They found that children in the high compliance group had a statistically significant decrease in rates of superficial surgical site infection when compared to children in the low compliance group, showing that standardization of perioperative care may decrease morbidity and improve outcomes in colorectal surgery.
So it seems like both of these options have their pros and cons with the intercostal nerve carablation group having a decreased total opioid use and decreased length of stay in the hospital, but increased operating room times and increased total cost.
So it seems like both of these options have their pros and cons with the intercostal nerve co ablation group having a decreased total opioid use and decreased length of stay in the hospital, but increased operating room times and increased total cost.
quotePain control after appendectomy for perforated appendicitis can be a huge problem in kids.↗
▶Ep 32 · 2:11
quoteCould Gabapentin help with pain control in these kids?↗
▶Ep 32 · 2:11
clinicalGabapentin is an anticonvulsant that is often used off label as part of multimodal pain control after major surgery.↗
▶Ep 32 · 2:11
clinicalKids who received gabapentin had a decreased postoperative length of stay after appendectomy for perforated appendicitis.↗
▶Ep 32 · 2:11
clinicalKids who received gabapentin had decreased postoperative opioid use after appendectomy for perforated appendicitis.↗
▶Ep 32 · 2:11
clinicalThe Children's Hospital of LA study was a retrospective cohort study looking at kids age 2 to 18 who underwent appendectomy for perforated appendicitis between 2014 and 2019.↗
Association of Exclusive Breast Milk Intake and Outcomes in Infants With Uncomplicated Gastroschisis: A National Cohort Study
▶Ep 35 · 0:00
quoteDoes exclusive breast milk intake affect outcomes and uncomplicated gastroschisis?↗
▶Ep 35 · 0:13
epidemiologicalMcMaster University performed a retrospective review of infants born between 2014 and 2022 with uncomplicated gastroschisis↗
▶Ep 35 · 0:24
clinicalNo significant differences were found between feeding groups in rates of necrotizing enterocolitis↗
▶Ep 35 · 0:24
clinicalNo significant differences were found between feeding groups in duration of parenteral nutrition↗
▶Ep 35 · 0:24
clinicalNo significant differences were found between feeding groups in time to reach full enteral feeds↗
▶Ep 35 · 0:24
clinicalInfants with exclusive breast milk intake and those with supplemental or exclusive formula intake had similar outcomes↗
▶Ep 35 · 0:24
clinicalNo significant differences were found between feeding groups in length of hospital stay↗
▶Ep 35 · 0:44
opinionFormula intake versus exclusive breast milk intake does not affect outcomes in uncomplicated gastroschisis↗
▶Ep 35 · 0:52
quoteDoes this information change your practice at all?↗
Use of a new vertical traction device for early traction-assisted staged closure of congenital abdominal wall defects: a prospective series of 16 patients
▶Ep 38 · 0:00
quoteCan a novel vertical traction device help facilitate early abdominal wall closure in children with congenital abdominal wall defects?↗
▶Ep 38 · 0:14
clinicalZiegler et al. performed a prospective study in 10 patients with giant omphalocele and 6 with complicated gastroschisis↗
▶Ep 38 · 0:24
clinicalThe study utilized Fascia Tenses Pediatric, a traction-assisted abdominal wall closure device↗
▶Ep 38 · 0:29
clinicalComplete fascial closure was achieved after a median time of 7 days in children with giant omphalocele↗
▶Ep 38 · 0:36
clinicalComplete fascial closure was achieved after a median time of 5 days in children with complicated gastroschisis↗
▶Ep 38 · 0:39
clinicalNo patients developed abdominal compartment syndrome↗
▶Ep 38 · 0:39
clinicalNo ventral hernias occurred after a median follow-up of 12 months↗
▶Ep 38 · 0:46
quoteSo it seems like fascia tends pediatric helps facilitate early fascial closure in these patients.↗
▶Ep 38 · 0:46
opinionFascia Tenses Pediatric helps facilitate early fascial closure in patients with congenital abdominal wall defects↗
Management of Gastroschisis: Timing of Delivery, Antibiotic Usage, and Closure Considerations
▶Ep 40 · 0:00
quoteWhat is the optimal initial management of an infant with gastroschisis?↗
▶Ep 40 · 0:10
guidelineThe ABSA Outcomes and Evidence-based Practice Committee performed a systematic review on optimal initial management of infants with gastroschisis.↗
▶Ep 40 · 0:17
guidelineDelivery after 37 weeks is optimal for infants with gastroschisis.↗
▶Ep 40 · 0:21
guidelineProphylactic antibiotics covering skin flora are adequate to reduce infection risk until closure in gastroschisis.↗
▶Ep 40 · 0:27
clinicalSutureless repair for gastroschisis is safe and effective.↗
▶Ep 40 · 0:27
guidelineStudies support primary fascial repair for gastroschisis as long as hemodynamics and abdominal domain permit.↗
▶Ep 40 · 0:37
clinicalSutureless repair does not delay feeding or increase length of stay in gastroschisis patients.↗
▶Ep 40 · 0:41
quoteThey concluded that there is a need for a high quality randomized controlled trials to help provide evidence-based care for these infants.↗
▶Ep 40 · 0:41
opinionThere is a need for high quality randomized controlled trials to provide evidence-based care for infants with gastroschisis.↗
▶Ep 40 · 0:50
quoteDoes this information change your practice at all?↗
Quick Literature Updates Episode 16
▶Ep 41 · 2:08
clinicalMcMaster University performed a retrospective review of infants born between 2014 and 2022 with uncomplicated gastroschisis↗
▶Ep 41 · 2:17
clinicalNo significant differences were found between breast milk and formula groups in length of hospital stay in uncomplicated gastroschisis↗
▶Ep 41 · 2:17
clinicalInfants with exclusive breast milk intake and those with supplemental or exclusive formula intake had similar outcomes in uncomplicated gastroschisis↗
▶Ep 41 · 2:17
clinicalNo significant differences were found between breast milk and formula groups in duration of parenteral nutrition in uncomplicated gastroschisis↗
▶Ep 41 · 2:17
clinicalNo significant differences were found between breast milk and formula groups in time to reach full enteral feeds in uncomplicated gastroschisis↗
▶Ep 41 · 2:17
clinicalNo significant differences were found between breast milk and formula groups in rates of necrotizing enterocolitis in uncomplicated gastroschisis↗
▶Ep 41 · 2:38
quoteSo it seems like formula intake versus exclusive breast milk intake does not really affect outcomes in uncomplicated gastroschisis.↗
▶Ep 41 · 2:38
clinicalFormula intake versus exclusive breast milk intake does not affect outcomes in uncomplicated gastroschisis↗
Quick Literature Updates Episode 20
▶Ep 43 · 1:59
epidemiologicalThe Ziegler study included 10 patients with giant omphalocele and 6 with complicated gastroschisis↗
▶Ep 43 · 2:13
clinicalComplete fascial closure was achieved after a median of 5 days in children with complicated gastroschisis using the fascia tense pediatric device↗
▶Ep 43 · 2:13
clinicalComplete fascial closure was achieved after a median of 7 days in children with giant omphalocele using the fascia tense pediatric device↗
▶Ep 43 · 2:23
clinicalNo patients developed abdominal compartment syndrome when using the fascia tense pediatric device↗
▶Ep 43 · 2:23
clinicalNo ventral hernias occurred after a median follow-up of 12 months in patients treated with the fascia tense pediatric device↗
▶Ep 43 · 2:29
quoteSo it seems like fascia tense pediatric helps facilitate early fascial closure in these patients.↗
Quick Literature Updates Ep 22
▶Ep 44 · 2:18
guidelineFor gastroschisis, delivery after 37 weeks is optimal↗
▶Ep 44 · 2:21
guidelineProphylactic antibiotics covering skin flora are adequate to reduce infection risk until closure in gastroschisis↗
▶Ep 44 · 2:28
guidelineStudies support primary fascial repair for gastroschisis as long as hemodynamics and abdominal domain permit↗
▶Ep 44 · 2:28
clinicalSutureless repair for gastroschisis is safe, effective, and does not delay feeding or increase length of stay↗
▶Ep 44 · 2:42
opinionThere is a need for high quality randomized controlled trials to help provide evidence-based care for gastroschisis infants↗
▶Ep 44 · 2:51
quoteDoes this information change your practice at all?↗
Standardized perioperative care reduces colorectal surgical site infection in children
▶Ep 134 · 0:00
quoteSurgical site infections are a major cause of perioperative morbidity in children undergoing colorectal surgery.↗
▶Ep 134 · 0:00
epidemiologicalSurgical site infections are a major cause of perioperative morbidity in children undergoing colorectal surgery↗
▶Ep 134 · 0:20
clinicalThe Western Pediatric Surgery Research Consortium conducted a prospective cohort study on children undergoing colorectal surgery across 10 hospitals in the US↗
▶Ep 134 · 0:32
clinicalChildren were split into either a high or low compliance group based on adherence to the care bundle↗
▶Ep 134 · 0:32
clinicalThe study utilized an 8-part perioperative care bundle↗
▶Ep 134 · 0:41
clinicalChildren in the high compliance group had a statistically significant decrease in rates of superficial surgical site infection when compared to children in the low compliance group↗
▶Ep 134 · 0:41
opinionStandardization of perioperative care may decrease morbidity and improve outcomes in colorectal surgery↗
▶Ep 134 · 0:41
quoteThey found that children in the high compliance group had a statistically significant decrease in rates of superficial surgical site infection when compared to children in the low compliance group, showing that standardization of perioperative care may decrease morbidity and improve outcomes in colorectal surgery.↗
Quick Literature Updates Episode 14
▶Ep 149 · 2:30
clinicalThoracic epidural and intercostal nerve cryoablation are two options for pain control in patients undergoing Nuss procedure for pectus excavatum↗
▶Ep 149 · 2:42
epidemiologicalThe study was a retrospective chart review of kids who underwent Nuss procedure between 2002 and 2020↗
▶Ep 149 · 2:56
clinicalThe intercostal nerve cryoablation group had lower total morphine milligram equivalent requirement compared to thoracic epidural↗
▶Ep 149 · 2:56
clinicalThe intercostal nerve cryoablation group had shorter length of stay in the hospital compared to thoracic epidural↗
▶Ep 149 · 2:56
clinicalThe intercostal nerve cryoablation group had lower rates of PCA use compared to thoracic epidural↗
▶Ep 149 · 3:07
clinicalThe intercostal nerve cryoablation group had higher total hospitalization cost compared to thoracic epidural↗
▶Ep 149 · 3:07
clinicalThe intercostal nerve cryoablation group had longer operative times compared to thoracic epidural↗
▶Ep 149 · 3:14
quoteSo it seems like both of these options have their pros and cons with the intercostal nerve carablation group having a decreased total opioid use and decreased length of stay in the hospital, but increased operating room times and increased total cost.↗
Transition From Pediatric to Adult Healthcare for Colorectal Conditions: A Systematic Review
▶Ep 163 · 0:00
clinicalPatients with anorectal malformations and Hirschsprung's disease need transfer from pediatric to adult providers to manage their colorectal conditions↗
▶Ep 163 · 0:22
epidemiologicalA team from Melbourne, Australia performed a systematic review and meta-analysis on transition of care for these conditions↗
▶Ep 163 · 0:28
epidemiologicalEight studies were found on the topic of transition care for anorectal malformations and Hirschsprung's disease↗
▶Ep 163 · 0:30
epidemiologicalLittle evidence exists that transfer from pediatric to adult care is happening in a coordinated or timely fashion↗
▶Ep 163 · 0:30
guidelineStudies agreed that transitional care should start early in adolescence↗
▶Ep 163 · 0:40
epidemiologicalNo models of transition care were identified in the systematic review↗
▶Ep 163 · 0:43
opinionMore work is needed to ensure children with anorectal malformations and Hirschsprung's disease continue to receive optimal care as they grow older↗
▶Ep 163 · 0:53
quoteDoes this information change your practice at all?↗
Does Delayed Diagnosis of Hirschsprung Disease Impact Post-operative and Functional Outcomes? A Multi-Center Review From the Pediatric Colorectal and Pelvic Learning Consortium
▶Ep 165 · 0:00
quoteDoes delayed diagnosis of Hirschrung disease affect postoperative and functional outcomes?↗
▶Ep 165 · 0:12
clinicalThe Pediatric Colorectal and Pelvic Learning Consortium conducted a multi-center retrospective review from 2017 to 2023 examining the relationship between delayed diagnosis of Hirschsprung disease and postoperative/functional outcomes.↗
▶Ep 165 · 0:23
epidemiologicalThe study included 679 patients with Hirschsprung disease from 14 different sites.↗
▶Ep 165 · 0:29
clinicalIncreased age at diagnosis was associated with a greater likelihood of undergoing fecal diversion after initial pull-through procedure.↗
▶Ep 165 · 0:39
clinicalIncreased age at diagnosis was associated with an increased risk of constipation or incontinence requiring intervention postoperatively.↗
▶Ep 165 · 0:49
clinicalNo association was found between age at diagnosis and need for pull-through revision.↗
▶Ep 165 · 0:49
clinicalNo association was found between age at diagnosis and 30-day complication rate after initial pull-through.↗
▶Ep 165 · 0:58
clinicalDelayed diagnosis of Hirschsprung disease affects certain postoperative and functional outcomes in patients.↗
▶Ep 165 · 1:04
quoteDoes this information change your practice at all?↗
Quick Literature Updates Episode 17
▶Ep 172 · 2:05
clinicalThe Pediatric Colorectal and Pelvic Learning Consortium study included 679 patients with Hirschsprung disease from 14 different sites between 2017 and 2023↗
▶Ep 172 · 2:22
clinicalIncreased age at diagnosis of Hirschsprung disease was associated with a greater likelihood of undergoing fecal diversion after initial pull-through procedure↗
▶Ep 172 · 2:32
clinicalIncreasing age at diagnosis of Hirschsprung disease was associated with an increased risk of constipation or incontinence requiring intervention postoperatively↗
▶Ep 172 · 2:42
clinicalNo association was found between age at diagnosis of Hirschsprung disease and 30-day complication rate after initial pull-through↗
▶Ep 172 · 2:48
clinicalNo association was found between age at diagnosis of Hirschsprung disease and need for pull-through revision↗
▶Ep 172 · 2:51
opinionDelayed diagnosis of Hirschsprung disease does affect certain outcomes in these patients↗
▶Ep 172 · 2:51
quoteSo, it seems like delayed diagnosis of Hirschrung's disease does affect certain outcomes in these patients.↗
Quick Literature Updates Episode 18
▶Ep 174 · 2:21
epidemiologicalEight studies were found examining transition from pediatric to adult healthcare for colorectal conditions↗
▶Ep 174 · 2:24
guidelineStudies agreed that transitional care should start early in adolescence↗
▶Ep 174 · 2:24
epidemiologicalLittle evidence exists that transfer from pediatric to adult care is happening in a coordinated or timely fashion↗
▶Ep 174 · 2:33
epidemiologicalNo models of transition care were identified for patients with anorectal malformations and Hirschsprung's disease↗
Quick Literature Updates Ep 22
▶Ep 184 · 2:18
guidelineFor gastroschisis, delivery after 37 weeks is optimal↗
▶Ep 184 · 2:21
guidelineProphylactic antibiotics covering skin flora are adequate to reduce infection risk until closure in gastroschisis↗
▶Ep 184 · 2:28
guidelineStudies support primary fascial repair for gastroschisis as long as hemodynamics and abdominal domain permit↗
▶Ep 184 · 2:28
clinicalSutureless repair for gastroschisis is safe, effective, and does not delay feeding or increase length of stay↗
▶Ep 184 · 2:42
opinionThere is a need for high quality randomized controlled trials to help provide evidence-based care for gastroschisis infants↗
▶Ep 184 · 2:51
quoteDoes this information change your practice at all?↗
Quick Literature Updates Ep 23
▶Ep 185 · 2:01
clinicalA working group of pediatric surgeons from Europe created 19 case scenarios with unexpected events to validate the Clavien-Madadi classification↗
▶Ep 185 · 2:10
clinicalSurgeons rated scenarios based on either Clavien-Dindo classification or Clavien-Madadi classification↗
▶Ep 185 · 2:10
clinicalScenarios were circulated within the European Reference Network of inherited and congenital anomalies↗
▶Ep 185 · 2:23
epidemiological59 surgeons completed the questionnaire↗
▶Ep 185 · 2:27
clinicalThe Clavien-Madadi classification showed significantly better agreement rates than Clavien-Dindo↗
▶Ep 185 · 2:27
clinicalThe Clavien-Madadi classification was less frequently considered inaccurate↗
▶Ep 185 · 2:34
opinionMore pediatric surgeons preferred using the Clavien-Madadi classification↗
▶Ep 185 · 2:38
quoteSo it seems like the Clavian-Matti classification is both an accurate and useful tool in grading unexpected events in pediatric surgery.↗
▶Ep 185 · 2:38
clinicalThe Clavien-Madadi classification is both an accurate and useful tool in grading unexpected events in pediatric surgery↗
Quick Literature Updates Ep 26
▶Ep 188 · 2:16
clinicalThe ARM study used the PHIS database and included all ARM patients between 2016 and 2022↗
▶Ep 188 · 2:25
epidemiologicalIn ARM patients, limb anomalies were diagnosed in 15.7% across all hospital encounters↗
▶Ep 188 · 2:25
epidemiologicalIn ARM patients, cardiac anomalies were diagnosed in 77.4% across all hospital encounters↗
▶Ep 188 · 2:25
epidemiologicalIn ARM patients, vertebral-spinal anomalies were diagnosed in 45.4% across all hospital encounters↗
▶Ep 188 · 2:25
epidemiologicalIn ARM patients, TEF was diagnosed in 10.2% across all hospital encounters↗
▶Ep 188 · 2:25
epidemiologicalIn ARM patients, renal anomalies were diagnosed in 39.9% across all hospital encounters↗
▶Ep 188 · 2:40
epidemiological25.8% of female ARM patients had a congenital gynecologic malformation diagnosed↗
▶Ep 188 · 2:45
quoteSo it seems like the most common anomalies associated with ARMs are cardiac, vertebrospinal, renal, and gynecologic.↗
▶Ep 188 · 2:45
clinicalThe most common anomalies associated with ARMs are cardiac, vertebrospinal, renal, and gynecologic↗
▶Ep 188 · 2:53
guidelineThe authors suggest changing the VACTERL acronym to VACTERL-GS to include gynecologic and spinal conditions↗
clinicalThe Children's Hospital of LA study was a retrospective cohort study looking at kids age 2 to 18 who underwent appendectomy for perforated appendicitis between 2014 and 2019.↗
▶Ep 52 · 2:11
clinicalGabapentin is an anticonvulsant that is often used off label as part of multimodal pain control after major surgery.↗
▶Ep 52 · 2:11
clinicalKids who received gabapentin had decreased postoperative opioid use after appendectomy for perforated appendicitis.↗
▶Ep 52 · 2:11
clinicalKids who received gabapentin had a decreased postoperative length of stay after appendectomy for perforated appendicitis.↗
▶Ep 52 · 2:11
quotePain control after appendectomy for perforated appendicitis can be a huge problem in kids.↗
▶Ep 52 · 2:11
quoteCould Gabapentin help with pain control in these kids?↗
Association of Exclusive Breast Milk Intake and Outcomes in Infants With Uncomplicated Gastroschisis: A National Cohort Study
▶Ep 55 · 0:00
quoteDoes exclusive breast milk intake affect outcomes and uncomplicated gastroschisis?↗
▶Ep 55 · 0:13
epidemiologicalMcMaster University performed a retrospective review of infants born between 2014 and 2022 with uncomplicated gastroschisis↗
▶Ep 55 · 0:24
clinicalNo significant differences were found between feeding groups in rates of necrotizing enterocolitis↗
▶Ep 55 · 0:24
clinicalNo significant differences were found between feeding groups in length of hospital stay↗
▶Ep 55 · 0:24
clinicalNo significant differences were found between feeding groups in duration of parenteral nutrition↗
▶Ep 55 · 0:24
clinicalNo significant differences were found between feeding groups in time to reach full enteral feeds↗
▶Ep 55 · 0:24
clinicalInfants with exclusive breast milk intake and those with supplemental or exclusive formula intake had similar outcomes↗
▶Ep 55 · 0:44
opinionFormula intake versus exclusive breast milk intake does not affect outcomes in uncomplicated gastroschisis↗
▶Ep 55 · 0:52
quoteDoes this information change your practice at all?↗
Use of a new vertical traction device for early traction-assisted staged closure of congenital abdominal wall defects: a prospective series of 16 patients
▶Ep 58 · 0:00
quoteCan a novel vertical traction device help facilitate early abdominal wall closure in children with congenital abdominal wall defects?↗
▶Ep 58 · 0:14
clinicalZiegler et al. performed a prospective study in 10 patients with giant omphalocele and 6 with complicated gastroschisis↗
▶Ep 58 · 0:24
clinicalThe study utilized Fascia Tenses Pediatric, a traction-assisted abdominal wall closure device↗
▶Ep 58 · 0:29
clinicalComplete fascial closure was achieved after a median time of 7 days in children with giant omphalocele↗
▶Ep 58 · 0:36
clinicalComplete fascial closure was achieved after a median time of 5 days in children with complicated gastroschisis↗
▶Ep 58 · 0:39
clinicalNo patients developed abdominal compartment syndrome↗
▶Ep 58 · 0:39
clinicalNo ventral hernias occurred after a median follow-up of 12 months↗
▶Ep 58 · 0:46
opinionFascia Tenses Pediatric helps facilitate early fascial closure in patients with congenital abdominal wall defects↗
▶Ep 58 · 0:46
quoteSo it seems like fascia tends pediatric helps facilitate early fascial closure in these patients.↗
Management of Gastroschisis: Timing of Delivery, Antibiotic Usage, and Closure Considerations
▶Ep 60 · 0:00
quoteWhat is the optimal initial management of an infant with gastroschisis?↗
▶Ep 60 · 0:10
guidelineThe ABSA Outcomes and Evidence-based Practice Committee performed a systematic review on optimal initial management of infants with gastroschisis.↗
▶Ep 60 · 0:17
guidelineDelivery after 37 weeks is optimal for infants with gastroschisis.↗
▶Ep 60 · 0:21
guidelineProphylactic antibiotics covering skin flora are adequate to reduce infection risk until closure in gastroschisis.↗
▶Ep 60 · 0:27
guidelineStudies support primary fascial repair for gastroschisis as long as hemodynamics and abdominal domain permit.↗
▶Ep 60 · 0:27
clinicalSutureless repair for gastroschisis is safe and effective.↗
▶Ep 60 · 0:37
clinicalSutureless repair does not delay feeding or increase length of stay in gastroschisis patients.↗
▶Ep 60 · 0:41
quoteThey concluded that there is a need for a high quality randomized controlled trials to help provide evidence-based care for these infants.↗
▶Ep 60 · 0:41
opinionThere is a need for high quality randomized controlled trials to provide evidence-based care for infants with gastroschisis.↗
▶Ep 60 · 0:50
quoteDoes this information change your practice at all?↗
Quick Literature Updates Episode 16
▶Ep 61 · 2:08
clinicalMcMaster University performed a retrospective review of infants born between 2014 and 2022 with uncomplicated gastroschisis↗
▶Ep 61 · 2:17
clinicalNo significant differences were found between breast milk and formula groups in duration of parenteral nutrition in uncomplicated gastroschisis↗
▶Ep 61 · 2:17
clinicalNo significant differences were found between breast milk and formula groups in rates of necrotizing enterocolitis in uncomplicated gastroschisis↗
▶Ep 61 · 2:17
clinicalNo significant differences were found between breast milk and formula groups in time to reach full enteral feeds in uncomplicated gastroschisis↗
▶Ep 61 · 2:17
clinicalNo significant differences were found between breast milk and formula groups in length of hospital stay in uncomplicated gastroschisis↗
▶Ep 61 · 2:17
clinicalInfants with exclusive breast milk intake and those with supplemental or exclusive formula intake had similar outcomes in uncomplicated gastroschisis↗
▶Ep 61 · 2:38
clinicalFormula intake versus exclusive breast milk intake does not affect outcomes in uncomplicated gastroschisis↗
▶Ep 61 · 2:38
quoteSo it seems like formula intake versus exclusive breast milk intake does not really affect outcomes in uncomplicated gastroschisis.↗
Conservative Management of Necrotizing Enterocolitis in Newborns: Incidence and Management of Intestinal Strictures
▶Ep 62 · 0:00
quoteHow big of a problem are intestinal strictures after conservative management of necrotizing enterocolitis?↗
▶Ep 62 · 0:13
clinicalThe study was a retrospective review of all patients who underwent conservative management of modified Bell stage 2A or greater NEC at a single institution from 2011 to 2022.↗
▶Ep 62 · 0:27
clinical24 of the 126 patients eventually underwent surgery for a post-NEC stricture.↗
▶Ep 62 · 0:27
epidemiological126 patients underwent conservative management of NEC in the study period.↗
▶Ep 62 · 0:36
clinicalPrimary resection and anastomosis was performed in all cases of post-NEC stricture requiring surgery.↗
▶Ep 62 · 0:36
quotePrimary resection and anastomosis was performed in all cases.↗
▶Ep 62 · 0:40
opinionPost-NEC strictures are a common occurrence after conservative management of NEC.↗
▶Ep 62 · 0:40
quoteSo, it seems like post neck strictures are a common occurrence after conservative management of neck.↗
Remote Ischemic Conditioning (RIC) Decreases the Incidence and Severity of Necrotizing Enterocolitis (NEC) - Validation in a Large Animal Model
▶Ep 64 · 0:00
clinicalRemote ischemic conditioning has been shown to decrease rates of necrotizing enterocolitis in a rat model.↗
▶Ep 64 · 0:00
quoteRIC, or remote ischemic conditioning, has been shown to decrease rates of necrotizing enterocolitis in a rat model.↗
▶Ep 64 · 0:16
clinicalGadal used an established piglet NEC model to test whether RIC works in a large animal model.↗
▶Ep 64 · 0:20
clinicalPiglets were randomly assigned to receive RIC or serve as controls.↗
▶Ep 64 · 0:24
clinicalRIC was initiated at 24 hours of life and consisted of 4 cycles of 4 minutes of arterial occlusion followed by reperfusion.↗
▶Ep 64 · 0:31
clinicalCycles were repeated every 24 hours in the low-frequency group and every 12 hours in the high-frequency group.↗
▶Ep 64 · 0:37
clinical38 piglets were randomized into the control group, 26 into the low-frequency group, and 22 into the high-frequency group.↗
▶Ep 64 · 0:45
clinicalHigh-frequency RIC significantly reduced the incidence of NEC when compared to controls.↗
▶Ep 64 · 0:50
clinicalLow-frequency RIC did not significantly reduce the incidence of NEC.↗
▶Ep 64 · 0:53
clinicalHigh-frequency RIC protects against NEC in a piglet model.↗
▶Ep 64 · 0:53
quoteSo it seems like high frequency Rick protects against neck in a piglet model.↗
Quick Literature Updates Ep 22
▶Ep 68 · 2:18
guidelineFor gastroschisis, delivery after 37 weeks is optimal↗
▶Ep 68 · 2:21
guidelineProphylactic antibiotics covering skin flora are adequate to reduce infection risk until closure in gastroschisis↗
▶Ep 68 · 2:28
clinicalSutureless repair for gastroschisis is safe, effective, and does not delay feeding or increase length of stay↗
▶Ep 68 · 2:28
guidelineStudies support primary fascial repair for gastroschisis as long as hemodynamics and abdominal domain permit↗
▶Ep 68 · 2:42
opinionThere is a need for high quality randomized controlled trials to help provide evidence-based care for gastroschisis infants↗
▶Ep 68 · 2:51
quoteDoes this information change your practice at all?↗
Quick Literature Updates Ep 27
▶Ep 69 · 2:05
clinicalThe Mina et al. study was a retrospective review of patients who underwent conservative management of modified Bell stage 2A or greater NEC from 2011 to 2022↗
▶Ep 69 · 2:20
clinical24 of 126 conservatively managed NEC patients eventually underwent surgery for a post-NEC stricture↗
▶Ep 69 · 2:20
epidemiological126 patients underwent conservative management of NEC in the study period↗
▶Ep 69 · 2:29
clinicalPrimary resection and anastomosis was performed in all post-NEC stricture cases↗
▶Ep 69 · 2:33
quoteSo it seems like post-neck strictures are a common occurrence after conservative management of neck.↗
▶Ep 69 · 2:33
clinicalPost-NEC strictures are a common occurrence after conservative management of NEC↗
quoteCould Gabapentin help with pain control in these kids?↗
▶Ep 76 · 2:11
clinicalThe Children's Hospital of LA study was a retrospective cohort study looking at kids age 2 to 18 who underwent appendectomy for perforated appendicitis between 2014 and 2019.↗
▶Ep 76 · 2:11
clinicalGabapentin is an anticonvulsant that is often used off label as part of multimodal pain control after major surgery.↗
▶Ep 76 · 2:11
clinicalKids who received gabapentin had decreased postoperative opioid use after appendectomy for perforated appendicitis.↗
▶Ep 76 · 2:11
clinicalKids who received gabapentin had a decreased postoperative length of stay after appendectomy for perforated appendicitis.↗
▶Ep 76 · 2:11
quotePain control after appendectomy for perforated appendicitis can be a huge problem in kids.↗
Association of Exclusive Breast Milk Intake and Outcomes in Infants With Uncomplicated Gastroschisis: A National Cohort Study
▶Ep 84 · 0:00
quoteDoes exclusive breast milk intake affect outcomes and uncomplicated gastroschisis?↗
▶Ep 84 · 0:13
epidemiologicalMcMaster University performed a retrospective review of infants born between 2014 and 2022 with uncomplicated gastroschisis↗
▶Ep 84 · 0:24
clinicalInfants with exclusive breast milk intake and those with supplemental or exclusive formula intake had similar outcomes↗
▶Ep 84 · 0:24
clinicalNo significant differences were found between feeding groups in time to reach full enteral feeds↗
▶Ep 84 · 0:24
clinicalNo significant differences were found between feeding groups in duration of parenteral nutrition↗
▶Ep 84 · 0:24
clinicalNo significant differences were found between feeding groups in rates of necrotizing enterocolitis↗
▶Ep 84 · 0:24
clinicalNo significant differences were found between feeding groups in length of hospital stay↗
▶Ep 84 · 0:44
opinionFormula intake versus exclusive breast milk intake does not affect outcomes in uncomplicated gastroschisis↗
▶Ep 84 · 0:52
quoteDoes this information change your practice at all?↗
Use of a new vertical traction device for early traction-assisted staged closure of congenital abdominal wall defects: a prospective series of 16 patients
▶Ep 87 · 0:00
quoteCan a novel vertical traction device help facilitate early abdominal wall closure in children with congenital abdominal wall defects?↗
▶Ep 87 · 0:14
clinicalZiegler et al. performed a prospective study in 10 patients with giant omphalocele and 6 with complicated gastroschisis↗
▶Ep 87 · 0:24
clinicalThe study utilized Fascia Tenses Pediatric, a traction-assisted abdominal wall closure device↗
▶Ep 87 · 0:29
clinicalComplete fascial closure was achieved after a median time of 7 days in children with giant omphalocele↗
▶Ep 87 · 0:36
clinicalComplete fascial closure was achieved after a median time of 5 days in children with complicated gastroschisis↗
▶Ep 87 · 0:39
clinicalNo patients developed abdominal compartment syndrome↗
▶Ep 87 · 0:39
clinicalNo ventral hernias occurred after a median follow-up of 12 months↗
▶Ep 87 · 0:46
opinionFascia Tenses Pediatric helps facilitate early fascial closure in patients with congenital abdominal wall defects↗
▶Ep 87 · 0:46
quoteSo it seems like fascia tends pediatric helps facilitate early fascial closure in these patients.↗
Management of Gastroschisis: Timing of Delivery, Antibiotic Usage, and Closure Considerations
▶Ep 90 · 0:00
quoteWhat is the optimal initial management of an infant with gastroschisis?↗
▶Ep 90 · 0:10
guidelineThe ABSA Outcomes and Evidence-based Practice Committee performed a systematic review on optimal initial management of infants with gastroschisis.↗
▶Ep 90 · 0:17
guidelineDelivery after 37 weeks is optimal for infants with gastroschisis.↗
▶Ep 90 · 0:21
guidelineProphylactic antibiotics covering skin flora are adequate to reduce infection risk until closure in gastroschisis.↗
▶Ep 90 · 0:27
guidelineStudies support primary fascial repair for gastroschisis as long as hemodynamics and abdominal domain permit.↗
▶Ep 90 · 0:27
clinicalSutureless repair for gastroschisis is safe and effective.↗
▶Ep 90 · 0:37
clinicalSutureless repair does not delay feeding or increase length of stay in gastroschisis patients.↗
▶Ep 90 · 0:41
opinionThere is a need for high quality randomized controlled trials to provide evidence-based care for infants with gastroschisis.↗
▶Ep 90 · 0:41
quoteThey concluded that there is a need for a high quality randomized controlled trials to help provide evidence-based care for these infants.↗
▶Ep 90 · 0:50
quoteDoes this information change your practice at all?↗
Quick Literature Updates Episode 16
▶Ep 91 · 2:08
clinicalMcMaster University performed a retrospective review of infants born between 2014 and 2022 with uncomplicated gastroschisis↗
▶Ep 91 · 2:17
clinicalNo significant differences were found between breast milk and formula groups in time to reach full enteral feeds in uncomplicated gastroschisis↗
▶Ep 91 · 2:17
clinicalInfants with exclusive breast milk intake and those with supplemental or exclusive formula intake had similar outcomes in uncomplicated gastroschisis↗
▶Ep 91 · 2:17
clinicalNo significant differences were found between breast milk and formula groups in length of hospital stay in uncomplicated gastroschisis↗
▶Ep 91 · 2:17
clinicalNo significant differences were found between breast milk and formula groups in duration of parenteral nutrition in uncomplicated gastroschisis↗
▶Ep 91 · 2:17
clinicalNo significant differences were found between breast milk and formula groups in rates of necrotizing enterocolitis in uncomplicated gastroschisis↗
▶Ep 91 · 2:38
clinicalFormula intake versus exclusive breast milk intake does not affect outcomes in uncomplicated gastroschisis↗
▶Ep 91 · 2:38
quoteSo it seems like formula intake versus exclusive breast milk intake does not really affect outcomes in uncomplicated gastroschisis.↗
Conservative Management of Necrotizing Enterocolitis in Newborns: Incidence and Management of Intestinal Strictures
▶Ep 92 · 0:00
quoteHow big of a problem are intestinal strictures after conservative management of necrotizing enterocolitis?↗
▶Ep 92 · 0:13
clinicalThe study was a retrospective review of all patients who underwent conservative management of modified Bell stage 2A or greater NEC at a single institution from 2011 to 2022.↗
▶Ep 92 · 0:27
epidemiological126 patients underwent conservative management of NEC in the study period.↗
▶Ep 92 · 0:27
clinical24 of the 126 patients eventually underwent surgery for a post-NEC stricture.↗
▶Ep 92 · 0:36
clinicalPrimary resection and anastomosis was performed in all cases of post-NEC stricture requiring surgery.↗
▶Ep 92 · 0:36
quotePrimary resection and anastomosis was performed in all cases.↗
▶Ep 92 · 0:40
opinionPost-NEC strictures are a common occurrence after conservative management of NEC.↗
▶Ep 92 · 0:40
quoteSo, it seems like post neck strictures are a common occurrence after conservative management of neck.↗
Remote Ischemic Conditioning (RIC) Decreases the Incidence and Severity of Necrotizing Enterocolitis (NEC) - Validation in a Large Animal Model
▶Ep 95 · 0:00
quoteRIC, or remote ischemic conditioning, has been shown to decrease rates of necrotizing enterocolitis in a rat model.↗
▶Ep 95 · 0:00
clinicalRemote ischemic conditioning has been shown to decrease rates of necrotizing enterocolitis in a rat model.↗
▶Ep 95 · 0:16
clinicalGadal used an established piglet NEC model to test whether RIC works in a large animal model.↗
▶Ep 95 · 0:20
clinicalPiglets were randomly assigned to receive RIC or serve as controls.↗
▶Ep 95 · 0:24
clinicalRIC was initiated at 24 hours of life and consisted of 4 cycles of 4 minutes of arterial occlusion followed by reperfusion.↗
▶Ep 95 · 0:31
clinicalCycles were repeated every 24 hours in the low-frequency group and every 12 hours in the high-frequency group.↗
▶Ep 95 · 0:37
clinical38 piglets were randomized into the control group, 26 into the low-frequency group, and 22 into the high-frequency group.↗
▶Ep 95 · 0:45
clinicalHigh-frequency RIC significantly reduced the incidence of NEC when compared to controls.↗
▶Ep 95 · 0:50
clinicalLow-frequency RIC did not significantly reduce the incidence of NEC.↗
▶Ep 95 · 0:53
quoteSo it seems like high frequency Rick protects against neck in a piglet model.↗
▶Ep 95 · 0:53
clinicalHigh-frequency RIC protects against NEC in a piglet model.↗
Quick Literature Updates Ep 22
▶Ep 99 · 2:18
guidelineFor gastroschisis, delivery after 37 weeks is optimal↗
▶Ep 99 · 2:21
guidelineProphylactic antibiotics covering skin flora are adequate to reduce infection risk until closure in gastroschisis↗
▶Ep 99 · 2:28
guidelineStudies support primary fascial repair for gastroschisis as long as hemodynamics and abdominal domain permit↗
▶Ep 99 · 2:28
clinicalSutureless repair for gastroschisis is safe, effective, and does not delay feeding or increase length of stay↗
▶Ep 99 · 2:42
opinionThere is a need for high quality randomized controlled trials to help provide evidence-based care for gastroschisis infants↗
▶Ep 99 · 2:51
quoteDoes this information change your practice at all?↗
Quick Literature Updates Ep 27
▶Ep 100 · 2:05
clinicalThe Mina et al. study was a retrospective review of patients who underwent conservative management of modified Bell stage 2A or greater NEC from 2011 to 2022↗
▶Ep 100 · 2:20
clinical24 of 126 conservatively managed NEC patients eventually underwent surgery for a post-NEC stricture↗
▶Ep 100 · 2:20
epidemiological126 patients underwent conservative management of NEC in the study period↗
▶Ep 100 · 2:29
clinicalPrimary resection and anastomosis was performed in all post-NEC stricture cases↗
▶Ep 100 · 2:33
quoteSo it seems like post-neck strictures are a common occurrence after conservative management of neck.↗
▶Ep 100 · 2:33
clinicalPost-NEC strictures are a common occurrence after conservative management of NEC↗
Multi-Institutional Analysis of Choledocholithiasis in Pediatric vs Adult Patients
▶Ep 22 · 0:00
quoteCan a surgery first approach be used for the management of cholodocholithiasis in children?↗
▶Ep 22 · 0:11
epidemiologicalDantes et al. performed a multi-center retrospective review of pediatric and adult patients treated for choledocholithiasis between 2018 and 2024↗
▶Ep 22 · 0:22
epidemiological724 patients were included in the study↗
▶Ep 22 · 0:25
clinicalSurgery first approach with upfront laparoscopic cholecystectomy with intraoperative cholangiogram was performed in 201 pediatric patients and 169 adult patients↗
▶Ep 22 · 0:35
clinicalLaparoscopic common bile duct exploration was attempted in 84 children and 140 adults in the surgery first group↗
▶Ep 22 · 0:43
clinicalCommon bile duct exploration success was higher in pediatric than adult patients↗
▶Ep 22 · 0:43
clinicalComplication rates were similar between pediatric and adult patients in the surgery first approach↗
▶Ep 22 · 0:49
opinionA surgery first approach can be a safe and effective tool for managing choledocholithiasis in pediatric patients↗
Cost and outcomes of intercostal nerve cryoablation versus thoracic epidural following the Nuss procedure
▶Ep 32 · 0:00
clinicalThoracic epidural and intercostal nerve cryoablation are two options for pain control in patients undergoing a Nuss procedure for pectus excavatum↗
▶Ep 32 · 0:00
quoteThoracic epidural and intercostal nerve coagabulations are two options for pain control in patients undergoing a NUS procedure for pectus excavatum.↗
▶Ep 32 · 0:19
clinicalDr. Tsai and his team from Penn State conducted a retrospective chart review looking at kids who underwent a Nuss procedure between 2002 and 2020↗
▶Ep 32 · 0:21
clinicalThe intercostal nerve cryoablation group had lower rates of PCA use compared to thoracic epidural↗
▶Ep 32 · 0:21
clinicalThe intercostal nerve cryoablation group had lower total morphine milligram equivalent requirement compared to thoracic epidural↗
▶Ep 32 · 0:21
clinicalThe intercostal nerve cryoablation group had shorter length of stay in the hospital compared to thoracic epidural↗
▶Ep 32 · 0:44
clinicalThe intercostal nerve cryoablation group had longer operative times compared to thoracic epidural↗
▶Ep 32 · 0:44
clinicalThe intercostal nerve cryoablation group had higher total hospitalization cost than the thoracic epidural group↗
▶Ep 32 · 0:51
quoteSo it seems like both of these options have their pros and cons with the intercostal nerve co ablation group having a decreased total opioid use and decreased length of stay in the hospital, but increased operating room times and increased total cost.↗
▶Ep 32 · 0:51
opinionBoth intercostal nerve cryoablation and thoracic epidural have pros and cons for pain control following Nuss procedure↗
Quick Literature Updates Episode 13
▶Ep 37 · 2:32
epidemiologicalThe meta-analysis included 5 studies on early peritoneal dialysis after pediatric cardiac surgery↗
▶Ep 37 · 2:35
clinicalEarly initiation of peritoneal dialysis was associated with decreased post-operative mortality in infants after cardiac surgery↗
▶Ep 37 · 2:41
clinicalEarly initiation of peritoneal dialysis shortened length of stay in the ICU after pediatric cardiac surgery↗
▶Ep 37 · 2:41
clinicalEarly initiation of peritoneal dialysis shortened duration of mechanical ventilation after pediatric cardiac surgery↗
▶Ep 37 · 2:49
quoteSo it seems that early initiation of peritoneal dialysis may benefit infants after pediatric cardiac surgery.↗
Vacuum Bell Therapy for Pectus Excavatum: Long-term Experience at a Single Center
▶Ep 48 · 0:00
quoteWhat factors affect outcomes in patients with pectus excavatum treated with vacuum valve therapy?↗
▶Ep 48 · 0:13
clinicalThe study was a single institution retrospective chart review conducted from 2012 to 2023↗
▶Ep 48 · 0:20
epidemiological278 patients were included in the analysis↗
▶Ep 48 · 0:23
clinical31 patients had excellent corrections with vacuum bell therapy↗
▶Ep 48 · 0:23
clinical247 patients had non-excellent corrections with vacuum bell therapy↗
▶Ep 48 · 0:29
clinicalInitial chest depth less than 1.5 centimeters is a predictor of positive outcomes↗
▶Ep 48 · 0:29
clinicalChest wall flexibility is a predictor of positive outcomes↗
▶Ep 48 · 0:29
clinicalExcellent correction was more common in children 8 to 12.9 years old↗
▶Ep 48 · 0:41
clinicalImproved outcomes are seen in younger patients with more mild defects and greater chest wall flexibility↗
▶Ep 48 · 0:41
opinionExcellent correction in children with pectus excavatum treated with vacuum bell therapy is uncommon↗
Female Fertility Cryopreservation Outcomes in Childhood Cancer: A Systematic Review
▶Ep 27 · 0:00
quoteWhat does the current literature say about outcomes of female fertility cryopreservation in children with cancer?↗
▶Ep 27 · 0:13
clinicalGillippelli et al. performed a systematic retrospective review of female fertility cryopreservation outcomes in children with cancer↗
▶Ep 27 · 0:19
clinical12 studies were included in the final systematic review↗
▶Ep 27 · 0:19
clinicalThe review initially examined 104 abstracts and 34 full text articles↗
▶Ep 27 · 0:27
epidemiological5.9% of patients who underwent ovarian tissue cryopreservation later received ovarian tissue transplantation↗
▶Ep 27 · 0:27
epidemiologicalOvarian tissue cryopreservation was performed in 501 patients across the included studies↗
▶Ep 27 · 0:38
clinical33% of patients who underwent ovarian tissue transplantation were able to become pregnant↗
▶Ep 27 · 0:44
opinionOvarian tissue cryopreservation has great advantages for pediatric cancer patients but needs to be studied further↗
▶Ep 27 · 0:44
quoteSo, it seems like ovarian tissue cryopreservation has great advantages for pediatric cancer patients, but needs to be studied further.↗
▶Ep 27 · 0:52
quoteDoes this information change your practice at all?↗
Same-Day Discharge for Elective Pediatric Laparoscopic Gastrostomy Tube Insertion is Safe and Increasing in Frequency; A NSQIP Pediatric Retrospective Review 2017 to 2021
▶Ep 29 · 0:00
quoteWhat are the trends and outcomes of same-day discharge after pediatric elective laparoscopic gastrostomy?↗
▶Ep 29 · 0:13
clinicalThe study analyzed the ACS NSQIP Pediatric database from 2017 to 2021↗
▶Ep 29 · 0:21
epidemiological5,947 pediatric patients underwent elective laparoscopic gastrostomy tube placement in the study period↗
▶Ep 29 · 0:29
epidemiological4.7% of patients were discharged the same day after laparoscopic gastrostomy tube placement↗
▶Ep 29 · 0:33
clinicalThere were no significant differences in any other complications between same-day discharge and 1-2 day discharge patients↗
▶Ep 29 · 0:33
clinicalThere were no significant differences in 30-day unplanned readmissions between same-day discharge and 1-2 day discharge patients↗
▶Ep 29 · 0:33
clinicalThere were no significant differences in reoperations between same-day discharge and 1-2 day discharge patients↗
▶Ep 29 · 0:46
epidemiologicalSame-day discharge after pediatric laparoscopic gastrostomy is not commonly done↗
▶Ep 29 · 0:46
quoteSo, it seems like same day discharge for pediatric patients after elective laparoscopic gastrostomy is safe, but not commonly done.↗
▶Ep 29 · 0:46
opinionSame-day discharge for pediatric patients after elective laparoscopic gastrostomy appears to be safe↗
