Journal of pediatric surgery
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Nasogastric tubes are often vitally important in post-operative management. Usually required for short term use, they are easily taped to the nose and face. Occasionally, longer term use is needed, such as in post esophageal reconstruction, where substitution and fixation of the NGT becomes an issue. We describe a novel method of NGT fixation that can be used for prolonged periods of time with minimal risk of dislodgement and without the need for suturing.
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Slipping rib syndrome (SRS) is a painful condition of hypermobile, detached lower costal cartilages impinging the intercostal nerves. While surgical resection of the cartilaginous rib is reported as definitive treatment, recurrent symptoms are common. We describe the addition of vertical bioabsorbable rib plating to decrease recurrence. ⋯ II.
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Pain control is challenging after minimally invasive repair of pectus excavatum (MIRPE). Cryoanalgesia, which temporarily ablates peripheral nerves, improves pain control and may accelerate post-operative recovery. We hypothesized that cryoanalgesia would be associated with shorter length of stay (LOS) in children undergoing MIRPE. ⋯ Cryoanalgesia is a promising adjunct in the care of pediatric patients undergoing MIRPE. Utilization is associated with a shorter LOS without an increase in operative time or complications. Cryoanalgesia should be considered for inclusion in enhanced recovery strategies for patients undergoing MIRPE.
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The COVID-19 pandemic resulted in the suspension of nonemergent surgeries throughout New York. Our tertiary care children's hospital pivoted towards a brief trial of intravenous (IV) antibiotic therapy in all patients in order to limit operating room (OR) utilization and avoid prolonged hospital stays. We describe our pandemic-based strategy for non-operative management (NOM) of appendicitis but with a limited duration of IV antibiotics. ⋯ IV.
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Relative value units (RVUs) are the measure of value used in United States Medicare and Medicaid reimbursement. The Relative Update Committee (RUC) determines physician work RVU (wRVUs) based on operative time, technical skill and effort, mental effort and judgment, and stress. The primary aim of this study was to assess whether operative time is adequately accounted for in the wRVU system in pediatric urology. ⋯ Retrospective comparative study.