Same-Day Home Recovery for Benign Foregut Surgery.

Importance: Same-day home recovery (SHR) is now the standard of care for many major surgical procedures and has the potential to become standard practice for benign foregut procedures (eg, hiatal hernia repair, fundoplication, and Heller myotomy).

Objective: To determine whether SHR for patients undergoing benign foregut surgery is feasible, safe, and effective.

Design, Setting, And Participants: This prospective cohort study took place across 19 medical centers within an integrated health care system in northern California from January 2019 through September 2021.

Single-stage abdominal wall reconstruction in contaminated and dirty wounds is safe: a single center experience.

Background: The proper approach to repair of complex abdominal wall hernia in contaminated and dirty surgical fields is unknown. Identification of a surgical approach limiting the number of operative procedures, post-operative complications, and financial burden is needed. We hypothesized that single-stage abdominal wall reconstruction using poly-4-hydroxybutyrate resorbable mesh would result in low incidence of post-operative surgical site occurrence and a low incidence of hernia recurrence in Centers for Disease Control class III and IV wounds.

Predictors of index admission mortality and morbidity in contemporary esophageal atresia patients.

Background/purpose: The Spitz classification for esophageal atresia with/without tracheoesophageal fistula (EA/TEF) predicts mortality. This study evaluates the contemporary relevance of the Spitz classification and investigates predictors of morbidity.

Methods: EA/TEF patients born between 1995 and 2018 at two centers were retrospectively reviewed.

Expanded indications for bariatric surgery: should patients on chronic steroids be offered bariatric procedures?

Background: Patients who take chronic corticosteroids are increasingly referred for bariatric surgery. Little is known about their clinical outcomes.

Objective: Determine whether chronic steroid use is associated with increased morbidity and mortality after stapled bariatric procedures.

Antenatal maternally-administered phosphodiesterase type 5 inhibitors normalize eNOS expression in the fetal lamb model of congenital diaphragmatic hernia.

Purpose: Pulmonary hypertension (pHTN), a main determinant of survival in congenital diaphragmatic hernia (CDH), results from in utero vascular remodeling. Phosphodiesterase type 5 (PDE5) inhibitors have never been used antenatally to treat pHTN. The purpose of this study is to determine if antenatal PDE5 inhibitors can prevent pHTN in the fetal lamb model of CDH.

Hepatic portocholecystostomy for biliary atresia: a 25-year follow-up and review.

We report the successful salvage of a patient's native liver 25 years after hepatic portocholecystostomy for biliary atresia. Our case demonstrates the effectiveness of biliary specific, high-resolution CT imaging in the diagnosis of, and operative planning for complex cases of biliary obstruction. We also report the longest-term pathologic follow-up of biliary atresia after hepatic portocholecystostomy.

Pediatric penetrating trauma: the epidemic continues.

Background: Pediatric penetrating injuries plague inner cities. Based on our clinical observations, we hypothesized that pediatric penetrating trauma (PPT) is increasing with the major increase occurring in communities with lower socioeconomic status.

Methods: We retrospectively reviewed the trauma databases between 2000 and 2009 of the three major trauma centers in Alameda and San Francisco counties.

Implantable ultra-low pulmonary pressure monitoring system for fetal surgery.

Congenital pulmonary hypoplasia is a devastating condition affecting fetal and newborn pulmonary physiology, resulting in great morbidity and mortality. The fetal lung develops in a fluid-filled environment. In this work, we describe a novel, implantable pressure sensing and recording device which we use to study the pressures present in the fetal pulmonary tree throughout gestation.

Long-term outcomes after fetal therapy for congenital high airway obstructive syndrome.

Background/purpose: Congenital high airway obstructive syndrome (CHAOS) is a rare and devastating condition that is uniformly fatal without fetal intervention. We sought to describe fetal treatment and long-term outcomes of CHAOS at a single referral center.

Methods: The medical records of patients with fetal CHAOS evaluated at our center between 1993 and 2011 were reviewed.

Guide wire assisted catheterization and colored dye injection for vascular mapping of monochorionic twin placentas.

Monochorionic (MC) twin pregnancies are associated with significantly higher morbidity and mortality rates than dichorionic twins. Approximately 50% of MC twin pregnancies develop complications arising from the shared placenta and associated vascular connections. Severe twin-to-twin syndrome (TTTS) is reported to account for approximately 20% of these complications.

Dynamic tracheal occlusion improves lung morphometrics and function in the fetal lamb model of congenital diaphragmatic hernia.

Background: Congenital diaphragmatic hernia (CDH) is associated with significant neonatal morbidity and mortality. Although prenatal complete tracheal occlusion (cTO) causes hypoplastic CDH lungs to enlarge, improved lung function has not been demonstrated. Furthermore, cTO interferes with the dynamic pressure change and fluid flow associated with fetal breathing.