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European Journal of Pediatric Surgery

Janina Fischer, Johannes Balleisen, Josef Holzki, Grigore Cernaianu, Miguel Alejandre Alcàzar, Martin Dübbers
INTRODUCTION:  Esophageal atresia (EA) is often accompanied by tracheobronchial malformations leading to stridor, recurrent bronchitis, and occasionally to life-threatening obstructive apnea after surgical repair. The aim of this study was to identify the presence of tracheomalacia in patients with EA and tracheoesophageal fistula (TEF) pre- and postoperatively and to find endoscopic correlates leading to clinical airway symptoms. METHODS:  In a cohort of 362 patients with EA-TEF who underwent 595 tracheoscopies at the Children's Hospital of Cologne between January 1983 and December 2002, impaired tracheal lumen, localization of TEF, tracheal pulsations, and corresponding clinical symptoms were retrospectively analyzed...
March 21, 2019: European Journal of Pediatric Surgery
Wietse P Zuidema, Alida F W van der Steeg, Stefan van der Heide, Gerda W Zijp, Robertine van Baren, Jan W A Oosterhuis, Ernest van Heurn
BACKGROUND:  Pectus excavatum (PE) is the most common chest wall deformity. Patients with PE may have cosmetic complaints, restricted physical capabilities, or both and may seek surgical correction. One method to assess satisfaction after surgery is the single step questionnaire (SSQ). Although the developers state that the SSQ produces a stabile score and only needs to be used once, we hypothesized that the score may depend on point in time after surgery. PATIENTS AND METHODS:  One hundred and eight patients from a longitudinal cohort of patients undergoing a Nuss bar placement for PE were selected...
March 1, 2019: European Journal of Pediatric Surgery
Linus Jönsson, Michaela Dellenmark-Blom, Oskar Enoksson, Lars Göran Friberg, Vladimir Gatzinsky, Anders Sandin, Kate Abrahamsson
INTRODUCTION:  Gastroesophageal reflux disease (GERD) is a common morbidity after esophageal atresia (EA) repair, and the antireflux procedure (ARP) is a way of treating GERD symptoms. The aim of this study was to evaluate whether reflux index (Ri) and growth were improved by ARP. MATERIALS AND METHODS:  Ninety-nine individuals with EA treated at the Queen Silvia Children's Hospital in Gothenburg, Sweden, between 1997 and 2010 were followed prospectively according to a structured care program...
March 1, 2019: European Journal of Pediatric Surgery
Mehrdad Hosseinpour, Bahareh Ahmadi, Sanaz Etezazian
INTRODUCTION:  Mechanical bowel prep (MBP) prior to surgical treatment of Hirschsprung's disease (HSCR) has been a great problem of pediatric surgeons for a long time. We conducted a single-institution randomized controlled trial to evaluate the efficacy of no MBP in children with HSCR undergoing the Duhamel procedure. MATERIALS AND METHODS:  In this study, children with HSCR who were candidate for the Duhamel procedure were included (40 cases vs. 40 controls)...
February 27, 2019: European Journal of Pediatric Surgery
Johannes Boettcher, Lea Klippgen, Stefan Mietzsch, Friederike Grube, Thomas Krebs, Robert Bergholz, Konrad Reinshagen, Michael Boettcher
BACKGROUND:  Spaced learning has been shown to be superior in complex motor skill acquisition like laparoscopic suturing and knot tying. By using a pre-post follow-up design, the aim of the study was to evaluate the long-term impact of implementation of the spaced learning concept in laparoscopic training. METHODS:  To evaluate the effectiveness of spaced learning, subjects were asked to perform four surgeon's square knots on a bowel model within 30 minutes-prior and after 3 hours of hands-on training...
February 27, 2019: European Journal of Pediatric Surgery
Xingqin Tan, Jianxia Liu, Chunbao Guo
BACKGROUND:  Intraoperative fluid administration is important for postoperative recovery and might be associated with postoperative complications. MATERIALS AND METHODS:  This retrospective review included 471 patients who underwent Roux-en-Y hepaticojejunostomy. Patients were separated into two groups based on whether they received low (<15.27 mL/kg/h) or high (>15.27 mL/kg/h) volumes of corrected crystalloid fluids. Propensity score matching was performed to adjust for any potential selection bios for the two groups...
January 21, 2019: European Journal of Pediatric Surgery
Mariela Dore, Alejandra Vilanova Sanchez, Paloma Triana Junco, S Barrena, María De Ceano-Vivas, Javier Jimenez Gomez, Ane M Andres Moreno, Manuel Lopez Santamaria, Leopoldo Martinez
INTRODUCTION:  There is a lack of an agreed Hirschsprung-associated enterocolitis (HAEC) definition. In 2009, a HAEC score was proposed for the diagnosis of HAEC episodes. Our aim was to apply the HAEC score on HAEC episodes to determine its diagnostic efficiency and whether it correlated to its severity. METHODS:  Retrospective study of patients with HAEC admitted between 2000 and 2016. Episodes of HAEC were identified and the HAEC score was calculated. A cut-off of ≥ 10 according to Pastor et al and ≥ 4 according to Frykman et al were used...
February 2019: European Journal of Pediatric Surgery
Zeng Hao Wong, Mark Davenport
AIM:  Biliary atresia (BA) remains a rare disease in Europe with an estimated incidence of 1 in 15-20,000 livebirths. While the Kasai portoenterostomy (KPE) is regarded as the standard operation for BA, there is no consensus on optimum adjuvant therapy. We sought to determine the variation in therapy and opinion in centers known to have an interest in pediatric hepatobiliary surgery across Europe. METHODS:  A survey of current pre- and postoperative practice was circulated to surgeons and centers known to have an interest in BA...
February 2019: European Journal of Pediatric Surgery
Sanjena Kumar Amuddhu, Yong Chen, Shireen Anne Nah
INTRODUCTION:  Recent literature advocates outpatient emergency department (ED) management of intussusception citing low recurrence rates and postreduction events after uncomplicated ileocolic reduction. However, few studies include both inpatient and outpatient cohorts. We performed a systematic review and meta-analysis to compare recurrence rates and length of hospital stay between the groups. MATERIALS AND METHODS:  Studies published in English up to January 2018 were searched from Medline, Embase, Google Scholar, and Cochrane databases, using a combination of the terms 'intussusception,' 'reduction,' and 'management'...
February 2019: European Journal of Pediatric Surgery
Paloma Triana Junco, Esther María Cano, Mariela Dore, Javier Jimenez Gomez, Alba Sánchez Galán, Alejandra Vilanova-Sánchez, Ane Andres, Jose Luis Encinas, Leopoldo Martinez, Francisco Hernandez, Manuel Lopez Santamaria
AIM:  Hepatoblastoma is the most frequent hepatic tumor in children, and its initial presentation will affect treatment and prognosis. The aim of this study is to evaluate long-term results of liver transplantation in children with unresectable hepatoblastoma. PATIENTS AND METHODS:  This is a retrospective review of patients with hepatoblastoma who underwent liver transplantation, analyzing risk factors, tumor presentation, treatment, and long-term survival to identify prognostic factors...
February 2019: European Journal of Pediatric Surgery
Roberta Iacona, Lisa Ramage, Georgina Malakounides
BACKGROUND:  Neuromodulation is the application of electrical stimulation on nerve fibers to modulate the neuronal activity. Its use for chronic constipation and fecal incontinence has increased in popularity over the past few years. Invasive and noninvasive techniques are currently available. We reviewed the current literature on the application of the neuromodulation techniques in the management of chronic constipation and fecal incontinence in children. MATERIALS AND METHODS:  A search of Healthcare Database Advanced Search, Embase, Medline, and Cochrane database was performed in accordance with PRISMA guideline...
January 16, 2019: European Journal of Pediatric Surgery
Nagoud Schukfeh, Dirk Huber, Martin L Metzelder, Gertrud Vieten, Oliver Keil, Nils Dennhardt, Robert Suempelmann, Benno M Ure, Joachim F Kuebler
BACKGROUND:  Infants are likely to develop anuria during laparoscopy which is uncommon in older patients. The reason for this susceptibility remains unknown. We compared the impact of CO2 pneumoperitoneum on renal perfusion and urine production in piglets compared with adolescent pigs. We furthermore investigated the effects of different resuscitation strategies. MATERIALS AND METHODS:  Male piglets ( n  = 21) were divided into four groups: (a) infant controls ( n  = 5), (b) infants with crystalloid restitution ( n  = 6), (c) infants with colloidal restitution ( n  = 5), and (d) adolescents with crystalloid restitution ( n  = 5)...
January 16, 2019: European Journal of Pediatric Surgery
Christina Oetzmann von Sochaczewski, Axel Heimann, Andreas Linder, Oliver Kempski, Oliver J Muensterer
BACKGROUND:  Anastomotic tension has been linked to leakage and stenosis in esophageal surgery in both adults and children. We aimed to determine the effects of esophageal topography, operative technique, and anastomotic tension on esophageal blood flow. MATERIALS AND METHODS:  We divided and reanastomosed the esophagi at the carinal level with increasing levels of anastomotic tension in piglets ( n  = 10) and sham controls ( n  = 4). We examined esophageal blood flow pre- and postoperatively using laser Doppler flowmetry at the anastomosis and two predetermined proximal and distal points...
January 4, 2019: European Journal of Pediatric Surgery
Omer Karaca, Huseyin Ulas Pinar, Zeynel Gokmen, Rafi Dogan
BACKGROUND:  Injection to the accurate area without any complications is the main factor for the efficiencies of caudal block. The aim of this study was to compare success and the complications of conventional and ultrasound method for caudal block in children. MATERIALS AND METHODS:  Two-hundred sixty-six American Society of Anesthesiologists (ASA) category 1 children aged between 6 months and 6 years undergoing hypospadias, circumcision, or both surgeries were randomly allocated two groups (Group C or Group H, n  = 133)...
January 2, 2019: European Journal of Pediatric Surgery
Vanita Kumari, Poonam Joshi, Anjan Kumar Dhua, Savita Sapra, Maddur Srinivas, Sandeep Agarwala, Veereshwar Bhatnagar
INTRODUCTION:  Esophageal atresia with or without tracheoesophageal fistula (EA with or without TEF) is one of the neonatal surgical emergencies requiring surgical intervention in the early neonatal period, influencing the developmental outcome in the operated children. This study was aimed to assess the developmental status of children operated for EA with or without TEF along with maternal stress, their quality of life (QOL), and coping abilities. MATERIALS AND METHODS:  A descriptive cross-sectional survey was conducted on 51 children aged up to 5 years after EA with or without TEF repair and their mothers' in a tertiary care facility...
December 31, 2018: European Journal of Pediatric Surgery
Robin B Wigen, Wenming Duan, Theo J Moraes, Priscilla P L Chiu
PURPOSE:  The aim is to identify prognostic markers of long-term pulmonary morbidity among congenital diaphragmatic hernia (CDH) survivors. METHODS:  A single-institution, retrospective review was performed on all CDH patients from 2000 and 2012 (REB#1000053383). Liver position, patch use, and pulmonary function tests (PFTs) (forced expiratory volume at 1 second [FEV1] and forced vital capacity [FVC] expressed as mean % predicted + SD) were recorded. Data were analyzed using analysis of variance...
December 24, 2018: European Journal of Pediatric Surgery
Ioannis A Ziogas, Konstantinos S Mylonas, Georgios Tsoulfas, Eleftherios Spartalis, Nikolaos Zavras, Nikolaos Nikiteas, Dimitrios Schizas
BACKGROUND:  Diffuse esophageal leiomyomatosis (DEL) is a rare disorder characterized by benign hypertrophy of esophageal smooth muscle cells. No rigorous summary of available evidence on how to best manage these patients exists. OBJECTIVE:  To define the clinical features and outcomes of pediatric patients with DEL. MATERIALS AND METHODS:  A systematic literature search of the PubMed and Cochrane databases was performed with respect to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (end-of-search date: October 6, 2018)...
December 21, 2018: European Journal of Pediatric Surgery
Laetitia-Marie Petit, Franziska Righini, Jessica Ezri, Prevost Jantchou, Ann Aspirot, Dorothée Dal Soglio, Christophe Faure
OBJECTIVES:  Endoscopic follow-up after esophageal atresia (EA) tracheoesophageal fistula (TEF) repair is recommended to detect esophageal histopathological complications. We investigated the prevalence of histopathologically proven esophageal complications (peptic esophagitis, gastric metaplasia, and eosinophilic esophagitis) and assessed the predictors of these complications in children with EA-TEF. METHODS:  This is a prospective longitudinal cohort study performed between September 2005 and December 2014 comprising 77 children with EA-TEF followed-up until February 2017...
December 19, 2018: European Journal of Pediatric Surgery
Christina Oetzmann von Sochaczewski, Evangelos Tagkalos, Andreas Lindner, Hauke Lang, Axel Heimann, Oliver J Muensterer
INTRODUCTION:  Traction procedures are useful to preserve the child's own esophagus in long-gap forms of esophageal atresia. To date, it remains unclear what suture size or position of the traction sutures is optimal to account for differences in anatomy and to reduce the risk of traction sutures being torn out of the esophageal tissue. MATERIALS AND METHODS:  Explanted porcine esophagi (from swine aged 100-120 days and weighing 100-120 kg) were divided at the carinal level...
December 19, 2018: European Journal of Pediatric Surgery
Laura A F Phillips, Ahmed A Darwish, Rajendra Surana
INTRODUCTION:  The U.K. National Institute for Health and Clinical Excellence (NICE) specify the following indications for performing rectal biopsy to rule out Hirschsprung's disease (HSD): (1) passage of meconium > 48 hours; (2) constipation since first few weeks of life; (3) chronic abdominal distension with vomiting; (4) family history of HSD; and (5) faltering growth in addition to any other indication. The aim of this study was to assess the compliance of a tertiary referral center with the current U...
December 10, 2018: European Journal of Pediatric Surgery
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