Quick Literature Updates Episode 7
Timestops (10)
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Topic Overview
Key Takeaways
- Duhamel procedure for Hirschsprung's has lowest incontinence risk but highest constipation risk in school-age children versus Soave or Swenson
- Preserving ileocecal valve in short bowel syndrome significantly reduces parenteral nutrition duration; <50% colon remnant also beneficial if ICV intact
- High-volume pediatric thyroid surgeons (definitions vary 9-200+ cases/year) achieve shorter hospital stays with better outcomes
- Tissue adhesive over sutures shows poorer cosmesis at 6 weeks but no difference by 6 months compared to tape or sutures alone
- Rectal dissection technique choice in Hirschsprung's should balance continence versus constipation risk based on patient-specific factors
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Transcript
Hello Pediatric Surgery family. I'm M Tombash, a research fellow from Cincinnati Children's Hospital Medical Center. And along with Stay Current, we are sharing knowledge to improve child health around the globe. Today, our team is going to deliver the articles that you should know about. We have four papers today. First three of them are from the Journal of Pediatric Surgery, and the last one is from the British Journal of Surgery. We don't have much time, so let's start. Our first paper titled as, Impact of Rectal Dissection Technique on Primary School Age Outcomes for a British and Irish Cohort of Children with Hirschsprung's Disease by Allen at all. This paper is summarized by Britney Levy. She's a research fellow at Cincinnati Children's Hospital. This article is asking, does the type of rectal dissection for Hirschsprung's disease matter as kids grow up? To answer this question, they looked at 277 kids. About half of them had a soave, a third duel, and the rest had a Swenson. 217 of those kids had long-term outcome data. So what did they find? What they found is that a duel has the lowest risk of incontinence but the highest risk of constipation in school age children. Great. Let's keep moving. Our second paper is the importance of the ileocecal valve and colon in achieving intestinal independence in infants with short bowel syndrome by Peters at all. This paper is summarized by Rod Gerardo. He's a general surgery resident at Wright State University and a former research fellow at Cincinnati Children's Hospital. In this retrospective review, the researchers looked at 55 pediatric patients with small bowel syndrome and whether or not the presence or absence of an ileocecal valve and or a colon can predict enteral autonomy. What did they find? Those infants with an ileocecal valve had significantly shorter duration on parental nutrition. And further those patients with less than 50% of their colon also had significantly less time on parental nutrition as long as they had their ileocecal valve. So what do you do? Do you try to preserve the ileocecal valve? Leave a comment below. Next, we have our third paper of the day. Effect of Surgeon volume on pediatric thyroid surgery outcomes, a systematic review by Olsen at all. This paper is summarized by Cecilia Hiena. She's also research fellow at Cincinnati Children's Hospital. This is a systematic review made by Lury Children's Hospital in Chicago. Their aim was to address the definition of a high volume surgeon and summon if that has a relationship with the patient's outcomes. And what did they found? They analyzed 10 studies with 6,430 patients. And what they found is that the definition of a high volume surgeon is changed a lot. It goes from nineth roidectomy a year to over 200roidectomies with at least being 30 in pediatric patients. Those that were made by high volume surgeons show shorter length of stays. So, it seems that for thyroid pathology, high volume surgeons does matter. And here's the last paper of today. It's from the British Journal of Surgery, tissue adhesive, adhesive tape and sutures for skin closure of pediatric surgical wounds, prospective randomized clinical trial by Tendon at all. And this paper is summarized by Ellen and Cisco. She's a research fellow at Cincinnati Children's Hospital as well. In this study, the authors wanted to see if there were differences in wound outcomes for kids with different types of skin closure. So they did a prospective randomized control trial between 2017 and 2018. They compared outcomes for three groups, sutures with tissue adhesive over top like Dermabond, sutures with adhesive tape over top, like stey strips and sutures alone. They assessed the wounds at two weeks, six weeks and more than six months after the operation by surveying clinicians and parents. They found that the wounds with tissue adhesive had poorer cosmesis at six weeks, but the difference is gone by six months. And overall there was no difference between the three groups at six months for clinicians or for parents. Check the link in the description below to read each paper. We hope you like this episode. Please follow us on social media, give us a rating and subscribe to our YouTube channel. And don't forget to download our Stay Current app on App Store or Play Store for more content. Thank you for listening. Cincinnati Children's Hospital and Stay Current are sharing knowledge to improve child health around the globe.