presenting in the machine learning showcase" — Michael Muley (epidemiological) [Ep 7 · 1:46](https://library.globalcastmd.com/watch/apsa50-artificial-intelligence-1445?t=106)
- "Yale has deployed AI for prioritization of head bleeds on head CTs, cutting down the time until a radiologist looks at studies with bleeds" — Michael Muley (clinical) [Ep 7 · 2:24](https://library.globalcastmd.com/watch/apsa50-artificial-intelligence-1445?t=144)
- "Most AI applications in radiology are currently in the operational realm, augmenting workflow rather than in the diagnostic sphere" — Michael Muley (clinical) [Ep 7 · 2:45](https://library.globalcastmd.com/watch/apsa50-artificial-intelligence-1445?t=165)
- "Evidence-based medicine has been discussed since the 70s, but most surgical training practices lack strong evidence behind them" — Michael Muley (opinion) [Ep 7 · 3:54](https://library.globalcastmd.com/watch/apsa50-artificial-intelligence-1445?t=234)
- "Laparoscopic surgery provides a natural opportunity for AI because it captures data digitally with video" — Michael Muley (clinical) [Ep 7 · 4:43](https://library.globalcastmd.com/watch/apsa50-artificial-intelligence-1445?t=283)
- "Surgical robots are not currently using AI tools primarily for regulatory reasons" — Michael Muley (clinical) [Ep 7 · 4:50](https://library.globalcastmd.com/watch/apsa50-artificial-intelligence-1445?t=290)
- "Trauma triaging is currently done based on very simple rules and is not very data driven" — Michael Muley (clinical) [Ep 7 · 5:28](https://library.globalcastmd.com/watch/apsa50-artificial-intelligence-1445?t=328)
- "Penn State rolled out a simple sepsis alert based on four criteria (elevated or low white count, temperature, heart rate) that did not work well because it went off too frequently" — Michael Muley (clinical) [Ep 7 · 6:29](https://library.globalcastmd.com/watch/apsa50-artificial-intelligence-1445?t=389)
- "Emory has sepsis alerts deployed into clinical workflow using deep learning" — Michael Muley (clinical) [Ep 7 · 7:06](https://library.globalcastmd.com/watch/apsa50-artificial-intelligence-1445?t=426)
- "Deep learning neural networks are very large and learn just by example, requiring many examples with good variety of the data space" — Michael Muley (clinical) [Ep 7 · 7:56](https://library.globalcastmd.com/watch/apsa50-artificial-intelligence-1445?t=476)
- "The type of acquisition device (GE versus Siemens) may affect what an AI algorithm learns in radiology" — Michael Muley (clinical) [Ep 7 · 8:11](https://library.globalcastmd.com/watch/apsa50-artificial-intelligence-1445?t=491)
- "There are approximately 7 to 8 billion people in the world, most without access to healthcare, and very few with medical conditions, making healthcare data availability very small" — Michael Muley (epidemiological) [Ep 7 · 8:31](https://library.globalcastmd.com/watch/apsa50-artificial-intelligence-1445?t=511)
- "Tesla has 100,000 to 200,000 cars collecting data daily for training self-driving capability" — Michael Muley (epidemiological) [Ep 7 · 9:11](https://library.globalcastmd.com/watch/apsa50-artificial-intelligence-1445?t=551)
- "Waymo has collected about 10 million miles of driving experience for self-driving car development" — Michael Muley (epidemiological) [Ep 7 · 9:26](https://library.globalcastmd.com/watch/apsa50-artificial-intelligence-1445?t=566)
- "AI models learn whatever associations are present in training data, including spurious correlations like rulers in melanoma images" — Michael Muley (clinical) [Ep 7 · 10:26](https://library.globalcastmd.com/watch/apsa50-artificial-intelligence-1445?t=626)
- "Cloud computing enables centralized data storage which makes it easier to create frameworks for data sharing between institutions for research" — Michael Muley (opinion) [Ep 7 · 11:33](https://library.globalcastmd.com/watch/apsa50-artificial-intelligence-1445?t=693)
- "A model trained on US data may not work anywhere else due to population differences" — Michael Muley (clinical) [Ep 7 · 12:26](https://library.globalcastmd.com/watch/apsa50-artificial-intelligence-1445?t=746)
- "If training data has racial or ethnic bias, the AI model will have that bias as well" — Michael Muley (clinical) [Ep 7 · 12:36](https://library.globalcastmd.com/watch/apsa50-artificial-intelligence-1445?t=756)
- "Training a machine learning model is a very small part of what needs to be done for clinical deployment" — Michael Muley (opinion) [Ep 7 · 13:00](https://library.globalcastmd.com/watch/apsa50-artificial-intelligence-1445?t=780)
- "How the FDA will decide what constitutes a safe medical device for AI applications remains an unsolved question" — Michael Muley (opinion) [Ep 7 · 13:12](https://library.globalcastmd.com/watch/apsa50-artificial-intelligence-1445?t=792)
- "AI models are much more consistent than humans even if not better, which is their great promise" — Michael Muley (opinion) [Ep 7 · 13:28](https://library.globalcastmd.com/watch/apsa50-artificial-intelligence-1445?t=808)
- "There is huge variance between how different radiologists read studies, sometimes incorrectly and sometimes due to difference of opinion" — Michael Muley (clinical) [Ep 7 · 13:38](https://library.globalcastmd.com/watch/apsa50-artificial-intelligence-1445?t=818)
- "Similar variance exists among ophthalmologists in their clinical interpretations" — Michael Muley (clinical) [Ep 7 · 13:53](https://library.globalcastmd.com/watch/apsa50-artificial-intelligence-1445?t=833)
- "Gillippelli et al. performed a systematic retrospective review of female fertility cryopreservation outcomes in children with cancer" — Alex Halpern (clinical) [Ep 27 · 0:13](https://library.globalcastmd.com/watch/female-fertility-cryopreservation-outcomes-in-childhood-cancer-a-systematic-review-9521?t=13)
- "The review initially examined 104 abstracts and 34 full text articles" — Alex Halpern (clinical) [Ep 27 · 0:19](https://library.globalcastmd.com/watch/female-fertility-cryopreservation-outcomes-in-childhood-cancer-a-systematic-review-9521?t=19)
- "12 studies were included in the final systematic review" — Alex Halpern (clinical) [Ep 27 · 0:19](https://library.globalcastmd.com/watch/female-fertility-cryopreservation-outcomes-in-childhood-cancer-a-systematic-review-9521?t=19)
- "Ovarian tissue cryopreservation was performed in 501 patients across the included studies" — Alex Halpern (epidemiological) [Ep 27 · 0:27](https://library.globalcastmd.com/watch/female-fertility-cryopreservation-outcomes-in-childhood-cancer-a-systematic-review-9521?t=27)
- "5.9% of patients who underwent ovarian tissue cryopreservation later received ovarian tissue transplantation" — Alex Halpern (epidemiological) [Ep 27 · 0:27](https://library.globalcastmd.com/watch/female-fertility-cryopreservation-outcomes-in-childhood-cancer-a-systematic-review-9521?t=27)
- "33% of patients who underwent ovarian tissue transplantation were able to become pregnant" — Alex Halpern (clinical) [Ep 27 · 0:38](https://library.globalcastmd.com/watch/female-fertility-cryopreservation-outcomes-in-childhood-cancer-a-systematic-review-9521?t=38)
- "Ovarian tissue cryopreservation has great advantages for pediatric cancer patients but needs to be studied further" — Alex Halpern (opinion) [Ep 27 · 0:44](https://library.globalcastmd.com/watch/female-fertility-cryopreservation-outcomes-in-childhood-cancer-a-systematic-review-9521?t=44)
- "The United States is one of the few industrialized countries that routinely circumcises newborns" — Patricio Gargollo (epidemiological) [Ep 9 · 1:56](https://library.globalcastmd.com/watch/urology-part-i-1980?t=116)
- "UTI risk in the first year of life is 3-4% overall, with uncircumcised boys having 1 in 100 chance versus circumcised boys 1 in 1000" — Patricio Gargollo (epidemiological) [Ep 9 · 2:40](https://library.globalcastmd.com/watch/urology-part-i-1980?t=160)
- "Circumcision provides 53% protection against HIV transmission based on Kenyan trial of 3000 subjects that was stopped early due to significant benefit" — Patricio Gargollo (clinical) [Ep 9 · 4:08](https://library.globalcastmd.com/watch/urology-part-i-1980?t=248)
- "Circumcision reduces risk of syphilis, gonococcus, HPV, and HSV-2, but not chlamydia" — Patricio Gargollo (clinical) [Ep 9 · 3:41](https://library.globalcastmd.com/watch/urology-part-i-1980?t=221)
- "AAP states that data are not sufficient to recommend routine neonatal circumcision despite strong evidence for certain benefits" — Patricio Gargollo (guideline) [Ep 9 · 5:19](https://library.globalcastmd.com/watch/urology-part-i-1980?t=319)
- "Elective circumcision in infants under 3 months should not require general anesthesia due to anesthetic safety concerns in young children" — Patricio Gargollo (opinion) [Ep 9 · 7:49](https://library.globalcastmd.com/watch/urology-part-i-1980?t=469)
- "Office circumcision cutoff is 3 months of age or 13 pounds body weight" — Patricio Gargollo (clinical) [Ep 9 · 6:56](https://library.globalcastmd.com/watch/urology-part-i-1980?t=416)
- "Best analgesia for circumcision is dorsal penile nerve block combined with ring block using 0.25% bupivacaine without epinephrine" — Patricio Gargollo (clinical) [Ep 9 · 9:28](https://library.globalcastmd.com/watch/urology-part-i-1980?t=568)
- "Gomco bell sizes are 1.1, 1.3, 1.45, and 1.6 cm, with 1.3 cm used 75% of the time" — Patricio Gargollo (clinical) [Ep 9 · 14:38](https://library.globalcastmd.com/watch/urology-part-i-1980?t=878)
- "Mismatched Gomco bell and base can cause the bell to pull up and expose the glans, risking injury during cutting" — Patricio Gargollo (clinical) [Ep 9 · 15:15](https://library.globalcastmd.com/watch/urology-part-i-1980?t=915)
- "Prepucial adhesions must be taken down completely to see the coronal ridge all around before circumcision" — Patricio Gargollo (clinical) [Ep 9 · 15:55](https://library.globalcastmd.com/watch/urology-part-i-1980?t=955)
- "Gomco clamp should be left on for 5 minutes in older infants and 1-2 minutes in newborns for hemostasis" — Patricio Gargollo (clinical) [Ep 9 · 20:12](https://library.globalcastmd.com/watch/urology-part-i-1980?t=1212)
- "Vaseline dissolves Dermabond, so parents should be instructed not to apply it after Dermabond circumcision" — Patricio Gargollo (clinical) [Ep 9 · 20:58](https://library.globalcastmd.com/watch/urology-part-i-1980?t=1258)
- "Mogen clamp carries risk of glans amputation if the glans is pulled through the slit during foreskin removal" — Patricio Gargollo (clinical) [Ep 9 · 13:13](https://library.globalcastmd.com/watch/urology-part-i-1980?t=793)
- "Plastibell device subjectively has more postoperative complications than Gomco clamp" — Patricio Gargollo (opinion) [Ep 9 · 10:22](https://library.globalcastmd.com/watch/urology-part-i-1980?t=622)
- "Physiologic post-circumcision adhesions show a distinct line where skin adheres to glans and resolve spontaneously as the child grows" — Patricio Gargollo (clinical) [Ep 9 · 25:38](https://library.globalcastmd.com/watch/urology-part-i-1980?t=1538)
- "Lysing physiologic adhesions in the office can create raw surfaces and convert them into pathologic skin bridges" — Patricio Gargollo (clinical) [Ep 9 · 26:14](https://library.globalcastmd.com/watch/urology-part-i-1980?t=1574)
- "Skin bridges show no distinct line, have holes on each side, and require treatment as they tether the penis with growth and erections" — Patricio Gargollo (clinical) [Ep 9 · 27:15](https://library.globalcastmd.com/watch/urology-part-i-1980?t=1635)
- "Most skin bridges can be lysed in the office with EMLA cream for 30-40 minutes, hemostat placement, and scissor division" — Patricio Gargollo (clinical) [Ep 9 · 27:47](https://library.globalcastmd.com/watch/urology-part-i-1980?t=1667)
- "Meatal stenosis is exclusively seen in circumcised boys due to meatal rubbing against diaper and underwear causing inflammatory web at 6 o'clock" — Patricio Gargollo (clinical) [Ep 9 · 32:11](https://library.globalcastmd.com/watch/urology-part-i-1980?t=1931)
- "Meatal stenosis requiring treatment presents with upward urinary stream deviation, sometimes requiring sitting to urinate" — Patricio Gargollo (clinical) [Ep 9 · 32:45](https://library.globalcastmd.com/watch/urology-part-i-1980?t=1965)
- "Meatotomy can be performed in office with EMLA, hemostat crush of 6 o'clock web, and scissor incision without sutures" — Patricio Gargollo (clinical) [Ep 9 · 33:44](https://library.globalcastmd.com/watch/urology-part-i-1980?t=2024)
- "Redundant foreskin after circumcision is often due to suprapubic fat pad displacing skin distally and resolves with growth" — Patricio Gargollo (clinical) [Ep 9 · 29:25](https://library.globalcastmd.com/watch/urology-part-i-1980?t=1765)
- "Adolescents do not present complaining of too much foreskin after childhood concerns about redundant skin" — Patricio Gargollo (clinical) [Ep 9 · 29:57](https://library.globalcastmd.com/watch/urology-part-i-1980?t=1797)
- "Buried penis appears as a short squat pyramid rather than a structure protruding from the body" — Patricio Gargollo (clinical) [Ep 9 · 37:22](https://library.globalcastmd.com/watch/urology-part-i-1980?t=2242)
- "Congenital megaprepuce occurs mostly in Hispanic patients and should not be circumcised without specialist consultation" — Patricio Gargollo (clinical) [Ep 9 · 37:40](https://library.globalcastmd.com/watch/urology-part-i-1980?t=2260)
- "Physiologic phimosis with supple, soft foreskin and no history of infections does not require treatment regardless of age" — Patricio Gargollo (clinical) [Ep 9 · 38:47](https://library.globalcastmd.com/watch/urology-part-i-1980?t=2327)
- "Betamethasone 0.1% three times daily for 2-3 months achieves >50% success rate for phimosis treatment" — Patricio Gargollo (clinical) [Ep 9 · 40:15](https://library.globalcastmd.com/watch/urology-part-i-1980?t=2415)
- "Balanitis xerotica obliterans (BXO) presents with white paper-like scaly skin at prepuce tip and does not respond to steroids" — Patricio Gargollo (clinical) [Ep 9 · 41:58](https://library.globalcastmd.com/watch/urology-part-i-1980?t=2518)
- "BXO can spread to glans and urethra causing significant urethral strictures" — Patricio Gargollo (clinical) [Ep 9 · 42:20](https://library.globalcastmd.com/watch/urology-part-i-1980?t=2540)
- "Secondary phimosis after circumcision with cicatrix contraction responds to betamethasone 0.1% TID for 2-3 months in >50% of cases" — Patricio Gargollo (clinical) [Ep 9 · 41:08](https://library.globalcastmd.com/watch/urology-part-i-1980?t=2468)
- "Paraphimosis requires pain control (EMLA or penile block), D50-soaked wrap to reduce edema, and manual reduction with thumbs on glans pushing into foreskin" — Patricio Gargollo (clinical) [Ep 9 · 44:02](https://library.globalcastmd.com/watch/urology-part-i-1980?t=2642)
- "Zipper injuries are the most common cause of penile trauma and should be managed by cutting the zipper bridge with bolt cutters" — Patricio Gargollo (clinical) [Ep 9 · 45:55](https://library.globalcastmd.com/watch/urology-part-i-1980?t=2755)
- "Toilet seat crush injuries with hematoma but normal voiding and no gross hematuria can be managed conservatively" — Patricio Gargollo (clinical) [Ep 9 · 46:32](https://library.globalcastmd.com/watch/urology-part-i-1980?t=2792)
- "Buck's fascia violation in penile trauma requires operative repair to prevent long-term scarring and potency issues" — Patricio Gargollo (clinical) [Ep 9 · 47:35](https://library.globalcastmd.com/watch/urology-part-i-1980?t=2855)
- "Gross blood at meatus or gross hematuria after trauma requires full urinary tract evaluation and should not be instrumented until urethral injury is ruled out" — Patricio Gargollo (clinical) [Ep 9 · 48:11](https://library.globalcastmd.com/watch/urology-part-i-1980?t=2891)
- "Hypospadias incidence is approximately 1 in 150 live births" — Patricio Gargollo (epidemiological) [Ep 9 · 49:34](https://library.globalcastmd.com/watch/urology-part-i-1980?t=2974)
- "Distal hypospadias repairs do not utilize foreskin, so circumcision can be completed if started" — Patricio Gargollo (clinical) [Ep 9 · 51:14](https://library.globalcastmd.com/watch/urology-part-i-1980?t=3074)
- "Hypospadias with undescended gonad, especially non-palpable, requires full DSD workup" — Patricio Gargollo (clinical) [Ep 9 · 52:55](https://library.globalcastmd.com/watch/urology-part-i-1980?t=3175)
- "Bilateral non-palpable gonads with hypospadias suggests congenital adrenal hyperplasia" — Patricio Gargollo (clinical) [Ep 9 · 53:15](https://library.globalcastmd.com/watch/urology-part-i-1980?t=3195)
- "Mild hypospadias repairs for cosmetic reasons only may warrant delaying surgery to avoid early anesthesia exposure" — Patricio Gargollo (opinion) [Ep 9 · 54:47](https://library.globalcastmd.com/watch/urology-part-i-1980?t=3287)
- "Epispadias incidence is less than 1 in 50,000 live births" — Patricio Gargollo (epidemiological) [Ep 9 · 57:22](https://library.globalcastmd.com/watch/urology-part-i-1980?t=3442)
- "Epispadias represents a spectrum with bladder exstrophy and is associated with urinary incontinence, pubic diastasis, and vesicoureteral reflux" — Patricio Gargollo (clinical) [Ep 9 · 57:48](https://library.globalcastmd.com/watch/urology-part-i-1980?t=3468)
- "Micropenis diagnosis requires stretched penile length greater than 2.5 standard deviations below age-specific mean" — Patricio Gargollo (clinical) [Ep 9 · 35:37](https://library.globalcastmd.com/watch/urology-part-i-1980?t=2137)
- "Mean stretched penile length for 6-12 month old is approximately 4 centimeters" — Patricio Gargollo (clinical) [Ep 9 · 35:50](https://library.globalcastmd.com/watch/urology-part-i-1980?t=2150)
- "Penile torsion is diagnosed by median raphe deviation from normal 6 o'clock position and requires repair only if close to 90 degrees" — Patricio Gargollo (clinical) [Ep 9 · 59:45](https://library.globalcastmd.com/watch/urology-part-i-1980?t=3585)
- "Isolated chordee without hypospadias benefits from OR circumcision to release adhesions and straighten the penis" — Patricio Gargollo (clinical) [Ep 9 · 60:24](https://library.globalcastmd.com/watch/urology-part-i-1980?t=3624)
- "Labial adhesions occur in up to 2% of girls in the first two years of life, not in newborns due to protective maternal estrogen" — Patricio Gargollo (epidemiological) [Ep 9 · 61:48](https://library.globalcastmd.com/watch/urology-part-i-1980?t=3708)
- "Labial adhesions without symptoms (post-void dribbling, skin breakdown, recurrent UTIs) do not require treatment" — Patricio Gargollo (clinical) [Ep 9 · 62:26](https://library.globalcastmd.com/watch/urology-part-i-1980?t=3746)
- "Betamethasone ointment is preferred over estrogen cream for labial adhesions to avoid pubic hair development in prepubertal children" — Patricio Gargollo (opinion) [Ep 9 · 62:53](https://library.globalcastmd.com/watch/urology-part-i-1980?t=3773)
- "Prolapsed ureterocele is distinct from vagina, associated with prenatal hydronephrosis, and diagnosed with renal bladder ultrasound and VCUG" — Patricio Gargollo (clinical) [Ep 9 · 66:30](https://library.globalcastmd.com/watch/urology-part-i-1980?t=3990)
- "Paraurethral and perivaginal cysts (Gartner's duct, Skene's gland) present at birth, spontaneously regress with loss of maternal estrogen, and show patent urethra and vagina" — Patricio Gargollo (clinical) [Ep 9 · 67:34](https://library.globalcastmd.com/watch/urology-part-i-1980?t=4054)
- "Vaginal rhabdomyosarcoma appears as grape-like mass rather than single bulge" — Patricio Gargollo (clinical) [Ep 9 · 68:03](https://library.globalcastmd.com/watch/urology-part-i-1980?t=4083)
- "Writer et al. published a multi-center retrospective study in the Journal of Pediatric Surgery through PeaceSOC in 2024" — Sophia Schermerhorn (clinical) [Ep 31 · 0:05](https://library.globalcastmd.com/watch/current-management-of-pulmonary-relapse-in-ewing-sarcoma-a-report-from-the-pediatric-surgical-oncology-research-collaborative-11335?t=5)
- "PeaceSOC is a network of over 50 centers in North America that work together to improve outcomes in pediatric surgical oncology" — Sophia Schermerhorn (clinical) [Ep 31 · 0:07](https://library.globalcastmd.com/watch/current-management-of-pulmonary-relapse-in-ewing-sarcoma-a-report-from-the-pediatric-surgical-oncology-research-collaborative-11335?t=7)
- "The study examined patients less than 22 years old with initially localized Ewing sarcoma who developed first pulmonary relapse between 2007 and 2020 across 19 different centers" — Sophia Schermerhorn (clinical) [Ep 31 · 0:20](https://library.globalcastmd.com/watch/current-management-of-pulmonary-relapse-in-ewing-sarcoma-a-report-from-the-pediatric-surgical-oncology-research-collaborative-11335?t=20)
- "Among 33 patients studied, about 2/3 had relapse limited to the lungs" — Sophia Schermerhorn (epidemiological) [Ep 31 · 0:32](https://library.globalcastmd.com/watch/current-management-of-pulmonary-relapse-in-ewing-sarcoma-a-report-from-the-pediatric-surgical-oncology-research-collaborative-11335?t=32)
- "Nearly half of patients with lung-limited relapse had just a solitary pulmonary nodule" — Sophia Schermerhorn (epidemiological) [Ep 31 · 0:32](https://library.globalcastmd.com/watch/current-management-of-pulmonary-relapse-in-ewing-sarcoma-a-report-from-the-pediatric-surgical-oncology-research-collaborative-11335?t=32)
- "Patients with solitary pulmonary nodule were more likely to undergo metastasectomy and whole lung radiation" — Sophia Schermerhorn (clinical) [Ep 31 · 0:39](https://library.globalcastmd.com/watch/current-management-of-pulmonary-relapse-in-ewing-sarcoma-a-report-from-the-pediatric-surgical-oncology-research-collaborative-11335?t=39)
- "Patients with solitary pulmonary nodule had the highest overall three-year survival at 73%" — Sophia Schermerhorn (epidemiological) [Ep 31 · 0:39](https://library.globalcastmd.com/watch/current-management-of-pulmonary-relapse-in-ewing-sarcoma-a-report-from-the-pediatric-surgical-oncology-research-collaborative-11335?t=39)
- "Three-year survival for patients with multiple nodules was 40%" — Sophia Schermerhorn (epidemiological) [Ep 31 · 0:50](https://library.globalcastmd.com/watch/current-management-of-pulmonary-relapse-in-ewing-sarcoma-a-report-from-the-pediatric-surgical-oncology-research-collaborative-11335?t=50)
- "Three-year survival for patients with extrapulmonary disease was 23%" — Sophia Schermerhorn (epidemiological) [Ep 31 · 0:50](https://library.globalcastmd.com/watch/current-management-of-pulmonary-relapse-in-ewing-sarcoma-a-report-from-the-pediatric-surgical-oncology-research-collaborative-11335?t=50)
- "Solitary pulmonary relapse may represent a biologically more favorable type of recurrence" — Sophia Schermerhorn (opinion) [Ep 31 · 0:57](https://library.globalcastmd.com/watch/current-management-of-pulmonary-relapse-in-ewing-sarcoma-a-report-from-the-pediatric-surgical-oncology-research-collaborative-11335?t=57)
- "Solitary pulmonary relapse is more amenable to achieving meaningful local control" — Sophia Schermerhorn (opinion) [Ep 31 · 0:57](https://library.globalcastmd.com/watch/current-management-of-pulmonary-relapse-in-ewing-sarcoma-a-report-from-the-pediatric-surgical-oncology-research-collaborative-11335?t=57)
- "Metastasectomy plays an important role as part of multimodal therapy for solitary pulmonary relapse in Ewing sarcoma" — Sophia Schermerhorn (opinion) [Ep 31 · 0:57](https://library.globalcastmd.com/watch/current-management-of-pulmonary-relapse-in-ewing-sarcoma-a-report-from-the-pediatric-surgical-oncology-research-collaborative-11335?t=57)
- "42% of 220 oncology patients had a fever in the 48 hours following tumor resection" — Sophia Schermerhorn (epidemiological) [Ep 32 · 0:12](https://library.globalcastmd.com/watch/early-postoperative-fever-in-pediatric-oncology-patients-undergoing-solid-tumor-resection-11354?t=12)
- "Only 2 of the febrile patients (2.8%) had an actual infection" — Sophia Schermerhorn (epidemiological) [Ep 32 · 0:19](https://library.globalcastmd.com/watch/early-postoperative-fever-in-pediatric-oncology-patients-undergoing-solid-tumor-resection-11354?t=19)
- "The two patients with actual infection were hemodynamically unstable with positive blood cultures" — Sophia Schermerhorn (clinical) [Ep 32 · 0:19](https://library.globalcastmd.com/watch/early-postoperative-fever-in-pediatric-oncology-patients-undergoing-solid-tumor-resection-11354?t=19)
- "Most fevers triggered a workup that costs on average about $500 per patient" — Sophia Schermerhorn (epidemiological) [Ep 32 · 0:30](https://library.globalcastmd.com/watch/early-postoperative-fever-in-pediatric-oncology-patients-undergoing-solid-tumor-resection-11354?t=30)
- "About a third of patients received empiric antibiotics that they did not need" — Sophia Schermerhorn (epidemiological) [Ep 32 · 0:30](https://library.globalcastmd.com/watch/early-postoperative-fever-in-pediatric-oncology-patients-undergoing-solid-tumor-resection-11354?t=30)
- "In the 48 hours following tumor resection, fever alone may not be a reason to panic" — Sophia Schermerhorn (opinion) [Ep 32 · 0:40](https://library.globalcastmd.com/watch/early-postoperative-fever-in-pediatric-oncology-patients-undergoing-solid-tumor-resection-11354?t=40)
- "Extensive workup should be reserved for patients who are hemodynamically unstable or have more overt signs of infection" — Sophia Schermerhorn (guideline) [Ep 32 · 0:45](https://library.globalcastmd.com/watch/early-postoperative-fever-in-pediatric-oncology-patients-undergoing-solid-tumor-resection-11354?t=45)
- "40 patients were referred after having an innocuous lesion removed that came back as non-rhabdomyosarcoma" — Todd Ponsky (clinical) [Ep 1 · 0:49](https://library.globalcastmd.com/watch/nonmetastatic-nonrhabdomyosarcoma-soft-tissue-sarcoma-326?t=49)
- "5 of the 40 referred patients were deemed impossible to re-excise based on location or other reasons" — Todd Ponsky (clinical) [Ep 1 · 1:00](https://library.globalcastmd.com/watch/nonmetastatic-nonrhabdomyosarcoma-soft-tissue-sarcoma-326?t=60)
- "35 patients underwent re-excision after unplanned primary excision" — Todd Ponsky (clinical) [Ep 1 · 1:00](https://library.globalcastmd.com/watch/nonmetastatic-nonrhabdomyosarcoma-soft-tissue-sarcoma-326?t=60)
- "44 patients had planned excision at the study hospital after workup with MRI or incisional biopsy or core biopsy" — Todd Ponsky (clinical) [Ep 1 · 1:10](https://library.globalcastmd.com/watch/nonmetastatic-nonrhabdomyosarcoma-soft-tissue-sarcoma-326?t=70)
- "23 of the 44 planned excision patients received neoadjuvant therapy" — Todd Ponsky (clinical) [Ep 1 · 1:33](https://library.globalcastmd.com/watch/nonmetastatic-nonrhabdomyosarcoma-soft-tissue-sarcoma-326?t=93)
- "21 patients had workup followed by planned wide local excision without neoadjuvant therapy" — Todd Ponsky (clinical) [Ep 1 · 1:38](https://library.globalcastmd.com/watch/nonmetastatic-nonrhabdomyosarcoma-soft-tissue-sarcoma-326?t=98)
- "45.7% of patients who underwent re-excision had residual tumor" — Todd Ponsky (clinical) [Ep 1 · 1:56](https://library.globalcastmd.com/watch/nonmetastatic-nonrhabdomyosarcoma-soft-tissue-sarcoma-326?t=116)
- "There was no difference in disease relapse between planned and unplanned excision groups" — Todd Ponsky (clinical) [Ep 1 · 2:13](https://library.globalcastmd.com/watch/nonmetastatic-nonrhabdomyosarcoma-soft-tissue-sarcoma-326?t=133)
- "There was no difference in 5-year overall survival between planned and unplanned excision groups" — Todd Ponsky (clinical) [Ep 1 · 2:21](https://library.globalcastmd.com/watch/nonmetastatic-nonrhabdomyosarcoma-soft-tissue-sarcoma-326?t=141)
- "There was no difference in disease-free survival between planned and unplanned excision groups" — Todd Ponsky (clinical) [Ep 1 · 2:26](https://library.globalcastmd.com/watch/nonmetastatic-nonrhabdomyosarcoma-soft-tissue-sarcoma-326?t=146)
- "There was no difference in local control rates or local recurrence between planned and unplanned excision groups" — Todd Ponsky (clinical) [Ep 1 · 2:26](https://library.globalcastmd.com/watch/nonmetastatic-nonrhabdomyosarcoma-soft-tissue-sarcoma-326?t=146)
- "The study authors concluded that patients should have a higher index of suspicion and should be worked up more thoroughly" — Todd Ponsky (guideline) [Ep 1 · 2:56](https://library.globalcastmd.com/watch/nonmetastatic-nonrhabdomyosarcoma-soft-tissue-sarcoma-326?t=176)
- "Since there is no outcome difference, it may be acceptable with low index of suspicion to excise the lesion and do re-excision if it comes back as non-rhabdomyosarcoma" — Todd Ponsky (opinion) [Ep 1 · 3:26](https://library.globalcastmd.com/watch/nonmetastatic-nonrhabdomyosarcoma-soft-tissue-sarcoma-326?t=206)
- "Re-excision sometimes has high morbidity because you have to take a lot more tissue" — Todd Ponsky (clinical) [Ep 1 · 3:39](https://library.globalcastmd.com/watch/nonmetastatic-nonrhabdomyosarcoma-soft-tissue-sarcoma-326?t=219)
- "BMIs in the 40s will predictably achieve BMIs less than 30 after bariatric surgery" (clinical) [Ep 2 · 0:56](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=56)
- "Patients above BMI 55 have only about 14% probability of getting down to BMI below 30 after surgery" (clinical) [Ep 2 · 3:05](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=185)
- "Once BMI crosses 50 threshold, probability of mitigating risk associated with BMI 35 and above becomes challenging" (clinical) [Ep 2 · 3:32](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=212)
- "Conversation about bariatric surgery should start when BMI reaches mid-30s range" (opinion) [Ep 2 · 3:59](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=239)
- "At BMI approaching 40 with comorbidity, surgery discussion should emphasize better results compared to other interventions" (opinion) [Ep 2 · 4:17](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=257)
- "At BMI 49, the time for medication has passed and surgery must be discussed" (opinion) [Ep 2 · 5:34](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=334)
- "Topiramate and phentermine can serve as bridge to surgery to allow 12-year-old patient to gain maturity" (opinion) [Ep 2 · 6:27](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=387)
- "Some children will need pharmacotherapy even after bariatric surgery" (clinical) [Ep 2 · 7:20](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=440)
- "Obesity is a heterogeneous disease requiring continuous treatment approach with escalation based on individual patient needs" (clinical) [Ep 2 · 7:56](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=476)
- "If healthy living is insufficient to control obesity after 3-6 months in program, need to move on to medications" (guideline) [Ep 2 · 8:31](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=511)
- "Hypothalamic obesity patients have biological drive to gain weight that defeats surgery, profoundly different from patients without brain injury" (clinical) [Ep 2 · 9:32](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=572)
- "Private insurers are limiting dietitian visits to 3 per year, insufficient for chronic disease management" (clinical) [Ep 2 · 13:36](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=816)
- "Sugar tax can be regressive depending on socioeconomic class" (opinion) [Ep 2 · 14:33](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=873)
- "Obesity does not result from sugar per se, so taxing specific products will not have desired impact" (opinion) [Ep 2 · 15:08](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=908)
- "Most severely obese patients meet objective criteria for binge eating disorder when screened, even without prior diagnosis" (clinical) [Ep 2 · 19:53](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=1193)
- "Bariatric surgery is effective at extinguishing binge eating behaviors" (clinical) [Ep 2 · 20:40](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=1240)
- "Prior binge eating disorder diagnosis may pose higher risk for weight regain after surgery" (clinical) [Ep 2 · 21:03](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=1263)
- "Rate of true binge eating disorder meeting diagnostic criteria is under 5% when screening new obesity patients" (epidemiological) [Ep 2 · 21:33](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=1293)
- "Disordered eating consisting of daytime restricting followed by evening overeating is common pattern in obese youth" (clinical) [Ep 2 · 21:18](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=1278)
- "Disordered eating applies to nearly every obese patient though it may not meet DSM diagnostic criteria" (clinical) [Ep 2 · 22:20](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=1340)
- "80% of ovarian masses are teratomas" — Andrea Hayes Jordan (epidemiological) [Ep 3 · 1:25](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=85)
- "Survival for ovarian germ cell tumors has improved to almost 100% by the year 2000" — Andrea Hayes Jordan (epidemiological) [Ep 3 · 1:46](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=106)
- "Stage one ovarian tumors limited to the ovary now receive only oophorectomy without chemotherapy" — Andrea Hayes Jordan (guideline) [Ep 3 · 2:10](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=130)
- "25% of girls will be missed if peritoneal cytology and washings are not performed" — Andrea Hayes Jordan (clinical) [Ep 3 · 3:16](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=196)
- "If staging procedures are omitted from the operative report, oncologists will treat patients as stage 2" — Andrea Hayes Jordan (clinical) [Ep 3 · 3:52](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=232)
- "Gliomatosis peritonei is a benign disease with 100% survival" — Andrea Hayes Jordan (clinical) [Ep 3 · 4:24](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=264)
- "For bilateral ovarian disease, tumors larger than 10 cm should be biopsied" — Andrea Hayes Jordan (guideline) [Ep 3 · 5:26](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=326)
- "If a teratoma is ruptured during laparoscopic removal, the patient is committed to chemotherapy including platinum" — Dan (clinical) [Ep 3 · 7:00](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=420)
- "15% of ovarian tumors in adolescents are epithelial tumors with different staging criteria" — Dan (epidemiological) [Ep 3 · 7:19](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=439)
- "The salvage rate for recurrent ovarian germ cell tumors is almost 100%" — Dan (clinical) [Ep 3 · 12:16](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=736)
- "Ovarian torsion is most common in teenage girls and should be considered urgent rather than emergent" — Andrea Hayes Jordan (clinical) [Ep 3 · 13:20](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=800)
- "Many black-colored ovaries have viable follicles and ovarian preservation should be the goal" — Andrea Hayes Jordan (clinical) [Ep 3 · 13:40](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=820)
- "76% of oophorectomy specimens removed for presumed necrosis had normal ovarian tissue, only 11% were completely necrotic" — Andrea Hayes Jordan (clinical) [Ep 3 · 15:33](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=933)
- "Pain after oophoropexy is usually short-lived and resolves in about a week" — Andrea Hayes Jordan (clinical) [Ep 3 · 16:34](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=994)
- "Ability to preserve ovarian function after torsion is related to age, with better outcomes in pediatric patients" — Andrea Hayes Jordan (clinical) [Ep 3 · 16:54](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1014)
- "Ultrasound for ovarian torsion has sensitivity and specificity in the 50-60% range" — Andrea Hayes Jordan (clinical) [Ep 3 · 20:58](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1258)
- "Blood flow on ultrasound does not exclude torsion because the ovary may be intermittently twisted" (clinical) [Ep 3 · 22:24](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1344)
- "Half of soft tissue sarcomas are rhabdomyosarcomas and half are non-rhabdo types" — Andrea Hayes Jordan (epidemiological) [Ep 3 · 25:58](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1558)
- "Abdominal, pelvic, and retroperitoneal rhabdomyosarcomas have the worst survival" — Andrea Hayes Jordan (epidemiological) [Ep 3 · 26:22](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1582)
- "Orbital rhabdomyosarcomas have the best survival" — Andrea Hayes Jordan (epidemiological) [Ep 3 · 26:22](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1582)
- "Group 1 and 2 rhabdomyosarcoma patients have excellent prognosis while group 3 patients do more poorly" — Andrea Hayes Jordan (clinical) [Ep 3 · 27:27](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1647)
- "Attempting to resect large unresectable rhabdomyosarcoma with high morbidity does not improve patient outcome" — Andrea Hayes Jordan (opinion) [Ep 3 · 27:44](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1664)
- "Sentinel lymph node biopsy is now required for all trunk and extremity rhabdomyosarcomas" — Andrea Hayes Jordan (guideline) [Ep 3 · 29:15](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1755)
- "For rhabdomyosarcoma, completion node dissection is not performed after positive sentinel node; radiation therapy is given instead" — Andrea Hayes Jordan (guideline) [Ep 3 · 29:31](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1771)
- "40-50% of biopsied lymph nodes are positive in rhabdomyosarcoma" — Andrea Hayes Jordan (epidemiological) [Ep 3 · 30:36](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1836)
- "Histologic grade is now critical in non-rhabdo soft tissue sarcomas, more important than just the diagnosis" — Andrea Hayes Jordan (guideline) [Ep 3 · 30:51](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1851)
- "Low-grade soft tissue sarcomas require only resection and observation without radiation or chemotherapy" — Andrea Hayes Jordan (guideline) [Ep 3 · 31:27](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1887)
- "Low-grade tumors with positive margins receive adjuvant radiation therapy" — Andrea Hayes Jordan (guideline) [Ep 3 · 31:34](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1894)
- "Unresectable soft tissue sarcomas should receive both preoperative radiation and chemotherapy" — Andrea Hayes Jordan (guideline) [Ep 3 · 31:49](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1909)
- "Synovial and undifferentiated sarcomas are chemosensitive" — Andrea Hayes Jordan (clinical) [Ep 3 · 32:07](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1927)
- "Alveolar soft part, malignant epithelioid, and clear cell sarcomas are chemoinsensitive" — Andrea Hayes Jordan (clinical) [Ep 3 · 32:25](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1945)
- "A 5 cm tumor in a child less than 3 years old is equivalent to a 3 cm tumor in a larger patient" — Andrea Hayes Jordan (clinical) [Ep 3 · 32:51](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1971)
- "3 centimeters should be the cutoff for excision versus biopsy in toddlers rather than 5 centimeters" — Andrea Hayes Jordan (guideline) [Ep 3 · 33:03](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=1983)
- "Core biopsies are acceptable for soft tissue sarcomas if 3-4 good non-necrotic cores are obtained" — Andrea Hayes Jordan (guideline) [Ep 3 · 34:07](https://library.globalcastmd.com/watch/ovarian-teratoma-ovarian-torsion-soft-tissue-sarcoma-update-course-2015-672?t=2047)
- "Patient is an 11-year-old boy with right pulmonary hydatid cyst from a particular area of Chile" — Marco (clinical) [Ep 6 · 0:00](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=0)
- "The hydatid cyst occupied the entire right thorax" — Marco (clinical) [Ep 6 · 0:15](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=15)
- "Initial thoracoscopic approach was impossible due to cyst size" — Marco (clinical) [Ep 6 · 0:26](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=26)
- "Eight bronchial fistulas were treated through mini-thoracotomy in the first surgery" — Marco (clinical) [Ep 6 · 1:10](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=70)
- "Surgeon used single-port technique because tissue was highly inflamed and to avoid excessive parenchymal trauma" — Marco (clinical) [Ep 6 · 3:12](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=192)
- "Bleeding occurred during closure of the last fistula due to limited working space" — Marco (clinical) [Ep 6 · 3:26](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=206)
- "Surgicel was placed in the fistula and closed with PDS suture to control bleeding" — Marco (clinical) [Ep 6 · 3:55](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=235)
- "Two fistulas were sutured during the thoracoscopic procedure" — Todd (clinical) [Ep 6 · 4:31](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=271)
- "Compression with needle driver was used to control bleeding before placing suture" — Marco (clinical) [Ep 6 · 5:30](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=330)
- "Patient was discharged 5 days after surgery without complications or pneumothorax" — Marco (clinical) [Ep 6 · 7:21](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=441)
- "Surgery was performed approximately 3 months prior to this discussion" — Marco (clinical) [Ep 6 · 7:59](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=479)
- "Complete removal of the mucosa is necessary rather than suturing from inside the cavity" — Marco (opinion) [Ep 6 · 8:12](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=492)
- "Concern that the fistulas will recur with the intracavitary suturing approach" — Todd (opinion) [Ep 6 · 8:23](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=503)
- "Recommended approach is bronchoscopy to identify involved segment followed by thoracotomy" — Marco (opinion) [Ep 6 · 8:36](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=516)
- "Intracavitary approach may be useful for treating pneumatoceles which lack mucosal lining" — Alan (opinion) [Ep 6 · 9:47](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=587)
- "Hydatid cyst is a parasitosis very common in southern Argentina but less common in first-world countries" — Marcello (epidemiological) [Ep 6 · 10:23](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=623)
- "The key to treating hydatid cysts is removing the white parasitic membrane from inside the lung" — Marcello (clinical) [Ep 6 · 12:06](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=726)
- "There is usually a good tissue plane between the lung and the hydatid cyst" — Marcello (clinical) [Ep 6 · 12:23](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=743)
- "After membrane removal, bronchial openings that bubble are visible and should be sutured" — Marcello (clinical) [Ep 6 · 12:33](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=753)
- "First surgery is optimal timing because tissues are not yet friable or bleeding" — Marcello (clinical) [Ep 6 · 12:42](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=762)
- "Once the parasitic membrane is removed, the patient is cured; subsequent management is only about closing fistulas" — Marcello (clinical) [Ep 6 · 13:13](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=793)
- "In the first attempt, all lung tissue was fixed to the thoracic wall, preventing thoracoscopic approach" — Marco (clinical) [Ep 6 · 13:36](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=816)
- "Bronchopleural fistula after staphylococcal pneumonia and empyema presents a similar clinical situation" — Liam (clinical) [Ep 6 · 14:30](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=870)
- "Thoracoscopy to remove membrane and allow lung expansion is essential for fistula healing" — Liam (opinion) [Ep 6 · 14:45](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=885)
- "The technique works because the fistula size was appropriate; would not attempt with a huge fistula" — Marco (opinion) [Ep 6 · 15:11](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=911)
- "One recurrence case after segmentectomy was easier to operate than expected" — Alan (clinical) [Ep 6 · 16:59](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=1019)
- "Hemalock clips have been used for esophageal atresia for at least 10 years without problems" — Marcello (clinical) [Ep 6 · 19:05](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=1145)
- "Hemalock clips are used for bronchi in lung lobectomies, even large bronchi, using three available sizes" — Marcello (clinical) [Ep 6 · 19:12](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=1152)
- "Large-size Hemalock with plier is 10mm diameter and can handle very wide bronchi" — Marcello (clinical) [Ep 6 · 19:21](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=1161)
- "Hemalock clips are used in patients over 7 years old for lobectomy" — Marcello (clinical) [Ep 6 · 19:31](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=1171)
- "For large vessels, a proximal Hemalock clip is placed before ligature when ligature alone feels insufficient" — Marcello (clinical) [Ep 6 · 19:31](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=1171)
- "Hemalock is described as a mechanical suture alternative for resource-limited settings because it is inexpensive compared to staplers" — Marcello (opinion) [Ep 6 · 20:00](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=1200)
- "Persistent air leak has not been a problem in infant lobectomies with incomplete fissures, lasting maximum a few days" — Alan (clinical) [Ep 6 · 21:22](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=1282)
- "Concern exists about tissue sealant potentially occluding the chest tube" — Alan (opinion) [Ep 6 · 21:38](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=1298)
- "Tissue sealant has not been needed in infant lobectomies" — Alan (opinion) [Ep 6 · 21:45](https://library.globalcastmd.com/watch/difficult-cases-of-lung-lesions-pediatric-thoracic-surgery-part-1-lung-1085?t=1305)
- "The risk of presenting with an emergency problem needing an operation due to hernia incarceration or strangulation in asymptomatic elderly patients is 0.3%" — Michael Rosen (clinical) [Ep 10 · 3:49](https://library.globalcastmd.com/watch/inguinal-hernia-adult-3441?t=229)
- "In the Fitzgibbons VA study over 2 years, almost one-third of patients with asymptomatic hernias went on to develop symptoms and need an operation" — Michael Rosen (clinical) [Ep 10 · 4:04](https://library.globalcastmd.com/watch/inguinal-hernia-adult-3441?t=244)
- "By 5 years follow-up, almost three-fifths of patients with initially asymptomatic hernias developed symptoms" — Michael Rosen (clinical) [Ep 10 · 4:21](https://library.globalcastmd.com/watch/inguinal-hernia-adult-3441?t=261)
- "Inguinal hernia repairs can be done under local anesthesia" — Michael Rosen (clinical) [Ep 10 · 6:06](https://library.globalcastmd.com/watch/inguinal-hernia-adult-3441?t=366)
- "The learning curve for laparoscopic inguinal hernia repair is 200 to 250 cases" — Michael Rosen (clinical) [Ep 10 · 9:04](https://library.globalcastmd.com/watch/inguinal-hernia-adult-3441?t=544)
- "In laparoscopic repair, mesh is placed away from the nerves, resulting in lower risk of chronic pain compared to open repair" — Michael Rosen (clinical) [Ep 10 · 9:31](https://library.globalcastmd.com/watch/inguinal-hernia-adult-3441?t=571)
- "Laparoscopic repair offers approximately 1 week to 10 days earlier recovery compared to open repair" — Michael Rosen (clinical) [Ep 10 · 12:23](https://library.globalcastmd.com/watch/inguinal-hernia-adult-3441?t=743)
- "Laparoscopic repair has risk of intestinal injury and major blood vessel injury because of operating near these structures" — Michael Rosen (clinical) [Ep 10 · 12:45](https://library.globalcastmd.com/watch/inguinal-hernia-adult-3441?t=765)
- "Parietalization of the cord (stripping peritoneum off the cord inferiorly and posteriorly) is the most important part of any laparoscopic repair" — Michael Rosen (clinical) [Ep 10 · 18:15](https://library.globalcastmd.com/watch/inguinal-hernia-adult-3441?t=1095)
- "The inferior dissection is the Achilles heel of any laparoscopic repair because it is awkward to view and surgeons risk making holes in the peritoneum" — Michael Rosen (clinical) [Ep 10 · 18:53](https://library.globalcastmd.com/watch/inguinal-hernia-adult-3441?t=1133)
- "Stoppa's original description for unilateral inguinal hernia was to never use less than a 15 by 15 centimeter piece of mesh" — Michael Rosen (guideline) [Ep 10 · 19:30](https://library.globalcastmd.com/watch/inguinal-hernia-adult-3441?t=1170)
- "For large direct hernias, a heavier weight mesh material should be used" — Michael Rosen (clinical) [Ep 10 · 20:26](https://library.globalcastmd.com/watch/inguinal-hernia-adult-3441?t=1226)
- "Heavyweight mesh is approximately 90 grams per meter squared (Marlex or Prolene)" — Michael Rosen (clinical) [Ep 10 · 21:47](https://library.globalcastmd.com/watch/inguinal-hernia-adult-3441?t=1307)
- "Midweight mesh is between 40 to 50 grams per meter squared" — Michael Rosen (clinical) [Ep 10 · 21:57](https://library.globalcastmd.com/watch/inguinal-hernia-adult-3441?t=1317)
- "Lightweight mesh (Ultrapro) is less than 30 grams per meter squared and contracts down to about 28 grams per meter squared over time" — Michael Rosen (clinical) [Ep 10 · 22:10](https://library.globalcastmd.com/watch/inguinal-hernia-adult-3441?t=1330)
- "Lightweight mesh is at risk for fracturing, particularly in direct hernias where it acts as a bridge" — Michael Rosen (clinical) [Ep 10 · 22:23](https://library.globalcastmd.com/watch/inguinal-hernia-adult-3441?t=1343)
- "For laparoscopic inguinal hernia repair, surgeons should never use smaller than a large pre-formed mesh to cover the whole myopectineal orifice" — Michael Rosen (clinical) [Ep 10 · 23:08](https://library.globalcastmd.com/watch/inguinal-hernia-adult-3441?t=1388)
- "There is no evidence that absorbable fixation causes reduction in pain, better fixation, or improved long-term outcomes compared to permanent fixation" — Michael Rosen (clinical) [Ep 10 · 24:10](https://library.globalcastmd.com/watch/inguinal-hernia-adult-3441?t=1450)
- "If a tack is put through a nerve, it is the neuroma that causes the problem, not the tack itself" — Michael Rosen (clinical) [Ep 10 · 24:22](https://library.globalcastmd.com/watch/inguinal-hernia-adult-3441?t=1462)
- "There is mounting evidence that medium weight polypropylene mesh can be placed in a contaminated field" — Michael Rosen (clinical) [Ep 10 · 24:56](https://library.globalcastmd.com/watch/inguinal-hernia-adult-3441?t=1496)
- "The lacunar ligament can be released to gain an extra 1 centimeter of space when reducing incarcerated femoral hernias without destroying the inguinal ligament" — Michael Rosen (clinical) [Ep 10 · 26:58](https://library.globalcastmd.com/watch/inguinal-hernia-adult-3441?t=1618)
- "For recurrent hernias, surgeons should go where nobody has been before, or if both approaches have been used, go where they are best" — Michael Rosen (opinion) [Ep 10 · 28:12](https://library.globalcastmd.com/watch/inguinal-hernia-adult-3441?t=1692)
- "Surgeons learning laparoscopic hernia repair should avoid bilateral and recurrent hernias during their learning curve" — Michael Rosen (opinion) [Ep 10 · 28:36](https://library.globalcastmd.com/watch/inguinal-hernia-adult-3441?t=1716)
- "For truly incarcerated hernias, TEP approach is not a good idea because you want the contents out of the hernia sac; TAPP is preferred" — Michael Rosen (clinical) [Ep 10 · 29:31](https://library.globalcastmd.com/watch/inguinal-hernia-adult-3441?t=1771)
- "Petcova et al. published in Annals of Surgery in 2020 a study of children with uncomplicated appendicitis randomized to medical management with antibiotics or surgery, with 5-year follow-up" — Ellen Encisco (clinical) [Ep 13 · 0:43](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=43)
- "In the surgery group for uncomplicated appendicitis, there were no complications" (clinical) [Ep 13 · 1:11](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=71)
- "46% of patients randomized to non-surgical management of uncomplicated appendicitis required appendectomy during follow-up" (clinical) [Ep 13 · 1:11](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=71)
- "Metastectomy for osteosarcoma lung metastases improves survival and can make patients long-term survivors" (clinical) [Ep 13 · 2:15](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=135)
- "60-10% of 1 millimeter lung nodules in osteosarcoma patients contain malignant disease" (clinical) [Ep 13 · 2:24](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=144)
- "The Children's Oncology Group is starting a study comparing thoracotomy vs. thoracoscopy for osteosarcoma lung metastases, with enrollment beginning end of 2021 or early 2022" (guideline) [Ep 13 · 2:40](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=160)
- "The Flourish device creates compression anastomosis by causing ischemia of tissue between two magnets, which then sloughs off" (clinical) [Ep 13 · 3:28](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=208)
- "Flourish device inclusion criteria: atretic gap <4cm, fistula repaired or absent, G-tube must accommodate 18 French catheter" (guideline) [Ep 13 · 3:39](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=219)
- "Flourish device is associated with high stricture rate and serious life-threatening complications" (clinical) [Ep 13 · 4:06](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=246)
- "ICG must be administered intravenously 12-18 hours prior to surgery to accumulate in extrahepatic ducts" — Ellen Encisco (clinical) [Ep 13 · 5:32](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=332)
- "ICG can be injected directly into the gallbladder during surgery as an alternative to pre-operative IV administration" — Ellen Encisco (clinical) [Ep 13 · 5:43](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=343)
- "For anorectal malformations with rectal perineal or rectal vestibular fistula, surgery before 14 days vs. after 14 days of life had similar complication outcomes" (clinical) [Ep 13 · 6:37](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=397)
- "For Hirschsprung disease, endorectal pull-through before 31 days vs. after 31 days showed same rates of preoperative enterocolitis, postoperative enterocolitis, constipation, and incontinence" (clinical) [Ep 13 · 6:54](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=414)
- "Delayed Hirschsprung pull-through with irrigations is a safe alternative to neonatal operation" (opinion) [Ep 13 · 7:14](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=434)
- "Cryoanalgesia for pectus repair reduced length of stay from 4 days to 1 day" (clinical) [Ep 13 · 8:22](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=502)
- "There are no long-term studies on cryoanalgesia effects for pectus repair" (opinion) [Ep 13 · 8:34](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=514)
- "Double rim sign or halo sign on X-ray indicates button battery ingestion rather than coin ingestion" — Ellen Encisco (clinical) [Ep 13 · 9:48](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=588)
- "Main goal of button battery ingestion treatment is removal within 2 hours of ingestion" — Ellen Encisco (guideline) [Ep 13 · 10:13](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=613)
- "Children <1 year with button battery ingestion should receive 10mL sucralfate every 10 minutes for up to 3 doses (not honey due to botulism risk)" — Ellen Encisco (guideline) [Ep 13 · 10:35](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=635)
- "Children ≥1 year with button battery ingestion should receive 10mL honey every 10 minutes for up to 6 doses" — Ellen Encisco (guideline) [Ep 13 · 10:51](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=651)
- "New ATLS recommendation for pediatric hemorrhagic shock: after one 20cc/kg crystalloid bolus, give blood using balanced transfusion protocol (10-20mL/kg PRBC plus FFP and platelets)" (guideline) [Ep 13 · 11:31](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=691)
- "Earlier transfusion in pediatric trauma was associated with shorter median time to transfusion and decreased total fluid volume administered" (clinical) [Ep 13 · 11:46](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=706)
- "Whole blood in trauma patients requires less volume compared to component therapy" (clinical) [Ep 13 · 11:59](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=719)
- "In adults, observation of spontaneous pneumothorax is non-inferior to immediate intervention with tube thoracostomy" (clinical) [Ep 13 · 12:42](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=762)
- "Midwest Pediatric Surgery Consortium study: 48% of spontaneous pneumothorax patients treated with simple aspiration were successful" (clinical) [Ep 13 · 12:53](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=773)
- "44% of spontaneous pneumothorax patients in the simple aspiration group recurred" (clinical) [Ep 13 · 12:53](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=773)
- "83% of spontaneous pneumothorax patients who failed simple aspiration ultimately required VATS or blebectomy" (clinical) [Ep 13 · 13:16](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=796)
- "Mortality among black newborns is 3 times that of white newborns" — Ellen Encisco (epidemiological) [Ep 13 · 14:13](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=853)
- "When black newborns are treated by black physicians, their mortality is reduced by 58% compared to black newborns treated by white physicians (Greenwood et al.)" — Ellen Encisco (epidemiological) [Ep 13 · 14:19](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=859)
- "Most children with prenatally diagnosed CPAMs are born asymptomatic" (clinical) [Ep 15 · 1:44](https://library.globalcastmd.com/watch/case-based-journal-review-cpam-in-2022-5319?t=104)
- "A prospective study followed prenatally diagnosed congenital cystic lung lesions for a median of 10 years" — Ellen Encisco (clinical) [Ep 15 · 2:30](https://library.globalcastmd.com/watch/case-based-journal-review-cpam-in-2022-5319?t=150)
- "57% or 68% of patients in the prospective study were managed conservatively" — Ellen Encisco (clinical) [Ep 15 · 2:38](https://library.globalcastmd.com/watch/case-based-journal-review-cpam-in-2022-5319?t=158)
- "Of the conservatively managed patients who were followed up, none became symptomatic" — Rod Gerardo (clinical) [Ep 15 · 2:43](https://library.globalcastmd.com/watch/case-based-journal-review-cpam-in-2022-5319?t=163)
- "Respiratory compromise at birth from CPAM is very unusual, not seen in 20 years by one speaker" (clinical) [Ep 15 · 2:49](https://library.globalcastmd.com/watch/case-based-journal-review-cpam-in-2022-5319?t=169)
- "The argument for early resection is that CPAMs will go on to cause pneumonia, pulmonary abscesses, and potentially cancer" (clinical) [Ep 15 · 2:58](https://library.globalcastmd.com/watch/case-based-journal-review-cpam-in-2022-5319?t=178)
- "Retrospective studies show a huge range of 3% to 85% for risk of becoming symptomatic" — Jose Campos (clinical) [Ep 15 · 3:37](https://library.globalcastmd.com/watch/case-based-journal-review-cpam-in-2022-5319?t=217)
- "Systematic reviews report symptomatic rates of 3.2% in one review and 25% in another" — Jose Campos (clinical) [Ep 15 · 3:37](https://library.globalcastmd.com/watch/case-based-journal-review-cpam-in-2022-5319?t=217)
- "Out of 344 prenatally diagnosed lesions, none had malignant pathology when resected" — Rod Gerardo (clinical) [Ep 15 · 4:36](https://library.globalcastmd.com/watch/case-based-journal-review-cpam-in-2022-5319?t=276)
- "Of 177 children with postnatal diagnosis of CPAM, 15 (8.7%) were classified as having a malignant tumor" — Ellen Encisco (clinical) [Ep 15 · 4:47](https://library.globalcastmd.com/watch/case-based-journal-review-cpam-in-2022-5319?t=287)
- "The International Pleuropulmonary Blastoma Registry has 350 cases reported worldwide and found only 9 cases of prenatally diagnosed lesions that turned out to be pleuropulmonary blastoma" — Jose Campos (epidemiological) [Ep 15 · 5:49](https://library.globalcastmd.com/watch/case-based-journal-review-cpam-in-2022-5319?t=349)
- "Patients without prior pulmonary infection had shorter operative times" — Ellen Encisco (clinical) [Ep 15 · 7:18](https://library.globalcastmd.com/watch/case-based-journal-review-cpam-in-2022-5319?t=438)
- "Patients without prior infection had fewer postoperative fevers and less need for antibiotics postoperatively" — Ellen Encisco (clinical) [Ep 15 · 7:18](https://library.globalcastmd.com/watch/case-based-journal-review-cpam-in-2022-5319?t=438)
- "There were no significant differences in postoperative complications between groups with and without prior infection" — Ellen Encisco (clinical) [Ep 15 · 7:37](https://library.globalcastmd.com/watch/case-based-journal-review-cpam-in-2022-5319?t=457)
- "There was no significant difference in conversion rate from thoracoscopic to open between groups with and without prior infection" — Rod Gerardo (clinical) [Ep 15 · 7:50](https://library.globalcastmd.com/watch/case-based-journal-review-cpam-in-2022-5319?t=470)
- "After infection, there is a higher rate of conversion from thoracoscopic to open surgery" — Jose Campos (clinical) [Ep 15 · 8:17](https://library.globalcastmd.com/watch/case-based-journal-review-cpam-in-2022-5319?t=497)
- "The number of patients who will have an infection is so low that the benefit of lesser conversion rate does not justify preemptive surgery" — Jose Campos (opinion) [Ep 15 · 8:25](https://library.globalcastmd.com/watch/case-based-journal-review-cpam-in-2022-5319?t=505)
- "If you only operate on those that get infected, you will miss those that get pleuropulmonary blastoma without a pre-existing infection" (clinical) [Ep 15 · 8:38](https://library.globalcastmd.com/watch/case-based-journal-review-cpam-in-2022-5319?t=518)
- "Operative time increased with each increase in age group" — Ellen Encisco (clinical) [Ep 15 · 9:32](https://library.globalcastmd.com/watch/case-based-journal-review-cpam-in-2022-5319?t=572)
- "At younger ages, the tissue planes are easier to dissect" — Ellen Encisco (clinical) [Ep 15 · 9:39](https://library.globalcastmd.com/watch/case-based-journal-review-cpam-in-2022-5319?t=579)
- "Between 1 and 3 months, operative time was 115 minutes compared to 163 minutes in the 6 to 12 months group" — Ellen Encisco (clinical) [Ep 15 · 9:50](https://library.globalcastmd.com/watch/case-based-journal-review-cpam-in-2022-5319?t=590)
- "There were no differences in major complications, conversion rates, or readmissions between age groups" — Rod Gerardo (clinical) [Ep 15 · 10:08](https://library.globalcastmd.com/watch/case-based-journal-review-cpam-in-2022-5319?t=608)
- "The 1 to 3 month group had a 40% thoracotomy rate" — Jose Campos (clinical) [Ep 15 · 10:28](https://library.globalcastmd.com/watch/case-based-journal-review-cpam-in-2022-5319?t=628)
- "The complication rate of operating on a perforated appendix with an abscess is the same as when doing an interval appendectomy, according to Kansas City data" (clinical) [Ep 15 · 10:42](https://library.globalcastmd.com/watch/case-based-journal-review-cpam-in-2022-5319?t=642)
- "Prophylactic operations should have nearly zero complications" — Jose Campos (opinion) [Ep 15 · 11:13](https://library.globalcastmd.com/watch/case-based-journal-review-cpam-in-2022-5319?t=673)
- "About 20% of osteosarcoma patients already have lung metastases by the time of diagnosis" — Ellen Encisco (epidemiological) [Ep 18 · 1:29](https://library.globalcastmd.com/watch/update-course-rewind-thoracotomy-vs-vats-for-lung-metastases-5632?t=89)
- "About 40% of patients can get a durable cure response after 5 years if you have complete metastatic site clearance" — Roshni Dasgupta (clinical) [Ep 18 · 2:08](https://library.globalcastmd.com/watch/update-course-rewind-thoracotomy-vs-vats-for-lung-metastases-5632?t=128)
- "Complete surgical resection of all metastatic tumor sites is an independent positive prognostic factor and affects overall survival, not just disease recurrence" — Roshni Dasgupta (clinical) [Ep 18 · 2:23](https://library.globalcastmd.com/watch/update-course-rewind-thoracotomy-vs-vats-for-lung-metastases-5632?t=143)
- "Even at the size of 1 millimeter, you can get about 60% of 1 millimeter nodules contained malignant disease in patients with metastatic osteosarcoma" — Roshni Dasgupta (clinical) [Ep 18 · 2:35](https://library.globalcastmd.com/watch/update-course-rewind-thoracotomy-vs-vats-for-lung-metastases-5632?t=155)
- "The bigger the nodule is, the more likely you're going to have malignancy, but all the way down to 1 millimeter, you will see tumor" — Roshni Dasgupta (clinical) [Ep 18 · 2:47](https://library.globalcastmd.com/watch/update-course-rewind-thoracotomy-vs-vats-for-lung-metastases-5632?t=167)
- "You will find about 30 to 40% more lung nodules with your fingers and looking than you actually find on CAT scan, even with special MP scanning and thin cut CT scans" — Roshni Dasgupta (clinical) [Ep 18 · 3:19](https://library.globalcastmd.com/watch/update-course-rewind-thoracotomy-vs-vats-for-lung-metastases-5632?t=199)
- "One of the issues with ICG is depth of penetration, so when you are open, it's a little bit easier to use ICG to find those deeper nodules" — Roshni Dasgupta (clinical) [Ep 18 · 3:54](https://library.globalcastmd.com/watch/update-course-rewind-thoracotomy-vs-vats-for-lung-metastases-5632?t=234)
- "Thoracotomy is more invasive than other alternatives and there is longer hospital stay" — Ellen Encisco (clinical) [Ep 18 · 4:10](https://library.globalcastmd.com/watch/update-course-rewind-thoracotomy-vs-vats-for-lung-metastases-5632?t=250)
- "We're not really sure that removing those tiny little 1 millimeter nodules actually gives you a survival advantage" — Roshni Dasgupta (opinion) [Ep 18 · 4:15](https://library.globalcastmd.com/watch/update-course-rewind-thoracotomy-vs-vats-for-lung-metastases-5632?t=255)
- "VATS is minimally invasive with shorter length of stay" — Roshni Dasgupta (clinical) [Ep 18 · 4:41](https://library.globalcastmd.com/watch/update-course-rewind-thoracotomy-vs-vats-for-lung-metastases-5632?t=281)
- "When you go back in for a repeat thoracoscopy, you don't have the same adhesions, it's not as stuck" — Roshni Dasgupta (clinical) [Ep 18 · 4:44](https://library.globalcastmd.com/watch/update-course-rewind-thoracotomy-vs-vats-for-lung-metastases-5632?t=284)
- "With VATS you often need to have some sort of localization process and need to have good interventional radiology" — Roshni Dasgupta (clinical) [Ep 18 · 4:58](https://library.globalcastmd.com/watch/update-course-rewind-thoracotomy-vs-vats-for-lung-metastases-5632?t=298)
- "Often with thoracotomy, you can take out 15 to 20 nodules, but with thoracoscopy, it's a little more limited as to how many you can actually find and localize" — Ellen Encisco (clinical) [Ep 18 · 5:07](https://library.globalcastmd.com/watch/update-course-rewind-thoracotomy-vs-vats-for-lung-metastases-5632?t=307)
- "A multi-institution study including 200 patients with metastatic osteosarcoma is the largest study that has ever been done" — Ellen Encisco (epidemiological) [Ep 18 · 5:23](https://library.globalcastmd.com/watch/update-course-rewind-thoracotomy-vs-vats-for-lung-metastases-5632?t=323)
- "In oligometastatic disease (patients who have less than 4 nodules on each side), there was no difference in terms of mortality between open resection and thoracoscopy" — Roshni Dasgupta (clinical) [Ep 18 · 5:34](https://library.globalcastmd.com/watch/update-course-rewind-thoracotomy-vs-vats-for-lung-metastases-5632?t=334)
- "The survival curves for thoracotomy versus VATS are pretty much exactly the same in oligometastatic disease" — Roshni Dasgupta (clinical) [Ep 18 · 5:44](https://library.globalcastmd.com/watch/update-course-rewind-thoracotomy-vs-vats-for-lung-metastases-5632?t=344)
- "Maybe those small little nodules that you're feeling with a grain of sand don't actually make that much difference" — Roshni Dasgupta (opinion) [Ep 18 · 5:52](https://library.globalcastmd.com/watch/update-course-rewind-thoracotomy-vs-vats-for-lung-metastases-5632?t=352)
- "There was definitely significant selection bias and institutional selection bias in the study comparing thoracotomy and VATS" — Roshni Dasgupta (clinical) [Ep 18 · 6:09](https://library.globalcastmd.com/watch/update-course-rewind-thoracotomy-vs-vats-for-lung-metastases-5632?t=369)
- "Metastatic disease is addressed after 4 cycles of chemotherapy, and often if these nodules are still residual, you're not going to see any change" — Roshni Dasgupta (clinical) [Ep 18 · 6:34](https://library.globalcastmd.com/watch/update-course-rewind-thoracotomy-vs-vats-for-lung-metastases-5632?t=394)
- "Most people do staged procedures, particularly for thoracotomy, between 4 and 6 weeks apart to allow a cycle of chemotherapy in between" — Roshni Dasgupta (clinical) [Ep 18 · 7:13](https://library.globalcastmd.com/watch/update-course-rewind-thoracotomy-vs-vats-for-lung-metastases-5632?t=433)
- "Survival didn't change when you had only 3 to 4 nodules on the side" — Steven Rothenberg (clinical) [Ep 18 · 7:29](https://library.globalcastmd.com/watch/update-course-rewind-thoracotomy-vs-vats-for-lung-metastases-5632?t=449)
- "The argument that you needed to put your hand in to feel all the granules means you automatically should do a bilateral thoracotomy because this is a systemic disease, not a unilateral disease" — Steven Rothenberg (opinion) [Ep 18 · 7:29](https://library.globalcastmd.com/watch/update-course-rewind-thoracotomy-vs-vats-for-lung-metastases-5632?t=449)
- "We can only see 1 or 2 millimeter nodules now even with the best CTs, and you still miss some" — Steven Rothenberg (clinical) [Ep 18 · 7:52](https://library.globalcastmd.com/watch/update-course-rewind-thoracotomy-vs-vats-for-lung-metastases-5632?t=472)
- "There's no question that tumor clearing improves survival" — Steven Rothenberg (clinical) [Ep 18 · 8:02](https://library.globalcastmd.com/watch/update-course-rewind-thoracotomy-vs-vats-for-lung-metastases-5632?t=482)
- "There are ones that you can feel and not see, and there are ones that you can't feel" — Steven Rothenberg (clinical) [Ep 18 · 8:05](https://library.globalcastmd.com/watch/update-course-rewind-thoracotomy-vs-vats-for-lung-metastases-5632?t=485)
- "If there's only 3 to 4 nodules on the side and they're applicable to thoracoscopy, that's how we go just to reduce the morbidity" — Steven Rothenberg (opinion) [Ep 18 · 8:12](https://library.globalcastmd.com/watch/update-course-rewind-thoracotomy-vs-vats-for-lung-metastases-5632?t=492)
- "The Children's Oncology Group is starting a study to answer the question of thoracotomy versus VATS, with enrollment starting towards the end of this year or early next year" — Todd Ponsky (clinical) [Ep 18 · 8:56](https://library.globalcastmd.com/watch/update-course-rewind-thoracotomy-vs-vats-for-lung-metastases-5632?t=536)
- "The azygous vein drains the bronchi, trachea, and esophagus" — Jose Campos (clinical) [Ep 17 · 3:25](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=205)
- "Dividing the azygous vein may lead to impaired clearance of mucus and debris from the tracheobronchial tree postoperatively" — Jose Campos (clinical) [Ep 17 · 3:30](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=210)
- "In a systematic review of almost 700 neonates, preserving the azygous vein resulted in significantly lower postoperative pneumonitis" — Ellen (clinical) [Ep 17 · 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 between preserved and divided azygous vein groups" — Ellen (clinical) [Ep 17 · 3:11](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=191)
- "There was no significant difference in stricture rate between preserved and divided azygous vein groups" — Ellen (clinical) [Ep 17 · 3:11](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=191)
- "The endpoint of chest infection was not clearly defined across studies in the azygous vein meta-analysis, with some using pneumonitis, some pneumonia, and some just chest infection" — Jose Campos (clinical) [Ep 17 · 4:54](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=294)
- "In a Quebec study of 244 patients, the overall anastomotic stricture rate at one year was 30%" — Ellen (epidemiological) [Ep 17 · 6:43](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=403)
- "Transanastomotic tubes were placed in 61% of patients in the Quebec study" — Ellen (epidemiological) [Ep 17 · 6:50](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=410)
- "36% of patients with transanastomotic tubes developed strictures compared to 19% without tubes" — Ellen (clinical) [Ep 17 · 6:50](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=410)
- "After multivariable analysis adjusting for gestational age, leak, gap length, and tension, patients with transanastomotic tubes had 2.72 times higher odds of developing strictures" — Ellen (clinical) [Ep 17 · 7:06](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=426)
- "Patients with transanastomotic tubes started feeding on day 2 versus day 10 for those without tubes" — Em (clinical) [Ep 17 · 7:54](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=474)
- "Despite earlier feeding with transanastomotic tubes, TPN duration was identical at 9 days in both groups" — Em (clinical) [Ep 17 · 7:58](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=478)
- "Early feeding with transanastomotic tubes did not result in earlier hospital discharge" — Em (clinical) [Ep 17 · 8:09](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=489)
- "Having a foreign body (transanastomotic tube) in the anastomosis does not stent it open and in fact makes it stricture" — Todd (clinical) [Ep 17 · 8:48](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=528)
- "Congenital esophageal stenosis is associated with esophageal atresia in 7% to 10% of cases" — Jose Campos (epidemiological) [Ep 17 · 9:44](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=584)
- "Most cases of congenital esophageal stenosis are diagnosed really late, some after the anastomosis fails" — Jose Campos (clinical) [Ep 17 · 9:54](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=594)
- "Passing a tube through the anastomosis and checking for resistance can detect distal esophageal stenosis intraoperatively" — Jose Campos (clinical) [Ep 17 · 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 chest drain placement" — Em (clinical) [Ep 17 · 12:20](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=740)
- "The group that received routine chest drains had significantly higher rates of return to the operating room" — Em (clinical) [Ep 17 · 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 (clinical) [Ep 17 · 11:23](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=683)
- "Chest tubes may injure, suck on, or increase the chance of anastomotic disruption" — Todd (opinion) [Ep 17 · 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 (clinical) [Ep 17 · 11:39](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=699)
- "If you place a prophylactic chest drain, the chances of needing another one later are the same as if you didn't place one initially" — Jose Campos (clinical) [Ep 17 · 13:14](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=794)
- "Giving acid suppression to neonates increases the risk of necrotizing enterocolitis according to neonatologists" — Todd (clinical) [Ep 17 · 13:53](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=833)
- "Giving PPIs to neonates can increase pneumonia in different populations, but the risk is very minimal" — Jose Campos (clinical) [Ep 17 · 14:24](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=864)
- "Antibiotics for more than 24 hours and acid suppression showed no difference in strictures or leaks in the Midwest Pediatric Surgery Consortium study" — Ellen (clinical) [Ep 17 · 14:54](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=894)
- "The theme emerging from recent esophageal atresia literature is that less is more, with studies showing things we don't need to do anymore" — Todd (opinion) [Ep 17 · 15:58](https://library.globalcastmd.com/watch/case-based-journal-review-esophageal-atresia-in-2022-5631?t=958)
- "Dr. Bailey Roberts from IPSO presented on extracellular vesicles for metastatic osteosarcoma contributing to the creation of pre-metastatic niche" — Cecilia (clinical) [Ep 21 · 0:08](https://library.globalcastmd.com/watch/heat-2-winner-matthew-urichuk-phd-best-of-the-best-in-pediatric-surgery-2024-8013?t=8)
- "Dr. Dominic Simons from IPSO presented on multimodal 3D visualization of pediatric neuroblastoma aiding surgical planning beyond anatomical information" — Cecilia (clinical) [Ep 21 · 0:19](https://library.globalcastmd.com/watch/heat-2-winner-matthew-urichuk-phd-best-of-the-best-in-pediatric-surgery-2024-8013?t=19)
- "Dr. Miyake from CAPS presented on using microinjection for drug delivery with nanoparticles in lung explants to study prenatal treatment of CDH" — Cecilia (clinical) [Ep 21 · 0:31](https://library.globalcastmd.com/watch/heat-2-winner-matthew-urichuk-phd-best-of-the-best-in-pediatric-surgery-2024-8013?t=31)
- "Dr. Urichuk from CAPS presented that individuals with thoracoabdominal congenital surgical anomalies are at increased risk of adverse mental health outcomes" — Cecilia (clinical) [Ep 21 · 0:47](https://library.globalcastmd.com/watch/heat-2-winner-matthew-urichuk-phd-best-of-the-best-in-pediatric-surgery-2024-8013?t=47)
- "Dr. Matthew Urichuk won Heat 2 of the Best of the Best in Pediatric Surgery 2024 competition" — Cecilia (clinical) [Ep 21 · 1:27](https://library.globalcastmd.com/watch/heat-2-winner-matthew-urichuk-phd-best-of-the-best-in-pediatric-surgery-2024-8013?t=87)
- "Osteosarcoma most commonly affects adolescents and young adults" — Bailey Roberts (epidemiological) [Ep 20 · 1:08](https://library.globalcastmd.com/watch/bailey-roberts-md-best-of-the-best-in-pediatric-surgery-2024-8011?t=68)
- "Gross metastasis at the time of diagnosis is present about 20% of the time in osteosarcoma" — Bailey Roberts (epidemiological) [Ep 20 · 1:11](https://library.globalcastmd.com/watch/bailey-roberts-md-best-of-the-best-in-pediatric-surgery-2024-8011?t=71)
- "The most common site of metastasis in osteosarcoma is in the lung" — Bailey Roberts (clinical) [Ep 20 · 1:11](https://library.globalcastmd.com/watch/bailey-roberts-md-best-of-the-best-in-pediatric-surgery-2024-8011?t=71)
- "Overall survival worsens from 80% to about 20% for metastatic osteosarcoma disease" — Bailey Roberts (epidemiological) [Ep 20 · 1:19](https://library.globalcastmd.com/watch/bailey-roberts-md-best-of-the-best-in-pediatric-surgery-2024-8011?t=79)
- "Recurrence is very common in osteosarcoma, and the most common site of recurrence is in the lungs" — Bailey Roberts (clinical) [Ep 20 · 1:25](https://library.globalcastmd.com/watch/bailey-roberts-md-best-of-the-best-in-pediatric-surgery-2024-8011?t=85)
- "Extracellular vesicles are carriers of amino acids, proteins, mRNA or other forms of cellular communication" — Bailey Roberts (clinical) [Ep 20 · 1:38](https://library.globalcastmd.com/watch/bailey-roberts-md-best-of-the-best-in-pediatric-surgery-2024-8011?t=98)
- "EV content is unique and specific to the cells that released it, and therefore can be traced back to the cell type" — Bailey Roberts (clinical) [Ep 20 · 1:45](https://library.globalcastmd.com/watch/bailey-roberts-md-best-of-the-best-in-pediatric-surgery-2024-8011?t=105)
- "EVs are involved in the metastatic cascade and implicated as potential markers for disease diagnosis and staging" — Bailey Roberts (clinical) [Ep 20 · 1:52](https://library.globalcastmd.com/watch/bailey-roberts-md-best-of-the-best-in-pediatric-surgery-2024-8011?t=112)
- "EVs have been shown to change fibroblasts, inhibit T cell activity, and are involved in establishing a pre-metastatic niche" — Bailey Roberts (clinical) [Ep 20 · 1:59](https://library.globalcastmd.com/watch/bailey-roberts-md-best-of-the-best-in-pediatric-surgery-2024-8011?t=119)
- "K12 is a spontaneous osteosarcoma with low metastatic capability" — Bailey Roberts (clinical) [Ep 20 · 2:31](https://library.globalcastmd.com/watch/bailey-roberts-md-best-of-the-best-in-pediatric-surgery-2024-8011?t=151)
- "K7M2 is a highly metastatic osteosarcoma derived from a spontaneous osteosarcoma that went through two reiterations of harvesting spontaneous lung metastases and reimplanting them into the mouse" — Bailey Roberts (clinical) [Ep 20 · 2:35](https://library.globalcastmd.com/watch/bailey-roberts-md-best-of-the-best-in-pediatric-surgery-2024-8011?t=155)
- "The K7M2 cell line is more aggressive and causes death at a much higher rate than K12" — Bailey Roberts (clinical) [Ep 20 · 2:57](https://library.globalcastmd.com/watch/bailey-roberts-md-best-of-the-best-in-pediatric-surgery-2024-8011?t=177)
- "Pre-education with K7M2 EVs drastically increases the metastatic burden in the lungs of mice with K7M2 tumors" — Bailey Roberts (clinical) [Ep 20 · 3:59](https://library.globalcastmd.com/watch/bailey-roberts-md-best-of-the-best-in-pediatric-surgery-2024-8011?t=239)
- "Pre-education with K7M2 EVs increased the overall mortality during the five-week study period in mice with K7M2 tumors" — Bailey Roberts (clinical) [Ep 20 · 4:18](https://library.globalcastmd.com/watch/bailey-roberts-md-best-of-the-best-in-pediatric-surgery-2024-8011?t=258)
- "K7M2 EV education led to increased metastatic burden in mice with K12 tumors" — Bailey Roberts (clinical) [Ep 20 · 4:44](https://library.globalcastmd.com/watch/bailey-roberts-md-best-of-the-best-in-pediatric-surgery-2024-8011?t=284)
- "Pre-education with highly metastatic cell line EVs increases the metastasis seen in a normally low metastatic tumor" — Bailey Roberts (clinical) [Ep 20 · 5:01](https://library.globalcastmd.com/watch/bailey-roberts-md-best-of-the-best-in-pediatric-surgery-2024-8011?t=301)
- "No mice with K12 tumors died in the study period" — Bailey Roberts (clinical) [Ep 20 · 5:09](https://library.globalcastmd.com/watch/bailey-roberts-md-best-of-the-best-in-pediatric-surgery-2024-8011?t=309)
- "Extracellular vesicles delivered prior to tumor implantation from highly metastatic K7M2 increase the metastatic burden of K7M2 tumors" — Bailey Roberts (clinical) [Ep 20 · 5:14](https://library.globalcastmd.com/watch/bailey-roberts-md-best-of-the-best-in-pediatric-surgery-2024-8011?t=314)
- "Increased metastatic burden from extracellular vesicles decreases overall survival" — Bailey Roberts (clinical) [Ep 20 · 5:24](https://library.globalcastmd.com/watch/bailey-roberts-md-best-of-the-best-in-pediatric-surgery-2024-8011?t=324)
- "Extracellular vesicles from highly metastatic K7M2 increase the metastatic burden of less metastatic K12 tumors" — Bailey Roberts (clinical) [Ep 20 · 5:30](https://library.globalcastmd.com/watch/bailey-roberts-md-best-of-the-best-in-pediatric-surgery-2024-8011?t=330)
- "Extracellular vesicles can cause metastatic spread and therefore be a therapeutic target for osteosarcoma metastasis" — Bailey Roberts (opinion) [Ep 20 · 5:39](https://library.globalcastmd.com/watch/bailey-roberts-md-best-of-the-best-in-pediatric-surgery-2024-8011?t=339)
- "All cells in the body release EVs, so we can't just generally target EVs and hope to decrease the establishment of a pre-metastatic niche" — Bailey Roberts (clinical) [Ep 20 · 6:27](https://library.globalcastmd.com/watch/bailey-roberts-md-best-of-the-best-in-pediatric-surgery-2024-8011?t=387)
- "IRF5 is a molecule being explored as a potential immunotherapy target in osteosarcoma EVs" — Bailey Roberts (clinical) [Ep 20 · 6:48](https://library.globalcastmd.com/watch/bailey-roberts-md-best-of-the-best-in-pediatric-surgery-2024-8011?t=408)
- "Surgically removing the primary tumor is the current standard of care for osteosarcoma" — Bailey Roberts (guideline) [Ep 20 · 7:10](https://library.globalcastmd.com/watch/bailey-roberts-md-best-of-the-best-in-pediatric-surgery-2024-8011?t=430)
- "There are certain membrane EV markers, but they're shared by all types of EVs" — Bailey Roberts (clinical) [Ep 20 · 7:31](https://library.globalcastmd.com/watch/bailey-roberts-md-best-of-the-best-in-pediatric-surgery-2024-8011?t=451)
- "The differences in EVs by cell type have more to do with the contents inside of them than the targets on them, which makes them difficult to target as far as treatment" — Bailey Roberts (clinical) [Ep 20 · 7:40](https://library.globalcastmd.com/watch/bailey-roberts-md-best-of-the-best-in-pediatric-surgery-2024-8011?t=460)
- "EVs are better for prognostic evaluation than treatment targeting" — Bailey Roberts (opinion) [Ep 20 · 7:52](https://library.globalcastmd.com/watch/bailey-roberts-md-best-of-the-best-in-pediatric-surgery-2024-8011?t=472)
- "Studies in dogs show ability to take serum of dogs with osteosarcoma and determine their likelihood of metastasis based on the EVs" — Bailey Roberts (clinical) [Ep 20 · 7:57](https://library.globalcastmd.com/watch/bailey-roberts-md-best-of-the-best-in-pediatric-surgery-2024-8011?t=477)
- "The systematic review aimed to highlight outcomes of cryopreservation in pediatric female patients with cancer" — Cecilia Gigena (epidemiological) [Ep 22 · 0:11](https://library.globalcastmd.com/watch/female-fertility-cryopreservation-outcomes-in-childhood-cancer-a-systematic-review-8647?t=11)
- "The review included 12 studies with 612 patients total" — Cecilia Gigena (epidemiological) [Ep 22 · 0:20](https://library.globalcastmd.com/watch/female-fertility-cryopreservation-outcomes-in-childhood-cancer-a-systematic-review-8647?t=20)
- "501 patients underwent ovarian tissue cryopreservation" — Cecilia Gigena (epidemiological) [Ep 22 · 0:26](https://library.globalcastmd.com/watch/female-fertility-cryopreservation-outcomes-in-childhood-cancer-a-systematic-review-8647?t=26)
- "Only 30 of the 501 patients received ovarian tissue transplantation" — Cecilia Gigena (epidemiological) [Ep 22 · 0:31](https://library.globalcastmd.com/watch/female-fertility-cryopreservation-outcomes-in-childhood-cancer-a-systematic-review-8647?t=31)
- "Of the 30 patients who received transplantation, 9 got pregnant" — Cecilia Gigena (clinical) [Ep 22 · 0:36](https://library.globalcastmd.com/watch/female-fertility-cryopreservation-outcomes-in-childhood-cancer-a-systematic-review-8647?t=36)
- "Only 6 of the 9 pregnancies resulted in live birth" — Cecilia Gigena (clinical) [Ep 22 · 0:40](https://library.globalcastmd.com/watch/female-fertility-cryopreservation-outcomes-in-childhood-cancer-a-systematic-review-8647?t=40)
- "More high quality studies are needed to understand cryopreservation better and improve its outcomes" — Cecilia Gigena (opinion) [Ep 22 · 0:43](https://library.globalcastmd.com/watch/female-fertility-cryopreservation-outcomes-in-childhood-cancer-a-systematic-review-8647?t=43)
- "Preterm infants with inguinal hernia have a very high rate of incarceration" — Todd Ponsky (clinical) [Ep 28 · 1:17](https://library.globalcastmd.com/watch/case-based-journal-review-inguinal-hernia-2025-10168?t=77)
- "The younger the baby, the higher the risk of incarceration" — Jose Campos (clinical) [Ep 28 · 1:43](https://library.globalcastmd.com/watch/case-based-journal-review-inguinal-hernia-2025-10168?t=103)
- "The multi-center RCT included 308 patients: 159 in early repair group and 149 in late repair group, across 39 US hospitals between 2013 and 2021" — Gody (clinical) [Ep 28 · 2:59](https://library.globalcastmd.com/watch/case-based-journal-review-inguinal-hernia-2025-10168?t=179)
- "44 patients in early repair group versus 27 in late repair group had at least one serious adverse event (28% vs 18%)" — Gody (clinical) [Ep 28 · 3:36](https://library.globalcastmd.com/watch/case-based-journal-review-inguinal-hernia-2025-10168?t=216)
- "Incarceration rate was around 4% in the late repair group" — Gody (clinical) [Ep 28 · 4:07](https://library.globalcastmd.com/watch/case-based-journal-review-inguinal-hernia-2025-10168?t=247)
- "In the early group 4% had spontaneous resolution, in the late group 11% had spontaneous resolution" — Jose Campos (clinical) [Ep 28 · 4:27](https://library.globalcastmd.com/watch/case-based-journal-review-inguinal-hernia-2025-10168?t=267)
- "One patient had a bowel injury during repair" — Todd Ponsky (clinical) [Ep 28 · 4:56](https://library.globalcastmd.com/watch/case-based-journal-review-inguinal-hernia-2025-10168?t=296)
- "There were more reintubations and more apnea in the early repair group" — Todd Ponsky (clinical) [Ep 28 · 5:26](https://library.globalcastmd.com/watch/case-based-journal-review-inguinal-hernia-2025-10168?t=326)
- "The study used 16 adverse events as a composite outcome including apnea, prolonged intubation, inguinal hernia complications like recurrence, incarceration, and re-operation" — Gody (clinical) [Ep 28 · 5:56](https://library.globalcastmd.com/watch/case-based-journal-review-inguinal-hernia-2025-10168?t=356)
- "The study was terminated early, had low recruitment rate, and ended up with less statistical power than initially calculated" — Gody (clinical) [Ep 28 · 7:12](https://library.globalcastmd.com/watch/case-based-journal-review-inguinal-hernia-2025-10168?t=432)
- "The one-stop surgery study from Netherlands included 91 patients: 54 one-stop surgery and 37 usual care, for children older than 3 months with inguinal hernia and ASA grade 1 or 2" — Gody (clinical) [Ep 28 · 10:32](https://library.globalcastmd.com/watch/case-based-journal-review-inguinal-hernia-2025-10168?t=632)
- "All but one of the one-stop surgery patients were discharged home on the day of surgery" — Gody (clinical) [Ep 28 · 10:54](https://library.globalcastmd.com/watch/case-based-journal-review-inguinal-hernia-2025-10168?t=654)
- "Post-op complication and recurrence rates did not differ between intervention and control patients in the one-stop surgery study" — Gody (clinical) [Ep 28 · 10:59](https://library.globalcastmd.com/watch/case-based-journal-review-inguinal-hernia-2025-10168?t=659)
- "General satisfaction and inclusion of family were higher after one-stop surgery experience" — Gody (clinical) [Ep 28 · 11:05](https://library.globalcastmd.com/watch/case-based-journal-review-inguinal-hernia-2025-10168?t=665)
- "There was no diagnostic uncertainty in the one-stop surgery program" — Jose Campos (clinical) [Ep 28 · 11:35](https://library.globalcastmd.com/watch/case-based-journal-review-inguinal-hernia-2025-10168?t=695)
- "A surgery journal article found that routine follow-up for pediatric surgical conditions like circumcision, orchiopexy, and inguinal hernia altered management less than 1% of the time" — Jose Campos (clinical) [Ep 28 · 12:26](https://library.globalcastmd.com/watch/case-based-journal-review-inguinal-hernia-2025-10168?t=746)
- "When facing medical problems with low risk of complications, family satisfaction becomes a surrogate for quality" — Jose Campos (opinion) [Ep 28 · 13:28](https://library.globalcastmd.com/watch/case-based-journal-review-inguinal-hernia-2025-10168?t=808)
- "The patent processus vaginalis study enrolled infants under 4 months undergoing laparoscopic pyloromyotomy at 8 children's hospitals, with 246 eligible infants with PPV and 85% responding to at least one annual follow-up" — Gody (clinical) [Ep 28 · 15:34](https://library.globalcastmd.com/watch/case-based-journal-review-inguinal-hernia-2025-10168?t=934)
- "Of all patients with PPV, two had inguinal hernia repair for symptomatic hernia, one had orchiopexy and incidental inguinal hernia repair, for total of 3 hernia repairs" — Gody (clinical) [Ep 28 · 15:49](https://library.globalcastmd.com/watch/case-based-journal-review-inguinal-hernia-2025-10168?t=949)
- "The presence of patent processus vaginalis at time of pyloromyotomy was common, but need for hernia repair was around 1% in first year of follow-up" — Gody (clinical) [Ep 28 · 16:13](https://library.globalcastmd.com/watch/case-based-journal-review-inguinal-hernia-2025-10168?t=973)
- "A Mayo Clinic study by Ben Zendejas showed contralateral hernia occurrence after 50 year follow-up" — Todd Ponsky (clinical) [Ep 28 · 16:43](https://library.globalcastmd.com/watch/case-based-journal-review-inguinal-hernia-2025-10168?t=1003)
- "The study analyzed the ACS NSQIP Pediatric database from 2017 to 2021" — Alex Halpern (clinical) [Ep 29 · 0:13](https://library.globalcastmd.com/watch/same-day-discharge-for-elective-pediatric-laparoscopic-gastrostomy-tube-insertion-is-safe-and-increasing-in-frequency-a-nsqip-pediatric-retrospective-review-2017-to-2021-10299?t=13)
- "5,947 pediatric patients underwent elective laparoscopic gastrostomy tube placement in the study period" — Alex Halpern (epidemiological) [Ep 29 · 0:21](https://library.globalcastmd.com/watch/same-day-discharge-for-elective-pediatric-laparoscopic-gastrostomy-tube-insertion-is-safe-and-increasing-in-frequency-a-nsqip-pediatric-retrospective-review-2017-to-2021-10299?t=21)
- "4.7% of patients were discharged the same day after laparoscopic gastrostomy tube placement" — Alex Halpern (epidemiological) [Ep 29 · 0:29](https://library.globalcastmd.com/watch/same-day-discharge-for-elective-pediatric-laparoscopic-gastrostomy-tube-insertion-is-safe-and-increasing-in-frequency-a-nsqip-pediatric-retrospective-review-2017-to-2021-10299?t=29)
- "There were no significant differences in 30-day unplanned readmissions between same-day discharge and 1-2 day discharge patients" — Alex Halpern (clinical) [Ep 29 · 0:33](https://library.globalcastmd.com/watch/same-day-discharge-for-elective-pediatric-laparoscopic-gastrostomy-tube-insertion-is-safe-and-increasing-in-frequency-a-nsqip-pediatric-retrospective-review-2017-to-2021-10299?t=33)
- "There were no significant differences in reoperations between same-day discharge and 1-2 day discharge patients" — Alex Halpern (clinical) [Ep 29 · 0:33](https://library.globalcastmd.com/watch/same-day-discharge-for-elective-pediatric-laparoscopic-gastrostomy-tube-insertion-is-safe-and-increasing-in-frequency-a-nsqip-pediatric-retrospective-review-2017-to-2021-10299?t=33)
- "There were no significant differences in any other complications between same-day discharge and 1-2 day discharge patients" — Alex Halpern (clinical) [Ep 29 · 0:33](https://library.globalcastmd.com/watch/same-day-discharge-for-elective-pediatric-laparoscopic-gastrostomy-tube-insertion-is-safe-and-increasing-in-frequency-a-nsqip-pediatric-retrospective-review-2017-to-2021-10299?t=33)
- "Same-day discharge for pediatric patients after elective laparoscopic gastrostomy appears to be safe" — Alex Halpern (opinion) [Ep 29 · 0:46](https://library.globalcastmd.com/watch/same-day-discharge-for-elective-pediatric-laparoscopic-gastrostomy-tube-insertion-is-safe-and-increasing-in-frequency-a-nsqip-pediatric-retrospective-review-2017-to-2021-10299?t=46)
- "Same-day discharge after pediatric laparoscopic gastrostomy is not commonly done" — Alex Halpern (epidemiological) [Ep 29 · 0:46](https://library.globalcastmd.com/watch/same-day-discharge-for-elective-pediatric-laparoscopic-gastrostomy-tube-insertion-is-safe-and-increasing-in-frequency-a-nsqip-pediatric-retrospective-review-2017-to-2021-10299?t=46)
- "The institution has about 10 years of experience with chest wall reconstructions" — Margaret Mutch (clinical) [Ep 30 · 0:16](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=16)
- "Patient presented with back pain and difficulty walking" — Lizzie Lee (clinical) [Ep 30 · 0:25](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=25)
- "Examination revealed incomplete cord injury with absent lower limb reflexes and altered motor and sensation below T6" — Margaret Mutch (clinical) [Ep 30 · 0:27](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=27)
- "Tumor arose from 6th rib and extended into spinal canal" — Lizzie Lee (clinical) [Ep 30 · 0:36](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=36)
- "Patient underwent emergency posterior laminectomy and partial tumor debulking for cord decompression between T3 and T7" — Margaret Mutch (clinical) [Ep 30 · 0:42](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=42)
- "Histopathology confirmed aggressive osteosarcoma" — Lizzie Lee (clinical) [Ep 30 · 0:51](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=51)
- "PET scan showed PET avid lesion on right side next to sternum" — Margaret Mutch (clinical) [Ep 30 · 1:04](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=64)
- "Radio guided occult lesion localization using technetium 99 was performed" — Lizzie Lee (clinical) [Ep 30 · 1:12](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=72)
- "Anterior thoracotomy removed lesion that confirmed aggressive osteosarcoma replacing lymph node" — Margaret Mutch (clinical) [Ep 30 · 1:17](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=77)
- "Most reconstruction needs to be tailored to individual needs, location and size of defects" — Margaret Mutch (opinion) [Ep 30 · 1:32](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=92)
- "There is lack of clear evidence-based guidelines for reconstructive materials" — Lizzie Lee (guideline) [Ep 30 · 1:45](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=105)
- "Priority is long-term durability, aesthetics, function, and accommodating future growth" — Lizzie Lee (opinion) [Ep 30 · 1:45](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=105)
- "Most literature on chest wall reconstruction comes from adults" — Margaret Mutch (epidemiological) [Ep 30 · 1:55](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=115)
- "Spinal surgeons removed all vertebral bodies between T4 and T7 and inserted a cage" — Margaret Mutch (clinical) [Ep 30 · 2:06](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=126)
- "Thoracic team resected ribs 4 to 7" — Margaret Mutch (clinical) [Ep 30 · 2:06](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=126)
- "Initial mapping showed right lower lobe nodules that were resected during surgery" — Lizzie Lee (clinical) [Ep 30 · 2:21](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=141)
- "During surgery, tumor thrombus was found in azygos extending into SVC" — Margaret Mutch (clinical) [Ep 30 · 2:28](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=148)
- "Gore-Tex soft tissue patch was placed" — Lizzie Lee (clinical) [Ep 30 · 2:34](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=154)
- "Team tends to use resorbable and biosynthetic materials for reconstruction" — Margaret Mutch (clinical) [Ep 30 · 2:44](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=164)
- "Two systems used in Australia: one by Stryker and one by KLS with resorbable plates" — Margaret Mutch (clinical) [Ep 30 · 2:51](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=171)
- "K-wire drill used to drill through remaining ribs instead of packaged screws" — Lizzie Lee (clinical) [Ep 30 · 3:05](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=185)
- "Proline sutures used to secure the implant" — Lizzie Lee (clinical) [Ep 30 · 3:11](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=191)
- "Permacol placed on top of implant, followed by latissimus dorsi pedicled flap to cover Permacol" — Margaret Mutch (clinical) [Ep 30 · 3:14](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=194)
- "Permacol is a porcine dermal collagen matrix surgical implant" — Lizzie Lee (clinical) [Ep 30 · 3:29](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=209)
- "Delta plates or sonic weld system are polylactide and polyglycolide and polydactide plates" — Margaret Mutch (clinical) [Ep 30 · 3:37](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=217)
- "Resorbable plates have strength of 78% at 2 months and 50% at 6 months" — Margaret Mutch (clinical) [Ep 30 · 3:47](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=227)
- "Patient had relapse 18 months following surgery close to sternum" — Margaret Mutch (clinical) [Ep 30 · 4:05](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=245)
- "Further chest wall reconstruction excised entire sternum, costochondrocartilages, and anterior ribs, replaced with cement mesh" — Lizzie Lee (clinical) [Ep 30 · 4:12](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=252)
- "Patient currently having adjuvant chemotherapy" — Margaret Mutch (clinical) [Ep 30 · 4:22](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=262)
- "One patient had early postoperative wound infection treated with IV antibiotics" — Margaret Mutch (clinical) [Ep 30 · 4:31](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=271)
- "Two patients had sterile seromas in early stages, one at 2 months and one at 8 months" — Margaret Mutch (clinical) [Ep 30 · 4:36](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=276)
- "Both seroma patients were treated with IR drainage" — Lizzie Lee (clinical) [Ep 30 · 4:42](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=282)
- "One case of minor scoliosis on follow-up being followed by spinal team, has not needed intervention so far" — Lizzie Lee (clinical) [Ep 30 · 4:45](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=285)
- "Bioengineering of tissue replacement and 3D printing may be the way of the future in chest wall reconstructions" — Lizzie Lee (opinion) [Ep 30 · 5:17](https://library.globalcastmd.com/watch/update-course-rewind-chest-wall-reconstruction-2024-10839?t=317)
- "The study was a multi-center prospective study conducted by PeaceOC evaluating indocyanine green (ICG) for identifying sentinel lymph nodes in pediatric patients with skin and soft tissue malignancies" — Sophia Schermerhorn (clinical) [Ep 34 · 0:05](https://library.globalcastmd.com/watch/indocyanine-green-assists-with-sentinel-lymph-node-mapping-in-pediatric-and-adolescent-patients-12056?t=5)
- "Peritumoral injection of ICG demonstrated almost 80% sensitivity for detecting a sentinel node" — Sophia Schermerhorn (clinical) [Ep 34 · 0:21](https://library.globalcastmd.com/watch/indocyanine-green-assists-with-sentinel-lymph-node-mapping-in-pediatric-and-adolescent-patients-12056?t=21)
- "All sentinel nodes that contained malignancy were ICG avid" — Sophia Schermerhorn (clinical) [Ep 34 · 0:28](https://library.globalcastmd.com/watch/indocyanine-green-assists-with-sentinel-lymph-node-mapping-in-pediatric-and-adolescent-patients-12056?t=28)
- "ICG diagnostic performance is similar to smaller pediatric studies previously evaluating ICG and sentinel lymph node biopsy" — Sophia Schermerhorn (clinical) [Ep 34 · 0:33](https://library.globalcastmd.com/watch/indocyanine-green-assists-with-sentinel-lymph-node-mapping-in-pediatric-and-adolescent-patients-12056?t=33)
- "ICG may outperform blue dye localization based on previously reported literature" — Sophia Schermerhorn (opinion) [Ep 34 · 0:33](https://library.globalcastmd.com/watch/indocyanine-green-assists-with-sentinel-lymph-node-mapping-in-pediatric-and-adolescent-patients-12056?t=33)
- "The study did not directly compare the effectiveness of ICG to blue dye localization" — Sophia Schermerhorn (clinical) [Ep 34 · 0:45](https://library.globalcastmd.com/watch/indocyanine-green-assists-with-sentinel-lymph-node-mapping-in-pediatric-and-adolescent-patients-12056?t=45)
- "ICG in most cases was used in conjunction with standard localization techniques such as technetium" — Sophia Schermerhorn (clinical) [Ep 34 · 0:49](https://library.globalcastmd.com/watch/indocyanine-green-assists-with-sentinel-lymph-node-mapping-in-pediatric-and-adolescent-patients-12056?t=49)
- "No adverse reactions to ICG were identified within 30 days of surgery" — Sophia Schermerhorn (clinical) [Ep 34 · 0:58](https://library.globalcastmd.com/watch/indocyanine-green-assists-with-sentinel-lymph-node-mapping-in-pediatric-and-adolescent-patients-12056?t=58)
- "Blue dye can cause permanent tattooing" — Sophia Schermerhorn (clinical) [Ep 34 · 1:02](https://library.globalcastmd.com/watch/indocyanine-green-assists-with-sentinel-lymph-node-mapping-in-pediatric-and-adolescent-patients-12056?t=62)
- "ICG has a favorable safety profile and lacks the permanent tattooing associated with blue dye, making it an attractive visualization adjunct for pediatric sentinel lymph node biopsy" — Sophia Schermerhorn (opinion) [Ep 34 · 1:02](https://library.globalcastmd.com/watch/indocyanine-green-assists-with-sentinel-lymph-node-mapping-in-pediatric-and-adolescent-patients-12056?t=62)
- "The ISSVA classification system was updated in 2014 to incorporate genomic testing and somatic mutations in stratifying lymphatic anomalies" — Denise Adams (guideline) [Ep 8 · 2:26](https://library.globalcastmd.com/watch/lymphatic-anomalies-290?t=146)
- "Lymphatic malformations are divided into macrocystic (larger cysts visible individually), microcystic (tiny cysts forming soft tissue mass), combined lesions, generalized lymphatic anomaly, Gorham-Stout disease, and central conducting anomalies" — Denise Adams (clinical) [Ep 8 · 3:06](https://library.globalcastmd.com/watch/lymphatic-anomalies-290?t=186)
- "Using proper nomenclature like 'lymphatic malformation' instead of outdated terms 'cystic hygroma' or 'lymphangioma' improves communication and guides appropriate treatment selection" — Steve Fishman (opinion) [Ep 8 · 4:33](https://library.globalcastmd.com/watch/lymphatic-anomalies-290?t=273)
- "Macrocystic lesions can be conceptualized as 'a bunch of grapes' where each cyst is large enough to access with a needle for sclerotherapy" — Steve Fishman (clinical) [Ep 8 · 5:49](https://library.globalcastmd.com/watch/lymphatic-anomalies-290?t=349)
- "Microcystic lesions are like a small porous sponge where individual cysts are too tiny to target with sclerotherapy, making this approach less valuable" — Steve Fishman (clinical) [Ep 8 · 6:20](https://library.globalcastmd.com/watch/lymphatic-anomalies-290?t=380)
- "Most lymphatic malformations are present at birth and visible at birth, though some can present with sudden expansion in a 2-year-old" — Steve Fishman (clinical) [Ep 8 · 9:06](https://library.globalcastmd.com/watch/lymphatic-anomalies-290?t=546)
- "Four general treatment options exist for lymphatic malformations: observation/reassurance, microinterventional therapy (sclerotherapy), resective surgery, and pharmacological therapy" — Steve Fishman (clinical) [Ep 8 · 10:05](https://library.globalcastmd.com/watch/lymphatic-anomalies-290?t=605)
- "For localized macrocystic lesions, sclerotherapy is preferred if one or two sessions can achieve durable effect without leaving a scar, versus resection for very small lesions that can be removed with minimal cosmetic impact" — Steve Fishman (opinion) [Ep 8 · 11:43](https://library.globalcastmd.com/watch/lymphatic-anomalies-290?t=703)
- "Very large macrocystic lesions extending from axilla to pelvis may warrant primary surgical resection rather than multiple sclerotherapy sessions that leave redundant skin and septal tissue requiring eventual resection anyway" — Steve Fishman (opinion) [Ep 8 · 12:30](https://library.globalcastmd.com/watch/lymphatic-anomalies-290?t=750)
- "Sirolimus (rapamycin) is an mTOR inhibitor that blocks the PIK3CA pathway, which has been shown to be a somatic mutation in many lymphatic malformations" — Denise Adams (clinical) [Ep 8 · 15:54](https://library.globalcastmd.com/watch/lymphatic-anomalies-290?t=954)
- "Sirolimus therapy improves quality of life, reduces pain, and decreases frequency of infections in patients with complicated lymphatic anomalies" — Denise Adams (clinical) [Ep 8 · 16:59](https://library.globalcastmd.com/watch/lymphatic-anomalies-290?t=1019)
- "Preoperative sirolimus can soften lymphatic tissue and decrease lesion size, making surgical procedures less extensive" — Denise Adams (clinical) [Ep 8 · 17:41](https://library.globalcastmd.com/watch/lymphatic-anomalies-290?t=1061)
- "Operating on patients while continuing sirolimus (rather than stopping it preoperatively) makes tissue softer and more pliable, allowing more extensive resection with better flap closure" — Steve Fishman (clinical) [Ep 8 · 19:31](https://library.globalcastmd.com/watch/lymphatic-anomalies-290?t=1171)
- "Sirolimus is not useful for purely macrocystic lesions because tissue expansion from the cysts actually makes surgery easier by providing bigger flaps for closure" — Steve Fishman (opinion) [Ep 8 · 20:25](https://library.globalcastmd.com/watch/lymphatic-anomalies-290?t=1225)
- "Observation and reassurance is an effective treatment option for many lymphatic malformations that are not cancers and often not dangerous" — Steve Fishman (clinical) [Ep 8 · 10:08](https://library.globalcastmd.com/watch/lymphatic-anomalies-290?t=608)
- "Spontaneous resolution of macrocystic lymphatic malformations occurs in less than a handful of cases out of several thousand patients" — Steve Fishman (epidemiological) [Ep 8 · 22:33](https://library.globalcastmd.com/watch/lymphatic-anomalies-290?t=1353)
- "EXIT procedures are not really necessary for lymphatic lesions because they are soft and compressible, allowing intubation, unlike firm teratomas where EXIT plays a role" — Steve Fishman (clinical) [Ep 8 · 23:27](https://library.globalcastmd.com/watch/lymphatic-anomalies-290?t=1407)
- "Babies with congenital lymphedema of lower extremities can have regression to the point of non-detection on physical exam, though this is uncommon" — Steve Fishman (clinical) [Ep 8 · 25:11](https://library.globalcastmd.com/watch/lymphatic-anomalies-290?t=1511)
- "Lesions impinging on the airway that could cause emergency if infected or bleeding should not be observed, as delayed treatment is not safe" — Steve Fishman (clinical) [Ep 8 · 25:55](https://library.globalcastmd.com/watch/lymphatic-anomalies-290?t=1555)
- "Early treatment in infancy is now favored for microcystic lesions on the face, tongue, and floor of mouth, as it likely achieves better long-term results than delayed treatment" — Steve Fishman (opinion) [Ep 8 · 26:20](https://library.globalcastmd.com/watch/lymphatic-anomalies-290?t=1580)
- "Burrough's rule states that if diagnosis is not classic on history, physical, and imaging, tissue biopsy is necessary" — Steve Fishman (guideline) [Ep 8 · 29:28](https://library.globalcastmd.com/watch/lymphatic-anomalies-290?t=1768)
- "Ultrasound with Doppler is the least invasive first imaging step after clinical exam, followed by MRI if diagnosis remains unclear" — Belinda Dickey (clinical) [Ep 8 · 28:56](https://library.globalcastmd.com/watch/lymphatic-anomalies-290?t=1736)
- "Number of sclerotherapy treatments needed varies by lesion size and type, ranging from one treatment to multiple treatments over years" — Belinda Dickey (clinical) [Ep 8 · 32:08](https://library.globalcastmd.com/watch/lymphatic-anomalies-290?t=1928)
- "Doxycycline is used for macrocystic lesions, bleomycin (with monitoring for side effects) for microcystic lesions, and sodium tetradecyl sulfate for venous components" — Belinda Dickey (clinical) [Ep 8 · 33:10](https://library.globalcastmd.com/watch/lymphatic-anomalies-290?t=1990)
- "Venous sclerotherapy requires fluoroscopic venous mapping to ensure sclerosant does not extend intravascularly" — Belinda Dickey (clinical) [Ep 8 · 33:40](https://library.globalcastmd.com/watch/lymphatic-anomalies-290?t=2020)
- "A small amount of ethanol systemically can cause sudden fatal pulmonary hypertension during venous sclerotherapy" — Steve Fishman (clinical) [Ep 8 · 34:25](https://library.globalcastmd.com/watch/lymphatic-anomalies-290?t=2065)
- "Large venous anomalies with direct macroscopic outflow to systemic veins can result in pulmonary embolism from clot induced by sclerotherapy" — Steve Fishman (clinical) [Ep 8 · 34:45](https://library.globalcastmd.com/watch/lymphatic-anomalies-290?t=2085)
- "Direct venous outflow must be obliterated first using intravenous laser, titanium coils, or glue before inducing clot with sclerotherapy to prevent fatal pulmonary embolism" — Steve Fishman (clinical) [Ep 8 · 35:24](https://library.globalcastmd.com/watch/lymphatic-anomalies-290?t=2124)
- "Bleomycin use for vascular anomalies requires monitoring because early use resulted in reported cases of pneumonitis when maximum dosing was not understood" — Denise Adams (clinical) [Ep 8 · 38:09](https://library.globalcastmd.com/watch/lymphatic-anomalies-290?t=2289)
- "Central conducting lymphatic anomalies present with subcutaneous chyle, eroding bones, chylous ascites, chylothorax, and chyle dripping from urethra, scrotum, vagina, or even from under toenails" — Steve Fishman (clinical) [Ep 8 · 39:38](https://library.globalcastmd.com/watch/lymphatic-anomalies-290?t=2378)
- "Half of soft tissue sarcomas are rhabdomyosarcomas and half are non-rhabdos" — Andrea (epidemiological) [Ep 4 · 0:00](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=0)
- "Prognosis in rhabdomyosarcoma varies depending on site" — Andrea (clinical) [Ep 4 · 0:25](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=25)
- "Abdominal, pelvic, and retroperitoneal rhabdomyosarcomas have the worst survival" — Andrea (clinical) [Ep 4 · 0:25](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=25)
- "Orbital rhabdomyosarcomas have the best survival" — Andrea (clinical) [Ep 4 · 0:25](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=25)
- "Favorable sites (vaginal, paratesticular rhabdos) are stage 1" — Andrea (clinical) [Ep 4 · 0:50](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=50)
- "Even small tumors in the extremity or abdomen can only achieve stage 2 at best" — Andrea (clinical) [Ep 4 · 1:02](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=62)
- "Surgical extent determines clinical group: group 1 if everything removed, group 2 if microscopic residual, group 3 if only biopsy performed" — Andrea (clinical) [Ep 4 · 1:14](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=74)
- "Group 1 and 2 patients have an excellent prognosis while group 3 patients do more poorly" — Andrea (clinical) [Ep 4 · 1:30](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=90)
- "Group assignment is a biologic determination, not a measure of surgical skill" — Andrea (opinion) [Ep 4 · 1:45](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=105)
- "Attempting to resect a large unresectable tumor with high morbidity will not improve patient outcome" — Andrea (clinical) [Ep 4 · 1:52](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=112)
- "5 centimeters is the cutoff for low versus high-risk patients in soft tissue sarcoma" — Andrea (clinical) [Ep 4 · 2:09](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=129)
- "Sentinel lymph node biopsies are now required for all trunk and extremity rhabdomyosarcomas" — Andrea (guideline) [Ep 4 · 3:18](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=198)
- "In rhabdomyosarcoma, completion node dissection is not performed after positive sentinel nodes; radiation therapy is given instead" — Andrea (guideline) [Ep 4 · 3:34](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=214)
- "40 to 50% of biopsy nodes are positive in rhabdomyosarcoma" — Andrea (epidemiological) [Ep 4 · 4:39](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=279)
- "Clinically negative nodes may be positive on sentinel node biopsy" — Andrea (clinical) [Ep 4 · 4:39](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=279)
- "Positive lymph nodes have worse prognosis and require radiation therapy" — Andrea (clinical) [Ep 4 · 4:39](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=279)
- "Histological grade is now critical in non-rhabdo soft tissue sarcomas" — Andrea (guideline) [Ep 4 · 4:54](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=294)
- "Large tumors should be biopsied first and chemotherapy tried" — Andrea (guideline) [Ep 4 · 4:54](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=294)
- "Sarcomas have been identified as chemotherapy-sensitive or chemotherapy-insensitive, which changes treatment" — Andrea (clinical) [Ep 4 · 5:13](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=313)
- "Low-grade tumors require only resection and observation with no radiation or chemotherapy" — Andrea (guideline) [Ep 4 · 5:21](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=321)
- "Low-grade tumors with positive margins receive adjuvant radiation therapy" — Andrea (guideline) [Ep 4 · 5:38](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=338)
- "Unresectable tumors now receive both preoperative chemotherapy and radiation therapy (previously only chemotherapy was recommended)" — Andrea (guideline) [Ep 4 · 5:52](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=352)
- "Small tumors less than 5 centimeters should be resected with attempt at negative margins" — Andrea (guideline) [Ep 4 · 6:10](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=370)
- "Chemosensitive tumors include synovial and undifferentiated sarcomas" — Andrea (clinical) [Ep 4 · 6:10](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=370)
- "Chemoinsensitive tumors include alveolar soft part, malignant epithelioid, and clear cell sarcomas" — Andrea (clinical) [Ep 4 · 6:28](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=388)
- "All chemoinsensitive tumors are high-grade; none are low-grade" — Andrea (clinical) [Ep 4 · 6:28](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=388)
- "Surgery and radiation are the primary treatments for chemoinsensitive tumors" — Andrea (guideline) [Ep 4 · 6:28](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=388)
- "A 5 centimeter tumor in a child less than 3 years old is equivalent to a 3 centimeter tumor in bigger patients" — Andrea (clinical) [Ep 4 · 6:54](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=414)
- "3 centimeters should be the cutoff for excision versus biopsy in toddlers rather than 5 centimeters" — Andrea (guideline) [Ep 4 · 6:54](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=414)
- "Sentinel lymph node biopsy should be performed if lymph nodes are clinically negative by imaging" — Andrea (guideline) [Ep 4 · 7:15](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=435)
- "Positive lymph nodes receive radiation to the lymph node basin without completion node dissection" — Andrea (guideline) [Ep 4 · 7:15](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=435)
- "Low-grade non-rhabdo tumors with negative margins can be cured with surgery alone without chemotherapy" — Andrea (clinical) [Ep 4 · 7:25](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=445)
- "Chemoinsensitive tumors require aggressive surgical extirpation" — Andrea (guideline) [Ep 4 · 7:37](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=457)
- "Core biopsies are acceptable if 3 or 4 good non-necrotic cores are obtained" — Andrea (clinical) [Ep 4 · 8:10](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=490)
- "Pathologist should check core biopsy samples before interventional radiologist finishes to ensure tissue is not all necrotic" — Andrea (guideline) [Ep 4 · 8:10](https://library.globalcastmd.com/watch/soft-tissue-sarcoma-rapid-fire-update-course-2015-980?t=490)
- "80% of ovarian masses are teratomas" — Andrea (epidemiological) [Ep 5 · 0:37](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=37)
- "By year 2000, girls with ovarian germ cell tumors have almost 100% survival" — Andrea (epidemiological) [Ep 5 · 1:03](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=63)
- "Stage one ovarian tumors limited to the ovary now receive only oophorectomy, no chemotherapy" — Andrea (guideline) [Ep 5 · 1:29](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=89)
- "Microscopic residual and lymph node involvement in ovarian tumors require chemotherapy" — Andrea (guideline) [Ep 5 · 1:38](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=98)
- "25% of girls with ovarian germ cell tumors will be missed if peritoneal cytology and washings are not performed" — Andrea (clinical) [Ep 5 · 2:28](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=148)
- "If staging procedures are omitted from operative report, oncologists will treat as stage 2" — Andrea (clinical) [Ep 5 · 3:04](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=184)
- "Gliomatosis peritonei is a benign disease with nearly 100% survival, usually associated with teratoma" — Andrea (clinical) [Ep 5 · 3:53](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=233)
- "In bilateral ovarian disease, tumors larger than 10 cm should be biopsied; have lower threshold for bilateral oophorectomy" — Andrea (clinical) [Ep 5 · 4:38](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=278)
- "If ovarian tumor is ruptured during laparoscopic removal, patient is committed to chemotherapy including platinum" — Dan (clinical) [Ep 5 · 6:12](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=372)
- "15% of ovarian tumors in adolescents are epithelial tumors with different staging criteria than germ cell tumors" — Dan (epidemiological) [Ep 5 · 6:31](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=391)
- "If AFP and beta-HCG levels are normal preoperatively, provides some comfort about draining cyst without contamination concern" — Andrea (clinical) [Ep 5 · 7:18](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=438)
- "Salvage rate for recurrent stage one ovarian germ cell tumors is almost 100% because chemotherapy is very effective" — Dan (clinical) [Ep 5 · 11:28](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=688)
- "Ovarian torsion is most common in teenage girls and should be considered urgent, not emergent" — Andrea (clinical) [Ep 5 · 12:52](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=772)
- "Many black-colored torsed ovaries have viable follicles and ovarian preservation should be the goal" — Andrea (clinical) [Ep 5 · 13:14](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=794)
- "Ability to preserve ovary depends on cyst size (greater or less than 10 cm), presence of torsion, and laparoscopic approach" — Andrea (clinical) [Ep 5 · 14:07](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=847)
- "76% of ovaries removed for torsion (surgeon thought dead) had normal ovarian tissue microscopically; only 11% were completely necrotic" — Andrea (clinical) [Ep 5 · 14:45](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=885)
- "Oophoropexy after ovarian preservation typically causes short-lived pain that resolves in about a week" — Andrea (clinical) [Ep 5 · 15:47](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=947)
- "Ability to preserve ovarian function in torsion is age-related; pediatric patients have more active follicles than older adults" — Andrea (clinical) [Ep 5 · 16:10](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=970)
- "Even preserving a thin layer of ovarian tissue will preserve enough follicles for function" — Andrea (clinical) [Ep 5 · 16:48](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1008)
- "Current recommendation is detorsion without complete oophorectomy for ovarian torsion" — Andrea (guideline) [Ep 5 · 17:17](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1037)
- "Ultrasound for ovarian torsion has sensitivity and specificity in the 50-60% range" — Andrea (clinical) [Ep 5 · 20:10](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1210)
- "Presence of blood flow on ultrasound does not exclude torsion; may indicate intermittent or partial occlusion" (clinical) [Ep 5 · 21:47](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1307)
- "Half of soft tissue sarcomas are rhabdomyosarcomas; the other half are non-rhabdo subtypes" — Andrea (epidemiological) [Ep 5 · 25:10](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1510)
- "Abdominal, pelvic, and retroperitoneal rhabdomyosarcomas have the worst survival; orbital rhabdo has the best" — Andrea (epidemiological) [Ep 5 · 25:39](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1539)
- "Even small tumors in extremity or abdomen can only achieve stage 2 at best (not stage 1)" — Andrea (clinical) [Ep 5 · 26:16](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1576)
- "Surgical group (1=complete resection, 2=microscopic residual, 3=biopsy only) combined with stage determines outcome" — Andrea (clinical) [Ep 5 · 26:27](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1587)
- "Group 1 and 2 rhabdomyosarcoma patients have excellent prognosis; group 3 do more poorly" — Andrea (clinical) [Ep 5 · 26:39](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1599)
- "Inability to resect large rhabdo tumor is a biologic determination, not surgical skill; aggressive resection with high morbidity does not improve outcome" — Andrea (opinion) [Ep 5 · 27:01](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1621)
- "5 centimeters is the cutoff for low versus high-risk soft tissue sarcoma" — Andrea (clinical) [Ep 5 · 27:18](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1638)
- "Sentinel lymph node biopsy now required for all trunk and extremity rhabdomyosarcomas" — Andrea (guideline) [Ep 5 · 28:27](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1707)
- "For rhabdomyosarcoma, positive sentinel nodes receive radiation therapy, not completion node dissection (unlike melanoma)" — Andrea (guideline) [Ep 5 · 28:43](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1723)
- "Sentinel lymph node mapping for rhabdo should be performed at time of re-excision if initial excisional biopsy had positive margins" — Andrea (clinical) [Ep 5 · 29:16](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1756)
- "40-50% of clinically negative lymph nodes are positive on biopsy in rhabdomyosarcoma" — Andrea (epidemiological) [Ep 5 · 29:48](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1788)
- "Histologic grade is now critical in non-rhabdo soft tissue sarcoma treatment decisions" — Andrea (guideline) [Ep 5 · 30:03](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1803)
- "Low-grade soft tissue sarcomas are treated with resection alone and observation (no chemo or radiation if negative margins)" — Andrea (guideline) [Ep 5 · 30:39](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1839)
- "Low-grade soft tissue sarcoma with positive margins receives adjuvant radiation therapy" — Andrea (guideline) [Ep 5 · 30:47](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1847)
- "Unresectable soft tissue sarcomas now receive both preoperative chemotherapy and radiation (previously chemo alone)" — Andrea (guideline) [Ep 5 · 31:01](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1861)
- "Chemosensitive soft tissue sarcomas are synovial and undifferentiated subtypes" — Andrea (clinical) [Ep 5 · 31:19](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1879)
- "Chemo-insensitive soft tissue sarcomas include alveolar soft part, malignant epithelioid, and clear cell; all are high-grade" — Andrea (clinical) [Ep 5 · 31:37](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1897)
- "For soft tissue sarcoma, 5 cm tumor in child under 3 years is equivalent to 3 cm tumor in older patient; use 3 cm cutoff for excision in toddlers" — Andrea (clinical) [Ep 5 · 32:03](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1923)
- "Core biopsies are acceptable for soft tissue sarcoma if 3-4 good non-necrotic cores obtained and checked by pathologist before procedure ends" — Andrea (clinical) [Ep 5 · 33:19](https://library.globalcastmd.com/watch/compiled-hayes-jordan-rapid-fire-sessions-update-course-2015-995?t=1999)
- "In adult centers, surgeons perform 100 to 300 cholecystectomies per year compared to 10 to 30 per year in pediatric centers" — Chiro Esposito (epidemiological) [Ep 16 · 3:34](https://library.globalcastmd.com/watch/update-course-2021-thoracotomy-vs-vats-for-osteo-mets-5417?t=214)
- "ICG is a soluble molecule that rapidly binds to albumin and is removed from circulation by the liver into bile juice" — Chiro Esposito (clinical) [Ep 16 · 0:23](https://library.globalcastmd.com/watch/update-course-2021-thoracotomy-vs-vats-for-osteo-mets-5417?t=23)
- "For cholecystectomy, ICG must be injected 12 to 15 hours preoperatively to allow secretion into bile juice for selective biliary tree visualization" — Chiro Esposito (clinical) [Ep 16 · 7:15](https://library.globalcastmd.com/watch/update-course-2021-thoracotomy-vs-vats-for-osteo-mets-5417?t=435)
- "If ICG is injected intraoperatively for cholecystectomy, the liver takes up the dye and appears green, making gallbladder identification difficult" — Chiro Esposito (clinical) [Ep 16 · 7:51](https://library.globalcastmd.com/watch/update-course-2021-thoracotomy-vs-vats-for-osteo-mets-5417?t=471)
- "For all ICG indications except cholecystectomy (kidney, varicocele, lymphoma, tumors), the injection is given intraoperatively" — Chiro Esposito (clinical) [Ep 16 · 7:51](https://library.globalcastmd.com/watch/update-course-2021-thoracotomy-vs-vats-for-osteo-mets-5417?t=471)
- "ICG vial contains 25 mg in 4 ml, diluted with 10 ml sterile water, with 6 ml injected intravenously for cholecystectomy" — Chiro Esposito (clinical) [Ep 16 · 4:40](https://library.globalcastmd.com/watch/update-course-2021-thoracotomy-vs-vats-for-osteo-mets-5417?t=280)
- "For partial nephrectomy in duplex kidney, ICG is injected three times: via ureteral catheter to identify normal ureter, intravenously to visualize kidney vasculature, and intravenously again after vessel clipping to show devascularization line" — Chiro Esposito (clinical) [Ep 16 · 9:34](https://library.globalcastmd.com/watch/update-course-2021-thoracotomy-vs-vats-for-osteo-mets-5417?t=574)
- "In duplex kidney with reflux, the two ureters are attached to each other, making identification of the normal ureter difficult without ICG" — Chiro Esposito (clinical) [Ep 16 · 9:34](https://library.globalcastmd.com/watch/update-course-2021-thoracotomy-vs-vats-for-osteo-mets-5417?t=574)
- "For varicocele repair, intratesticular injection of 2 ml ICG solution allows intraoperative fluorescence lymphography to identify and spare lymphatic vessels" — Chiro Esposito (clinical) [Ep 16 · 17:30](https://library.globalcastmd.com/watch/update-course-2021-thoracotomy-vs-vats-for-osteo-mets-5417?t=1050)
- "Palomo varicocele repair has success rate of more than 97-98% but ligating lymphatics in the spermatic bundle causes postoperative hydrocele in about 20% of cases" — Chiro Esposito (clinical) [Ep 16 · 17:30](https://library.globalcastmd.com/watch/update-course-2021-thoracotomy-vs-vats-for-osteo-mets-5417?t=1050)
- "In a series of more than 150 varicocele patients using ICG lymphatic sparing technique, there were zero postoperative hydroceles" — Chiro Esposito (clinical) [Ep 16 · 19:10](https://library.globalcastmd.com/watch/update-course-2021-thoracotomy-vs-vats-for-osteo-mets-5417?t=1150)
- "The spermatic bundle contains three to four lymphatic vessels" — Chiro Esposito (clinical) [Ep 16 · 17:30](https://library.globalcastmd.com/watch/update-course-2021-thoracotomy-vs-vats-for-osteo-mets-5417?t=1050)
- "There is no maximum dose limit for ICG based on adult surgery studies" — Chiro Esposito (clinical) [Ep 16 · 21:53](https://library.globalcastmd.com/watch/update-course-2021-thoracotomy-vs-vats-for-osteo-mets-5417?t=1313)
- "ICG vial remains usable for six hours after preparation" — Chiro Esposito (clinical) [Ep 16 · 21:24](https://library.globalcastmd.com/watch/update-course-2021-thoracotomy-vs-vats-for-osteo-mets-5417?t=1284)
- "No adverse effects of ICG were observed in the presenter's experience" — Chiro Esposito (clinical) [Ep 16 · 21:24](https://library.globalcastmd.com/watch/update-course-2021-thoracotomy-vs-vats-for-osteo-mets-5417?t=1284)
- "ICG technology can be used in both laparoscopy (requiring special camera and optic) and robotic surgery with Da Vinci XI Firefly system" — Chiro Esposito (clinical) [Ep 16 · 1:20](https://library.globalcastmd.com/watch/update-course-2021-thoracotomy-vs-vats-for-osteo-mets-5417?t=80)
- "The newer Rubin ICG system allows visualization in color with biliary tree appearing green, compared to older systems showing black and white images" — Chiro Esposito (clinical) [Ep 16 · 5:40](https://library.globalcastmd.com/watch/update-course-2021-thoracotomy-vs-vats-for-osteo-mets-5417?t=340)
- "For elective cholecystectomy cases, patients are hospitalized the day before surgery for ICG injection in the late afternoon if surgery is scheduled early morning" — Chiro Esposito (clinical) [Ep 16 · 8:42](https://library.globalcastmd.com/watch/update-course-2021-thoracotomy-vs-vats-for-osteo-mets-5417?t=522)
- "ICG technology helps reduce complications in laparoscopic cholecystectomy, particularly beneficial for trainees and in centers with longer learning curves due to lower case volumes" — Chiro Esposito (opinion) [Ep 16 · 3:34](https://library.globalcastmd.com/watch/update-course-2021-thoracotomy-vs-vats-for-osteo-mets-5417?t=214)
- "Infants with gastroschisis often require prolonged hospitalization for surgical repair and then initiation and advancement of feeds" — Em Tombash (clinical) [Ep 19 · 1:00](https://library.globalcastmd.com/watch/update-course-rewind-2022-top-ten-key-takeaways-6766?t=60)
- "For babies with uncomplicated gastroschisis, feeds can be started immediately after sutureless abdominal closure, beginning with 10 to 20 milliliters per kilogram per day with advancements of 20 milliliters per kilogram per day if tolerated" — Em Tombash (guideline) [Ep 19 · 2:30](https://library.globalcastmd.com/watch/update-course-rewind-2022-top-ten-key-takeaways-6766?t=150)
- "Immediate feeding after gastroschisis closure has been shown to be associated with shorter length of stay and faster attainment of goal feeds" — Em Tombash (clinical) [Ep 19 · 3:00](https://library.globalcastmd.com/watch/update-course-rewind-2022-top-ten-key-takeaways-6766?t=180)
- "For babies with uncomplicated gastroschisis tolerating feeds for a few days, it is okay to continue with the feeding protocol even after one bout of emesis" — Em Tombash (guideline) [Ep 19 · 3:30](https://library.globalcastmd.com/watch/update-course-rewind-2022-top-ten-key-takeaways-6766?t=210)
- "High resolution esophageal manometry, esophagography, and endoscopy can help determine the diagnosis of congenital esophageal stenosis" — Em Tombash (clinical) [Ep 19 · 5:00](https://library.globalcastmd.com/watch/update-course-rewind-2022-top-ten-key-takeaways-6766?t=300)
- "Serial dilatations may be used to manage congenital esophageal stenosis if there is no cartilage component suspected in the stenotic area" — Em Tombash (guideline) [Ep 19 · 5:30](https://library.globalcastmd.com/watch/update-course-rewind-2022-top-ten-key-takeaways-6766?t=330)
- "Surgical resection for congenital esophageal stenosis can be reserved for patients where serial dilatations are unsuccessful or there is concern for cartilaginous component" — Em Tombash (guideline) [Ep 19 · 5:30](https://library.globalcastmd.com/watch/update-course-rewind-2022-top-ten-key-takeaways-6766?t=330)
- "A systematic review and meta-analysis found that overall recurrence rates and recurrences within 24 and 48 hours of intussusception were similar between inpatient and outpatient management groups after enema reduction" — Em Tombash (epidemiological) [Ep 19 · 7:30](https://library.globalcastmd.com/watch/update-course-rewind-2022-top-ten-key-takeaways-6766?t=450)
- "There was no significant difference in the rate of return to the emergency department between inpatient and outpatient management of intussusception after enema reduction" — Em Tombash (epidemiological) [Ep 19 · 8:00](https://library.globalcastmd.com/watch/update-course-rewind-2022-top-ten-key-takeaways-6766?t=480)
- "Both inpatient and outpatient groups had similar rates of requiring operative intervention after intussusception reduction" — Em Tombash (epidemiological) [Ep 19 · 8:00](https://library.globalcastmd.com/watch/update-course-rewind-2022-top-ten-key-takeaways-6766?t=480)
- "Outpatient management of intussusception after air enema reduction results in a shorter hospital stay with no difference in rate of returns to emergency department, recurrence, need for operation, or mortality" — Em Tombash (clinical) [Ep 19 · 8:30](https://library.globalcastmd.com/watch/update-course-rewind-2022-top-ten-key-takeaways-6766?t=510)
- "There is no compelling evidence in pediatric or adult literature to support mechanical bowel preparation for reducing surgical site infections in colorectal surgery" — Em Tombash (epidemiological) [Ep 19 · 9:30](https://library.globalcastmd.com/watch/update-course-rewind-2022-top-ten-key-takeaways-6766?t=570)
- "Recent adult studies have shown no benefit from mechanical bowel preparation in terms of reducing surgical site infections, and some studies showed an increase in wound infections" — Em Tombash (epidemiological) [Ep 19 · 10:00](https://library.globalcastmd.com/watch/update-course-rewind-2022-top-ten-key-takeaways-6766?t=600)
- "Case appropriate pre-operative IV antibiotics may reduce surgical site infection incidents in colorectal operations" — Em Tombash (guideline) [Ep 19 · 10:30](https://library.globalcastmd.com/watch/update-course-rewind-2022-top-ten-key-takeaways-6766?t=630)
- "Firearms are now the leading cause of death in all children and adolescents in the United States, overtaking motor vehicle crashes in 2019" — Em Tombash (epidemiological) [Ep 19 · 11:30](https://library.globalcastmd.com/watch/update-course-rewind-2022-top-ten-key-takeaways-6766?t=690)
- "Low-dose non-contrast CT of the chest has high sensitivity and specificity for identification of airway foreign bodies" — Em Tombash (clinical) [Ep 19 · 14:00](https://library.globalcastmd.com/watch/update-course-rewind-2022-top-ten-key-takeaways-6766?t=840)
- "CT bronchoscopy can avoid the cost and resources of taking a child to the operating room for a non-therapeutic bronchoscopy procedure" — Em Tombash (clinical) [Ep 19 · 14:30](https://library.globalcastmd.com/watch/update-course-rewind-2022-top-ten-key-takeaways-6766?t=870)
- "Death or neurodevelopmental impairment occurred in 69% of patients with necrotizing enterocolitis who underwent initial laparotomy versus 85% of those who underwent initial peritoneal drainage" — Em Tombash (epidemiological) [Ep 19 · 16:00](https://library.globalcastmd.com/watch/update-course-rewind-2022-top-ten-key-takeaways-6766?t=960)
- "A prospective randomized cohort study showed no difference in overall survival between laparotomy and peritoneal drainage for necrotizing enterocolitis, but did show improved long-term neurodevelopmental outcomes with laparotomy" — Em Tombash (epidemiological) [Ep 19 · 16:30](https://library.globalcastmd.com/watch/update-course-rewind-2022-top-ten-key-takeaways-6766?t=990)
- "Racism and sexism that manifest as microaggressions are commonly experienced by members of minority groups in medical settings" — Em Tombash (opinion) [Ep 19 · 18:00](https://library.globalcastmd.com/watch/update-course-rewind-2022-top-ten-key-takeaways-6766?t=1080)
- "Microaggressions can harm trainees's performance and sense of belonging" — Em Tombash (opinion) [Ep 19 · 18:30](https://library.globalcastmd.com/watch/update-course-rewind-2022-top-ten-key-takeaways-6766?t=1110)
- "In a 10-year retrospective review of isolated traumatic skull fractures with normal neurologic exam findings, 77% of patients were admitted for observation but none needed neurosurgical intervention or additional imaging during the index admission" — Em Tombash (epidemiological) [Ep 19 · 20:00](https://library.globalcastmd.com/watch/update-course-rewind-2022-top-ten-key-takeaways-6766?t=1200)
- "Pediatric isolated skull fractures are low risk conditions with a low likelihood of complications and can be discharged safely from the emergency department without inpatient observation" — Em Tombash (clinical) [Ep 19 · 20:30](https://library.globalcastmd.com/watch/update-course-rewind-2022-top-ten-key-takeaways-6766?t=1230)
- "In the IMPACT trial, patients with perforated appendicitis taking piperacillin-tazobactam had lower incidence of intra-abdominal abscesses, lower usage of CT scans, and fewer ED revisits compared to ceftriaxone and metronidazole combination therapy" — Em Tombash (epidemiological) [Ep 19 · 22:00](https://library.globalcastmd.com/watch/update-course-rewind-2022-top-ten-key-takeaways-6766?t=1320)
- "Piperacillin-tazobactam monotherapy did not have an increase in antibiotic usage or increase in antibiotic related complications compared to combination therapy" — Em Tombash (epidemiological) [Ep 19 · 22:30](https://library.globalcastmd.com/watch/update-course-rewind-2022-top-ten-key-takeaways-6766?t=1350)
- "In North America, the preferred approach for resectable renal tumors is primary nephrectomy and ureterectomy with lymph node sampling" — Peter Ehrlich (guideline) [Ep 12 · 6:23](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=383)
- "Preoperative chemotherapy is recommended if tumor extends into IVC beyond the infrahepatic vena cava" — Peter Ehrlich (guideline) [Ep 12 · 7:33](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=453)
- "Wilms tumors tend to push structures out of the way rather than growing around them, unlike neuroblastoma" — Peter Ehrlich (clinical) [Ep 12 · 4:16](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=256)
- "The claw sign on CT scan—normal kidney displaced into horseshoe pattern with tumor in the center—is classic for Wilms tumor" — Peter Ehrlich (clinical) [Ep 12 · 3:49](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=229)
- "Tumors between 13-15 centimeters or larger have higher risk of rupture and may warrant preoperative chemotherapy" — Peter Ehrlich (clinical) [Ep 12 · 14:33](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=873)
- "Core needle biopsy should include 10-20 cores to increase diagnostic accuracy; fine needle aspiration cannot diagnose anaplasia" — Peter Ehrlich (guideline) [Ep 12 · 18:03](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=1083)
- "Stage 1 and 2 Wilms tumor patients receive only two-drug chemotherapy (vincristine and dactinomycin) for 19 weeks without radiation" — Peter Ehrlich (guideline) [Ep 12 · 20:36](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=1236)
- "Stage 3 patients receive three-drug chemotherapy (adding doxorubicin) plus abdominal radiation" — Peter Ehrlich (guideline) [Ep 12 · 20:28](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=1228)
- "A patient with lung metastases but stage 1-2 abdominal disease does not require abdominal radiation if primary tumor is completely resected with negative lymph nodes" — Peter Ehrlich (clinical) [Ep 12 · 24:15](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=1455)
- "Approximately 40% of patients with pulmonary metastases achieve complete response by 6 weeks of chemotherapy and can avoid pulmonary radiation" — Peter Ehrlich (clinical) [Ep 12 · 26:44](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=1604)
- "Fifteen percent of girls who receive pulmonary radiation for Wilms tumor develop breast cancer as a late effect" — Peter Ehrlich (epidemiological) [Ep 12 · 26:08](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=1568)
- "The main late effects of Wilms tumor treatment are renal failure, second malignancies, pregnancy complications, hypertension, and cardiovascular disease, primarily from radiation and doxorubicin" — Peter Ehrlich (clinical) [Ep 12 · 23:37](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=1417)
- "Loss of heterozygosity at both 1p and 16q occurs in 5-7% of patients and predicts 10% lower survival in stage 1-2 and 18% lower survival in stage 3-4" — Peter Ehrlich (clinical) [Ep 12 · 54:41](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=3281)
- "Patients with tumors less than 550g, stage 1, favorable histology, and age under 2 years can be treated with surgery alone with greater than 95% survival" — Peter Ehrlich (clinical) [Ep 12 · 43:41](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=2621)
- "IVC tumor thrombus extension is not a negative prognostic factor if completely resected" — Peter Ehrlich (clinical) [Ep 12 · 46:14](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=2774)
- "Major complication rate for tumors extending beyond infrahepatic IVC operated upfront is 26-30% with documented mortality" — Peter Ehrlich (clinical) [Ep 12 · 48:49](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=2929)
- "Bilateral Wilms tumor occurs in 8-10% of cases with historically lower survival: 61% event-free and 80% overall compared to 88% and 95% for unilateral disease" — Peter Ehrlich (epidemiological) [Ep 12 · 58:51](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=3531)
- "Maximum tumor response to chemotherapy typically occurs by 12 weeks, with early response at 6 weeks predicting late response" — Peter Ehrlich (clinical) [Ep 12 · 59:37](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=3577)
- "In bilateral Wilms tumor, there is discordant pathology between kidneys in up to 20% of cases" — Peter Ehrlich (clinical) [Ep 12 · 62:14](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=3734)
- "SIOP protocols use preoperative chemotherapy for all patients with post-treatment staging based on blastemal predominance" — Peter Ehrlich (guideline) [Ep 12 · 30:31](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=1831)
- "Lymph node positivity is the main prognostic factor in stage 3 disease" — Peter Ehrlich (clinical) [Ep 12 · 32:45](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=1965)
- "Acquired von Willebrand disease occurs in Wilms tumor patients and may rarely cause significant intraoperative bleeding" — Peter Ehrlich (clinical) [Ep 12 · 35:11](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=2111)
- "Minimum lymph node sampling should be 5-6 nodes, though more than one may be better based on secondary evidence" — Peter Ehrlich (guideline) [Ep 12 · 39:49](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=2389)
- "Taking a rim of adherent diaphragm or liver capsule to avoid tumor violation does not upstage the tumor if the tumor itself is not divided" — Peter Ehrlich (clinical) [Ep 12 · 42:31](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=2551)
- "Positive surgical margins automatically make a tumor stage 3" — Peter Ehrlich (guideline) [Ep 12 · 41:24](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=2484)
- "Favorable histology Wilms tumor has three components: blastemal, stromal, and epithelial; tumors with only two components are still considered favorable" — Peter Ehrlich (clinical) [Ep 12 · 52:52](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=3172)
- "In COG protocols, the amount of blastema in favorable histology tumors has never correlated with outcome" — Peter Ehrlich (clinical) [Ep 12 · 53:13](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=3193)
- "Stage 2 patients receive vincristine and dactinomycin for 19 weeks; stage 3 patients receive DD4A regimen (adding doxorubicin) for 25 weeks" — Peter Ehrlich (guideline) [Ep 12 · 53:56](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=3236)
- "Renal cell carcinoma is the second most common renal tumor in children, with no effective therapy for metastatic disease" — Peter Ehrlich (clinical) [Ep 12 · 56:51](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=3411)
- "Rhabdoid tumors have terrible outcomes except for stage 1; most present at stage 3 or 4" — Peter Ehrlich (clinical) [Ep 12 · 57:27](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=3447)
- "Point-of-care ultrasound for intussusception diagnosis has approximately 95% sensitivity and 99% specificity" — Rod Gerardo (clinical) [Ep 14 · 2:12](https://library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=132)
- "Ultrasound-guided hydrostatic reduction has a 95.8% success rate versus 93.1% for fluoroscopy-guided air reduction" — Rod Gerardo (clinical) [Ep 14 · 5:50](https://library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=350)
- "Obstructive gas pattern on radiograph is associated with decreased success of air enema and increased need for bowel resection" — Rod Gerardo (clinical) [Ep 14 · 7:58](https://library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=478)
- "A prediction model using clinical and sonographic data can identify 80% of failed ultrasound-guided saline enema reductions before the procedure" — Rod Gerardo (clinical) [Ep 14 · 8:50](https://library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=530)
- "Free fluid and extension beyond the splenic angle are sonographic predictors of failed reduction" — Rod Gerardo (clinical) [Ep 14 · 9:06](https://library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=546)
- "Altered Doppler signal is a predictor of failed enema reduction" — Rod Gerardo (clinical) [Ep 14 · 9:06](https://library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=546)
- "Sedation during pneumatic reduction has slightly better success rate than no sedation, but the difference is approximately 7%" — Jose Campos (clinical) [Ep 14 · 10:12](https://library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=612)
- "Bowel perforation occurred in 3 patients in the sedation group and none in the non-sedation group, but this was not statistically significant" — Jose Campos (clinical) [Ep 14 · 10:12](https://library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=612)
- "Recurrence rate was 5.1% with sedation versus 1.3% without sedation, not statistically significant but concerning" — Jose Campos (clinical) [Ep 14 · 10:12](https://library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=612)
- "Ketamine sedation had 90% success rate versus 70% for morphine analgesia during hydrostatic reduction, but difference was not statistically significant" — Rod Gerardo (clinical) [Ep 14 · 11:27](https://library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=687)
- "Recurrence rates were 10% for ketamine and 15% for morphine, not statistically significant" — Rod Gerardo (clinical) [Ep 14 · 11:27](https://library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=687)
- "There were no bowel perforations in the ketamine versus morphine comparison study" — Todd (clinical) [Ep 14 · 11:27](https://library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=687)
- "Systematic review found no significant difference in emergency department returns, recurrence, need for operation, or mortality between inpatient and outpatient management after successful air enema reduction" — Rod Gerardo (clinical) [Ep 14 · 13:23](https://library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=803)
- "Nationwide database study of 8,289 patients found 3.7% readmission and recurrence rate after intussusception reduction" — Rod Gerardo (epidemiological) [Ep 14 · 15:31](https://library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=931)
- "Single-center study of 200 cases found 13.5% overall recurrence rate with 7.3% recurring within 48 hours" — Todd (epidemiological) [Ep 14 · 16:17](https://library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=977)
- "Fever and female sex are risk factors for early recurrence of intussusception" — Todd (clinical) [Ep 14 · 16:17](https://library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=977)
- "Point-of-care ultrasound results are institution-dependent and require adequate training and volume" — Todd (opinion) [Ep 14 · 2:52](https://library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=172)
- "It would be irresponsible for an institution to adopt emergency department point-of-care ultrasound based solely on published sensitivity/specificity data without adequate local training" — Todd (opinion) [Ep 14 · 3:50](https://library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=230)
- "Standardized point-of-care ultrasound training in residency programs is likely more than 5-10 years away in the United States" — Todd (opinion) [Ep 14 · 3:50](https://library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=230)
- "If obstructive gas pattern predicts bowel resection but not perforation risk, attempted enema reduction is still worthwhile" — Todd (opinion) [Ep 14 · 7:58](https://library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=478)
- "If sedation is equally safe for perforation as no sedation, then sedation should be used for patient comfort" — Todd (opinion) [Ep 14 · 11:47](https://library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=707)
- "COVID-19 hospital resource constraints are forcing reconsideration of traditional admission practices" — Todd (opinion) [Ep 14 · 13:46](https://library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=826)
- "Clinicians should increase tolerance for recurrence risk if it benefits the majority of children by avoiding unnecessary admission" — Jose Campos (opinion) [Ep 14 · 16:59](https://library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=1019)
- "The speaker is Rod Gerardo from Cincinnati Children's" — Rod Gerardo (clinical) [Ep 36 · 0:00](https://library.globalcastmd.com/watch/commercial-audio-only-13743?t=0)
- "The new content format differs from existing YouTube videos and podcasts that go deep in the weeds with pediatric surgery" — Rod Gerardo (opinion) [Ep 36 · 0:10](https://library.globalcastmd.com/watch/commercial-audio-only-13743?t=10)
- "Dr. Jeff Ponsky will co-conduct interviews with Rod Gerardo" — Rod Gerardo (clinical) [Ep 36 · 0:20](https://library.globalcastmd.com/watch/commercial-audio-only-13743?t=20)
- "Interview subjects will include residents, fellows, and attendings from around the globe" — Rod Gerardo (clinical) [Ep 36 · 0:24](https://library.globalcastmd.com/watch/commercial-audio-only-13743?t=24)
- "Topics will cover resident wellness, general surgery concepts, and new technologies" — Rod Gerardo (clinical) [Ep 36 · 0:28](https://library.globalcastmd.com/watch/commercial-audio-only-13743?t=28)
- "Episodes will be available on the Stay Current Pediatric Surgery app and social media channels" — Rod Gerardo (clinical) [Ep 36 · 0:32](https://library.globalcastmd.com/watch/commercial-audio-only-13743?t=32)

## Changelog
- Aug 31: 38 doctors auto-found from episode dossiers
- Aug 30: 37 doctors auto-found from episode dossiers
- Aug 30: 29 doctors auto-found from episode dossiers
- Aug 30: Members-only episodes removed from this collection
- Aug 29: 32 doctors auto-found from episode dossiers
- Aug 29: 33 doctors auto-found from episode dossiers
- Aug 29: Collection generated from campaign corpus: 42 items, 28 dossiers, summaries for 4 audience(s)
- Aug 29: Collection reviewed and published
- Aug 29: Collection generated from campaign corpus: 31 items, 28 dossiers, summaries for 3 audience(s)
- Aug 29: Collection generated from campaign corpus: 31 items, 28 dossiers, summaries for 1 audience(s)

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Educational content from recorded physician discussions — not medical advice. Cite the canonical URL or the ?t= deep link. Policy: https://library.globalcastmd.com/ai