Scholars@Duke
Elisabeth Tomlinson Tracy

Elisabeth Tomlinson Tracy

Assistant Professor of Surgery
Surgery, Pediatric General Surgery
elisabeth.tracy@duke.edu
Box 3443 Med Ctr, Durham, NC 27710
Department of Surgery, Durham, NC 27710

Selected Publications

Student and Attending Preceptor Perceptions of Longitudinal Clinic as a Surgical Education and Assessment Tool.

Journal Article J Surg Res · November 20, 2024 INTRODUCTION: As undergraduate medical education becomes increasingly longitudinal, particular attention is needed to maintain sufficient exposure to surgical disciplines. While traditional medical student clerkships are isolated 4 to 8-wk blocks on a sing ... Full text Link to item Cite

Interfacility Transfer of Children With Time-Sensitive Surgical Conditions, 2002-2017.

Journal Article JAMA Netw Open · October 1, 2024 IMPORTANCE: Surgical care for children in the United States has become increasingly regionalized among fewer centers over time. The degree to which regionalization may be associated with access to urgent surgical care for time-sensitive conditions is not c ... Full text Link to item Cite

Management of Pediatric Breast Masses for the Pediatric Surgeon: Expert Consensus Recommendations From the APSA Cancer Committee.

Journal Article J Pediatr Surg · September 16, 2024 BACKGROUND: The pathology and management of breast masses in pediatric patients is markedly different than in adults. The vast majority of lesions in children and adolescents are benign, but the rare malignant breast masses require prompt recognition and t ... Full text Link to item Cite

A Comparison of Commonly Utilized Diagnostic Biopsy Techniques for Pediatric Patients With Cancer: A Systematic Review by the APSA Cancer Committee.

Journal Article J Pediatr Surg · September 2, 2024 BACKGROUND: Historically, surgical biopsy (SB) for diagnosis of pediatric solid tumors was considered necessary to provide adequate tissue for histologic and molecular analysis. Less invasive biopsy techniques such as image-guided core needle biopsy (CNB), ... Full text Link to item Cite

Wilms tumor characteristics, surgical management, outcomes, and chronic kidney disease in children with WAGR syndrome: A report from the International WAGR Syndrome Association survey.

Journal Article Pediatr Blood Cancer · September 2024 INTRODUCTION: Children with WAGR (Wilms tumor, aniridia, genitourinary anomalies, and range of development delays) syndrome are predisposed to Wilms tumor (WT) and intrinsic kidney disease. Using the comprehensive International WAGR Syndrome Association (I ... Full text Link to item Cite

Prior Teaching Experience and Barriers to Effective Resident Teaching: A Cross-Sectional Study.

Journal Article J Surg Res · September 2024 INTRODUCTION: Resident physicians play an important role in teaching the next generation of health-care providers, yet limited research has explored factors influencing effective teaching, such as preresidency experiences or barriers within residency. This ... Full text Link to item Cite

Roles, Responsibilities, and Expectations of Medical Students on Surgical Subinternships: A Modified Delphi Consensus Study.

Journal Article Acad Med · August 1, 2024 PURPOSE: Surgical subinternships are important rotations for students preparing for a career in general surgery; however, these rotations often vary by institution and service. This modified Delphi study was conducted to reach a consensus set of roles, res ... Full text Link to item Cite

Survival outcomes in pediatric patients with metastatic Ewing sarcoma who achieve a rapid complete response of pulmonary metastases.

Conference Pediatr Blood Cancer · July 2024 PURPOSE: Our objectives were to compare overall survival (OS) and pulmonary relapse between patients with metastatic Ewing sarcoma (EWS) at diagnosis who achieve rapid complete response (RCR) and those with residual pulmonary nodules after induction chemot ... Full text Link to item Cite

The Surgical Clerkship in the COVID Era: A Natural Language Processing and Thematic Analysis.

Journal Article J Surg Res · July 2024 INTRODUCTION: Responses to COVID-19 within medical education prompted significant changes to the surgical clerkship. We analyzed the changes in medical student end of course feedback before and after the COVID-19 outbreak. METHODS: Postclerkship surveys fr ... Full text Link to item Cite

Use of Antipseudomonal Antibiotics is Not Associated With Lower Rates of Postoperative Drainage Procedures or More Favorable Culture Profiles in Children With Complicated Appendicitis: Results From a Multicenter Regional Research Consortium.

Journal Article Ann Surg · June 1, 2024 OBJECTIVE: To compare rates of postoperative drainage and culture profiles in children with complicated appendicitis treated with the 2 most common antibiotic regimens with and without antipseudomonal activity [piperacillin-tazobactam (PT) and ceftriaxone ... Full text Link to item Cite

Educational Strategies in Pediatric Trauma Resuscitation Across Disciplines: A Scoping Review.

Journal Article J Surg Res · June 2024 INTRODUCTION: Trauma is the leading cause of death and disability in children. Differences in mechanism, injury pattern, severity, and physiology in this population distinguish pediatric trauma patients from adults. Educational techniques including simulat ... Full text Link to item Cite

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

Journal Article Pediatr Blood Cancer · June 2024 BACKGROUND: Undifferentiated embryonal sarcoma of the liver (UESL) is a rare tumor for which there are few evidence-based guidelines. The aim of this study was to define current management strategies and outcomes for these patients using a multi-institutio ... Full text Link to item Cite

Pediatric urothelial cancer: a cross-sectional descriptive analysis of the National Cancer Database.

Journal Article Transl Androl Urol · May 31, 2024 BACKGROUND: Urothelial cancer is a rare pediatric malignancy; previous analyses suggest lower rates of recurrence and death as compared to adults. We analyzed pediatric bladder cancer information in a national database, hypothesizing that survival would be ... Full text Link to item Cite

Current surgical approaches to pediatric renal tumors.

Journal Article Pediatr Blood Cancer · May 29, 2024 Pediatric renal tumors are among the most common pediatric solid malignancies. Surgical resection is a key component in the multidisciplinary therapy for children with kidney tumors. Therefore, it is imperative that surgeons caring for children with renal ... Full text Link to item Cite

Postoperative Antibiotics, Outcomes, and Resource Use in Children With Gangrenous Appendicitis.

Journal Article JAMA Surg · May 1, 2024 IMPORTANCE: Gangrenous, suppurative, and exudative (GSE) findings have been associated with increased surgical site infection (SSI) risk and resource use in children with nonperforated appendicitis. Establishing the role for postoperative antibiotics may h ... Full text Link to item Cite

Contemporary trends in choledochal cyst excision: An analysis of the pediatric national surgical quality improvement program.

Journal Article World J Surg · April 2024 BACKGROUND: Choledochal cysts are rare congenital anomalies of the biliary tree that may lead to obstruction, chronic inflammation, infection, and malignancy. There is wide variation in the timing of resection, operative approach, and reconstructive techni ... Full text Link to item Cite

Who Benefits? An Assessment of Resident Benefits at Top 50 Academic Institutions.

Journal Article J Surg Educ · March 2024 OBJECTIVE: Residency serves as a crucial time in the professional and personal development of young physicians. Extensive effort is devoted to the clinical training of residents across the country. However, many residents report concerns with compensation, ... Full text Link to item Cite

Comparison of Outcomes Between Surveillance Ultrasound and Completion Lymph Node Dissection in Children and Adolescents With Sentinel Lymph Node-Positive Cutaneous Melanoma.

Conference Ann Surg · March 1, 2024 OBJECTIVE: To determine the impact of nodal basin ultrasound (US) surveillance versus completion lymph node dissection (CLND) in children and adolescents with sentinel lymph node (SLN) positive melanoma. BACKGROUND: Treatment for children and adolescents w ... Full text Link to item Cite

Surgical Residents as Clerkship Scholars May Improve Student Perception of the Surgery Clerkship.

Journal Article J Surg Res · February 2024 INTRODUCTION: The surgical clerkship is a formative experience in the medical school curriculum and can leave a lasting impression on students' perception of surgery. Given the historical negative stereotypes of surgeons, the clerkship represents an opport ... Full text Link to item Cite

Where Are the Children? A Thematic Analysis of State, Territory, and Tribal Organization Comprehensive Cancer Control Plans.

Journal Article J Pediatr Surg · January 2024 BACKGROUND: The Center for Disease Control's Comprehensive Cancer Control Program (CCCP) funds initiatives in fifty states, the District of Columbia, seven U.S. territories, and seven tribal organizations to prevent and control cancer. These initiatives in ... Full text Link to item Cite

Use of Palliative Site-Directed Ablation in Pediatric Oncology: A Retrospective Study from the Pediatric Surgical Oncology Research Collaborative

Journal Article Pediatric Blood and Cancer · January 1, 2024 Background: Children with end-stage solid tumors would benefit from established nonsurgical options for palliative site-directed local control with the intent of improving quality of life (QOL) and extending survival. We investigated the practice and toler ... Full text Cite

Use of pediatric trauma simulations to facilitate exposure to pediatric trauma resuscitations during training.

Journal Article Surgery · December 2023 BACKGROUND: Pediatric traumas are often high-acuity but are low-frequency compared to adult trauma activations. This is reflected in the relatively limited experience with these events during training. Although some principles of trauma resuscitation are s ... Full text Link to item Cite

Perforated appendicitis without peritonitis in a premature newborn- A case report

Journal Article Journal of Pediatric Surgery Case Reports · December 1, 2023 Introduction: Neonatal appendicitis is extremely rare and lacks specific clinical signs. Given its rarity, lack of specific physical signs and the subsequent low index of suspicion; diagnosis and surgical intervention are often delayed in neonates resultin ... Full text Cite

A National Comparison of Volume and Acuity for Adult and Pediatric Trauma: A Trauma Quality Improvement Program Cohort Study.

Journal Article J Surg Res · November 2023 INTRODUCTION: Most injured children receive trauma care outside of a pediatric trauma center. Differences in physiology, dosing, and injury pattern limit extrapolation of adult trauma principles to pediatrics. We compare US trauma center experience with pe ... Full text Link to item Cite

Using Crowdfunding Campaigns to Examine Financial Toxicity and Logistical Burdens Facing Families of Children With Wilms Tumor.

Journal Article J Surg Res · November 2023 INTRODUCTION: Treatment for pediatric solid tumors is often intense and multidisciplinary and can create a substantial financial burden for families. Assessing these burdens, termed the financial toxicity of treatment, can be difficult. Using Wilms tumor a ... Full text Link to item Cite

Implications of Immunotherapy for Pediatric Malignancies: A Summary from the APSA Cancer Committee.

Journal Article J Pediatr Surg · November 2023 Although survival for many pediatric cancers has improved with advances in conventional chemotherapeutic regimens and surgical techniques in the last several decades, it remains a leading cause of disease-related death in children. Outcomes in patients wit ... Full text Link to item Cite

Association Between Antibiotic Redosing Before Incision and Risk of Incisional Site Infection in Children With Appendicitis.

Journal Article Ann Surg · October 1, 2023 OBJECTIVE: To evaluate whether redosing antibiotics within an hour of incision is associated with a reduction in incisional surgical site infection (iSSI) in children with appendicitis. BACKGROUND: Existing data remain conflicting as to whether children wi ... Full text Link to item Cite

Revisiting Medical Student Expectations on the Surgery Clerkship.

Journal Article J Surg Educ · October 2023 OBJECTIVE: Medical students frequently report ambiguity of expectations in their feedback of the surgery clerkship. Herein, we aimed to gauge general surgery resident and attending expectations of students on their clerkship. DESIGN: Residents and attendin ... Full text Link to item Cite

Changing Landscape of Routine Pediatric Surgery for Rural and Urban Children: A Report From the Child Health Evaluation of Surgical Services (CHESS) Group.

Journal Article Ann Surg · October 1, 2023 OBJECTIVE: To describe the changes to routine pediatric surgical care over the past 2 decades for children living in urban and rural environments. BACKGROUND: A knowledge gaps exists regarding trends in the location where routine pediatric surgical care is ... Full text Link to item Cite

Critical elements of radical nephroureterectomy for pediatric unilateral renal tumor.

Journal Article Semin Pediatr Surg · October 2023 Children with renal masses require surgical management to provide accurate surgical staging and skilled resection of the tumor. This document includes evidence-based recommendations for pediatric surgeons regarding the resection, staging, and proper nodal ... Full text Link to item Cite

The Utility of Intraoperative Neuromonitoring in Pediatric Surgical Oncology.

Journal Article J Pediatr Surg · September 2023 BACKGROUND: Intraoperative nerve monitoring (IONM) is a technique used to decrease the possibility of nerve-associated morbidity and damage to nearby neural structures during complex surgical procedures. The use and potential benefits of IONM in pediatric ... Full text Link to item Cite

Quality improvement strategies in pediatric ECMO.

Journal Article Semin Pediatr Surg · August 2023 Pediatric extracorporeal membrane oxygenation is an increasingly utilized, life-saving technology with high mortality and morbidity. A complex technology employed urgently or emergently for some of the sickest children in the hospital by a large multidisci ... Full text Link to item Cite

Pediatric renal malignancy diagnosis is associated with significant burden of care for families.

Journal Article Pediatr Blood Cancer · June 19, 2023 BACKGROUND AND OBJECTIVES: New childhood cancer diagnoses require timely, complex care coordination and cause considerable logistic burden for families. We used renal tumors as a model to examine healthcare utilization and cost following new solid tumor di ... Full text Link to item Cite

Risk of Surgical Intervention in Children with Diagnoses of Cancer and Preoperative Malnutrition: A National Analysis.

Journal Article J Pediatr Surg · June 2023 BACKGROUND: Perioperative nutrition is a critical component of appropriate healing and recovery after surgery. We sought to identify perioperative risk in children with cancer and low preoperative hypoalbuminemia undergoing surgical intervention. METHODS: ... Full text Link to item Cite

Outcomes and Resource Utilization Associated with Use of Routine Pre-Discharge White Blood Cell Count for Clinical Decision-Making in Children with Complicated Appendicitis: A Multicenter Hospital-Level Analysis.

Journal Article J Pediatr Surg · June 2023 BACKGROUND: The objective was to explore the hospital-level relationship between routine pre-discharge WBC utilization (RPD-WBC) and outcomes in children with complicated appendicitis. METHODS: Multicenter analysis of NSQIP-Pediatric data from 14 consortiu ... Full text Link to item Cite

The Surgical Subinternship: A Unique Opportunity for Early Leadership Development.

Journal Article J Surg Educ · June 2023 Subinternships are formative rotations in the surgery-bound medical student's journey to surgical training. This experience allows for further exploration of career goals, plays an important evaluative role in the residency selection process, and offers on ... Full text Link to item Cite

Nephron sparing surgery and surgical management of intravascular extension of Wilms tumor.

Journal Article Pediatr Blood Cancer · May 2023 Although general treatment approaches for Wilms tumor differ between Children's Oncology Group and Société Internationale d'Oncologie Pédiatrique-Renal Tumors Study Group protocols, complex tumors that may be candidates for nephron sparing surgery (NSS) an ... Full text Link to item Cite

Congenital lobar emphysema in monozygotic twins.

Journal Article Respir Med Case Rep · 2023 Congenital lobar emphysema (CLE) is caused by airway defects resulting in air trapping and hyperinflation of the affected lobe. Case reports of families affected with CLE imply a genetic etiology. However, the genetic contributions have not been well-descr ... Full text Link to item Cite

Improved survival and higher rates of surgical resection associated with hepatocellular carcinoma in children as compared to young adults.

Journal Article Int J Cancer · December 15, 2022 Hepatocellular adenocarcinoma (HCC) is the second most common primary hepatic malignancy in children with a 5-year overall survival of 30%. Few studies have examined the similarities and differences between pediatric and adult HCC. This article aims to exa ... Full text Link to item Cite

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.

Journal Article Ann Surg · December 1, 2022 OBJECTIVE: To determine the impact of tumor characteristics and treatment approach on (1) local recurrence, (2) scoliosis development, and (3) patient-reported quality of life in children with sarcoma of the chest wall. SUMMARY OF BACKGROUND DATA: Children ... Full text Link to item Cite

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

Journal Article Int J Cancer · November 15, 2022 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 eff ... Full text Link to item Cite

Examining the role of wide excision margins in pediatric melanoma: A National Cancer Database analysis.

Journal Article Pediatr Blood Cancer · November 2022 BACKGROUND: Although adult guidelines are often applied to children, age-specific surgical margins have not been defined for pediatric melanoma. PROCEDURE: Patients <20 years of age with invasive, cutaneous melanoma were identified using the 2004-2016 N ... Full text Link to item Cite

Inflammatory myofibroblastic tumor: A multi-institutional study from the Pediatric Surgical Oncology Research Collaborative.

Journal Article Int J Cancer · October 1, 2022 Inflammatory myofibroblastic tumor (IMT) is a mesenchymal neoplasm of intermediate malignancy. We describe the largest cohort of IMT patients to date, aiming to further characterize this rare, poorly understood tumor. This is a multi-institutional review o ... Full text Link to item Cite

Coagulation Abnormalities and Clinical Complications in Children With SARS-CoV-2: A Systematic Review of 48,322 Patients.

Journal Article J Pediatr Hematol Oncol · August 1, 2022 Given the limited information on the coagulation abnormalities of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in pediatric patients, we designed a systematic review to evaluate this topic. A comprehensive literature search was conducted fo ... Full text Link to item Cite

Association of Gangrenous, Suppurative, and Exudative Findings With Outcomes and Resource Utilization in Children With Nonperforated Appendicitis.

Journal Article JAMA Surg · August 1, 2022 IMPORTANCE: The clinical significance of gangrenous, suppurative, or exudative (GSE) findings is poorly characterized in children with nonperforated appendicitis. OBJECTIVE: To evaluate whether GSE findings in children with nonperforated appendicitis are a ... Full text Link to item Cite

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

Conference Cancer · July 15, 2022 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 neopla ... Full text Link to item Cite

Interhospital variability in localization techniques for small pulmonary nodules in children: A pediatric surgical oncology research collaborative study.

Journal Article J Pediatr Surg · June 2022 BACKGROUND: Pulmonary nodules that are deep within lung parenchyma and/or small in size can be challenging to localize for biopsy. This study describes current trends in performance of image-guided localization techniques for pulmonary nodules in pediatric ... Full text Link to item Cite

Update on pediatric testicular germ cell tumors.

Journal Article J Pediatr Surg · April 2022 BACKGROUND: Testicular germ cell tumors are uncommon tumors that are encountered by pediatric surgeons and urologists and require a knowledge of appropriate contemporary evaluation and surgical and medical management. METHOD: A review of the recommended di ... Full text Link to item Cite

Surgical Site Infection in Children with Neuromuscular Disorders after Laparoscopic Gastrostomy: A Propensity-Matched National Surgical Quality Improvement Program Pediatrics Database Analysis.

Journal Article Surg Infect (Larchmt) · April 2022 Background: Prior studies have demonstrated that children with neuromuscular scoliosis have a higher incidence of infection after spine surgery. The purpose of the study is to determine whether children with neuromuscular disorders (NMDs) have higher rate ... Full text Link to item Cite

Aptamer-based factor IXa inhibition preserves hemostasis and prevents thrombosis in a piglet model of ECMO.

Journal Article Mol Ther Nucleic Acids · March 8, 2022 Extracorporeal membrane oxygenation (ECMO) requires anticoagulation to prevent clotting when the patient's blood contacts the circuit. Unfractionated heparin (UFH) usually prevents clotting but can cause life-threatening bleeding. An anticoagulant that sel ... Full text Link to item Cite

Pediatric solid tumors and associated cancer predisposition syndromes: Workup, management, and surveillance. A summary from the APSA Cancer Committee.

Journal Article J Pediatr Surg · March 2022 BACKGROUND/PURPOSE: Cancer predisposition syndromes (CPS) are a heterogeneous group of inherited disorders that greatly increase the risk of developing malignancies. CPS are particularly relevant to pediatric surgeons since nearly 10% of cancer diagnoses a ... Full text Link to item Cite

Use of a Structured Observation Tool to Promote Medical Student Engagement in Trauma Resuscitations.

Journal Article J Surg Educ · 2022 OBJECTIVE: We describe a novel approach to promoting medical student learning and engagement during trauma resuscitation with implementation of a structured observation and debriefing tool. DESIGN: In the context of a multifaceted quality improvement effor ... Full text Link to item Cite

Surgical Disorders of the Spleen

Chapter · January 1, 2022 Splenectomy is often considered for children with various benign and malignant conditions. Total splenectomy (TS) or partial splenectomy (PS) can safely be performed in children with minimal risks, although understanding the indications, expected benefits, ... Full text Cite

Non-inferiority of fragmented care for high-risk pediatric neuroblastoma patients: a single institution analysis.

Journal Article Pediatr Hematol Oncol · November 2021 Pediatric neuroblastoma (NB) patients receive multi-modal therapy and may experience care fragmented among multiple institutions with a significant travel burden, which has been associated with poor outcomes for some adult cancers. We hypothesized that fra ... Full text Link to item Cite

Open versus minimally-invasive surgical techniques in pediatric renal tumors: A population-level analysis of in-hospital outcomes.

Journal Article J Pediatr Urol · August 2021 INTRODUCTION: Minimally-invasive surgery (MIS) has been adopted slowly in pediatric oncology. We attempted to describe contemporary national trends in MIS use; we hypothesized that adolescents (who are more likely to have relatively small renal cell carcin ... Full text Link to item Cite

Examining the Effect of Travel Distance to Pediatric Cancer Centers and Rurality on Survival and Treatment Experiences: A Systematic Review.

Journal Article J Pediatr Hematol Oncol · July 1, 2021 Accessing pediatric cancer treatment remains problematic for rural families or those living at increased distances from specialized centers. Rural adult cancer patients or those living far removed from treatment may present with later stage disease, receiv ... Full text Link to item Cite

Hepatic vascular malignancies in children are associated with increased rates of surgical resection and improved overall survival compared with adults.

Journal Article Pediatr Blood Cancer · May 2021 BACKGROUND: Hepatic vascular malignancies (HVMs) are rare malignancies, with no standardized treatment regimens. The most common HVMs, angiosarcoma and malignant epithelioid hemangioendothelioma (EHE), are often grouped together in the literature complicat ... Full text Link to item Cite

Thrombosis in infants in the neonatal intensive care unit: Analysis of a large national database.

Journal Article J Thromb Haemost · February 2021 BACKGROUND: Thrombosis in the neonatal population is rare, but increasing. Its incidence and management are not well understood. OBJECTIVES: To investigate the incidence, associated factors, and management of thrombosis in the neonatal intensive care unit ... Full text Link to item Cite

Lymphadenopathy in children: A streamlined approach for the surgeon - A report from the APSA Cancer Committee.

Journal Article J Pediatr Surg · February 2021 BACKGROUND/PURPOSE: Lymphadenopathy is a common complaint in children. Pediatric surgeons are often called upon to evaluate, treat, and/or biopsy enlarged lymph nodes. With many nonsurgical causes in the differential diagnosis, the surgeon plays the import ... Full text Link to item Cite

Appendectomy Versus Observation for Appendicitis in Neutropenic Children With Cancer.

Journal Article Pediatrics · February 2021 BACKGROUND: Optimal management of neutropenic appendicitis (NA) in children undergoing cancer therapy remains undefined. Management strategies include upfront appendectomy or initial nonoperative management. We aimed to characterize the effect of managemen ... Full text Link to item Cite

Minimally invasive surgery for abdominal and thoracic neuroblastic tumors: A systematic review by the APSA Cancer committee.

Journal Article J Pediatr Surg · November 2020 BACKGROUND: Minimally invasive surgery has broad applicability to pediatric diseases, including pediatric cancer resection. Neuroblastic tumors of childhood are highly variable in presentation, and so careful selection of appropriate candidates for minimal ... Full text Link to item Cite

Minimally invasive surgery for pediatric renal tumors: A systematic review by the APSA Cancer Committee.

Journal Article J Pediatr Surg · November 2020 UNLABELLED: Minimally invasive nephrectomy is performed routinely for adult renal tumors and for many benign pediatric conditions. Although open radical nephroureterectomy remains the standard of care for Wilms tumor and most pediatric renal malignancies, ... Full text Link to item Cite

Update on pediatric rhabdomyosarcoma: A report from the APSA Cancer Committee.

Journal Article J Pediatr Surg · October 2020 BACKGROUND/PURPOSE: Rhabdomyosarcoma is the most common soft tissue sarcoma in children and young adults and requires multimodality treatment. The purpose of this review is to present an update on risk stratification as well as surgical and medical managem ... Full text Link to item Cite

What's new in pediatric melanoma: An update from the APSA cancer committee.

Journal Article J Pediatr Surg · September 2020 BACKGROUND/PURPOSE: Melanoma is the most common skin cancer in children and often presents in an atypical fashion when compared to adults. The purpose of this review is to present an update on the epidemiology, surgical and medical management and preventio ... Full text Link to item Cite

Precision oncology: A primer for pediatric surgeons from the APSA cancer committee.

Journal Article J Pediatr Surg · September 2020 Although most children with cancer can be cured of their disease, a subset of patients with adverse tumor types or biological features, and those with relapsed or refractory disease have significantly worse prognosis. Furthermore, current cytotoxic therapy ... Full text Link to item Cite

Safety of Metronidazole in Late Pre-term and Term Infants with Complicated Intra-abdominal Infections.

Journal Article Pediatr Infect Dis J · September 2020 BACKGROUND: Metronidazole is frequently used off-label in infants with complicated intra-abdominal infections (cIAI) to provide coverage against anaerobic organisms, but its safety and efficacy in this indication are unknown. METHODS: In the Antibiotic Saf ... Full text Link to item Cite

Pancreaticoduodenectomy for the treatment of pancreatic neoplasms in children: A Pediatric Surgical Oncology Research Collaborative study.

Journal Article Pediatr Blood Cancer · September 2020 BACKGROUND: To better characterize short-term and long-term outcomes in children with pancreatic tumors treated with pancreaticoduodenectomy (PD). METHODS: Patients 21 years of age or younger who underwent PD at Pediatric Surgical Oncology Collaborative (P ... Full text Link to item Cite

Coagulopathy Characterized by Rotational Thromboelastometry in a Porcine Pediatric ECMO Model.

Journal Article J Extra Corpor Technol · September 2020 Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is used to support patients with reversible cardiopulmonary insufficiency. Although it is a lifesaving technology, bleeding, inflammation, and thrombosis are well-described complications of ECMO. A ... Full text Link to item Cite

Proteomic Analysis of Infants Undergoing Cardiopulmonary Bypass Using Contemporary Ontological Tools.

Journal Article J Surg Res · February 2020 BACKGROUND: Cardiopulmonary bypass (CPB) is essential for the repair of many congenital cardiac defects in infants but is associated with significant derangements in hemostasis and systemic inflammation. As a result, hemorrhagic complications and thrombosi ... Full text Link to item Cite

The Developing Balance of Thrombosis and Hemorrhage in Pediatric Surgery: Clinical Implications of Age-Related Changes in Hemostasis.

Journal Article Clin Appl Thromb Hemost · 2020 Bleeding and thrombosis in critically ill infants and children is a vexing clinical problem. Despite the relatively low incidence of bleeding and thrombosis in the overall pediatric population relative to adults, these critically ill children face unique c ... Full text Link to item Cite

Partial and radical nephrectomy in children, adolescents, and young adults: Equivalent readmissions and postoperative complications.

Journal Article J Pediatr Surg · November 2019 OBJECTIVES: To compare and contrast the use of partial nephrectomy (PN) and radical nephrectomy (RN) in pediatric malignant renal tumors using a nationally representative database. METHODS: The 2010-2014 Nationwide Readmissions Database (NRD) was used to o ... Full text Link to item Cite

Immune expression in children with Wilms tumor: a pilot study.

Journal Article J Pediatr Urol · October 2019 BACKGROUND: Given improvements in multimodality therapy, survival among children with Wilms tumor (WT) exceeds 90%. However, 15% of children with favorable histology and 50% of children with anaplastic WT experience recurrence or progression. Of patients w ... Full text Link to item Cite

Management of symptomatic neonatal aortic thrombosis: When is surgery indicated?

Journal Article Journal of Pediatric Surgery Case Reports · August 1, 2019 Neonatal aortic thrombosis is a rare but potentially life-threatening condition. Treatment is patient-specific and may include expectant management, therapeutic anticoagulation, systemic thrombolysis or surgical thrombectomy. The majority of cases are mana ... Full text Cite

Cervical seatbelt sign is not associated with blunt cerebrovascular injury in children: A review of the national trauma databank.

Journal Article Am J Surg · July 2019 BACKGROUND: Blunt cerebrovascular injury (BCVI) is a rare consequence of blunt trauma. There appears to be benefit to an aggressive approach to screening for BCVI due to catastrophic sequelae of unrecognized injury. However, screening for BCVI carries exte ... Full text Link to item Cite

Higher mortality in pediatric and adult trauma patients with traumatic coagulopathy, using age-adjusted diagnostic criteria.

Journal Article Surgery · June 2019 BACKGROUND: Acute traumatic coagulopathy has been described in adult trauma patients. Acute traumatic coagulopathy may be associated with higher mortality and morbidity in pediatric trauma patients. We aimed to (1) compare acute traumatic coagulopathy inci ... Full text Link to item Cite

Massive transfusion in the pediatric population: A systematic review and summary of best-evidence practice strategies.

Journal Article J Trauma Acute Care Surg · April 2019 BACKGROUND: Pediatric patients require massive transfusion (MT) in a variety of settings. Multiple studies of adult MT support balanced ratio transfusion to improve outcomes; however, it is unclear if these findings can be extrapolated to pediatric populat ... Full text Link to item Cite

Outcomes of laparoscopic resection of Meckel's diverticulum are equivalent to open laparotomy.

Journal Article J Pediatr Surg · March 2019 PURPOSE: Meckel's diverticulum (MD) is a common congenital anomaly caused by failure of involution of the omphalomesenteric duct. Enthusiasm for minimally invasive surgery (MIS) in children has burgeoned as technologies have advanced, but the outcomes of l ... Full text Link to item Cite

Routine postprocedure ultrasound increases rate of detection of femoral arterial thrombosis in infants after cardiac catheterization.

Journal Article Catheter Cardiovasc Interv · March 1, 2019 OBJECTIVES: To examine the effect of implementing postcatheterization ultrasound (US) on femoral arterial thrombosis detection rates and factors associated with thrombosis in infants. BACKGROUND: Although femoral arterial thrombosis is an uncommon complica ... Full text Link to item Cite

Health Career Academy: Addition of a Surgical Case-Based Learning Curriculum Captures the Interest of High School Students.

Journal Article J Surg Educ · 2019 OBJECTIVE: The Health Career Academy (HCA) is a national program which provides a structure to introduce underserved high school students to healthcare careers. Utilizing the HCA framework, we adapted the curriculum to emphasize surgical cases and invited ... Full text Link to item Cite

Improved contemporary outcomes of liver transplantation for pediatric hepatoblastoma and hepatocellular carcinoma.

Journal Article Pediatr Transplant · December 2018 PURPOSE: Improvement in outcomes of LT for pediatric HB and HCC has been reported in small series. We analyzed national outcomes and changes in donor, recipient, and perioperative factors over time that may contribute to survival differences. METHODS: The ... Full text Link to item Cite

Racial/ethnic differences in necrotizing enterocolitis incidence and outcomes in premature very low birth weight infants.

Journal Article J Perinatol · October 2018 BACKGROUND: As advances in neonatal intensive care increase the survival of extremely premature infants, the at-risk population for necrotizing enterocolitis (NEC) continues to rise. Although racial health disparities in preterm births have been well docum ... Full text Link to item Cite

Pediatric phyllodes tumors: A review of the National Cancer Data Base and adherence to NCCN guidelines for phyllodes tumor treatment.

Journal Article J Pediatr Surg · June 2018 BACKGROUND: Phyllodes tumors are fibroepithelial breast lesions that are uncommon in women and rare among children. Due to scarcity, few large pediatric phyllodes tumor series exist. Current guidelines do not differentiate treatment recommendations between ... Full text Link to item Cite

Solid Pseudopapillary Neoplasm of the Pancreas in Children and Adults: A National Study of 369 Patients.

Journal Article J Pediatr Hematol Oncol · May 2018 BACKGROUND: Solid pseudopapillary neoplasm (SPN) of the pancreas is a rare tumor in children, with current evidence limited to single-center studies. We examined treatment and clinical outcomes for pediatric and adult SPN with a national data set. METHODS: ... Full text Link to item Cite

A multi-institution analysis of predictors of timing of inguinal hernia repair among premature infants.

Journal Article J Pediatr Surg · April 2018 PURPOSE: Inguinal hernias are common in premature infants, but there is substantial variation with regards to timing of repair. We sought to quantify and explain this variation. METHODS: Cohort study of infants <34weeks gestation diagnosed with an inguinal ... Full text Link to item Cite

Comparing oncologic outcomes after minimally invasive and open surgery for pediatric neuroblastoma and Wilms tumor.

Journal Article Pediatr Blood Cancer · January 2018 BACKGROUND: Minimally invasive surgery (MIS) has been widely adopted for common operations in pediatric surgery; however, its role in childhood tumors is limited by concerns about oncologic outcomes. We compared open and MIS approaches for pediatric neurob ... Full text Link to item Cite

Instituting a Surgical Skills Competition Increases Technical Performance of Surgical Clerkship Students Over Time.

Journal Article J Surg Educ · 2018 INTRODUCTION: Surgical skills training varies greatly between institutions and is often left to students to approach independently. Although many studies have examined single interventions of skills training, no data currently exists about the implementati ... Full text Link to item Cite

Renal medullary carcinoma: A national analysis of 159 patients.

Journal Article Pediatr Blood Cancer · November 2017 BACKGROUND: Renal medullary carcinoma (RMC) is an aggressive malignancy seen predominantly in young males with sickle cell trait. RMC is poorly understood, with fewer than 220 cases described in the medical literature to date. We used a large national regi ... Full text Link to item Cite

Epidemiologic Analysis of Elective Operative Procedures in Infants Less Than 6 Months of Age in the United States.

Journal Article Anesth Analg · November 2017 BACKGROUND: This study uses publicly available data to analyze the total number of elective, potentially deferrable operative procedures involving infants <6 months of age in the United States. We investigated the factors associated with the performance of ... Full text Link to item Cite

Outcomes following elective resection of congenital pulmonary airway malformations are equivalent after 3 months of age and a weight of 5 kg.

Journal Article J Pediatr Surg · October 9, 2017 PURPOSE: Resection of congenital pulmonary airway malformations (CPAMs) is often performed to reduce the risk of recurrent infection and malignant transformation. However, there is substantial variation in the timing of resection. This study was performed ... Full text Link to item Cite

Children Receiving Hematopoietic Stem Cell Transplantation are at Increased Risk of Onychocryptosis Requiring Surgical Management.

Journal Article J Pediatr Hematol Oncol · October 2017 PURPOSE: At our institution, a high proportion of children with onychocryptosis (ingrown toenail) requiring surgical intervention were noted to have a history of hematopoietic stem cell transplantation (HSCT). We analyzed the characteristics of patients wh ... Full text Link to item Cite

Risk prediction in children and adults less than 45 years old with papillary thyroid cancer.

Journal Article Expert Rev Endocrinol Metab · September 2017 The incidence of papillary thyroid cancer is increasing faster than any other cancer in young patients. The purpose of this review is to discuss the most recent determinants of risk of recurrence and compromised outcomes in this population. Areas covered: ... Full text Link to item Cite

The impact of femoral arterial thrombosis in paediatric cardiac catheterisation: a national study.

Journal Article Cardiol Young · July 2017 BACKGROUND: Previous studies have identified risk factors for femoral arterial thrombosis after paediatric cardiac catheterisation, but none of them have evaluated the clinical and economic significance of this complication at the population level. Therefo ... Full text Link to item Cite

Clinical considerations for blunt laryngotracheal trauma in children.

Journal Article J Pediatr Surg · May 2017 OBJECTIVE: Systematic review of blunt pediatric laryngeal and tracheal trauma and development of proposed evaluation and management strategy. STUDY DESIGN: Systematic review and proposed clinical consideration algorithm. DATA SOURCES: PubMed, EMBASE, Web o ... Full text Link to item Cite

Vascular Complications in Pediatric Port Removal.

Journal Article Am Surg · April 1, 2017 Link to item Cite

Gallbladder abnormalities in children with metachromatic leukodystrophy.

Journal Article J Surg Res · February 2017 BACKGROUND: Metachromatic leukodystrophy (MLD) is a lysosomal storage disease that leads to neurological deterioration and visceral involvement, including sulphatide deposition in the gallbladder wall. Using our institution's extensive experience in treati ... Full text Open Access Link to item Cite

Morbidity and healthcare costs of vascular anomalies: a national study.

Journal Article Pediatr Surg Int · February 2017 PURPOSE: This study aimed to define morbidities and costs related to modern-day medical care for children with vascular anomalies. METHODS: We reviewed the 2003-2009 Kids' Inpatient Database for pediatric patients (age < 21 years) hospitalized with hemangi ... Full text Link to item Cite

Predictors of nodal metastasis in pediatric differentiated thyroid cancer.

Journal Article J Pediatr Surg · January 2017 BACKGROUND/PURPOSE: There are limited data identifying risk factors for nodal metastasis in children with differentiated thyroid cancer. METHODS: The 1998-2011 Surveillance, Epidemiology, and End Results Program database was queried for patients ≤18years o ... Full text Link to item Cite

Current use and outcomes of helicopter transport in pediatric trauma: a review of 18,291 transports.

Journal Article J Pediatr Surg · January 2017 PURPOSE: The role of helicopter emergency medical services (HEMS) in pediatric trauma remains controversial. We examined its use in pediatric trauma and its effectiveness in children with moderate/severe injuries. METHODS: All blunt/penetrating trauma pati ... Full text Link to item Cite

Influence of weight at enterostomy reversal on surgical outcomes in infants after emergent neonatal stoma creation.

Journal Article J Pediatr Surg · January 2017 PURPOSE: Neonates after emergent enterostomy creation frequently require reversal at low weight because of complications including cholestasis, dehydration, dumping, failure to thrive, and failure to achieve enteral independence. We investigated whether st ... Full text Link to item Cite

Extracorporeal life support use in pediatric trauma: a review of the National Trauma Data Bank.

Journal Article J Pediatr Surg · January 2017 PURPOSE: As the role of extracorporeal life support (ECLS) continues to evolve in the adult and pediatric populations, smaller studies and case reports have described successful use of ECLS in specific groups of pediatric trauma patients. To further define ... Full text Link to item Cite

Biomarkers for Wilms Tumor: A Systematic Review.

Journal Article J Urol · November 2016 PURPOSE: Wilms tumor is the most common childhood renal malignancy and the fourth most common childhood cancer. Many biomarkers have been studied but there has been no comprehensive summary. We systematically reviewed the literature on biomarkers in Wilms ... Full text Link to item Cite

Laparoscopy Is Safe in Infants and Neonates with Congenital Heart Disease: A National Study of 3684 Patients.

Journal Article J Laparoendosc Adv Surg Tech A · October 2016 PURPOSE: Concerns have been raised about the use of laparoscopic surgery (LS) in infants with congenital heart disease (CHD) due to their unique physiology. Prior studies on the safety and effectiveness of laparoscopy in children with CHD are limited in sc ... Full text Link to item Cite

Pediatric melanoma.

Journal Article Semin Pediatr Surg · October 2016 Childhood melanoma is a rare pediatric malignancy, with fewer than 500 new diagnoses annually. The incidence is increasing, particularly in the adolescent population. This review highlights the epidemiology, clinical presentation, and histopathologic chall ... Full text Link to item Cite

Congenital duodenal obstruction: causes and imaging approach.

Journal Article Pediatr Radiol · July 2016 Bilious emesis is a common cause for evaluation in pediatric radiology departments. There are several causes of congenital duodenal obstruction, most of which require elective surgical correction, but the potential of malrotation with midgut volvulus deman ... Full text Link to item Cite

Sentinel lymph node biopsy is a prognostic measure in pediatric melanoma.

Journal Article J Pediatr Surg · June 2016 BACKGROUND/PURPOSE: Sentinel lymph node biopsy (SLNB)-based management has been shown to improve disease-free survival in adult melanoma, but there is scant evidence regarding the utility of SLNB in pediatric melanoma. METHODS: The 2004-2011 Surveillance, ... Full text Link to item Cite

Current management of pediatric thyroid disease and differentiated thyroid cancer.

Journal Article Curr Opin Oncol · January 2016 PURPOSE OF REVIEW: In this article, we focus on the role of ultrasound and fine needle aspiration, management of benign nodules, extent of thyroid resection, management of regional lymph node disease, and risk stratification in staging for well differentia ... Full text Link to item Cite

Factors associated with survival in pediatric adrenocortical carcinoma: An analysis of the National Cancer Data Base (NCDB).

Journal Article J Pediatr Surg · January 2016 PURPOSE: Adrenocortical carcinoma (ACC) is a rare tumor in children with important distinctions from the adult disease. We reviewed the National Cancer Data Base (NCDB) to determine factors associated with long-term survival. METHODS: The NCDB was queried ... Full text Link to item Cite

Surgical disorders of the spleen

Chapter · January 1, 2016 For children with many conditions, splenectomy can cure the disease or effectively control the associated clinical symptoms. However, the risks associated with splenectomy such as overwhelming postsplenectomy sepsis are not trivial, and there is increasing ... Full text Cite

Use of patient registries and administrative datasets for the study of pediatric cancer.

Journal Article Pediatr Blood Cancer · September 2015 Analysis of data from large administrative databases and patient registries is increasingly being used to study childhood cancer care, although the value of these data sources remains unclear to many clinicians. Interpretation of large databases requires a ... Full text Link to item Cite

Human Umbilical Cord Blood Cells Ameliorate Motor Deficits in Rabbits in a Cerebral Palsy Model.

Journal Article Dev Neurosci · 2015 Cerebral palsy (CP) has a significant impact on both patients and society, but therapy is limited. Human umbilical cord blood cells (HUCBC), containing various stem and progenitor cells, have been used to treat various brain genetic conditions. In small an ... Full text Open Access Link to item Cite

Pediatric injury patterns by year of age.

Journal Article J Pediatr Surg · June 2013 PURPOSE: Since trauma is the leading cause of death and disability among children, understanding injury patterns may reduce morbidity and mortality through targeted prevention efforts. The purpose of this study was to identify pediatric injury patterns by ... Full text Link to item Cite

Resident designed intern orientation to address the new ACGME Common Program Requirements for resident supervision.

Journal Article J Surg Educ · 2013 OBJECTIVE: To design an orientation for surgical interns to meet the new Accreditation Council for Graduate Medical Education Common Program Requirements regarding supervision, to test patient-management competencies, and to assess confidence on skills and ... Full text Link to item Cite

Partial splenectomy but not total splenectomy preserves immunoglobulin M memory B cells in mice.

Journal Article J Pediatr Surg · September 2011 PURPOSE: The mechanism by which partial splenectomy preserves splenic immune function is unknown. Immunoglobulin (Ig) M memory B cells are critical for the immune response against encapsulated bacteria and are reduced in asplenic patients, although it is u ... Full text Open Access Link to item Cite

Bone marrow transplantation augments the effect of brain- and spinal cord-directed adeno-associated virus 2/5 gene therapy by altering inflammation in the murine model of globoid-cell leukodystrophy.

Journal Article J Neurosci · July 6, 2011 Globoid-cell leukodystrophy (GLD) is an inherited demyelinating disease caused by the deficiency of the lysosomal enzyme galactosylceramidase (GALC). A previous study in the murine model of GLD (twitcher) demonstrated a dramatic synergy between CNS-directe ... Full text Link to item Cite

Isolation and expansion of oligodendrocyte progenitor cells from cryopreserved human umbilical cord blood.

Journal Article Cytotherapy · July 2011 BACKGROUND AIMS: Oligodendrocyte precursor cells (OPC) hold promise as a cellular therapy for demyelinating diseases. The feasibility of using OPC-based therapies in humans depends upon a reliable, readily available source. We have previously described the ... Full text Open Access Link to item Cite

Partial splenectomy for hereditary spherocytosis: a multi-institutional review.

Journal Article J Pediatr Surg · January 2011 BACKGROUND/PURPOSE: Partial splenectomy has emerged as a surgical option for selected children with hereditary spherocytosis, with the goal of reducing anemia while preserving splenic function. This multi-institutional study is the largest series to date e ... Full text Link to item Cite

Management of unusual sources of upper GI bleeding

Chapter · December 1, 2010 Recognizing unusual sources of upper GI bleeding is important in evaluating individual patients who present diagnostic dilemmas and in promptly managing patients with uncommon but potentially catastrophic bleeding sources. As upper GI bleeds are relatively ... Full text Cite

Splenectomy and partial splenectomy improve hematopoietic stem cell engraftment in hypersplenic mice.

Journal Article J Pediatr Surg · June 2010 BACKGROUND: Hematopoietic stem cell (HSC) engraftment is delayed after transplantation in children with hypersplenism, increasing the morbidity and costs of care. Preliminary clinical data suggest that splenectomy before HSC transplantation may improve HSC ... Full text Open Access Link to item Cite

Protocolized approach to the management of congenital diaphragmatic hernia: benefits of reducing variability in care.

Journal Article J Pediatr Surg · June 2010 PURPOSE: Variable approaches to the care of infants with congenital diaphragmatic hernia (CDH) by multiple providers may contribute to inconsistent care. Our institution developed a comprehensive evidence-based protocol to standardize the management of CDH ... Full text Link to item Cite

Preliminary observations of the use of high-frequency jet ventilation as rescue therapy in infants with congenital diaphragmatic hernia.

Journal Article J Pediatr Surg · April 2010 BACKGROUND/PURPOSE: Congenital diaphragmatic hernia (CDH) is associated with mortality of 10% to 50%. Several investigators have reported outcomes from centers using high-frequency oscillatory ventilation in their management of CDH, but there are no recent ... Full text Link to item Cite

Temporal trends in lung transplant center volume and outcomes in the United States.

Journal Article Transplantation · March 27, 2010 Publicly available program-specific data from the scientific registry of transplant recipients were used to determine the association between adult lung transplant center volume and 1-year recipient mortality from 2000 to 2007. We found a significant inver ... Full text Link to item Cite

Low volume is associated with worse patient outcomes for pediatric liver transplant centers.

Journal Article J Pediatr Surg · January 2010 BACKGROUND: An inverse association between hospital procedure volume and postoperative mortality has been demonstrated for a variety of pediatric surgical procedures. The objective of our study was to determine whether such an association exists for pediat ... Full text Link to item Cite

Temporal trends in liver transplant centre volume in the USA.

Journal Article HPB (Oxford) · August 2009 BACKGROUND: Although prior studies have suggested an inverse association between liver transplant centre volume and postoperative patient mortality, more recent analyses have failed to confirm this association. To date, all studies of the relationship betw ... Full text Link to item Cite

Partial splenectomy for hereditary spherocytosis.

Journal Article Pediatr Clin North Am · April 2008 The significant risks associated with total splenectomy have led to interest in the use of partial splenectomy as an alternative surgical therapy for children who have congenital hemolytic anemia. Partial splenectomy is designed to remove enough spleen to ... Full text Link to item Cite

Isolation of oligodendrocyte-like cells from human umbilical cord blood.

Journal Article Cytotherapy · 2008 BACKGROUND: As human umbilical cord blood (UCB) is known to be a rich source of progenitor cells, the prospect of isolating a subset of these cells that could differentiate into cells of non-hematopoietic lineages suggests a therapeutic use for patients wi ... Full text Link to item Cite