Are paediatric operations evidence based? A prospective analysis of general surgery practice in a teaching paediatric hospital

Zani‐Ruttenstock, Elke; Zani, Augusto; Bullman, Emma; Lapidus-Krol, Eveline; Pierro, Agostino

doi:10.1007/s00383-014-3624-5

Cited by 21 publications

(7 citation statements)

References 68 publications

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“…The prospective RCT performed to eliminate selection, allocation, and performance bias has been established as the highest level of evidence [5]. We previously reported that although evidence-based paediatric surgical practice has improved over the years, more than a third of the surgical procedures still lack sufficient evidence-based literature support [22]. With the present study, we confirmed that appendectomy and pyloromyotomy were supported by RCTs performed in…”

Section: Discussionsupporting

confidence: 83%

Laparoscopy in pediatric surgery: Implementation in Canada and supporting evidence

Sattarova

Eaton²,

Hall

et al. 2016

Journal of Pediatric Surgery

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Section: Discussionsupporting

confidence: 83%

Laparoscopy in pediatric surgery: Implementation in Canada and supporting evidence

Sattarova

Eaton²,

Hall

et al. 2016

Journal of Pediatric Surgery

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“…Modern medicine increasingly places emphasis on evidence-based medicine, 43 defined by Sackett et al as "(…) the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients." 44 Nonetheless, the paucity of high-level evidence in the literature on pediatric surgical procedures was highlighted in 1999, when Hardin et al 45 reported that only 0.3% of the literature relevant for pediatric surgery consisted of CEBM level-1 evidence studies.…”

Section: Rct Rctmentioning

confidence: 99%

ERNICA Consensus Conference on the Management of Patients with Esophageal Atresia and Tracheoesophageal Fistula: Diagnostics, Preoperative, Operative, and Postoperative Management

et al. 2019

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Introduction Many aspects of the management of esophageal atresia (EA) and tracheoesophageal fistula (TEF) are controversial and the evidence for decision making is limited. Members of the European Reference Network for Rare Inherited Congenital Anomalies (ERNICA) conducted a consensus conference on the surgical management of EA/TEF based on expert opinions referring to the latest literature. Materials and Methods Nineteen ERNICA representatives from nine European countries participated in the conference. The conference was prepared by item generation, item prioritization by online survey, formulation of a final list containing the domains diagnostics, preoperative, operative, and postoperative management, and literature review. The 2-day conference was held in Berlin in October 2018. Anonymous voting was conducted via an internet-based system. Consensus was defined when 75% of the votes scored 6 to 9. Results Fifty-two items were generated with 116 relevant articles of which five studies (4.3%) were assigned as level-1evidence. Complete consensus (100%) was achieved on 20 items (38%), such as TEF closure by transfixing suture, esophageal anastomosis by interrupted sutures, and initiation of feeding 24 hours postoperatively. Consensus ≥75% was achieved on 37 items (71%), such as routine insertion of transanastomotic tube or maximum duration of thoracoscopy of 3 hours. Thirteen items (25%) were controversial (range of scores, 1–9). Eight of these (62%) did not reach consensus. Conclusion Participants of the conference reached significant consensus on the management of patients with EA/TEF. The consensus may facilitate standardization and development of generally accepted guidelines. The conference methodology may serve as a blueprint for further conferences on the management of congenital malformations in pediatric surgery.

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“…Pediatric Surgery is a specialty characterized by the rarity of the conditions treated and the infrequency of complex procedures performed by a single surgeon in a year. This is one of the reasons why the surgical practice within this specialty lacks sufficient evidence-based literature support, 7 and why practice surveys are an effective tool for data gathering on the views, practice, and management of pediatric surgeons. The pediatric surgical literature contains hundreds of surveys, many of which have been promoted by surgical societies and administered at the annual meeting.…”

Section: Value Of Surveys In Pediatric Surgerymentioning

confidence: 99%

The Value of Surveys in Pediatric Surgery

et al. 2015

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Surveys are an important research tool to evaluate the practice patterns of physicians. In the medical literature, practice surveys are increasingly used in specialties, such as pediatric surgery, characterized by the lack of sufficient evidence-based literature due to the rarity of the conditions treated. To maintain a level that yields to a meaningful scientific contribution the design, data collection and analysis of the survey have to be rigorous. Herein, we describe the general principles of survey methodology, we report the benefits and limitations of this statistical method, and we discuss the value of surveys in pediatric surgery.

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Are paediatric operations evidence based? A prospective analysis of general surgery practice in a teaching paediatric hospital

Cited by 21 publications

References 68 publications

Laparoscopy in pediatric surgery: Implementation in Canada and supporting evidence

Laparoscopy in pediatric surgery: Implementation in Canada and supporting evidence

ERNICA Consensus Conference on the Management of Patients with Esophageal Atresia and Tracheoesophageal Fistula: Diagnostics, Preoperative, Operative, and Postoperative Management

The Value of Surveys in Pediatric Surgery

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