Canadian Association of Radiologists Pediatric Imaging Referral Guideline.

The Canadian Association of Radiologists (CAR) Pediatric Expert Panel is made up of pediatric physicians from the disciplines of radiology, emergency medicine, endocrinology, gastroenterology, general surgery, neurology, neurosurgery, respirology, orthopaedic surgery, otolaryngology, urology, a patient advisor, and an epidemiologist/guideline methodologist. After developing a list of 50 clinical/diagnostic scenarios, a rapid scoping review was undertaken to identify systematically produced referral guidelines that provide recommendations for one or more of these clinical/diagnostic scenarios. Recommendations from 32 guidelines and contextualization criteria in the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) for guidelines framework were used to develop 133 recommendation statements across the 50 scenarios.

Application rates to surgical residency programs in Canada.

Purpose: The purpose of this study is to identify if the previously reported declining interest in surgery amongst medical students persists, and also to provide more descriptive analysis of trends by surgical specialty and medical school. Our hypothesis is that the previously reported decreasing interest in surgery remains constant for some surgical disciplines.

Methods: The Canadian Resident Matching Service and the Association of Faculties of Medicine of Canada provided data for this study.

The future is here! Pediatric surgery and the move to the royal college of physicians and surgeons of Canada's competence by design.

This interactive session was held at the 51st Annual Meeting of the Canadian Association of Pediatric Surgeons (CAPS) in preparation for the transition of Pediatric Surgery training in Canada to Competency by Design (a CBME-based model of residency training developed by the Royal College of Physicians and Surgeons of Canada).

Predictors for surgical intervention and surgical outcomes in neonates with cystic fibrosis.

Background/purpose: To identify prenatal and perinatal predictors of surgery and describe surgical findings/outcomes of neonates with Meconium Ileus (MI) secondary to Cystic Fibrosis (CF).

Methods: Potential risk factors (prenatal bowel echogenicity, CF genotype, birthweight, prematurity and sex) for MI and surgery were examined in a retrospective cohort of neonates with CF presenting to a tertiary center between 1997 and 2015. Following univariable analysis, predictors of MI and surgery were determined using multivariable logistic regression.

Appendectomy versus non-operative treatment for acute uncomplicated appendicitis in children: study protocol for a multicentre, open-label, non-inferiority, randomised controlled trial.

Background: Appendectomy is considered the gold standard treatment for acute appendicitis. Recently the need for surgery has been challenged in both adults and children. In children there is growing clinician, patient and parental interest in non-operative treatment of acute appendicitis with antibiotics as opposed to surgery.

Decision-Making Criteria for Observational Management of Congenital Pulmonary Airway Malformations (CPAMs).

Purpose: The purpose of this study was to determine practice patterns of Canadian surgeons managing congenital pulmonary airway malformations (CPAMs) and factors influencing practice.

Methods: Pediatric surgeons in Canada were surveyed regarding their experience, evaluation, and management CPAMs, and what factors they feel qualify patients for observation vs resection. Data were summarized, and Fisher's-Exact and Kruskal-Wallis Tests applied where appropriate.

Evidence supporting laparoscopic hernia repair in children.

Purpose Of Review: Pediatric inguinal hernias are a commonly performed surgical procedure. Currently, they can be approached via open or laparoscopic surgery. We summarize the current evidence for laparoscopic inguinal hernia repairs in children.

The International Pediatric Endosurgery Group Evidence-Based Guideline on Minimal Access Approaches to the Operative Management of Inguinal Hernia in Children.

Minimally invasive surgery (MIS) for inguinal hernia repair (IHR) in children has been reported for more than two decades. The International Pediatric Endosurgery Group (IPEG) Evidence-Based Review Committee chose MIS IHR as the inaugural topic for review and presentation at the 2016 IPEG annual meeting. English language articles published between January 1, 2009, and December 31, 2015, were reviewed and included in this evidence-based review after searching PubMed, Cochrane Reviews, ClinicalTrials.

Determinants of wait time for infant inguinal hernia repair in a Canadian children's hospital.

Background: Longer wait time for infant inguinal hernia (IH) repair is associated with higher complication rates. We wished to determine if socioeconomic and demographic factors influence wait times for IH repair.

Methods: Children <2 years old with IH at a Canadian children's hospital were retrospectively reviewed.

Adolescent bariatric surgery: the Canadian perspective.

Canada faces a similar epidemic of obesity in their adolescent population as other Western countries. However, the development of programs to treat obesity and manage its sequelae has evolved in a unique way. This is in part due to differences in health care funding, population distribution, public demand, and availability of expertise and resources.

Loop versus divided colostomy for the management of anorectal malformations.

Purpose: The purpose of this study was to compare the clinical outcomes of loop and divided colostomies in patients with anorectal malformations (ARM).

Methods: We performed a retrospective cohort study reviewing the medical records of all patients with ARM managed with diverting colostomies between 2000 and 2010 at our institution. Independent variables and outcomes of stoma complications were analyzed by parametric measures and logistic regression.

What is the significance of contrast "blush" in pediatric blunt splenic trauma?

Purpose: Contrast extravasation (CE) associated with blunt splenic injuries (BSIs) in adults is commonly treated with embolization or splenectomy. Whether this is necessary in children is unclear. We sought to determine if CE on initial computed tomography (CT) is associated with negative outcomes in children with BSI.

What's the incidence of delayed splenic bleeding in children after blunt trauma? An institutional experience and review of the literature.

Background: The existence and incidence of delayed splenic bleeding (DSB) in children are controversial but the implications are significant. We sought to determine the incidence of DSB in children and to look for similarities between reported cases.

Methods: A retrospective cohort study of all children admitted from 1992 to 2006 to our level 1 pediatric trauma center with blunt splenic injuries to calculate the incidence of DSB.

Management of blunt splenic injury in children: evolution of the nonoperative approach.

Background: Nonoperative management of blunt splenic injury (BSI) was first proposed at our institution in 1948. Since that time, treatment of patients with BSI has evolved from routine splenectomy to an aggressive spleen-preserving philosophy. This report summarizes our institutional experience for the last 50 years.

Appendicitis in the obese child.

Background/purpose: Little data exist that examine the surgical challenges of obese children. We hypothesize that obesity affects the presentation, diagnosis, surgery, and postoperative course in children with appendicitis.

Methods: Cases of all children treated for appendicitis over 6 years were reviewed retrospectively.