Does the false-negative rate for 1 or 2 negative sentinel nodes after neo-adjuvant chemotherapy translate into a high local recurrence rate?

Prospective trials demonstrate that sentinel node (SN) biopsy after neo-adjuvant chemotherapy (NACT) has a significant false-negative rate (FNR) when only 1 or 2 SNs are removed. It is unknown whether this increased FNR correlates with an elevated risk of recurrence. Tumor Registry data at an NCI-Designated Comprehensive Cancer Center were reviewed from 2004 to 2018 for patients having a negative SN biopsy after NACT.

Robotic Inguinal Hernia Repair Outcomes: Operative Time and Cost Analysis.

Background: Robotic inguinal hernia repair is the latest iteration of minimally invasive herniorrhaphy. Previous studies have shown expedited learning curves compared to traditional laparoscopy, which may be offset by higher cost and longer operative time. We sought to compare operative time and direct cost across the evolving surgical practice of 10 surgeons in our healthcare system.

Meaningful autonomy in general surgery training: Exploring for gender bias.

Background: Resident autonomy is essential to the development of a surgical resident. This study aims to analyze gender differences in meaningful autonomy (MA) given to general surgery trainees intraoperatively.

Methods: This is a retrospective study of general surgery residents at an academic-affiliated tertiary care facility.

The role of 2-octyl cyanoacrylate in prevention of penile adhesions after circumcision: A prospective, randomized trial.

Purpose: Penile adhesions are the most common complication after circumcision, although strategies to decrease them are poorly studied. We conducted a prospective, randomized trial comparing the use of 2-octyl cyanoacrylate (glue) skin adhesive to hydrophobic ointment after circumcision.

Methods: Patients <7years old undergoing circumcision were randomized to glue around the sutures and corona of the penis or antibiotic ointment.

Inflammatory myofibroblastic tumors in children.

Background: Inflammatory myofibroblastic tumor (IMFT) is an uncommon neoplasm in children.

Methods: Retrospective review from 1993 to 2014 of patients ≤18years of age with a histopathologic diagnosis of IMFT treated at two tertiary centers.

Results: Thirty-two patients were diagnosed with IMFT.

Treatment of Idiopathic Achalasia in the Pediatric Population: A Systematic Review.

Background: Achalasia is a rare idiopathic neuromuscular disorder of the esophagus, characterized as a syndrome of impaired relaxation of the lower esophageal sphincter and decreased peristalsis of the esophageal body.

Objective: The primary objective is to determine the best first-line treatment for pediatric achalasia based on the consolidation of the current literature that compares outcomes after pneumatic dilatation (PD) versus surgical myotomy (Heller esophagomyotomy [HM]).

Data Sources: A systematic review of English articles using OVID was performed.

The Role of Medication in Spontaneous Gastrocutaneous Fistula Closure.

Purpose: Factors precipitating persistence of gastrocutaneous fistulas (GCFs) are not clearly understood. The role of proton pump inhibitors (PPIs) or histamine receptor antagonists in GCF closure is not yet studied. We aimed to identify whether these medications influence spontaneous GCF closure.

Lower radiation exposure from body CT imaging for trauma at a dedicated pediatric hospital.

Purpose: We compare radiation exposure from body CT imaging for blunt trauma performed at outside hospitals (OH) versus our children's hospital (CH).

Methods: We performed a retrospective chart review of all children transferred to our facility for management of trauma after undergoing a body CT scan at an OH from June 2011 to August 2013. Radiation from OH images was compared to our CH by matching to age, gender, and nearest date.

Single-site Nissen fundoplication versus laparoscopic Nissen fundoplication.

Background: Advances in minimally invasive surgery have led to the emergence of single-incision laparoscopic surgery (SILS). The purpose of this study is to assess the feasibility of SILS Nissen fundoplication and compare its outcomes with traditional laparoscopic Nissen fundoplication.

Methods: This is a retrospective study of 33 patients who underwent Nissen fundoplication between January 2009 and September 2010.

Nursing preference of topical silver sulfadiazine versus collagenase ointment for treatment of partial thickness burns in children: survey follow-up of a prospective randomized trial.

We performed a nursing survey to inquire about nursing preferences toward the use of silver sulfadiazine (SSD) and collagenase (CO). We performed a survey between September 2012 and December 2012 asking nurses to rate the application/removal of both products and provide a description of their preferences. Ten study nurses (83%) preferred CO over SSD (P < .

Influence of body mass index on skin grafting in pediatric burns.

Background: There is heterogeneous literature on the association of obese and underweight body habitus on burn outcomes in adult and pediatric literature. We examine the effect of standardized pediatric body mass index (BMI) categories skin graft utilisation.

Methods: A retrospective chart review was performed on children who underwent burn treatment from January 1995 to November 2011.

Radiation exposure from head computed tomography scans in pediatric trauma.

Background: We have previously reported that children receive significantly less radiation exposure after abdominal and/or pelvis computed tomography (CT) scanning for acute appendicitis when performed at our children's hospital (CH) rather than at outside hospitals (OH). In this study, we compare the amount of radiation children receive from head CTs for trauma done at OH versus those at our CH.

Methods: A retrospective chart review was performed on all children transferred to our hospital after receiving a head CT for trauma at an OH between July 2012 and December 2012.

Fever after redo Nissen fundoplication with hiatal hernia repair.

Background: Fevers often arise after redo fundoplication with hiatal hernia repair. We reviewed our experience to evaluate the yield of a fever work-up in this population.

Methods: We performed a retrospective review of children undergoing redo Nissen fundoplication with hiatal hernia repair between December 2001 and September 2012.

Single-incision laparoscopic ileocecectomy in children with Crohn's disease.

Introduction: We previously reported our experience with standard laparoscopic ileocecectomy, but we have recently used a single-incision laparoscopic approach.

Patients And Methods: We conducted a retrospective review of a single surgeon's experience from 2009 to 2013.

Results: Twenty-eight children 11-18 years of age (mean, 15.

Radiation exposure - how do CT scans for appendicitis compare between a free standing children's hospital and non-dedicated pediatric facilities?

Background: We compare the amount of radiation children receive from CT scans performed at non-dedicated pediatric facilities (OH) versus those at a dedicated children's hospital (CH).

Methods: Using a retrospective chart review, all children undergoing CT scanning for appendicitis at an OH were compared to children undergoing CT imaging for appendicitis at a CH between January 2011 and November 2012.

Results: One hundred sixty-three children underwent CT scans at 42 different OH.

Burden of complications from needle penetration of plastic ports in children.

Background: Complications of totally implanted venous access ports are well documented. A concerning mechanical complication we have encountered is posterior penetration of plastic ports with the access needle. The purpose of this study is to investigate the burden of posterior penetrations.

Laparoscopic pyloromyotomy: comparing the arthrotomy knife to the Bovie blade.

Background: Laparoscopic pyloromyotomy was performed at our institution using an arthrotomy knife until it became unavailable in 2010. Thus, we adapted the use of the blunt Bovie tip, which can be used with or without electrocautery to perform the myotomy. This study compared the outcomes between using the arthrotomy knife versus the Bovie blade in laparoscopic pyloromyotomies.

Comparison of outcomes for single-incision laparoscopic inguinal herniorrhaphy and traditional three-port laparoscopic herniorrhaphy at a single institution.

Background: Evidence in the literature regarding the potential of single-incision laparoscopic (SILS) inguinal herniorrhaphy currently is limited. A retrospective comparison of SILS and traditional multiport laparoscopic (MP) inguinal hernia repair was conducted to assess the safety and feasibility of the minimally invasive laparoscopic technique.

Methods: All laparoscopic inguinal hernia repairs performed by three surgeons at a single institution during 4 years were reviewed.

The role of minimally invasive surgery in pediatric trauma: a collective review.

Although minimally invasive surgery (MIS) has been utilized in selective trauma patients, there a relative paucity of literature on its role in both blunt and penetrating trauma in the pediatric population. Our purpose is to review the current literature on the role of MIS in abdominal and thoracic pediatric trauma. A review of the literature, indications, risks, and benefits of MIS in trauma will be presented.

Reduced use of computed tomography in patients treated with interval appendectomy after implementing a protocol from a prospective, randomized trial.

Background: In 2009, we instituted a protocol to standardize care for patients undergoing interval appendectomy based on results from a prospective trial that demonstrated a reduction in the mean number of computed tomography (CT) scans performed. The goal of this study was to determine if our current practice now resulted in fewer CT scans as a result of this trial.

Methods: A retrospective review of all patients undergoing interval appendectomy for perforated appendicitis from March 2009 to March 2011 was performed.

Accuracy of American College of Surgeons National Surgical Quality Improvement Program Pediatric for laparoscopic appendectomy at a single institution.

Background: In October 2008, the American College of Surgeons revealed the National Surgical Quality Improvement Program (NSQIP) Pediatric in an effort to improve quality of surgical care in children. A 5% disagreement rate of data reported between institutions is accepted. The two goals of this study were to (1) determine if the random sampling performed with NSQIP data collection was representative of the population, and (2) verify that data captured in NSQIP was accurate.

Current patterns of practice and technique in the repair of esophageal atresia and tracheoesophageal fistua: an IPEG survey.

Background: Optimal surgical treatment of infants with esophageal atresia (EA) and tracheoesophageal fistula (TEF) remains controversial. In order to better understand variability in management, we surveyed the International Pediatric Endosurgery Group (IPEG) membership.

Materials And Methods: An online-based survey, conducted in 2012, was sent to all IPEG members.

Implications of Foley catheterization in children with perforated appendicitis.

Background: We treat patients after appendectomy for perforated appendicitis with patient controlled analgesia (PCA) using a background continuous dose. We usually place urinary catheters in these patients because of concerns of urinary retention. The objective of the present study was to determine the rate of urinary retention in this patient population when a catheter was not used or was removed before the continuous PCA infusion was discontinued.

Patient scar assessment after single-incision versus four-port laparoscopic cholecystectomy: long-term follow-up from a prospective randomized trial.

Background: The single-incision laparoscopic approach for cholecystectomy has been reported to be cosmetically superior in the traditional four-port technique in several case series; however, prospective comparative data are lacking. We conducted a 60-patient, prospective, randomized trial comparing single-incision laparoscopic cholecystectomy with standard four-port cholecystectomy, including validated scar assessment evaluation around 6 weeks and 18 months after the operation in an effort to determine if a cosmetic advantage existed.

Patients And Methods: Patients over 12 years of age and parents of patients under 12 years of age enrolled in the trial were asked to complete the validated Patient Scar Assessment Questionnaire (PSAQ).