Stay Current In Pediatric Surgery

An interactive discussion between Todd Ponsky, MD and Max Langham, MD on the management of hepatoblastomas. Dr. Max Langham is a Professor of Surgery and Pediatrics and the Vice Chairman of the Department of Surgery at the University of Tennessee Health Science Center. Table of Contents 00:00 - Introduction 01:15 - Work-up of a newly diagnosed liver mass 04:20 - Differential diagnosis of liver mass 08:03 - Tumor biopsy 10:11 - Pretext staging system 14:43 - Upfront resection 16:18 - How to use the pretext system to determine resectability 20:14 - Annotation factors 22:25 - Histologic subtypes 25:17 - Management of unresectable tumors 28:44 - What makes hepatoblastoma high-risk? 30:52 - Approach to pulmonary metastases 34:01 - Chemotherapy regimen for metastatic hepatoblastoma 35:29 - Maneuvers to improve safety and success of liver resection 38:27 - Anesthesia care during resection 39:32 - Key surgical steps 41:58 - When to consider extreme resection and Vascular reconstruction 44:35 - Recurrent disease