Quick Literature Updates Episode 20
Timestops (10)
Tools Used
Topic Overview
Key Takeaways
- Thoracoscopic CDH repair has higher recurrence rates and longer OR times than open repair, but lower postoperative bowel obstruction rates.
- Fascia Tends Pediatric device achieved complete fascial closure in giant omphalocele (median 7 days) and complicated gastroschisis (median 5 days) without compartment syndrome.
- ICG fluorescent cholangiography during pediatric laparoscopic cholecystectomy reduced complications to 0% (vs 12% without ICG) and improved biliary tree visualization.
- Meta-analysis of 709 CDH patients from 15 studies confirms thoracoscopic repair trade-offs: lower morbidity but higher recurrence versus open approach.
- Traction-assisted closure for abdominal wall defects showed no ventral hernias at 12-month follow-up, suggesting durable outcomes with early fascial approximation.
Keywords
Hashtags
Transcript
Hello pediatric surgery family, I'm Em Gdy from Cincinnati Children's Hospital Medical Center, and today our team is gonna deliver the articles that you should know about. We have 3 papers today, all from different journals. We don't have much time, so let's start. Our first paper titled Comprehensive Meta-analysis of Surgical procedure for congenital diaphragmatic Hernia Torcoscopic versus Open Repair by Shibuya et al. This paper is summarized by Lizzie Lee, a physician associate by profession and a member of our team here at Cincinnati Children's dedicated to creating content for pediatric surgery. This meta-analysis included 709 patients from 15 research studies across multiple international centers. They wanted to know whether thoracoscopic repair has a higher recurrence rate and longer operating room time compared to open repair. They found that thoracoscopic repair has higher recurrence rates and longer operative times compared to open repair. However, thoracoscopic repair has a lower incidence of postoperative bowel obstruction compared to open repair. Here's our second paper. Use of a new vertical traction device for early traction assisted stage closure of congenital abdominal wall defects, a prospective series of 16 patients by Ziegler et al. and this paper summarized by Alex Holpern. He's a research fellow at Children's National and collaborates with us to produce these article reviews. Ziegler et al. performed the prospective study in 10 patients with ginumphalocele and 6 with complicated gastroschisis, trying to answer this question. They utilized fascia tends pediatric, a traction-assisted abdominal wall closure device. They were able to achieve complete fascial closure after a median. of 7 days in children with giant omphalocele and 5 days in children with complicated gastroschisis. No patients developed abdominal compartment syndrome and no ventral hernias occurred after a median follow-up of 12 months. So it seems like fascia tense pediatric helps facilitate early fascial closure in these patients. Let's move to the last paper of the day. In the sanding green fluorescent cholangiography during laparoscopic cholecystectomy using Rubina technology, preliminary experience in two pediatric surgery centers by Esposito et al. This paper is summarized by Cecilia Gena. She's one of the previous research fellows at Cincinnati Children's. This is a retrospective comparison done in Italy between the laparoscopic cholecystectomy with and without ICG. They had 83 patients in group one, that was laparoscopic cholecystectomy without ICG and 90 patients in group two, there was laparoscopic cholecystectomy with ICG. And what they found is that group 2, meaning with ICD, had no complications compared to 12% in group one, had shorter surgery time, and a better visualization of the body retry. So it seems that laparoscopic cholecystectomy with ICG can be the new standard in our practice. Thank you for listening. Please check the link in the description below to read each paper. We hope you liked this episode. Please follow Stay Cern MD on social media, give us a rating, and subscribe to our YouTube channel. And don't forget to download the Stay Cn app on the App Store or Play Store for tons of content.