Quick Literature Updates Ep 22

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, but don't have much time, so let's start. Our first paper titled The Use of Postoperative Calibrations in Hirschprung Disease, a Practice to reconsider by Beotti 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 prospective study took place 2021 to 2023 and included 33 patients under six months old who underwent endorectal pull-through surgeries. Patients were assigned to a new non-dilation protocol group or a traditional dilation group. The primary outcomes they looked at were anastomotic complications, enterocolitis, and constipation. What did they find? There was no significant difference in anastomotic complications between the two groups, but the non-dilation group had less enterocolitis and less constipation. This means that choosing not to do postoperative anal dilations may be a good alternative with benefits like lower constipation and enterocolitis. Our second paper is Management of Gastroschisis, timing of Delivery, antibiotic usage, and closure Consideration. A systematic review from the ABSA Outcomes and Evidence-based Practice Committee by Slidell et al. and this paper is summarized by Alex Halpern. He is a research fellow at Children's National and collaborates with us to produce these article reviews. The APSA Outcomes and Evidence-based Practice Committee performed a systematic review to try and answer this question. They found that delivery after 37 weeks is optimal. Prophylactic antibiotics covering skin floor are adequate to reduce infection risk until closure. Studies support primary fascial repair as long as hemodynamics and abdominal domain permit, and sutureless repair is safe, effective. And does not delay feeding or increased length of stay. They concluded that there is a need for a high quality randomized controlled trials to help provide evidence-based care for these infants. Does this information change your practice at all? Moving to the last paper of the day, treatment facility case volume and disparities in outcomes of congenital diaphragmatic hernia cases by Pefer et al. This paper is summarized by Cecilia Ina. She's one of the previous research fellows at Cincinnati Children's Hospital. This is a retrospective study done in Texas using a state hospital database, and their aim was to see if there were a difference in the outcomes of patients with CDH that were operated in high, low, or mid-volume centers. They identified 1,314 patients. 728 were from high volume centers, 9 were from mid-volume centers, and 79 were from low volume centers. And what they found is that high volume centers had significantly less mortality rates, even though they have significantly sicker patients, and also they had significantly less length of stay. So it seems that high volume centers had better outcomes for patients with CDH. 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 Current MD on social media, give us a rating, and subscribe to our YouTube channel. And don't forget to download the Stay Current app on the App Store or Play Store for tons of content.