# Uncomplicated Appendicitis — GCMD Library living collection

Everything in the library about uncomplicated appendicitis — built automatically from dossiers that name it.

Updated: n/a · 4 episodes · 36 cited statements

## Episodes
### Medical Management
- [2025 Pediatric Surgery Update Course - Updates in Appendicitis Management](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-appendicitis-management-10900) — video · 21:49 · [machine version](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-appendicitis-management-10900.md)

### Evidence & Research
- [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)
- [2025 Pediatric Surgery Update Course - Updates in Pediatric Surgery feat. non-JPS Journals](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-pediatric-surgery-feat-non-jps-journals-10897) — video · 22:32 · [machine version](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-pediatric-surgery-feat-non-jps-journals-10897.md)

### Emerging & Future Directions
- [2025 Pediatric Surgery Update Course - Top AI Tools of 2025](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-top-ai-tools-of-2025-10907) — video · 17:17 · [machine version](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-top-ai-tools-of-2025-10907.md)

## Chapters
- [0:12](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=12) Takeaway #10: Medical Management of Uncomplicated Appendicitis (Ep 1)
- [1:45](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=105) Takeaway #9: Surgical Approach to Osteosarcoma Lung Metastases (Ep 1)
- [3:08](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=188) Takeaway #8: Flourish Device for Esophageal Atresia (Ep 1)
- [4:43](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=283) Takeaway #7: Indocyanine Green Applications in Pediatric Surgery (Ep 1)
- [6:06](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=366) Takeaway #6: Timing of Colorectal Procedures (Ep 1)
- [7:42](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=462) Takeaway #5: Pain Management for Pectus Repair (Ep 1)
- [9:29](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=569) Takeaway #4: Button Battery Ingestion Management (Ep 1)
- [11:12](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=672) Takeaway #3: Updated ATLS Guidelines for Pediatric Hemorrhagic Shock (Ep 1)
- [12:21](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=741) Takeaway #2: Management of Primary Spontaneous Pneumothorax (Ep 1)
- [13:49](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=829) Takeaway #1: Diversity, Equity, and Inclusion in Pediatric Surgery (Ep 1)
- [0:00](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-pediatric-surgery-feat-non-jps-journals-10897?t=0) Introduction and Nonoperative Management of Appendicitis (Ep 2)
- [4:07](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-pediatric-surgery-feat-non-jps-journals-10897?t=247) DVT Prophylaxis in Pediatric Trauma (Ep 2)
- [9:28](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-pediatric-surgery-feat-non-jps-journals-10897?t=568) Neuroendocrine Tumors of the Appendix (Ep 2)
- [16:52](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-pediatric-surgery-feat-non-jps-journals-10897?t=1012) Stoma versus Anastomosis in Necrotizing Enterocolitis (Ep 2)
- [0:00](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-appendicitis-management-10900?t=0) Audience polling on current practice patterns and initial discussion of non-operative management adoption barriers (Ep 3)
- [3:43](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-appendicitis-management-10900?t=223) Review of randomized trial evidence and failure rates (Ep 3)
- [8:41](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-appendicitis-management-10900?t=521) Debate on treatment efficacy versus safety and clinical context (Ep 3)
- [14:26](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-appendicitis-management-10900?t=866) Outpatient management feasibility and cost-effectiveness (Ep 3)
- [17:21](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-appendicitis-management-10900?t=1041) Patient selection criteria and future practice predictions (Ep 3)
- [0:00](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-top-ai-tools-of-2025-10907?t=0) Introduction and Session Overview (Ep 4)
- [1:35](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-top-ai-tools-of-2025-10907?t=95) OpenEvidence: Medical Large Language Model (Ep 4)
- [7:08](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-top-ai-tools-of-2025-10907?t=428) ChatGPT Operator and Projects (Ep 4)
- [9:34](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-top-ai-tools-of-2025-10907?t=574) Custom GPT for Case-Based Learning (Ep 4)
- [14:31](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-top-ai-tools-of-2025-10907?t=871) AI Coding Agents and Workflow Automation (Ep 4)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- "In the Petcova et al. study published in Annals of Surgery 2020, children with uncomplicated appendicitis were randomized to medical management with antibiotics or surgery, with 5-year follow-up." — Ellen Encisco (host_summary) [Ep 1 · 0:43](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=43)
- "In the Petcova et al. appendicitis study, the surgery group had no complications, while 46% of patients in the non-surgical management group required appendectomy during follow-up." (host_summary) [Ep 1 · 1:11](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=71)
- "Medical management of acute uncomplicated appendicitis may be safe but is associated with a high failure rate, with many children ultimately requiring laparoscopic appendectomy." — Ellen Encisco (host_summary) [Ep 1 · 1:22](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=82)
- "Metastectomy for osteosarcoma lung metastases improves survival and can make patients long-term survivors." (host_summary) [Ep 1 · 2:15](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=135)
- "Approximately 10% of 1 millimeter lung nodules in osteosarcoma patients contain malignant disease." (host_summary) [Ep 1 · 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 to determine whether thoracotomy or thoracoscopy is superior for resection of pulmonary metastases in osteosarcoma, with enrollment expected late 2021 or early 2022." (host_summary) [Ep 1 · 2:40](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=160)
- "The Flourish device is a catheter-based device that places magnets in proximal and distal esophageal pouches to create a compression anastomosis by causing ischemia of tissue between the magnets, which then sloughs off." (host_summary) [Ep 1 · 3:16](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=196)
- "Inclusion criteria for the Flourish device are: atretic gap less than 4 centimeters long, fistula repaired or absent, and G-tube able to accommodate an 18 French catheter." (host_summary) [Ep 1 · 3:39](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=219)
- "The Flourish device is associated with a high stricture rate and known serious life-threatening complications, and should only be used by centers with capabilities to treat the many issues associated with esophageal atresia." (host_summary) [Ep 1 · 3:57](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=237)
- "Indocyanine green (ICG) has become a topic of interest in the last few years for use in pediatric surgery, especially in minimally invasive procedures to improve visualization of structures." — Ellen Encisco (host_summary) [Ep 1 · 4:43](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=283)
- "For laparoscopic cholecystectomy, ICG must be administered intravenously 12 to 18 hours prior to surgery to allow time for accumulation in the extrahepatic ducts, or can be injected directly into the gallbladder during surgery." — Ellen Encisco (host_summary) [Ep 1 · 5:32](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=332)
- "ICG applications in pediatric surgery include laparoscopic cholecystectomies, varicocele repairs, partial nephrectomies, and tumor excisions." — Ellen Encisco (host_summary) [Ep 1 · 5:48](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=348)
- "For anorectal malformations with rectal-perineal or rectal-vestibular fistula, outcomes including complications are similar whether the procedure is done before or after 14 days of life." (host_summary) [Ep 1 · 6:37](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=397)
- "A PCPLC consortium study comparing endorectal pull-through for Hirschsprung disease at less than 31 days versus greater than 31 days found that preoperative enterocolitis, postoperative enterocolitis, constipation, and incontinence were the same between both groups." (host_summary) [Ep 1 · 6:54](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=414)
- "Delayed pull-through with irrigations is a safe alternative to an operation in the neonatal period for Hirschsprung disease." (host_summary) [Ep 1 · 7:14](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=434)
- "Cryoanalgesia is probably effective at improving post-operative pain and decreasing length of stay for pectus patients, with length of stay reduced from 4 days to 1 day." (host_summary) [Ep 1 · 8:11](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=491)
- "There are no long-term studies on the effects of cryoanalgesia for pectus repair." (host_summary) [Ep 1 · 8:34](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=514)
- "The double rim sign or halo sign on X-ray indicates a child has swallowed a button battery rather than a coin." — Ellen Encisco (host_summary) [Ep 1 · 9:48](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=588)
- "The main goal of button battery ingestion treatment is to remove the battery within 2 hours of ingestion." — Ellen Encisco (host_summary) [Ep 1 · 10:13](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=613)
- "Sucralfate or honey can help reduce damage from button batteries on the child's esophagus as temporizing measures." — Ellen Encisco (host_summary) [Ep 1 · 10:20](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=620)
- "Children less than 1 year old should not receive honey due to risk of botulism and should instead receive 10 mL of sucralfate every 10 minutes for up to 3 doses for button battery ingestion." — Ellen Encisco (host_summary) [Ep 1 · 10:35](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=635)
- "Children over age 1 with button battery ingestion should receive honey 10 mL every 10 minutes for up to 6 doses." — Ellen Encisco (host_summary) [Ep 1 · 10:51](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=651)
- "New ATLS recommendations for pediatric trauma patients in hemorrhagic shock call for earlier transfusion: after 1 bolus of 20 cc per kilogram of crystalloid fluid, blood should be given." (host_summary) [Ep 1 · 11:28](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=688)
- "Balanced transfusion protocol for pediatric hemorrhagic shock typically includes 10 to 20 mLs per kilogram of packed red blood cells, plus inclusion of FFP and platelets." (host_summary) [Ep 1 · 11:38](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=698)
- "Earlier transfusion in pediatric trauma was associated with shorter median time to transfusion and a decrease in total fluid volume administered." (host_summary) [Ep 1 · 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." (host_summary) [Ep 1 · 11:59](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=719)
- "Research shows that observation of spontaneous pneumothorax in adults is non-inferior to immediate intervention with tube thoracostomy." (host_summary) [Ep 1 · 12:42](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=762)
- "The Midwest Pediatric Surgery Consortium study on spontaneous pneumothorax management with simple aspiration showed 48% success rate, but 44% of patients in the simple aspiration group recurred." (host_summary) [Ep 1 · 12:53](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=773)
- "83% of patients who failed simple aspiration for spontaneous pneumothorax ultimately ended up with VATS or blebectomy." (host_summary) [Ep 1 · 13:16](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=796)
- "Greenwood et al. showed that mortality amongst black newborns is 3 times that of white newborns." — Ellen Encisco (host_summary) [Ep 1 · 14:10](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=850)
- "When black newborns are treated by black physicians, their mortality is reduced by 58% compared to black newborns treated by white physicians." — Ellen Encisco (host_summary) [Ep 1 · 14:19](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=859)
- "Bias exists within medicine and can change outcomes; representation matters and can make a difference." — Ellen Encisco (host_summary) [Ep 1 · 14:30](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=870)
- "OpenEvidence is a large language model trained specifically on medical text through partnerships with organizations including JAMA" (clinical) [Ep 4 · 1:35](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-top-ai-tools-of-2025-10907?t=95)
- "Large language models are fundamentally text completers that depend on their training data" (clinical) [Ep 4 · 2:52](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-top-ai-tools-of-2025-10907?t=172)
- "OpenEvidence provides source citations for its answers and does not hallucinate like other large language models" — Mike (clinical) [Ep 4 · 3:38](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-top-ai-tools-of-2025-10907?t=218)
- "OpenEvidence is HIPAA compliant when registered through a hospital business administrator, allowing input of actual patient information for case solutions" (clinical) [Ep 4 · 3:59](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-top-ai-tools-of-2025-10907?t=239)
- "OpenEvidence's attachment feature (US-only) allows uploading hospital guidelines for comparison against current evidence" (clinical) [Ep 4 · 4:19](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-top-ai-tools-of-2025-10907?t=259)
- "OpenEvidence still sometimes hallucinates and outputs must always be checked" (clinical) [Ep 4 · 4:19](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-top-ai-tools-of-2025-10907?t=259)
- "OpenEvidence is the first AI large language model to score 100% on USMLE" (clinical) [Ep 4 · 5:44](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-top-ai-tools-of-2025-10907?t=344)
- "OpenEvidence offers USMLE study sessions for Steps 1, 2, and 3 with adaptive difficulty based on performance" (clinical) [Ep 4 · 5:44](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-top-ai-tools-of-2025-10907?t=344)
- "OpenEvidence provides templates for patient notes to decrease charting time" (clinical) [Ep 4 · 6:35](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-top-ai-tools-of-2025-10907?t=395)
- "ChatGPT's Operator feature functions as a human-AI co-pilot where AI performs tasks while humans can intervene to steer direction" (clinical) [Ep 4 · 7:08](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-top-ai-tools-of-2025-10907?t=428)
- "ChatGPT Projects allow creation of specialized AI team members with uploaded documents and specific expertise" — Todd Ponsky (clinical) [Ep 4 · 7:56](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-top-ai-tools-of-2025-10907?t=476)
- "The best way to learn in residency is by making mistakes" (opinion) [Ep 4 · 9:34](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-top-ai-tools-of-2025-10907?t=574)
- "A custom GPT was designed for case-based learning that presents consequences of clinical mistakes without immediately revealing the error" (clinical) [Ep 4 · 9:34](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-top-ai-tools-of-2025-10907?t=574)
- "ChatGPT study mode changes the endpoint from providing answers to helping users learn through step-by-step explanation with adaptive difficulty" (clinical) [Ep 4 · 13:15](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-top-ai-tools-of-2025-10907?t=795)
- "AI coding agents enable creation of custom applications through natural language prompts without traditional development" (clinical) [Ep 4 · 14:31](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-top-ai-tools-of-2025-10907?t=871)
- "Vibe coding (natural language app creation) is expected to be democratized within a year, allowing everyone to make hyper-customized solutions" — Todd Ponsky (opinion) [Ep 4 · 14:48](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-top-ai-tools-of-2025-10907?t=888)
- "The effectiveness of AI coding agents raises questions about the viability of software-as-a-service as a business model" (opinion) [Ep 4 · 15:57](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-top-ai-tools-of-2025-10907?t=957)
- "Division-by-division workflow automation could save hundreds of millions of dollars over three to four years" (epidemiological) [Ep 4 · 15:57](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-top-ai-tools-of-2025-10907?t=957)
- "Organizations need both top-down technology purchases and bottom-up workforce empowerment for AI adoption" — Todd Ponsky (opinion) [Ep 4 · 14:48](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-top-ai-tools-of-2025-10907?t=888)
- "In the European pilot trial by Thomas Wester and Yann Spenson, 24 patients received antibiotics, 2 failed early, and 6 of the remainder required appendectomy, though only 1 had histologically proven appendicitis." (host_summary) [Ep 3 · 3:43](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-appendicitis-management-10900?t=223)
- "At five-year follow-up of the European pilot trial, only 2 additional patients required appendectomy, with failures occurring relatively early." (host_summary) [Ep 3 · 4:50](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-appendicitis-management-10900?t=290)
- "The Midwest Pediatric Surgery Consortium non-randomized patient preference trial enrolled 1,068 patients with about one-third selecting antibiotics and had a 33% failure rate requiring operation." (host_summary) [Ep 3 · 5:20](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-appendicitis-management-10900?t=320)
- "Patients who respond well to antibiotics have essentially zero disability days with no somatic injury incurred." (host_summary) [Ep 3 · 5:50](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-appendicitis-management-10900?t=350)
- "The international randomized trial found a 26% total difference between groups, with 7% failure in the operative group (negative appendectomies) versus 34% failure in the antibiotic arm." (clinical) [Ep 3 · 7:20](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-appendicitis-management-10900?t=440)
- "Approximately 300 appendectomy studies reviewed over 20 years consistently show around 30% failure rate with non-operative management." (epidemiological) [Ep 3 · 9:00](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-appendicitis-management-10900?t=540)
- "Every study has shown non-operative management is safe, which is the key finding when comparing treatment differences." (clinical) [Ep 3 · 9:48](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-appendicitis-management-10900?t=588)
- "For patients requiring four-hour transfer from Eastern Washington, antibiotic treatment allows them to stay home with telehealth follow-up and later interval appendectomy, saving transfer costs and family hardship." (clinical) [Ep 3 · 10:12](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-appendicitis-management-10900?t=612)
- "In the outpatient management study published in JPS, 121 patients were screened with strict criteria and had a 12% appendectomy rate at one year." (host_summary) [Ep 3 · 14:26](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-appendicitis-management-10900?t=866)
- "Two-thirds of patients in the outpatient study went home from the ED after a single IV antibiotic dose, with one-third staying overnight, and no differences in outcomes between groups." (host_summary) [Ep 3 · 15:11](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-appendicitis-management-10900?t=911)
- "The Midwest pediatric study found 10 versus 6 disability days comparing surgery to antibiotics, while another study found 1 versus 4 days difference." (host_summary) [Ep 3 · 16:00](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-appendicitis-management-10900?t=960)
- "Multiple studies show non-operative approach is more cost-effective with higher quality-adjusted life years, even when including interval appendectomy costs." (host_summary) [Ep 3 · 16:30](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-appendicitis-management-10900?t=990)
- "Appendicolith has been demonstrated to reduce the effectiveness of non-operative management and increase recurrence." (host_summary) [Ep 3 · 17:21](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-appendicitis-management-10900?t=1041)
- "Around age 14, patients have doubled the chance of failing non-operative management." (host_summary) [Ep 3 · 17:47](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-appendicitis-management-10900?t=1067)
- "The adult CODA trial with 1,400 randomized patients had the exact same one-third failure rate as pediatric studies." (clinical) [Ep 3 · 18:08](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-appendicitis-management-10900?t=1088)
- "Early case series reported 90% success rates with non-operative management, likely because approximately 20% of those highly selected patients didn't actually have appendicitis." (clinical) [Ep 3 · 18:55](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-appendicitis-management-10900?t=1135)
- "In Mexico private practice, no pediatric surgeons want to offer non-operative management due to trust issues - when it fails, parents seek another practitioner rather than accepting the recurrence risk." (opinion) [Ep 3 · 1:34](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-appendicitis-management-10900?t=94)
- "Parents who have been up 36 hours with a sick child don't want to hear about any recurrence rate, even when told it could be as low as 30% - they immediately opt for appendectomy." (clinical) [Ep 3 · 7:20](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-appendicitis-management-10900?t=440)
- "The Chilean Society of Pediatric Surgery Journal Hive team screens through 1200 articles each month using a method to select high-quality publications" — Jose Campos (clinical) [Ep 2 · 0:48](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-pediatric-surgery-feat-non-jps-journals-10897?t=48)
- "The APPY trial is an international multicenter study comparing appendectomy versus antibiotics for acute uncomplicated appendicitis in children, with 936 patients aged 5-16 years randomized across 11 hospitals" — Jose Campos (host_summary) [Ep 2 · 4:33](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-pediatric-surgery-feat-non-jps-journals-10897?t=273)
- "In the APPY trial, treatment failure was defined differently in each arm: in the antibiotic group as appendectomy needed within one year, and in the surgical group as negative appendectomy or any procedure under general anesthesia related to appendicitis within one year" — Jose Campos (host_summary) [Ep 2 · 4:33](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-pediatric-surgery-feat-non-jps-journals-10897?t=273)
- "At one year in the APPY trial, 31% of children in the antibiotic group failed treatment compared with 7% in the appendectomy group, with the 26.7% difference exceeding the pre-specified 20% non-inferiority margin" — Jose Campos (host_summary) [Ep 2 · 4:33](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-pediatric-surgery-feat-non-jps-journals-10897?t=273)
- "Children in the antibiotic group of the APPY trial returned to school earlier and needed almost no pain medication" — Jose Campos (host_summary) [Ep 2 · 6:10](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-pediatric-surgery-feat-non-jps-journals-10897?t=370)
- "The APPY trial had 10% of patients with incomplete data and consent refusal reasons were not collected" — Jose Campos (host_summary) [Ep 2 · 6:10](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-pediatric-surgery-feat-non-jps-journals-10897?t=370)
- "The failure rate over 30% in nonoperative management of appendicitis is concerning, but nonoperative management is still safe with no adverse events in both groups" (opinion) [Ep 2 · 6:37](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-pediatric-surgery-feat-non-jps-journals-10897?t=397)
- "Some guidelines recommend against DVT prophylaxis in pediatric trauma, and in the study only 50% of doctors caring for these children gave DVT prophylaxis" — Jose Campos (host_summary) [Ep 2 · 7:25](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-pediatric-surgery-feat-non-jps-journals-10897?t=445)
- "A JAMA Surgery 2024 study prospectively evaluated 462 pediatric trauma patients with high risk for deep vein thrombosis across level one trauma centers, comparing outcomes based on whether prophylaxis was given and when it was initiated" — Johan Karameez (host_summary) [Ep 2 · 9:28](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-pediatric-surgery-feat-non-jps-journals-10897?t=568)
- "No major bleeding event occurred in any patient who received anticoagulation in the DVT prophylaxis study" — Johan Karameez (host_summary) [Ep 2 · 9:28](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-pediatric-surgery-feat-non-jps-journals-10897?t=568)
- "Patients who received DVT prophylaxis within 24 hours had a venous thromboembolism rate of 1.6%, while those who received it after 24 hours had a rate of 6.9%, nearly identical to the 5.3% in patients who never received prophylaxis" — Johan Karameez (host_summary) [Ep 2 · 9:28](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-pediatric-surgery-feat-non-jps-journals-10897?t=568)
- "The DVT prophylaxis study had low adherence to VTE guidelines with almost half of patients never receiving prophylaxis and relatively low absolute numbers of VTE events restricting statistical power" — Johan Karameez (host_summary) [Ep 2 · 10:36](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-pediatric-surgery-feat-non-jps-journals-10897?t=636)
- "In pediatric trauma, the cutoff of approximately 12 years or puberty is used as the breaking point for when to think about VTE prophylaxis" — Katie Rossel (guideline) [Ep 2 · 11:04](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-pediatric-surgery-feat-non-jps-journals-10897?t=664)
- "VTE prophylaxis should be started as soon as the patient is stable unless there are contraindications like TBI, and conversations with neurosurgeons can often clarify when it is safe to start" — Katie Rossel (clinical) [Ep 2 · 11:57](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-pediatric-surgery-feat-non-jps-journals-10897?t=717)
- "The DVT prophylaxis study was powered to detect any adverse event and there was no adverse event whatsoever from prophylaxis" — Jose Campos (host_summary) [Ep 2 · 13:06](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-pediatric-surgery-feat-non-jps-journals-10897?t=786)
- "Only one in every 1000 appendectomy patients will have a tumor in the appendix, and not all are neuroendocrine tumors, meaning every surgeon will only treat a handful of these cases in their lifetime" — Jose Campos (epidemiological) [Ep 2 · 13:37](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-pediatric-surgery-feat-non-jps-journals-10897?t=817)
- "A Journal of American College of Surgeons 2025 study using the National Cancer Database between 2004 and 2022 identified 1339 patients under 18 years with appendiceal neuroendocrine tumors, comparing appendectomy versus right hemicolectomy" — Jose Campos (host_summary) [Ep 2 · 15:12](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-pediatric-surgery-feat-non-jps-journals-10897?t=912)
- "In the neuroendocrine tumor study, survival was excellent and equivalent between appendectomy and hemicolectomy groups: 99.9% at 5 years and 99.4% at 10 years without chemotherapy or additional treatment" — Jose Campos (host_summary) [Ep 2 · 15:12](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-pediatric-surgery-feat-non-jps-journals-10897?t=912)
- "No forced disease progression occurred in children treated with appendectomy alone, even when high-risk features like tumor larger than 2 centimeters, positive margins, or positive lymph nodes were present" — Jose Campos (host_summary) [Ep 2 · 15:12](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-pediatric-surgery-feat-non-jps-journals-10897?t=912)
- "Multiple retrospective studies and the large database study have shown that appendectomy alone is sufficient for appendiceal neuroendocrine tumors, and additional imaging is not needed because it does not change management" (clinical) [Ep 2 · 17:18](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-pediatric-surgery-feat-non-jps-journals-10897?t=1038)
- "A review of 5000 children who had appendectomy at SickKids found about 30 had a carcinoid, only 10 underwent right hemicolectomy, and of these 10 maybe only half actually needed it" (clinical) [Ep 2 · 17:44](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-pediatric-surgery-feat-non-jps-journals-10897?t=1064)
- "The biology of appendiceal neuroendocrine tumors is totally different in children compared to adults, and the behavior in pediatric patients and adolescents is entirely different than in adults, with margins not making a difference when doing appendectomy alone" — Jose Campos (clinical) [Ep 2 · 18:51](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-pediatric-surgery-feat-non-jps-journals-10897?t=1131)
- "Previous studies on appendiceal neuroendocrine tumors drew the line at 15 years, but the database study compared up to 18 years, so conclusions are valid up to 18 years of age" — Jose Campos (clinical) [Ep 2 · 19:35](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-pediatric-surgery-feat-non-jps-journals-10897?t=1175)
- "The TOUCH trial was the first multicenter randomized control trial comparing stoma versus anastomosis in necrotizing enterocolitis, randomizing patients during laparotomy when both options were deemed feasible" — Jose Campos (host_summary) [Ep 2 · 20:31](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-pediatric-surgery-feat-non-jps-journals-10897?t=1231)
- "The TOUCH trial found no difference in mortality or complications in general between stoma and anastomosis groups, but the stoma group had up to 19% of intestinal and stoma complications" — Jose Campos (host_summary) [Ep 2 · 21:30](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-pediatric-surgery-feat-non-jps-journals-10897?t=1290)
- "In the TOUCH trial, the likelihood of being weaned from parenteral nutrition was much higher in the anastomosis group, and children were weaned 20 days earlier compared to the stoma group" — Jose Campos (host_summary) [Ep 2 · 21:30](https://library.globalcastmd.com/watch/2025-pediatric-surgery-update-course-updates-in-pediatric-surgery-feat-non-jps-journals-10897?t=1290)

## Changelog
- Sep 25: 4 items added automatically

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