Abstract:
BACKGROUND:Transumbilical laparoscopic-assisted appendectomy (TULAA) is fast and cost-effective since no endoloops, staplers or wound protection devices are used. We analyzed the effects of TULAA as first approach for perforated (PA) and non-perforated (NPA) appendicitis in children. PATIENTS:We performed a retrospective analysis of 181 children for whom TULAA was the first approach for appendicitis between October 2010 and March 2016. METHODS:Morbidity, additional laparoscopic instrument insertion (AI), conversions to open extraumbilical appendectomy (OC), and complications were evaluated. RESULTS:TULAA was initiated in 181 (87.4%) children (113 boys: 68 girls). Median age was 10.3 years (3.3-13.9 years) and BMI 16.8 kg/m2 (12.4-30.8). Appendicitis was non-perforated in 157 (86.7%) and perforated in 24 (13.3%) patients. TULAA was finalized in 142 (78.5%) patients, AI were inserted in 20 (11%) and OC were performed in 19 (10.5%) patients. Duration of surgery did not exceed 20 min for 12.8%, and 30 min for 43.6% of patients with TULAA and NPA. The rate of wound infections did not differ between procedures (TULAA 3/142 (2.1%), AI 0 (0%), OC 1/19 (5.3%), P=1.000). Further postoperative course was uneventful in 179 (98.9%) patients. CONCLUSION:TULAA can be used as first approach for appendicitis in all children with a low rate of complications. Extracorporeal appendix stump closure can be safely achieved in the majority of children without using laparoscopic disposable devices. HINTERGRUND:Die transumbilikale laparoskopisch assistierte Appendektomie (TULAA) ist aufgrund des Verzichts auf endoskopisches Einweg-Material schnell und kostengünstig. Wir untersuchten die Auswirkungen von TULAA als primäres Verfahren bei perforierter (PA) und nicht perforierter (NPA) Appendizitis im Kindesalter. PATIENTEN:Wir führten eine retrospektive Analyse bei 181 Kindern durch, bei denen zwischen Oktober 2000 und März 2016 TULAA als primäres Verfahren zur Behandlung der Appendizitis eingesetzt wurde. METHODEN:Erfasst wurden Morbidität, die Insertion zusätzlicher laparoskopischer Instrumente (AI), Konversionen zur offenen extraumbilikalen Appendektomie (OC) und Komplikationen. ERGEBNISSE:TULAA wurde bei 181 Kindern begonnen (87,4%) (113 Jungen: 68 Mädchen). Das mediane Alter betrug 10,3 Jahre (3,3 – 13,9) und der BMI 16.8 kg/m2 (12,4–30,8). NPA lag in 157 (86,7%) und PA in 24 (13.3%) Patienten vor. TULAA wurde in 142 (78,5%) durchgeführt, AI erfolgte in 20 (11%) und OC in 19 (10,5%) Patienten. Die OP-Dauer überschritt nicht 20 Min bei 12,8%, und nicht 30 Min bei 43,6% der Patienten mit TULAA und NPA. Die Rate von Wundheilungsstörungen unterschied sich nicht zwischen den OP-Verfahren (TULAA 3/142 (2,1%), AI 0 (0%), OC 1/19 (5,3%), P=1,000). Der postoperative Verlauf gestaltete sich komplikationslos in 179 (98,9%) Patienten. ZUSAMMENFASSUNG:TULAA kann als primäres Appendektomie-Verfahren mit einer niedrigen Komplikationsrate bei allen Kindern verwendet werden. Der extrakorporale Appendixstumpfverschluß kann bei den meisten Kindern ohne Einsatz von endoskopischem Einweg-Material durchgeführt werden.
journal_name
Klin Padiatrjournal_title
Klinische Padiatrieauthors
Dübbers M,Nikolaou E,Fuchs H,Fischer J,Alakus H,Leers J,Bruns C,Cernaianu Gdoi
10.1055/s-0044-101622subject
Has Abstractpub_date
2018-07-01 00:00:00pages
194-199issue
4eissn
0300-8630issn
1439-3824journal_volume
230pub_type
杂志文章abstract:BACKGROUND:A fast and comprehensive diagnostic by means of whole-body CT has been shown to reduce mortality in the adult trauma population. Therefore whole-body CT seems to be the standard in adult trauma-patients. Due to the higher radiation exposure of whole-body CT the use of this diagnostic toll in pediatric trauma...
journal_title:Klinische Padiatrie
pub_type: 杂志文章,多中心研究
doi:10.1055/s-0035-1547311
更新日期:2015-07-01 00:00:00
abstract:OBJECTIVE:To identify obstetric and neonatal risk factors associated with the development of germinal matrix-intraventricular hemorrhage (GM-IVH) in high-risk preterm neonates. METHODS AND PATIENTS:Data from 279 preterm infants (246 mothers) with a gestational age≤28+0 weeks admitted to our NICU between January 2004 a...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-0042-111689
更新日期:2016-09-01 00:00:00
abstract::In approximately 10% of the children suffering from juvenile chronic arthritis (JCA), rheumatic iridocyclitis was also diagnosed. In 90 JCA and iridocyclitis patients we studied relative risk, clinical course and prognosis by means of several clinical and immunological parameters. Antinuclear antibodies (ANA), selecti...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2008-1033783
更新日期:1982-03-01 00:00:00
abstract::The clinical significance of colloid osmotic pressure (COP) in transcapillary fluid exchange and water homeostasis in health and disease is described. Under pathophysiological circumstances measurement of COP should be preferred to COP value calculation. After extensive COP experiences in critically ill adults and num...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2008-1034010
更新日期:1985-09-01 00:00:00
abstract::In Germany, about 1,800 new cases of childhood cancer are diagnosed every year. The chances of survival have increased significantly over the last 40 years due to the continuous improvement of treatment strategies. The number of childhood cancer survivors in Germany thus ranges around 30,000 nowadays. But their treatm...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-0035-1548840
更新日期:2015-05-01 00:00:00
abstract:UNLABELLED:Sickle cell disease is a chronic hematologic disease with variable but often severe systemic symptoms. In this report, we describe a 6-year-old boy presenting with acute bowel pseudo-obstruction. During this episode, previously undiagnosed sickle cell disease was discovered upon peripheral blood smear analys...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-0034-1389907
更新日期:2014-11-01 00:00:00
abstract::The psychosocial and intellectual development of 4 boys with nephropathic cystinosis and brain atrophy documented by cranial computerized tomography was investigated by use of biographical data and psychological tests (HAWIK, Deutscher Rechtschreibtest). Inspite of the brain atrophy the patients showed low-normal inte...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:
更新日期:1979-09-01 00:00:00
abstract::The increasing importance of radiotherapy in tumor of childhood demands the investigation and consideration of the psychological aspects of this afflicting therapy. In this paper the results obtained by questioning and observing 28 children of different ages, their parents, attendants and employees of several radiolog...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2008-1034457
更新日期:1981-05-01 00:00:00
abstract:BACKGROUND:Intracellular antibodies (intrabodies) have been used for the generation of phenotypic knockouts in vivo by surface depletion of extracellular or transmembrane proteins. Intrabodies present an alternative to methods of gene inactivation that target genomic DNA or m-RNA, such as RNA interference. Several stud...
journal_title:Klinische Padiatrie
pub_type: 杂志文章,收录出版
doi:10.1055/s-2006-933415
更新日期:2006-05-01 00:00:00
abstract::An eight-year old girl showing a X/X-translocation (45,X/46,Xt(X;X)(q26;p11)) is presented. Besides short stature and congenital heart-anomaly no other phenotypical abnormalities were present. In all cells containing the abnormal X-chromosome, the latter was late labeling as shown by autoradiography and BrdU-labeling....
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:
更新日期:1975-11-01 00:00:00
abstract::Mycobacterial infections are rarely reported in Cystic Fibrosis patients although they quite often develop predisposing risk factors such as underweight, secondary diabetes mellitus and chronic inflammatory pulmonary disease. Furthermore glucocorticoid therapy is mandatory in some patients. CF heterozygotes are said t...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2007-1025461
更新日期:1991-09-01 00:00:00
abstract:BACKGROUND:One of the strongest predictive factors for therapy outcome in childhood acute lymphoblastic leukaemia (ALL), treated according to ALL-BFM protocols, is the response to initial prednisone treatment. Prednisone response is characterized by the peripheral leukaemic blast count. The threshold value for the char...
journal_title:Klinische Padiatrie
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1055/s-2001-16848
更新日期:2001-07-01 00:00:00
abstract::During angiogenesis new blood vessels sprout from an existing vascular bed. This is a prerequisite for tumor growth beyond a certain size and for metastasis formation. Tumors produce a number of cytokines. The development of in vivo bio-assays for angiogenesis and in vitro analysis of endothelial cells permits charact...
journal_title:Klinische Padiatrie
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1043960
更新日期:1997-07-01 00:00:00
abstract::Possibilities of recognizing cerebral function disturbances in newborns as early as the acute phase of the condition, and of prognosticating permanent brain damage are described. Clinical findings such as lethargy or spasms in the second and third weeks of life following hypoxia indicate severe function disturbances w...
journal_title:Klinische Padiatrie
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1034092
更新日期:1984-11-01 00:00:00
abstract::Hypotension is diagnosed in a high percentage of very low birth weight infants, particularly in the first 24 hours after birth and the resultant clinical approach is to support the blood pressure vigorously. However, the research base is not yet available to give a definite answer to the question, which blood pressure...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2003-36890
更新日期:2003-01-01 00:00:00
abstract::Problems of terminology, differential diagnosis, etiology and therapy of language development disorders are demonstrated by a casuistic example. Besides the importance of clinical date special attention was laid on neuropsychological diagnostic procedures and their therapeutic implications. Therapeutic interventions c...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:
更新日期:1978-09-01 00:00:00
abstract:BACKGROUND:It has been shown that Interleukin 10 (IL-10) is able to inhibit alloreactivity in a mixed lymphocyte culture. Therefore, here IL-10 production in patients after allogeneic BMT was investigated and correlated with the incidence of acute GvHD. PATIENTS:14 patients after allogeneic BMT have been investigated....
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2008-1046464
更新日期:1996-07-01 00:00:00
abstract::In the period from 1965 to 1979 biopsies from the oropharynx of 11 children with non-Hodgkin's lymphoma were collected at the Lymph Node Registry in Kiel. Palatine tonsil tissue was examined in all cases and, in addition, specimens from the retrolingual region of one child and the epipharynx of two patients. All biops...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2008-1034073
更新日期:1983-05-01 00:00:00
abstract::The influence of a single intravenous infusion of triglycerides (1 g triglyceride per kg body weight) on the acid base equilibrium was investigated in 16 newborn infants with low birth weight during the first days of age. No changes of pH, PCO2 and standard bicarbonate, base excess, buffer base and actuelle bicarbonat...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:
更新日期:1975-09-01 00:00:00
abstract::The lipodystrophy syndromes are rare disorders characterized by the loss of adipose tissue. The loss of fat tissue can have genetic, immune, or infectious/drug-associated causes. With the extent of fat loss metabolic complications, such as insulin resistance, diabetes mellitus, hypertriglyceridemia, and fatty liver in...
journal_title:Klinische Padiatrie
pub_type: 杂志文章,评审
doi:10.1055/s-2002-30142
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abstract:BACKGROUND:The prevalence of asthma and overweight/obesity in children and adolescents is continuously increasing over the last decades. It remains unclear if overweight/obesity raises the risk of developing asthma or if an uncontrolled asthma increases the risk of developing overweight/obesity by restricting physical ...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-0042-102254
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:Spinal compression can be a complication of neuroblastoma (NBL). Delayed or insufficient treatment of this condition may lead to permanent neurological sequelae. Therefore, appropriate treatment should be introduced promptly. Therapeutic options include neurosurgery, chemotherapy, and radiation therapy. CAS...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2008-1065340
更新日期:2008-05-01 00:00:00
abstract::A boy with dysplastic features had to be treated for recurrent diarrhoea and bronchitis since his tenth month of life. Defects in humoral and cellular immunity were found. The ecto-mesodermal abnormalities are so characteristic that in connection with the immunological changes it seems to be justified to assume a yet ...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:
更新日期:1978-11-01 00:00:00
abstract::Easier access to prenatal diagnostic procedures led to its widespread use as a screening measure. Hence, today it is more common for life-limiting illnesses to be diagnosed during fetal life. The concept of Advance Care Planning (ACP) provides a framework for caregivers, families and their multidisciplinary teams to a...
journal_title:Klinische Padiatrie
pub_type: 杂志文章,评审
doi:10.1055/a-1179-0530
更新日期:2020-09-01 00:00:00
abstract::The integration of colleagues from psychosocial occupations into the traditional team of doctors and nurses demands a holistic treatment concept, the general desire for interdisciplinary action, and readiness for patience in the process of mutual learning. The acceptance of the psychosocial services by the patient and...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2008-1026726
更新日期:1989-07-01 00:00:00
abstract::Central nervous system (CNS) tumors account for the highest mortality among pediatric malignancies. Accurate diagnosis is essential for optimal clinical management. The increasing use of molecular diagnostics has opened up novel possibilities for more precise classification of CNS tumors. We here report a single-insti...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/a-0637-9653
更新日期:2018-10-01 00:00:00
abstract::Since reliable diagnosis of cystic fibrosis (CF) is still difficult, the occurrence of serum markers CA 19-9, CA 50 and elastase 1 was analysed. Serum levels of CA 19-9, CA 50, CA 125 and elastase 1 were estimated in 54 CF patients as well as in a control group of 66 children of similar age suffering from various othe...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2008-1033692
更新日期:1988-03-01 00:00:00
abstract::Waardenburg syndrome Type I is described on the basis of an observation of a family. The characteristic signs including lateral displacement of medial canthi ("telecanthus"), wide bridge of the nose, white forelock and severe cochlear deafness are found in one female patient only; however, her eyes are not of differen...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2008-1033785
更新日期:1982-03-01 00:00:00
abstract::Severe combined immunodeficiency (SCID) is a heterogeneous group of congenital diseases characterized by their presentation with life threatening infections in the first months of life. The clinical presentation and the therapeutic outcome is influenced by multiple factors: the genetic defect, infectious complications...
journal_title:Klinische Padiatrie
pub_type: 杂志文章,评审
doi:10.1055/s-0031-1287826
更新日期:2011-11-01 00:00:00
abstract::We report the first case of non-immune hydrops fetalis (NIHF) with trisomy 15q11/17q22.5 resulting from a familial translocation 15/17. Furthermore the cytogenetic findings of 50 cases with hydrops fetalis are presented. Of the 30 cytogenetic analyzable cases 7 showed chromosomal abnormalities (4x45,X; 2x47,XY,+21; 1x...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2008-1026810
更新日期:1987-07-01 00:00:00