In this recap from the 12th Annual Pediatric Surgery Update Course, Dr. Carlos Colunga highlights the potential of CO2 lasers in pediatric surgery. From circumcisions to frenulectomies and pilonidal cyst ablations, CO2 lasers are gaining traction for their precision, reduced pain, and shorter operating times.

Key Highlights:

• Clinical Applications: Successfully used for circumcision, frenulectomy, perianal fistulas, pilonidal cysts, and more.
• Benefits of CO2 Lasers: Reduced bleeding, lower complication rates, shorter operative times, and improved cosmetic outcomes.
• Evidence-Based Insights: Meta-analyses show CO2 laser-assisted surgeries have better results than traditional techniques in specific cases.
• Challenges: High equipment cost, steep learning curve, and the need for specialized training remain barriers to adoption.

Join us to explore how CO2 lasers are transforming pediatric surgery and learn about the exciting possibilities for the future!

Host: Lizzy Lee, PA-C

We’re back with seventeenth 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/37983822/

Zhang M, Huang J, Jin Z, Zhang X, Zhou Y, Chi S, Rong L, Zhang Y, Cao G, Li S, Tang ST. Comparison of robotic versus thoracoscopic repair for congenital esophageal atresia: a propensity score matching analysis. Int J Surg. 2024 Feb 1;110(2):891-901. doi: 10.1097/JS9.0000000000000889. PMID: 37983822; PMCID: PMC10871573.

https://pubmed.ncbi.nlm.nih.gov/38677965/

Ullrich S, Austin K, Avansino JR, Badillo A, Calkins CM, Crady RC, Durham MM, Fuller MK, Rana A, Reeder RW, Rentea RM, Rollins MD, Saadai P, Speck KE, Wood RJ, van Leeuwen K, Frischer JS; Pediatric Colorectal and Pelvic Learning Consortium. Does Delayed Diagnosis of Hirschsprung Disease Impact Post-operative and Functional Outcomes? A Multi-Center Review From the Pediatric Colorectal and Pelvic Learning Consortium. J Pediatr Surg. 2024 Jul;59(7):1250-1255. doi: 10.1016/j.jpedsurg.2024.03.034. Epub 2024 Mar 18. PMID: 38677965.

https://pubmed.ncbi.nlm.nih.gov/37978002/

Ameer A, Mirza MB, Talat N. The Outcome of Purse-string Versus Conventional Wound Closure Techniques in Patients Undergoing Stoma Reversal: A Randomized Controlled Trial. J Pediatr Surg. 2024 Jun;59(6):1186-1189. doi: 10.1016/j.jpedsurg.2023.10.062. Epub 2023 Oct 30. PMID: 37978002.

In this episode of the Colorectal Quiz, Drs. Marc Levitt, Jason Frischer, and Martin Lacher dive into the intricacies of frozen sections and reoperative strategies in Hirschsprung disease. Using a fascinating case of a late-diagnosed Hirschsprung patient, they explore critical decision-making in staged repairs and reoperative pull-through surgeries.

Key Highlights:

• Frozen Section Techniques: Best practices for biopsy marking and pathology review to confirm ganglion cells.
• Staged Repairs: Why ileostomy followed by a laparoscopic-assisted Swenson pull-through was chosen for this case.
• Reoperative Strategies: Managing transition zone pull-throughs, early reoperations, and avoiding long-term complications.
• Surgical Pearls: Insights into laparoscopic port placement, anastomotic site preparation, and collaboration with pathologists for accurate diagnoses.

Whether you're a seasoned colorectal surgeon or new to the field, this episode is packed with practical tips and lessons learned. Download the Stay Current app to view related images, X-rays, and resources discussed in the episode.

In this episode, Dr. Greg Burg, a pulmonologist at Cincinnati Children’s, discusses the medical management of minor laryngeal clefts, highlighting a comprehensive approach that includes swallow assessments, pulmonary therapies, and long-term monitoring. Learn how a combination of safe swallowing strategies, dietary modifications, and reactive therapies can help manage aspiration risks in pediatric patients.

Key Takeaways:

• Diagnostic Approach: Importance of bronchoscopy, swallow studies, and chest CT scans in identifying aspiration-related issues.
• Medical Management: Use of inhaled steroids, macrolide therapy, and saline treatments to reduce inflammation and improve airway clearance.
• Swallowing & Nutrition: Thickened feeds, pacing, and feeding tube strategies to prevent aspiration.
• Long-Term Monitoring: Vaccination recommendations, environmental risk reduction, and periodic reassessments to guide further intervention.

This discussion provides valuable insights into how a multidisciplinary approach can improve outcomes for children with minor laryngeal clefts. Don’t forget to like, comment, and subscribe for more expert discussions!

We are back with another episode of our Journal of Pediatric Surgery article review podcast.

This time we have three publications from the fourth quarter of 2024, October, November and December issues. This time we're talking to editors Drs. Mauricio "Tony" Escobar, Mikko Pakarinen, and Pablo Laje joined by authors Drs. Aodhnait Fahy, Anne-Fleur van Hal, John M. Woodward and Ben Ham III.

Host: Em Gootee

Articles:

Fahy AS, Klima DA, Gillam MM, Aprahamian CJ, Kim SS, Kokoska ER, Teeple EA, Weiss RG, Escobar MA Jr. Locum Tenens and Pediatric Surgery: A Position Statement and Practice Guidelines From the American Pediatric Surgical Association (APSA). J Pediatr Surg. 2024 Oct;59(10):161567. doi: 10.1016/j.jpedsurg.2024.04.021. Epub 2024 May 8. PMID: 38806318.

https://pubmed.ncbi.nlm.nih.gov/38806318/

van Hal ARL, Aanen IP, Wijnen RMH, Pullens B, Vlot J. The Value of Preoperative Rigid Tracheobronchoscopy for the Diagnosis of Tracheomalacia in Oesophageal Atresia Patients. J Pediatr Surg. 2024 Nov;59(11):161620. doi: 10.1016/j.jpedsurg.2024.07.005. Epub 2024 Jul 14. PMID: 39089893.

https://pubmed.ncbi.nlm.nih.gov/39089893/

Woodward JM, Chunco C, Brierley SF, Bittner K, Osei H, Harmon CM, Ham PB 3rd. Same-Day Discharge for Elective Pediatric Laparoscopic Gastrostomy Tube Insertion is Safe and Increasing in Frequency; A NSQIP Pediatric Retrospective Review 2017 to 2021. J Pediatr Surg. 2024 Dec;59(12):161665. doi: 10.1016/j.jpedsurg.2024.08.005. Epub 2024 Aug 6. PMID: 39261186.

https://pubmed.ncbi.nlm.nih.gov/39261186/

We’re back with sixteenth 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/36805142/

Brandt K, Dukleska K, McKeown M, Brancato J, Grossi V, Schoem S, Sacco T, D'Amato J, Bourque MD, Campbell BT. Utilizing a critical airway response team expedites esophageal button battery removal. J Pediatr Surg. 2023 May;58(5):810-813. doi: 10.1016/j.jpedsurg.2023.01.037. Epub 2023 Jan 19. PMID: 36805142.

https://pubmed.ncbi.nlm.nih.gov/38413262/

Hodgson E, Briatico D, Klapman S, Skarsgard E, Beltempo M, Shah PS, Huisman E, Walton JM, Livingston MH; Canadian Association of Pediatric Surgeons Network (CAPSNet) and Canadian Neonatal Network (CNN) investigators. Association of Exclusive Breast Milk Intake and Outcomes in Infants With Uncomplicated Gastroschisis: A National Cohort Study. J Pediatr Surg. 2024 May;59(5):863-868. doi: 10.1016/j.jpedsurg.2024.01.045. Epub 2024 Feb 3. PMID: 38413262.

https://pubmed.ncbi.nlm.nih.gov/36494205/

Lai K, Notrica DM, McMahon LE, Kang P, Molitor MS, Egan JC, Bae JO, Hunteman ZM, Ostlie DJ, Lee JH, Padilla BE. Cryoablation in 350 Nuss Procedures: Evolution of Hospital Length of Stay and Opioid Use. J Pediatr Surg. 2023 Aug;58(8):1435-1439. doi: 10.1016/j.jpedsurg.2022.10.051. Epub 2022 Nov 7. PMID: 36494205.

At the 2024 Western Pediatric Trauma Conference, Katherine Alvarez, PA-C from Stanford University, presented her research on screening for acute stress and post-traumatic stress disorders in pediatric trauma patients. Her study highlights the importance of early mental health screening and follow-up evaluations to identify at-risk children who may otherwise go unnoticed.

Key Takeaways:

• Trauma & Mental Health: Pediatric trauma is a leading cause of morbidity, but mental health consequences are often overlooked.
• Screening Program: A pilot program using the Acute Stress Checklist 3 for initial screening and follow-up evaluations in outpatient trauma clinics.
• Impact of PTSD: Persistent PTSD symptoms correlate with decreased quality of life, even after full physical recovery.
• Call to Action: Serial screenings and proactive mental health interventions should be a standard part of pediatric trauma care.

This research underscores the need for integrating mental health evaluations into pediatric trauma protocols.

At the 2024 Western Pediatric Trauma Conference, Dr. David Notrica presented groundbreaking research on managing hypotensive children with blunt liver or spleen injuries. Using data from the ATOMIC+ Pediatric Trauma Resource Network, his study challenges the need for immediate surgery, emphasizing the importance of assessing blood transfusion response first.

Key Takeaways:

• Study Findings: 73% of hypotensive children responded to their initial blood transfusion.
• Non-Operative Success Rate: Among responders, 70% avoided surgery and had successful non-operative management.
• Guideline Recommendation: Children should not be rushed to the OR without first receiving blood and assessing their response.
• Impact on Pediatric Trauma Care: This approach can reduce unnecessary surgeries, improving outcomes and recovery times for young trauma patients.

Learn how these findings are shaping the future of pediatric trauma care. Don’t forget to like, comment, and subscribe for more updates on the latest research!

In this eye-opening presentation, Dr. Caroline Melhado discusses the findings of a retrospective study on the overuse of whole-body CT scans in pediatric trauma patients transferred between facilities. The study, conducted at Northern California Pediatric Trauma Centers, reveals that a significant number of these scans were unnecessary, exposing children to avoidable radiation risks.

Key Highlights:

• Overuse of CT Scans: 18% of children in the study had no clinical indication for any CT imaging.
• Avoidable Radiation Exposure: If guidelines had been followed, 867 CT scans across 417 patients could have been avoided.
• No Missed Injuries: None of the unindicated scans revealed any previously undiagnosed injuries.
• Consequences of Unnecessary Imaging: Increased healthcare costs, delayed transfers, and potential long-term cancer risks.

Dr. Mehaldo’s research emphasizes the critical need for improved guideline adherence and physician education to minimize unnecessary radiation exposure in pediatric trauma care.

In this episode from the 12th Annual Update Course in Pediatric Surgery, Dr. Nelson Rosen discusses non-surgical approaches to managing pilonidal disease, emphasizing the importance of patient education and hygiene. Learn how techniques like hair removal, meticulous hygiene, and lifestyle adjustments can significantly reduce the need for invasive procedures.

Key Highlights:

• Non-Surgical Success Rates: Up to 60-70% of patients experience improvement with non-surgical interventions alone.
• Hair Removal Techniques: Options include weekly clipping, waxing, Nair-type agents, and even laser removal for long-term maintenance.
• Hygiene Best Practices: Showering regularly, using washlets, and debunking myths about bathing restrictions for faster healing.
• Setting Expectations: How to guide patients and families through treatment while balancing realistic outcomes.

Join us to explore how non-surgical management can transform the care and recovery of patients with pilonidal disease. Don’t forget to like, comment, and subscribe for more pediatric surgery updates!

Host: Em Gootee, MD