Daniel Ostlie | University of Wisconsin-Madison (original) (raw)

Papers by Daniel Ostlie

Journal of Laparoendoscopic & Advanced Surgical Techniques, 2015

Intraabdominal testes that lack sufficient vessel length to perform an orchiopexy require divisio... more Intraabdominal testes that lack sufficient vessel length to perform an orchiopexy require division of the testicular vessels. Historically, the vessels are divided at the initial operation, and the orchiopexy is then performed as a two-stage procedure with the assumption for the development of neovascularization along the vas deferens during the interim. Recent reports suggest the orchiopexy may be performed primarily at the time of vessel division. However, these strategies have not been prospectively compared. Therefore, we conducted a randomized pilot trial to examine the role for a larger comparative study. After Internal Review Board approval, all patients undergoing laparoscopic orchiopexy for a nonpalpable testis were considered for enrollment. This study was designed as a pilot study to evaluate testicular survival at 6 months of follow-up. After consent was obtained, computer randomization was used to determine a primary or two-stage orchiopexy. All procedures were performed by five surgeons, and allotment had no affect on surgeon selection. Between October 2007 and September 2013, 112 patients were enrolled in the study. Twenty-seven patients (14 primary and 13 two-stage) met criteria for randomization based on inability to bring the testis to the contralateral internal ring. There was no difference in the approach among surgeons. Mean operative time and cost significantly favored the primary approach, and testicular survival rates were the same. Based on the data in our pilot study, approximately 70% of patients with a nonpalpable testis will not require vascular division. This study suggests that when vascular division is required, the primary orchiopexy may be equivalent to the traditional two-stage procedure with regard to testicular survival and superior to the two stage in total operative time and charges. These data provide evidence for sufficient equipoise to proceed with the development of a large multi-institutional trial comparing these two approaches.

Seminars in pediatric surgery, 2015

Extracorporeal membrane oxygenation (ECMO) is a vital pre-operative adjunct for the stabilization... more Extracorporeal membrane oxygenation (ECMO) is a vital pre-operative adjunct for the stabilization of patients with severe congenital diaphragmatic hernia (CDH) that develop cardiorespiratory failure. The optimal timing of diaphragmatic repair in patients with CDH that require ECMO remains controversial. This article offers a review of the data available addressing the risks and outcomes of patients who require ECMO support with regard to timing of repair.

Journal of Pediatric Surgery, 2002

Background/Purpose: Esophageal atresia with tracheoesophageal fistula (EA/TEF) is a relatively co... more Background/Purpose: Esophageal atresia with tracheoesophageal fistula (EA/TEF) is a relatively common congenital anomaly, but its pathogenesis remains poorly understood. Previous studies using the experimental Adriamycin-induced rat model of EA/TEF suggest that the fistula tract, or [ldquo ]distal esophagus,[rdquo ] is derived from respiratory epithelium and expresses the respiratory-specific transcription factor TTF-1. To better correlate the experimental rat model of EA/TEF

Journal of Pediatric Surgery, 2003

Background/Purpose: Many theories of the pathogenesis of esophageal atresia with tracheoesophagea... more Background/Purpose: Many theories of the pathogenesis of esophageal atresia with tracheoesophageal fistula (EA/TEF) have been proposed, but no specific mechanism has been demonstrated. The authors previously reported data suggesting a respiratory origin of the fistula tract in the rat model and in humans. Sonic hedgehog (Shh) [ldquo ]knockout[rdquo ] mice have the VACTERL association, and thus it was hypothesized that

Seminars in pediatric surgery, 2002

Minimally invasive surgical approaches to various pediatric surgical disease processes are becomi... more Minimally invasive surgical approaches to various pediatric surgical disease processes are becoming the standard of care. Laparoscopic Nissen fundoplication is transitioning toward the preferred method for the surgical correction of gastroesophageal reflux (GER) disease in infants and children that do not respond to medical management or have complications from their GER. This approach offers a shorter hospitalization, reduced discomfort, and cosmetic advantages when compared with the open operation. This report discusses the pathophysiology of GER, its clinical manifestations, and the diagnostic evaluation for this disorder. Also, the laparoscopic Nissen fundoplication technique currently utilized at Children's Mercy Hospital is described.

Seminars in pediatric surgery, 2007

Laparoscopic Nissen fundoplication is successful in preventing reflux in more than 95% of patient... more Laparoscopic Nissen fundoplication is successful in preventing reflux in more than 95% of patients. However, over time, there appears to be failure of the fundoplication either with wrap breakdown and/or transmigration of the wrap through the esophageal hiatus in 5% to 10% of patients. It is unlikely that medical management will be successful in controlling the reflux symptoms following either wrap breakdown and/or transmigration. Thus, operative repair for control of recurrent symptoms is required in most cases. This article outlines the etiology for recurrent gastroesophageal reflux disease, presentation of the patient with wrap failure or transmigration, steps which the authors have taken to help prevent these complications from developing, and our approach for those patients who require re-operation.

Advances in surgery, 2007

Transactions of the ... Meeting of the American Surgical Association, 2005

Journal of Pediatric Surgery, 2004

BackgroundAlthough the pathogenesis of esophageal atresia with tracheoesophageal fistula (EA/TEF)... more BackgroundAlthough the pathogenesis of esophageal atresia with tracheoesophageal fistula (EA/TEF) remains unknown, it has been shown that despite its esophageal appearance, the fistula tract originates from respiratory epithelium. The authors now hypothesize that defects in fibroblast growth factor (FGF) signaling contribute to the esophaguslike phenotype of the fistula tract. FGF2R is critical to normal lung morphogenesis and occurs in 2

Surgery, 2003

Background. The pathogenesis of esophageal atresia and tracheoesophageal fistula (EA/TEF) remains... more Background. The pathogenesis of esophageal atresia and tracheoesophageal fistula (EA/TEF) remains unknown. We have found previously that an initial esophageal atresia, followed by an abnormal (absent) branching pattern of the middle branch of a trifurcation of the lung/tracheal bud, leads to the neonatal finding of TEF. Mice null mutant for hedgehog signaling can experience the development of EA/TEF, but the

Journal of Surgical Research, 2008

Surgery, 2004

Traditional management of pyloric stenosis has consisted of open pyloromyotomy during which the s... more Traditional management of pyloric stenosis has consisted of open pyloromyotomy during which the surgeon is able to palpate and determine whether the hypertrophied pylorus has been completely divided. During the last decade, laparoscopic pyloromyotomy has become an increasingly popular approach for this condition. The purpose of this study was to determine whether there is an effective pyloromyotomy length that will allow the surgeon to feel confident that a complete pyloromyotomy was performed with the laparoscopic approach. All infants undergoing laparoscopic pyloromyotomy from October 1999 through October 2003 at a single institution were retrospectively studied. Clinical variables collected included the patient's age, gender, electrolyte status on admission, the elapsed time from admission to operation, ultrasonographic dimensions of the hypertrophied pylorus, operative time, the length of the pyloromyotomy performed, the time to initial and to full feedings, and the duration...