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Article ; Online: Roadmap to Liquid Biopsy Biobanking from Pediatric Cancers-Challenges and Opportunities.

Kahana-Edwin, Smadar / Cain, Lucy E / Karpelowsky, Jonathan

2021 Volume 19, Issue 2, Page(s) 124–129

Abstract: Liquid biopsy is rapidly gaining traction for potentially revolutionizing cancer diagnosis and treatment through blood-based utilization of shed biomolecules. This approach can provide a global picture of the cancer in real time, at multiple time points, ...

Abstract	Liquid biopsy is rapidly gaining traction for potentially revolutionizing cancer diagnosis and treatment through blood-based utilization of shed biomolecules. This approach can provide a global picture of the cancer in real time, at multiple time points, and with minimal invasiveness. In this review, we familiarize cancer biobanks with the principles used for liquid biopsy work and highlight unique aspects of applying liquid biopsy approaches to pediatric cancers to enable high-quality and efficient translational research.
MeSH term(s)	Biological Specimen Banks ; Child ; Humans ; Liquid Biopsy ; Neoplasms ; Translational Medical Research
Language	English
Publishing date	2021-01-27
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2593993-2
ISSN	1947-5543 ; 1947-5535
ISSN (online)	1947-5543
ISSN	1947-5535
DOI	10.1089/bio.2020.0117
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: The effect of standardized feeding protocol on early outcome following gastroschisis repair: A systematic review and meta-analysis.

Raduma, Ochieng Sephenia / Jehangir, Susan / Karpelowsky, Jonathan

Journal of pediatric surgery

2021 Volume 56, Issue 10, Page(s) 1776–1784

Abstract: Background: Improved post-operative outcomes following gastroschisis repair are attributed to advancement in perioperative and post-operative care and early enteral feeding. This study evaluates the role of standardized postoperative feeding protocols ... ...

Abstract	Background: Improved post-operative outcomes following gastroschisis repair are attributed to advancement in perioperative and post-operative care and early enteral feeding. This study evaluates the role of standardized postoperative feeding protocols in gastroschisis. Study design: A systematic review and meta-analysis of studies published from January 2000 to April 2019 in MEDLINE, EMBASE, Cochrane Library databases and Google Scholar was conducted. Primary outcomes were duration to full enteral feeding and cessation of parenteral nutrition. Secondary outcomes included days to first enteral feeding, length of stay, compliance, complication and mortality rates. Meta-analysis was done using the RevMan Analysis Statistical Package in Review Manager (Version 5.3) using a random effects model and reported as pooled Risk Ratio and Mean Difference. p-value < 0.05 was considered statistically significant. Results: Eight observational cohort studies were identified and their data analyzed. Significant heterogeneity was noted for some outcomes. Standardized feeding protocols resulted in fewer days to first enteral feeding by 3.19 days (95% CI: -4.73, -1.66, p < 0.0001) than non-protocolized feeding, less complication rates, reduced mortality and better compliance to care. The duration of parenteral nutrition and time to full enteral feeding were not significantly affected. Conclusion: Protocolized feeding post-gastroschisis repair is associated with early initiation of enteral feeding. There is a likelihood of reduced rates of sepsis; shorter duration of parenteral nutrition, length of hospital stay and time to full enteral feeding. However, the latter trends are not statistically significant and will require further studies best accomplished with a prospective randomized trial or more cohort studies.
MeSH term(s)	Enteral Nutrition ; Gastroschisis/surgery ; Humans ; Length of Stay ; Meta-Analysis as Topic ; Parenteral Nutrition ; Prospective Studies ; Systematic Reviews as Topic
Language	English
Publishing date	2021-06-08
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	80165-3
ISSN	1531-5037 ; 0022-3468
ISSN (online)	1531-5037
ISSN	0022-3468
DOI	10.1016/j.jpedsurg.2021.05.022
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Article ; Online: Corrigendum to "Open vs Ultrasound Guided Tunneled Central Venous Access in Children: A Randomised Controlled Study": Journal of Surgical Research April 2021 (260) 284-292.

Soundappan, Soundappan S V / Lam, Lawrence / Cass, Daniel T / Karpelowsky, Jonathan

The Journal of surgical research

2021 Volume 267, Page(s) 568

Language	English
Publishing date	2021-07-12
Publishing country	United States
Document type	Published Erratum
ZDB-ID	80170-7
ISSN	1095-8673 ; 0022-4804
ISSN (online)	1095-8673
ISSN	0022-4804
DOI	10.1016/j.jss.2021.06.039
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Article: Surgeon Performed Ultrasound for Diagnosis of Intussusception - A Pilot Study.

Soundappan, Soundappan S V / Lam, Albert / Lam, Lawrence / Cass, Danny / Holland, Andrew J A / Karpelowsky, Jonathan

POCUS journal

2021 Volume 6, Issue 1, Page(s) 33–35

Abstract: Aim: ...

Abstract	Aim:
Language	English
Publishing date	2021-04-22
Publishing country	Canada
Document type	Journal Article
ISSN	2369-8543
ISSN	2369-8543
DOI	10.24908/pocus.v6i1.14760
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Article ; Online: Open Versus Ultrasound Guided Tunneled Central Venous Access in children: A Randomized Controlled Study.

Soundappan, Soundappan S V / Lam, Lawrence / Cass, Daniel T / Karpelowsky, Jonathan

The Journal of surgical research

2020 Volume 260, Page(s) 284–292

Abstract: Background: The purpose of this study was to compare open insertion to ultrasound guided percutaneous insertion of central access catheters performed in a tertiary pediatric hospital in terms of its safety and complication rates.: Methods: This was ... ...

Abstract	Background: The purpose of this study was to compare open insertion to ultrasound guided percutaneous insertion of central access catheters performed in a tertiary pediatric hospital in terms of its safety and complication rates. Methods: This was an ethics approved prospective randomized trial of children under 16 y of age. Procedure was performed by surgeons with varying experience with percutaneous and open insertion. Primary outcome studied was complications-immediate and late. Secondary outcomes were time taken to complete procedure, conversion rates, duration of line use. Results: A total of 108 patients were analyzed. Sixty-four were male. Right internal jugular vein was accessed in 97. Eighty-one lines were double lumen, 23 implantable access devices, and the rest were single lumen catheters. More than one needle puncture was needed in 22% of the cases but there were no conversions in the ultrasound group. Twelve patients needed more than one insertion to achieve optimal position of the tip. Eleven patients had immediate and late complications. Percutaneous lines lasted 45 d longer though this was not statistically significant. Operating time was 20.6% shorter with percutaneous access. Post-removal measurement of vein size by ultrasound demonstrated significant decrease in size in the open group. Conclusions: Ultrasound guided percutaneous insertion was safe. The study also demonstrated a decrease in operating times, preservation of vein size, and no increase in complication rates in the US group when performed by operators of varying expertise.
MeSH term(s)	Adolescent ; Catheterization, Central Venous/adverse effects ; Catheterization, Central Venous/instrumentation ; Catheterization, Central Venous/methods ; Central Venous Catheters ; Child ; Child, Preschool ; Female ; Hospitals, Pediatric ; Humans ; Incidence ; Infant ; Infant, Newborn ; Male ; Medical Errors/statistics & numerical data ; Operative Time ; Outcome Assessment, Health Care ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/prevention & control ; Prospective Studies ; Reoperation/statistics & numerical data ; Single-Blind Method ; Ultrasonography, Interventional
Language	English
Publishing date	2020-12-24
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Randomized Controlled Trial
ZDB-ID	80170-7
ISSN	1095-8673 ; 0022-4804
ISSN (online)	1095-8673
ISSN	0022-4804
DOI	10.1016/j.jss.2020.11.065
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Article ; Online: Radiation exposure in infants with oesophageal atresia and tracheo-oesophageal fistula.

Roberts, Kiera / Karpelowsky, Jonathan / Fitzgerald, Dominic A / Soundappan, Soundappan S V

Pediatric surgery international

2019 Volume 35, Issue 4, Page(s) 509–515

Abstract: Purpose: Oesophageal atresia and tracheo-oesophageal atresia require surgical repair in early infancy. These children have significant disease-related morbidity requiring frequent radiological examinations resulting in an increased malignancy risk.: ... ...

Abstract	Purpose: Oesophageal atresia and tracheo-oesophageal atresia require surgical repair in early infancy. These children have significant disease-related morbidity requiring frequent radiological examinations resulting in an increased malignancy risk. Methods: A single-centre, retrospective review was performed of radiation exposure in children with OA/TOF born 2011-2015. Medical records were reviewed to determine the number and type of imaging studies involving ionising radiation exposure enabling the calculation of the estimated effective dose per child over the first year of life. Results: Forty-nine children were included. Each child underwent a median of 19 (IQR 11.5-35) imaging studies, which were primarily plain radiography (median = 14, IQR 7-26.5). The overall median estimated effective dose per patient was 4.7 (IQR 3.0-9.4) mSv, with the majority of radiation exposure resulting from fluoroscopic imaging (median 3.3 mSv, IQR 2.2-6.0). 'Routine' postoperative oesophagrams showed no leak in 35/36 (97%) with the remaining study showing an insignificant leak that did not alter management. Conclusions: Careful consideration should be given to the use of imaging in OA/TOF to minimise morbidity in these vulnerable infants. Oesophagrams in children without the symptoms of anastomotic leak or stricture should be discontinued. Standardisation of monitoring protocols with regard to radiation exposure should be considered.
MeSH term(s)	Australia/epidemiology ; Esophageal Atresia/diagnosis ; Esophageal Atresia/surgery ; Female ; Fluoroscopy/adverse effects ; Humans ; Incidence ; Infant, Newborn ; Male ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Radiation Exposure/adverse effects ; Radiation Exposure/statistics & numerical data ; Radiography/adverse effects ; Retrospective Studies ; Tracheoesophageal Fistula/diagnosis ; Tracheoesophageal Fistula/surgery
Language	English
Publishing date	2019-02-01
Publishing country	Germany
Document type	Journal Article
ZDB-ID	632773-4
ISSN	1437-9813 ; 0179-0358
ISSN (online)	1437-9813
ISSN	0179-0358
DOI	10.1007/s00383-019-04450-z
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Article ; Online: Early enteral feeding after pediatric abdominal surgery: A systematic review of the literature.

Greer, Douglas / Karunaratne, Yasiru G / Karpelowsky, Jonathan / Adams, Susan

Journal of pediatric surgery

2019 Volume 55, Issue 7, Page(s) 1180–1187

Abstract: Introduction: Traditionally enteral nutrition has been delayed following abdominal surgery in children, to prevent complications. However, recent evidence in the adult literature refutes the supposed benefits of fasting and suggests decreased ... ...

Abstract	Introduction: Traditionally enteral nutrition has been delayed following abdominal surgery in children, to prevent complications. However, recent evidence in the adult literature refutes the supposed benefits of fasting and suggests decreased complications with early enteral nutrition (EEN). This review aimed to compile the evidence for EEN in children in this setting. Methods: Databases Pubmed, EmBase, Medline and reference lists were searched for articles containing relevant search terms according to PRISMA guidelines. First and second authors reviewed abstracts. Studies containing patients less than 18 years undergoing abdominal surgery, with feeding initiated earlier than standard practice, were included. Studies including pyloromyotomy were excluded. Primary outcome was length of stay (LOS). Secondary outcomes included time to full enteral nutrition, time to stool and postoperative complications. Results: Fourteen articles met inclusion criteria - five on neonatal abdominal surgery, three on gastrostomy formation and six on intestinal anastomoses. There were three randomized control trials (RCTs), five cohort studies, four historical control trials, one nonrandomized trial and one case series. Nine studies showed a decreased LOS with EEN. Most studies which reported time to full enteral nutrition showed improvement with EEN; however, time to stool was similar in most studies. Postoperative complications were either decreased or not statistically different in EEN groups in all studies. Conclusion: Studies to date in a limited number of procedures suggest EEN appears safe and effective in children undergoing abdominal surgery. Although robust evidence is lacking, there are clear benefits in LOS and time to full feeds, and no increase in complications. Level of evidence: IV.
MeSH term(s)	Abdomen/surgery ; Adolescent ; Child ; Child, Preschool ; Digestive System Surgical Procedures/adverse effects ; Digestive System Surgical Procedures/statistics & numerical data ; Enteral Nutrition/statistics & numerical data ; Humans ; Infant ; Infant, Newborn ; Length of Stay/statistics & numerical data ; Postoperative Complications
Language	English
Publishing date	2019-09-05
Publishing country	United States
Document type	Journal Article ; Systematic Review
ZDB-ID	80165-3
ISSN	1531-5037 ; 0022-3468
ISSN (online)	1531-5037
ISSN	0022-3468
DOI	10.1016/j.jpedsurg.2019.08.055
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Article: Quantitative ctDNA Detection in Hepatoblastoma: Implications for Precision Medicine.

Kahana-Edwin, Smadar / Torpy, James / Cain, Lucy E / Mullins, Anna / McCowage, Geoffrey / Woodfield, Sarah E / Vasudevan, Sanjeev A / Shea, Dan P T / Minoche, Andre E / Espinoza, Andres F / Kummerfeld, Sarah / Goldstein, Leonard D / Karpelowsky, Jonathan

Cancers

2023 Volume 16, Issue 1

Abstract: Hepatoblastoma is characterized by driver mutations ... ...

Abstract	Hepatoblastoma is characterized by driver mutations in
Language	English
Publishing date	2023-12-19
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers16010012
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Article ; Online: Five lessons in uncomplicated appendicitis: Can we remove the surgery?

Read, Andrew / Xu, Jane / Adams, Susan / Karpelowsky, Jonathan

Journal of paediatrics and child health

2017 Volume 53, Issue 11, Page(s) 1127–1130

Abstract: Appendicectomy has remained the treatment of choice for appendicitis for over a century and is the most commonly performed emergency operation in children. However, emerging evidence suggests that appendicectomy may not always be necessary in ... ...

Abstract	Appendicectomy has remained the treatment of choice for appendicitis for over a century and is the most commonly performed emergency operation in children. However, emerging evidence suggests that appendicectomy may not always be necessary in uncomplicated appendicitis, with early paediatric trials demonstrating that antibiotic-only therapy can be safe and effective. Further rigorously designed and appropriately powered studies are necessarily to establish the place of non-operative management of uncomplicated appendicitis in the future.
MeSH term(s)	Acute Disease ; Anti-Bacterial Agents/therapeutic use ; Appendectomy/history ; Appendicitis/drug therapy ; Appendicitis/history ; Appendicitis/surgery ; History, 18th Century ; History, 19th Century ; History, 20th Century ; Humans
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2017-11
Publishing country	Australia
Document type	Historical Article ; Journal Article
ZDB-ID	1024476-1
ISSN	1440-1754 ; 1034-4810
ISSN (online)	1440-1754
ISSN	1034-4810
DOI	10.1111/jpc.13741
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Article ; Online: Tunnelled central venous access devices in small children: A comparison of open vs. ultrasound-guided percutaneous insertion in children weighing ten kilograms or less.

Vierboom, Liam / Darani, Alexandre / Langusch, Catherine / Soundappan, Svs / Karpelowsky, Jonathan

Journal of pediatric surgery

2018 Volume 53, Issue 9, Page(s) 1832–1838

Abstract: Purpose: Ultrasound-guided (USG) percutaneous insertion of tunnelled central venous access devices (CVADs) has been shown to be safe and effective in adults. However, there have been concerns over the safety of this technique in small children. This ... ...

Abstract	Purpose: Ultrasound-guided (USG) percutaneous insertion of tunnelled central venous access devices (CVADs) has been shown to be safe and effective in adults. However, there have been concerns over the safety of this technique in small children. This paper analyses the safety of USG percutaneous CVAD insertion in the pediatric population weighing ten kilograms or less. Method: All surgically inserted CVADs for children weighing ten kilograms or less, between January 2010 and December 2015 at the Children's Hospital at Westmead were retrospectively reviewed. Open and USG percutaneous techniques were compared with intraoperative complications as the primary outcome variable. Secondary outcome measures included conversion to open technique, postoperative complications, operating time and catheter longevity. Results: 232 cases were identified: 96 (41.4%) open, 136 (58.6%) USG percutaneous. Age ranged <1-48 months; weight 0.7-10 kg. CVADs ranged 2Fr-9Fr in size. Eleven USG percutaneous cases required conversion to open. There was no significant difference in intraoperative complication rate between open (11/96, 11.5%) and USG percutaneous (19/136, 14.0%) groups (p = 0.574). There was no significant difference in overall postoperative complications, operative time or catheter longevity. Mechanical blockage was significantly higher in the open group than the USG percutaneous group (21% vs 10%, p = 0.015). Conclusion: USG percutaneous CVAD insertion is safe in children weighing ten kilograms or less. Open catheter insertion may be associated with higher rates of post-operative catheter blockage in small children. Level of evidence: Level III.
MeSH term(s)	Adult ; Body Weight ; Catheterization, Central Venous/methods ; Catheters, Indwelling/standards ; Catheters, Indwelling/statistics & numerical data ; Central Venous Catheters/standards ; Central Venous Catheters/statistics & numerical data ; Child ; Child, Preschool ; Female ; Hospitals, Pediatric ; Humans ; Male ; Postoperative Complications/prevention & control ; Retrospective Studies ; Ultrasonography, Interventional/methods
Language	English
Publishing date	2018-04-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	80165-3
ISSN	1531-5037 ; 0022-3468
ISSN (online)	1531-5037
ISSN	0022-3468
DOI	10.1016/j.jpedsurg.2018.03.025
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