Journal of Pediatric Surgery Article Highlights: April 2022
With Dr. Christina Theodoro & Dr. Todd Ponsky & Dr. Natalie Lopian · hosted by Dr. Rod Gerardo & Dr. Brittany Levy · StayCurrentMD
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Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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Updated Favorable histology Wilms tumor risk stratification: Rationale for future Children’s Oncology Group clinical trials
53 s · Published Apr 2026
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Social Determinants of Health Influence on Survival in Wilms Tumor, Neuroblastoma, and Hepatoblastoma
1 min · Published Jan 2026
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Impact of Pulmonary Tumor Burden in Favorable Histology Wilms Tumor Outcomes: A Report From the Children's Oncology Group Study AREN053
1 min · Published Mar 2026
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Update Course Rewind: Updates in Wilms Management 2024
4 min · Published Sep 2025
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Wilms Tumor Protocol Violations: 2018 Pediatric Surgery Practice Gap #3
Dr. Todd Ponsky · Published Jun 2019
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Wilms Tumor Protocol Violations: Practice Gap discussion at Update Course 2018
9 min · Published Aug 2018
Only a few other public items share this expert — go deeper there →
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Pediatric Surgical Oncology Research Collaborative (PSORC): Studying Rare Pediatric Tumors
56 s · Published May 2026
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Update Course Rewind 2025: Hirschsprung + ARM: Rare but Real
1 min · Published May 2026
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Update Course Rewind 2025: Hirschsprung + ARM: Rare but Real
1 min · Published May 2026
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Pooling Patients to Study Rare Pediatric Tumors: An Introduction to PSORC
56 s · Published May 2026
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The fetal frontier: A review of current and emerging fetal therapies for genetic diseases
44 s · Published May 2026
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Indocyanine green assists with sentinel lymph node mapping in pediatric and adolescent patients
1 min · Published May 2026
What the experts said
Dr. Christina Theodoro states this study is a pivotal study in obtaining approval from the FDA for use of clinical grade stem cells in fetal myelomeningocele repair.
The technique involves exposing the fetal back, re-exposing the spinal cord, identifying the myelomeningocele defect, placing an extracellular matrix patch with placental stem cells facing the spinal cord in direct contact, closing the skin, and returning the baby to the uterus to continue gestation until term.
Lambs repaired with clinical grade placental stem cells have significantly improved motor function compared to lambs that did not receive the stem cells.
Dr. Todd Ponsky states that in utero repair of myelomeningocele has already shown benefit, and impregnating the repair with mesenchymal stromal cells provides an even larger benefit in the chance of ambulation.
The survey included self-identified specialists within the field of fetal surgery, yet only 4% of those people reported receiving formal training in fetal surgery.
Dr. Natalie Lopian suggests it will be interesting to see whether fetal surgery exposure becomes a requirement during training or whether fetal centers become the primary training ground for fetal surgeons as the field expands.
Dr. Todd Ponsky states that disparities in practice patterns are what happens in an emerging field, and it is reasonable to expect different levels of what different hospitals do in fetal surgery.
The study was not designed to link subspecialization of fetal surgery to outcomes and was not designed to provide a clear definition of a fetal surgery center.
The first article examines surgical management, staging and outcomes of Wilms tumors with intravascular extension, using results from the SIOP (International Society of Pediatric Oncology) Renal Tumor Study.
The study looked at children with Wilms tumor where tumor thrombus extended into the renal vein and provided outcomes for when complete resection of tumor thrombus was successful versus when it was not.
Dr. Paul Tam states that Wilms tumor has been a great success story for pediatric surgery and pediatric oncology.
Dr. Paul Tam suggests improving outcomes by identifying subgroups of patients who are still not doing well and trying to improve care in those particular areas.
If half of Wilms tumor patients have complete tumor removal and half do not, and there is an outcome difference, then surgeons should still try hard to remove all of the tumor.
The second article examines efficacy of clinical grade human placental mesenchymal stromal cells in fetal ovine myelomeningocele repair.
The article discussed use of mesenchymal stromal cells on an extracellular matrix in ovine fetuses to determine if there was a benefit to motor function in fetal lambs given the intervention.
The third article is titled 'Current Status of Sub-specialization in Pediatric Surgery, a Focus on fetal Surgery' and surveys practice patterns in fetal surgery across the country.
Many survey respondents reported receiving fetal training during their pediatric surgery fellowship training, yet when the question was posed differently, many responded that they did not have exposure to fetal surgery during fellowship training.
Dr. Paul Tam states that fetal surgery is a frontier for pediatric surgery and the survey provides a reality check on how to develop a treatment which remains rare and often experimental.