PEDIATRIC SURGERY RESEARCH COLLABORATIVE
Current Projects
High Ligation and Recurrence of Inguinal Hernias in Adolescents
Enrollment Completed; Data Analysis
Different surgical techniques are used to repair indirect inguinal hernias in children than are used in adults, but it is unclear how adolescents should be treated. Some surgeons use a set age to determine when to offer an “adult-style” repair, which traditionally uses mesh to reinforce the pelvic floor, but there are other important factors to consider such as patient sex, obesity, and history of athletic participation. This study will identify patient factors in addition to age that should be used to select which adolescents are optimally treated with a “pediatric-style” repair (high-ligation) and which should receive an ”adult-style” repair (mesh-based floor repair).
PI: Brian Gulack
Water Beads Ingestion in Children - Who Requires Surgery
Enrollment Completed; Data Analysis
Water beads are commonly ingested in children, and while some may pass spontaneously, others can become stuck requiring surgery to relieve the associated bowel obstruction. This study will use multi-institutional data to better determine which patients can be safely observed, and which are more likely to require surgery after water bead ingestion.
PI: Jose Salazar Osuna
Infant Perianal Abscess Quality Improvement Project
Enrollment Completed; Data Analysis
Perianal abscesses are very common in children under on year of age. These often recur and can be frustrating to treat for both families and caregivers. Current management may include incision and drainage, aspiration, observation, antibiotics, or a combination of these. There is no standard of care, and evidence-to-date is mixed with a wide range of reported recurrence rates from various methods of treatment. Our hypothesis is that implementation of a protocol for management of infant perianal abscesses that minimizes early surgical instrumentation will improve patient care, decreased time to abscess resolution and decreased use of surgical intervention.
PI: Elizabeth Fialkowski
Management of Pilonidal Disease
Enrollment Completed; Data Analysis
This study is a multi-center, non-randomized controlled trial. Pilonidal disease can be a frustrating condition, with a chronic and relapsing course. There is no clear optimal treatment. Minimally invasive pilonidal excision (MIPE) allows for a rapid return to activity following treatment, likely at a cost of higher recurrence. This is a prospective observational non-randomized clinical trial assessing different surgical treatments for pilonidal disease. This trial allows for patient and/or surgeon to dictate the operation performed. Outcome measures, including need for second operative procedure, time to return to school/work, frequency of surgical complications, patient satisfaction and QOL will be captured. In addition, surgeon perspectives on the procedure will be studied. This study is registered on clinicaltrials.gov.
PI: Aaron Lipskar (https://clinicaltrials.gov/ct2/show/NCT03772873)
Using Electronic Medical Record Autopopulation for Clinical Studies
In Development
Clinical trials require a lot of time and energy from study staff, limiting the ability to promote useful data to guide clinical decisions. Improving efficiency in these arena will make clinical trials easier, and improve the care of children everywhere. This study is developing and validating methods to use automated processes in electronic medical records (EMR) to improve efficiency in clinical trials.
PI: Brian Englum
Non-Operative Management (NOM) Appendicitis: Real-World Applications
In Development
Non-operative management (NOM) of simple appendicitis has been demonstrated to be safe and effective in children, however its implementation in real world scenarios has been limited and varied. This study is investigating the current use of NOM in the real world, including outcomes of extended inclusion criteria (outside the normal inclusion criteria used in previous clinical trials).
PI: Beth Slater
Hand Sewn vs Stapled Bowel Anastomoses in Children
In Development
Most bowel anastomoses in children are formed by sewing two pieces of bowel together, unlike in adults, in which staplers are often used. Staplers are quicker and more efficient, reducing operative time and costs, however there has long been concern of higher risks of stricture and limited application due to the size of the stapler in children which has limited the application in this population. This study is evaluating current use of staplers in bowel anastomoses in children under 3, and comparing these outcomes to hand-sewn anastomoses.
PI: Brian Gulack
Predictors of Short- and Long-Term Respiratory Morbidity in Esophageal Atresia
In Development
Recent data has demonstrated that children with esophageal atresia/tracheoesophageal fistula (EA/TEF) are at increased risk of respiratory issues later in life. It is unclear, however, which children are actually at risk, limiting the ability to develop guidelines for screening of at-risk children. This study is expanding on work done by the PI at a single center to better understand what risk factors are associated with long-term respiratory morbidity after repair of EA/TEF.
PI: Jamie Robinson