Research Overview

Terry Buchmiller's investigations utilize fetal models for in utero studies of congenital abnormalities. Areas of interest include the surgical implantation of amniotic fluid catheters for supplementation studies in two different arenas. The first involves a fetal rabbit model of in uterine growth retardation (IUGR). Experimental amniotic fluid supplementation with hormones including EGF and gastrin has successfully reversed IUGR by increasing small intestinal nutrient absorption.

Current studies are underway to elucidate the molecular events controlling these mechanisms. The second involves a large animal model in which we have created mid-gestational obstructive uropathy by both urachal and bladder outlet ligation in fetal sheep, resulting in Potter’s syndrome with subsequent oligohydramnios and pulmonary hypoplasia. Implanted amniotic fluid catheters are used to reconstitute the amniotic fluid during the remainder of gestation. We have reversed the detrimental effects on pulmonary growth by this intra-amniotic supplementation. Additionally we have examined the working collaborative with Dr. Dario Fauza in examining the effect on renal function and potential predictive urinary markers of renal dysfunction. 

Major research goals:

  • Understand the mechanisms underlying fetal small bowel nutrient transport and motility.
  • Define the role of epidermal growth factor in fetal gut development.
  • Design in utero treatments for intrauterine growth retardation utilizing amniotic fluid supplementation.
  • Validate a fetal model of obstructive uropathy with resultant pulmonary hypoplasia which is reversible with amniotic fluid supplementation.

Education

Medical School

University of California
1988 Davis CA

Residency

University of California
1995 Los Angeles CA

Fellowship

Pediatric Surgery Boston Children's Hospital
1997 Boston MA

Publications

  1. Mode of Delivery and Subsequent Motor Function in Children With Myelomeningocele Without In Utero Repair. Obstet Gynecol. 2025 Jan 16. View Abstract
  2. APSA Coaching Program. J Pediatr Surg. 2024 Oct 05; 161987. View Abstract
  3. Mitigating Ergonomic Injury. J Pediatr Surg. 2024 Oct 01; 161979. View Abstract
  4. "Connect & Share": Collaboratively Addressing Moral Distress Among Pediatric Surgeons. J Pediatr Surg. 2025 Feb; 60(2):161978. View Abstract
  5. The Leader's Role in Hospital Surgeon Wellbeing: Organizational Wellness and Peer Support for APSA. J Pediatr Surg. 2025 Jan; 60(1):161977. View Abstract
  6. Toxic Environments: Recovery or Renewal. J Pediatr Surg. 2024 Oct 01; 161980. View Abstract
  7. Common variants increase risk for congenital diaphragmatic hernia within the context of de novo variants. Am J Hum Genet. 2024 Nov 07; 111(11):2362-2381. View Abstract
  8. Long-term follow-up in congenital diaphragmatic hernia. Semin Pediatr Surg. 2024 Aug; 33(4):151443. View Abstract
  9. Disparities in Healthcare Utilization: An Analysis of Disease Specific and Patient Level Factors in a Congenital Diaphragmatic Hernia Clinic. J Pediatr Surg. 2024 Oct; 59(10):161569. View Abstract
  10. Long-term follow-up of patients with congenital diaphragmatic hernia. World J Pediatr Surg. 2024; 7(2):e000758. View Abstract
  11. Exercise-Induced Pulmonary Hypertension in Long-Term Survivors of Congenital Diaphragmatic Hernia. J Pediatr. 2024 Aug; 271:114034. View Abstract
  12. Reply to Letter to the Editor by Lohmann and Fernandes. J Pediatr Surg. 2024 Aug; 59(8):1659-1660. View Abstract
  13. Risk Factors for Preoperative Pneumothorax in Neonates With Isolated Left-Sided Congenital Diaphragmatic Hernia: An International Cohort Study. J Pediatr Surg. 2024 Aug; 59(8):1451-1457. View Abstract
  14. Peer Support to Promote Surgeon Well-being: The APSA Program Experience. J Pediatr Surg. 2024 Sep; 59(9):1665-1671. View Abstract
  15. High prevalence of left superior vena cava and congenital heart disease in patients with pre- and postnatally diagnosed esophageal atresia/tracheoesophageal fistula. Ultrasound Obstet Gynecol. 2023 09; 62(3):439-440. View Abstract
  16. A Tracheal Aspirate-derived Airway Basal Cell Model Reveals a Proinflammatory Epithelial Defect in Congenital Diaphragmatic Hernia. Am J Respir Crit Care Med. 2023 05 01; 207(9):1214-1226. View Abstract
  17. Long-Term Functional Outcomes at 1-Year After Hospital Discharge in Critically Ill Neonates With Congenital Diaphragmatic Hernia. Pediatr Crit Care Med. 2023 08 01; 24(8):e372-e381. View Abstract
  18. The Timing of Congenital Diaphragmatic Hernia Repair on Extracorporeal Membrane Oxygenation Impacts Surgical Bleeding Risk. J Pediatr Surg. 2023 Sep; 58(9):1656-1662. View Abstract
  19. Impact of bowel rotation and fixation on obstructive complications in congenital diaphragmatic hernia. J Pediatr Surg. 2023 Feb; 58(2):209-212. View Abstract
  20. Diverting Ileostomy in Children With Functional Constipation: A Study Evaluating the Utility of Colon Manometry. J Pediatr Gastroenterol Nutr. 2022 11 01; 75(5):578-583. View Abstract
  21. Supraventricular Tachycardia in Infants With Congenital Diaphragmatic Hernia: Prevalence, Associations, and Outcomes. Pediatr Crit Care Med. 2022 07 01; 23(7):e329-e337. View Abstract
  22. High altitude simulation testing in patients with congenital diaphragmatic hernia. J Pediatr Surg. 2022 Feb; 57(2):195-198. View Abstract
  23. Mortality in Congenital Diaphragmatic Hernia: A Multicenter Registry Study of Over 5000 Patients Over 25 Years. Ann Surg. 2023 03 01; 277(3):520-527. View Abstract
  24. Surgical Repair of Congenital Diaphragmatic Hernia After Extracorporeal Membrane Oxygenation Cannulation: Early Repair Improves Survival. Ann Surg. 2021 07 01; 274(1):186-194. View Abstract
  25. Novel Approach for Laparoscopically Placed Chronic Amniotic Fluid Catheters in Sheep. Fetal Diagn Ther. 2021; 48(5):400-406. View Abstract
  26. Prenatal Imaging Diagnosis of Suprarenal Lesions. Fetal Diagn Ther. 2021; 48(3):235-242. View Abstract
  27. Pediatric Magnet Ingestions After Federal Rule Changes, 2009-2019. JAMA. 2020 11 24; 324(20):2102-2104. View Abstract
  28. Use of Cadaveric Skin Graft for Staged Gastroschisis Repair in a Premature Infant. Neonatology. 2020; 117(6):771-775. View Abstract
  29. Early Left Ventricular Dysfunction and Severe Pulmonary Hypertension Predict Adverse Outcomes in "Low-Risk" Congenital Diaphragmatic Hernia. Pediatr Crit Care Med. 2020 07; 21(7):637-646. View Abstract
  30. A novel anorectal malformation variant: Anocutaneous fistula presenting as median raphe abscesses. J Paediatr Child Health. 2021 May; 57(5):718-720. View Abstract
  31. Genetic diagnoses and associated anomalies in fetuses prenatally diagnosed with esophageal atresia. Am J Med Genet A. 2020 08; 182(8):1890-1895. View Abstract
  32. The in-utero diagnosis of choledochal cyst: can postnatal imaging predict benefit from early surgical intervention? J Matern Fetal Neonatal Med. 2022 Mar; 35(6):1070-1074. View Abstract
  33. Predictors of index admission mortality and morbidity in contemporary esophageal atresia patients. J Pediatr Surg. 2020 Nov; 55(11):2322-2328. View Abstract
  34. Non-operative management of extralobar pulmonary sequestration: a safe alternative to resection? Pediatr Surg Int. 2020 Mar; 36(3):325-331. View Abstract
  35. Longitudinal Analysis of Pulmonary Function in Survivors of Congenital Diaphragmatic Hernia. J Pediatr. 2020 01; 216:158-164.e2. View Abstract
  36. Longitudinal Analysis of Ventilation Perfusion Mismatch in Congenital Diaphragmatic Hernia Survivors. J Pediatr. 2020 04; 219:160-166.e2. View Abstract
  37. Long term follow-up in congenital diaphragmatic hernia. Semin Perinatol. 2020 02; 44(1):151171. View Abstract
  38. Prenatal imaging throughout gestation in Beckwith-Wiedemann syndrome. Prenat Diagn. 2019 08; 39(9):792-795. View Abstract
  39. A new variant of type III jejunoileal atresia. J Pediatr Surg. 2019 Jun; 54(6):1257-1260. View Abstract
  40. Disparity in online health information in pediatric vs. adult surgical conditions. Pediatr Surg Int. 2019 Jul; 35(7):813-821. View Abstract
  41. Primary placement of a skin-level Cecostomy Tube for Antegrade Colonic Enema Administration Using a Modification of the Laparoscopic-Assisted Percutaneous Endoscopic Cecostomy (LAPEC). J Pediatr Surg. 2019 Mar; 54(3):486-490. View Abstract
  42. The Distended Fetal Hypopharynx: A Sensitive and Novel Sign for the Prenatal Diagnosis of Esophageal Atresia. J Pediatr Surg. 2018 Jun; 53(6):1137-1141. View Abstract
  43. Percent predicted lung volume changes on fetal magnetic resonance imaging throughout gestation in congenital diaphragmatic hernia. J Pediatr Surg. 2017 Jun; 52(6):933-937. View Abstract
  44. 1629: LIQUID FLUOROCARBON LAVAGE FOR AIRWAY THROMBUS AFTER SEVERE HEMOPTYSIS REQUIRING ECMO. Crit Care Med. 2016 Dec; 44(12 Suppl 1):482. View Abstract
  45. Does the ex utero intrapartum treatment to extracorporeal membrane oxygenation procedure change morbidity outcomes for high-risk congenital diaphragmatic hernia survivors? J Pediatr Surg. 2017 Jan; 52(1):22-25. View Abstract
  46. Late-onset hypertrophic pyloric stenosis with gastric outlet obstruction: case report and review of the literature. Pediatr Surg Int. 2016 Oct; 32(10):1013-6. View Abstract
  47. Direct Tracheobronchopexy and Posterior Descending Aortopexy for Severe Left Mainstem Bronchomalacia Associated With Congenital Pulmonary Airway Malformation and Left Circumflex Aortic Arch. Ann Thorac Surg. 2016 Jul; 102(1):e1-4. View Abstract
  48. Surgical skills competitions at ACS chapter meetings can increase resident engagement. Bull Am Coll Surg. 2016 May; 101(5):44-5. View Abstract
  49. Standardized reporting for congenital diaphragmatic hernia--an international consensus. J Pediatr Surg. 2013 Dec; 48(12):2408-15. View Abstract
  50. Does professional orientation predict ethical sensitivities? Attitudes of paediatric and obstetric specialists toward fetuses, pregnant women and pregnancy termination. J Med Ethics. 2014 Feb; 40(2):117-22. View Abstract
  51. Multiple duplication cysts diagnosed prenatally: case report and review of the literature. Pediatr Surg Int. 2013 Apr; 29(4):397-400. View Abstract
  52. Congenital diaphragmatic hernia associated with esophageal atresia: incidence, outcomes, and determinants of mortality. J Am Coll Surg. 2013 Jan; 216(1):90-95.e2. View Abstract
  53. Differing attitudes toward fetal care by pediatric and maternal-fetal medicine specialists. Pediatrics. 2012 Dec; 130(6):e1534-40. View Abstract
  54. Management of giant congenital pulmonary airway malformations requiring pneumonectomy. Ann Thorac Surg. 2012 Oct; 94(4):1073-8. View Abstract
  55. Does the ex utero intrapartum treatment to extracorporeal membrane oxygenation procedure change outcomes for high-risk patients with congenital diaphragmatic hernia? J Pediatr Surg. 2012 Jun; 47(6):1053-7. View Abstract
  56. Prenatally diagnosed fetal conditions in the age of fetal care: does who counsels matter? Am J Obstet Gynecol. 2012 May; 206(5):409.e1-11. View Abstract
  57. Serial amnioinfusions prevent fetal pulmonary hypoplasia in a large animal model of oligohydramnios. J Pediatr Surg. 2011 Jan; 46(1):67-71. View Abstract
  58. Conditional Gata4 deletion in mice induces bile acid absorption in the proximal small intestine. Gut. 2010 Jul; 59(7):888-95. View Abstract
  59. Correlation between prenatal urinary matrix metalloproteinase activity and the degree of kidney damage in a large animal model of congenital obstructive uropathy. J Pediatr Surg. 2010 Jun; 45(6):1120-5. View Abstract
  60. Prenatal urinary matrix metalloproteinase profiling as a potential diagnostic tool in fetal obstructive uropathy. J Pediatr Surg. 2010 Jan; 45(1):70-3. View Abstract
  61. A case report of a congenital left subcostal hernia in a neonate. J Pediatr Surg. 2009 Aug; 44(8):1653-5. View Abstract
  62. Removal of a sewing needle from an occult esophageal ingestion in a 9-month-old. J Pediatr Surg. 2009 Jul; 44(7):1450-3. View Abstract
  63. Atypical manifestation of patent ductus venosus in a child: intervening against a paradoxical presentation. J Vasc Interv Radiol. 2009 Apr; 20(4):537-42. View Abstract
  64. Segmental dilatation of the ileum: diagnostic clarification by prenatal and postnatal imaging. J Ultrasound Med. 2007 Sep; 26(9):1251-6. View Abstract
  65. Ex utero intrapartum treatment with extracorporeal membrane oxygenation for severe congenital diaphragmatic hernia. J Pediatr Surg. 2007 Jan; 42(1):98-104; discussion 104-6. View Abstract
  66. Effect of esophageal ligation on small intestinal development in normal and growth-retarded fetal rabbits. J Pediatr Gastroenterol Nutr. 2006 Sep; 43(3):291-8. View Abstract
  67. Intercostal lung hernia in a 7-year-old boy. J Pediatr Surg. 2005 Sep; 40(9):1508-9. View Abstract
  68. Maternal steroid enhancement of fetal rabbit gastrointestinal motility. J Obstet Gynaecol Res. 2005 Jun; 31(3):263-7. View Abstract
  69. Effect of epidermal growth factor infusion on fetal rabbit intrauterine growth retardation and small intestinal development. J Pediatr Surg. 2004 Jun; 39(6):891-7; discussion 891-7. View Abstract
  70. Ontogeny of cholinergic regulation of fetal upper gastrointestinal motility. J Matern Fetal Neonatal Med. 2003 Aug; 14(2):102-6. View Abstract
  71. Management of ovarian cysts in women undergoing restorative proctocolectomy for ulcerative colitis. Am Surg. 2003 Apr; 69(4):339-42. View Abstract
  72. Initial presentation of coccidioidomycosis during inguinal herniorrhaphy. Hernia. 2003 Jun; 7(2):92-4. View Abstract
  73. Anticholinergic suppression of fetal rabbit upper gastrointestinal motility. J Matern Fetal Neonatal Med. 2002 Mar; 11(3):153-7. View Abstract
  74. Impact of mentor guidance in surgical career selection. J Pediatr Surg. 2001 Dec; 36(12):1802-4. View Abstract
  75. Ontogeny of fetal rabbit upper gastrointestinal motility. J Surg Res. 2001 Nov; 101(1):68-72. View Abstract
  76. Delayed disaccharidase development in a rabbit model of intrauterine growth retardation. Pediatr Res. 2001 Oct; 50(4):520-4. View Abstract
  77. Scrotal abscess following appendectomy. Pediatr Surg Int. 2001 Sep; 17(7):569-71. View Abstract
  78. Effect of hypoxia on fetal rabbit gastrointestinal motility. J Surg Res. 2001 Aug; 99(2):347-51. View Abstract
  79. Gene transfer to the embryo: strategies for the delivery and expression of proteins at 48 to 56 hours postfertilization. J Pediatr Surg. 2001 Aug; 36(8):1304-7. View Abstract
  80. Effect of acute anemia on the healing of intestinal anastomoses in the rabbit. J Trauma. 2001 Aug; 51(2):363-8. View Abstract
  81. Surgical treatment of severe colonic inertia with restorative proctocolectomy. Am Surg. 2001 Jan; 67(1):36-40. View Abstract
  82. Bronchial perforation after closed-tube endotracheal suction. J Pediatr Surg. 2000 Sep; 35(9):1353-5. View Abstract
  83. Ontogeny of insulin-like growth factor 1 in a rabbit model of growth retardation. J Surg Res. 2000 Jun 15; 91(2):135-40. View Abstract
  84. Effect of dexamethasone on insulin-like growth factor-1 expression in a rabbit model of growth retardation. J Pediatr Surg. 2000 Jun; 35(6):898-904; discussion 904-5. View Abstract
  85. The outcome of research training during surgical residency. J Surg Res. 2000 May 01; 90(1):10-2. View Abstract
  86. A novel technique for correction of intestinal atresia at the ligament of Treitz. J Pediatr Surg. 2000 Feb; 35(2):353-5; discussion 356. View Abstract
  87. Congenital gastrointestinal pacemaker cell tumor. Arch Pathol Lab Med. 1999 Sep; 123(9):842-5. View Abstract
  88. Pulmonary arteriovenous malformation complicating coccidioidal pneumonia. Ann Thorac Surg. 1995 Aug; 60(2):454-7. View Abstract
  89. Effect of prenatal dexamethasone administration: fetal rabbit intestinal nutrient uptake and disaccharidase development. J Surg Res. 1994 Aug; 57(2):274-9. View Abstract
  90. Transamniotic fetal feeding: enhancement of growth in a rabbit model of intrauterine growth retardation. Surgery. 1994 Jul; 116(1):36-41. View Abstract
  91. Impairment of nutrient uptake in a rabbit model of gastroschisis. J Pediatr Surg. 1994 Mar; 29(3):376-8. View Abstract
  92. Assessment of alkaline reflux in children after Nissen fundoplication and pyloroplasty. J Am Coll Surg. 1994 Jan; 178(1):1-5. View Abstract
  93. Reduction of wound infection in high-risk surgical patients. Am Surg. 1993 Dec; 59(12):838-41. View Abstract
  94. Effect of esophageal ligation on the development of fetal rabbit intestinal lactase. J Pediatr Surg. 1993 Nov; 28(11):1473-7. View Abstract
  95. Effect of transamniotic administration of epidermal growth factor on fetal rabbit small intestinal nutrient transport and disaccharidase development. J Pediatr Surg. 1993 Oct; 28(10):1239-44. View Abstract
  96. The effect of anabolic steroids on ameliorating the adverse effects of chronic corticosteroids on intestinal anastomotic healing in rabbits. Surg Gynecol Obstet. 1993 Jan; 176(1):73-9. View Abstract
  97. Upregulation of nutrient transport in fetal rabbit intestine by transamniotic substrate administration. J Surg Res. 1992 May; 52(5):443-7. View Abstract

Contact Terry Buchmiller

Print Profile