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Pediatric surgery

Mustafa Erdoğan Cicik, Cezmi Doğan, Selim Bölükbaşı, Mehmet Necdet Cinhüseyinoğlu, Osman Şevki Arslan
BACKGROUND: Pediatric cataract surgery differs substantially from adult cataract surgery. Numerous studies have focused on reducing the development of postoperative complications. AIMS: To compare two intraocular lens implantation techniques used in pediatric cataract surgery in terms of postoperative complications. STUDY DESIGN: Case-control study. METHODS: Patients who underwent pediatric cataract surgery and intraocular lens implantation between 2008 and 2016 were evaluated in this retrospective study...
March 15, 2018: Balkan Medical Journal
Maanasi S Mistry, Sara M Trucco, Timothy Maul, Mahesh S Sharma, Li Wang, Shawn West
BACKGROUND: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) provides respiratory and hemodynamic support to pediatric patients in severe cardiac failure. We aim to identify risk factors associated with poorer outcomes in this population. METHODS: A retrospective chart review was conducted of pediatric patients requiring VA-ECMO support for cardiac indications at our institution from 2004 to 2015. Data were collected on demographics, indication, markers of cardiac output, ventricular assist device (VAD) insertion, heart transplantation, or left atrial (LA) decompression...
January 1, 2018: World Journal for Pediatric & Congenital Heart Surgery
Maitham A Moslim, Gavin A Falk, Federico G Seifarth
Background: Temporary or long-term nutritional support through gastrojejunal (GJ) feeding tubes is a safe and common means of enteral feeding in adults and children. It is indicated in patients with severe gastroesophageal reflux disease, gastric outlet obstruction, or severe gastric dysfunction or gastroparesis. Several techniques for GJ feeding tube placement have been reported. The most technically challenging part of GJ tube placement is the advancement and optimal positioning of the jejunal extension into the proximal jejunum...
January 2018: JSLS: Journal of the Society of Laparoendoscopic Surgeons
Jonathan Roth, Haggai Benvenisti, Shlomi Constantini
BACKGROUND: Dural closure following intracranial procedures is considered crucial to reduce postoperative complications such as pseudomeningoceles (PM), CSF leaks, hydrocephalus, and infections. However, watertight dural closure (WTDC) is often difficult to achieve, and dural substitutes are often used. We describe our experience with non-WTDC in children. METHODS: Data was collected retrospectively. Redo and craniectomy cases were excluded. Collected data included demographics, surgical etiology, various radiological parameters, ventricular opening, usage of drains and shunts, dural closure technique, and complications...
March 15, 2018: World Neurosurgery
Céline Klein, Tiphanie Delcourt, Arielle Salon, Georges Finidori, Christophe Glorion, Stéphanie Pannier
PURPOSE: The objective of the present study was to evaluate the outcome of surgical treatment of hand lesions in Ollier disease (OD) carried out during childhood. METHODS: A retrospective review was carried out of 10 pediatric patients with hand involvement of OD, who had undergone surgery for metacarpal or phalangeal enchondromas. The technique comprised curettage and cortical bone reconstruction with corticoplasty, to restore a near-normal phalangeal volume. The range of finger motion (pulp-to-palm distance), the shortened Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire score, cosmetic improvement, radiological findings (according to Tordai's classification), and recurrence were recorded after a mean follow-up of 7...
March 15, 2018: Journal of Hand Surgery
Richard L Hutchison, Janet O'Rear, Cindy Olson-Burgess, Angela L Myers
PURPOSE: The purpose of this study was to evaluate the utility of providing immediate access to the influenza vaccination for patients seen in a pediatric hand surgery clinic. Our hypothesis was that providing access would increase the rate of vaccination. METHODS: This pilot study was a randomized, controlled, prospective clinical trial that included all patients seen by a single surgeon, on a single day each week, in a hospital-based pediatric hand surgery practice clinic from October 18, 2016, to March 14, 2017...
March 15, 2018: Journal of Hand Surgery
Yun-Sik Dho, Hyoungmin Kim, Kyu-Chang Wang, Seung-Ki Kim, Ji Yeoun Lee, Hee Young Shin, Kyung Duk Park, Hyoung Jin Kang, Il Han Kim, Sung-Hye Park, Ji Hoon Phi
PURPOSE: s: Spinal epidural lymphoma with compressive myelopathy is a rarely found condition. The aims of this study are to describe the clinical features and to analyze its treatment outcome and prognostic factors. MATERIALS & METHODS: We searched for all pediatric patients with newly diagnosed spinal epidural lymphoma from 1999 to 2014 in our institution. We evaluated the clinical features, including neurological status, time interval to treatment, treatment modality, and outcomes...
March 14, 2018: World Neurosurgery
Joyce T Johnson, Jacob F Wilkes, Shaji C Menon, Lloyd Y Tani, Hsin-Yi Weng, Bradley S Marino, Nelangi M Pinto
OBJECTIVE: Neonates undergoing congenital heart surgery require highly specialized, resource-intensive care. Location of care and degree of specialization can vary between and within institutions. Using a multi-institutional cohort, we sought to determine whether location of admission is associated with an increase in health care costs, resource use and mortality. METHODS: We retrospectively analyzed admission for neonates (<30 days) undergoing congenital heart surgery between 2004-2013 using the Pediatric Health Information Systems database (44 children's hospitals)...
February 21, 2018: Journal of Thoracic and Cardiovascular Surgery
Quan Wang, Shulei Fan, Chun Wu, Xianqing Jin, Zhengxia Pan, Daqing Hong
BACKGROUND: Pectus excavatum, the most common congenital chest wall deformity in pediatric patients, leads to pulmonary dysfunction. There is no consensus regarding the effectiveness of the Nuss procedure for recovering pulmonary function. In this meta- analysis, we focused on the changes that occur in pulmonary function after the Nuss procedure. METHODS: We performed a literature search in the MEDLINE, Embase, Cochrane library and PubMed databases. The included studies were required to contain pulmonary function tests with results adjusted to predicted values both before and after the Nuss procedure...
February 21, 2018: Journal of Pediatric Surgery
Junhao Lei, Chunhua Luo, Songtao Cheng, Wen Yan, Xinghuan Wang, Xinjun Su
BACKGROUND: To introduce the detailed procedures of two innovative surgical options for pediatric buried penis and prospectively compare their efficacy and safety. METHODS: A single-center, non-randomized, prospective study was conducted at the Zhongnan Hospital of Wuhan University, where patients were operated on using the so-called "one stitch" (OS) or "four stitch" (FS) methods. The operation time, adverse events, and satisfaction were recorded for both groups...
March 16, 2018: World Journal of Urology
Mercedes Pilkington, Martin Situma, Andrea Winthrop, Dan Poenaru
PURPOSE: Favorable surgical outcomes depend on timely access to care. This study quantifies these delays and explores caregiver barriers to access in a Ugandan facility. METHODS: An interviewer-facilitated survey was administered over 8months to consecutive pediatric surgical families at Mbarara Regional Referral Hospital (MRRH). Delays were classified using the Three Delays Model: care-seeking, arrival at health facility, and from surgical consultation to surgery...
February 12, 2018: Journal of Pediatric Surgery
Andrew B Nordin, Sohail R Shah, Brian D Kenney
Ambulatory pediatric surgery has become increasingly common in recent years, with greater numbers of procedures being performed on an outpatient basis. This practice has clear benefits for hospitals and healthcare providers, but patients and families also often prefer outpatient surgery for a variety of reasons. However, maximizing the potential opportunities requires critical attention to patient and procedure selection, as well as anesthetic choice. A subset of outpatient procedures can be performed as single visit procedures, further simplifying the process for families and providers...
April 2018: Seminars in Pediatric Surgery
Joseph D Tobias
The preoperative evaluation is the first step in ensuring the safe conduct of anesthetic care in pediatric patients of all ages. Over time, this process has changed significantly from a time when patients were admitted to the hospital the night before surgery to a time when the majority of patients, including those scheduled for major surgical procedures, arrive the day of surgery. For most patients, the preoperative examiantion can be conducted over the phone by a trained nurse or on-line via a survey thereby eliminating the need for a separate visit merely for the preoperative evaluation...
April 2018: Seminars in Pediatric Surgery
Aaron P Lesher, Sohail R Shah
Telemedicine, the remote diagnosis and treatment of patients by means of technology, provides an alternative means for patients to gain access to health care services. Telemedicine is a general term that includes the use of various communication technologies, including telephone, email, or videoconferencing. Telemedicine has the potential to reduce inefficiencies in the delivery of healthcare, diminish patient travel and wait times, and increase access to specialists for patients in rural settings. We review the use of telemedicine in the perioperative phase of care for pediatric surgical patients, their caregivers, and surgical providers, including pre-operative assessments, and post-operative follow-up...
April 2018: Seminars in Pediatric Surgery
Benjamin H Goot, Jon Kaufman, Zhaoxing Pan, David W A Bourne, Francis Hickey, Mark Twite, Jeffrey Galinkin, Uwe Christians, Jeannie Zuk, Eduardo M da Cruz
OBJECTIVES: To assess if morphine pharmacokinetics are different in children with Down syndrome when compared with children without Down syndrome. DESIGN: Prospective single-center study including subjects with Down syndrome undergoing cardiac surgery (neonate to 18 yr old) matched by age and cardiac lesion with non-Down syndrome controls. Subjects were placed on a postoperative morphine infusion that was adjusted as clinically necessary, and blood was sampled to measure morphine and its metabolites concentrations...
March 15, 2018: Pediatric Critical Care Medicine
Joseph P Herbert, Sidish S Venkataraman, Ali H Turkmani, Liang Zhu, Marcia L Kerr, Rajan P Patel, Irma T Ugalde, Stephen A Fletcher, David I Sandberg, Charles S Cox, Ryan S Kitagawa, Arthur L Day, Manish N Shah
OBJECTIVE The objective of this study was to assess the incidence, diagnosis, and treatment of pediatric blunt cerebrovascular injury (BCVI) at a busy Level 1 trauma center and to develop a tool for accurately predicting pediatric BCVI and the need for diagnostic testing. METHODS This is a retrospective cohort study of a prospectively collected database of pediatric patients who had sustained blunt trauma (patient age range 0-15 years) and were treated at a Level 1 trauma center between 2005 and 2015. Digital subtraction angiography, MR angiography, or CT angiography was used to confirm BCVI...
March 16, 2018: Journal of Neurosurgery. Pediatrics
Patricia Lacourt, Julio Soto, Hana Rumié, Roger Gejman, Juan Carlos Pattillo, Cristián García, Hernán García
INTRODUCTION: Juvenile granulosa cell tumors (JGCT) are very rare, especially in infants under the age of one. The most frequent presentation is with signs of precocious puberty. OBJECTIVE: Present an in fant with peripheral precocious puberty, diagnosis of JGCT and follow up. CLINICAL CASE: 10-month-old female infant with thelarche, pubic hair and palpable abdominal mass accompanied with eleva ted levels of estradiol, very low gonadotrophins and images that show a very large ovarian mass...
December 2017: Revista Chilena de Pediatría
Wail Alkashkari, Amani Alsubei, Ziyad M Hijazi
PURPOSE OF REVIEW: The past couple of decades have brought tremendous advances to the field of pediatric and adult congenital heart disease (CHD). Percutaneous valve interventions are now a cornerstone of not just the congenital cardiologist treating patients with congenital heart disease, but also-and numerically more importantly-for adult interventional cardiologists treating patients with acquired heart valve disease. Transcatheter pulmonary valve replacement (tPVR) is one of the most exciting recent developments in the treatment of CHD and has evolved to become an attractive alternative to surgery in patients with right ventricular outflow tract (RVOT) dysfunction...
March 15, 2018: Current Cardiology Reports
Jun Hui Lee, Lucia Rivera Sanchez, Travis Porco, Ying Han, Alejandra G de Alba Campomanes
PURPOSE: To study the correlation between corneal and scleral intraocular pressure (IOP) by pneumatonometry in pediatric patients. DESIGN: Cross-sectional study. PARTICIPANTS: Patients (age range, 0-15 years) undergoing an eye examination under anesthesia or eye surgery were recruited at the University of California, San Francisco, Benioff Children's Hospital between July 2015 and April 2016. METHODS: Intraocular pressure measurements were obtained by pneumatonometry on the central cornea and the inferonasal and inferotemporal sclera in a random order...
March 12, 2018: Ophthalmology
Mio Noma, Muneaki Matsubara, Chiho Tokunaga, Tomomi Nakajima, Bryan James Mathis, Hiroaki Sakamoto, Yuji Hiramatsu
BACKGROUND: Although pulmonary artery banding (PAB) is a common palliative procedure for pediatric heart malformation, there are concerns of pressure overload and concomitant immune reactions in the right ventricle causing postsurgical complications such as pericardial effusion. At this time, no clear guidelines as to potential risk factors or procedural contraindications have been widely disseminated. Therefore, a study was undertaken to examine wide-ranging factors to find potential biomarkers for postsurgical pericardial effusion formation risk...
March 2018: World Journal for Pediatric & Congenital Heart Surgery
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