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476 results on '"Diefenbach, Karen"'

14. Management of the undescended testis in children: An American Pediatric Surgical Association Outcomes and Evidence Based Practice Committee Systematic Review

Author

Gates, Robert L, Shelton, Julia, Diefenbach, Karen A, Arnold, Meghan, St. Peter, Shawn D., Renaud, Elizabeth J., Slidell, Mark B., Sømme, Stig, Valusek, Patricia, Villalona, Gustavo A., McAteer, Jarod P., Beres, Alana L., Baerg, Joanne, Rentea, Rebecca M., Kelley-Quon, Lorraine, Kawaguchi, Akemi L., Hu, Yue-Yung, Miniati, Doug, Ricca, Robert, and Baird, Robert

Published
2022
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16. Robotic-Assisted Versus Laparoscopic Approach for Treatment of Acute Cholecystitis in Children.

Author

Svetanoff, Wendy Jo, Diefenbach, Karen, Aldrink, Jennifer H., and Michalsky, Marc P.

Subjects
*PEDIATRIC surgery, *CHILD patients, *SURGICAL robots, *GALLSTONES, *CHOLECYSTITIS, *CHOLECYSTECTOMY
Abstract

Introduction: Laparoscopic cholecystectomy (Lap-C) is the standard of care for patients requiring cholecystectomy in the acute setting. Although robotic-assisted cholecystectomy (RA-C) performance has increased, utilization in the acute setting has not been widely reported. We describe the feasibility of RA-C for pediatric patients undergoing acute inpatient cholecystectomy. Methods: A single institutional retrospective review of patients receiving RA-C while admitted for acute cholecystitis and/or choledocholithiasis (June 2017–June 2022) was compared with a matched cohort who underwent traditional multiport Lap-C (June 2021–June 2022). Demographic, perioperative, and postoperative data were analyzed. Results: Fifty patients were included: 25 each in the RA-C and Lap-C groups. Fifty-four percent were female; 66% were non-Hispanic white. Median age (15.7 years [interquartile range, IQR 14.7, 17.3] versus 15.3 years [IQR 14.5, 16.9], P =.91) and preoperative weight (92.6 kg [IQR 60, 105.9] versus 72.3 kg [IQR 61.6, 85.6], P =.15) were similar between the RA-C and Lap-C groups, respectively. No differences were observed in median operating time (89 minutes [IQR 76, 103] versus 88 minutes [IQR 77, 137], P =.70), postoperative length of stay (22.5 hours [21.4, 24.9] versus 20.6 hours [18.0, 25.1], P =.06), or 30-day complications (12% versus 16%, P =.69). Although opioid utilization (.23 milliequivalents/kilogram [MME/kg] [IQR.03,.30] versus.03 MME/kg [0,.09], P =.02) was higher in the RA-C cohort overall, no differences were detected during an analysis of the most recent 2 years (P =.96). Conclusion: RA-C in the acute setting can be performed safely in the pediatric population with comparable procedural times as well as perioperative and 30-day outcomes. [ABSTRACT FROM AUTHOR]

Published
2024
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30. Utilization of a Single-Site Port as an Adjunct for Multi-Port Robotic-Assisted Surgery in Children.

Author

Svetanoff, Wendy Jo, Michalsky, Marc P., Aldrink, Jennifer H., and Diefenbach, Karen A.

Subjects
MINIMALLY invasive procedures, PEDIATRIC surgery, CHILD patients, SURGICAL robots, ADRENALECTOMY
Abstract

Introduction: The focused use of a single-site port as an adjunct designed to decrease overall port site number and/or assist with specimen extraction in pediatric robotic surgery has not been fully elucidated. We aimed to describe the feasibility of using the single-site port as an adjunct during multi-port robotic-assisted minimally invasive surgery (RA-MIS). Methods: A single institution retrospective review of pediatric patients who underwent multiport RA-MIS with an adjunctive single-site (SS) port from August 2018 to October 2022 was performed. Demographic, perioperative, and postoperative variables were collected; descriptive analysis was performed. Results: A total of 13 patients were included; 46% were female, and 47% were Caucasian. Median age at surgery was 14.9 years of age (interquartile range [IQR] 10.6, 18); median weight was 61.1 kg (IQR 39.7, 73.6). Eleven patients (85%) underwent splenectomy; 2 patients (15%) underwent adrenalectomy. Four patients had a combined procedure (SS cholecystectomy with multi-port splenectomy [n = 3], multi-port bilateral adrenalectomy [n = 1]). The median total operative time was 197 minutes (IQR 131, 316); median console time was 59 minutes (IQR 40, 126). Two 8 mm robotic ports were utilized for all but 1 patient who required a third 8 mm port. The median length of stay was 2.1 days (IQR 2.0, 3.1). One readmission for fever occurred following a combined cholecystectomy/splenectomy. No hernias or wound infections were identified at the single-site port. Conclusion: Use of a SS port as an adjunct is a feasible option and should be considered for those with splenomegaly or need for combined procedures in different quadrants of the abdomen. [ABSTRACT FROM AUTHOR]

Published
2024
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31. Sacral nerve stimulation leads to long‐term improvement in fecal incontinence and quality of life for children with functional and organic defecation disorders.

Author

Park, Candice K., Wang, Lyon, Koppen, Ilan J. K., Alpert, Seth A., Diefenbach, Karen A., Wood, Richard J., Bali, Neetu, Vaz, Karla, Yacob, Desale, Di Lorenzo, Carlo, and Lu, Peter L.

Subjects
DEFECATION disorders, SACRAL nerves, FECAL incontinence, NEURAL stimulation, PATIENT satisfaction
Abstract

Background: Our objective was to evaluate long‐term outcomes of sacral nerve stimulation (SNS) for children with functional and organic defecation disorders. Methods: We performed a prospective study of children <21 years of age who started SNS treatment between 2012 and 2018. We recorded demographics, medical history, and diagnostic testing. We obtained measures of symptom severity and quality of life at baseline and follow up at 1, 6, 12, 24, 36, 48, and ≥60 months. Successful response was defined as bowel movements >2 times/week and fecal incontinence (FI) <1 time/week. Families were contacted to administer the Glasgow Children's Benefit Inventory and to evaluate patient satisfaction. Key Results: We included 65 patients (59% female, median age at SNS 14 years, range 9–21) with median follow‐up of 32 months. Thirty patients had functional constipation (FC), 15 had non‐retentive FI (NRFI), and 16 had an anorectal malformation (ARM). The percentage with FI <1 time/week improved from 30% at baseline to 64% at 1 year (p < 0.001) and 77% at most recent follow‐up (p < 0.001). Patients with FC, NRFI, and ARM had sustained improvement in FI (p = 0.02, p < 0.001, p = 0.02). Patients also reported fewer hard stools (p = 0.001). Bowel movement frequency did not improve after SNS. At most recent follow‐up, 77% of patients with a functional disorder and 50% with an organic disorder had responded (p = 0.03). Nearly all families reported benefit. Conclusions and Inferences: SNS led to sustained improvement in FI regardless of underlying etiology, but children with functional disorders were more likely to respond than those with organic disorders. [ABSTRACT FROM AUTHOR]

Published
2024
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40. Laparoscopic Colonic Mapping

Author

Coyle, David, Diefenbach, Karen A., Papandria, Dominic J., editor, Besner, Gail E., editor, Moss, R. Lawrence, editor, and Diefenbach, Karen A., editor

Published
2019
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44. The management of pilonidal disease: A systematic review

Author

Grabowski, Julia, Oyetunji, Tolulope A., Goldin, Adam B., Baird, Robert, Gosain, Ankush, Lal, Dave R., Kawaguchi, Akemi, Downard, Cynthia, Sola, Juan E., Arthur, L. Grier, Shelton, Julia, Diefenbach, Karen A., Kelley-Quon, Lorraine I., Williams, Regan F., Ricca, Robert L., Dasgupta, Roshni, St. Peter, Shawn D., Sømme, Stig, Guner, Yigit S., and Jancelewicz, Tim

Published
2019
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45. Non-operative management of solid organ injuries in children: An American Pediatric Surgical Association Outcomes and Evidence Based Practice Committee systematic review

Author

Gates, Robert L., Price, Mitchell, Cameron, Danielle B., Somme, Stig, Ricca, Robert, Oyetunji, Tolulope A., Guner, Yigit S., Gosain, Ankush, Baird, Robert, Lal, Dave R., Jancelewicz, Tim, Shelton, Julia, Diefenbach, Karen A., Grabowski, Julia, Kawaguchi, Akemi, Dasgupta, Roshni, Downard, Cynthia, Goldin, Adam, Petty, John K., Stylianos, Steven, and Williams, Regan

Published
2019
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46. Management of long gap esophageal atresia: A systematic review and evidence-based guidelines from the APSA Outcomes and Evidence Based Practice Committee

Author

Baird, Robert, Lal, Dave R., Ricca, Robert L., Diefenbach, Karen A., Downard, Cynthia D., Shelton, Julia, Sømme, Stig, Grabowski, Julia, Oyetunji, Tolulope A, Williams, Regan F., Jancelewicz, Tim, Dasgupta, Roshni, Arthur, L. Grier, Kawaguchi, Akemi L., Guner, Yigit S., Gosain, Ankush, Gates, Robert L., Sola, Juan E., Kelley-Quon, Lorraine I., St. Peter, Shawn D., and Goldin, Adam

Published
2019
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48. Ovarian masses in the child and adolescent: An American Pediatric Surgical Association Outcomes and Evidence-Based Practice Committee systematic review

Author

Renaud, Elizabeth J., Sømme, Stig, Islam, Saleem, Cameron, Danielle B., Gates, Robert L., Williams, Regan F, Jancelewicz, Tim, Oyetunji, Tolulope A, Grabowski, Julia, Diefenbach, Karen A., Baird, Robert, Arnold, Meghan A., Lal, Dave R., Shelton, Julia, Guner, Yigit S., Gosain, Ankush, Kawaguchi, Akemi L, Ricca, Robert L., Goldin, Adam B., and Dasgupta, Roshni

Published
2019
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49. A descriptive model for a multidisciplinary unit for colorectal and pelvic malformations

Author

Vilanova-Sanchez, Alejandra, Halleran, Devin R, Reck-Burneo, Carlos A., Gasior, Alessandra C., Weaver, Laura, Fisher, Meghan, Wagner, Andrea, Nash, Onnalisa, Booth, Kristina, Peters, Kaleigh, Williams, Charae, Brown, Sarah Mayer, Lu, Peter, Fuchs, Molly, Diefenbach, Karen, Leonard, Jeffrey R, Hewitt, Geri, McCracken, Kate, Di Lorenzo, Carlo, Wood, Richard J., and Levitt, Marc A.

Published
2019
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