28 statements
· 2 topics
· summaries given as host listed separately
Featured statements
▶Ep 68 · 9:00
We're really bad at predicting what a preoperative bronchoscopy will mean for clinical evidence of tracheumalacia. We're just not very good. The sensitivity is probably only 50%.
Preoperative bronchoscopy has only approximately 50% sensitivity for predicting clinically significant tracheomalacia; about half of patients without evidence of tracheomalacia on preoperative bronchoscopy will go on to develop clinically significant tracheomalacia.
Posterior tracheopexy involves placing horizontal mattress sutures in the posterior membranous portion of the trachea under flexible bronchoscopic guidance and suturing them to the anterior longitudinal ligament of the spine.
Rare findings on preoperative bronchoscopy include subglottic or molecular cysts that may have implications for respiratory support and postoperative course.
2025 Pediatric Surgery Update Course - Updates in Esophageal Atresia Management
▶Ep 68 · 2:35
quoteOne of the arguments was safety and I think safety, it could be done very safely without major complications.↗
▶Ep 68 · 3:30
quoteI think there's utility in knowing whether or not they have a laryngeoclefs and developing a safe feeding plan for them.↗
▶Ep 68 · 5:20
clinicalUnusual fistula locations can occur in EA, including peck bronchus or main stem bronchus fistula.↗
▶Ep 68 · 5:30
epidemiologicalUp to 20% of patients with EA will have a laryngeal cleft.↗
▶Ep 68 · 5:40
clinicalRare findings on preoperative bronchoscopy include subglottic or molecular cysts that may have implications for respiratory support and postoperative course.↗
▶Ep 68 · 8:00
quoteI wish I had a better answer about which kids get it and which don't.↗
▶Ep 68 · 9:00
quoteWe're really bad at predicting what a preoperative bronchoscopy will mean for clinical evidence of tracheumalacia. We're just not very good. The sensitivity is probably only 50%.↗
▶Ep 68 · 9:00
clinicalPreoperative bronchoscopy has only approximately 50% sensitivity for predicting clinically significant tracheomalacia; about half of patients without evidence of tracheomalacia on preoperative bronchoscopy will go on to develop clinically significant tracheomalacia.↗
▶Ep 68 · 11:20
clinicalPosterior tracheopexy involves placing horizontal mattress sutures in the posterior membranous portion of the trachea under flexible bronchoscopic guidance and suturing them to the anterior longitudinal ligament of the spine.↗
▶Ep 68 · 14:30
quoteI think we injure recurrent lurinjial nerves maybe more than we appreciate.↗
▶Ep 68 · 14:30
epidemiologicalRecurrent laryngeal nerve injury occurs in 11% of EA repair patients overall, which may be an underestimation.↗
▶Ep 68 · 14:45
epidemiologicalIn H-type EA repairs, which are often addressed through a cervical surgical approach, recurrent laryngeal nerve injury rates are up to 50%.↗
▶Ep 68 · 15:00
clinicalInjury rates for recurrent laryngeal nerve may be higher during thoracoscopic EA repair when mobilizing the proximal pouch.↗
▶Ep 68 · 15:40
clinicalModifying nerve monitoring electrodes to small endotracheal tubes for use in EA repair is technically challenging and has a learning curve.↗
Matt's statements about Tracheomalacia14 statements
2025 Pediatric Surgery Update Course - Updates in Esophageal Atresia Management
▶Ep 11 · 2:35
quoteOne of the arguments was safety and I think safety, it could be done very safely without major complications.↗
▶Ep 11 · 3:30
quoteI think there's utility in knowing whether or not they have a laryngeoclefs and developing a safe feeding plan for them.↗
▶Ep 11 · 5:20
clinicalUnusual fistula locations can occur in EA, including peck bronchus or main stem bronchus fistula.↗
▶Ep 11 · 5:30
epidemiologicalUp to 20% of patients with EA will have a laryngeal cleft.↗
▶Ep 11 · 5:40
clinicalRare findings on preoperative bronchoscopy include subglottic or molecular cysts that may have implications for respiratory support and postoperative course.↗
▶Ep 11 · 8:00
quoteI wish I had a better answer about which kids get it and which don't.↗
▶Ep 11 · 9:00
quoteWe're really bad at predicting what a preoperative bronchoscopy will mean for clinical evidence of tracheumalacia. We're just not very good. The sensitivity is probably only 50%.↗
▶Ep 11 · 9:00
clinicalPreoperative bronchoscopy has only approximately 50% sensitivity for predicting clinically significant tracheomalacia; about half of patients without evidence of tracheomalacia on preoperative bronchoscopy will go on to develop clinically significant tracheomalacia.↗
▶Ep 11 · 11:20
clinicalPosterior tracheopexy involves placing horizontal mattress sutures in the posterior membranous portion of the trachea under flexible bronchoscopic guidance and suturing them to the anterior longitudinal ligament of the spine.↗
▶Ep 11 · 14:30
quoteI think we injure recurrent lurinjial nerves maybe more than we appreciate.↗
▶Ep 11 · 14:30
epidemiologicalRecurrent laryngeal nerve injury occurs in 11% of EA repair patients overall, which may be an underestimation.↗
▶Ep 11 · 14:45
epidemiologicalIn H-type EA repairs, which are often addressed through a cervical surgical approach, recurrent laryngeal nerve injury rates are up to 50%.↗
▶Ep 11 · 15:00
clinicalInjury rates for recurrent laryngeal nerve may be higher during thoracoscopic EA repair when mobilizing the proximal pouch.↗
▶Ep 11 · 15:40
clinicalModifying nerve monitoring electrodes to small endotracheal tubes for use in EA repair is technically challenging and has a learning curve.↗
Summaries Matt gave as host
· 12 summaries
Recaps of other experts' statements, not Matt's own clinical position.
Summaries Matt gave as host · Esophageal Atresia6 summaries
2025 Pediatric Surgery Update Course - Updates in Esophageal Atresia Management
▶Ep 68 · 2:27
host summaryMatt Dellinger summarizing a resource: In a 2012 survey of IPEG surgeons by Dr. St. Peter, 60% of approximately 170 surgeons over 30 countries responded that they would routinely do preoperative bronchoscopy for EA repair.↗
▶Ep 68 · 2:45
host summaryMatt Dellinger summarizing a resource: An Italian group found that preoperative bronchoscopy was useful in 45% of EA patients, including for identifying proximal fistula in type A or type C, fistula occlusion concerns, and alteration of operative approach.↗
▶Ep 68 · 4:45
host summaryMatt Dellinger summarizing a resource: Laryngeal clefts come in different forms, and major clefts may require careful consideration before proceeding with general anesthesia as patients can decompensate if intubated.↗
▶Ep 68 · 10:00
host summaryMatt Dellinger summarizing a resource: Primary tracheopexy at the time of EA repair in children with moderate to severe tracheomalacia (75% or greater collapse) has been associated with fewer life-threatening events, fewer hospitalizations for respiratory illnesses, and improved weight-for-age scores at 12 months, according to studies from Boston, Johns Hopkins, All Children's, and a group in the Netherlands.↗
▶Ep 68 · 11:00
host summaryMatt Dellinger summarizing a resource: Posterior tracheopexy was originally described in cases of recurrent tracheoesophageal fistula to separate suture lines and prevent second recurrence.↗
▶Ep 68 · 15:15
host summaryMatt Dellinger summarizing a resource: Data from Austin shows that intraoperative recurrent laryngeal nerve monitoring appears to decrease nerve injury rates in high-risk cases, defined as esophageal atresia, cardiac surgery, or a combination thereof.↗
Summaries Matt gave as host · Tracheomalacia6 summaries
2025 Pediatric Surgery Update Course - Updates in Esophageal Atresia Management
▶Ep 11 · 2:27
host summaryMatt Dellinger summarizing a resource: In a 2012 survey of IPEG surgeons by Dr. St. Peter, 60% of approximately 170 surgeons over 30 countries responded that they would routinely do preoperative bronchoscopy for EA repair.↗
▶Ep 11 · 2:45
host summaryMatt Dellinger summarizing a resource: An Italian group found that preoperative bronchoscopy was useful in 45% of EA patients, including for identifying proximal fistula in type A or type C, fistula occlusion concerns, and alteration of operative approach.↗
▶Ep 11 · 4:45
host summaryMatt Dellinger summarizing a resource: Laryngeal clefts come in different forms, and major clefts may require careful consideration before proceeding with general anesthesia as patients can decompensate if intubated.↗
▶Ep 11 · 10:00
host summaryMatt Dellinger summarizing a resource: Primary tracheopexy at the time of EA repair in children with moderate to severe tracheomalacia (75% or greater collapse) has been associated with fewer life-threatening events, fewer hospitalizations for respiratory illnesses, and improved weight-for-age scores at 12 months, according to studies from Boston, Johns Hopkins, All Children's, and a group in the Netherlands.↗
▶Ep 11 · 11:00
host summaryMatt Dellinger summarizing a resource: Posterior tracheopexy was originally described in cases of recurrent tracheoesophageal fistula to separate suture lines and prevent second recurrence.↗
▶Ep 11 · 15:15
host summaryMatt Dellinger summarizing a resource: Data from Austin shows that intraoperative recurrent laryngeal nerve monitoring appears to decrease nerve injury rates in high-risk cases, defined as esophageal atresia, cardiac surgery, or a combination thereof.↗
