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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
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...
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
Hiroki Nakamura, Julia Zimmer, Florian Friedmacher, Prem Puri
INTRODUCTION:  Persistent pulmonary hypertension (PPH) is a major cause of morbidity and mortality in newborns with congenital diaphragmatic hernia (CDH). PPH is characterized by increased vascular resistance and smooth muscle cell (SMC) proliferation, leading to obstructive changes in the pulmonary vasculature. Nitric oxide (NO), generated by endothelial NO synthase (eNOS), is an important regulator of vascular tone and plays a key role in pulmonary vasodilatation. NO synthase interacting protein (NOSIP), which is strongly expressed by pulmonary SMCs, has recently been identified to reduce the endogenous NO production by interacting with eNOS...
December 10, 2018: European Journal of Pediatric Surgery
Thomas Sebastian Bott, Thekla von Kalle, Alexander Schilling, Oliver Heinz Diez, Sarah Besch, Ulrike Mehlig, Svetlana Hetjens, Lucas Wessel, Steffan Loff
INTRODUCTION:  The development of stenoses after correction of an esophageal atresia or acid and lye burn of the esophagus are well-known problems in pediatric surgery. Currently, stenoses are treated in the majority of cases by repeated balloon dilatations. The diameter of the balloons used is not standardized; standard curves do not exist. The aim of this study was to evaluate the diameter of the esophagus correlated to the body weight of the children as measured in upper gastrointestinal (GI) studies to answer the important question to what extent a stenosis should be dilated...
November 26, 2018: European Journal of Pediatric Surgery
Toshiaki Takahashi, Florian Friedmacher, Julia Zimmer, Prem Puri
INTRODUCTION:  Congenital diaphragmatic hernia (CDH) is assumed to originate from a malformation of the amuscular mesenchymal component of the primordial diaphragm. Mutations in ephrin-B1, a membrane protein that is expressed by mesenchymal cells, have been found in newborn infants with CDH and associated pulmonary hypoplasia (PH), highlighting its important role during diaphragmatic and airway development. Ephrin-B1, -B2, and -B4 are expressed in fetal rat lungs and have been identified as key players during lung branching morphogenesis...
November 23, 2018: European Journal of Pediatric Surgery
Paula Nurminen, Antti Koivusalo, Maria Hukkinen, Mikko Pakarinen
INTRODUCTION: Esophageal atresia (EA) is associated with significant respiratory mortality. We aimed to assess incidence and predictive factors of EA associated pneumonia during the first 5 years of life. MATERIALS AND METHODS:  Institutional ethical consent was obtained. Hospital records of patients with EA from 2002 to 2017 were reviewed. Episodes of pneumonia that were diagnosed in university or regional hospitals were included. For instance, respiratory infections other than pneumonia, anastomotic complications, aortopexy, fundoplication, major EA associated diseases, types of EA, and EA anastomosis dilatations were tested as potential risk factors for pneumonia...
November 23, 2018: European Journal of Pediatric Surgery
Mariela Dore, S Barrena, Paloma Triana Junco, Alba Sánchez Galán, Javier Jimenez Gomez, Leopoldo Martinez
INTRODUCTION:  Central venous port (CVP) placement is traditionally performed under fluoroscopy guidance. However, efforts for radiation dose reduction in children have allowed the introduction of ultrasound guidance (USG) and anatomic landmarks as an alternative technique for CVP placement. The aim of this study is to determine whether intraoperative fluoroscopy (IF) is required to confirm the correct position of the catheter tip in children. PATIENTS AND METHODS:  A prospective, single-center study was performed between July and December 2017...
November 23, 2018: European Journal of Pediatric Surgery
Shohei Hiwatashi, Yasuhide Nakayama, Satoshi Umeda, Yuichi Takama, Takeshi Terazawa, Hiroomi Okuyama
INTRODUCTION:  Tracheal reconstruction for long-segment stenosis remains challenging. We investigate the usefulness of BIOTUBE, an in-body tissue-engineered collagenous tube with a biodegradable stent, as a novel tracheal scaffold in a beagle model. MATERIALS AND METHODS:  We prepared BIOTUBEs by embedding specially designed molds, including biodegradable stents, into subcutaneous pouches in beagles. After 2 months, the molds were filled with ingrown connective tissues and were harvested to obtain the BIOTUBEs...
November 2, 2018: European Journal of Pediatric Surgery
Bilge Karabulut, Gulsah Bayram, Can Ihsan Oztorun, Burak Ozcift, Tuğrul Hüseyin Tiryaki
INTRODUCTION:  Detecting renal scar is important in pediatric patients with vesicoureteral reflux (VUR) for deciding on treatment option. The aim of this study is to detect whether freehand elastosonography technique could be an alternative to dimercaptosuccinic acid (DMSA) scan in determining renal scar formation. MATERIALS AND METHODS:  Between November 2015 and April 2016, 25 VUR patients, age ranging from 3 to 17 years admitted to our clinic, had urinary ultrasound and elastosonography, and data of approximately 147 renal region were recorded...
October 31, 2018: European Journal of Pediatric Surgery
Wei Yao, Kai Li, Zuopeng Wang, Jiahao Pei, Xiangqi Liu, Shan Zheng, Kuiran Dong
OBJECTIVE:  To evaluate the outcome and safety of corticosteroids and vincristine (VCR) in the treatment of kaposiform hemangioendothelioma (KHE) and tufted angioma (TA). MATERIALS AND METHODS:  Clinical studies involving corticosteroids and VCR therapies in treating KHE/TA were identified by using PubMed, Cochrane Library, OVID, EBSCO, CNKI, VIP, and Wanfang databases from their establishment date to December 2017. Randomized controlled trials, case-control, or case series with more than five cases were included...
October 29, 2018: European Journal of Pediatric Surgery
Zoran Marjanovic, Maja Raicevic, Andjelka Slavkovic, Dragoljub Zivanovic, Ivan Filipovic, Nikola Bojovic
INTRODUCTION:  Child migrants are the most vulnerable population, prone to various health conditions due to trauma and the bad living conditions that they experience during their migration. The objective of this study was to determine the pediatric surgical conditions of migrant children treated in our hospital on their way toward North-West Europe. MATERIALS AND METHODS:  A retrospective analysis was performed on all admitted migrants in one tertiary and one secondary level hospital from 2016 to 2018...
October 29, 2018: European Journal of Pediatric Surgery
Julia Elrod, Doris Mannhard, Christoph Mohr, Christine Lienert, Kerstin Hagemann-Gysling, Clemens Schiestl, Luca Mazzone
INTRODUCTION:  Meningococcal septicemia is not merely an acute disease with a high lethality, but patients surviving the fulminant phase can suffer from serious long-term sequelae. MATERIALS AND METHODS:  The records of 165 patients admitted to the hospital from 1968 to 2008 with the diagnosis of meningococcal septicemia were retrospectively reviewed for early signs at presentation, intensive care management, acute symptoms, the necessity of plastic and orthopaedic surgical management, and long-term orthopaedic sequelae...
October 29, 2018: European Journal of Pediatric Surgery
Omid Madadi-Sanjani, Julia Zimmer, Jan-Hendrik Gosemann, Benno M Ure, Martin Lacher, Roland Boehm
OBJECTIVE:  Recurrent esophageal strictures (ESs) following esophageal atresia repair or caustic ingestion represent a common clinical problem. Recently, Mitomycin C was reported to improve the outcome of patients by reducing the number of endoscopic dilatations. However, other groups failed to exhibit a beneficial effect. We report on our experience with topic Mitomycin C application following endoscopic dilatation for recurrent ES. METHODS:  Retrospective chart review of patients with ES treated at the Hannover Medical School (Location A) and the University of Leipzig (Location B) between 2009 and 2015...
December 2018: European Journal of Pediatric Surgery
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