Whit Holcomb

255 timestamped statements across 8 collections — auto-found in recorded discussions, each timestamp jumps to the exact moment.

Abdominal Wall Defects · guest expert Aerodigestive / ENT · guest expert Biliary Atresia · guest expert Colorectal / ARM & Hirschsprung · guest expert Etiologies (Gastroschisis/NEC/Atresia/Volvulus) · guest expert Intestinal Failure · guest expert Intestinal Rehab · guest expert Intestinal Transplant · guest expert

Featured diaries

▶ Ep 36 · 14:22
This one sentence says it all. There was little evidence from patients that transfer happened in a timely or coordinated manner. And patients felt that the clinicians did not always understand the significance of transfer to an adult service. No models of transfer of care were identified.
quote · Abdominal Wall Defects
▶ Ep 23 · 14:22
This one sentence says it all. There was little evidence from patients that transfer happened in a timely or coordinated manner. And patients felt that the clinicians did not always understand the significance of transfer to an adult service. No models of transfer of care were identified.
quote · Biliary Atresia
▶ Ep 164 · 14:22
This one sentence says it all. There was little evidence from patients that transfer happened in a timely or coordinated manner. And patients felt that the clinicians did not always understand the significance of transfer to an adult service. No models of transfer of care were identified.
quote · Colorectal / ARM & Hirschsprung
▶ Ep 56 · 14:22
This one sentence says it all. There was little evidence from patients that transfer happened in a timely or coordinated manner. And patients felt that the clinicians did not always understand the significance of transfer to an adult service. No models of transfer of care were identified.
quote · Etiologies (Gastroschisis/NEC/Atresia/Volvulus)
▶ Ep 85 · 14:22
This one sentence says it all. There was little evidence from patients that transfer happened in a timely or coordinated manner. And patients felt that the clinicians did not always understand the significance of transfer to an adult service. No models of transfer of care were identified.
quote · Intestinal Rehab
▶ Ep 36 · 15:21
We need to do a better job. Of structuring this transition, we're doing better with handoffs in the hospital with patient care. We need to do a better job with handing off the care for any pediatric patient who needs a transitioning to adult providers.
quote · Abdominal Wall Defects

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Abdominal Wall Defects 10 entries

Journal of Pediatric Surgery Article Review: 2nd Quarter (Apr-Jun) 2024

▶ Ep 36 · 12:46
epidemiological The transition systematic review found 8 studies that included patient and parent responses and clinician perspectives ↗
▶ Ep 36 · 14:22
quote This one sentence says it all. There was little evidence from patients that transfer happened in a timely or coordinated manner. And patients felt that the clinicians did not always understand the significance of transfer to an adult service. No models of transfer of care were identified. ↗
▶ Ep 36 · 14:22
clinical There was little evidence that transfer of colorectal patients happened in a timely or coordinated manner ↗
▶ Ep 36 · 14:31
opinion Patients felt clinicians did not always understand the significance of transfer to an adult service ↗
▶ Ep 36 · 14:38
clinical No models of transfer of care for colorectal conditions were identified ↗
▶ Ep 36 · 15:21
quote We need to do a better job. Of structuring this transition, we're doing better with handoffs in the hospital with patient care. We need to do a better job with handing off the care for any pediatric patient who needs a transitioning to adult providers. ↗

Journal of Pediatric Surgery Article Review: 3rd Quarter (Jul-Sep) 2024

▶ Ep 37 · 14:30
quote We didn't really have a classification system that was unique to pediatric surgery, so that's why we have used the Clavian dindo classification, although that was validated in the adult world. ↗
▶ Ep 37 · 15:19
quote This is the first attempt at creating a classification system for pediatric surgery. So that's why I thought this was an important article. ↗
▶ Ep 37 · 16:39
clinical The Clavien-Madadi classification showed improved agreement rates of respondents at 85% versus 76% for the Clavien-Dindo classification ↗
▶ Ep 37 · 16:53
clinical The Clavien-Madadi classification was less frequently considered inaccurate for rating in the pediatric population compared to the Clavien-Dindo classification ↗
Aerodigestive / ENT 20 entries

Pediatric Gastroesophageal Reflux Disease

▶ Ep 1 · 14:36
quote I don't think that the surgeon, especially myself, is the best person to be evaluating all these other conditions that may be in play. ↗
▶ Ep 1 · 22:32
quote An upper GI is really not a good study for reflux. ↗
▶ Ep 1 · 22:32
clinical An upper GI is not a good study for reflux; it's useful for identifying anatomical problems which occur in about 4% of patients ↗
▶ Ep 1 · 36:08
quote I would like to thank Rachel for not sending that child who's wretching preoperatively to the surgeons. ↗
▶ Ep 1 · 51:25
epidemiological Neurologically impaired children in the United States tend to have less severe impairment than those seen internationally because they enter healthcare earlier ↗
▶ Ep 1 · 57:00
clinical The primary reason for redo fundoplication is transmigration of the wrap into the chest ↗
▶ Ep 1 · 57:23
clinical Minimal mobilization technique for fundoplication reduced transmigration rate from 12% to 5%, and in recent prospective trial to zero ↗
▶ Ep 1 · 59:22
quote We need to do less rather than more dissection around the GE junction. ↗
▶ Ep 1 · 59:22
clinical Surgeons need to do less rather than more dissection around the GE junction to prevent fundoplication failure ↗
▶ Ep 1 · 1:00:49
clinical The fundoplication wrap must be done cephalad to the left gastric artery to ensure it's over the lower esophagus, not the stomach ↗
▶ Ep 1 · 1:03:40
clinical Using an esophageal bougie at the time of fundoplication prevents postoperative dysphagia and need for dilation ↗

Gastroesophageal Reflux Disease

▶ Ep 8 · 22:38
clinical An upper GI is not a good study for reflux diagnosis; it only helps identify anatomical problems in about 4% of patients ↗
▶ Ep 8 · 36:08
quote I would like to thank Rachel for not sending that child who's wretching preoperatively to the surgeons. ↗
▶ Ep 8 · 46:40
clinical In a prospective randomized trial of 107 patients using minimal mobilization technique, neither group required a redo fundoplication for transmigration ↗
▶ Ep 8 · 47:08
epidemiological The primary reason for redo fundoplication historically was transmigration of the wrap into the chest ↗
▶ Ep 8 · 47:09
quote We spent 15 years or so trying to investigate this issue surgically and we feel like we've come up with, you know, what we call, you know, jokingly the perfect Nissan. ↗
▶ Ep 8 · 57:32
clinical By doing minimal mobilization and placing sutures between esophagus and crura, transmigration rate was reduced from 12% to 5% ↗
▶ Ep 8 · 58:23
clinical With minimal mobilization alone (no sutures), there was zero transmigration in prospective trial, with only one wrap loosening ↗
▶ Ep 8 · 59:22
quote The surgical message that we should impart is that we need to do less rather than more dissection around the GE junction. ↗
▶ Ep 8 · 1:03:46
clinical Using esophageal bougie at time of fundoplication has resulted in very little need for postoperative dilation ↗
Biliary Atresia 44 entries

Biliary Atresia, Appendicitis, Intestinal Failure, and Anesthetic...

▶ Ep 6 · 12:02
clinical Washington State registry study included over 50 hospitals and analyzed clean-contaminated operations over 18 months beginning January 2011 ↗
▶ Ep 6 · 13:05
epidemiological Overall surgical site infection rate was 4.6%, varying by procedure: 6.6% colorectal, 1.4% bariatric, 1.5% other ↗
▶ Ep 6 · 13:39
clinical No single antiseptic agent was associated with lower risk of surgical site infection than any other agent ↗
▶ Ep 6 · 13:49
clinical Isopropyl alcohol provided no benefit: 4.5% SSI rate without alcohol versus 4.6% with alcohol ↗
▶ Ep 6 · 14:20
clinical Registry data could not identify surgical site infections diagnosed after discharge, likely underestimating true SSI rate ↗
▶ Ep 6 · 14:40
epidemiological Recent reports show 50% or more surgical site infections are diagnosed after discharge ↗
▶ Ep 6 · 14:48
clinical Most surgical site infections occur 3 to 10 days after operation ↗
▶ Ep 6 · 17:19
quote We continue to use the chlorhexidine or chloroprep just as you are and have found that we've not noticed either an increase or even a decrease in SSI ↗
▶ Ep 6 · 18:33
clinical Chlorhexidine prep dries faster than betadine, allowing cases to start sooner ↗
▶ Ep 6 · 18:40
quote If you're doing 6 or 7 cases a day, every minute seems to help get the cases moving along ↗
▶ Ep 6 · 22:58
clinical Appendicitis pilot RCT enrolled 50 patients aged 5-15 years with non-perforated appendicitis: 26 randomized to operation, 24 to antibiotics ↗
▶ Ep 6 · 23:14
clinical Of 24 patients randomized to non-operative treatment, 2 underwent appendectomy during primary treatment course and 1 had appendectomy at 9 months for recurrent appendicitis ↗
▶ Ep 6 · 23:32
clinical An additional 6 patients in the non-operative group underwent appendectomy for recurrent abdominal pain or parental desire during 1-year follow-up, with no appendicitis found on histology ↗
▶ Ep 6 · 24:10
clinical Total of 9 of 24 patients (38%) initially randomized to antibiotic therapy underwent appendectomy within first year, making success rate 62% ↗
▶ Ep 6 · 24:35
clinical Median time to discharge was significantly shorter in surgical group than non-operative group, possibly due to stipulated 48-hour minimum hospitalization for non-operative patients ↗
▶ Ep 6 · 24:55
clinical Cost for initial inpatient stay was significantly lower in non-operative treatment group despite longer hospitalizations ↗
▶ Ep 6 · 27:00
clinical Immunosuppressed cancer patients with typhlitis are sometimes treated non-operatively and most resolve with antibiotics ↗
▶ Ep 6 · 28:07
quote Most patients in such a trial will only be 15 to 20 years of age with a 10 year follow up, and so they're going to live for another 40 or 50 years ↗
▶ Ep 6 · 30:00
quote An important aspect of any study will be getting the parents' perspective on treatment, whether it's operative or non-operative ↗

Biliary Atresia, Appendicitis, Intestinal Failure, and Anesthetic...

▶ Ep 10 · 12:02
clinical Washington State registry study included over 50 hospitals and analyzed clean-contaminated operations over 18 months beginning January 2011 ↗
▶ Ep 10 · 13:05
epidemiological Overall surgical site infection rate was 4.6%, varying by procedure: 6.6% colorectal, 1.4% bariatric, 1.5% other ↗
▶ Ep 10 · 13:39
clinical No single antiseptic agent was associated with lower risk of surgical site infection than any other agent ↗
▶ Ep 10 · 13:49
clinical Isopropyl alcohol provided no benefit: 4.5% SSI rate without alcohol versus 4.6% with alcohol ↗
▶ Ep 10 · 14:20
clinical Registry data could not identify surgical site infections diagnosed after discharge, likely underestimating true SSI rate ↗
▶ Ep 10 · 14:40
epidemiological Recent reports show 50% or more surgical site infections are diagnosed after discharge ↗
▶ Ep 10 · 14:48
clinical Most surgical site infections occur 3 to 10 days after operation ↗
▶ Ep 10 · 17:19
quote We continue to use the chlorhexidine or chloroprep just as you are and have found that we've not noticed either an increase or even a decrease in SSI ↗
▶ Ep 10 · 18:33
clinical Chlorhexidine prep dries faster than betadine, allowing cases to start sooner ↗
▶ Ep 10 · 18:40
quote If you're doing 6 or 7 cases a day, every minute seems to help get the cases moving along ↗
▶ Ep 10 · 22:58
clinical Appendicitis pilot RCT enrolled 50 patients aged 5-15 years with non-perforated appendicitis: 26 randomized to operation, 24 to antibiotics ↗
▶ Ep 10 · 23:14
clinical Of 24 patients randomized to non-operative treatment, 2 underwent appendectomy during primary treatment course and 1 had appendectomy at 9 months for recurrent appendicitis ↗
▶ Ep 10 · 23:32
clinical An additional 6 patients in the non-operative group underwent appendectomy for recurrent abdominal pain or parental desire during 1-year follow-up, with no appendicitis found on histology ↗
▶ Ep 10 · 24:10
clinical Total of 9 of 24 patients (38%) initially randomized to antibiotic therapy underwent appendectomy within first year, making success rate 62% ↗
▶ Ep 10 · 24:35
clinical Median time to discharge was significantly shorter in surgical group than non-operative group, possibly due to stipulated 48-hour minimum hospitalization for non-operative patients ↗
▶ Ep 10 · 24:55
clinical Cost for initial inpatient stay was significantly lower in non-operative treatment group despite longer hospitalizations ↗
▶ Ep 10 · 27:00
clinical Immunosuppressed cancer patients with typhlitis are sometimes treated non-operatively and most resolve with antibiotics ↗
▶ Ep 10 · 28:07
quote Most patients in such a trial will only be 15 to 20 years of age with a 10 year follow up, and so they're going to live for another 40 or 50 years ↗
▶ Ep 10 · 30:00
quote An important aspect of any study will be getting the parents' perspective on treatment, whether it's operative or non-operative ↗

Journal of Pediatric Surgery Article Review: 2nd Quarter (Apr-Jun) 2024

▶ Ep 23 · 12:46
epidemiological The transition systematic review found 8 studies that included patient and parent responses and clinician perspectives ↗
▶ Ep 23 · 14:22
clinical There was little evidence that transfer of colorectal patients happened in a timely or coordinated manner ↗
▶ Ep 23 · 14:22
quote This one sentence says it all. There was little evidence from patients that transfer happened in a timely or coordinated manner. And patients felt that the clinicians did not always understand the significance of transfer to an adult service. No models of transfer of care were identified. ↗
▶ Ep 23 · 14:31
opinion Patients felt clinicians did not always understand the significance of transfer to an adult service ↗
▶ Ep 23 · 14:38
clinical No models of transfer of care for colorectal conditions were identified ↗
▶ Ep 23 · 15:21
quote We need to do a better job. Of structuring this transition, we're doing better with handoffs in the hospital with patient care. We need to do a better job with handing off the care for any pediatric patient who needs a transitioning to adult providers. ↗
Colorectal / ARM & Hirschsprung 29 entries

Biliary Atresia, Appendicitis, Intestinal Failure, and Anesthetic...

▶ Ep 76 · 12:02
clinical Washington State registry study included over 50 hospitals and analyzed clean-contaminated operations over 18 months beginning January 2011 ↗
▶ Ep 76 · 13:05
epidemiological Overall surgical site infection rate was 4.6%, varying by procedure: 6.6% colorectal, 1.4% bariatric, 1.5% other ↗
▶ Ep 76 · 13:39
clinical No single antiseptic agent was associated with lower risk of surgical site infection than any other agent ↗
▶ Ep 76 · 13:49
clinical Isopropyl alcohol provided no benefit: 4.5% SSI rate without alcohol versus 4.6% with alcohol ↗
▶ Ep 76 · 14:20
clinical Registry data could not identify surgical site infections diagnosed after discharge, likely underestimating true SSI rate ↗
▶ Ep 76 · 14:40
epidemiological Recent reports show 50% or more surgical site infections are diagnosed after discharge ↗
▶ Ep 76 · 14:48
clinical Most surgical site infections occur 3 to 10 days after operation ↗
▶ Ep 76 · 17:19
quote We continue to use the chlorhexidine or chloroprep just as you are and have found that we've not noticed either an increase or even a decrease in SSI ↗
▶ Ep 76 · 18:33
clinical Chlorhexidine prep dries faster than betadine, allowing cases to start sooner ↗
▶ Ep 76 · 18:40
quote If you're doing 6 or 7 cases a day, every minute seems to help get the cases moving along ↗
▶ Ep 76 · 22:58
clinical Appendicitis pilot RCT enrolled 50 patients aged 5-15 years with non-perforated appendicitis: 26 randomized to operation, 24 to antibiotics ↗
▶ Ep 76 · 23:14
clinical Of 24 patients randomized to non-operative treatment, 2 underwent appendectomy during primary treatment course and 1 had appendectomy at 9 months for recurrent appendicitis ↗
▶ Ep 76 · 23:32
clinical An additional 6 patients in the non-operative group underwent appendectomy for recurrent abdominal pain or parental desire during 1-year follow-up, with no appendicitis found on histology ↗
▶ Ep 76 · 24:10
clinical Total of 9 of 24 patients (38%) initially randomized to antibiotic therapy underwent appendectomy within first year, making success rate 62% ↗
▶ Ep 76 · 24:35
clinical Median time to discharge was significantly shorter in surgical group than non-operative group, possibly due to stipulated 48-hour minimum hospitalization for non-operative patients ↗
▶ Ep 76 · 24:55
clinical Cost for initial inpatient stay was significantly lower in non-operative treatment group despite longer hospitalizations ↗
▶ Ep 76 · 27:00
clinical Immunosuppressed cancer patients with typhlitis are sometimes treated non-operatively and most resolve with antibiotics ↗
▶ Ep 76 · 28:07
quote Most patients in such a trial will only be 15 to 20 years of age with a 10 year follow up, and so they're going to live for another 40 or 50 years ↗
▶ Ep 76 · 30:00
quote An important aspect of any study will be getting the parents' perspective on treatment, whether it's operative or non-operative ↗

Journal of Pediatric Surgery Article Review: 2nd Quarter (Apr-Jun) 2024

▶ Ep 164 · 12:46
epidemiological The transition systematic review found 8 studies that included patient and parent responses and clinician perspectives ↗
▶ Ep 164 · 14:22
quote This one sentence says it all. There was little evidence from patients that transfer happened in a timely or coordinated manner. And patients felt that the clinicians did not always understand the significance of transfer to an adult service. No models of transfer of care were identified. ↗
▶ Ep 164 · 14:22
clinical There was little evidence that transfer of colorectal patients happened in a timely or coordinated manner ↗
▶ Ep 164 · 14:31
opinion Patients felt clinicians did not always understand the significance of transfer to an adult service ↗
▶ Ep 164 · 14:38
clinical No models of transfer of care for colorectal conditions were identified ↗
▶ Ep 164 · 15:21
quote We need to do a better job. Of structuring this transition, we're doing better with handoffs in the hospital with patient care. We need to do a better job with handing off the care for any pediatric patient who needs a transitioning to adult providers. ↗

Journal of Pediatric Surgery Article Review: 3rd Quarter (Jul-Sep) 2024

▶ Ep 167 · 14:30
quote We didn't really have a classification system that was unique to pediatric surgery, so that's why we have used the Clavian dindo classification, although that was validated in the adult world. ↗
▶ Ep 167 · 15:19
quote This is the first attempt at creating a classification system for pediatric surgery. So that's why I thought this was an important article. ↗
▶ Ep 167 · 16:39
clinical The Clavien-Madadi classification showed improved agreement rates of respondents at 85% versus 76% for the Clavien-Dindo classification ↗
▶ Ep 167 · 16:53
clinical The Clavien-Madadi classification was less frequently considered inaccurate for rating in the pediatric population compared to the Clavien-Dindo classification ↗
Etiologies (Gastroschisis/NEC/Atresia/Volvulus) 38 entries

Gastroesophageal Reflux Disease

▶ Ep 24 · 22:38
clinical An upper GI is not a good study for reflux diagnosis; it only helps identify anatomical problems in about 4% of patients ↗
▶ Ep 24 · 36:08
quote I would like to thank Rachel for not sending that child who's wretching preoperatively to the surgeons. ↗
▶ Ep 24 · 46:40
clinical In a prospective randomized trial of 107 patients using minimal mobilization technique, neither group required a redo fundoplication for transmigration ↗
▶ Ep 24 · 47:08
epidemiological The primary reason for redo fundoplication historically was transmigration of the wrap into the chest ↗
▶ Ep 24 · 47:09
quote We spent 15 years or so trying to investigate this issue surgically and we feel like we've come up with, you know, what we call, you know, jokingly the perfect Nissan. ↗
▶ Ep 24 · 57:32
clinical By doing minimal mobilization and placing sutures between esophagus and crura, transmigration rate was reduced from 12% to 5% ↗
▶ Ep 24 · 58:23
clinical With minimal mobilization alone (no sutures), there was zero transmigration in prospective trial, with only one wrap loosening ↗
▶ Ep 24 · 59:22
quote The surgical message that we should impart is that we need to do less rather than more dissection around the GE junction. ↗
▶ Ep 24 · 1:03:46
clinical Using esophageal bougie at time of fundoplication has resulted in very little need for postoperative dilation ↗

Biliary Atresia, Appendicitis, Intestinal Failure, and Anesthetic...

▶ Ep 26 · 12:02
clinical Washington State registry study included over 50 hospitals and analyzed clean-contaminated operations over 18 months beginning January 2011 ↗
▶ Ep 26 · 13:05
epidemiological Overall surgical site infection rate was 4.6%, varying by procedure: 6.6% colorectal, 1.4% bariatric, 1.5% other ↗
▶ Ep 26 · 13:39
clinical No single antiseptic agent was associated with lower risk of surgical site infection than any other agent ↗
▶ Ep 26 · 13:49
clinical Isopropyl alcohol provided no benefit: 4.5% SSI rate without alcohol versus 4.6% with alcohol ↗
▶ Ep 26 · 14:20
clinical Registry data could not identify surgical site infections diagnosed after discharge, likely underestimating true SSI rate ↗
▶ Ep 26 · 14:40
epidemiological Recent reports show 50% or more surgical site infections are diagnosed after discharge ↗
▶ Ep 26 · 14:48
clinical Most surgical site infections occur 3 to 10 days after operation ↗
▶ Ep 26 · 17:19
quote We continue to use the chlorhexidine or chloroprep just as you are and have found that we've not noticed either an increase or even a decrease in SSI ↗
▶ Ep 26 · 18:33
clinical Chlorhexidine prep dries faster than betadine, allowing cases to start sooner ↗
▶ Ep 26 · 18:40
quote If you're doing 6 or 7 cases a day, every minute seems to help get the cases moving along ↗
▶ Ep 26 · 22:58
clinical Appendicitis pilot RCT enrolled 50 patients aged 5-15 years with non-perforated appendicitis: 26 randomized to operation, 24 to antibiotics ↗
▶ Ep 26 · 23:14
clinical Of 24 patients randomized to non-operative treatment, 2 underwent appendectomy during primary treatment course and 1 had appendectomy at 9 months for recurrent appendicitis ↗
▶ Ep 26 · 23:32
clinical An additional 6 patients in the non-operative group underwent appendectomy for recurrent abdominal pain or parental desire during 1-year follow-up, with no appendicitis found on histology ↗
▶ Ep 26 · 24:10
clinical Total of 9 of 24 patients (38%) initially randomized to antibiotic therapy underwent appendectomy within first year, making success rate 62% ↗
▶ Ep 26 · 24:35
clinical Median time to discharge was significantly shorter in surgical group than non-operative group, possibly due to stipulated 48-hour minimum hospitalization for non-operative patients ↗
▶ Ep 26 · 24:55
clinical Cost for initial inpatient stay was significantly lower in non-operative treatment group despite longer hospitalizations ↗
▶ Ep 26 · 27:00
clinical Immunosuppressed cancer patients with typhlitis are sometimes treated non-operatively and most resolve with antibiotics ↗
▶ Ep 26 · 28:07
quote Most patients in such a trial will only be 15 to 20 years of age with a 10 year follow up, and so they're going to live for another 40 or 50 years ↗
▶ Ep 26 · 30:00
quote An important aspect of any study will be getting the parents' perspective on treatment, whether it's operative or non-operative ↗

Journal of Pediatric Surgery Article Review: 2nd Quarter (Apr-Jun) 2024

▶ Ep 56 · 12:46
epidemiological The transition systematic review found 8 studies that included patient and parent responses and clinician perspectives ↗
▶ Ep 56 · 14:22
quote This one sentence says it all. There was little evidence from patients that transfer happened in a timely or coordinated manner. And patients felt that the clinicians did not always understand the significance of transfer to an adult service. No models of transfer of care were identified. ↗
▶ Ep 56 · 14:22
clinical There was little evidence that transfer of colorectal patients happened in a timely or coordinated manner ↗
▶ Ep 56 · 14:31
opinion Patients felt clinicians did not always understand the significance of transfer to an adult service ↗
▶ Ep 56 · 14:38
clinical No models of transfer of care for colorectal conditions were identified ↗
▶ Ep 56 · 15:21
quote We need to do a better job. Of structuring this transition, we're doing better with handoffs in the hospital with patient care. We need to do a better job with handing off the care for any pediatric patient who needs a transitioning to adult providers. ↗

Journal of Pediatric Surgery Article Review: 3rd Quarter (Jul-Sep) 2024

▶ Ep 57 · 14:30
quote We didn't really have a classification system that was unique to pediatric surgery, so that's why we have used the Clavian dindo classification, although that was validated in the adult world. ↗
▶ Ep 57 · 15:19
quote This is the first attempt at creating a classification system for pediatric surgery. So that's why I thought this was an important article. ↗
▶ Ep 57 · 16:39
clinical The Clavien-Madadi classification showed improved agreement rates of respondents at 85% versus 76% for the Clavien-Dindo classification ↗
▶ Ep 57 · 16:53
clinical The Clavien-Madadi classification was less frequently considered inaccurate for rating in the pediatric population compared to the Clavien-Dindo classification ↗
Intestinal Failure 38 entries

Biliary Atresia, Appendicitis, Intestinal Failure, and Anesthetic...

▶ Ep 3 · 12:02
clinical Washington State registry study included over 50 hospitals and analyzed clean-contaminated operations over 18 months beginning January 2011 ↗
▶ Ep 3 · 13:05
epidemiological Overall surgical site infection rate was 4.6%, varying by procedure: 6.6% colorectal, 1.4% bariatric, 1.5% other ↗
▶ Ep 3 · 13:39
clinical No single antiseptic agent was associated with lower risk of surgical site infection than any other agent ↗
▶ Ep 3 · 13:49
clinical Isopropyl alcohol provided no benefit: 4.5% SSI rate without alcohol versus 4.6% with alcohol ↗
▶ Ep 3 · 14:20
clinical Registry data could not identify surgical site infections diagnosed after discharge, likely underestimating true SSI rate ↗
▶ Ep 3 · 14:40
epidemiological Recent reports show 50% or more surgical site infections are diagnosed after discharge ↗
▶ Ep 3 · 14:48
clinical Most surgical site infections occur 3 to 10 days after operation ↗
▶ Ep 3 · 17:19
quote We continue to use the chlorhexidine or chloroprep just as you are and have found that we've not noticed either an increase or even a decrease in SSI ↗
▶ Ep 3 · 18:33
clinical Chlorhexidine prep dries faster than betadine, allowing cases to start sooner ↗
▶ Ep 3 · 18:40
quote If you're doing 6 or 7 cases a day, every minute seems to help get the cases moving along ↗
▶ Ep 3 · 22:58
clinical Appendicitis pilot RCT enrolled 50 patients aged 5-15 years with non-perforated appendicitis: 26 randomized to operation, 24 to antibiotics ↗
▶ Ep 3 · 23:14
clinical Of 24 patients randomized to non-operative treatment, 2 underwent appendectomy during primary treatment course and 1 had appendectomy at 9 months for recurrent appendicitis ↗
▶ Ep 3 · 23:32
clinical An additional 6 patients in the non-operative group underwent appendectomy for recurrent abdominal pain or parental desire during 1-year follow-up, with no appendicitis found on histology ↗
▶ Ep 3 · 24:10
clinical Total of 9 of 24 patients (38%) initially randomized to antibiotic therapy underwent appendectomy within first year, making success rate 62% ↗
▶ Ep 3 · 24:35
clinical Median time to discharge was significantly shorter in surgical group than non-operative group, possibly due to stipulated 48-hour minimum hospitalization for non-operative patients ↗
▶ Ep 3 · 24:55
clinical Cost for initial inpatient stay was significantly lower in non-operative treatment group despite longer hospitalizations ↗
▶ Ep 3 · 27:00
clinical Immunosuppressed cancer patients with typhlitis are sometimes treated non-operatively and most resolve with antibiotics ↗
▶ Ep 3 · 28:07
quote Most patients in such a trial will only be 15 to 20 years of age with a 10 year follow up, and so they're going to live for another 40 or 50 years ↗
▶ Ep 3 · 30:00
quote An important aspect of any study will be getting the parents' perspective on treatment, whether it's operative or non-operative ↗

Biliary Atresia, Appendicitis, Intestinal Failure, and Anesthetic...

▶ Ep 7 · 12:02
clinical Washington State registry study included over 50 hospitals and analyzed clean-contaminated operations over 18 months beginning January 2011 ↗
▶ Ep 7 · 13:05
epidemiological Overall surgical site infection rate was 4.6%, varying by procedure: 6.6% colorectal, 1.4% bariatric, 1.5% other ↗
▶ Ep 7 · 13:39
clinical No single antiseptic agent was associated with lower risk of surgical site infection than any other agent ↗
▶ Ep 7 · 13:49
clinical Isopropyl alcohol provided no benefit: 4.5% SSI rate without alcohol versus 4.6% with alcohol ↗
▶ Ep 7 · 14:20
clinical Registry data could not identify surgical site infections diagnosed after discharge, likely underestimating true SSI rate ↗
▶ Ep 7 · 14:40
epidemiological Recent reports show 50% or more surgical site infections are diagnosed after discharge ↗
▶ Ep 7 · 14:48
clinical Most surgical site infections occur 3 to 10 days after operation ↗
▶ Ep 7 · 17:19
quote We continue to use the chlorhexidine or chloroprep just as you are and have found that we've not noticed either an increase or even a decrease in SSI ↗
▶ Ep 7 · 18:33
clinical Chlorhexidine prep dries faster than betadine, allowing cases to start sooner ↗
▶ Ep 7 · 18:40
quote If you're doing 6 or 7 cases a day, every minute seems to help get the cases moving along ↗
▶ Ep 7 · 22:58
clinical Appendicitis pilot RCT enrolled 50 patients aged 5-15 years with non-perforated appendicitis: 26 randomized to operation, 24 to antibiotics ↗
▶ Ep 7 · 23:14
clinical Of 24 patients randomized to non-operative treatment, 2 underwent appendectomy during primary treatment course and 1 had appendectomy at 9 months for recurrent appendicitis ↗
▶ Ep 7 · 23:32
clinical An additional 6 patients in the non-operative group underwent appendectomy for recurrent abdominal pain or parental desire during 1-year follow-up, with no appendicitis found on histology ↗
▶ Ep 7 · 24:10
clinical Total of 9 of 24 patients (38%) initially randomized to antibiotic therapy underwent appendectomy within first year, making success rate 62% ↗
▶ Ep 7 · 24:35
clinical Median time to discharge was significantly shorter in surgical group than non-operative group, possibly due to stipulated 48-hour minimum hospitalization for non-operative patients ↗
▶ Ep 7 · 24:55
clinical Cost for initial inpatient stay was significantly lower in non-operative treatment group despite longer hospitalizations ↗
▶ Ep 7 · 27:00
clinical Immunosuppressed cancer patients with typhlitis are sometimes treated non-operatively and most resolve with antibiotics ↗
▶ Ep 7 · 28:07
quote Most patients in such a trial will only be 15 to 20 years of age with a 10 year follow up, and so they're going to live for another 40 or 50 years ↗
▶ Ep 7 · 30:00
quote An important aspect of any study will be getting the parents' perspective on treatment, whether it's operative or non-operative ↗
Intestinal Rehab 57 entries

Biliary Atresia, Appendicitis, Intestinal Failure, and Anesthetic...

▶ Ep 14 · 12:02
clinical Washington State registry study included over 50 hospitals and analyzed clean-contaminated operations over 18 months beginning January 2011 ↗
▶ Ep 14 · 13:05
epidemiological Overall surgical site infection rate was 4.6%, varying by procedure: 6.6% colorectal, 1.4% bariatric, 1.5% other ↗
▶ Ep 14 · 13:39
clinical No single antiseptic agent was associated with lower risk of surgical site infection than any other agent ↗
▶ Ep 14 · 13:49
clinical Isopropyl alcohol provided no benefit: 4.5% SSI rate without alcohol versus 4.6% with alcohol ↗
▶ Ep 14 · 14:20
clinical Registry data could not identify surgical site infections diagnosed after discharge, likely underestimating true SSI rate ↗
▶ Ep 14 · 14:40
epidemiological Recent reports show 50% or more surgical site infections are diagnosed after discharge ↗
▶ Ep 14 · 14:48
clinical Most surgical site infections occur 3 to 10 days after operation ↗
▶ Ep 14 · 17:19
quote We continue to use the chlorhexidine or chloroprep just as you are and have found that we've not noticed either an increase or even a decrease in SSI ↗
▶ Ep 14 · 18:33
clinical Chlorhexidine prep dries faster than betadine, allowing cases to start sooner ↗
▶ Ep 14 · 18:40
quote If you're doing 6 or 7 cases a day, every minute seems to help get the cases moving along ↗
▶ Ep 14 · 22:58
clinical Appendicitis pilot RCT enrolled 50 patients aged 5-15 years with non-perforated appendicitis: 26 randomized to operation, 24 to antibiotics ↗
▶ Ep 14 · 23:14
clinical Of 24 patients randomized to non-operative treatment, 2 underwent appendectomy during primary treatment course and 1 had appendectomy at 9 months for recurrent appendicitis ↗
▶ Ep 14 · 23:32
clinical An additional 6 patients in the non-operative group underwent appendectomy for recurrent abdominal pain or parental desire during 1-year follow-up, with no appendicitis found on histology ↗
▶ Ep 14 · 24:10
clinical Total of 9 of 24 patients (38%) initially randomized to antibiotic therapy underwent appendectomy within first year, making success rate 62% ↗
▶ Ep 14 · 24:35
clinical Median time to discharge was significantly shorter in surgical group than non-operative group, possibly due to stipulated 48-hour minimum hospitalization for non-operative patients ↗
▶ Ep 14 · 24:55
clinical Cost for initial inpatient stay was significantly lower in non-operative treatment group despite longer hospitalizations ↗
▶ Ep 14 · 27:00
clinical Immunosuppressed cancer patients with typhlitis are sometimes treated non-operatively and most resolve with antibiotics ↗
▶ Ep 14 · 28:07
quote Most patients in such a trial will only be 15 to 20 years of age with a 10 year follow up, and so they're going to live for another 40 or 50 years ↗
▶ Ep 14 · 30:00
quote An important aspect of any study will be getting the parents' perspective on treatment, whether it's operative or non-operative ↗

Gastroesophageal Reflux Disease

▶ Ep 33 · 22:38
clinical An upper GI is not a good study for reflux diagnosis; it only helps identify anatomical problems in about 4% of patients ↗
▶ Ep 33 · 36:08
quote I would like to thank Rachel for not sending that child who's wretching preoperatively to the surgeons. ↗
▶ Ep 33 · 46:40
clinical In a prospective randomized trial of 107 patients using minimal mobilization technique, neither group required a redo fundoplication for transmigration ↗
▶ Ep 33 · 47:08
epidemiological The primary reason for redo fundoplication historically was transmigration of the wrap into the chest ↗
▶ Ep 33 · 47:09
quote We spent 15 years or so trying to investigate this issue surgically and we feel like we've come up with, you know, what we call, you know, jokingly the perfect Nissan. ↗
▶ Ep 33 · 57:32
clinical By doing minimal mobilization and placing sutures between esophagus and crura, transmigration rate was reduced from 12% to 5% ↗
▶ Ep 33 · 58:23
clinical With minimal mobilization alone (no sutures), there was zero transmigration in prospective trial, with only one wrap loosening ↗
▶ Ep 33 · 59:22
quote The surgical message that we should impart is that we need to do less rather than more dissection around the GE junction. ↗
▶ Ep 33 · 1:03:46
clinical Using esophageal bougie at time of fundoplication has resulted in very little need for postoperative dilation ↗

Biliary Atresia, Appendicitis, Intestinal Failure, and Anesthetic...

▶ Ep 35 · 12:02
clinical Washington State registry study included over 50 hospitals and analyzed clean-contaminated operations over 18 months beginning January 2011 ↗
▶ Ep 35 · 13:05
epidemiological Overall surgical site infection rate was 4.6%, varying by procedure: 6.6% colorectal, 1.4% bariatric, 1.5% other ↗
▶ Ep 35 · 13:39
clinical No single antiseptic agent was associated with lower risk of surgical site infection than any other agent ↗
▶ Ep 35 · 13:49
clinical Isopropyl alcohol provided no benefit: 4.5% SSI rate without alcohol versus 4.6% with alcohol ↗
▶ Ep 35 · 14:20
clinical Registry data could not identify surgical site infections diagnosed after discharge, likely underestimating true SSI rate ↗
▶ Ep 35 · 14:40
epidemiological Recent reports show 50% or more surgical site infections are diagnosed after discharge ↗
▶ Ep 35 · 14:48
clinical Most surgical site infections occur 3 to 10 days after operation ↗
▶ Ep 35 · 17:19
quote We continue to use the chlorhexidine or chloroprep just as you are and have found that we've not noticed either an increase or even a decrease in SSI ↗
▶ Ep 35 · 18:33
clinical Chlorhexidine prep dries faster than betadine, allowing cases to start sooner ↗
▶ Ep 35 · 18:40
quote If you're doing 6 or 7 cases a day, every minute seems to help get the cases moving along ↗
▶ Ep 35 · 22:58
clinical Appendicitis pilot RCT enrolled 50 patients aged 5-15 years with non-perforated appendicitis: 26 randomized to operation, 24 to antibiotics ↗
▶ Ep 35 · 23:14
clinical Of 24 patients randomized to non-operative treatment, 2 underwent appendectomy during primary treatment course and 1 had appendectomy at 9 months for recurrent appendicitis ↗
▶ Ep 35 · 23:32
clinical An additional 6 patients in the non-operative group underwent appendectomy for recurrent abdominal pain or parental desire during 1-year follow-up, with no appendicitis found on histology ↗
▶ Ep 35 · 24:10
clinical Total of 9 of 24 patients (38%) initially randomized to antibiotic therapy underwent appendectomy within first year, making success rate 62% ↗
▶ Ep 35 · 24:35
clinical Median time to discharge was significantly shorter in surgical group than non-operative group, possibly due to stipulated 48-hour minimum hospitalization for non-operative patients ↗
▶ Ep 35 · 24:55
clinical Cost for initial inpatient stay was significantly lower in non-operative treatment group despite longer hospitalizations ↗
▶ Ep 35 · 27:00
clinical Immunosuppressed cancer patients with typhlitis are sometimes treated non-operatively and most resolve with antibiotics ↗
▶ Ep 35 · 28:07
quote Most patients in such a trial will only be 15 to 20 years of age with a 10 year follow up, and so they're going to live for another 40 or 50 years ↗
▶ Ep 35 · 30:00
quote An important aspect of any study will be getting the parents' perspective on treatment, whether it's operative or non-operative ↗

Journal of Pediatric Surgery Article Review: 2nd Quarter (Apr-Jun) 2024

▶ Ep 85 · 12:46
epidemiological The transition systematic review found 8 studies that included patient and parent responses and clinician perspectives ↗
▶ Ep 85 · 14:22
quote This one sentence says it all. There was little evidence from patients that transfer happened in a timely or coordinated manner. And patients felt that the clinicians did not always understand the significance of transfer to an adult service. No models of transfer of care were identified. ↗
▶ Ep 85 · 14:22
clinical There was little evidence that transfer of colorectal patients happened in a timely or coordinated manner ↗
▶ Ep 85 · 14:31
opinion Patients felt clinicians did not always understand the significance of transfer to an adult service ↗
▶ Ep 85 · 14:38
clinical No models of transfer of care for colorectal conditions were identified ↗
▶ Ep 85 · 15:21
quote We need to do a better job. Of structuring this transition, we're doing better with handoffs in the hospital with patient care. We need to do a better job with handing off the care for any pediatric patient who needs a transitioning to adult providers. ↗

Journal of Pediatric Surgery Article Review: 3rd Quarter (Jul-Sep) 2024

▶ Ep 86 · 14:30
quote We didn't really have a classification system that was unique to pediatric surgery, so that's why we have used the Clavian dindo classification, although that was validated in the adult world. ↗
▶ Ep 86 · 15:19
quote This is the first attempt at creating a classification system for pediatric surgery. So that's why I thought this was an important article. ↗
▶ Ep 86 · 16:39
clinical The Clavien-Madadi classification showed improved agreement rates of respondents at 85% versus 76% for the Clavien-Dindo classification ↗
▶ Ep 86 · 16:53
clinical The Clavien-Madadi classification was less frequently considered inaccurate for rating in the pediatric population compared to the Clavien-Dindo classification ↗
Intestinal Transplant 19 entries

Biliary Atresia, Appendicitis, Intestinal Failure, and Anesthetic...

▶ Ep 4 · 12:02
clinical Washington State registry study included over 50 hospitals and analyzed clean-contaminated operations over 18 months beginning January 2011 ↗
▶ Ep 4 · 13:05
epidemiological Overall surgical site infection rate was 4.6%, varying by procedure: 6.6% colorectal, 1.4% bariatric, 1.5% other ↗
▶ Ep 4 · 13:39
clinical No single antiseptic agent was associated with lower risk of surgical site infection than any other agent ↗
▶ Ep 4 · 13:49
clinical Isopropyl alcohol provided no benefit: 4.5% SSI rate without alcohol versus 4.6% with alcohol ↗
▶ Ep 4 · 14:20
clinical Registry data could not identify surgical site infections diagnosed after discharge, likely underestimating true SSI rate ↗
▶ Ep 4 · 14:40
epidemiological Recent reports show 50% or more surgical site infections are diagnosed after discharge ↗
▶ Ep 4 · 14:48
clinical Most surgical site infections occur 3 to 10 days after operation ↗
▶ Ep 4 · 17:19
quote We continue to use the chlorhexidine or chloroprep just as you are and have found that we've not noticed either an increase or even a decrease in SSI ↗
▶ Ep 4 · 18:33
clinical Chlorhexidine prep dries faster than betadine, allowing cases to start sooner ↗
▶ Ep 4 · 18:40
quote If you're doing 6 or 7 cases a day, every minute seems to help get the cases moving along ↗
▶ Ep 4 · 22:58
clinical Appendicitis pilot RCT enrolled 50 patients aged 5-15 years with non-perforated appendicitis: 26 randomized to operation, 24 to antibiotics ↗
▶ Ep 4 · 23:14
clinical Of 24 patients randomized to non-operative treatment, 2 underwent appendectomy during primary treatment course and 1 had appendectomy at 9 months for recurrent appendicitis ↗
▶ Ep 4 · 23:32
clinical An additional 6 patients in the non-operative group underwent appendectomy for recurrent abdominal pain or parental desire during 1-year follow-up, with no appendicitis found on histology ↗
▶ Ep 4 · 24:10
clinical Total of 9 of 24 patients (38%) initially randomized to antibiotic therapy underwent appendectomy within first year, making success rate 62% ↗
▶ Ep 4 · 24:35
clinical Median time to discharge was significantly shorter in surgical group than non-operative group, possibly due to stipulated 48-hour minimum hospitalization for non-operative patients ↗
▶ Ep 4 · 24:55
clinical Cost for initial inpatient stay was significantly lower in non-operative treatment group despite longer hospitalizations ↗
▶ Ep 4 · 27:00
clinical Immunosuppressed cancer patients with typhlitis are sometimes treated non-operatively and most resolve with antibiotics ↗
▶ Ep 4 · 28:07
quote Most patients in such a trial will only be 15 to 20 years of age with a 10 year follow up, and so they're going to live for another 40 or 50 years ↗
▶ Ep 4 · 30:00
quote An important aspect of any study will be getting the parents' perspective on treatment, whether it's operative or non-operative ↗