I read this article very carefully and I said, look, I could actually change my practice and actually sending the baby home. I could reduce the hospital stay and, more importantly, reduce the chance of them having a serious adverse effect by 10%. I thought to myself that there was really significant.
I read this article very carefully and I said, look, I could actually change my practice and actually sending the baby home. I could reduce the hospital stay and, more importantly, reduce the chance of them having a serious adverse effect by 10%. I thought to myself that there was really significant.
I, I really love this study because you said it requires a lot of skills, but this is not just a single center, one expert surgeon showing off what they can do. This is 4 centers, so the range of surgeons that are doing this, it's, it's. Quite broad, so this article is trying to say it's feasible.
I would only accept radiology because you have to do an intervention after that. So if it's positive, you have to do an intervention, whether it is enema reduction or surgery. And at least I'm not trained in point-of-care ultrasound and neither are the emergency doctors I work with.
The International Pulmonary blastoma Registry has 350 cases reported worldwide. They, they have the most, the, the largest collection of cases worldwide, and they've only found 9 cases of uh prenatally diagnosed lesions that actually turned out to be pleuropulmonary blastoma.
They're not comparing ICG compared to intraparative cholalangiogram. They're comparing ICG versus nothing versus just simple visualization. So of course, of course your endpoint is going to be, of course you see more if you use a technique to visualize more structures.
quoteI was always told that. This should be operated because the risk of them becoming symptomatic was pretty high.↗
▶Ep 27 · 3:37
clinicalRetrospective studies show a huge range of 3% to 85% for risk of becoming symptomatic↗
▶Ep 27 · 3:37
clinicalSystematic reviews report symptomatic rates of 3.2% in one review and 25% in another↗
▶Ep 27 · 3:37
quoteI know you get a huge range from 3 to 85% on retrospective studies, but all of their biased, but when you get to a systematic review of mess, actually one of them comes to the number 3.2% and the other one comes to the number 25%.↗
▶Ep 27 · 5:24
quoteTo me, my opinion is that prenatally diagnosed asymptomatic, I would find it very difficult for them to give them an operation, very difficult, and postnatally diagnosed, I would find it very difficult not to do an operation.↗
▶Ep 27 · 5:49
epidemiologicalThe International Pleuropulmonary Blastoma Registry has 350 cases reported worldwide and found only 9 cases of prenatally diagnosed lesions that turned out to be pleuropulmonary blastoma↗
▶Ep 27 · 5:49
quoteThe International Pulmonary blastoma Registry has 350 cases reported worldwide. They, they have the most, the, the largest collection of cases worldwide, and they've only found 9 cases of uh prenatally diagnosed lesions that actually turned out to be pleuropulmonary blastoma.↗
▶Ep 27 · 8:17
clinicalAfter infection, there is a higher rate of conversion from thoracoscopic to open surgery↗
▶Ep 27 · 8:25
opinionThe number of patients who will have an infection is so low that the benefit of lesser conversion rate does not justify preemptive surgery↗
▶Ep 27 · 10:28
clinicalThe 1 to 3 month group had a 40% thoracotomy rate↗
▶Ep 27 · 11:06
quoteI, I see your point, but actually if you're doing an, an elective preventive resection of something. Uh, it, it should be easy. It should be easy. It should have nearly zero complications like prophylactic operations should be close to zero complications.↗
▶Ep 27 · 11:13
opinionProphylactic operations should have nearly zero complications↗
Update Course 2022 - TOP PUBLICATIONS IN NON- PED SURG JOURNALS - Jose Campos
▶Ep 44 · 1:38
epidemiologicalThe Chilean Society of Pediatric Surgery screens 1,200 articles each month, with only 3% relevant to pediatric surgery↗
▶Ep 44 · 2:30
quoteWe screen 1,200 articles each month and we want to get the best to you↗
▶Ep 44 · 4:00
clinicalA multi-institutional prospective randomized trial compared piperacillin-tazobactam to ceftriaxone plus metronidazole for perforated appendicitis↗
▶Ep 44 · 5:00
clinicalAt 75% enrollment, interim analysis favored piperacillin-tazobactam and the study was stopped↗
▶Ep 44 · 5:20
clinicalIntra-abdominal abscess formation was significantly lower in the piperacillin-tazobactam group with an odds ratio of 4.8↗
▶Ep 44 · 5:50
clinicalThe number needed to treat with piperacillin-tazobactam to prevent one intra-abdominal abscess was 5.7↗
▶Ep 44 · 10:50
clinicalA 20-center randomized controlled trial compared initial laparotomy versus peritoneal drainage for NEC, enrolling 310 premature newborns↗
▶Ep 44 · 11:20
clinicalAt 18 to 22 months corrected age, the composite of death and neurodevelopmental impairment was similar in both groups in frequentist analysis↗
▶Ep 44 · 11:30
quoteThis huge and challenging study brings the best quality evidence to a long-standing question↗
▶Ep 44 · 11:40
clinicalBayesian analysis showed a high probability of laparotomy being superior to peritoneal drainage↗
▶Ep 44 · 18:20
clinicalA systematic review examined 900 publications on gastrostomy insertion, with 58 used for final recommendations↗
▶Ep 44 · 18:50
clinicalTwelve studies directly compared outcomes between laparoscopic and percutaneous endoscopic gastrostomy↗
▶Ep 44 · 19:10
clinicalMajor complication rates were significantly less common with laparoscopic gastrostomy placement↗
▶Ep 44 · 19:30
clinicalThe number needed to treat to prevent one major complication from PEG is 24↗
▶Ep 44 · 25:49
clinicalA database comparison of 3,000 patients found no survival difference between total thyroidectomy and thyroid lobectomy for differentiated papillary thyroid cancer↗
clinicalThe younger the baby, the higher the risk of incarceration↗
▶Ep 17 · 3:49
quoteI read this article very carefully and I said, look, I could actually change my practice and actually sending the baby home. I could reduce the hospital stay and, more importantly, reduce the chance of them having a serious adverse effect by 10%. I thought to myself that there was really significant.↗
▶Ep 17 · 4:27
clinicalIn the early group 4% had spontaneous resolution, in the late group 11% had spontaneous resolution↗
▶Ep 17 · 11:26
quoteThe more rigid teaching, at least for me in Chile, has been that if you don't feel the hernia for yourself, you do not operate on that child, you know.↗
▶Ep 17 · 11:35
clinicalThere was no diagnostic uncertainty in the one-stop surgery program↗
▶Ep 17 · 12:26
clinicalA surgery journal article found that routine follow-up for pediatric surgical conditions like circumcision, orchiopexy, and inguinal hernia altered management less than 1% of the time↗
▶Ep 17 · 13:28
opinionWhen facing medical problems with low risk of complications, family satisfaction becomes a surrogate for quality↗
▶Ep 17 · 13:28
quoteWhen you were facing medical problems with a low risk of complications, then family satisfaction becomes a surrogate for quality.↗
Update Course 2022 - TOP PUBLICATIONS IN NON- PED SURG JOURNALS - Jose Campos
▶Ep 60 · 1:38
epidemiologicalThe Chilean Society of Pediatric Surgery screens 1,200 articles each month, with only 3% relevant to pediatric surgery↗
▶Ep 60 · 2:30
quoteWe screen 1,200 articles each month and we want to get the best to you↗
▶Ep 60 · 4:00
clinicalA multi-institutional prospective randomized trial compared piperacillin-tazobactam to ceftriaxone plus metronidazole for perforated appendicitis↗
▶Ep 60 · 5:00
clinicalAt 75% enrollment, interim analysis favored piperacillin-tazobactam and the study was stopped↗
▶Ep 60 · 5:20
clinicalIntra-abdominal abscess formation was significantly lower in the piperacillin-tazobactam group with an odds ratio of 4.8↗
▶Ep 60 · 5:50
clinicalThe number needed to treat with piperacillin-tazobactam to prevent one intra-abdominal abscess was 5.7↗
▶Ep 60 · 10:50
clinicalA 20-center randomized controlled trial compared initial laparotomy versus peritoneal drainage for NEC, enrolling 310 premature newborns↗
▶Ep 60 · 11:20
clinicalAt 18 to 22 months corrected age, the composite of death and neurodevelopmental impairment was similar in both groups in frequentist analysis↗
▶Ep 60 · 11:30
quoteThis huge and challenging study brings the best quality evidence to a long-standing question↗
▶Ep 60 · 11:40
clinicalBayesian analysis showed a high probability of laparotomy being superior to peritoneal drainage↗
▶Ep 60 · 18:20
clinicalA systematic review examined 900 publications on gastrostomy insertion, with 58 used for final recommendations↗
▶Ep 60 · 18:50
clinicalTwelve studies directly compared outcomes between laparoscopic and percutaneous endoscopic gastrostomy↗
▶Ep 60 · 19:10
clinicalMajor complication rates were significantly less common with laparoscopic gastrostomy placement↗
▶Ep 60 · 19:30
clinicalThe number needed to treat to prevent one major complication from PEG is 24↗
▶Ep 60 · 25:49
clinicalA database comparison of 3,000 patients found no survival difference between total thyroidectomy and thyroid lobectomy for differentiated papillary thyroid cancer↗
epidemiologicalChile has the highest rate of cholelithiasis globally↗
▶Ep 18 · 1:07
quoteChile is the country with the highest rate of cholelithiasis, so this is something we we can actually say something.↗
▶Ep 18 · 1:53
clinicalHistorical threshold for 'cool-off period' before cholecystectomy was 7-10 days in general surgery, later reduced to 2-3 days in pediatric surgery↗
▶Ep 18 · 4:00
quoteNot even the reliable patient, we should send them home without their gallbladder removed.↗
▶Ep 18 · 7:11
quoteThe negative predictive value of this algorithm is 98%. That means that you're gonna be in that nasty situation, uh, if, uh, only 2% of the time if you trust this algorithm.↗
▶Ep 18 · 7:11
clinicalThe predictive algorithm has a 98% negative predictive value for common bile duct stones↗
▶Ep 18 · 7:22
clinicalUsing the algorithm, risk of encountering unexpected CBD stone intraoperatively is only 2%↗
▶Ep 18 · 7:22
quoteSo that's why I think this is the one to use, and I don't think we can get more precise than this algorithm in terms of predicting CBDs tolls pre preoperatively.↗
▶Ep 18 · 11:56
clinicalThe multi-center laparoscopic CBD exploration study included 4 centers with a broad range of surgeon expertise, demonstrating feasibility beyond single expert centers↗
▶Ep 18 · 11:56
quoteI, I really love this study because you said it requires a lot of skills, but this is not just a single center, one expert surgeon showing off what they can do. This is 4 centers, so the range of surgeons that are doing this, it's, it's. Quite broad, so this article is trying to say it's feasible.↗
▶Ep 18 · 12:15
clinical14% of patients who underwent laparoscopic CBD exploration required subsequent ERCP without increased complications such as bile duct leak↗
▶Ep 18 · 12:30
clinicalIn stepwise laparoscopic CBD exploration approach, 84% of CBD stones cleared with simple saline flush through ureteral catheter↗
▶Ep 18 · 14:21
quoteI, I don't like this study a lot to call it the new standard practice. I think with you too much.↗
▶Ep 18 · 14:25
opinionICG study compared different time periods (2013-2023) rather than concurrent randomized groups, introducing confounding from improved surgical technique and instrumentation over time↗
▶Ep 18 · 14:43
opinionICG study grouped all complications together without separately reporting common bile duct injuries, and bleeding complications are unlikely attributable to presence/absence of ICG↗
▶Ep 18 · 14:57
opinionZero complications in ICG group raises methodological concerns about reporting accuracy↗
▶Ep 18 · 15:38
quoteThey're not comparing ICG compared to intraparative cholalangiogram. They're comparing ICG versus nothing versus just simple visualization. So of course, of course your endpoint is going to be, of course you see more if you use a technique to visualize more structures.↗
▶Ep 18 · 15:38
opinionICG study compared ICG to simple visualization without intraoperative cholangiogram, not ICG vs. intraoperative cholangiogram↗
Case-Based Journal Review- Intussusception in 2022
▶Ep 14 · 1:34
quoteI would only accept radiology because you have to do an intervention after that. So if it's positive, you have to do an intervention, whether it is enema reduction or surgery. And at least I'm not trained in point-of-care ultrasound and neither are the emergency doctors I work with.↗
▶Ep 14 · 3:14
quoteTo me, this article changed a lot because sometimes we do unnecessary laparotamins in the middle of the night just to just to make a diagnosis because we don't have a radiologist at night at our institution and we don't have any formal training in point of care ultrasound.↗
clinicalSedation during pneumatic reduction has slightly better success rate than no sedation, but the difference is approximately 7%↗
▶Ep 14 · 10:12
clinicalRecurrence rate was 5.1% with sedation versus 1.3% without sedation, not statistically significant but concerning↗
▶Ep 14 · 10:12
clinicalBowel perforation occurred in 3 patients in the sedation group and none in the non-sedation group, but this was not statistically significant↗
▶Ep 14 · 14:45
quoteI share that same feeling. I feel like I lie when I'm saying the number I have in my mind, but actually my number is 10%. That's the number I tell residents, not the number I tell families, 10%.↗
▶Ep 14 · 16:59
quoteIncreasing our recurrence or failure tolerance, it benefits the vast majority of children with lower chances of getting a complication.↗
▶Ep 14 · 16:59
opinionClinicians should increase tolerance for recurrence risk if it benefits the majority of children by avoiding unnecessary admission↗
Case Based Journal Review - CPAM in 2022
▶Ep 15 · 1:51
quoteI was always told that. This should be operated because the risk of them becoming symptomatic was pretty high.↗
▶Ep 15 · 3:37
clinicalSystematic reviews report symptomatic rates of 3.2% in one review and 25% in another↗
▶Ep 15 · 3:37
clinicalRetrospective studies show a huge range of 3% to 85% for risk of becoming symptomatic↗
▶Ep 15 · 3:37
quoteI know you get a huge range from 3 to 85% on retrospective studies, but all of their biased, but when you get to a systematic review of mess, actually one of them comes to the number 3.2% and the other one comes to the number 25%.↗
▶Ep 15 · 5:24
quoteTo me, my opinion is that prenatally diagnosed asymptomatic, I would find it very difficult for them to give them an operation, very difficult, and postnatally diagnosed, I would find it very difficult not to do an operation.↗
▶Ep 15 · 5:49
epidemiologicalThe International Pleuropulmonary Blastoma Registry has 350 cases reported worldwide and found only 9 cases of prenatally diagnosed lesions that turned out to be pleuropulmonary blastoma↗
▶Ep 15 · 5:49
quoteThe International Pulmonary blastoma Registry has 350 cases reported worldwide. They, they have the most, the, the largest collection of cases worldwide, and they've only found 9 cases of uh prenatally diagnosed lesions that actually turned out to be pleuropulmonary blastoma.↗
▶Ep 15 · 8:17
clinicalAfter infection, there is a higher rate of conversion from thoracoscopic to open surgery↗
▶Ep 15 · 8:25
opinionThe number of patients who will have an infection is so low that the benefit of lesser conversion rate does not justify preemptive surgery↗
▶Ep 15 · 10:28
clinicalThe 1 to 3 month group had a 40% thoracotomy rate↗
▶Ep 15 · 11:06
quoteI, I see your point, but actually if you're doing an, an elective preventive resection of something. Uh, it, it should be easy. It should be easy. It should have nearly zero complications like prophylactic operations should be close to zero complications.↗
▶Ep 15 · 11:13
opinionProphylactic operations should have nearly zero complications↗
Case Based Journal Review: Esophageal Atresia in 2022
▶Ep 17 · 3:25
clinicalThe azygous vein drains the bronchi, trachea, and esophagus↗
▶Ep 17 · 3:30
clinicalDividing the azygous vein may lead to impaired clearance of mucus and debris from the tracheobronchial tree postoperatively↗
▶Ep 17 · 4:54
clinicalThe endpoint of chest infection was not clearly defined across studies in the azygous vein meta-analysis, with some using pneumonitis, some pneumonia, and some just chest infection↗
▶Ep 17 · 7:31
quoteI think this article is well done. They actually adjusted for gestational earthquake leak the. Length of the gap, the tension, everything. After adjusting for everything else, they still got almost 3 more stricture rates.↗
▶Ep 17 · 8:19
quoteI think we should get rid of it, and it's going to take a while for people to be brave and change their practice, but I think this one's a no-brainer for me.↗
▶Ep 17 · 9:44
epidemiologicalCongenital esophageal stenosis is associated with esophageal atresia in 7% to 10% of cases↗
▶Ep 17 · 9:54
clinicalMost cases of congenital esophageal stenosis are diagnosed really late, some after the anastomosis fails↗
▶Ep 17 · 9:58
clinicalPassing a tube through the anastomosis and checking for resistance can detect distal esophageal stenosis intraoperatively↗
▶Ep 17 · 13:14
clinicalIf you place a prophylactic chest drain, the chances of needing another one later are the same as if you didn't place one initially↗
▶Ep 17 · 14:24
clinicalGiving PPIs to neonates can increase pneumonia in different populations, but the risk is very minimal↗
▶Ep 17 · 16:25
quoteI think it's difficult as a trainee or as a young surgeon to challenge the very same people who has taught you to do something. But with this new evidence, I feel that we can find common ground.↗
Case-Based Journal Review: Inguinal Hernia 2025
▶Ep 28 · 1:43
clinicalThe younger the baby, the higher the risk of incarceration↗
▶Ep 28 · 3:49
quoteI read this article very carefully and I said, look, I could actually change my practice and actually sending the baby home. I could reduce the hospital stay and, more importantly, reduce the chance of them having a serious adverse effect by 10%. I thought to myself that there was really significant.↗
▶Ep 28 · 4:27
clinicalIn the early group 4% had spontaneous resolution, in the late group 11% had spontaneous resolution↗
▶Ep 28 · 11:26
quoteThe more rigid teaching, at least for me in Chile, has been that if you don't feel the hernia for yourself, you do not operate on that child, you know.↗
▶Ep 28 · 11:35
clinicalThere was no diagnostic uncertainty in the one-stop surgery program↗
▶Ep 28 · 12:26
clinicalA surgery journal article found that routine follow-up for pediatric surgical conditions like circumcision, orchiopexy, and inguinal hernia altered management less than 1% of the time↗
▶Ep 28 · 13:28
quoteWhen you were facing medical problems with a low risk of complications, then family satisfaction becomes a surrogate for quality.↗
▶Ep 28 · 13:28
opinionWhen facing medical problems with low risk of complications, family satisfaction becomes a surrogate for quality↗