Quick Literature Updates Ep 25

Hello pediatric surgery family. I'm M. Gody from Cincinnati Children's Hospital Medical Center. And today, our team is going to deliver the articles that you should know about. We have three papers today, but don't have much time. So let's start. Our first paper titled management and outcomes of pediatric lymphatic malformations, a systematic review from the Apsa outcomes and evidence-based practice committee by Wertheim at all. 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. Texas Children's Hospital researchers did a systematic review focusing on 200 articles published from 1990 to 2021. They found that sclerotherapy had a success rate of over 90% for macrocytic lesions. Medications like cyromus are helpful for extensive malformations that are refractory to surgery and or sclerotherapy. Cyromus is also used as an initial treatment for extensive lymphatic malformations. For example, those that compromise the airway. Small asymptomatic lesions can be observed, while large symptomatic lesions need to be further divided into macrocytic, microcytic, or mixed lesions. If it is a localized lesion, surgery or sclerotherapy is effective. Our second paper is identifying quality improvement targets after pediatric gastrostomy tube insertion, a Nisc pediatric pilot study by Mo at all. 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. Motura at all performed a retrospective cohort analysis of the Nisc pediatric database, looking at all pediatric patients who underwent G2 placement in 2023 to try and answer this question. They found that G2 placement made up 5.3% of all cases submitted to Nisc pediatric. Upper GI studies were obtained in 45% of G2 cases with significant interhospital variability. In the first 30 days postoperatively after G2 placement, 14% of patients went to the ED, and 5.2% of patients experienced G2 dislodgement. So it seems like there is high postoperative G2 related morbidity as well as high variability in preoperative upper GI use, which can both serve as targets for future quality improvement projects. Now, moving to the last paper of the day. Testicular volume at puberty in boys with congenital cryptoorchidism randomized to treatment at different ages by Colin at all, at all. This paper is summarized by Cecilia Hina. She's one of the previous research fellows at Cincinnati Children's Hospital. This is a prospective randomized study done in Sweden that aimed to compare the testicular volume at puberty in patients with undescended tested that have a spontaneous descent versus a surgery at 9 months or at 3 years of age. They had 22 patients with spontaneous descent, 37 with a surgery at 9 months, and 48 with a surgery at three years of age. And they found that there was a significant difference in testicular volume being higher in spontaneous descent versus the 9 month, and also significantly higher in those who were operated at 9 month versus those who were operated at three years of age. So it seems that the earlier we operate on this patient is better, as long as we give them enough time to spontaneous descent. Thank you for listening. Please check the link in the description below to read each paper. We hope you like 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.