Glycopyrrolate for Anastomtic Dehiscence in Esophageal Atresia

Space: StayCurrentMD Published: 2018-09-14

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Timestops

Introduction to the Study

Todd Ponsky introduces the study on glycopyrolate's role in healing anastomotic dehiscence after esophageal atresia repair, featuring guest reviewer Dr. Abdul Raoof Lamoshi.

Discussion of the study's design, including the randomized control trial format and patient demographics, highlighting the incidence of leaks post-repair.

Results of the Trial

Presentation of key results, comparing chest tube output, leak resolution rates, and oral feeding success between the glycopyrolate and placebo groups.

Quality of the Study

Evaluation of the study's quality, emphasizing its robust design, sample size, and the significance of its findings.

Implications for Practice

Discussion on how the study's findings may influence clinical practice, with personal reflections from Todd and Raouf on adopting glycopyrolate in treatment.

Conclusion and Viewer Engagement

Wrap-up of the discussion, encouraging viewers to share their thoughts and experiences related to the study's findings.

Topic overview

Administration of glycopyrrolate in patients of anastomotic leak after primary repair of esophageal atresia resulted in reduced oral secretions, which helped in healing of the anastomotic dehiscence in a significant number of patients.

Intended audience: Healthcare professionals and clinicians.

Categories

Anatomy/Organ System

Head and Neck

Procedure/Intervention

Primary Repair Reconstruction Repair

Keywords

Glycopyrolate Anastomotic dehiscence Esophageal atresia Primary repair Randomized control trial Chest tube output Leak resolution Oral feeding Pediatric surgery Clinical significance Research fellow Low resource setting Saline placebo Statistical analysis Treatment efficacy Postoperative care Surgical complications Patient outcomes Novel treatment TEF repair

Hashtags

#Glycopyrolate #EsophagealAtresia #PediatricSurgery #AnastomoticDehiscence #ClinicalTrial #SurgicalResearch #PatientCare #SurgicalOutcomes #PediatricHealth #ResearchFellow #PostoperativeCare #SurgicalComplications #NovelTreatment #ChestTubeOutput #OralFeeding #LeakResolution #RandomizedControlTrial #StatisticalSignificance #LowResourceSetting #TEFRepair

Transcript

This is Todd Ponsky from the Journal of Pediatric Surgery, and today we have a guest reviewer, Doctor Abdul Raoof Lamoshi. Raoof, thanks for joining us. Thank you, Todd. Raoof is a research fellow here at Akron Children's Hospital, and today he reviewed a great paper. The title of today's article is Role of Glycopyrolate in Healing of Anastomotic dehiscence after Primary Repair of esophageal atresia in a Low Resource setting, a randomized control study. The first author on this paper was Doctor Vela. This was a prospective randomized control trial studying the effect of glycopyrolate on patients that had leak after oesophageal atresia repair. There were 297 patients over a 10 year period that underwent esophageal atresia repair. Of the 297, there were 42 leaks. That's about 14%. They then prospectively randomized the 42 patients into two groups, 21 each, the one group receiving glycopyrrolate and the other group receiving placebo, which was saline. The observer was blinded to which treatment group the patient was in. And Raouf, what were the results? So the main explored variables were chest tube output, which was 124 mL in the treatment group, compared to 370 mL in the placebo group. Second variable was the leak resolution, which was accomplished in 76% of the treatment group compared to 29% of the placebo group. And oral feeding, which was achieved in 71% of treatment group compared to only 14% of the placebo group. OK, so the results are pretty astounding. The Robinol or the glycopyrolate group really had impressive results compared to the placebo group. But what about the quality of the study? I think this was a very well done study because it's a randomized controlled trial and has a very good. Sample size and the results were both statistically and the clinically significant. Yeah, I agree. I, uh, think this is a great study to review because it's a novel treatment that can have substantial effect on a very complicated problem we all deal with. I know that I'll change my practice based on this and start giving Roben all to my, uh, leaks after TEF repair, but I'm curious what you all would do. So leave your comments below. Thanks for watching, Rove. Thanks for the review. Thank you, Todd, and we'll see you next time.

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