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1. Common variants increase risk for congenital diaphragmatic hernia within the context of de novo variants

Author

Qiao, Lu, Welch, Carrie L., Hernan, Rebecca, Wynn, Julia, Krishnan, Usha S., Zalieckas, Jill M., Buchmiller, Terry, Khlevner, Julie, De, Aliva, Farkouh-Karoleski, Christiana, Wagner, Amy J., Heydweiller, Andreas, Mueller, Andreas C., de Klein, Annelies, Warner, Brad W., Maj, Carlo, Chung, Dai, McCulley, David J., Schindel, David, Potoka, Douglas, Fialkowski, Elizabeth, Schulz, Felicitas, Kipfmuller, Florian, Lim, Foong-Yen, Magielsen, Frank, Mychaliska, George B., Aspelund, Gudrun, Reutter, Heiko Martin, Needelman, Howard, Schnater, J. Marco, Fisher, Jason C., Azarow, Kenneth, Elfiky, Mahmoud, Nöthen, Markus M., Danko, Melissa E., Li, Mindy, Kosiński, Przemyslaw, Wijnen, Rene M.H., Cusick, Robert A., Soffer, Samuel Z., Cochius-Den Otter, Suzan C.M., Schaible, Thomas, Crombleholme, Timothy, Duron, Vincent P., Donahoe, Patricia K., Sun, Xin, High, Frances A., Bendixen, Charlotte, Brosens, Erwin, Shen, Yufeng, and Chung, Wendy K.

Published
2024
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2. Comparison of Postoperative Antibiotic Protocols for Pediatric Complicated Appendicitis: A Western Pediatric Surgery Research Consortium Study

Author

Patwardhan, Utsav M., Kahan, Anastasia, Eldredge, R. Scott, Russell, Katie W., Lee, Justin, Short, Scott S., Padilla, Benjamin, Cairo, Sarah B., Acker, Shannon N., Jensen, Aaron R., Kelley-Quon, Lorraine I., Rothstein, David H., Fialkowski, Elizabeth A., Chao, Stephanie D., Gillory, Lauren, Pandya, Samir, Diaz-Miron, Jose, and Ignacio, Romeo C., Jr.

Published
2025
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3. A Survey of Current Approaches to Inguinal Hernia Repair by Pediatric General Surgeons in the United States

Author

Alhajjat, Amir M., Chao, Stephanie D., Clifton, Matthew S., Diaz-Miron, Jose L., Fialkowski, Elizabeth A., Guner, Yigit S., Gurria, Juan P., Jensen, Aaron R., Keane, Olivia A., Kelley-Quon, Lorraine, Laje, Pablo, Le, Hau D., Lesher, Aaron P., Pandya, Samir R., Perez, Eduardo A., Russell, Katie W., Slater, Bethany J., Tsao, KuoJen, Velazco, Cristine S., Wieck, Minna M., Ochoa, Brielle V., Eldredge, R. Scott, and Padilla, Benjamin E.

Published
2024
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4. Decision-Making in Pleural Drainage Following Lung Resection in Children: A Western Pediatric Surgery Research Consortium Survey

Author

Cairo, Sarah, Chao, Stephanie D., Fenton, Stephen J., Gollin, Gerald, Jensen, Aaron, Keane, Olivia A., Nicassio, Lauren, Ochoa, Brielle, Pandya, Samir, Patwardhan, Utsav M., Schnuck, Jamie K., Acker, Shannon N., Kelley-Quon, Lorraine I., Lee, Justin H., Shew, Stephen B., Fialkowski, Elizabeth, Ignacio, Romeo C., Melhado, Caroline, Qureshi, Faisal G., Russell, Katie W., and Rothstein, David H.

Published
2024
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5. Critical elements of pediatric neuroblastoma surgery

Author

Shaffiey, Shahab A., Le, Hau D., Christison-Lagay, Emily, Fialkowski, Elizabeth A., Aldrink, Jennifer H., Grant, Christa N., Honeyman, Joshua N., Janek, Kevin C., Madonna, Mary Beth, Rhee, Daniel S., Nuchtern, Jed G., Newman, Erika A., LaQuaglia, Michael P., Davidoff, Andrew M., Shamberger, Robert C., and Malek, Marcus M.

Published
2023
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6. Postoperative Respiratory Complications in SARS-CoV-2 Positive Pediatric Patients Across 20 United States Hospitals: A Cohort Study

Author

Reiter, Audra J., Ingram, Martha-Conley E., Raval, Mehul V., Garcia, Elisa, Hill, Madelyn, Aranda, Arturo, Chandler, Nicole M, Gonzalez, Raquel, Born, Kristen, Mack, Shale, Lamoshi, Abdulraouf, Lipskar, Aaron M., Han, Xiao-Yue, Fialkowski, Elizabeth, Spencer, Brianna, Kulaylat, Afif N., Barde, Amrene, Shah, Ami N., Adoumie, Maeva, Gross, Erica, Mehl, Steven C., Lopez, Monica E., Polcz, Valerie, Mustafa, Moiz M., Gander, Jeffrey W., Sullivan, Travis M., Sulkowski, Jason P., Ghani, Owais, Huang, Eunice Y., Rothstein, David, Muenks, E. Peter, St. Peter, Shawn D., Fisher, Jason C., Levy-Lambert, Dina, Reichl, Allison, Ignacio, Romeo C., Slater, Bethany J., Tsao, KuoJen, and Berman, Loren

Published
2023
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7. Standardized perioperative care reduces colorectal surgical site infection in children: A Western Pediatric Surgery Research Consortium multicenter analysis

Author

Tobias, Joseph, Padilla, Benjamin E., Lee, Justin, Chen, Stephanie, Wang, Kasper S., Kelley-Quon, Lorraine I., Mueller, Claudia, Shew, Stephen B., Joskowitz, Katie, Ignacio, Romeo C., Jr., Evans, Lauren L., Jensen, Aaron R., Acker, Shannon N., Mason, Andrew, Johnson, Alicia, McConahey, Jessica, Hansen, Erik, Pandya, Samir R., Short, Scott S., Russell, Katie W., Nicassio, Lauren, Smith, Caitlin A., and Fialkowski, Elizabeth

Published
2023
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9. Association between COVID-19 related elective surgery cancellations and pediatric inguinal hernia complications: A nationwide multicenter cohort study

Author

Hu, Andrew, Reiter, Audra J., Gerardo, Rodrigo, Skertich, Nicholas J., Lewit, Ruth, Ghani, Muhammad, Witte, Amanda, Kang, Hae-Sung, Richards, Holden, Perry, Bradley, Tian, Yao, Mehl, Steven C., Gonzalez, Andres, Novotny, Nathan M., Haynes, Jeffrey, Aranda, Arturo, Zamora, Irving J., Rhee, Daniel, Fialkowski, Elizabeth, Slater, Bethany J., Van Arendonk, Kyle, Gosain, Ankush, Lopez, Monica E., and Raval, Mehul V.

Published
2022
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10. Adolescent Vaping-Associated Trauma in the Western United States

Author

Russell, Katie W., Katz, Micah G., Phillips, Ryan C., Kelley-Quon, Lorraine I., Acker, Shannon N., Shahi, Niti, Lee, Justin H., Fialkowski, Elizabeth A., Nacharaju, Deepthi, Smith, Caitlin A., Jensen, Aaron R., Mueller, Claudia M., Padilla, Benjamin E., Ignacio, Romeo C., Ourshalimian, Shadassa, Wang, Kasper S., Ostlie, Daniel J., Fenton, Stephen J., and Kastenberg, Zachary J.

Published
2022
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11. Identification and validation of candidate risk genes in endocytic vesicular trafficking associated with esophageal atresia and tracheoesophageal fistulas

Author

Zhong, Guojie, Ahimaz, Priyanka, Edwards, Nicole A., Hagen, Jacob J., Faure, Christophe, Lu, Qiao, Kingma, Paul, Middlesworth, William, Khlevner, Julie, El Fiky, Mahmoud, Schindel, David, Fialkowski, Elizabeth, Kashyap, Adhish, Forlenza, Sophia, Kenny, Alan P., Zorn, Aaron M., Shen, Yufeng, and Chung, Wendy K.

Published
2022
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14. The need for early Kasai portoenterostomy: a Western Pediatric Surgery Research Consortium study

Author

Kelley-Quon, Lorraine I., Shue, Eveline, Burke, Rita V., Smith, Caitlin, Kling, Karen, Mahdi, Elaa, Ourshalimian, Shadassa, Fenlon, Michael, Dellinger, Matthew, Shew, Stephen B., Lee, Justin, Padilla, Benjamin, Inge, Thomas, Roach, Jonathan, Marwan, Ahmed I., Russell, Katie W., Ignacio, Romeo, Fialkowski, Elizabeth, Nijagal, Amar, Im, Cecilia, Azarow, Kenneth S., Ostlie, Daniel J., and Wang, Kasper

Published
2022
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15. Rare and de novo variants in 827 congenital diaphragmatic hernia probands implicate LONP1 as candidate risk gene

Author

Qiao, Lu, Xu, Le, Yu, Lan, Wynn, Julia, Hernan, Rebecca, Zhou, Xueya, Farkouh-Karoleski, Christiana, Krishnan, Usha S., Khlevner, Julie, De, Aliva, Zygmunt, Annette, Crombleholme, Timothy, Lim, Foong-Yen, Needelman, Howard, Cusick, Robert A., Mychaliska, George B., Warner, Brad W., Wagner, Amy J., Danko, Melissa E., Chung, Dai, Potoka, Douglas, Kosiński, Przemyslaw, McCulley, David J., Elfiky, Mahmoud, Azarow, Kenneth, Fialkowski, Elizabeth, Schindel, David, Soffer, Samuel Z., Lyon, Jane B., Zalieckas, Jill M., Vardarajan, Badri N., Aspelund, Gudrun, Duron, Vincent P., High, Frances A., Sun, Xin, Donahoe, Patricia K., Shen, Yufeng, and Chung, Wendy K.

Published
2021
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16. Implications of Tumor Characteristics and Treatment Modality on Local Recurrence and Functional Outcomes in Children With Chest Wall Sarcoma: A Pediatric Surgical Oncology Research Collaborative Study

Author

Harris, Courtney J., Helenowski, Irene, Murphy, Andrew J., Mansfield, Sara A., LaQuaglia, Michael P., Heaton, Todd E., Cavalli, Michele, Murphy, Joseph T., Newman, Erika A., Overmen, Richard E., Kartal, Tanvi T., Cooke-Barber, J., Donaher, Addison, Malek, Marcus M., Kalsi, Ranjeet, Kim, Eugene S., Zobel, Michael J., Goodhue, Catherine J., Naik-Mathuria, Bindi J., Jefferson, Imory N., Roach, Jonathan P., Mata, Claudia, Piché, Nelson, Joharifard, Shahrzad, Sultan, Serge, Short, Scott S., Meyers, Rebecka L., Bleicher, Josh, Le, Hau D., Janek, Kevin, Bütter, Andreana, Davidson, Jacob, Aldrink, Jennifer H., Richards, Holden W., Tracy, Elisabeth T., Commander, Sarah J., Fialkowski, Elizabeth A., Troutt, Misty, Dasgupta, Roshni, and Lautz, Timothy B.

Published
2022
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18. Decision-Making in Pleural Drainage Following Lung Resection in Children: A Western Pediatric Surgery Research Consortium Survey.

Author

Schnuck, Jamie K., Acker, Shannon N., Kelley-Quon, Lorraine I., Lee, Justin H., Shew, Stephen B., Fialkowski, Elizabeth, Ignacio, Romeo C., Melhado, Caroline, Qureshi, Faisal G., Russell, Katie W., and Rothstein, David H.

Abstract

Studies of adults undergoing lung resection indicated that selective omission of pleural drains is safe and advantageous. Significant practice variation exists for pleural drainage practices for children undergoing lung resection. We surveyed pediatric surgeons in a 10-hospital research consortium to understand decision-making for placement of pleural drains following lung resection in children. Faculty surgeons at the 10 member institutions of the Western Pediatric Surgery Research Consortium completed questionnaires using a REDCap survey platform. Descriptive statistics and bivariate analyses were used to characterize responses regarding indications and management of pleural drains following lung resection in pediatric patients. We received 96 responses from 109 surgeons (88 %). Most surgeons agreed that use of a pleural drain after lung resection contributes to post-operative pain, increases narcotic use, and prolongs hospitalization. Opinions varied around the immediate use of suction compared to water seal, and half routinely completed a water seal trial prior to drain removal. Surgeons who completed fellowship within the past 10 years left a pleural drain after wedge resection in 45 % of cases versus 78 % in those who completed fellowship more than 10 years ago (p = 0.001). The mean acceptable rate of unplanned post-operative pleural drain placement when pleural drainage was omitted at index operation was 6.3 % (±4.6 %). Most pediatric surgeons use pleural drainage following lung resection, with recent fellowship graduates more often omitting it. Future studies of pleural drain omission demonstrating low rates of unplanned postoperative pleural drain placement may motivate practice changes for children undergoing lung resection. V. • What is currently known about this topic? Although adult trials have shown the safety and benefits of pleural drain omission following resectional lung surgery, few such trials exist in children. • What new information is contained in this article? Wide practice variations exist in pleural drain utilization and management, providing an opportunity for standardization of care and elimination of drains in a majority of patients. [ABSTRACT FROM AUTHOR]

Published
2024
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21. Variability in perioperative evaluation and resource utilization in pediatric patients with suspected biliary dyskinesia: A multi-institutional retrospective cohort study

Author

Cairo, Sarah B, Aranda, Arturo, Bartz-Kurycki, Marisa, Baxter, Katherine J, Bonasso, Patrick, Dassinger, Melvin, Deans, Katherine J, Dorey, Danielle, Emengo, Pamela, Fialkowski, Elizabeth, Gayer, Christopher, Gonzales, Brandy, Gusman, Nakada, Hawkins, Russell B, Herzing, Karen, Huang, Eunice, Islam, Saleem, Jancelewicz, Timothy, Landman, Matthew P, Lally, Kevin P, Lesher, Aaron, Minneci, Peter C, Raval, Mehul V, Russell, Robert, Shah, Sohail, Slater, Bethany, Schoel, Leah J, Peter, Shawn St, Sujka, Joseph, Waterhouse, Jennifer, and Rothstein, David H

Published
2019
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22. Management of undifferentiated embryonal sarcoma of the liver: A Pediatric Surgical Oncology Research Collaborative study.

Author

Kastenberg, Zachary J., Short, Scott S., Riehle, Kimberly J., Utria, Alan, Lautz, Timothy B., Ott, Katherine C., Murphy, Andrew J., Mansfield, Sara, Lal, Dave R., Hallis, Brian, Murphy, Joseph T., Roach, Jonathan P., Polites, Stephanie F., Beckhorn, Catherine, Tracy, Elisabeth T., Fialkowski, Elizabeth A., Seemann, Natashia M., Bütter, Andreana M., Rich, Barrie S., and Glick, Richard D.

Published
2024
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23. Implications of Tumor Characteristics and Treatment Modality on Local Recurrence and Functional Outcomes in Children with Chest Wall Sarcoma: A Pediatric Surgical Oncology Research Collaborative Study

Author

Harris, Courtney J., Helenowski, Irene, Murphy, Andrew J., Mansfield, Sara A., LaQuaglia, Michael P., Heaton, Todd E., Cavalli, Michele, Murphy, Joseph T., Newman, Erika, Overmen, Richard E., Kartal, Tanvi T., Cooke-Barber, Jo, Donaher, Addison, Malek, Marcus M., Kalsi, Ranjeet, Kim, Eugene S., Zobel, Michael J., Goodhue, Catherine J., Naik-Mathuria, Bindi J., Jefferson, Imory N., Roach, Jonathan P., Mata, Claudia, Piché, Nelson, Joharifard, Shahrzad, Sultan, Serge, Short, Scott S., Meyers, Rebecka L., Bleicher, Josh, Le, Hau D., Janek, Kevin, Bütter, Andreana, Davidson, Jacob, Aldrink, Jennifer H., Richards, Holden W., Tracy, Elisabeth T., Commander, Sarah J., Fialkowski, Elizabeth A., Troutt, Misty, Dasgupta, Roshni, and Lautz, Timothy B.

Published
2020
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29. Corrigendum to Adolescent Vaping-Associated Trauma in the Western United States [J Surg Res. 2022 Aug;276:251–255]

Author

Russell, Katie W., Katz, Micah G., Phillips, Ryan C., Kelley-Quon, Lorraine I., Acker, Shannon N., Shahi, Niti, Lee, Justin H., Fialkowski, Elizabeth A., Nacharaju, Deepthi, Smith, Caitlin A., Jensen, Aaron R., Mueller, Claudia M., Padilla, Benjamin E., Ignacio, Romeo C., Ourshalimian, Shadassa, Wang, Kasper S., Ostlie, Daniel J., Fenton, Stephen J., and Kastenberg, Zachary J.

Published
2024
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38. Optimization of percutaneous biopsy for diagnosis and pretreatment risk assessment of neuroblastoma.

Author

Overman, Richard E., Kartal, Tanvi T., Cunningham, Aaron J., Fialkowski, Elizabeth A., Naik‐Mathuria, Bindi J., Vasudevan, Sanjeev A., Malek, Marcus M., Kalsi, Ranjeet, Le, Hau D., Stafford, Linda Cherney, Lautz, Timothy B., Many, Benjamin T., Jones, Rachel E., Bütter, Andreana, Davidson, Jacob, Williams, Andrew, Dasgupta, Roshni, Lewis, Jana, Troutt, Misty, and Aldrink, Jennifer H.

Published
2020
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40. Acute cholecystitis

Author

Fialkowski, Elizabeth, Halpin, Valerie, and Whinney, Robb R

Subjects
Hospitalization, Treatment Outcome, Cholecystectomy, Laparoscopic, Acute Disease, Cholecystitis, Acute, Cholecystitis, food and beverages, Humans, Digestive System Disorders, Cholecystectomy, Gallstones, Severity of Illness Index
Abstract

Of people admitted to hospital for biliary tract disease, 20% have acute cholecystitis. Up to the age of 50 years, acute calculous cholecystitis is three times more common in women than in men, and about 1.5 times more common in women than in men thereafter. About 95% of people with acute cholecystitis have gallstones. Optimal therapy for acute cholecystitis, based on timing and severity of presentation, remains controversial.We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for acute cholecystitis? We searched: Medline, Embase, The Cochrane Library, and other important databases up to December 2006 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).We found 12 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.In this systematic review we present information relating to the effectiveness and safety of the following interventions: early cholecystectomy, laparoscopic cholecystectomy, minilaparoscopic cholecystectomy, observation alone, and open cholecystectomy.

Published
2008

42. Exclusion of Malignancy in Thyroid Nodules with Indeterminate Fine-Needle Aspiration Cytology After Negative 18F-Fluorodeoxyglucose Positron Emission Tomography: Interim Analysis.

Author

Traugott, Amber L., Dehdashti, Farrokh, Trinkaus, Kathryn, Cohen, Mark, Fialkowski, Elizabeth, Quayle, Frank, Hussain, Hameda, Davila, Rosa, Ylagan, Lourdes, and Moley, Jeffrey F.

Subjects
THYROID gland tumors, POSITRON emission tomography, MEDICAL imaging systems, BIOPSY, ULTRASONIC imaging
Abstract

In all, 20% of fine-needle aspiration (FNA) biopsies of thyroid nodules have an indeterminate diagnosis; of these, 80% are found to be benign after thyroidectomy. Some previous reports indicate that positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) imaging may predict malignancy status. We now report results on the first 51 patients in the largest prospective study of FDG-PET in patients with an indeterminate thyroid nodule FNA. Eligible patients had a dominant thyroid nodule that was palpable or ≥1 cm in greatest dimension as seen by ultrasonography, and indeterminate histology of the FNA biopsy specimen. Participants underwent preoperative neck FDG-PET alone or FDG-PET with computed tomography (FDG-PET/CT). Images were evaluated qualitatively and semiquantitatively using the maximum standardized uptake value (SUVmax). Final diagnosis was determined by histopathologic analysis after thyroidectomy. Descriptive statistical analysis was performed. A total of 51 patients underwent preoperative FDG-PET or FDG-PET/CT. Studies without focally increased uptake localized to the lesion were considered negative. For all lesions (10 malignant, 41 benign), the sensitivity, specificity, positive-predictive value (PPV), and negative-predictive value (NPV) were 80%, 61%, 33%, and 93%, respectively. Postoperatively, two malignant and six benign lesions were found to be <1 cm by pathology examination; one lesion was not measured. When these lesions were excluded, the sensitivity, specificity, PPV, and NPV were 100%, 59%, 36%, and 100%, respectively. Based on these preliminary data, FDG-PET may have a role in excluding malignancy in thyroid nodules with an indeterminate FNA biopsy. This finding justifies ongoing accrual to our target population of 125 participants. [ABSTRACT FROM AUTHOR]

Published
2010
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43. Incidence and management of pleural effusions in patients with Wilms tumor: A Pediatric Surgical Oncology Research Collaborative study.

Author

Al-Hadidi A, Rinehardt HN, Sutthatarn P, Talbot LJ, Murphy AJ, Whitlock R, Condon S, Naik-Mathuria B, Utria AF, Rothstein DH, Chen SY, Wong-Michalak S, Kim ES, Short SS, Meyers RL, Kastenberg ZJ, Johnston ME 2nd, Zens T, Dasgupta R, Malek MM, Calabro K, Piché N, Callas H, Lautz TB, McKay K, Lovvorn HN 3rd, Commander SJ, Tracy ET, Lund SB, Polites SF, Davidson J, Dhooma J, Seemann NM, Marquart JP, Gainer H, Lal DR, Rich BS, Glick RD, Maloney L, Radu S, Fialkowski EA, Kwok PE, Romao RLP, Rubalcava N, Ehrlich PF, Newman E, Diehl T, Le HD, Polcz V, Petroze RT, Stanek J, and Aldrink JH

Subjects
Child, Humans, Incidence, Retrospective Studies, Kidney Neoplasms epidemiology, Kidney Neoplasms surgery, Pleural Effusion epidemiology, Pleural Effusion etiology, Pleural Effusion, Malignant epidemiology, Pleural Effusion, Malignant etiology, Pleural Effusion, Malignant surgery, Surgical Oncology, Wilms Tumor epidemiology, Wilms Tumor surgery
Abstract

Wilms tumor (WT) is the most common renal malignancy in children. Children with favorable histology WT achieve survival rates of over 90%. Twelve percent of patients present with metastatic disease, most commonly to the lungs. The presence of a pleural effusion at the time of diagnosis of WT may be noted on staging imaging; however, minimal data exist regarding the significance and prognostic importance of this finding. The objectives of our study are to identify the incidence of pleural effusions in patients with WT, and to determine the potential impact on oncologic outcomes. A multi-institutional retrospective review was performed from January 2009 to December 2019, including children with WT and a pleural effusion on diagnostic imaging treated at Pediatric Surgical Oncology Research Collaborative (PSORC) participating institutions. Of 1259 children with a new WT diagnosis, 94 (7.5%) had a pleural effusion. Patients with a pleural effusion were older than those without (median 4.3 vs 3.5 years; P = .004), and advanced stages were more common (local stage III 85.9% vs 51.9%; P < .0001). Only 14 patients underwent a thoracentesis for fluid evaluation; 3 had cytopathologic evidence of malignant cells. Event-free and overall survival of all children with WT and pleural effusions was 86.2% and 91.5%, respectively. The rate and significance of malignant cells present in pleural fluid is unknown due to low incidence of cytopathologic analysis in our cohort; therefore, the presence of an effusion does not appear to necessitate a change in therapy. Excellent survival can be expected with current stage-specific treatment regimens., (© 2022 UICC.)

Published
2022
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44. Histologic type predicts disparate outcomes in pediatric hepatocellular neoplasms: A Pediatric Surgical Oncology Research Collaborative study.

Author

Short SS, Kastenberg ZJ, Wei G, Bondoc A, Dasgupta R, Tiao GM, Watters E, Heaton TE, Lotakis D, La Quaglia MP, Murphy AJ, Davidoff AM, Mansfield SA, Langham MR, Lautz TB, Superina RA, Ott KC, Malek MM, Morgan KM, Kim ES, Zamora A, Lascano D, Roach J, Murphy JT, Rothstein DH, Vasudevan SA, Whitlock R, Lal DR, Hallis B, Bütter A, Baertschiger RM, Lapidus-Krol E, Putra J, Tracy ER, Aldrink JH, Apfeld J, Le HD, Park KY, Rich BS, Glick RD, Fialkowski EA, Utria AF, Meyers RL, and Riehle KJ

Subjects
Child, Humans, Neoplasm Recurrence, Local pathology, Neoplasm Staging, Retrospective Studies, Carcinoma, Hepatocellular pathology, Liver Neoplasms pathology, Surgical Oncology
Abstract

Background: Hepatocellular carcinoma (HCC) is a rare cancer in children, with various histologic subtypes and a paucity of data to guide clinical management and predict prognosis., Methods: A multi-institutional review of children with hepatocellular neoplasms was performed, including demographic, staging, treatment, and outcomes data. Patients were categorized as having conventional HCC (cHCC) with or without underlying liver disease, fibrolamellar carcinoma (FLC), and hepatoblastoma with HCC features (HB-HCC). Univariate and multivariate analyses identified predictors of mortality and relapse., Results: In total, 262 children were identified; and an institutional histologic review revealed 110 cHCCs (42%; 69 normal background liver, 34 inflammatory/cirrhotic, 7 unknown), 119 FLCs (45%), and 33 HB-HCCs (12%). The authors observed notable differences in presentation and behavior among tumor subtypes, including increased lymph node involvement in FLC and higher stage in cHCC. Factors associated with mortality included cHCC (hazard ratio [HR], 1.63; P = .038), elevated α-fetoprotein (HR, 3.1; P = .014), multifocality (HR, 2.4; P < .001), and PRETEXT (pretreatment extent of disease) stage IV (HR, 5.76; P < .001). Multivariate analysis identified increased mortality in cHCC versus FLC (HR, 2.2; P = .004) and in unresectable tumors (HR, 3.4; P < .001). Disease-free status at any point predicted survival., Conclusions: This multi-institutional, detailed data set allowed a comprehensive analysis of outcomes for children with these rare hepatocellular neoplasms. The current data demonstrated that pediatric HCC subtypes are not equivalent entities because FLC and cHCC have distinct anatomic patterns and outcomes in concert with their known molecular differences. This data set will be further used to elucidate the impact of histology on specific treatment responses, with the goal of designing risk-stratified algorithms for children with HCC., Lay Summary: This is the largest reported granular data set on children with hepatocellular carcinoma. The study evaluates different subtypes of hepatocellular carcinoma and identifies key differences between subtypes. This information is pivotal in improving understanding of these rare cancers and may be used to improve clinical management and subsequent outcome in children with these rare malignancies., (© 2022 American Cancer Society.)

Published
2022
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45. Thoracoscopy vs thoracotomy for the management of metastatic osteosarcoma: A Pediatric Surgical Oncology Research Collaborative Study.

Author

Lautz TB, Farooqui Z, Jenkins T, Heaton TE, Doski JJ, Cooke-Barber J, Murphy AJ, Davidoff AM, Mansfield SA, Kim ES, Zuber S, Goodhue C, Vasudevan SA, LaQuaglia MP, Piche N, Le-Nguyen A, Aldrink JH, Malek MM, Siow VS, Glick RD, Rich BS, Meyers RL, Short SS, Butter A, Baertschiger RM, Fialkowski EA, and Dasgupta R

Subjects
Bone Neoplasms pathology, Child, Disease-Free Survival, Female, Humans, Intersectoral Collaboration, Male, Osteosarcoma pathology, Retrospective Studies, Surgical Oncology, Bone Neoplasms surgery, Lung Neoplasms mortality, Lung Neoplasms secondary, Metastasectomy methods, Osteosarcoma surgery, Thoracoscopy methods, Thoracotomy methods
Abstract

Complete surgical resection of pulmonary metastatic disease in patients with osteosarcoma is crucial to long-term survival. Open thoracotomy allows palpation of nodules not identified on imaging but the impact on survival is unknown. The objective of this study was to compare overall survival (OS) and pulmonary disease-free survival (DFS) in children who underwent thoracotomy vs thoracoscopic surgery for pulmonary metastasectomy. A multi-institutional collaborative group retrospectively reviewed 202 pediatric patients with osteosarcoma who underwent pulmonary metastasectomy by thoracotomy (n = 154) or thoracoscopy (n = 48). Results were analyzed by Kaplan-Meier survival estimates and multivariate Cox proportional hazard regression models. With median follow-up of 45 months, 135 (67.5%) patients had a pulmonary relapse and 95 (47%) patients were deceased. Kaplan-Meier analysis showed no significant difference in 5-year pulmonary DFS (25% vs 38%; P = .18) or OS (49% vs 42%, P = .37) between the surgical approaches of thoracotomy and thoracoscopy. In Cox regression analysis controlling for other factors impacting outcome, there was a significantly increased risk of mortality (HR 2.11; P = .027; 95% CI 1.09-4.09) but not pulmonary recurrence (HR 0.96; P = .90; 95% CI 0.52-1.79) with a thoracoscopic approach. However, in the subset analysis limited to patients with oligometastatic disease, thoracoscopy had no increased risk of mortality (HR 1.16; P = .62; 0.64-2.11). In conclusion, patients with metastatic osteosarcoma and limited pulmonary disease burden demonstrate comparable outcomes after thoracotomy and thoracoscopy for metastasectomy. While significant selection bias in these surgical cohorts limits the generalizability of the conclusions, clinical equipoise for a randomized clinical trial in patients with oligometastatic disease is supported., (© 2020 Union for International Cancer Control.)

Published
2021
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46. "Sideways": results of repair of biliary injuries using a policy of side-to-side hepatico-jejunostomy.

Author

Winslow ER, Fialkowski EA, Linehan DC, Hawkins WG, Picus DD, and Strasberg SM

Subjects
Abdominal Injuries complications, Adult, Aged, Digestive System Surgical Procedures adverse effects, Female, Humans, Male, Middle Aged, Retrospective Studies, Bile Ducts injuries, Cholecystectomy adverse effects, Hepatic Duct, Common surgery, Jejunum surgery, Portoenterostomy, Hepatic methods
Abstract

Background: The Hepp-Couinaud technique describes side-to-side HJ to the main left hepatic duct but a side-to-side approach is not consistently used when repairing other ducts. Compared with end-to-side repairs, side-to-side anastomoses require less dissection, theoretically preserving blood supply to the bile ducts, and usually permit wider anastomoses., Methods: We report the treatment results of 113 consecutive biliary injuries, with intention to perform side-to side anastomosis in all., Results: 113 biliary injuries, 109 associated with cholecystectomy, were treated from 1992-2006. Injury types were B (7 patients, 6%); C (11 patients, 10%); E1 (8 patients, 7%); E2 (37 patients, 33%); E3 (20 patients, 18%); E4 (24 patients, 21%); E5 (6 patients, 5%). 19% of repairs were early (within 1 week after cholecystectomy), 58% were delayed (at least 6 weeks after cholecystectomy), and 22% were reoperations for recurrent strictures. In 92% of cases, side-to-side repair was accomplished. 23/113 (20%) developed postoperative complications, with one postoperative death. Mean follow-up was 4.9 years. Excellent anastomotic function was achieved in 107/112 (95%). "Poor" anastomotic results occurred in 5 patients: 2 patients with E4 injuries had postoperative anastomotic stenting >3 months, and 3 developed strictures requiring percutaneous dilation. There have been no reoperations for biliary strictures., Conclusions: HJ using side-to-side anastomosis has theoretical advantages and is usually possible. In some high right-sided injuries it could not be achieved. 95% excellent anastomotic function without intervention attests to the benefit of the method, especially as postoperative stenting >3 months was considered to be a "poor" result.

Published
2009
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47. Acute cholecystitis.

Author

Fialkowski E, Halpin V, and Whinney RR

Subjects
Acute Disease, Cholecystectomy, Laparoscopic, Cholecystitis surgery, Gallstones surgery, Hospitalization, Humans, Severity of Illness Index, Treatment Outcome, Cholecystectomy, Cholecystitis, Acute surgery
Abstract

Introduction: Of people admitted to hospital for biliary tract disease, 20% have acute cholecystitis. Up to the age of 50 years, acute calculous cholecystitis is three times more common in women than in men, and about 1.5 times more common in women than in men thereafter. About 95% of people with acute cholecystitis have gallstones. Optimal therapy for acute cholecystitis, based on timing and severity of presentation, remains controversial., Methods and Outcomes: We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for acute cholecystitis? We searched: Medline, Embase, The Cochrane Library, and other important databases up to December 2006 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA)., Results: We found 12 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions., Conclusions: In this systematic review we present information relating to the effectiveness and safety of the following interventions: early cholecystectomy, laparoscopic cholecystectomy, minilaparoscopic cholecystectomy, observation alone, and open cholecystectomy.

Published
2008

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