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By Ismael Medécigo Pediatric surgery resident.
Chase A Arbra, Andra Oprisan, Dulaney A Wilson, Rita M Ryan, Aaron P Lesher
BACKGROUND: For infants with necrotizing enterocolitis (NEC) treated nonoperatively, no consensus exists on the optimal fasting period prior to reintroducing feeds after NEC. We report our experience with early (<7days) and late (≥7days) refeeding in this population. METHODS: A chart review of infants with NEC born between 2006 and 2016 was performed. Data elements include demographics, comorbidities, day of diagnosis, Bell's stage, recurrence, strictures, length of stay and mortality, and were grouped into early and late refeeding...
March 7, 2018: Journal of Pediatric Surgery
Christoph Zoeller, Benno M Ure, Jens Dingemann
Video-assisted thoracoscopic surgery (VATS) has gained broad acceptance among pediatric surgeons. Today, VATS can be regarded as a routine approach for various conditions in neonates and infants. However, there is a lack of information concerning the complications of thoracoscopic pulmonary surgery in neonates and infants. We aimed to review the available data. A systematic review of the literature was performed using PubMed. All publications reporting on VATS for pulmonary procedures in neonates and infants up to the age of 1 year were included...
April 2018: European Journal of Pediatric Surgery
Kensuke Ohashi, Tsugumichi Koshinaga, Shuichiro Uehara, Takeshi Furuya, Hide Kaneda, Hiroyuki Kawashima, Taro Ikeda
OBJECTIVE: In recent years, improved survival rates of extremely low birth weight infants (ELBWIs) have led to an increasing number of enterostomy performed for those with meconium obstruction of prematurity (MOP)1,2, spontaneous intestinal perforation (SIP)3,4. To prevent serious stoma-related complications such as stoma side perforation, prolapse, fall and surgical site infection, we introduce our new "sutureless enterostomy" technique. METHODS: We present the procedures in detail...
November 2017: Journal of Pediatric Surgery
Lori A Gurien, Melvin S Dassinger, Jeffrey M Burford, Marie E Saylors, Samuel D Smith
BACKGROUND: There is no consensus on optimal timing of gastroschisis repair. The 2012-2014 ACS NSQIP Pediatric Participant Use Data File was used to compare outcomes of primary versus staged gastroschisis repair. METHODS: Cases were divided into primary repair (0-1day) and staged repair (4-14days). Baseline characteristics and outcomes were compared for primary versus staged closure using Fisher's exact tests for categorical variables and Wilcoxon rank-sum tests for continuous variables...
November 2017: Journal of Pediatric Surgery
Lori A Gurien, Deidre L Wyrick, Melvin S Dassinger, Jeffrey M Burford, Steven C Mehl, Marie E Saylors, Samuel D Smith
BACKGROUND: Optimal timing to begin feeds in neonates with gastroschisis remains unclear. We examined if bedside abdominal ultrasound for intestinal motility is a feasible tool to detect return of bowel function in neonates with gastroschisis. METHODS: Neonates born with uncomplicated gastroschisis who underwent closure received daily ultrasound exams. Full motility was defined as peristalsis seen in all quadrants. Average length of time between abdominal wall closure and start of enteral feeds, full ultrasound motility, and clinical characteristics was compared using Student's t-tests...
May 2017: Journal of Pediatric Surgery
Yuhki Koike, Bo Li, Carol Lee, Shigang Cheng, Hiromu Miyake, Christopher Welsh, Alison Hock, Jaques Belik, Augusto Zani, Agostino Pierro
PURPOSE: The aim of this study is to assess gastric emptying in experimental necrotizing enterocolitis (NEC) and its diagnostic significance using non-invasive ultrasound imaging. METHODS: Fourteen neonatal mice (C57BL/6) were randomized into two groups: NEC [n=10] and control [n=4]. NEC was induced by gavage feeding of hyperosmolar formula, hypoxia, and lipopolysaccharide between postnatal day 5 (P5) and 9 (P9). Stomach volume was measured using a 40-MHz ultrasound transducer on P5 and P9...
May 2017: Journal of Pediatric Surgery
Pramod S Puligandla, Robert Baird, Eric D Skarsgard, Sherif Emil, Jean-Martin Laberge
PURPOSE: The GPS enables risk stratification for gastroschisis and helps discriminate low from high morbidity groups. The purpose of this study was to revalidate GPS's characterization of a high morbidity group and to quantify relationships between the GPS and outcomes. METHODS: With REB approval, complete survivor data from a national gastroschisis registry was collected. GPS bowel injury scoring was revalidated excluding the initial inception/validation cohorts (>2011)...
May 2017: Journal of Pediatric Surgery
Titilayo Oluyomi-Obi, Verena Kuret, Pramod Puligandla, Abhay Lodha, Helen Lee-Robertson, Kovid Lee, David Somerset, Joann Johnson, Greg Ryan
BACKGROUND: Pulmonary hypoplasia is the main cause of mortality in isolated congenital diaphragmatic hernia (CDH) and its prediction is paramount when counseling parents. We sought to identify antenatal parameters that predicted neonatal mortality in CDH. METHOD: Search was conducted in MEDLINE, EMBASE, Cochrane Database of Systematic reviews, PubMed, Scopus, and Web of Science on the ability of lung-to-head ratio (LHR), observed-to-expected LHR (o/e LHR), total fetal lung volume (TFLV), o/e TFLV, percentage predicted lung volume (PPLV) and degree of liver herniation to predict neonatal morbidity and mortality in fetuses with CDH...
May 2017: Journal of Pediatric Surgery
Anthony Owen, Sean Marven, Laura Jackson, Brice Antao, Julian Roberts, Jenny Walker, Rang Shawis
AIM: The purpose of this study was to assess the effectiveness of routine staged reduction and closure at the bedside, using preformed silos with no general anesthesia (PSnoGA), compared to emergency operative fascial closure (OFC) under general anesthesia for gastroschisis (GS). METHODS: A retrospective matched case-control analysis of neonates with GS was performed between 1990 and 2004 inclusively. Assessment included demographics, method of closure, days on ventilator, days to first enteral feed, days to full oral feeds, days on parenteral nutrition, length of hospital stay, and complications...
November 2006: Journal of Pediatric Surgery
Andrzej Zajac, Bartosz Bogusz, Piotr Soltysiak, Przemyslaw Tomasik, Michal Wolnicki, Andrzej Wedrychowicz, Piotr Wojciechowski, Wojciech Gorecki
Purpose  A sutureless gastroschisis repair allows for spontaneous closure of abdominal wall defect. We report our experience focusing on final esthetic outcome. Methods  Retrospective data were collected from medical reports of all neonates with gastroschisis operated from January 2009 to December 2013. Variables recorded included patients descriptors, management modality, and cosmetic outcome. Results  From the overall group of 38 patients with gastroschisis, 20 infants treated with sutureless closure were included in this study...
December 2016: European Journal of Pediatric Surgery
Wilson W Choi, Craig A McBride, Chris Bourke, Peter Borzi, Kelvin Choo, Rosslyn Walker, Tuan Nguyen, Mark Davies, Tim Donovan, David Cartwright, Roy M Kimble
BACKGROUND: A sutureless ward reduction (SWR) protocol was implemented in the neonatal intensive care unit of a tertiary level hospital in 1999. Although the short-term outcomes associated with SWR have been documented, the long-term outcomes are unknown. METHODS: Retrospective data were collected from the medical records of all neonates with gastroschisis from September 1999 to December 2010. Data on their growth and development and the prevalence of any health problems were collected...
August 2012: Journal of Pediatric Surgery
Joseph N Kidd, Richard J Jackson, Samuel D Smith, Charles W Wagner
OBJECTIVE: Since the introduction of a preformed silo to the authors' practice in 1997, there has been a decrease in primary closure of gastroschisis. To clarify the impact of this change, the authors reviewed their results over the past 10 years. METHODS: From patient records, the authors abstracted the closure method, mechanical ventilation days, time to full feeds, mechanical and infectious complications, and length of stay. The authors compared groups using the Student t test and the Mann-Whitney test, as appropriate...
June 2003: Annals of Surgery
Arash Safavi, Erik D Skarsgard
Gastroschisis (GS) is a structural defect of the anterior abdominal wall, usually diagnosed antenatally, that occurs with a frequency of approximately 4 per 10,000 pregnancies. Babies born with GS require neonatal intensive care and surgical management of the abdominal wall defect soon after birth. Although contemporary survival rates for GS are over 90%, these babies are at risk for significant morbidity, and require 4 to 6 weeks of costly, resource-intensive care in specialized neonatal units. Much consideration has been given to how best to treat the abdominal wall defect of GS...
May 2015: Surgical Technology International
Paul Charlesworth, Ibiyinka Akinnola, Charlotte Hammerton, Pranithia Praveena, Ashish Desai, Shailish Patel, Mark Davenport
INTRODUCTION: The surgical management of gastroschisis (GS) is controversial. The most commonly used strategy for abdominal wall closure is surgery on day 1 of life with the aim of primary closure (PC) or construction of a surgical silo (SS) and secondary closure thereafter. The other widely used technique is application of a preformed silo (PFS) and reduction of contents over a few days before final closure. There is still a paucity of comparative outcome data. METHODS: A retrospective case note review of all infants initially treated at a single institution between October 1993 and October 2012...
February 2014: European Journal of Pediatric Surgery
Cindy Gomes Ferreira, Isabelle Lacreuse, Dorothée Geslin, Françoise Schmitt, Anne Schneider, Guillaume Podevin, François Becmeur
INTRODUCTION: The aim of this study is to analyze the effectiveness of an Alexis wound retractor (AWR) device for staged gastroschisis closures. PATIENTS AND METHODS: AWR device was used to cover unreduced viscera of a gastroschisis when primary abdominal wall closure was not convenient. The eviscerated organs were covered with one of the two spring-loaded rings of the AWR inserted underneath the abdominal wall. Gradual reduction was guaranteed through careful traction on the external ring...
March 2014: Pediatric Surgery International
Jonathan Riboh, Claire T Abrajano, Karen Garber, Gary Hartman, Marilyn A Butler, Craig T Albanese, Karl G Sylvester, Sanjeev Dutta
INTRODUCTION: A new technique of gastroschisis closure in which the defect is covered with sterile dressings and allowed to granulate without suture repair was first described in 2004. Little is known about the outcomes of this technique. This study evaluated short-term outcomes from the largest series of sutureless gastroschisis closures. METHODS AND PATIENTS: A retrospective case control study of 26 patients undergoing sutureless closure between 2006 and 2008 was compared to a historical control group of 20 patients with suture closure of the abdominal fascia between 2004 and 2006...
October 2009: Journal of Pediatric Surgery
Junichi Kusafuka, Atsuyuki Yamataka, Tadaharu Okazaki, Manabu Okawada, Masahiko Urao, Geoffrey J Lane, Takeshi Miyano
We used an Applied Alexis (Applied Medical Resources Corp, USA) wound protector and retractor (WPAR) instead of a "spring loaded silo" (SLS) for gastroschisis reduction because SLS is currently unavailable in Japan. Our patient was a 1,707 g female diagnosed prenatally with gastroschisis born at 35 weeks gestation by spontaneous vaginal delivery. Attempted primary closure failed and a WPAR was used as a silo. A piece of the bottom ring of the WPAR was cut out and a smaller ring was made from it, so it would fit into the patient's abdomen...
November 2005: Pediatric Surgery International
Nick Lansdale, Richard Hill, Sobbia Gull-Zamir, Melanie Drewett, Emma Parkinson, Mark Davenport, Javaid Sadiq, Kokila Lakhoo, Sean Marven
PURPOSE: Previous single-center studies have reported favorable outcomes when preformed silos (PFS) are used for the staged reduction of gastroschisis. The aim of this study was to assess the frequency and nature of complications associated with PFS in a large population and provide an insight into the practicalities of their routine use. METHODS: A retrospective review was carried out of all cases of gastroschisis managed with PFS in 4 UK neonatal surgical units for a 6-year period...
November 2009: Journal of Pediatric Surgery
J Allotey, M Davenport, I Njere, P Charlesworth, A Greenough, N Ade-Ajayi, S Patel
Gastroschisis is traditionally managed by primary closure (PC) or delayed closure after surgical silo placement. Bedside insertion of preformed silos (PFS) and delayed closure has become more widespread, although its benefits remain unclear. To identify differences in outcome of infants managed with PFS compared with traditional closure (TC) techniques. Single-centre retrospective review of 53 consecutive neonates admitted between February 2000 and January 2006. Data expressed as median (range). Non-parametric statistical analysis used with P < 0...
November 2007: Pediatric Surgery International
Anthony Sandler, John Lawrence, John Meehan, Laura Phearman, Robert Soper
BACKGROUND/PURPOSE: Several techniques are described for closure of the gastroschisis abdominal wall defect. The authors describe a technique that allows for spontaneous closure that is simple, cosmetically appealing, and minimizes intraabdominal pressure after bowel reduction. METHODS: Under either general anesthetic or analgesia with sedation, the gastroschisis bowel is decompressed, and the bowel is primarily reduced. The gastroschisis defect is covered with the umbilical cord tailored to fit the opening, and 2 Tegaderm (3M Healthcare, MN) dressings reinforce the defect ("plastic closure")...
May 2004: Journal of Pediatric Surgery
2017-01-31 01:49:33
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