Three research papers from faculty members at Texas Children’s Hospital were presented at the 128th annual meeting of the Southern Surgical Association in Palm Beach, Florida. Researchers from Congenital Heart Surgery, Pediatric Surgery and Transplant Services brought new information to the association for presentation and discussion.
Congenital Heart Surgery researchers presented a paper on the Mid-term Outcomes of Patients Diagnosed with Congenitally Corrected Transposition of the Great Arteries: A Single Center Experience. After retrospectively reviewing the records of 89 patients with Congenitally Corrected Transposition of the Great Arteries, it was found that transplant free survival is similar in all of the patients no matter the type of surgical correction they received. Proper post-surgical care and medical management is needed, however, to reduce systemic right ventricle dysfunction, which is a risk factor for death and transplant.
“It will be interesting to follow our patients and evaluate which of these repair techniques is superior over the longer term,” said Dr. Charles D. Fraser, Jr., surgeon-in-chief and chief of Congenital Heart Surgery.
Members of Congenital Heart Surgery who contributed to the paper were: Drs. Carlos M. Mery, Iki Adachi, Luis E. De León, Raymond A. Verm, Francisco A. Guzmán and Ms. Ankita Patro.
Researchers in the Division of Pediatric Surgery contributed to a 14-center study evaluating the need for CT scans in children with blunt abdominal trauma. In the paper Identifying Children at Very Low Risk of Blunt Intra-abdominal Injury in whom Computed Tomography (CT) of the Abdomen Can Safely Be Avoided, researchers derived a prediction rule using common and rapidly available clinical data available in the trauma bay to identify children at very low risk for intra-abdominal injury following blunt abdominal trauma. The goal was to identify children for whom a CT of the abdomen would be unnecessary.
Analysis showed that a prediction rule composed of five variables (complaint of abdominal pain, abnormal abdominal exam, elevate liver enzymes, abnormal chest radiograph, and abnormal pancreatic enzymes) identified a population with a risk of intra-abdominal injury of 0.6 percent. This very low risk group represented almost 34 percent of the total population.
“When validated, this rule has the potential to identify children in which an abdominal CT scan could be avoided,” said pediatric surgeon and co-author Dr. Adam Vogel, who worked with Dr. Bindi Naik-Mathuria on the study. The rule potentially results in reduced radiation exposure and reduced costs not only to the hospital but also to the patient and family.
In the study No Child Left behind: Liver Transplantation in the Sickest Children, researchers hypothesized that more critically ill children can undergo liver transplantation due to advances in ICU care for children with liver failure. After analyzing data from 468 patients from 1987 to 2015, it was found that survival in life support recipients was considerably better after 2002, Texas Children’s had excellent outcomes as compared to the national benchmark for 5-year survival, and overall outcomes are superior in high volume transplant centers.
“Our analysis suggests that high volume transplant centers are the most appropriate type of institutions to care for critically ill children with liver failure because of the level of ICU care they receive prior to transplant,” said Dr. John Goss, co-investigator and transplant medical director. Other researchers involved in the study were Drs. Christine O’Mahony, Ronald Cotton, Abbas Rana, Michael Kueht and Saira Khaderi.
The Southern Surgical Association is a group of more than 700 accomplished professionals actively practicing in surgery or one of its sub-specialties. Since 1887, the association has hosted an annual meeting dedicated to the dissemination of research and discovery of superior surgical techniques, better outcomes and applicable knowledge.
Click here to view a program of the annual meeting.