Publications by authors named "Jean Martin Laberge"
Purpose: Pediatric surgical care in low- and middle-income countries is often hindered by systemic gaps in healthcare resources, infrastructure, training, and organization. This study aims to develop and validate the Global Assessment of Pediatric Surgery (GAPS) to appraise pediatric surgical capacity and discriminate between levels of care across diverse healthcare settings.
Methods: The GAPS Version 1 was constructed through a synthesis of existing assessment tools and expert panel consultation.
Objectives: Recurrent and primary tracheoesophageal fistulas (TEFs) are a challenging surgical pathology to treat, as standard open surgical approaches are associated with high morbidity and mortality. As such, endoscopic modalities have gained interest as an alluring alternative, yet variable success rates have been reported in the literature. The aim of this study was to provide a contemporary update of the literature and describe our institutional experience with the bronchoscopic obliteration of recurrent and primary TEFs.
View Article and Find Full Text PDFA minimally invasive hybrid procedure to correct pectus arcuatum.
J Plast Reconstr Aesthet Surg
June 2024
Background: Pectus arcuatum, also known as horns of steer anomaly or Currarino-Silverman Syndrome, is a distinct chest wall anomaly characterized by severe manubriosternal angulation, a shortened sternum, and mild pectus excavatum. The anomaly is typically repaired using open techniques, employing orthopedic fixation devices. Here, we report the results of a minimally invasive hybrid procedure to repair pectus arcuatum.
View Article and Find Full Text PDFArticle Synopsis
- * Parents in Phase I received standard information, while those in Phase II received an additional educational brochure; most Phase II parents found the materials helpful in reducing stress and improving understanding, yet anxiety and productivity outcomes remained similar in both groups.
- * Despite increased parental satisfaction with the provided surgical care, the study concluded that additional interventions are needed to effectively reduce preoperative anxiety and improve productivity after surgery.
Background: Minimally Invasive Repair of Pectus Excavatum (MIRPE) is associated with significant postoperative pain. The objective of our study was to characterize the severity and duration of this pain, and to investigate possible associations with pectus severity.
Methods: We conducted a retrospective cohort study of pediatric patients who underwent MIRPE from January 2014 to April 2018.
Purpose: Echocardiography (ECHO) and pulmonary function testing (PFT) are routinely performed during the preoperative evaluation of pectus excavatum (PE). We hypothesized that these investigations may be performed selectively based on patient symptoms and pectus severity.
Methods: A retrospective review of all PE patients who underwent a Nuss procedure during a 15-year period (2004-2018) was conducted.
Purpose: Recent studies have identified transanastomotic tubes (TATs) as a risk factor for the development of anastomotic strictures after repair of esophageal atresia with tracheoesophageal fistula (EATEF). We further investigated these findings in a multicenter study.
Methods: We conducted a retrospective cohort study at three university-affiliated hospitals in the province of Quebec.
Purpose: This study reports the incidence, severity, and predictors of musculoskeletal deformities (MD), including scoliosis and chest wall anomalies, following thoracic procedures in children.
Methods: Children younger than 14 years who had thoracic surgery between 1997 and 2012 and had no other predispositions to MD, underwent longitudinal follow-ups with dedicated musculoskeletal examination performed in an esophageal atresia, orthopedic, or research clinic. Incidence of MD was calculated, and logistic regression methods were used to determine independent predictors, including sex, gestational age, age at procedure, serratus anterior muscle division, and chest tube placement.
Article Synopsis
- - Low- and middle-income countries (LMICs) have a disproportionately low surgical workforce, comprising only 19% of the global total while facing 80% of deaths from noncommunicable diseases, prompting an analysis of the link between pediatric surgical workforce density (PSWD) and survival rates for pediatric surgical conditions.
- - The study revealed a significant variation in PSWD, with LICs showing very low densities (some at zero) while HICs had higher densities, correlating higher PSWD of ≥4 pediatric surgeons per million children under 15 years with a much higher survival rate of ≥80%.
- - The findings indicate that increasing PSWD in LICs and MICs to the suggested benchmark would require the
Purpose: Effective antenatal counseling in congenital diaphragmatic hernia (CDH) relies on proper measurement of prognostic indices. This quality initiative audited the accuracy of prenatal imaging with postnatal outcomes at two tertiary pediatric referral centers.
Methods: Prenatal lung-head ratio (LHR) and total fetal lung volume (TFLV) for CDH patients treated between 2006 and 2017 were retrieved.
Purpose: Conservative treatment of pectus excavatum with a vacuum bell device may be an attractive alternative to surgical repair. We describe an early North American experience with this device.
Methods: Prospectively maintained chest wall clinic registries from two institutions were reviewed to identify pectus excavatum patients ≤21 years treated with the vacuum bell from 2013 to 2017.
Purpose: Postoperative pain remains a considerable concern for patients and families. We assessed whether nebulized ropivacaine reduces morphine consumption and pain after laparoscopic appendectomy for uncomplicated appendicitis in children.
Methods: Patients 7-17 years old with uncomplicated appendicitis were randomized to ropivacaine (intervention arm) or saline nebulization (placebo arm) at the onset of laparoscopy.
Background: The utility of magnetic resonance imaging (MRI) in the diagnosis and management of pediatric ovarian lesions has not been well defined.
Methods: A retrospective review of all girls who underwent MRI evaluation of ovarian masses during the period 2009-2015 was performed. The accuracy of MRI was evaluated by comparing results with surgical findings, pathology reports, and subsequent imaging.
Purpose: Despite a wide spectrum of severity, perforated appendicitis in children is typically considered a single entity in outcomes studies. We performed a prospective cohort study to define a risk stratification system that correlates with outcomes and resource utilization.
Methods: A prospective study was conducted of all children operated for perforated appendicitis between May 2015 and December 2016 at a tertiary free-standing university children's hospital.
Background: The treatment of perforated appendicitis in children is characterized by significant variability in care, morbidity, resource utilization, and outcomes. We prospectively studied how minimization of care variability affects outcomes.
Methods: A clinical pathway for perforated appendicitis, in use for three decades, was further standardized in May 2015 by initiation of a disease severity classification, refinement of discharge criteria, standardization of the operation, and establishment of criteria for use of postoperative total parenteral nutrition, imaging, and invasive procedures.
INoEA is the International Network of Esophageal Atresia and consists of a broad spectrum of pediatric specialties and patient societies. The working group on long-gap esophageal atresia (LGEA) set out to develop guidelines regarding the definition of LGEA, the best diagnostic and treatment strategies, and highlight the necessity of experience and communication in the management of these challenging patients. Review of the literature and expert discussion concluded that LGEA should be defined as any esophageal atresia (EA) that has no intra-abdominal air, realizing that this defines EA with no distal tracheoesophageal fistula (TEF).
View Article and Find Full Text PDFBackground: Orofacial clefts are usually isolated cases but can be associated with other congenital malformations that are either recognised or unrecognised syndromes. The reported prevalence and pattern of such associated malformations, however, vary among studies.
Objectives: To assess the frequencies and aetiologies of congenital malformations and associated medical conditions in children with orofacial clefts in Burkina Faso (Western Africa).
Background: The Canadian 4-year native liver survival rate for biliary atresia (BA) after Kasai Portoenterostomy (KP) is 39%. The Canadian Biliary Atresia Registry (CBAR) was used to examine variability of surgical and medical management of BA.
Methods: Gastroenterologists and surgeons in all 14 Canadian pediatric tertiary centers were invited to complete an online survey of their BA management practices.
Article Synopsis
- - The study focused on simple gastroschisis patients without additional complications, analyzing factors impacting their health outcomes using data from a national registry between 2005 and 2013.
- - Of the 700 patients examined, 98.6% survived, with notable use of total parenteral nutrition (TPN) and hospital stays varying based on certain health metrics.
- - Key findings showed that prenatal bowel dilation, older age at closure, and CLABSI significantly affected recovery, with CLABSI emerging as the strongest predictor of extended TPN duration and hospital stays.
Purpose: The GPS enables risk stratification for gastroschisis and helps discriminate low from high morbidity groups. The purpose of this study was to revalidate GPS's characterization of a high morbidity group and to quantify relationships between the GPS and outcomes.
Methods: With REB approval, complete survivor data from a national gastroschisis registry was collected.
Background: This study sought to establish factors that can prognosticate outcomes of bracing for pectus carinatum (PC).
Methods: Prospective data were collected on all patients enrolled in a dynamic bracing protocol from July 2011 to July 2015. Pressure of correction (POC) was measured at initiation of treatment, and pressure of treatment (POT) was measured pre- and post-adjustment at every follow-up visit.