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By Martyn Flett Consultant paediatric urologist. Glasgow UK.
Vincenzo Davide Catania, Giuseppe Lauriti, Agostino Pierro, Augusto Zani
PURPOSE: Although the principles of the Ladd's procedure for intestinal malrotation in children have remained unchanged since its first description, in the era of minimally invasive surgery it is controversial whether laparoscopy is advantageous over open surgery. The aim of our study was to determine whether the surgical approach for the treatment of malrotation had an impact on patient outcome. METHODS: Using a defined strategy (PubMed, Cochrane, Embase and Web of Science MeSH headings), two investigators independently searched for studies comparing open versus laparoscopic Ladd's procedure in children...
December 2016: Pediatric Surgery International
Benjamin Cribb, Naveen Vishwanath, Vipul Upadhyay
AIM: To review the experience of paediatric ovarian masses at Starship Children's Hospital (Auckland, New Zealand). Primarily to assess the range of pathology, the presenting features, and the surgical management of these lesions. METHODS: A search of the hospital surgical pathology database was carried out to identify patients less than 16 years in whom ovarian tissue was submitted for pathological analysis during the 12 year period from January 2000 to December 2011...
June 6, 2014: New Zealand Medical Journal
Paulette I Abbas, Jennifer E Dietrich, Jessica A Francis, Mary L Brandt, Darrell L Cass, Monica E Lopez
STUDY OBJECTIVE: To evaluate outcomes of children after ovarian-sparing surgery (OSS) for non-neoplastic and benign neoplastic ovarian lesions. DESIGN: Retrospective cohort study from January 2003 to January 2012. SETTING: Single, high-volume, tertiary care hospital. PARTICIPANTS: Children 18 years of age and younger. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Postoperative complications and tumor recurrence after OSS...
October 2016: Journal of Pediatric and Adolescent Gynecology
Jeremy N Friedman, Carolyn E Beck, Julie DeGroot, Denis F Geary, Daniel J Sklansky, Stephen B Freedman
IMPORTANCE: Use of hypotonic intravenous fluids for maintenance requirements is associated with increased risk of hyponatremia that results in morbidity and mortality in children. Clinical trial data comparing isotonic and hypotonic maintenance fluids in nonsurgical hospitalized pediatric patients outside intensive care units are lacking. OBJECTIVE: To compare isotonic (sodium chloride, 0.9%, and dextrose, 5%) with hypotonic (sodium chloride, 0.45%, and dextrose, 5%) intravenous maintenance fluids in a hospitalized general pediatric population...
May 2015: JAMA Pediatrics
A L van den Boom, R R Gorter, P M M van Haard, P G Doornebosch, H A Heij, I Dawson
PURPOSE: Although a national guideline has been implemented, the optimal approach for appendectomy in children remains subject of debate in the Netherlands. Opponents of laparoscopy raise their concerns regarding its use in complex appendicitis as it is reported to be associated with an increased incidence of intra-abdominal abscesses. The aim of this study was to evaluate the outcome of surgical approaches in both simple and complex appendicitis in paediatric patients. METHODS: A 10-year retrospective cohort study was performed (2001-2010) in paediatric patients treated for suspected acute appendicitis...
April 2015: Pediatric Surgery International
Shawn D St Peter, George W Holcomb, Casey M Calkins, J Patrick Murphy, Walter S Andrews, Ronald J Sharp, Charles L Snyder, Daniel J Ostlie
BACKGROUND: Pyloric stenosis, the most common surgical condition of infants, is treated by longitudinal myotomy of the pylorus. Comparative studies to date between open and laparoscopic pyloromyotomy have been retrospective and report conflicting results. To scientifically compare the 2 techniques, we conducted the first large prospective, randomized trial between the 2 approaches. METHODS: After obtaining IRB approval, subjects with ultrasound-proven pyloric stenosis were randomized to either open or laparoscopic pyloromyotomy...
September 2006: Annals of Surgery
Michael Berger, Oliver Muensterer, Carroll M Harmon
The use of eponyms in medicine has a long and captivating tradition, which applies to pediatric surgery as well. Unfortunately, even though these eponyms are widely used, oftentimes the fascinating personalities and lives behind these names remain unrecognized or underappreciated, especially among residents, fellows and younger-generation pediatric surgeons. Therefore, in this article, we review 15 names that are frequently used as eponyms in modern pediatric surgery and hereby enlighten the personalities behind them...
January 2014: Pediatric Surgery International
Matias Bruzoni, Bethany J Slater, James Wall, Shawn D St Peter, Sanjeev Dutta
BACKGROUND: The purpose of this prospective randomized study was to compare landmark- to ultrasound-guided central venous access when performed by pediatric surgeons. The American College of Surgeons advocates for use of ultrasound in central venous catheter placement; however, this is not universally embraced by pediatric surgeons. Complication risk correlates positively with number of venous cannulation attempts. STUDY DESIGN: With IRB approval, a randomized prospective study of children under 18 years of age undergoing tunneled central venous catheter placement was performed...
May 2013: Journal of the American College of Surgeons
Shannon N Acker, Allan J Garcia, James T Ross, Stig Somme
AIM: We hypothesized that recent trends towards earlier diagnosis of hypertrophic pyloric stenosis continued throughout the early part of the 21st century. METHODS: We reviewed the medical records of patients with HPS at a single institution during two periods: 1/03-12/05 and 4/09-7/13. RESULTS: A total of 433 patients with hypertrophic pyloric stenosis who underwent pyloromyotomy were included (modern cohort = 259; historic = 174). The two cohorts did not differ in terms of age, weight, or median time from symptom onset to physician (5 vs 6...
April 2015: Pediatric Surgery International
F L Cameron, M L Wilson, N Basheer, A Jamison, P McGrogan, W M Bisset, P M Gillett, R K Russell, D C Wilson
BACKGROUND AND AIMS: Biological agents are being increasingly used in the UK for paediatric-onset inflammatory bowel disease (PIBD) despite limited evidence and safety concerns. We evaluated effectiveness and safety in the clinical setting, highlighting drug cost pressures, using our national Scottish PIBD biological registry. METHODS: Complete usage of the biological agents, infliximab (IFX) and adalimumab (ADA) for treatment of PIBD (in those aged <18 years) from 1 January 2000 to 30 September 2010 was collated from all treatments administered within the Scottish Paediatric Gastroenterology, Hepatology and Nutrition (PGHAN) national managed service network (all regional PGHAN centres and paediatric units within their associated district general hospitals)...
April 2015: Archives of Disease in Childhood
Kartikey A Pandya, Pramod S Puligandla
The management of pulmonary hypertension is multi-faceted, with therapies directed at supporting cardiovascular and pulmonary function, treating the underlying cause (if feasible), and preventing irreversible remodeling of the pulmonary vasculature. Recently, manipulation of signaling pathways and mediators contained within the pulmonary vascular endothelial cell has become a new target. This article will review the pathophysiology of pulmonary hypertension and the broad principles involved in its management, with specific emphasis on pharmacological therapies directed at the pulmonary vascular endothelium...
February 2015: Seminars in Pediatric Surgery
Samir K Gadepalli, Ronald B Hirschl
The use of Extracorporeal Life Support (ECLS) in children and adults has markedly increased during the past few years with over 4000 patients placed on ECLS every year in over 200 centers. This article focuses on updates to the physiology and mechanics of ECLS with use of magnetically levitated centrifugal pumps, hollow-fiber gas-exchange devices, and bi-caval dual-lumen catheters. We also explore controversies in management including indications, cannulation approaches, renal replacement, monitoring of anticoagulation, early ambulation, and termination of ECLS...
February 2015: Seminars in Pediatric Surgery
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