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Journal of Pediatric Surgery

Florent Guérin, Lionel Charre, Stéphanie Jasienski, Mathieu Duché, Stéphanie Franchiabella, Olivier Bernard, Emmanuel Jacquemin, Hélène Agostini, Frédéric Gauthier, Sophie Branchereau
BACKGROUND: To assess the outcome of patients with biliary atresia (BA) who underwent a surgical shunt (SS) for severe portal hypertension (PH) following a Kasai procedure. METHODS: We collected and analyzed the data and outcomes of patients with BA who underwent SS for severe PH following a Kasai procedure between 1974 and 2014, focusing on complications related to the procedure, overall survival (OS), and transplant-free survival (TFS). RESULTS: SS was performed at a median age of 5...
June 25, 2018: Journal of Pediatric Surgery
Gehad Ahmed, Manal Zamzam, Ahmed Kamel, Sonia Ahmed, Asmaa Salama, Iman Zaki, Nehal Kamal, Maged Elshafiey
BACKGROUND: Complete metastasectomy is the best predictor of survival in patients with osteosarcoma pulmonary metastases. There has been some controversy in the literature regarding the prognostic significance of the timing of occurrence of lung metastasis. METHODS: We reviewed the clinical course of all osteosarcoma patients with pulmonary metastases treated by metastasectomy in our hospital from January 2008 through December 2016. Each patient who underwent metastasectomy was placed into one of three groups based on whether lung metastases were present at initial presentation (Group 1), developed during chemotherapy (Group 2), or appeared after completion of chemotherapy (Group 3)...
June 23, 2018: Journal of Pediatric Surgery
Kristine S Corkum, Tolulope A Oyetunji, Julia E Grabowski, Cynthia K Rigsby, Timothy B Lautz
BACKGROUND/PURPOSE: To assess the additive value of magnetic resonance imaging (MRI) in the setting of an equivocal US (Eq-US) with or without an elevated absolute neutrophil count (ANC). METHODS: Single-institution, retrospective review of children ages 5-18 years who presented to the ER with suspected appendicitis from 9/2015 to 8/2016. US, ANC, and MRI results were reviewed. Imaging was identified as positive/suspicious, normal, or equivocal and ANC <8000/mm3 was defined as normal...
June 22, 2018: Journal of Pediatric Surgery
Sherif Emil
No abstract text is available yet for this article.
June 22, 2018: Journal of Pediatric Surgery
Rachel M Landisch, Sheila J Hanson, Rowena C Punzalan, Kristin Braun, Laura D Cassidy, David M Gourlay
INTRODUCTION: Venous thromboembolism (VTE) is increasingly prevalent in injured children admitted to the intensive care unit (ICU). Few data exist to support VTE pharmacologic prophylaxis or ultrasound (US) surveillance in children with high bleeding risk. After implementation of screening US guidelines, we sought to describe our experience, hypothesizing that screening US of children at highest risk for VTE results in earlier detection and management. STUDY DESIGN: A retrospective analysis was conducted on prospectively collected data of injured children admitted to an American College of Surgeons Verified level 1 Pediatric Trauma Center from 2010 to 2015...
June 20, 2018: Journal of Pediatric Surgery
Young Mee Choi, Kristen Campbell, Claire Levek, John Recicar, Steven Moulton
INTRODUCTION: Antibiotic or silver-based dressings are widely used in burn wound care. Our standard method of dressing pediatric extremity burn wounds consists of an antibiotic ointment or nystatin ointment-impregnated nonadherent gauze (primary layer), followed by rolled gauze, soft cast pad, plaster and soft casting tape (3M™ Scotchcast™, St. Paul, MN). The aim of this study was to compare our standard ointment-based primary layer versus Mepitel Ag® (Mölnlycke Health Care, Gothenburg, Sweden) in the management of pediatric upper and lower extremity burn wounds...
June 18, 2018: Journal of Pediatric Surgery
Steven J Staffa, David Zurakowski
BACKGROUND/PURPOSE: Diagnostic tests are of paramount importance for informing decision making in the surgical setting. Certain statistical methods are necessary to properly analyze data for diagnostic or prognostic tests involving biomarkers and risk factor data. Our goal is to provide a useful primer for the surgical researcher when performing a diagnostic research study in order to best analyze their data. METHODS: We present the key concepts and statistics for diagnostic tests and receiver operating characteristic (ROC) curve analysis, and we illustrate each with hypothetical surgery research examples...
June 18, 2018: Journal of Pediatric Surgery
David J Hackam, Chhinder P Sodhi, Misty Good
BACKGROUND/PURPOSE: Necrotizing enterocolitis (NEC) is a devastating disease of prematurity that develops after feeding, often without warning, and results in diffuse intestinal necrosis leading to sepsis and death in many cases. The lack of improvement in overall survival is influenced by nonspecific diagnostic modalities as well as inexact and nonpersonalized treatment strategies. METHODS/RESULTS: Recently, we and others have shown that NEC develops in response to exaggerated bacterial signaling in the premature intestine, as a consequence of elevated expression and activity of the bacterial receptor toll-like receptor 4 (TLR4), which is important for normal gut development...
June 18, 2018: Journal of Pediatric Surgery
Jill L Morsberger, Heather L Short, Katherine J Baxter, Curtis Travers, Matthew S Clifton, Megan M Durham, Mehul V Raval
PURPOSE: The aim of this study was to determine long-term outcomes for congenital diaphragmatic hernia (CDH) patients including quality of life (QoL), symptom burden, reoperation rates, and health status. METHODS: A chart review and phone QoL survey were performed for patients who underwent CDH repair between 2007 and 2014 at a tertiary free-standing children's hospital. Comprehensive outcomes were collected including subsequent operations and health status. Associations with QoL were tested using Wilcoxon Rank-Sum tests and Pearson correlation coefficients...
June 18, 2018: Journal of Pediatric Surgery
Seyedeh-Sanam Ladi-Seyedian, Lida Sharifi-Rad, Abdol-Mohammad Kajbafzadeh
PURPOSE: To assess the efficacy of combined transcutaneous interferential (IF) electrical stimulation and pelvic floor muscle training through biofeedback on non-neuropathic urinary incontinence in children. METHODS: This prospective study comprised of 46 anatomically and neurologically normal children (9 boys, 37 girls; mean age of 8.4 ± 2.2 years old) with non-neuropathic urinary incontinence. All children were evaluated by kidney and bladder ultrasounds, uroflowmetry with electromyography (EMG), a complete voiding diary and a dysfunctional voiding scoring questionnaire at the baseline...
June 11, 2018: Journal of Pediatric Surgery
Chiara Grimaldi, Arianna Bertocchini, Alessandro Crocoli, Jean de Ville de Goyet, Aurora Castellano, Analisa Serra, Marco Spada, Alessandro Inserra
BACKGROUND: Complete encasement of the inferior vena cava by retroperitoneal tumors is rare. Although replacement of the vena cava has been considered for various conditions in adults, it is rarely used in children except for challenging resections and as a last chance approach - often aiming more at debulking than cure. MATERIALS AND METHODS: From January 2009 to February 2017, 4 patients (2 adrenal neuroblastomas, 1 renal cell carcinoma, 1 infantile fibrosarcoma) underwent elective en-bloc resection of tumor and of the infrahepatic portion of the inferior vena cava (IVC), with planned IVC prosthetic replacement...
June 10, 2018: Journal of Pediatric Surgery
Alvin P Chan, Pamela S Baldivia, Laurie E Reyen, Alissa N Lund, Elizabeth A Marcus, Robert S Venick, Jorge H Vargas, Laura J Wozniak
PURPOSE: Damaged central venous catheters (CVCs) are commonly repaired to avoid line replacement and preserve vascular access. However, limited data suggest an increased risk for central line-associated bloodstream infections (CLABSIs) associated with the repair procedure. The purpose of this study was to describe outcomes of CVC repairs among parenteral nutrition (PN) dependent children with intestinal failure (IF). METHODS: A 2-year retrospective review was performed on children with IF on home PN > 6 months...
June 9, 2018: Journal of Pediatric Surgery
Angelina L Schwartz, Maziar M Nourian, Brian T Bucher
BACKGROUND: Retained foreign bodies discovered after surgery are documented as Agency for Health Care Quality and Research Patient Safety Indicators. Our goal was to identify pediatric patient and procedure risk factors and outcomes associated with RFB based on AHRQ Definitions. METHODS: We performed a retrospective case-control study of children with RFB using the PHIS database. Patients were defined as having RFB based on the AHRQ PSI definition. Controls were matched in a 5:1 ratio on age, procedure date, and hospital...
June 9, 2018: Journal of Pediatric Surgery
Joseph T Church, Megan A Coughlin, Elena M Perkins, Hayley R Hoffman, John D Barks, Raja Rabah, J Kelley Bentley, Marc B Hershenson, Robert H Bartlett, George B Mychaliska
PURPOSE: An artificial placenta (AP) utilizing extracorporeal life support (ECLS) could avoid the harm of mechanical ventilation (MV) while allowing the lungs to develop. METHODS: AP lambs (n = 5) were delivered at 118 days gestational age (GA; term = 145 days) and placed on venovenous ECLS (VV-ECLS) with jugular drainage and umbilical vein reinfusion. Lungs remained fluid-filled. After 10 days, lambs were ventilated. MV control lambs were delivered at 118 ("early MV"; n = 5) or 128 days ("late MV"; n = 5), and ventilated...
June 8, 2018: Journal of Pediatric Surgery
Abdrabuh M Abdrabuh, Elsayed M Salih, Mahmoud Aboelnasr, Hussein Galal, Abdelbasset El-Emam, Tarek El-Zayat
PURPOSE: We compared endopyelotomy to redo pyeloplasty for the treatment of failed pyeloplasty in children to identify factors that may have an impact on outcome and favor one procedure over the other. METHODS: Of 43 patients with recurrent UPJO, EP was performed in 27 and RP was performed in 16. Age, gender, side, presentation of secondary UPJO, hospital stay, complications and success rates were compared. Success was defined as radiographic relief of obstruction as determined by ultrasound or diuretic renography at latest follow-up...
June 7, 2018: Journal of Pediatric Surgery
Jake D Foster, Nigel J Hall, S Charles Keys, David M Burge
BACKGROUND: Many pediatric surgeons have limited experience of esophageal replacement. This study reports outcomes of esophageal replacement by gastric transposition performed by a single UK-based pediatric surgeon. METHODS: Consecutive patients were identified who underwent esophageal replacement by gastric transposition over a 28 year period. Clinical and demographic data were collected. Weight-for-age Z-scores were calculated for esophageal atresia patients...
June 2, 2018: Journal of Pediatric Surgery
Benjamin R White, Chong Zhang, Angela P Presson, Kim Friddle, Robert DiGeronimo
OBJECTIVE: To describe the prevalence and outcome of assisted home feeding (AHF) in medically complex neonatal intensive care unit (NICU) patients, and to identify variables associated with AHF in this population. STUDY DESIGN: 1223 infants who survived to discharge from 2013 to 2015 were identified in our single-center, retrospective cohort study at a large tertiary referral NICU. Demographic and selected disease-specific variables were compared between infants discharged on full oral feeding (PO) versus AHF...
June 2, 2018: Journal of Pediatric Surgery
Eda Tokat, Serhat Gurocak, Iyimser Ure, Cenk Acar, Zafer Sınık, Mustafa Ozgur Tan
BACKGROUND/PURPOSE: The "European Association of Urology (EAU) Guidelines on Vesicoureteral Reflux (VUR) in Children (September 2012)" established risk classification by analyzing and defining risk factors for each patient. In this study we aimed to investigate how our initial treatment procedures were affected by EAU/ESPU guideline vesicoureteral reflux risk grouping and to compare the early clinical results of treatments performed before and after the risk classification in our patients with VUR...
June 2, 2018: Journal of Pediatric Surgery
Dhanya Mullassery, Roberta Iacona, Kate Cross, Simon Blackburn, Edward Kiely, Simon Eaton, Joe Curry, Paolo De Coppi
AIM OF THE STUDY: Divided colostomy (DC) has been recommended in anorectal malformations (ARMs) with previously reported advantages of decreasing overflow into the distal limb and urinary tract infections (UTIs). Skin bridge loop colostomy (LC) is a technically easier alternative without an increase in these complications. We report our institutional experience of LC in ARM. METHODS: Retrospective study (Institution-approved Clinical Audit) reviewing the clinical records of all patients with ARM undergoing stoma formation in a single UK tertiary pediatric surgical center (2000-2015)...
June 1, 2018: Journal of Pediatric Surgery
Maadrika M N P Kanglie, Nanko de Graaf, Femke Beije, Elise M J Brouwers, Sabine D M Theuns-Valks, Frits H Jansen, Diederick B W de Roy van Zuidewijn, Bas Verhoeven, Rick R van Rijn, Roel Bakx
BACKGROUND: There is a lack of studies addressing the occurrence of negative intraoperative findings (that is the absence of intussusception) after an unsuccessful hydrostatic reduction of an ileocolic intussusception. The aim of this study is to determine the incidence of negative intraoperative findings after unsuccessful hydrostatic reduction of ileocolic intussusception. METHODS: We conducted a multicentre retrospective study of all children aged 0-18 years treated for ileocolic intussusception from January 1, 2010 to December 31, 2015 in 9 Dutch hospitals...
June 1, 2018: Journal of Pediatric Surgery
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