StayCurrentMD · Journal of Pediatric Surgery Article Review: Q1 (Jan-Mar) 2024
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Podcast13 min·Published Jun 2024Older

Journal of Pediatric Surgery Article Review: Q1 (Jan-Mar) 2024

With Dr. Romeo Ignacio & Dr. Mark Davenport & Dr. Scott Short or Katie Russell & Dr. Bruce Jeffrey · hosted by Dr. Cecilia Jigena · StayCurrentMD
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What the experts said25 expert statements
The study compared two cohorts defined by time frame before and after implementation of stopping antibiotics at discharge
ClinicalScott Short or Katie Russell
185 patients were in the home antibiotic group and 121 patients in the no home antibiotic group
ClinicalCecilia Gigena
There was no significant difference in deep organ space infection requiring intervention between groups
ClinicalCecilia Gigena
There was no difference in length of stay between antibiotic groups
ClinicalCecilia Gigena
Secondary outcomes including C. diff infections, superficial site infections, post-operative CT imaging, and readmission showed no difference
ClinicalRomeo Ignacio
The study was a 25 year experience describing 220 consecutive infants with esophageal atresia in Newcastle
ClinicalMark Davenport
13% of the 215 esophageal atresia patients had complex esophageal atresia
EpidemiologicalEgodi
25 patients with complex EA survived the repair: 14 were type A and 11 were type C
ClinicalEgodi
Type C esophageal atresia is the most common type and means esophageal atresia with a distal fistula
ClinicalCecilia Gigena
Type A means pure esophageal atresia with no fistula to the trachea
ClinicalCecilia Gigena
Of 25 survivors, 18 had delayed primary anastomosis and 7 had esophageal replacement
ClinicalEgodi
Two of the esophageal replacements were salvage procedures following failed traction
ClinicalEgodi
Only 4 patients with esophageal atresia were potentially treatable by traction
ClinicalEgodi
The esophagus has a great intrinsic blood supply and can be mobilized right down to the diaphragm and up to the thoracic inlet while staying alive
ClinicalBruce Jeffrey
Many cases proposed for lengthening may be because surgeons get cold feet about attempting a primary anastomosis
OpinionBruce Jeffrey
Native esophagus was retained in 80% of cases where traction techniques had not been attempted
ClinicalEgodi
Median time to esophageal continuity was 77 days
ClinicalEgodi
Management of complex esophageal atresia without lengthening procedures can result in similar rates of native esophagus retention but with significantly less morbidity
ClinicalEgodi
The pectus study enrolled 47 patients with median bar dwell time of approximately 2.9 years
ClinicalCecilia Gigena
Patients had a median of 2 bars placed, with almost 81% secured with pericostal sutures
ClinicalCecilia Gigena
About half of the patients had some degree of hypoesthesia
ClinicalCecilia Gigena
T5 was the most common dermatome with hypoesthesia
ClinicalCecilia Gigena
The area with hypoesthesia was less than 5% of the entire surface treated with cryo
ClinicalCecilia Gigena
Neuropathic symptoms were identified by only 13% of patients and none required treatment
ClinicalCecilia Gigena
Long-term chest wall hypoesthesia after minimally invasive pectus repair with cryo is limited to one or two dermatomes and chronic symptomatic neuropathic pain is very rare
ClinicalCecilia Gigena