2025 Pediatric Surgery Update Course - Updates in Pediatric Surgery feat. JPS Articles
With Dr. Alex Halpern · hosted by Dr. Jill Napworth · Live Event Content
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
Home device delivery companies and ensuring patients have feeding pumps is a major bottleneck for same-day discharge after G-tube placement
Same-day discharge works best when patients already have an NG tube and feeding pump set up, requiring only G-tube education and care
Same-day surgery nurses' reluctance to teach G-tube care was a barrier to same-day discharge
Medical safety is not the reason clinicians keep G-tube patients in hospital overnight; logistics are the primary barrier
Morbidity does not change if a patient with penetrating abdominal trauma is observed for 24 hours without operation
Using two small holes to drain abscess, flushing it out, and placing a vessel loop resulted in one to two percent recurrence rate
Antibiotics can cool off perianal abscess and reduce recurrent problems, avoiding months of parental anxiety
Spinal ultrasound should be performed for imperforate anus to detect tethered cord and spinal dysraphism before spinal ossification
5,947 pediatric patients underwent elective laparoscopic gastrostomy tube placement in the study
4.7% of patients were discharged the same day after laparoscopic G-tube placement
Same day discharge rates nearly tripled during the study period for laparoscopic G-tube placement
There were no significant differences in any complications between patients discharged same day and those discharged one to two days postoperatively after laparoscopic G-tube placement
A NSQIP pediatric study from 2017 to 2021 found 6.2% of patients were discharged same day at the highest year, much lower than reported in the presented study
The American College of Surgeons study included approximately 1,900 patients with penetrating trauma
Laparoscopy was performed in 12% of penetrating trauma cases, mainly for stab wounds and at pediatric trauma centers
Laparoscopy for penetrating trauma showed no increase in complications compared to open surgery
Patients who had laparoscopy for penetrating trauma had shorter hospital stays and fewer follow-up procedures
The study found a low occurrence of missed injuries after laparoscopic exploration for penetrating trauma
Injury severity score was lower for patients who underwent laparoscopic surgery for penetrating trauma
A 2008 article by Amasiacos showed antibiotics decrease the formation of fistula in perianal abscess
The UK retrospective study included 43 patients managed surgically and 73 managed non-surgically for first episode of perianal abscess in children under 12 months
Surgical management for perianal abscess in infants included general anesthesia, incision and drainage, with some needing fistula treatment
Non-operative management for perianal abscess in infants included antibiotics, bedside aspiration, and bedside drainage
Non-operatively managed perianal abscess patients had higher risk of abscess recurrence and needing subsequent surgery, but avoided general anesthesia
The American Academy of Pediatrics recommends against incision and drainage for perianal abscess in infants
The American Academy of Pediatrics recommends against antibiotics if possible for perianal abscess in infants
If fistulas from perianal abscess are not operated on, they eventually go away in the high 90% of cases