# Quick Literature Updates Ep 26 — GCMD Library We’re back with 26th episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review articles covering the most interesting and relevant topics in the field.

These articles are either chosen by JPS editors or our collaborators. We present these reviews as short news pieces with a summarization of key points.

Whether you're a trainee, attending, or an advanced medical professional, tune in to our podcast for a dose of medical knowledge in every episode. Stay up to date on the latest trends and advancements in pediatric surgery with "Quick Literature Updates".

Host: Em Gootee

https://pubmed.ncbi.nlm.nih.gov/39826968/

St Peter SD, Noel-MacDonnell JR, Hall NJ, Eaton S, Suominen JS, Wester T, Svensson JF, Almström M, Muenks EP, Beaudin M, Piché N, Brindle M, MacRobie A, Keijzer R, Engstrand Lilja H, Kassa AM, Jancelewicz T, Butter A, Davidson J, Skarsgard E, Te-Lu Y, Nah S, Willan AR, Pierro A. Appendicectomy versus antibiotics for acute uncomplicated appendicitis in children: an open-label, international, multicentre, randomised, non-inferiority trial. Lancet. 2025 Jan 18;405(10474):233-240. doi: 10.1016/S0140-6736(24)02420-6. Erratum in: Lancet. 2025 Feb 8;405(10477):468. doi: 10.1016/S0140-6736(25)00206-5. PMID: 39826968.

https://pubmed.ncbi.nlm.nih.gov/40032536/

Xu TO, Hanke RE, Das K, Bowser M, Hisam B, Samuk I, Wissanji H, Teeple E, Mayhew A, Myseros JS, Badillo A, Levitt MA, Varda BK, Feng C. VACTERL Screening in Newborns With Anorectal Malformations - An Opportunity to Optimize Screening Practices, add Gynecologic and Spinal Conditions, and Utilize a New Acronym: VACTE(G)RLS. J Pediatr Surg. 2025 Jun;60(6):162252. doi: 10.1016/j.jpedsurg.2025.162252. Epub 2025 Feb 20. PMID: 40032536.

https://pubmed.ncbi.nlm.nih.gov/38245889/

Schlapbach LJ, Watson RS, Sorce LR, Argent AC, Menon K, Hall MW, Akech S, Albers DJ, Alpern ER, Balamuth F, Bembea M, Biban P, Carrol ED, Chiotos K, Chisti MJ, DeWitt PE, Evans I, Flauzino de Oliveira C, Horvat CM, Inwald D, Ishimine P, Jaramillo-Bustamante JC, Levin M, Lodha R, Martin B, Nadel S, Nakagawa S, Peters MJ, Randolph AG, Ranjit S, Rebull MN, Russell S, Scott HF, de Souza DC, Tissieres P, Weiss SL, Wiens MO, Wynn JL, Kissoon N, Zimmerman JJ, Sanchez-Pinto LN, Bennett TD; Society of Critical Care Medicine Pediatric Sepsis Definition Task Force. International Consensus Criteria for Pediatric Sepsis and Septic Shock. JAMA. 2024 Feb 27;331(8):665-674. doi: 10.1001/jama.2024.0179. PMID: 38245889; PMCID: PMC10900966.
Type: video · 4 min · posted 2026-01-22 Canonical: https://library.globalcastmd.com/watch/quick-literature-updates-ep-26-11413 ## Chapters - [0:00](https://library.globalcastmd.com/watch/quick-literature-updates-ep-26-11413?t=0) Introduction and Appendicitis Treatment Study - [1:51](https://library.globalcastmd.com/watch/quick-literature-updates-ep-26-11413?t=111) VACTERL Screening in Anorectal Malformations - [3:01](https://library.globalcastmd.com/watch/quick-literature-updates-ep-26-11413?t=181) Pediatric Sepsis Consensus Definitions ## Statements - "Recent literature has been supporting treating appendicitis with antibiotics rather than surgery" — Lizzie Lee (opinion) [1:07](https://library.globalcastmd.com/watch/quick-literature-updates-ep-26-11413?t=67) - "The appendicitis study was a multi-center randomized trial conducted in Canada, the US, Finland, Sweden, and Singapore" — Lizzie Lee (clinical) [1:12](https://library.globalcastmd.com/watch/quick-literature-updates-ep-26-11413?t=72) - "34% of children treated with antibiotics for appendicitis eventually required surgery within a year" — Lizzie Lee (clinical) [1:24](https://library.globalcastmd.com/watch/quick-literature-updates-ep-26-11413?t=84) - "Only 7% in the appendectomy group required additional surgery within a year" — Lizzie Lee (clinical) [1:24](https://library.globalcastmd.com/watch/quick-literature-updates-ep-26-11413?t=84) - "There were no deaths in either the antibiotic or surgery group for appendicitis treatment" — Lizzie Lee (clinical) [1:32](https://library.globalcastmd.com/watch/quick-literature-updates-ep-26-11413?t=92) - "Children in the antibiotic group had a higher risk of mild to moderate adverse events compared to surgery group" — Lizzie Lee (clinical) [1:32](https://library.globalcastmd.com/watch/quick-literature-updates-ep-26-11413?t=92) - "Antibiotics were not as effective as surgery for treating non-perforated appendicitis in children and did not meet the threshold for non-inferiority" — Lizzie Lee (clinical) [1:39](https://library.globalcastmd.com/watch/quick-literature-updates-ep-26-11413?t=99) - "The ARM study used the PHIS database and included all ARM patients between 2016 and 2022" — Alex Halpern (clinical) [2:16](https://library.globalcastmd.com/watch/quick-literature-updates-ep-26-11413?t=136) - "In ARM patients, vertebral-spinal anomalies were diagnosed in 45.4% across all hospital encounters" — Alex Halpern (epidemiological) [2:25](https://library.globalcastmd.com/watch/quick-literature-updates-ep-26-11413?t=145) - "In ARM patients, cardiac anomalies were diagnosed in 77.4% across all hospital encounters" — Alex Halpern (epidemiological) [2:25](https://library.globalcastmd.com/watch/quick-literature-updates-ep-26-11413?t=145) - "In ARM patients, TEF was diagnosed in 10.2% across all hospital encounters" — Alex Halpern (epidemiological) [2:25](https://library.globalcastmd.com/watch/quick-literature-updates-ep-26-11413?t=145) - "In ARM patients, renal anomalies were diagnosed in 39.9% across all hospital encounters" — Alex Halpern (epidemiological) [2:25](https://library.globalcastmd.com/watch/quick-literature-updates-ep-26-11413?t=145) - "In ARM patients, limb anomalies were diagnosed in 15.7% across all hospital encounters" — Alex Halpern (epidemiological) [2:25](https://library.globalcastmd.com/watch/quick-literature-updates-ep-26-11413?t=145) - "25.8% of female ARM patients had a congenital gynecologic malformation diagnosed" — Alex Halpern (epidemiological) [2:40](https://library.globalcastmd.com/watch/quick-literature-updates-ep-26-11413?t=160) - "The most common anomalies associated with ARMs are cardiac, vertebrospinal, renal, and gynecologic" — Alex Halpern (clinical) [2:45](https://library.globalcastmd.com/watch/quick-literature-updates-ep-26-11413?t=165) - "The authors suggest changing the VACTERL acronym to VACTERL-GS to include gynecologic and spinal conditions" — Alex Halpern (guideline) [2:53](https://library.globalcastmd.com/watch/quick-literature-updates-ep-26-11413?t=173) - "The sepsis study was a worldwide study with a Delphi consensus process that aimed to update the definitions of sepsis and septic shock" — Cecilia Gigena (clinical) [3:20](https://library.globalcastmd.com/watch/quick-literature-updates-ep-26-11413?t=200) - "The Phoenix sepsis score includes variables in cardiovascular function, respiratory function, coagulation, and neurological function" — Cecilia Gigena (clinical) [3:29](https://library.globalcastmd.com/watch/quick-literature-updates-ep-26-11413?t=209) - "The Phoenix sepsis score correlates the definition with actual mortality rate" — Cecilia Gigena (clinical) [3:42](https://library.globalcastmd.com/watch/quick-literature-updates-ep-26-11413?t=222) - "Sepsis is defined as suspected infection plus 2 points in the Phoenix sepsis score" — Cecilia Gigena (guideline) [3:48](https://library.globalcastmd.com/watch/quick-literature-updates-ep-26-11413?t=228) - "Septic shock is defined as sepsis plus cardiovascular dysfunction seen when there is 1 point in the cardiovascular variable of the Phoenix sepsis score" — Cecilia Gigena (guideline) [3:48](https://library.globalcastmd.com/watch/quick-literature-updates-ep-26-11413?t=228) - "Sepsis has a mortality rate of 7.1%" — Cecilia Gigena (epidemiological) [4:06](https://library.globalcastmd.com/watch/quick-literature-updates-ep-26-11413?t=246) - "Septic shock has a mortality rate of 10.8 to 33.5% according to the research settings" — Cecilia Gigena (epidemiological) [4:06](https://library.globalcastmd.com/watch/quick-literature-updates-ep-26-11413?t=246) ## Transcript Hello pediatric surgery family, I'm Em Gdy from Cincinnati Children's Hospital Medical Center, and today our team is gonna deliver the articles that you should know about. We have 3 papers today, but don't have much time, so let's start. Our first paper titled Appendicectomy versus Antibiotics for Acute uncomplicated Appendicitis in Children, an Open label International multi-enter randomized non-inferiority trial by Saint Peter et al. This paper is summarized by Lizzie Lee, a physician associate by profession and a member of our team here at Cincinnati Children's dedicated to creating content for pediatric surgery. Recent literature has been supporting treating appendicitis with antibiotics rather than surgery. This is a multi-center randomized trial in Canada, the US, Finland, Sweden, and Singapore that investigated whether antibiotic treatment is inferior to appendicectomy by comparing failure rates for the two options. They found that 34% of children treated with Antibiotics eventually required surgery within a year compared to only 7% in the surgery group. While there were no deaths in either group, children in the antibiotic group had a higher risk of mild to moderate adverse events. The key takeaway is that antibiotics were not as effective as surgery for treating non-perforated appendicitis in children, as it did not meet the threshold for non-inferiority. Our second paper is Vactal screening in newborns with anorectal malformations, an opportunity to optimize screening practices at gynecologic and spinal conditions and utilize a new acronym by SH et al. And this paper is summarized by Alex Halpern. He is a research fellow at Children's National and collaborates with us to produce these article reviews. To try and answer this question, Zoo Aal used the PIS database and performed a multi-institutional cohort study of all ARM patients between 2016 and 2022. The rates of actual diagnoses across all hospital encounters were 45.4% vertebral spinal, 77.4% cardiac, 10.2% TEF, 39, 0.9% renal and 15.7% limb. 25.8% of female patients had a congenital gynecologic malformation diagnosed. So it seems like the most common anomalies associated with ARMs are cardiac, vertebrospinal, renal, and gynecologic. Due to this, the authors suggest changing the Vacto acronym to Vector Gs. Let's move to the last paper of the day. International Consensus Criteria for Pediatric sepsis and septic Shock by Schlappbach et al. This paper is summarized by Cecilia Jhena. She's one of the previous research fellows at Cincinnati Children's Hospital. This is a worldwide study with a Delphi consensus process that aimed to update the definitions of sepsis and septic shock. After multiple analysis, they came up with a Phoenix sepsis score that included variables in cardiovascular function, respiratory function, coagulation, and neurological function. This helped the author correlates the definition with an actual mortality rate. So for sepsis, the definition is suspected infection plus 2 points in the Phoenix sepsis score, and septic shock is sepsis plus cardiovascular dysfunction that is seen when we have 1 point in the cardiovascular variable of the Phoenix sepsis score. Sepsis mental mortality of 7.1%, whereas septic shock imply 10.8 to 33.5% according to the research settings. Thank you for listening. Please check the link in the description below to read each paper. We hope you liked this episode. Please follow Stay Current MD on social media. Give us a rating, and subscribe to our YouTube channel. And don't forget to download the Stay Current app on the App Store or Play Store for tons of content. --- Not medical advice · citation policy: https://library.globalcastmd.com/ai