journal
https://read.qxmd.com/read/38599148/inflammatory-bowel-disease-evolving-therapeutic-approaches-to-a-hidden-epidemic
#1
EDITORIAL
Lisa McMahon, Samir K Gadepalli
No abstract text is available yet for this article.
April 1, 2024: Seminars in Pediatric Surgery
https://read.qxmd.com/read/38603820/perianal-disease-updates-and-controversies-in-closing-the-gaps
#2
JOURNAL ARTICLE
Samir K Gadepalli, Jeremy Adler
Perianal complications are common and morbid in children with Crohn's disease. In this review, we describe the epidemiology, the presentation and diagnosis, evaluation and management. We focus on updates such as the increasing frequency of biologic medications and MRI for evaluation. We also highlight controversies on the timing and approaches to surgical techniques. Finally, perianal disease requires the coordination of multidisciplinary care with nursing, radiology, gastroenterology, and surgery to optimize outcomes - both medical and patient-centered...
March 30, 2024: Seminars in Pediatric Surgery
https://read.qxmd.com/read/38615424/surgery-for-ulcerative-colitis
#3
JOURNAL ARTICLE
Brielle Ochoa, Lisa McMahon
Ulcerative colitis (UC) has a more severe presentation and rapid progression in pediatric patients, resulting in a greater need for surgical intervention compared to adults. Though medical management of UC has advanced with new biologic therapies, surgery continues to play an important role when disease progresses in the form of worsened or persistent symptoms, hemodynamic instability, or sepsis. The goals of surgical management are to restore intestinal continuity with a functional pouch when possible. While the literature has been growing regarding studies of pediatric patients with UC, high level of evidence studies are limited and most recommendations are based on adult studies...
March 28, 2024: Seminars in Pediatric Surgery
https://read.qxmd.com/read/38615423/surgical-management-of-pediatric-crohn-s-disease
#4
JOURNAL ARTICLE
Michela Carter, Irene Isabel P Lim
Management of pediatric-onset Crohn's disease uniquely necessitates consideration of growth, pubertal development, psychosocial function and an increased risk for multiple future surgical interventions. Both medical and surgical management are rapidly advancing; therefore, it is increasingly important to define the role of surgery and the breadth of surgical options available for this complex patient population. Particularly, the introduction of biologics has altered the disease course; however, the ultimate need for surgical intervention has remained unchanged...
March 28, 2024: Seminars in Pediatric Surgery
https://read.qxmd.com/read/38608432/evolution-of-enhanced-recovery-for-children-undergoing-elective-intestinal-surgery
#5
JOURNAL ARTICLE
Mallory N Perez, Mehul V Raval
Enhanced recovery protocols (ERP) have been widely adopted in adult populations, with over 30 years of experience demonstrating the effectiveness of these protocols in patients undergoing gastrointestinal (GI) surgery. In the last decade, ERPs have been applied to pediatric populations across multiple subspecialties. The objective of this manuscript is to explore the evolution of how ERPs have been implemented and adapted specifically for pediatric populations undergoing GI surgery, predominantly for inflammatory bowel disease...
March 28, 2024: Seminars in Pediatric Surgery
https://read.qxmd.com/read/38593515/recurrent-crohn-s-disease
#6
JOURNAL ARTICLE
Mahmoud Shehada, Lisa E McMahon
Although surgical management of the ileocolic segment in pediatric Crohn's disease is not curative, the main goal of therapy is to allow for growth, adequate nutrition, and age-appropriate development. Recurrent disease at the site of anastomosis presents as a major morbidity. Several factors have been implicated in the development of surgical recurrence though data in the literature is scarce. This review explores the epidemiology of recurrent ileocolic disease following primary surgery, indications for surgical intervention, and techniques reported in the literature...
March 28, 2024: Seminars in Pediatric Surgery
https://read.qxmd.com/read/38583361/complications-following-ileal-pouch-anal-anastomosis-in-pediatric-ulcerative-colitis
#7
JOURNAL ARTICLE
Preston H Palm, Monique C Matos, Cristine S Velazco
Ileal pouch-anal anastomosis (IPAA) is the procedure of choice for reconstruction after total proctocolectomy in pediatric patients with ulcerative colitis. 30-60 % of patients undergoing IPAA will experience a postoperative complication. The primary objective of this article is to address the most common complications specific to IPAA in the pediatric population and provide an up-to-date review of their presentation, risk factors, workup, and management. We also share our preferred approaches to management and prevention of complications, where relevant...
March 28, 2024: Seminars in Pediatric Surgery
https://read.qxmd.com/read/38642531/surgical-management-of-complicated-crohn-s-disease
#8
REVIEW
Sarah J Ullrich, Jason S Frischer
Surgical management of pediatric Crohn's disease is fundamentally palliative, aiming to treat the sequalae of complicated disease while preserving intestinal length. Multidisciplinary discussion of risk factors and quality of life should take place prior to operative intervention. Though the surgical management of pediatric Crohn's disease is largely based on the adult literature, there are considerations specific to the pediatric population - notably disease and treatment effects on growth and development...
April 2024: Seminars in Pediatric Surgery
https://read.qxmd.com/read/38636151/ouch-my-pouch-a-clinician-s-guide-to-pouchitis
#9
REVIEW
Vincent P Anto, Anna E Ramos, Kevin P Mollen
Pouchitis is defined as inflammation of the ileal pouch created during a restorative proctocolectomy with ileal pouch-anal anastomosis. Although the incidence of this inflammatory condition is high, the exact etiology often remains unclear and the management challenging. In this review, we summarize the clinical presentation, pathogenesis, diagnosis, and management of this common complication.
April 2024: Seminars in Pediatric Surgery
https://read.qxmd.com/read/38582057/medical-management-of-pediatric-inflammatory-bowel-disease
#10
REVIEW
Brad Pasternak
Management of inflammatory bowel disease, both Crohn's disease (CD) and ulcerative colitis (UC), has seen a seismic shift over the past decade. Over the past five years, there has been the introduction of many new therapies with differing mechanisms of action and a goal of achieving mucosal healing, as well as clinical and biochemical remission (1,2). In addition, management is aimed at restoring normal growth and normalizing quality of life. The ultimate goal is to individualize medical management and determine the right drug for the right patient by identifying which inflammatory pathway is predominant and avoiding unwarranted lack of efficacy or side effects through biomarkers and risk prognostication...
April 2024: Seminars in Pediatric Surgery
https://read.qxmd.com/read/38262206/virtual-reality-applications-in-pediatric-surgery
#11
JOURNAL ARTICLE
Daniel J Robertson, Zachary R Abramson, Andrew M Davidoff, Matthew T Bramlet
Virtual reality modeling (VRM) is a 3-dimensional (3D) simulation. It is a powerful tool and has multiple uses and applications in pediatric surgery. Patient-specific 2-dimensional imaging can be used to generate a virtual reality model, which can improve anatomical perception and understanding, and can aid in preoperative planning for complex operations. VRM can also be used for realistic training and simulation. It has also proven effective in distraction for pediatric patients experiencing pain and/or anxiety...
February 2024: Seminars in Pediatric Surgery
https://read.qxmd.com/read/38245993/framework-for-pediatric-robotic-surgery-program-development
#12
JOURNAL ARTICLE
Chirag Ram, J Benjamin Pitt, Marshall W Wallace, Seth D Goldstein, Irving J Zamora
Pediatric robotic surgery has seen increasing implementation for its many benefits over the past two decades. As more pediatric surgeons gain exposure to robotic surgery, the interest in utilizing this technology is growing. However, there are no guidelines or existing framework for developing pediatric general surgery robotic programs. Programmatic development can be challenging, requiring institutional support, a minimum 12-month multistep process in partnership with the robot manufacturer, and organization of a local dedicated team...
February 2024: Seminars in Pediatric Surgery
https://read.qxmd.com/read/38245992/diaphragmatic-pacing-for-respiratory-failure-in-children
#13
REVIEW
Daniel J Robertson, Paul M Jeziorczak, Charles J Aprahamian
Diaphragm pacing is a ventilation strategy in respiratory failure. Most of the literature on pacing involves adults with common indications being spinal cord injury and amyotrophic lateral sclerosis (ALS). Previous reports in pediatric patients consist of case reports or small series; most describe direct phrenic nerve stimulation for central hypoventilation syndrome. This differs from adult reports that focus most commonly on spinal cord injuries and the rehabilitative nature of diaphragm pacing. This review describes the current state of diaphragm pacing in pediatric patients...
February 2024: Seminars in Pediatric Surgery
https://read.qxmd.com/read/38245991/indocyanine-green-icg-fluorescence-enhanced-applications-in-pediatric-surgery
#14
JOURNAL ARTICLE
John Sincavage, Brian C Gulack, Irving J Zamora
The breadth of pediatric surgical practice and variety of anatomic anomalies that characterize surgical disease in children and neonates require a unique level of operative mastery and versatility. Intraoperative navigation of small, complex, and often abnormal anatomy presents a particular challenge for pediatric surgeons. Clinical experience with fluorescent tissue dye, specifically indocyanine green (ICG), is quickly gaining widespread incorporation into adult surgical practice as a safe, non-toxic means of accurately visualizing tissue perfusion, lymphatic flow, and biliary anatomy to enhance operative speed, safety, and patient outcomes...
February 2024: Seminars in Pediatric Surgery
https://read.qxmd.com/read/38242062/3d-printing-in-pediatric-surgery
#15
JOURNAL ARTICLE
Anthony Y Tsai, Alicia C Greene
Pediatric surgery presents a unique challenge, requiring a specialized approach due to the intricacies of compact anatomy and the presence of distinct congenital features in young patients. Surgeons are tasked with making decisions that not only address immediate concerns but also consider the evolving needs of children as they grow. The advent of three-dimensional (3D) printing has emerged as a valuable tool to facilitate a personalized medical approach. This paper starts by outlining the basics of 3D modeling and printing...
February 2024: Seminars in Pediatric Surgery
https://read.qxmd.com/read/38242061/artificial-intelligence-in-pediatric-surgery
#16
REVIEW
Anthony Y Tsai, Stewart R Carter, Alicia C Greene
Artificial intelligence (AI) is rapidly changing the landscape of medicine and is already being utilized in conjunction with medical diagnostics and imaging analysis. We hereby explore AI applications in surgery and examine its relevance to pediatric surgery, covering its evolution, current state, and promising future. The various fields of AI are explored including machine learning and applications to predictive analytics and decision support in surgery, computer vision and image analysis in preoperative planning, image segmentation, surgical navigation, and finally, natural language processing assist in expediting clinical documentation, identification of clinical indications, quality improvement, outcome research, and other types of automated data extraction...
February 2024: Seminars in Pediatric Surgery
https://read.qxmd.com/read/38232468/preface
#17
EDITORIAL
Bethany J Slater
No abstract text is available yet for this article.
February 2024: Seminars in Pediatric Surgery
https://read.qxmd.com/read/38219537/non-surgical-approaches-to-the-management-of-chest-wall-deformities
#18
JOURNAL ARTICLE
Jacky Z Kwong, Brian Ch Gulack
Chest wall deformities in children encompass a broad spectrum of disorders but pectus excavatum and carinatum are by far the most common. Treatment varies substantially by center, and depends on patient symptoms, severity of disease, and surgeon preference. Historically, surgical approaches were the mainstay of treatment for these disease processes but new advances in non-surgical approaches have demonstrated reasonable results in select patients. These non-surgical approaches include vacuum bell therapy, autologous fat grafting and hyaluronic acid injections for pectus excavatum, and orthotic brace therapy for pectus carinatum...
February 2024: Seminars in Pediatric Surgery
https://read.qxmd.com/read/38190770/applications-for-ultrasound-in-pediatric-surgery
#19
JOURNAL ARTICLE
Kevin N Johnson, Jonathan Vacek, Stewart Carter
Ultrasound (US) use within pediatric surgery is expanding rapidly. While US guidance for central line placement has been common practice for many years now, advances in the quality of images, portability of US machines, and a lack of radiation associated with imaging has led to broader application in many other aspects of surgery, ranging from diagnostics to performing operations under the direction of point-of-care ultrasound (POCUS). The relatively short learning curve for providers along with excellent image quality in children due to their small size provides an easy, effective imaging modality with diverse applications...
February 2024: Seminars in Pediatric Surgery
https://read.qxmd.com/read/38194748/use-of-magnets-in-pediatric-surgery
#20
JOURNAL ARTICLE
Norah E Liang, Saunders Lin, Bethany J Slater, Matias Bruzoni
Since the 1970s, magnets have been progressively harnessed for use in minimally invasive treatment of pediatric surgical disease. In particular, multiple magnetic devices have been developed for treating esophageal atresia, pectus excavatum and scoliosis. These devices, which can be placed via small incisions or under endoscopic or fluoroscopic guidance, provide the added benefit of sparing patients multiple large, invasive procedures, and allowing for gradual correction of congenital anomalies over days to months, depending on the disease...
January 4, 2024: Seminars in Pediatric Surgery
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