Quick Literature Updates Episode 14
With Dr. Ellen Cissko & Dr. Alex Halpern & Dr. Cecily Ghena · hosted by Dr. E Gdy · StayCurrentMD
Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
384 females with anorectal malformations were studied from the Pediatric Colorectal and Pelvic Learning Consortium database
About 27% of patients with anorectal malformations had a gynecologic anomaly
About 46% of females with anorectal malformations had VACTERL association (anorectal malformation plus two of: vertebral, cardiac, tracheoesophageal, renal, or limb anomaly)
Having VACTERL association was associated with more gynecologic anomalies compared to those without VACTERL
The association between VACTERL and gynecologic anomalies was especially true when renal anomalies were found
The association between VACTERL and gynecologic anomalies was especially true when patients had recto vestibular or rectal perineal fistulas
For females with anorectal malformations and VACTERL association, especially renal anomalies, clinicians should look carefully for gynecologic anomalies
Thoracic epidural and intercostal nerve cryoablation are two options for pain control in patients undergoing Nuss procedure for pectus excavatum
The study was a retrospective chart review of kids who underwent Nuss procedure between 2002 and 2020
The intercostal nerve cryoablation group had lower rates of PCA use compared to thoracic epidural
The intercostal nerve cryoablation group had lower total morphine milligram equivalent requirement compared to thoracic epidural
The intercostal nerve cryoablation group had shorter length of stay in the hospital compared to thoracic epidural
The intercostal nerve cryoablation group had longer operative times compared to thoracic epidural
The intercostal nerve cryoablation group had higher total hospitalization cost compared to thoracic epidural
The anal sphincter reconstruction study was a multi-institutional one-year outcome study
Six patients underwent anal sphincter reconstruction for patulous sphincter after Hirschsprung pull-through
Two of the six patients had Down syndrome
Two patients underwent redo pull-through with anal sphincter reconstruction
Four patients received only anal sphincter reconstruction without redo pull-through
The four patients who received only sphincter reconstruction achieved voluntary bowel movements with higher productivity and confidence
Anal sphincter reconstruction is an option for overstretched anal sphincters in patients with Hirschsprung disease after pull-through