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Cirugía Pediátrica

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113 papers 0 to 25 followers
By Ismael Medécigo Pediatric surgery resident.
Qingjiang Chen, Zhigang Gao, Lifeng Zhang, Yuebin Zhang, Tao Pan, Duote Cai, Qixing Xiong, Qiang Shu, Yunzhong Qian
PURPOSE/BACKGROUND: Meckel's diverticulum (MD) is one of the most common congenital malformations of gastrointestinal tract in children. However, the nonspecific clinical manifestations of MD often cause a diagnostic as well as therapeutic challenge to pediatric surgeon. This study aimed to review our experience in managing this disease while evaluating the management strategies. METHODS: We retrospectively analyzed the clinical data of all patients diagnosed with MD admitted to our center between January 2010 and December 2015...
December 5, 2017: Journal of Pediatric Surgery
Shawn D St Peter, Obinna O Adibe, Corey W Iqbal, Frankie B Fike, Susan W Sharp, David Juang, David Lanning, J Patrick Murphy, Walter S Andrews, Ronald J Sharp, Charles L Snyder, George W Holcomb, Daniel J Ostlie
BACKGROUND: The efficacy of irrigating the peritoneal cavity during appendectomy for perforated appendicitis has been debated extensively. To date, prospective comparative data are lacking. Therefore, we conducted a prospective, randomized trial comparing peritoneal irrigation to suction alone during laparoscopic appendectomy in children. METHODS: Children younger than 18 years with perforated appendicitis were randomized to peritoneal irrigation with a minimum of 500 mL normal saline, or suction only during laparoscopic appendectomy...
October 2012: Annals of Surgery
Jin K Kim, Michael E Chua, Jessica M Ming, Joana Dos Santos, Elke Zani-Ruttenstock, Alanna Marson, Mark Bayley, Martin A Koyle
BACKGROUND/PURPOSE: Limited efforts have been made in assessing the qualities of clinical practice guidelines (CPGs) on cryptorchidism (UDT). This appraisal aims to determine the quality of recent CPGs on the management of UDT. METHODS: After systematic literature search, all English-based CPGs providing recommendations for the management of UDT from 2012 to 2017 were reviewed. Using the AGREE II (Appraisal of Guidelines and Research Evaluation) instrument, eligible CPGs were independently appraised by 5 reviewers...
November 24, 2017: Journal of Pediatric Surgery
Z Perović
INTRODUCTION: Controversies regarding drainage and irrigation with antibiotics following perforated appendicitis still exist in literature. Some authors concluded that undrained patients treated with systemic antimicrobial therapy, adequate fluid resuscitation, emergency appendicectomy, peritoneal lavage and primary abdominal wall closure are less exposed to complications. On the other hand, Lund and Murphy and Schwartz and Tapper are still advocating transperitoneal drainage. In that context the aim of this study was to contribute to the current debate with its original results and conclusions...
March 2000: Medicinski Pregled
Ra-Yeong Song, Kyuwhan Jung
PURPOSE: Management of appendicitis in children has always been an issue in pediatric surgery. Both diagnostic methods and treatment vary significantly among medical centers, and little consensus exists in many aspects of the care for patients with appendicitis. Here, we assessed the value of drain insertion after appendectomy in children. METHODS: This study is a retrospective review of pediatric patients who underwent appendectomy for perforated appendicitis at a tertiary medical center between 2003 and 2012...
June 2015: Annals of Surgical Treatment and Research
Sherif Emil, Sherif Elkady, Layla Shbat, Fouad Youssef, Robert Baird, Jean-Martin Laberge, Pramod Puligandla, Kenneth Shaw
PURPOSE: Postoperative abscesses after perforated appendicitis have no clear risk factors or indications for percutaneous drainage. Our study addressed these two issues. METHODS: A logistic regression model was used to delineate risk factors for postoperative abscess in children with perforated appendicitis treated during a recent 5-year period. Drainage of abscess was compared to antibiotic treatment. RESULTS: Postoperative abscess occurred in 42 (14...
December 2014: Pediatric Surgery International
Hannah G Piper, Betul Derinkuyu, Korgun Koral, Eduardo A Perez, Joseph T Murphy
PURPOSE: Children treated for perforated appendicitis can have significant morbidity. Management often includes looking for and draining postoperative fluid collections. We sought to determine if drainage hastens recovery. METHODS: Children with perforated appendicitis treated with appendectomy from 2006 to 2009 were reviewed. Patients with postoperative fluid that was drained were compared with patients with undrained fluid with regard to preoperative features and postoperative outcomes...
June 2011: Journal of Pediatric Surgery
Janice D McDaniel, Mark T Warren, Jeffrey C Pence, Elizabeth H Ey
BACKGROUND: Appendicitis is a common cause of acute surgical abdomen in children and often presents after perforation. Intra-abdominal abscesses can be drained percutaneously via transabdominal, transgluteal or, in the case of deep pelvis abscess, via transrectal approach. OBJECTIVE: To describe a modification of previously described techniques for transrectal drainage procedures, which involves the use of a transvaginal probe and a modified enema tip as a guide for the one-step trocar technique...
March 2015: Pediatric Radiology
Shawn D St Peter, Sohail R Shah, Obinna O Adibe, Susan W Sharp, Brent Reading, Brent Cully, George W Holcomb, Douglas C Rivard
BACKGROUND: Emerging data suggest instillation of tissue plasminogen activator (tPA) is safe and potentially efficacious in the treatment of intra-abdominal abscess. To date, prospective comparative data are lacking in children. Therefore, we conducted a randomized trial comparing abscess irrigation with tPA and irrigation with saline alone. STUDY DESIGN: After IRB approval, children with an abscess secondary to perforated appendicitis who had a percutaneous drain placed for treatment were randomized to twice-daily instillation of 13 mL 10% tPA or 13 mL normal saline...
August 2015: Journal of the American College of Surgeons
B Tander, O Pektas, M Bulut
Peritoneal drainage in children with uncomplicated perforated appendicitis (UPA) is still controversial. Many pediatric surgeons prefer not to drain the peritoneal cavity in such cases. However, there is no randomized controlled study performed in children. We aimed to study the effects of peritoneal drainage in children with UPA in a randomized prospective trial. One hundred and forty consecutive patients with UPA were divided randomly into 2 groups. Group I (70 patients) consisted of cases with peritoneal drainage, and group II (70 patients) without drainage...
September 2003: Pediatric Surgery International
Zafer Dokumcu, Emre Divarci, Yesim Ertan, Ahmet Celik
BACKGROUND: Laparoscopic adrenalectomy (LA) is the gold standard and is widely performed in adults, but its use in children is relatively new. We aim to present our experience in twenty-five children with diverse adrenal pathologies and to discuss an extensive review of pediatric LA in English literature. METHODS: Medical records of children with adrenal tumors admitted to a tertiary center and treated with LA were reviewed. Characteristics and outcome of patients were compared with results of a systematic Pubmed/Medline literature review...
November 28, 2017: Journal of Pediatric Surgery
Danielle B Cameron, Regan Williams, Yimin Geng, Ankush Gosain, Meghan A Arnold, Yigit S Guner, Martin L Blakely, Cynthia D Downard, Adam B Goldin, Julia Grabowski, Dave R Lal, Roshni Dasgupta, Robert Baird, Robert L Gates, Julia Shelton, Tim Jancelewicz, Shawn J Rangel, Mary T Austin
OBJECTIVE: The goal of this systematic review by the American Pediatric Surgical Association Outcomes and Evidence-Based Practice Committee was to develop recommendations regarding time to appendectomy for acute appendicitis in children within the context of preventing adverse events, reducing cost, and optimizing patient/parent satisfaction. METHODS: The committee selected three questions that were addressed by searching MEDLINE, Embase, and the Cochrane Library databases for English language articles published between January 1, 1970 and November 3, 2016...
November 20, 2017: Journal of Pediatric Surgery
Thejasvi Subramanian, Ellen Jerome, Ian Jones, Ingo Jester
AIM OF STUDY: Streptococcus anginosus group (SA) (formerly Streptococcus milleri) are pathogens recognised to have a high risk of postoperative collection in appendicitis, although little data exist specifically in children. We performed a retrospective review of all microbiological data from appendicectomies to assess whether there was an association in children. METHODS: A retrospective case note review of patients admitted to a paediatric tertiary centre coded for appendicitis from January 2015 to October 2016 was completed...
November 12, 2017: Journal of Pediatric Surgery
Antti I Koivusalo, Risto J Rintala, Mikko P Pakarinen
AIM OF THE STUDY: Conservative management of gastrooesophageal reflux (GORD) in oesophageal atresia (OA) is sometimes inefficient, and fundoplication is required. We assessed the outcomes of fundoplication among OA patients from 1980 to 2016. METHODS: After ethical consent, hospital records of 290 patients, including 22 referred patients, were reviewed. Included were 262 patients with end-to-end repair. Excluded were patients who underwent oesophageal reconstruction (n=23) or no repair (n=5)...
November 12, 2017: Journal of Pediatric Surgery
Christian Radmayr, Hasan S Dogan, Piet Hoebeke, Radim Kocvara, Rien Nijman, Selcuk Silay, Raimund Stein, Shabnam Undre, Serdar Tekgul
CONTEXT: Undescended testis is the most common endocrinological disease in the male newborn period. Incidence varies between 1.0% and 4.6% in full-term neonates, with rates as high as 45% in preterm neonates. Failure or delay of treatment can result in reduced fertility and/or increased testicular cancer risk in adulthood. OBJECTIVE: To provide recommendations for the diagnosis and treatment of boys with undescended testes which reduce the risk of impaired fertility and testicular cancer in adulthood...
December 2016: Journal of Pediatric Urology
David I Chu, Jonathan M Tan, Peter Mattei, Allan F Simpao, Andrew T Costarino, Aseem R Shukla, Joseph W Rossano, Gregory E Tasian
BACKGROUND: Children with congenital heart disease (CHD) often require noncardiac surgery. We compared outcomes following open and laparoscopic intraabdominal surgery among children with and without CHD. METHODS: We performed a retrospective cohort study using the 2013-2015 National Surgical Quality Improvement Project-Pediatrics. We matched 45,012 children <18years old who underwent laparoscopic surgery to 45,012 children who underwent open surgery. We determined the associations between laparoscopic (versus open) surgery and 30-day mortality, in-hospital mortality, 30-day morbidity, and postoperative length-of-stay...
November 17, 2017: Journal of Pediatric Surgery
Kamlesh Kumar Sharma, Pankaj Ranka, Pushpa Goyal, D R Dabi
BACKGROUND/PURPOSE: Gastric outlet obstruction (GOO) is overwhelmingly described as infantile hypertrophic pyloric stenosis that overshadows other causes; thereby, there is a need to develop an elaborate and comprehensive classification. We present the same and establish a new disease called primary acquired gastric outlet obstruction during infancy and childhood that was reported for the first time by us in 1997, reviewing the literature published since then, with report of our new cases...
October 2008: Journal of Pediatric Surgery
Saurabh Saluja, Tianyi Sun, Jialin Mao, Shaun A Steigman, P Stephen Oh, Heather L Yeo, Art Sedrakyan, Demetri J Merianos
BACKGROUND: Complicated appendicitis is common in children, yet the timing of surgical management remains controversial. Some support initial antibiotics with delayed operation whereas others support immediate operation. While a few randomized trials have evaluated this question, they have been small, single-center trials with limited follow-up. We present a database analysis of outcomes in early versus late surgical management of complicated appendicitis with one-year follow-up. METHODS: We conducted a retrospective review of children with complicated appendicitis presenting between 2000 and 2013, utilizing a New York State database...
October 2, 2017: Journal of Pediatric Surgery
Yasmine Yousef, Fouad Youssef, Michael Homsy, Trish Dinh, Kartikey Pandya, Hayden Stagg, Robert Baird, Jean-Martin Laberge, Dan Poenaru, Pramod Puligandla, Kenneth Shaw, Sherif Emil
BACKGROUND: The treatment of perforated appendicitis in children is characterized by significant variability in care, morbidity, resource utilization, and outcomes. We prospectively studied how minimization of care variability affects outcomes. METHODS: A clinical pathway for perforated appendicitis, in use for three decades, was further standardized in May 2015 by initiation of a disease severity classification, refinement of discharge criteria, standardization of the operation, and establishment of criteria for use of postoperative total parenteral nutrition, imaging, and invasive procedures...
December 2017: Journal of Pediatric Surgery
Juma Obayashi, Kohei Kawaguchi, Shutaro Manabe, Hideki Nagae, Munechika Wakisaka, Junki Koike, Masayuki Takagi, Hiroaki Kitagawa
BACKGROUND: The number of the bile ducts in the portal canal/measured surface area of the portal canal (BDP ratio) indicates prognosis in biliary atresia (BA), as does an elevated cytokeratin 7 positivity percentage (PCK7). We compared these two markers. METHODS: We reviewed 32 BA cases undergoing Kasai operation from 1976 to 2016 with >5 portal canals in biopsy samples. Group I required liver transplantation or died within a year of operation (n = 8). Group II survived with their native liver (n = 24)...
October 2017: Pediatric Surgery International
2017-09-10 14:30:08
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