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Pediatric surgery quality

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https://www.readbyqxmd.com/read/29049268/patient-and-parent-satisfaction-with-sling-use-after-pediatric-upper-extremity-fractures-a-randomized-controlled-trial-of-a-customized-cast-sling-versus-standard-cast-and-sling
#1
Aristides I Cruz, Steven F DeFroda, Joseph A Gil, Heather Hansen, Alexandre Bolous, Michaela Procaccini, Mark R Zonfrillo
BACKGROUND: Long arm cast immobilization after operative and nonoperative treatment of pediatric upper extremity fractures is common. The use of a sling to aid in carrying the casted extremity as well as provide further immobilization is also common practice. Off-the-shelf slings vary in quality and fit, can be confusing for parents/patients to apply, and lead to frustration and dissatisfaction with its use. The purpose of this investigation was to compare patient/parent centered outcomes after the use of a customized sling compared with a standard sling by utilizing a prospective, randomized-controlled trial...
October 18, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29049043/challenges-of-healthcare-administration-optimizing-quality-and-value-at-an-affordable-cost-in-pediatric-cardiology
#2
Mitchell I Cohen, Patricio A Frias
PURPOSE OF REVIEW: The purpose of this review is to explore the paradigm shift in healthcare delivery that will need to take place over the next few years away from an emphasis on supply-driven health care to better quality transparent-driven health care whose focus is on the consumer's best interest. RECENT FINDINGS: The current healthcare system is fragmented and costs continue to rise. The best way to contain costs is to improve quality to the consumer, the patient...
October 18, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29038894/the-supraorbital-eyebrow-approach-for-removal-of-craniopharyngioma-in-children-a-case-series
#3
Ricardo Santos de Oliveira, Dinark Conceição Viana, Lucas Pires Augusto, Marcelo Volpon Santos, Hélio Rubens Machado
OBJECTIVE: Craniopharyngiomas can be a surgical challenge for the pediatric neurosurgeon. Ideally, total removal must be achieved. However, the need to reduce surgical morbidity and preserve quality of life has led to a number of neurosurgical approaches in order to attain this goal. The aim of this article is to present an alternative surgical approach to these lesions and to provide the rationale for this technique. MATERIAL AND METHODS: Medical charts and operative records of eight pediatric patients harboring craniopharyngiomas who underwent surgical treatment using a supraorbital eyebrow approach (SOA) were reviewed from 2014 to 2016...
October 16, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29027867/unplanned-readmission-within-90-days-after-pediatric-neurosurgery
#4
Silky Chotai, Bradley S Guidry, Emily W Chan, Katherine D Sborov, Stephen Gannon, Chevis Shannon, Christopher M Bonfield, John C Wellons, Robert P Naftel
OBJECTIVE Readmission and return to operating room after surgery are increasingly being used as a proxy for quality of care. Nearly 60% of these readmissions are unplanned, which translates into billions of dollars in health care costs. The authors set out to analyze the incidence of readmission at their center, to define causes of unplanned readmission, and to determine the preoperative and surgical variables associated with readmissions following pediatric neurosurgery. METHODS A total of 536 children who underwent operations for neurosurgical diagnoses between 2012 and 2015 and who were later readmitted were included in the final analysis...
October 13, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29018940/laparoscopy-or-laparotomy-for-adhesive-bowel-obstruction-in-children-a-systematic-review-and-meta-analysis
#5
Hiromu Miyake, Shogo Seo, Agostino Pierro
PURPOSE: Adhesive small bowel obstruction (ASBO) is one of the most important cause of postoperative morbidity in children who underwent abdominal surgery. Laparoscopic management for ASBO in pediatric patients has been reported. However, its safety and efficacy has not been evaluated in details. The aim of this study is to compare the outcomes of laparoscopy and laparotomy for the treatment of ASBO in children. METHODS: A systematic review and meta-analysis were performed following the Cochrane Handbook for systematic reviews of intervention and the preferred reporting item for systematic reviews and meta-analysis (PRISMA) and a protocol registered in PROSPERO (CRD42017067914)...
October 10, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/29017082/temporal-lobe-surgery-for-intractable-epilepsy-in-children-what-to-do-with-the-hippocampus
#6
Mony Benifla, Odeya Bennet-Back, Zamir Shorer, Iris Noyman, Rima Bar-Yosef, Dana Ekstein
PURPOSE: Resection of the hippocampus can cause verbal memory decline, especially in the pediatric population. Thus, preservation of the hippocampus can be crucial for the quality of life of children with intractable temporal lobe epilepsy (TLE) who are candidates for epilepsy surgery. We investigated techniques that determine whether the hippocampus is part of the epileptogenic zone and the outcomes of pediatric surgery aimed to spare the hippocampus. METHODS: We accessed data of children with normal hippocampus on MRI, who underwent surgery for medically refractory TLE...
October 2, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28987855/comparison-of-quality-metrics-for-pediatric-shunt-surgery-and-proposal-of-the-negative-shunt-revision-rate
#7
Thomas Beez, Hans-Jakob Steiger
OBJECTIVE: Shunt surgery is common in pediatric neurosurgery and is associated with relevant complication rates. We sought to compare previously published metrics in a single data set and propose the Negative Shunt Revision Rate (NSRR) as a new quality metric, defined as the proportion of shunt explorations revealing a properly working system. METHODS: A retrospective analysis of our shunt surgery activity in 2015 was performed. Demographic, clinical and radiological variables were extracted from electronic medical notes...
October 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28987837/physiologic-growth-hormone-replacement-therapy-and-craniopharyngioma-recurrence-in-pediatric-patients-a-meta-analysis
#8
REVIEW
Nawaf M Alotaibi, Nadia Noormohamed, David J Cote, Salman Alharthi, Joanne Doucette, Hasan A Zaidi, Rania A Mekary, Timothy R Smith
OBJECTIVE: A systematic review and meta-analysis were conducted to examine the effect of growth hormone replacement therapy (GHRT) on the recurrence of craniopharyngioma in children. METHODS: PubMed, EMBASE, and Cochrane databases were searched through April 2017 for studies that evaluated the effect of GHRT on the recurrence of pediatric craniopharyngioma. Pooled effect estimates were calculated using fixed- and random-effects models. RESULTS: Ten studies (n=3,487 patients) met all inclusion criteria, including 2 retrospective cohorts and 8 case series...
October 4, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28985868/clinical-and-socioeconomic-factors-associated-with-negative-pediatric-appendicitis
#9
Genia Dubrovsky, Josh Rouch, Nhan Huynh, Scott Friedlander, Yang Lu, Steven L Lee
BACKGROUND: Misdiagnosing appendicitis may lead to unnecessary surgery. The study evaluates the risk factors for negative appendectomies, as well as the clinical and socioeconomic consequences of negative appendectomy across three states. MATERIALS AND METHODS: Data were obtained from the California, New York, and Florida State Inpatient Databases 2005-2011. Patients (<18 years) who underwent nonincidental appendectomies (n = 156,660) were evaluated with hierarchical and multivariate negative binomial regression analyses on outcomes including hospital cost, length of stay (LOS), and associated morbidity...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28985855/safety-of-perioperative-ketorolac-administration-in-pediatric-appendectomy
#10
Hibbut-Ur-Rauf Naseem, Robert Michael Dorman, George Ventro, David H Rothstein, Kaveh Vali
BACKGROUND: Recent studies in adults undergoing gastrointestinal surgeries show an increased rate of complications with the use of ketorolac. This calls into question the safety of ketorolac in certain procedures. We sought to evaluate the impact of perioperative ketorolac administration on outcomes in pediatric appendectomy. METHODS: The Pediatric Health Information System database was queried for patients aged 5-17 y with a primary diagnosis of appendicitis and a primary procedure of appendectomy during the period 2010-2014...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28984537/neurosurgical-transection-of-the-breast-an-unexpected-extracranial-complication-of-ventriculoperitoneal-shunt-insertion
#11
Molly Jakeman, Ranjeet Jeevan, Sasha C Burn, Sian Falder
Ventriculoperitoneal (VP) shunt placement is among the most common surgical procedures undertaken by neurosurgeons. Complications arising from the thoracic portion of the shunt are relatively rare in comparison with those of the intraventricular and peritoneal portions. Disruption of primary breast development following VP shunt placement has not previously been reported. The authors describe the case of a 15-year-old girl referred to the plastic surgery department with a significant right breast deformity and associated asymmetry following VP shunt placement performed during the neonatal period...
October 6, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28977312/analysis-of-surgical-site-infections-in-pediatric-patients-after-orthopedic-surgery-a-case-control-study
#12
Mariana de Queiroz Leite Chagas, Ana Maria Magalhães Costa, Pedro Henrique Barros Mendes, Saint Clair Gomes
OBJECTIVES: To describe the rate of surgical site infections in children undergoing orthopedic surgery in centers of excellence and analyze the patients' profiles. METHODS: Medical records of pediatric patients undergoing orthopedic surgery in the Jamil Haddad National Institute of Traumatology and Orthopedics from January 2012 to December 2013 were analyzed and monitored for one year. Patients diagnosed with surgical site infection were matched with patients without infection by age, date of admission, field of orthopedic surgery and type of surgical procedure...
January 2017: Revista Paulista de Pediatria: Orgão Oficial da Sociedade de Pediatria de São Paulo
https://www.readbyqxmd.com/read/28977197/collaborative-quality-improvement-in-the-congenital-heart-defects-development-of-the-assist-consortium-and-a-preliminary-surgical-outcomes-report
#13
Fabio Carmona, Paulo Henrique Manso, Mariana Nicoletti Ferreira, Nana Miura Ikari, Marcelo Biscegli Jatene, Luciana Amato, Aida Luiza Turquetto, Luiz Fernando Caneo
OBJECTIVE: ASSIST is the first Brazilian initiative in building a collaborative quality improvement program in pediatric cardiology and congenital heart disease. The purposes of this manuscript are: (a) to describe the development of the ASSIST project, including the historical, philosophical, organizational, and infrastructural components that will facilitate collaborative quality improvement in congenital heart disease care; (b) to report past and ongoing challenges faced; and (c) to report the first preliminary data analysis...
July 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28974875/parental-satisfaction-with-pediatric-day-care-surgery-and-its-determinants-in-a-tertiary-care-hospital
#14
Cenita James Sam, Pavai A Arunachalam, Sivamani Manivasagan, T Surya
OBJECTIVE: The objective is to assess the level of parental satisfaction of pediatric day-care surgery and its different determinants. MATERIALS AND METHODS: This is a descriptive study performed in a tertiary care hospital in India among parents of pediatric day-care surgery patients from June 2013 to March 2015. The core questionnaire for the assessment of patient satisfaction for general day care (COPS-D) was used. Variables related to surgery, overall satisfaction, one open-ended question, and socio-demographic data were also collected...
October 2017: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/28968151/cerebellar-pilocytic-astrocytoma-in-childhood-investigating-the-long-term-impact-of-surgery-on-cognitive-performance-and-functional-outcome
#15
Thomas Pletschko, Anna Felnhofer, Doris Lamplmair, Christian Dorfer, Thomas Czech, Monika Chocholous, Irene Slavc, Ulrike Leiss
OBJECTIVE: Previous studies differ regarding the long-term effects of surgically removed pediatric cerebellar pilocytic astrocytomas (CPA). Thus, the aim of this study was to investigate the long-term impact on neurocognitive and functional outcome and to analyze age as an influencing factor. METHODS: Fourteen CPA patients were compared to the age norm and to a group of 14 high-achieving peers regarding cognitive functioning, health-related quality of life (HRQoL), and stress regulation...
October 2, 2017: Developmental Neurorehabilitation
https://www.readbyqxmd.com/read/28967607/reduction-and-standardization-of-surgical-instruments-in-pediatric-inguinal-hernia-repair
#16
Martin A Koyle, Naif AlQarni, Rakan Odeh, Hissan Butt, Mohammed M Alkahtani, Louis Konstant, Lisa Pendergast, Leah C C Koyle, G Ross Baker
AIM: To standardize and reduce surgical instrumentation by >25% within a 9-month period for pediatric inguinal hernia repair (PIHR), using "improvement science" methodology. METHODS: We prospectively evaluated instruments used for PIHR in 56 consecutive cases by individual surgeons across two separate subspecialties, pediatric surgery (S) and pediatric urology (U), to measure actual number of instruments used compared with existing practice based on preference cards...
September 8, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28965232/the-role-of-simultaneous-abdominal-surgery-and-wound-classification-in-ventriculoperitoneal-shunt-complication
#17
Shin Miyata, Jamie Golden, Olga Lebedevskiy, James E Stein, David W Bliss
PURPOSE: To evaluate whether simultaneous abdominal surgery or wound contamination at the time of ventriculoperitoneal (VP) shunt placement are associated with increased shunt complications. METHODS: Pediatric patients who underwent VP shunt placement were identified using the National Surgical Quality Improvement Program Pediatric database. VP shunt complication rates were compared between patients who underwent simultaneous abdominal surgeries at the time of VP shunt placement vs those who did not and between those with clean/clean-contaminated and contaminated/dirty wound classifications...
September 30, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28953730/age-related-differences-in-psychosocial-function-of-children-with-craniofacial-anomalies
#18
Elizabeth J Volpicelli, Miles J Pfaff, Kevin Hakimi, James P Bradley, R Christian Solem, Justine C Lee
BACKGROUND: Age is a frequent consideration for surgical timing in pediatric craniofacial surgery for optimal psychosocial development. However, systematic evaluations of the effects of age in children under active treatment have not been thoroughly evaluated. METHODS: Ninety-nine patients (age, 8 to 17 years; 46.5 percent male) from the University of California, Los Angeles, Craniofacial Clinic were prospectively evaluated using the Pediatric Patient-Reported Outcomes Measurement Information System to assess anger, anxiety, depression, and quality of peer relationships...
October 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28953606/an-analysis-of-safety-and-adverse-events-following-cochlear-implantation-in-children-under-12-months-of-age
#19
Yesul Kim, Vijay A Patel, Huseyin Isildak, Michele M Carr
OBJECTIVE: To determine perioperative morbidity of children ≤12 months undergoing cochlear implantation (CI). STUDY DESIGN: Retrospective analysis using the American College of Surgeons National Surgical Quality Improvement Program Pediatric Database (ACS-NSQIP-P). SETTING: General acute care children's hospitals, children's hospitals within larger hospitals, specialty children's hospitals, and general acute care hospitals with a pediatric wing...
September 26, 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28922233/endoscopic-versus-open-repair-for-craniosynostosis-in-infants-using-propensity-score-matching-to-compare-outcomes-a-multicenter-study-from-the-pediatric-craniofacial-collaborative-group
#20
Douglas R Thompson, David Zurakowski, Charles M Haberkern, Paul A Stricker, Petra M Meier
BACKGROUND: The North American Pediatric Craniofacial Collaborative Group (PCCG) established the Pediatric Craniofacial Surgery Perioperative Registry to evaluate outcomes in infants and children undergoing craniosynostosis repair. The goal of this multicenter study was to utilize this registry to assess differences in blood utilization, intensive care unit (ICU) utilization, duration of hospitalization, and perioperative complications between endoscopic-assisted (ESC) and open repair in infants with craniosynostosis...
September 14, 2017: Anesthesia and Analgesia
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