Quick Literature Updates Ep 22

The Beotti et al. prospective study on postoperative calibrations in Hirschsprung disease took place 2021 to 2023 and included 33 patients under six months old who underwent endorectal pull-through surgeries.

In the Beotti study, patients were assigned to a new non-dilation protocol group or a traditional dilation group.

The Beotti study primary outcomes were anastomotic complications, enterocolitis, and constipation.

In the Beotti study, there was no significant difference in anastomotic complications between the two groups, but the non-dilation group had less enterocolitis and less constipation.

Choosing not to do postoperative anal dilations after Hirschsprung pull-through may be a good alternative with benefits like lower constipation and enterocolitis.

The APSA Outcomes and Evidence-based Practice Committee systematic review by Slidell et al. found that delivery after 37 weeks is optimal for gastroschisis.

For gastroschisis, prophylactic antibiotics covering skin flora are adequate to reduce infection risk until closure.

Studies support primary fascial repair for gastroschisis as long as hemodynamics and abdominal domain permit.

Sutureless repair for gastroschisis is safe, effective, and does not delay feeding or increase length of stay.

The APSA systematic review concluded that there is a need for high quality randomized controlled trials to help provide evidence-based care for gastroschisis infants.

The Pefer et al. study is a retrospective study done in Texas using a state hospital database examining CDH outcomes by center volume.

The Pefer study identified 1,314 CDH patients: 728 from high volume centers, 9 from mid-volume centers, and 79 from low volume centers.

High volume centers had significantly lower mortality rates for CDH, even though they have significantly sicker patients.

High volume centers had significantly shorter length of stay for CDH patients.

High volume centers had better outcomes for patients with CDH.