We were happy that our first procedure was successful. When we did another one, it was much easier. Of course, at the beginning, the first procedure took us almost 4 hours. Right now it's a 1 hour procedure, but of course it's very difficult, but we are very happy to have no conversion.
We were happy that our first procedure was successful. When we did another one, it was much easier. Of course, at the beginning, the first procedure took us almost 4 hours. Right now it's a 1 hour procedure, but of course it's very difficult, but we are very happy to have no conversion.
We were happy that our first procedure was successful. When we did another one, it was much easier. Of course, at the beginning, the first procedure took us almost 4 hours. Right now it's a 1 hour procedure, but of course it's very difficult, but we are very happy to have no conversion.
recognizing that we all have biases and not being defensive when someone says there's bias in that because we all have bias. We know that we all have bias. And so the question is, what are your biases and how do they affect what you do?
recognizing that we all have biases and not being defensive when someone says there's bias in that because we all have bias. We know that we all have bias. And so the question is, what are your biases and how do they affect what you do?
recognizing that we all have biases and not being defensive when someone says there's bias in that because we all have bias. We know that we all have bias. And so the question is, what are your biases and how do they affect what you do?
Intestinal rehabilitation: What is intestinal rehab? - Episode 1
▶Ep 23 · 6:30
host_summaryMucosal defects in enteropathies lead to hypersecretion and profuse fluid losses, preventing nutrient absorption.↗
▶Ep 23 · 7:22
host_summaryGastroschisis can involve all three categories: short bowel from nonviable tissue, inflammation affecting absorption, and motility issues.↗
Quick Literature Updates Episode 6
▶Ep 30 · 0:20
host_summaryGunshot wound victims were more likely to require immediate surgery and had increased mortality compared to MVC victims.↗
▶Ep 30 · 0:20
host_summaryGunshot wound victims were 7.8 times more likely to die than MVC victims.↗
▶Ep 30 · 0:20
host_summaryIn California statewide data, the case fatality rate for gunshot wound victims was higher than that for motor vehicle collisions.↗
▶Ep 30 · 0:20
host_summaryTeodoro et al. studied pediatric trauma patients presenting to a level one trauma center with gunshot wounds or MVCs between 2009 and 2019.↗
▶Ep 30 · 0:20
host_summaryTeodoro et al. examined California Department of Public Health data on pediatric gunshot wounds and MVCs from 2006 to 2015.↗
Quick Literature Updates Episode 11
▶Ep 32 · 0:46
host_summaryStevens et al. examined CDC Wonder database data between 1999 and 2020 for pediatric firearm and automobile fatalities.↗
▶Ep 32 · 0:46
quoteThere was a 55% lower firearm fatality rate for the states with the strongest gun laws compared to those with the weakest gun laws.↗
▶Ep 32 · 0:46
quoteAs other recent studies had shown, in the last few years, the fatality rate for firearms has surpassed the fatality rate for automobiles in children.↗
▶Ep 32 · 0:46
host_summaryStronger gun laws were associated with decreased fatality rates, with a 55% lower firearm fatality rate for states with the strongest gun laws compared to those with the weakest gun laws.↗
▶Ep 32 · 0:46
host_summaryIn recent years, the fatality rate for firearms has surpassed the fatality rate for automobiles in children.↗
▶Ep 32 · 0:46
host_summaryStevens et al. used the Gifford's Law Center annual gun law scorecard between 2014 and 2020 to assess state gun law scores.↗
host_summaryA Texas report described component separation use in nine children aged seven days to 10 years, mostly for omphaloceles and giant defects, achieving fascial closure in the vast majority with some mesh use for bridging↗
▶Ep 49 · 10:26
host_summaryComponent separation technique involves separating tissue at the external oblique about a centimeter beyond the rectus sheath on both sides, dissecting between external and internal oblique, and optionally making an incision on the anterior rectus sheath for another centimeter of space↗
clinicalThere is literature suggesting a component of psychosocial, psychologic dissociation in children on later testing related to dilations↗
▶Ep 48 · 2:55
clinicalThe number of strictures, number who needed anoplasties, and number of redo operations was the same between the dilation and no-dilation groups↗
▶Ep 48 · 3:04
clinicalThe number of patients who had rectal prolapse is consistent with the literature↗
▶Ep 48 · 5:20
clinicalA study looked at 30-day outcomes for patients with ARM with perineal or rectovestibular fistulas who underwent repair, divided between early (before 6 days old) and late repair (6-8 weeks)↗
▶Ep 48 · 5:31
clinicalThere were 291 patients in the early vs late repair study: 66 underwent early repair and 231 underwent late repair↗
Quick Literature Updates Episode 14
▶Ep 51 · 1:13
epidemiological384 females with anorectal malformations were studied from the Pediatric Colorectal and Pelvic Learning Consortium database↗
▶Ep 51 · 1:22
epidemiologicalAbout 27% of patients with anorectal malformations had a gynecologic anomaly↗
▶Ep 51 · 1:22
epidemiologicalAbout 46% of females with anorectal malformations had VACTERL association (anorectal malformation plus two of: vertebral, cardiac, tracheoesophageal, renal, or limb anomaly)↗
▶Ep 51 · 1:39
clinicalHaving VACTERL association was associated with more gynecologic anomalies compared to those without VACTERL↗
▶Ep 51 · 1:49
clinicalThe association between VACTERL and gynecologic anomalies was especially true when patients had recto vestibular or rectal perineal fistulas↗
▶Ep 51 · 1:49
clinicalThe association between VACTERL and gynecologic anomalies was especially true when renal anomalies were found↗
▶Ep 51 · 1:57
quoteSo for females with inner rectum malformations and veal association, especially renal anomalies, we should look carefully for gynecologic anomalies.↗
▶Ep 51 · 1:57
guidelineFor females with anorectal malformations and VACTERL association, especially renal anomalies, clinicians should look carefully for gynecologic anomalies↗
host_summaryStevens et al. used the Gifford's Law Center annual gun law scorecard between 2014 and 2020 to assess state gun law scores.↗
▶Ep 7 · 0:46
quoteThere was a 55% lower firearm fatality rate for the states with the strongest gun laws compared to those with the weakest gun laws.↗
▶Ep 7 · 0:46
quoteAs other recent studies had shown, in the last few years, the fatality rate for firearms has surpassed the fatality rate for automobiles in children.↗
▶Ep 7 · 0:46
host_summaryStronger gun laws were associated with decreased fatality rates, with a 55% lower firearm fatality rate for states with the strongest gun laws compared to those with the weakest gun laws.↗
▶Ep 7 · 0:46
host_summaryIn recent years, the fatality rate for firearms has surpassed the fatality rate for automobiles in children.↗
▶Ep 7 · 0:46
host_summaryStevens et al. examined CDC Wonder database data between 1999 and 2020 for pediatric firearm and automobile fatalities.↗
Outcomes of laparoscopic versus open resection of pediatric choledochal cyst
▶Ep 3 · 0:13
epidemiologicalThe study used the nationwide readmissions database and identified 577 children who underwent choledochal cyst resection between 2016 and 2018.↗
▶Ep 3 · 0:24
clinicalPatients who underwent laparoscopic resection were more likely to have a hepaticoduodenostomy.↗
▶Ep 3 · 0:24
clinicalPatients who underwent open resection were more likely to have a Roux-en-Y hepaticojejunostomy.↗
▶Ep 3 · 0:24
epidemiologicalThe majority of patients underwent open resection.↗
▶Ep 3 · 0:39
clinicalPatients who underwent open resection had higher total costs.↗
▶Ep 3 · 0:39
clinicalPatients who underwent open resection were more likely to have more complications.↗
▶Ep 3 · 0:39
clinicalPatients who underwent open resection were more likely to have a longer length of hospital stay.↗
▶Ep 3 · 0:47
quoteHow do you resect colodocal cysts in pediatric patients?↗
Outcomes of laparoscopic versus open resection of pediatric choledochal cyst
▶Ep 3 · 0:13
epidemiologicalThe study used the nationwide readmissions database and identified 577 children who underwent choledochal cyst resection between 2016 and 2018.↗
▶Ep 3 · 0:24
clinicalPatients who underwent laparoscopic resection were more likely to have a hepaticoduodenostomy.↗
▶Ep 3 · 0:24
clinicalPatients who underwent open resection were more likely to have a Roux-en-Y hepaticojejunostomy.↗
▶Ep 3 · 0:24
epidemiologicalThe majority of patients underwent open resection.↗
▶Ep 3 · 0:39
clinicalPatients who underwent open resection were more likely to have a longer length of hospital stay.↗
▶Ep 3 · 0:39
clinicalPatients who underwent open resection had higher total costs.↗
▶Ep 3 · 0:39
clinicalPatients who underwent open resection were more likely to have more complications.↗
▶Ep 3 · 0:47
quoteHow do you resect colodocal cysts in pediatric patients?↗
Journal of pediatric surgery Article Review: April 2023, IPEG issue
▶Ep 4 · 5:36
clinicalSevere outcomes in button battery ingestion were defined as deep mucosal erosion, perforation, mediastinitis, vascular or airway injury or fistula, and development of esophageal stricture↗
▶Ep 4 · 6:05
epidemiologicalThe Boston study included 143 patients under 21 years old from 2008 to 2021, with 24 having severe outcomes↗
▶Ep 4 · 6:20
clinicalThree predictive factors for severe button battery outcomes were: presence in esophagus at presentation, two centimeter or larger battery size, and presence of any symptoms↗
Quick Literature Updates Episode 15
▶Ep 5 · 2:11
epidemiologicalThe choledochal cyst study used the nationwide readmissions database and identified 577 children who underwent choledochal cyst resection between 2016 and 2018↗
▶Ep 5 · 2:21
epidemiologicalThe majority of choledochal cyst patients underwent open resection↗
▶Ep 5 · 2:21
clinicalPatients who underwent laparoscopic choledochal cyst resection were more likely to have a hepaticoduodenostomy↗
▶Ep 5 · 2:21
clinicalPatients who underwent open choledochal cyst resection were more likely to have a Roux-en-Y hepaticojejunostomy↗
▶Ep 5 · 2:36
clinicalPatients who underwent open choledochal cyst resection had higher total costs compared to laparoscopic resection↗
▶Ep 5 · 2:36
clinicalPatients who underwent open choledochal cyst resection had more complications compared to laparoscopic resection↗
▶Ep 5 · 2:36
clinicalPatients who underwent open choledochal cyst resection had longer length of hospital stay compared to laparoscopic resection↗
Journal of Pediatric Surgery Article Review: October 2021
▶Ep 110 · 12:12
host_summaryAfter one year in the bowel management program, 30% of patients still struggled with fecal incontinence despite intensive resources.↗
▶Ep 110 · 14:46
host_summaryThe Italian anorectal malformation study was a retrospective review of 350 patients between 1999 and 2019, representing one of the largest series.↗
▶Ep 110 · 15:29
host_summaryThe Italian study demonstrated a close relationship between spinal cord abnormalities and spinal bone anomalies in anorectal malformation patients.↗
▶Ep 110 · 15:44
host_summaryDespite correlation between spinal bone and cord abnormalities, many patients without sacral or vertebral anomalies still had spinal cord abnormalities, making MRI necessary for screening.↗
▶Ep 110 · 16:01
host_summaryIn typical US practice for anorectal malformations, ultrasound shortly after birth is usually sufficient to look for spinal cord abnormalities, whereas the Italian practice finds MRI necessary.↗
Intestinal rehabilitation: What is intestinal rehab? - Episode 1
▶Ep 112 · 6:30
host_summaryMucosal defects in enteropathies lead to hypersecretion and profuse fluid losses, preventing nutrient absorption.↗
▶Ep 112 · 7:22
host_summaryGastroschisis can involve all three categories: short bowel from nonviable tissue, inflammation affecting absorption, and motility issues.↗
clinicalThere is literature suggesting a component of psychosocial, psychologic dissociation in children on later testing related to dilations↗
▶Ep 122 · 2:55
clinicalThe number of strictures, number who needed anoplasties, and number of redo operations was the same between the dilation and no-dilation groups↗
▶Ep 122 · 3:04
clinicalThe number of patients who had rectal prolapse is consistent with the literature↗
▶Ep 122 · 5:20
clinicalA study looked at 30-day outcomes for patients with ARM with perineal or rectovestibular fistulas who underwent repair, divided between early (before 6 days old) and late repair (6-8 weeks)↗
▶Ep 122 · 5:31
clinicalThere were 291 patients in the early vs late repair study: 66 underwent early repair and 231 underwent late repair↗
Journal of Pediatric Surgery Article Review: February 2023, BAPS issue
▶Ep 135 · 1:38
clinicalDr. Patkowski's center in Poland has been performing thoracoscopic esophageal atresia repair exclusively since 2005↗
▶Ep 135 · 1:47
quoteWe were happy that our first procedure was successful. When we did another one, it was much easier. Of course, at the beginning, the first procedure took us almost 4 hours. Right now it's a 1 hour procedure, but of course it's very difficult, but we are very happy to have no conversion.↗
▶Ep 135 · 1:54
clinicalThe first thoracoscopic EA procedure took almost 4 hours, but the procedure now takes 1 hour↗
▶Ep 135 · 1:59
clinicalThe Polish center has had no conversions from thoracoscopic to open approach since beginning the technique↗
▶Ep 135 · 2:06
clinicalAll thoracoscopic EA cases at the Polish center have been managed by one team using only the thoracoscopic approach↗
▶Ep 135 · 2:25
quoteThe first, you need experience in endoscopic surgery. And then just you need time, and you must be very experienced in endoscopic suturing. You must be very slow. If you do it slowly, you will do it fast.↗
▶Ep 135 · 2:25
clinicalExperience in endoscopic surgery and endoscopic suturing is required for thoracoscopic EA repair↗
▶Ep 135 · 2:58
opinionCentralization of EA care is important even if transportation costs are higher, because complication costs are much higher↗
▶Ep 135 · 2:58
quoteEven if this is a higher cost, but probably the costs of complications are much, much more higher than transportation.↗
▶Ep 135 · 3:06
clinicalThe Polish center handles 15 to 20 EA cases per year, which provides sufficient volume for good experience↗
▶Ep 135 · 3:06
quoteAt my center we have about 15 to 20 cases a year. It depends on the year, and it shows that with such a number of cases you can get a good experience.↗
▶Ep 135 · 5:25
epidemiologicalThe Sheffield study included 95 Hirschsprung disease patients from January 2004 to August 2021↗
▶Ep 135 · 5:41
clinicalIn the stoma cohort, 38 patients had ileostomies and the remainder had colostomies↗
▶Ep 135 · 5:46
clinicalThe most common indication for initial stoma was washout failure in nearly 40% of cases↗
host_summaryTendon et al. conducted a prospective randomized control trial between 2017 and 2018 comparing three skin closure methods: sutures with tissue adhesive, sutures with adhesive tape, and sutures alone.↗
▶Ep 138 · 3:35
host_summaryWounds were assessed at two weeks, six weeks, and more than six months after operation by surveying clinicians and parents.↗
Quick Literature Updates Episode 14
▶Ep 149 · 1:13
epidemiological384 females with anorectal malformations were studied from the Pediatric Colorectal and Pelvic Learning Consortium database↗
▶Ep 149 · 1:22
epidemiologicalAbout 27% of patients with anorectal malformations had a gynecologic anomaly↗
▶Ep 149 · 1:22
epidemiologicalAbout 46% of females with anorectal malformations had VACTERL association (anorectal malformation plus two of: vertebral, cardiac, tracheoesophageal, renal, or limb anomaly)↗
▶Ep 149 · 1:39
clinicalHaving VACTERL association was associated with more gynecologic anomalies compared to those without VACTERL↗
▶Ep 149 · 1:49
clinicalThe association between VACTERL and gynecologic anomalies was especially true when renal anomalies were found↗
▶Ep 149 · 1:49
clinicalThe association between VACTERL and gynecologic anomalies was especially true when patients had recto vestibular or rectal perineal fistulas↗
▶Ep 149 · 1:57
guidelineFor females with anorectal malformations and VACTERL association, especially renal anomalies, clinicians should look carefully for gynecologic anomalies↗
▶Ep 149 · 1:57
quoteSo for females with inner rectum malformations and veal association, especially renal anomalies, we should look carefully for gynecologic anomalies.↗
Quick Literature Updates Episode 15
▶Ep 156 · 2:11
epidemiologicalThe choledochal cyst study used the nationwide readmissions database and identified 577 children who underwent choledochal cyst resection between 2016 and 2018↗
▶Ep 156 · 2:21
epidemiologicalThe majority of choledochal cyst patients underwent open resection↗
▶Ep 156 · 2:21
clinicalPatients who underwent laparoscopic choledochal cyst resection were more likely to have a hepaticoduodenostomy↗
▶Ep 156 · 2:21
clinicalPatients who underwent open choledochal cyst resection were more likely to have a Roux-en-Y hepaticojejunostomy↗
▶Ep 156 · 2:36
clinicalPatients who underwent open choledochal cyst resection had higher total costs compared to laparoscopic resection↗
▶Ep 156 · 2:36
clinicalPatients who underwent open choledochal cyst resection had more complications compared to laparoscopic resection↗
▶Ep 156 · 2:36
clinicalPatients who underwent open choledochal cyst resection had longer length of hospital stay compared to laparoscopic resection↗
Journal of Pediatric Surgery Article Review: November 2021
▶Ep 7 · 1:09
clinical40% of patients ultimately required a central venous line within 30 days after ECMO decannulation↗
▶Ep 7 · 2:27
clinicalIn neonates (babies less than 28 days), the primary reason for needing a central line after ECMO decannulation was access, with many being CDH babies↗
▶Ep 7 · 2:41
clinicalIn older children or babies, the primary reason for needing a line after ECMO decannulation was hemodialysis↗
▶Ep 7 · 8:35
clinicalThe partial splenectomy study reviewed cases from 2002 to 2019, spanning 17 years↗
▶Ep 7 · 9:33
clinicalOther indications included splenomegaly or hereditary pyropoikilocytosis in about 3 patients↗
Neonatal Gastric Volvulus with Dr. Jason Frischer
▶Ep 8 · 5:32
quoteYou would probably see that it doesn't go past the stomach if it makes it into the stomach.↗
▶Ep 8 · 5:32
clinicalOn upper GI contrast study in gastric volvulus, contrast probably does not go past the stomach if it makes it into the stomach.↗
▶Ep 8 · 5:53
clinicalIn organoaxial volvulus, if contrast gets past the GE junction into the stomach, the greater curvature appears flipped up.↗
Journal of Pediatric Surgery Article Review: November 2021
▶Ep 26 · 1:09
clinical40% of patients ultimately required a central venous line within 30 days after ECMO decannulation↗
▶Ep 26 · 2:27
clinicalIn neonates (babies less than 28 days), the primary reason for needing a central line after ECMO decannulation was access, with many being CDH babies↗
▶Ep 26 · 2:41
clinicalIn older children or babies, the primary reason for needing a line after ECMO decannulation was hemodialysis↗
▶Ep 26 · 8:35
clinicalThe partial splenectomy study reviewed cases from 2002 to 2019, spanning 17 years↗
▶Ep 26 · 9:33
clinicalOther indications included splenomegaly or hereditary pyropoikilocytosis in about 3 patients↗
Case Based Journal Review - CPAM in 2022
▶Ep 27 · 2:30
clinicalA prospective study followed prenatally diagnosed congenital cystic lung lesions for a median of 10 years↗
▶Ep 27 · 2:38
clinical57% or 68% of patients in the prospective study were managed conservatively↗
▶Ep 27 · 4:47
clinicalOf 177 children with postnatal diagnosis of CPAM, 15 (8.7%) were classified as having a malignant tumor↗
▶Ep 27 · 7:18
clinicalPatients without prior pulmonary infection had shorter operative times↗
▶Ep 27 · 7:18
clinicalPatients without prior infection had fewer postoperative fevers and less need for antibiotics postoperatively↗
▶Ep 27 · 7:37
clinicalThere were no significant differences in postoperative complications between groups with and without prior infection↗
▶Ep 27 · 9:32
clinicalOperative time increased with each increase in age group↗
▶Ep 27 · 9:39
clinicalAt younger ages, the tissue planes are easier to dissect↗
▶Ep 27 · 9:50
clinicalBetween 1 and 3 months, operative time was 115 minutes compared to 163 minutes in the 6 to 12 months group↗
epidemiological384 females with anorectal malformations were studied from the Pediatric Colorectal and Pelvic Learning Consortium database↗
▶Ep 9 · 1:22
epidemiologicalAbout 46% of females with anorectal malformations had VACTERL association (anorectal malformation plus two of: vertebral, cardiac, tracheoesophageal, renal, or limb anomaly)↗
▶Ep 9 · 1:22
epidemiologicalAbout 27% of patients with anorectal malformations had a gynecologic anomaly↗
▶Ep 9 · 1:39
clinicalHaving VACTERL association was associated with more gynecologic anomalies compared to those without VACTERL↗
▶Ep 9 · 1:49
clinicalThe association between VACTERL and gynecologic anomalies was especially true when renal anomalies were found↗
▶Ep 9 · 1:49
clinicalThe association between VACTERL and gynecologic anomalies was especially true when patients had recto vestibular or rectal perineal fistulas↗
▶Ep 9 · 1:57
guidelineFor females with anorectal malformations and VACTERL association, especially renal anomalies, clinicians should look carefully for gynecologic anomalies↗
▶Ep 9 · 1:57
quoteSo for females with inner rectum malformations and veal association, especially renal anomalies, we should look carefully for gynecologic anomalies.↗
Journal of Pediatric Surgery Article Review: February 2023, BAPS issue
▶Ep 4 · 1:38
clinicalDr. Patkowski's center in Poland has been performing thoracoscopic esophageal atresia repair exclusively since 2005↗
▶Ep 4 · 1:47
quoteWe were happy that our first procedure was successful. When we did another one, it was much easier. Of course, at the beginning, the first procedure took us almost 4 hours. Right now it's a 1 hour procedure, but of course it's very difficult, but we are very happy to have no conversion.↗
▶Ep 4 · 1:54
clinicalThe first thoracoscopic EA procedure took almost 4 hours, but the procedure now takes 1 hour↗
▶Ep 4 · 1:59
clinicalThe Polish center has had no conversions from thoracoscopic to open approach since beginning the technique↗
▶Ep 4 · 2:06
clinicalAll thoracoscopic EA cases at the Polish center have been managed by one team using only the thoracoscopic approach↗
▶Ep 4 · 2:25
clinicalExperience in endoscopic surgery and endoscopic suturing is required for thoracoscopic EA repair↗
▶Ep 4 · 2:25
quoteThe first, you need experience in endoscopic surgery. And then just you need time, and you must be very experienced in endoscopic suturing. You must be very slow. If you do it slowly, you will do it fast.↗
▶Ep 4 · 2:58
opinionCentralization of EA care is important even if transportation costs are higher, because complication costs are much higher↗
▶Ep 4 · 2:58
quoteEven if this is a higher cost, but probably the costs of complications are much, much more higher than transportation.↗
▶Ep 4 · 3:06
clinicalThe Polish center handles 15 to 20 EA cases per year, which provides sufficient volume for good experience↗
▶Ep 4 · 3:06
quoteAt my center we have about 15 to 20 cases a year. It depends on the year, and it shows that with such a number of cases you can get a good experience.↗
▶Ep 4 · 5:25
epidemiologicalThe Sheffield study included 95 Hirschsprung disease patients from January 2004 to August 2021↗
▶Ep 4 · 5:41
clinicalIn the stoma cohort, 38 patients had ileostomies and the remainder had colostomies↗
▶Ep 4 · 5:46
clinicalThe most common indication for initial stoma was washout failure in nearly 40% of cases↗
Journal of Pediatric Surgery Article Review: October 2021
▶Ep 33 · 12:12
host_summaryAfter one year in the bowel management program, 30% of patients still struggled with fecal incontinence despite intensive resources.↗
▶Ep 33 · 14:46
host_summaryThe Italian anorectal malformation study was a retrospective review of 350 patients between 1999 and 2019, representing one of the largest series.↗
▶Ep 33 · 15:29
host_summaryThe Italian study demonstrated a close relationship between spinal cord abnormalities and spinal bone anomalies in anorectal malformation patients.↗
▶Ep 33 · 15:44
host_summaryDespite correlation between spinal bone and cord abnormalities, many patients without sacral or vertebral anomalies still had spinal cord abnormalities, making MRI necessary for screening.↗
▶Ep 33 · 16:01
host_summaryIn typical US practice for anorectal malformations, ultrasound shortly after birth is usually sufficient to look for spinal cord abnormalities, whereas the Italian practice finds MRI necessary.↗
Intestinal rehabilitation: What is intestinal rehab? - Episode 1
▶Ep 34 · 6:30
host_summaryMucosal defects in enteropathies lead to hypersecretion and profuse fluid losses, preventing nutrient absorption.↗
▶Ep 34 · 7:22
host_summaryGastroschisis can involve all three categories: short bowel from nonviable tissue, inflammation affecting absorption, and motility issues.↗
Neonatal Gastric Volvulus with Dr. Jason Frischer
▶Ep 43 · 5:32
quoteYou would probably see that it doesn't go past the stomach if it makes it into the stomach.↗
▶Ep 43 · 5:32
clinicalOn upper GI contrast study in gastric volvulus, contrast probably does not go past the stomach if it makes it into the stomach.↗
▶Ep 43 · 5:53
clinicalIn organoaxial volvulus, if contrast gets past the GE junction into the stomach, the greater curvature appears flipped up.↗
host_summaryIn California statewide data, the case fatality rate for gunshot wound victims was higher than that for motor vehicle collisions.↗
▶Ep 49 · 0:20
host_summaryTeodoro et al. studied pediatric trauma patients presenting to a level one trauma center with gunshot wounds or MVCs between 2009 and 2019.↗
▶Ep 49 · 0:20
host_summaryTeodoro et al. examined California Department of Public Health data on pediatric gunshot wounds and MVCs from 2006 to 2015.↗
▶Ep 49 · 0:20
host_summaryGunshot wound victims were more likely to require immediate surgery and had increased mortality compared to MVC victims.↗
▶Ep 49 · 0:20
host_summaryGunshot wound victims were 7.8 times more likely to die than MVC victims.↗
Quick Literature Updates Episode 11
▶Ep 52 · 0:46
host_summaryStevens et al. examined CDC Wonder database data between 1999 and 2020 for pediatric firearm and automobile fatalities.↗
▶Ep 52 · 0:46
quoteAs other recent studies had shown, in the last few years, the fatality rate for firearms has surpassed the fatality rate for automobiles in children.↗
▶Ep 52 · 0:46
host_summaryStronger gun laws were associated with decreased fatality rates, with a 55% lower firearm fatality rate for states with the strongest gun laws compared to those with the weakest gun laws.↗
▶Ep 52 · 0:46
host_summaryIn recent years, the fatality rate for firearms has surpassed the fatality rate for automobiles in children.↗
▶Ep 52 · 0:46
host_summaryStevens et al. used the Gifford's Law Center annual gun law scorecard between 2014 and 2020 to assess state gun law scores.↗
▶Ep 52 · 0:46
quoteThere was a 55% lower firearm fatality rate for the states with the strongest gun laws compared to those with the weakest gun laws.↗
host_summaryComponent separation technique involves separating tissue at the external oblique about a centimeter beyond the rectus sheath on both sides, dissecting between external and internal oblique, and optionally making an incision on the anterior rectus sheath for another centimeter of space↗
▶Ep 73 · 10:26
host_summaryA Texas report described component separation use in nine children aged seven days to 10 years, mostly for omphaloceles and giant defects, achieving fascial closure in the vast majority with some mesh use for bridging↗
host_summaryGunshot wound victims were 7.8 times more likely to die than MVC victims.↗
▶Ep 7 · 0:20
host_summaryIn California statewide data, the case fatality rate for gunshot wound victims was higher than that for motor vehicle collisions.↗
▶Ep 7 · 0:20
host_summaryGunshot wound victims were more likely to require immediate surgery and had increased mortality compared to MVC victims.↗
▶Ep 7 · 0:20
host_summaryTeodoro et al. examined California Department of Public Health data on pediatric gunshot wounds and MVCs from 2006 to 2015.↗
▶Ep 7 · 0:20
host_summaryTeodoro et al. studied pediatric trauma patients presenting to a level one trauma center with gunshot wounds or MVCs between 2009 and 2019.↗
Quick Literature Updates Episode 11
▶Ep 21 · 0:46
quoteThere was a 55% lower firearm fatality rate for the states with the strongest gun laws compared to those with the weakest gun laws.↗
▶Ep 21 · 0:46
host_summaryStevens et al. examined CDC Wonder database data between 1999 and 2020 for pediatric firearm and automobile fatalities.↗
▶Ep 21 · 0:46
quoteAs other recent studies had shown, in the last few years, the fatality rate for firearms has surpassed the fatality rate for automobiles in children.↗
▶Ep 21 · 0:46
host_summaryStronger gun laws were associated with decreased fatality rates, with a 55% lower firearm fatality rate for states with the strongest gun laws compared to those with the weakest gun laws.↗
▶Ep 21 · 0:46
host_summaryStevens et al. used the Gifford's Law Center annual gun law scorecard between 2014 and 2020 to assess state gun law scores.↗
▶Ep 21 · 0:46
host_summaryIn recent years, the fatality rate for firearms has surpassed the fatality rate for automobiles in children.↗
host_summaryA Texas report described component separation use in nine children aged seven days to 10 years, mostly for omphaloceles and giant defects, achieving fascial closure in the vast majority with some mesh use for bridging↗
▶Ep 9 · 10:26
host_summaryComponent separation technique involves separating tissue at the external oblique about a centimeter beyond the rectus sheath on both sides, dissecting between external and internal oblique, and optionally making an incision on the anterior rectus sheath for another centimeter of space↗
clinicalPetcova 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↗
▶Ep 46 · 5:20
quoteYou can see very well the biliary anatomy is absolutely. Amazing, as you can see, the main biliary tree, the gallbladder, and then the cystic duct.↗
▶Ep 46 · 5:32
clinicalICG must be administered intravenously 12-18 hours prior to surgery to accumulate in extrahepatic ducts↗
▶Ep 46 · 5:43
clinicalICG can be injected directly into the gallbladder during surgery as an alternative to pre-operative IV administration↗
▶Ep 46 · 9:48
clinicalDouble rim sign or halo sign on X-ray indicates button battery ingestion rather than coin ingestion↗
▶Ep 46 · 10:13
guidelineMain goal of button battery ingestion treatment is removal within 2 hours of ingestion↗
▶Ep 46 · 10:27
quoteWhat you need to do is cut down on the damage, the injury that this is doing. Sucralfate or honey can help.↗
▶Ep 46 · 10:35
guidelineChildren <1 year with button battery ingestion should receive 10mL sucralfate every 10 minutes for up to 3 doses (not honey due to botulism risk)↗
▶Ep 46 · 10:51
guidelineChildren ≥1 year with button battery ingestion should receive 10mL honey every 10 minutes for up to 6 doses↗
▶Ep 46 · 14:13
epidemiologicalMortality among black newborns is 3 times that of white newborns↗
▶Ep 46 · 14:19
epidemiologicalWhen black newborns are treated by black physicians, their mortality is reduced by 58% compared to black newborns treated by white physicians (Greenwood et al.)↗
▶Ep 46 · 14:57
quoterecognizing that we all have biases and not being defensive when someone says there's bias in that because we all have bias. We know that we all have bias. And so the question is, what are your biases and how do they affect what you do?↗
▶Ep 46 · 15:14
quoteSo I would push everyone. To say, as you're thinking about this work, as you, as you live in this space, you know, what are you doing about it?↗
▶Ep 46 · 15:21
quoteSo let's not just settle to talk about it, but let's figure out what the system level changes are that make a difference and change the outcome.↗
clinicalThere is literature suggesting a component of psychosocial, psychologic dissociation in children on later testing related to dilations↗
▶Ep 51 · 2:55
clinicalThe number of strictures, number who needed anoplasties, and number of redo operations was the same between the dilation and no-dilation groups↗
▶Ep 51 · 3:04
clinicalThe number of patients who had rectal prolapse is consistent with the literature↗
▶Ep 51 · 5:20
clinicalA study looked at 30-day outcomes for patients with ARM with perineal or rectovestibular fistulas who underwent repair, divided between early (before 6 days old) and late repair (6-8 weeks)↗
▶Ep 51 · 5:31
clinicalThere were 291 patients in the early vs late repair study: 66 underwent early repair and 231 underwent late repair↗
Journal of Pediatric Surgery Article Review: February 2023, BAPS issue
▶Ep 55 · 1:38
clinicalDr. Patkowski's center in Poland has been performing thoracoscopic esophageal atresia repair exclusively since 2005↗
▶Ep 55 · 1:47
quoteWe were happy that our first procedure was successful. When we did another one, it was much easier. Of course, at the beginning, the first procedure took us almost 4 hours. Right now it's a 1 hour procedure, but of course it's very difficult, but we are very happy to have no conversion.↗
▶Ep 55 · 1:54
clinicalThe first thoracoscopic EA procedure took almost 4 hours, but the procedure now takes 1 hour↗
▶Ep 55 · 1:59
clinicalThe Polish center has had no conversions from thoracoscopic to open approach since beginning the technique↗
▶Ep 55 · 2:06
clinicalAll thoracoscopic EA cases at the Polish center have been managed by one team using only the thoracoscopic approach↗
▶Ep 55 · 2:25
clinicalExperience in endoscopic surgery and endoscopic suturing is required for thoracoscopic EA repair↗
▶Ep 55 · 2:25
quoteThe first, you need experience in endoscopic surgery. And then just you need time, and you must be very experienced in endoscopic suturing. You must be very slow. If you do it slowly, you will do it fast.↗
▶Ep 55 · 2:58
opinionCentralization of EA care is important even if transportation costs are higher, because complication costs are much higher↗
▶Ep 55 · 2:58
quoteEven if this is a higher cost, but probably the costs of complications are much, much more higher than transportation.↗
▶Ep 55 · 3:06
clinicalThe Polish center handles 15 to 20 EA cases per year, which provides sufficient volume for good experience↗
▶Ep 55 · 3:06
quoteAt my center we have about 15 to 20 cases a year. It depends on the year, and it shows that with such a number of cases you can get a good experience.↗
▶Ep 55 · 5:25
epidemiologicalThe Sheffield study included 95 Hirschsprung disease patients from January 2004 to August 2021↗
▶Ep 55 · 5:41
clinicalIn the stoma cohort, 38 patients had ileostomies and the remainder had colostomies↗
▶Ep 55 · 5:46
clinicalThe most common indication for initial stoma was washout failure in nearly 40% of cases↗
host_summaryWounds were assessed at two weeks, six weeks, and more than six months after operation by surveying clinicians and parents.↗
▶Ep 58 · 3:35
host_summaryTendon et al. conducted a prospective randomized control trial between 2017 and 2018 comparing three skin closure methods: sutures with tissue adhesive, sutures with adhesive tape, and sutures alone.↗
Quick Literature Updates Episode 15
▶Ep 66 · 2:11
epidemiologicalThe choledochal cyst study used the nationwide readmissions database and identified 577 children who underwent choledochal cyst resection between 2016 and 2018↗
▶Ep 66 · 2:21
clinicalPatients who underwent laparoscopic choledochal cyst resection were more likely to have a hepaticoduodenostomy↗
▶Ep 66 · 2:21
clinicalPatients who underwent open choledochal cyst resection were more likely to have a Roux-en-Y hepaticojejunostomy↗
▶Ep 66 · 2:21
epidemiologicalThe majority of choledochal cyst patients underwent open resection↗
▶Ep 66 · 2:36
clinicalPatients who underwent open choledochal cyst resection had more complications compared to laparoscopic resection↗
▶Ep 66 · 2:36
clinicalPatients who underwent open choledochal cyst resection had longer length of hospital stay compared to laparoscopic resection↗
▶Ep 66 · 2:36
clinicalPatients who underwent open choledochal cyst resection had higher total costs compared to laparoscopic resection↗
epidemiologicalThe choledochal cyst study used the nationwide readmissions database and identified 577 children who underwent choledochal cyst resection between 2016 and 2018↗
▶Ep 3 · 2:21
clinicalPatients who underwent laparoscopic choledochal cyst resection were more likely to have a hepaticoduodenostomy↗
▶Ep 3 · 2:21
epidemiologicalThe majority of choledochal cyst patients underwent open resection↗
▶Ep 3 · 2:21
clinicalPatients who underwent open choledochal cyst resection were more likely to have a Roux-en-Y hepaticojejunostomy↗
▶Ep 3 · 2:36
clinicalPatients who underwent open choledochal cyst resection had longer length of hospital stay compared to laparoscopic resection↗
▶Ep 3 · 2:36
clinicalPatients who underwent open choledochal cyst resection had more complications compared to laparoscopic resection↗
▶Ep 3 · 2:36
clinicalPatients who underwent open choledochal cyst resection had higher total costs compared to laparoscopic resection↗
Intestinal rehabilitation: What is intestinal rehab? - Episode 1
▶Ep 8 · 6:30
host_summaryMucosal defects in enteropathies lead to hypersecretion and profuse fluid losses, preventing nutrient absorption.↗
▶Ep 8 · 7:22
host_summaryGastroschisis can involve all three categories: short bowel from nonviable tissue, inflammation affecting absorption, and motility issues.↗
Intestinal Rehabilitation, Episode 4: Surgical Management, Part 1
▶Ep 18 · 1:50
host_summaryIn the 1980s and 1990s, babies with intestinal failure had poor outcomes primarily due to liver progression to inflammation and fibrosis associated with parenteral nutrition, lipids, and phytosterols.↗
▶Ep 18 · 9:36
host_summaryAt birth, neonatal bowel is usually not dilated enough to apply the STEP procedure.↗
▶Ep 18 · 15:57
host_summaryIf one part of the stepped bowel becomes dilated, the STEP segments can rotate away from each other separately, causing twisting and functional obstruction.↗
Intestinal Rehabilitation, Episode 4: Surgical Management, Part 1
▶Ep 19 · 1:50
host_summaryIn the 1980s and 1990s, babies with intestinal failure had poor outcomes primarily due to liver progression to inflammation and fibrosis associated with parenteral nutrition, lipids, and phytosterols.↗
▶Ep 19 · 9:36
host_summaryAt birth, neonatal bowel is usually not dilated enough to apply the STEP procedure.↗
▶Ep 19 · 15:57
host_summaryIf one part of the stepped bowel becomes dilated, the STEP segments can rotate away from each other separately, causing twisting and functional obstruction.↗
Intestinal Rehabilitation, Episode 4: Surgical Management, Part 2
▶Ep 20 · 2:04
host_summarySTEP does not create new bowel but redistributes it to reestablish more normal caliber bowel, which helps improve motility overall.↗
▶Ep 20 · 3:33
host_summaryAbout 50% reduction in parental nutrition support can be expected after STEP.↗
▶Ep 20 · 6:32
host_summaryThere is a whole spectrum of findings from ulcers at staple lines, from just having specks of blood in the stool to enough bleeding that kids might have to be transfused every week and a half.↗
▶Ep 20 · 6:47
host_summaryStaple line ulcers can recur after treatment.↗
▶Ep 20 · 7:21
host_summaryTeams have tried enteral omega 3 lipid supplements, bacterial overgrowth management with cycled antibiotics or probiotics, 5ASA, budesonide, and immune modulators like Remicade for staple line bleeding, but none have been the perfect remedy.↗
▶Ep 20 · 7:52
host_summaryThe underlying issue in staple line bleeding is not in the bowel but actually in the mesentery.↗
▶Ep 20 · 8:17
host_summaryMesenteric inflammation causes scarring and obstructs venous outflow, leading to enlarged veins and venous hypertension on the bowel, and even large lymph nodes from lymphatic obstruction.↗
▶Ep 20 · 9:00
host_summaryDr. Helmrath typically revises the staple line with a hand sewn stitch when mesenteric scarring and venous hypertension are present.↗
▶Ep 20 · 10:25
host_summaryDoing things in a staged fashion is typical for the intestinal rehabilitation patient population.↗
▶Ep 20 · 10:45
host_summaryAs intestinal rehabilitation patients grow and develop, more issues might arise requiring additional operations.↗
▶Ep 20 · 11:15
host_summaryIntestinal rehabilitation is a lifelong issue, and surgeons typically follow these patients for a long time.↗
Journal of Pediatric Surgery Article Review: October 2021
▶Ep 45 · 12:12
host_summaryAfter one year in the bowel management program, 30% of patients still struggled with fecal incontinence despite intensive resources.↗
▶Ep 45 · 14:46
host_summaryThe Italian anorectal malformation study was a retrospective review of 350 patients between 1999 and 2019, representing one of the largest series.↗
▶Ep 45 · 15:29
host_summaryThe Italian study demonstrated a close relationship between spinal cord abnormalities and spinal bone anomalies in anorectal malformation patients.↗
▶Ep 45 · 15:44
host_summaryDespite correlation between spinal bone and cord abnormalities, many patients without sacral or vertebral anomalies still had spinal cord abnormalities, making MRI necessary for screening.↗
▶Ep 45 · 16:01
host_summaryIn typical US practice for anorectal malformations, ultrasound shortly after birth is usually sufficient to look for spinal cord abnormalities, whereas the Italian practice finds MRI necessary.↗
Intestinal rehabilitation: What is intestinal rehab? - Episode 1
▶Ep 46 · 6:30
host_summaryMucosal defects in enteropathies lead to hypersecretion and profuse fluid losses, preventing nutrient absorption.↗
▶Ep 46 · 7:22
host_summaryGastroschisis can involve all three categories: short bowel from nonviable tissue, inflammation affecting absorption, and motility issues.↗
Neonatal Gastric Volvulus with Dr. Jason Frischer
▶Ep 59 · 5:32
quoteYou would probably see that it doesn't go past the stomach if it makes it into the stomach.↗
▶Ep 59 · 5:32
clinicalOn upper GI contrast study in gastric volvulus, contrast probably does not go past the stomach if it makes it into the stomach.↗
▶Ep 59 · 5:53
clinicalIn organoaxial volvulus, if contrast gets past the GE junction into the stomach, the greater curvature appears flipped up.↗
Intestinal Rehabilitation, Episode 4: Surgical Management, Part 1
▶Ep 66 · 1:50
host_summaryIn the 1980s and 1990s, babies with intestinal failure had poor outcomes primarily due to liver progression to inflammation and fibrosis associated with parenteral nutrition, lipids, and phytosterols.↗
▶Ep 66 · 9:36
host_summaryAt birth, neonatal bowel is usually not dilated enough to apply the STEP procedure.↗
▶Ep 66 · 15:57
host_summaryIf one part of the stepped bowel becomes dilated, the STEP segments can rotate away from each other separately, causing twisting and functional obstruction.↗
Intestinal Rehabilitation, Episode 4: Surgical Management, Part 1
▶Ep 67 · 1:50
host_summaryIn the 1980s and 1990s, babies with intestinal failure had poor outcomes primarily due to liver progression to inflammation and fibrosis associated with parenteral nutrition, lipids, and phytosterols.↗
▶Ep 67 · 9:36
host_summaryAt birth, neonatal bowel is usually not dilated enough to apply the STEP procedure.↗
▶Ep 67 · 15:57
host_summaryIf one part of the stepped bowel becomes dilated, the STEP segments can rotate away from each other separately, causing twisting and functional obstruction.↗
Intestinal Rehabilitation, Episode 4: Surgical Management, Part 2
▶Ep 68 · 2:04
host_summarySTEP does not create new bowel but redistributes it to reestablish more normal caliber bowel, which helps improve motility overall.↗
▶Ep 68 · 3:33
host_summaryAbout 50% reduction in parental nutrition support can be expected after STEP.↗
▶Ep 68 · 6:32
host_summaryThere is a whole spectrum of findings from ulcers at staple lines, from just having specks of blood in the stool to enough bleeding that kids might have to be transfused every week and a half.↗
▶Ep 68 · 6:47
host_summaryStaple line ulcers can recur after treatment.↗
▶Ep 68 · 7:21
host_summaryTeams have tried enteral omega 3 lipid supplements, bacterial overgrowth management with cycled antibiotics or probiotics, 5ASA, budesonide, and immune modulators like Remicade for staple line bleeding, but none have been the perfect remedy.↗
▶Ep 68 · 7:52
host_summaryThe underlying issue in staple line bleeding is not in the bowel but actually in the mesentery.↗
▶Ep 68 · 8:17
host_summaryMesenteric inflammation causes scarring and obstructs venous outflow, leading to enlarged veins and venous hypertension on the bowel, and even large lymph nodes from lymphatic obstruction.↗
▶Ep 68 · 9:00
host_summaryDr. Helmrath typically revises the staple line with a hand sewn stitch when mesenteric scarring and venous hypertension are present.↗
▶Ep 68 · 10:25
host_summaryDoing things in a staged fashion is typical for the intestinal rehabilitation patient population.↗
▶Ep 68 · 10:45
host_summaryAs intestinal rehabilitation patients grow and develop, more issues might arise requiring additional operations.↗
▶Ep 68 · 11:15
host_summaryIntestinal rehabilitation is a lifelong issue, and surgeons typically follow these patients for a long time.↗
Quick Literature Updates Episode 6
▶Ep 71 · 0:20
host_summaryGunshot wound victims were 7.8 times more likely to die than MVC victims.↗
▶Ep 71 · 0:20
host_summaryTeodoro et al. examined California Department of Public Health data on pediatric gunshot wounds and MVCs from 2006 to 2015.↗
▶Ep 71 · 0:20
host_summaryGunshot wound victims were more likely to require immediate surgery and had increased mortality compared to MVC victims.↗
▶Ep 71 · 0:20
host_summaryTeodoro et al. studied pediatric trauma patients presenting to a level one trauma center with gunshot wounds or MVCs between 2009 and 2019.↗
▶Ep 71 · 0:20
host_summaryIn California statewide data, the case fatality rate for gunshot wound victims was higher than that for motor vehicle collisions.↗
Quick Literature Updates Episode 7
▶Ep 72 · 3:35
host_summaryTendon et al. conducted a prospective randomized control trial between 2017 and 2018 comparing three skin closure methods: sutures with tissue adhesive, sutures with adhesive tape, and sutures alone.↗
▶Ep 72 · 3:35
host_summaryWounds were assessed at two weeks, six weeks, and more than six months after operation by surveying clinicians and parents.↗
Quick Literature Updates Episode 11
▶Ep 76 · 0:46
host_summaryIn recent years, the fatality rate for firearms has surpassed the fatality rate for automobiles in children.↗
▶Ep 76 · 0:46
host_summaryStevens et al. examined CDC Wonder database data between 1999 and 2020 for pediatric firearm and automobile fatalities.↗
▶Ep 76 · 0:46
host_summaryStevens et al. used the Gifford's Law Center annual gun law scorecard between 2014 and 2020 to assess state gun law scores.↗
▶Ep 76 · 0:46
host_summaryStronger gun laws were associated with decreased fatality rates, with a 55% lower firearm fatality rate for states with the strongest gun laws compared to those with the weakest gun laws.↗
▶Ep 76 · 0:46
quoteAs other recent studies had shown, in the last few years, the fatality rate for firearms has surpassed the fatality rate for automobiles in children.↗
▶Ep 76 · 0:46
quoteThere was a 55% lower firearm fatality rate for the states with the strongest gun laws compared to those with the weakest gun laws.↗
host_summaryA Texas report described component separation use in nine children aged seven days to 10 years, mostly for omphaloceles and giant defects, achieving fascial closure in the vast majority with some mesh use for bridging↗
▶Ep 105 · 10:26
host_summaryComponent separation technique involves separating tissue at the external oblique about a centimeter beyond the rectus sheath on both sides, dissecting between external and internal oblique, and optionally making an incision on the anterior rectus sheath for another centimeter of space↗
Intestinal rehabilitation: What is intestinal rehab? - Episode 1
▶Ep 5 · 6:30
host_summaryMucosal defects in enteropathies lead to hypersecretion and profuse fluid losses, preventing nutrient absorption.↗
▶Ep 5 · 7:22
host_summaryGastroschisis can involve all three categories: short bowel from nonviable tissue, inflammation affecting absorption, and motility issues.↗
Journal of Pediatric Surgery Article Review: October 2021
▶Ep 5 · 12:12
host_summaryAfter one year in the bowel management program, 30% of patients still struggled with fecal incontinence despite intensive resources.↗
▶Ep 5 · 14:46
host_summaryThe Italian anorectal malformation study was a retrospective review of 350 patients between 1999 and 2019, representing one of the largest series.↗
▶Ep 5 · 15:29
host_summaryThe Italian study demonstrated a close relationship between spinal cord abnormalities and spinal bone anomalies in anorectal malformation patients.↗
▶Ep 5 · 15:44
host_summaryDespite correlation between spinal bone and cord abnormalities, many patients without sacral or vertebral anomalies still had spinal cord abnormalities, making MRI necessary for screening.↗
▶Ep 5 · 16:01
host_summaryIn typical US practice for anorectal malformations, ultrasound shortly after birth is usually sufficient to look for spinal cord abnormalities, whereas the Italian practice finds MRI necessary.↗
clinicalPetcova 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↗
▶Ep 1 · 5:20
quoteYou can see very well the biliary anatomy is absolutely. Amazing, as you can see, the main biliary tree, the gallbladder, and then the cystic duct.↗
▶Ep 1 · 5:32
clinicalICG must be administered intravenously 12-18 hours prior to surgery to accumulate in extrahepatic ducts↗
▶Ep 1 · 5:43
clinicalICG can be injected directly into the gallbladder during surgery as an alternative to pre-operative IV administration↗
▶Ep 1 · 9:48
clinicalDouble rim sign or halo sign on X-ray indicates button battery ingestion rather than coin ingestion↗
▶Ep 1 · 10:13
guidelineMain goal of button battery ingestion treatment is removal within 2 hours of ingestion↗
▶Ep 1 · 10:27
quoteWhat you need to do is cut down on the damage, the injury that this is doing. Sucralfate or honey can help.↗
▶Ep 1 · 10:35
guidelineChildren <1 year with button battery ingestion should receive 10mL sucralfate every 10 minutes for up to 3 doses (not honey due to botulism risk)↗
▶Ep 1 · 10:51
guidelineChildren ≥1 year with button battery ingestion should receive 10mL honey every 10 minutes for up to 6 doses↗
▶Ep 1 · 14:13
epidemiologicalMortality among black newborns is 3 times that of white newborns↗
▶Ep 1 · 14:19
epidemiologicalWhen black newborns are treated by black physicians, their mortality is reduced by 58% compared to black newborns treated by white physicians (Greenwood et al.)↗
▶Ep 1 · 14:57
quoterecognizing that we all have biases and not being defensive when someone says there's bias in that because we all have bias. We know that we all have bias. And so the question is, what are your biases and how do they affect what you do?↗
▶Ep 1 · 15:14
quoteSo I would push everyone. To say, as you're thinking about this work, as you, as you live in this space, you know, what are you doing about it?↗
▶Ep 1 · 15:21
quoteSo let's not just settle to talk about it, but let's figure out what the system level changes are that make a difference and change the outcome.↗
Update Course Rewind: Thoracotomy vs VATS for Lung Metastases
▶Ep 2 · 1:29
epidemiologicalAbout 20% of osteosarcoma patients already have lung metastases by the time of diagnosis↗
▶Ep 2 · 4:10
clinicalThoracotomy is more invasive than other alternatives and there is longer hospital stay↗
▶Ep 2 · 5:07
clinicalOften 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↗
▶Ep 2 · 5:23
epidemiologicalA multi-institution study including 200 patients with metastatic osteosarcoma is the largest study that has ever been done↗
clinicalCryoanalgesia uses cold temperatures to cause a conduction block that interrupts pain impulses to the brain↗
Update Course Rewind: Pectus Excavatum 2021
▶Ep 26 · 1:57
clinicalCryoanalgesia uses cold temperatures to cause a conduction block that interrupts pain impulses to the brain↗
Novel index to estimate the cephalocaudal extent of the excavation in pectus excavatum - JPS article
▶Ep 29 · 0:11
clinicalThe Haller index and correction index are the currently primarily used indices for pectus excavatum and tell us about the severity of the deformity.↗
▶Ep 29 · 0:19
clinicalThe Titanic index takes into account the extent of the pectus excavatum deformity.↗
▶Ep 29 · 0:25
clinicalThe Titanic index is calculated as the percentage of the sternum that lies behind the anterior costal line as seen on CT scans.↗
▶Ep 29 · 0:35
clinicalThe study was a retrospective review of patients at an institution in Argentina who had undergone minimally invasive repair of pectus excavatum.↗
▶Ep 29 · 0:46
clinicalThe Titanic index might be more helpful for helping determine how many bars a patient is going to need for repair.↗
▶Ep 29 · 0:46
clinicalThe study found a weak correlation between the Titanic index and the other indices (Haller and correction index).↗
▶Ep 29 · 0:57
clinicalThe threshold established was 66.5%, meaning that patients with a higher Titanic index than that probably needed more than 2 bars.↗
▶Ep 29 · 0:57
quoteThe threshold they established here was 66.5%, meaning that patients with a higher titanic index than that probably needed more than 2 bars.↗
Journal of pediatric surgery Article Review: April 2023, IPEG issue
▶Ep 31 · 5:36
clinicalSevere outcomes in button battery ingestion were defined as deep mucosal erosion, perforation, mediastinitis, vascular or airway injury or fistula, and development of esophageal stricture↗
▶Ep 31 · 6:05
epidemiologicalThe Boston study included 143 patients under 21 years old from 2008 to 2021, with 24 having severe outcomes↗
▶Ep 31 · 6:20
clinicalThree predictive factors for severe button battery outcomes were: presence in esophagus at presentation, two centimeter or larger battery size, and presence of any symptoms↗
Quick Literature Updates Episode 13
▶Ep 37 · 1:12
clinicalThe Haller index and correction index are currently the primary indices used for pectus excavatum and tell us about the severity of the deformity↗
▶Ep 37 · 1:20
quoteThis new index, or the Titanic index as they're calling it, takes into account the extent of the deformity.↗
▶Ep 37 · 1:26
clinicalThe Titanic index is the percentage of the sternum that lies behind the anterior costal line as seen on CT scans↗
▶Ep 37 · 1:44
clinicalThere is a weak correlation between the Titanic index and the other indices (Haller and correction indices)↗
▶Ep 37 · 1:44
clinicalThe Titanic index might be more helpful for determining how many bars a patient will need for pectus excavatum repair↗
▶Ep 37 · 1:55
clinicalA Titanic index threshold of 66.5% was established, with patients above this threshold probably needing more than 2 bars for repair↗
clinicalThe Haller index and correction index are currently the primary indices used for pectus excavatum and tell us about the severity of the deformity↗
▶Ep 7 · 1:20
quoteThis new index, or the Titanic index as they're calling it, takes into account the extent of the deformity.↗
▶Ep 7 · 1:26
clinicalThe Titanic index is the percentage of the sternum that lies behind the anterior costal line as seen on CT scans↗
▶Ep 7 · 1:44
clinicalThe Titanic index might be more helpful for determining how many bars a patient will need for pectus excavatum repair↗
▶Ep 7 · 1:44
clinicalThere is a weak correlation between the Titanic index and the other indices (Haller and correction indices)↗
▶Ep 7 · 1:55
clinicalA Titanic index threshold of 66.5% was established, with patients above this threshold probably needing more than 2 bars for repair↗
clinicalThere is literature suggesting a component of psychosocial, psychologic dissociation in children on later testing related to dilations↗
▶Ep 1 · 2:55
clinicalThe number of strictures, number who needed anoplasties, and number of redo operations was the same between the dilation and no-dilation groups↗
▶Ep 1 · 3:04
clinicalThe number of patients who had rectal prolapse is consistent with the literature↗
▶Ep 1 · 5:20
clinicalA study looked at 30-day outcomes for patients with ARM with perineal or rectovestibular fistulas who underwent repair, divided between early (before 6 days old) and late repair (6-8 weeks)↗
▶Ep 1 · 5:31
clinicalThere were 291 patients in the early vs late repair study: 66 underwent early repair and 231 underwent late repair↗
clinicalPetcova 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↗
▶Ep 13 · 5:20
quoteYou can see very well the biliary anatomy is absolutely. Amazing, as you can see, the main biliary tree, the gallbladder, and then the cystic duct.↗
▶Ep 13 · 5:32
clinicalICG must be administered intravenously 12-18 hours prior to surgery to accumulate in extrahepatic ducts↗
▶Ep 13 · 5:43
clinicalICG can be injected directly into the gallbladder during surgery as an alternative to pre-operative IV administration↗
▶Ep 13 · 9:48
clinicalDouble rim sign or halo sign on X-ray indicates button battery ingestion rather than coin ingestion↗
▶Ep 13 · 10:13
guidelineMain goal of button battery ingestion treatment is removal within 2 hours of ingestion↗
▶Ep 13 · 10:27
quoteWhat you need to do is cut down on the damage, the injury that this is doing. Sucralfate or honey can help.↗
▶Ep 13 · 10:35
guidelineChildren <1 year with button battery ingestion should receive 10mL sucralfate every 10 minutes for up to 3 doses (not honey due to botulism risk)↗
▶Ep 13 · 10:51
guidelineChildren ≥1 year with button battery ingestion should receive 10mL honey every 10 minutes for up to 6 doses↗
▶Ep 13 · 14:13
epidemiologicalMortality among black newborns is 3 times that of white newborns↗
▶Ep 13 · 14:19
epidemiologicalWhen black newborns are treated by black physicians, their mortality is reduced by 58% compared to black newborns treated by white physicians (Greenwood et al.)↗
▶Ep 13 · 14:57
quoterecognizing that we all have biases and not being defensive when someone says there's bias in that because we all have bias. We know that we all have bias. And so the question is, what are your biases and how do they affect what you do?↗
▶Ep 13 · 15:14
quoteSo I would push everyone. To say, as you're thinking about this work, as you, as you live in this space, you know, what are you doing about it?↗
▶Ep 13 · 15:21
quoteSo let's not just settle to talk about it, but let's figure out what the system level changes are that make a difference and change the outcome.↗
Case Based Journal Review - CPAM in 2022
▶Ep 15 · 2:30
clinicalA prospective study followed prenatally diagnosed congenital cystic lung lesions for a median of 10 years↗
▶Ep 15 · 2:38
clinical57% or 68% of patients in the prospective study were managed conservatively↗
▶Ep 15 · 4:47
clinicalOf 177 children with postnatal diagnosis of CPAM, 15 (8.7%) were classified as having a malignant tumor↗
▶Ep 15 · 7:18
clinicalPatients without prior pulmonary infection had shorter operative times↗
▶Ep 15 · 7:18
clinicalPatients without prior infection had fewer postoperative fevers and less need for antibiotics postoperatively↗
▶Ep 15 · 7:37
clinicalThere were no significant differences in postoperative complications between groups with and without prior infection↗
▶Ep 15 · 9:32
clinicalOperative time increased with each increase in age group↗
▶Ep 15 · 9:39
clinicalAt younger ages, the tissue planes are easier to dissect↗
▶Ep 15 · 9:50
clinicalBetween 1 and 3 months, operative time was 115 minutes compared to 163 minutes in the 6 to 12 months group↗
Update Course Rewind: Thoracotomy vs VATS for Lung Metastases
▶Ep 18 · 1:29
epidemiologicalAbout 20% of osteosarcoma patients already have lung metastases by the time of diagnosis↗
▶Ep 18 · 4:10
clinicalThoracotomy is more invasive than other alternatives and there is longer hospital stay↗
▶Ep 18 · 5:07
clinicalOften 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↗
▶Ep 18 · 5:23
epidemiologicalA multi-institution study including 200 patients with metastatic osteosarcoma is the largest study that has ever been done↗
Intestinal rehabilitation: What is intestinal rehab? - Episode 1
▶Ep 3 · 6:30
host_summaryMucosal defects in enteropathies lead to hypersecretion and profuse fluid losses, preventing nutrient absorption.↗
▶Ep 3 · 7:22
host_summaryGastroschisis can involve all three categories: short bowel from nonviable tissue, inflammation affecting absorption, and motility issues.↗
Intestinal Rehabilitation, Episode 4: Surgical Management, Part 1
▶Ep 5 · 1:50
host_summaryIn the 1980s and 1990s, babies with intestinal failure had poor outcomes primarily due to liver progression to inflammation and fibrosis associated with parenteral nutrition, lipids, and phytosterols.↗
▶Ep 5 · 9:36
host_summaryAt birth, neonatal bowel is usually not dilated enough to apply the STEP procedure.↗
▶Ep 5 · 15:57
host_summaryIf one part of the stepped bowel becomes dilated, the STEP segments can rotate away from each other separately, causing twisting and functional obstruction.↗
Quick Literature Updates Episode 7
▶Ep 6 · 3:35
host_summaryWounds were assessed at two weeks, six weeks, and more than six months after operation by surveying clinicians and parents.↗
▶Ep 6 · 3:35
host_summaryTendon et al. conducted a prospective randomized control trial between 2017 and 2018 comparing three skin closure methods: sutures with tissue adhesive, sutures with adhesive tape, and sutures alone.↗
