Catherine LaRusso

34 statements · 2 topics · summaries given as host listed separately

Featured statements

▶ Ep 31 · 2:35
Due to recent studies implicating transanastomotic feeding tubes as an independent risk factor for postoperative strictures, Montreal Children's Hospital initiated a moratorium on their use until evaluating their own outcomes.
guideline · Esophageal Atresia
▶ Ep 31 · 4:45
On multivariate analysis adjusting for gestational age, leak, long gap, anastomotic tension, and daily acid suppression, transanastomotic tubes conferred almost 3 times higher odds of developing a stricture compared to those without.
epidemiological · Esophageal Atresia
▶ Ep 21 · 5:05
Transanastomotic feeding tubes are associated with an increased rate of postoperative strictures, decreased time to enteral feeding, but do not confer a major benefit in the number of days on postoperative TPN.
clinical · Tracheoesophageal Fistula
▶ Ep 21 · 7:25
In the study data, only about 30 cases were done thoracoscopically out of 244 patients, so numbers are not large enough to definitively say whether MIS techniques impact stricture rates.
epidemiological · Tracheoesophageal Fistula

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Catherine's statements about Esophageal Atresia 17 statements

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APSA - Effect of transanastomotic feeding tubes on anastomotic strictures in patients with esophageal atresia and tracheoesophageal fistula- the Quebec experience - Kathryn LaRusso

▶ Ep 31 · 2:35
guideline Due to recent studies implicating transanastomotic feeding tubes as an independent risk factor for postoperative strictures, Montreal Children's Hospital initiated a moratorium on their use until evaluating their own outcomes. ↗
▶ Ep 31 · 2:55
quote Our hypothesis was that was that transastomotic tubes increase the rate of postoperative strictures following EA and TEF repair. ↗
▶ Ep 31 · 3:05
clinical The study included all type C and type D EA-TEF patients at three university-affiliated hospitals in Quebec over 25 years (1993-2018) who had primary repair within 6 months of birth and at least 1 year follow-up. ↗
▶ Ep 31 · 3:40
clinical Stricture was defined as symptoms with imaging confirmation (upper GI or endoscopy) at one year. ↗
▶ Ep 31 · 4:10
epidemiological Of 371 EA-TEF patients born during the study period, 344 were type C or D, and 244 were included in the analysis. ↗
▶ Ep 31 · 4:25
epidemiological About 30% of patients had strictures, and transanastomotic tubes were used in 61% of patients. ↗
▶ Ep 31 · 4:35
epidemiological On univariate analysis, transanastomotic tubes were significantly associated with strictures. ↗
▶ Ep 31 · 4:45
epidemiological On multivariate analysis adjusting for gestational age, leak, long gap, anastomotic tension, and daily acid suppression, transanastomotic tubes conferred almost 3 times higher odds of developing a stricture compared to those without. ↗
▶ Ep 31 · 5:05
epidemiological Days on postoperative TPN were the same between transanastomotic tube and non-tube groups; all patients in the study cohort were on TPN. ↗
▶ Ep 31 · 5:05
clinical Transanastomotic feeding tubes are associated with an increased rate of postoperative strictures, decreased time to enteral feeding, but do not confer a major benefit in the number of days on postoperative TPN. ↗
▶ Ep 31 · 5:05
epidemiological Days to first enteral feeding were shorter in the transanastomotic feeding tube group than those without. ↗
▶ Ep 31 · 7:25
epidemiological In the study data, only about 30 cases were done thoracoscopically out of 244 patients, so numbers are not large enough to definitively say whether MIS techniques impact stricture rates. ↗
▶ Ep 31 · 7:50
clinical One standard type of tube was used as a transanastomotic feeding tube in the study. ↗
▶ Ep 31 · 8:00
opinion Data on replacement tubes when children fail oral enteral feeding is difficult to analyze retrospectively and needs to be captured in future studies with more randomization. ↗
▶ Ep 31 · 8:00
quote Oftentimes these kids fail PO at uh enteral feeding, and then they have to get either a follow-up feeding tube placed or the uh a similar tube gets replaced. And that data is still really difficult to analyze retrospectively. ↗
▶ Ep 31 · 8:20
quote I think going forward, we need to capture that data and have like more randomization, um, techniques involved in like who we're putting tubes into to really like highlight the data further ↗
▶ Ep 31 · 8:30
opinion Transanastomotic tubes potentially increase inflammation and acid exposure to the anastomosis, increasing stricture rate overall. ↗
Catherine's statements about Tracheoesophageal Fistula 17 statements

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APSA - Effect of transanastomotic feeding tubes on anastomotic strictures in patients with esophageal atresia and tracheoesophageal fistula- the Quebec experience - Kathryn LaRusso

▶ Ep 21 · 2:35
guideline Due to recent studies implicating transanastomotic feeding tubes as an independent risk factor for postoperative strictures, Montreal Children's Hospital initiated a moratorium on their use until evaluating their own outcomes. ↗
▶ Ep 21 · 2:55
quote Our hypothesis was that was that transastomotic tubes increase the rate of postoperative strictures following EA and TEF repair. ↗
▶ Ep 21 · 3:05
clinical The study included all type C and type D EA-TEF patients at three university-affiliated hospitals in Quebec over 25 years (1993-2018) who had primary repair within 6 months of birth and at least 1 year follow-up. ↗
▶ Ep 21 · 3:40
clinical Stricture was defined as symptoms with imaging confirmation (upper GI or endoscopy) at one year. ↗
▶ Ep 21 · 4:10
epidemiological Of 371 EA-TEF patients born during the study period, 344 were type C or D, and 244 were included in the analysis. ↗
▶ Ep 21 · 4:25
epidemiological About 30% of patients had strictures, and transanastomotic tubes were used in 61% of patients. ↗
▶ Ep 21 · 4:35
epidemiological On univariate analysis, transanastomotic tubes were significantly associated with strictures. ↗
▶ Ep 21 · 4:45
epidemiological On multivariate analysis adjusting for gestational age, leak, long gap, anastomotic tension, and daily acid suppression, transanastomotic tubes conferred almost 3 times higher odds of developing a stricture compared to those without. ↗
▶ Ep 21 · 5:05
clinical Transanastomotic feeding tubes are associated with an increased rate of postoperative strictures, decreased time to enteral feeding, but do not confer a major benefit in the number of days on postoperative TPN. ↗
▶ Ep 21 · 5:05
epidemiological Days on postoperative TPN were the same between transanastomotic tube and non-tube groups; all patients in the study cohort were on TPN. ↗
▶ Ep 21 · 5:05
epidemiological Days to first enteral feeding were shorter in the transanastomotic feeding tube group than those without. ↗
▶ Ep 21 · 7:25
epidemiological In the study data, only about 30 cases were done thoracoscopically out of 244 patients, so numbers are not large enough to definitively say whether MIS techniques impact stricture rates. ↗
▶ Ep 21 · 7:50
clinical One standard type of tube was used as a transanastomotic feeding tube in the study. ↗
▶ Ep 21 · 8:00
opinion Data on replacement tubes when children fail oral enteral feeding is difficult to analyze retrospectively and needs to be captured in future studies with more randomization. ↗
▶ Ep 21 · 8:00
quote Oftentimes these kids fail PO at uh enteral feeding, and then they have to get either a follow-up feeding tube placed or the uh a similar tube gets replaced. And that data is still really difficult to analyze retrospectively. ↗
▶ Ep 21 · 8:20
quote I think going forward, we need to capture that data and have like more randomization, um, techniques involved in like who we're putting tubes into to really like highlight the data further ↗
▶ Ep 21 · 8:30
opinion Transanastomotic tubes potentially increase inflammation and acid exposure to the anastomosis, increasing stricture rate overall. ↗

Summaries Catherine gave as host · 8 summaries

Recaps of other experts' statements, not Catherine's own clinical position.

Summaries Catherine gave as host · Esophageal Atresia 4 summaries

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APSA - Effect of transanastomotic feeding tubes on anastomotic strictures in patients with esophageal atresia and tracheoesophageal fistula- the Quebec experience - Kathryn LaRusso

▶ Ep 31 · 0:37
host summary Catherine LaRusso summarizes what Dr. Miguel Guelfand said: Risk factors for the development of post-operative stricture in EA-TEF include anastomotic tension, long gap atresia, leak, gastroesophageal reflux, and more recently, trans anastomotic tubes have been implicated. ↗
▶ Ep 31 · 1:20
host summary Catherine LaRusso summarizes what Dr. Miguel Guelfand said: Use of transanastomotic tubes has increased since the 1980s, the rationale being a shorter time to feeds and a shorter duration of postoperative TPN. ↗
▶ Ep 31 · 1:40
host summary Catherine LaRusso summarizes what Dr. Miguel Guelfand said: A recent Midwest Pediatric Surgery Consortium study of 292 type C EA-TEF patients found an increased rate of strictures in the transanastomotic tube group that was almost 2 times that of those without. ↗
▶ Ep 31 · 2:10
host summary Catherine LaRusso summarizes what Dr. Miguel Guelfand said: A Children's Hospital of Pittsburgh study of EA-TEF (all types, majority type C) found a significant difference in stricture rates between transanastomotic tube and non-tube groups. ↗
Summaries Catherine gave as host · Tracheoesophageal Fistula 4 summaries

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APSA - Effect of transanastomotic feeding tubes on anastomotic strictures in patients with esophageal atresia and tracheoesophageal fistula- the Quebec experience - Kathryn LaRusso

▶ Ep 21 · 0:37
host summary Catherine LaRusso summarizes what Dr. Miguel Guelfand said: Risk factors for the development of post-operative stricture in EA-TEF include anastomotic tension, long gap atresia, leak, gastroesophageal reflux, and more recently, trans anastomotic tubes have been implicated. ↗
▶ Ep 21 · 1:20
host summary Catherine LaRusso summarizes what Dr. Miguel Guelfand said: Use of transanastomotic tubes has increased since the 1980s, the rationale being a shorter time to feeds and a shorter duration of postoperative TPN. ↗
▶ Ep 21 · 1:40
host summary Catherine LaRusso summarizes what Dr. Miguel Guelfand said: A recent Midwest Pediatric Surgery Consortium study of 292 type C EA-TEF patients found an increased rate of strictures in the transanastomotic tube group that was almost 2 times that of those without. ↗
▶ Ep 21 · 2:10
host summary Catherine LaRusso summarizes what Dr. Miguel Guelfand said: A Children's Hospital of Pittsburgh study of EA-TEF (all types, majority type C) found a significant difference in stricture rates between transanastomotic tube and non-tube groups. ↗