Abstract:
:For infants with omphalocele, the size of the defect and the presence of associated anomalies are well known prognostic factors. However, the prognostic importance of the respiratory status at birth has not been well defined. The authors reviewed the records of 30 infants with omphalocele (treated during a 10-year period) to determine whether respiratory insufficiency at birth affected survival. Eighteen infants did not require ventilatory support before repair of the omphalocele. The mean gestational age and birth weight were 38.2 +/- 2.6 weeks and 3.4 +/- 0.6 kg, respectively. Cardiac or other major associated anomalies were present in six infants (33%). Seven (39%) had a "giant" omphalocele (ie, liver-containing and/or omphalocele sac > 5 cm in diameter). The average length of ventilatory support was 3.2 days. All infants in this group were managed by primary (14) or staged closure of the omphalocele (4) immediately after birth. One infant died, but the remainder survived without any significant complications. Twelve infants had severe respiratory distress at birth and required positive pressure ventilation (mean peak inspiratory pressure, 31.4 +/- 1.2 cm H2O; mean FiO2, 0.8 +/- 0.1). The mean gestational age and birth weight were 32.7 +/- 3.5 weeks and 1.9 +/- 0.8 kg, respectively. Cardiac or other major associated anomalies were present in nine infants (75%), and eight (67%) had a giant omphalocele. The average length of ventilatory support was 57.7 days, which was significantly longer than for the previous group (P < 0.001). Two infants died of respiratory failure within 48 hours of birth, before the initiation of any treatment for the omphalocele. Six were managed with surgical repair of the omphalocele, primary or staged, immediately after birth. In four, topical treatment was used to allow improvement in the respiratory status. Only one of the six infants initially managed by surgical repair survived, whereas three of the four infants managed nonsurgically recovered. Stepwise logistic regression analysis showed that the presence of respiratory distress at birth was the only significant predictor of mortality, independent of gender, gestational age, birth weight, presence of other anomalies, or size of the omphalocele (odds ratio = 25.48; likelihood ratio test = 13.86; P < .001). In conclusion, respiratory failure at birth in infants with omphalocele is a significant predictor of mortality. Initial conservative management of the omphalocele until there is improvement in the respiratory status may result in a better outcome.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Tsakayannis DE,Zurakowski D,Lillehei CWdoi
10.1016/s0022-3468(96)90093-7subject
Has Abstractpub_date
1996-08-01 00:00:00pages
1088-90; discussion 1090-1issue
8eissn
0022-3468issn
1531-5037pii
S0022346896003429journal_volume
31pub_type
杂志文章abstract:BACKGROUND/PURPOSE:Transanal endorectal pull-through (TEPT) is the latest development in treatment of Hirschsprung's disease (HD). This prospective study was designed to evaluate the safety and efficacy of 1 stage TEPT technique in the management of patients with HD. METHODS:One hundred forty-nine children (116 boys a...
journal_title:Journal of pediatric surgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.jpedsurg.2003.11.038
更新日期:2004-03-01 00:00:00
abstract::This article reviews of the current evidence-based treatment standards for children with Wilms tumor. In this article, a summary of recently completed clinical trials by the Children's Oncology Group is provided, the current diagnostic evaluation and surgical standards are discussed, and the surgical impact on current...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jpedsurg.2018.09.005
更新日期:2019-03-01 00:00:00
abstract::Over a 5-year period, the authors examined 30 consecutively treated patients, aged 16 years or younger, who underwent total colectomy and ileal pouch-anal anastomosis, (IPAA) using two different surgical methods. In 16 patients (group I), extrarectal dissection with stapled J pouch and anastomosis was performed. In 14...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(94)90337-9
更新日期:1994-02-01 00:00:00
abstract::Hirschsprung's disease has become a more common cause of newborn intestinal obstruction in the past 30 years. In a group of 137 newborns with intestinal obstruction the most common diagnosis was necrotizing enterocolitis. The second most common cause, however, was Hirschsprung's disease. We have reviewed 26 infants wi...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(84)80255-9
更新日期:1984-08-01 00:00:00
abstract:PURPOSE:The signals that govern the upregulation of nutrient absorption (adaptation) after intestinal resection are not well understood. A Gastric Roux-en-Y bypass (GRYB) model was used to isolate the relative contributions of direct mucosal stimulation by nutrients, biliary-pancreatic secretions, and systemic enteric ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2010.02.036
更新日期:2010-05-01 00:00:00
abstract::An infant presented with abdominal distension and failure to thrive. This patient was a 3.5-month-old, ex-26-week premature infant at the time of presentation who required supplemental parenteral nutrition until day 9 of life. Workup found ascites and a complex cystic mass in the porta hepatis. A perforated gallbladde...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2002.35029
更新日期:2002-09-01 00:00:00
abstract:PURPOSE:The sphincter muscles in anorectal anomalies, which do not appear in the surgical field, cannot be described adequately. Details of the anal sphincter in low-type anorectal malformations were investigated using 3-dimensional (3D) image analysis. PATIENTS AND METHODS:Thirty patients (10 males and 20 females) wi...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2009.07.073
更新日期:2009-12-01 00:00:00
abstract::Carcinoma of the breast is rarely encountered in the male population and is even less prevalent in the pediatric male population. Studies have suggested an association between male breast carcinoma and gynecomastia, but conflicting results have been shown. Only 3 cases of carcinoma in situ associated with bilateral gy...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jpedsurg.2011.06.010
更新日期:2011-09-01 00:00:00
abstract:PURPOSE:Currently, animal models used for mechanical intestinal lengthening utilize a single lengthening procedure prior to analysis or restoration back into continuity. Here we developed a novel surgical model to examine the feasibility of repeated lengthening of intestinal segments. METHODS:A Roux-en-Y jejunojejunos...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2015.03.020
更新日期:2015-06-01 00:00:00
abstract::Chronic central venous catheters are an important component in the management of chronically ill infants and children. Sepsis and thrombosis are common complications of these catheters. When the combination of Candida sepsis and caval thrombosis occurs, the prognosis is very poor. Lysis of the thrombus is critical to ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(88)80345-2
更新日期:1988-12-01 00:00:00
abstract::The radical anions of molecular oxygen reduction, superoxide (O2), hydrogen peroxide (H2O2), and hydroxyl radical (OH), have been implicated in a number of disease processes, including ischemic bowel injury. This report evaluates the effect of superoxide dismutase (SOD), catalase (CAT), dimethyl sulfoxide (DMSO), sele...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(84)80361-9
更新日期:1984-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Gastric outlet obstruction (GOO) may be caused by various congenital and acquired conditions in children. The authors report 11 cases of GOO caused by muscular hypertrophy of the pylorus, which was proven histologically in 7. They describe this entity as "late-onset hypertrophic pyloric stenosis ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2010.04.014
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND/PURPOSE:The management of neonates with giant omphalocele remains challenging and multiple strategies have been described. We present the case of a 34-week-old neonate with isolated giant omphalocele managed with an external surgical skin closure system as a component of a staged closure strategy. CASE PRES...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2010.05.004
更新日期:2010-07-01 00:00:00
abstract::Congenital microgastria is an extremely uncommon dysplasic condition of the newborn stomach. With only 26 well-documented accounts of this anomaly reported in the literature, its treatment and long-term outcome have not been well elucidated. Herein, the authors report on a newborn with multiple congenital anomalies wh...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(94)90228-3
更新日期:1994-12-01 00:00:00
abstract::Fourteen patients with rectal prolapse (age range, 1 to 12 years) underwent posterior plication of the rectum for rectal prolapse. The procedure consisted of (1) natal cleft incision, (2) midline separation of the levator muscle, (3) dissection of two thirds of the circumference of the rectum, (4) plication of the pos...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(95)90692-4
更新日期:1995-05-01 00:00:00
abstract:AIM OF THE STUDY:Management of isolated intestinal perforation (IIP) poses a challenge for the pediatric surgeon. Intestinal resection and primary anastomosis is considered to be as good as the classical approach, namely, intestinal diversion by ileostomy. However, few reports compare primary anastomosis and ileostomy ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2016.02.086
更新日期:2016-08-01 00:00:00
abstract:PURPOSE:Esophageal atresia is known to be associated with a variety of additional congenital anomalies in multiple organ systems. Emphasis on cardiovascular anomalies has been focused on aortic arch and intrinsic cardiac malformations. Persistent left superior vena cava (PLSVC) is the most common venous thoracic anomal...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2005.10.094
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND/PURPOSE:Permanent hyperinsulinemic hypoglycaemia in infancy (PHHI)I is a severe disease that leads to brain damage. Since 1989, pathologists have identified 2 different forms of the disease: a diffuse form (DiPHHI) and a focal form (FoPHHI). The purpose of this study was to adapt surgical techniques in case ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2002.30241
更新日期:2002-02-01 00:00:00
abstract::Undifferentiated embryonic liver sarcoma (UELS) is a rare highly malignant neoplasm that predominantly occurs in children between 5 and 10 years of age. The typical radiologic appearance on ultrasound and computed tomography of UELS shows a large septated mass having combined cystic and solid components. These radiogr...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2011.07.006
更新日期:2011-11-01 00:00:00
abstract::The minimal hepatic mass necessary to reverse the metabolic defect of unconjugated hyperbilirubinemia in the rat model of Crigler-Najjar type I deficiency was determined using heterotopic (auxiliary) partial liver transplantation (HLT) and orthotopic liver transplantation (OLT). In HLT, the donor graft consisted of th...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(92)90850-7
更新日期:1992-03-01 00:00:00
abstract:PURPOSE:Persistent pulmonary hypertension remains a major cause of mortality and morbidity in cases of congenital diaphragmatic hernia (CDH). Recently, RhoA/Rho-kinase-mediated vasoconstriction has been reported to be important in the pathogenesis of pulmonary hypertension (PH). Several recent reports have described th...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2015.02.063
更新日期:2015-09-01 00:00:00
abstract::Pediatric, orthopedic, plastic, and hand surgeons perform the surgical correction of syndactylism. It is sometimes forgotten, however, that syndactylism can be part of a syndrome. The components of such a syndrome can each be life threatening. A 7-month-old boy was hospitalized for correction of cutaneous syndactylism...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2004.06.042
更新日期:2004-10-01 00:00:00
abstract:INTRODUCTION:The purpose of this study is to examine the scientific program of the Canadian Association of Pediatric Surgeons (CAPS) to determine if the quality of research has improved. METHODS:CAPS abstracts from 2010 to 2013 were reviewed by two independent researchers. Presentation type, study design, and level of...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jpedsurg.2015.02.045
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:The study investigates the diagnostic value of calretinin immunohistochemical staining (CIS) on rectal suction biopsies (RSB) in Hirschsprung's disease (HD). METHODS:A prospective study was conducted at Children's Hospital 2 in Ho Chi Minh City, Vietnam, from January through December 2015. Patients suspecte...
journal_title:Journal of pediatric surgery
pub_type: 临床试验,杂志文章
doi:10.1016/j.jpedsurg.2016.09.027
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND/PURPOSE:The risks of homologous transfusion and the effectiveness of predeposit autologous transfusion have been described. The authors examined the clinical usefulness of cord-blood harvesting for autologous transfusion in newborns who had congenital anomalies antenatally diagnosed that would require surgic...
journal_title:Journal of pediatric surgery
pub_type: 临床试验,杂志文章
doi:10.1053/jpsu.2001.23952
更新日期:2001-06-01 00:00:00
abstract::Extrahepatic portal hypertension was induced in rats by portal venous constriction. Portal pressures on the fourth postconstriction day were significantly elevated in PVC rats when compared to control rats. Splenoportograms showed decreased hepatic flow and venous collaterals. Histologic sections showed gastric mucosa...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(75)90363-2
更新日期:1975-10-01 00:00:00
abstract::A 13-year-old girl with multiple genitourinary malformations, incomplete bladder exstrophy, urethral duplication with single bladder, septate vagina, and total urinary incontinence is presented. Prior to admission she had undergone surgery for teratoma and calculi of the bladder and partial fecal incontinence. A conti...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(90)90534-g
更新日期:1990-12-01 00:00:00
abstract:AIM:The aim of this study was to investigate whether racial disparities in healthcare exist within a New Zealand pediatric surgical outreach service in a high indigenous Māori population. METHODOLOGY:This retrospective study assessed all pediatric surgical procedures performed within a secondary center in New Zealand ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2018.02.037
更新日期:2018-05-01 00:00:00
abstract::The ability of physicians to identify a patent processus vaginalis by laparoscopic examination of the internal ring is now well established, but the efficacy on patient outcome is not. The authors reviewed their experience to determine the effect of diagnostic laparoscopy of the internal ring on the management of chil...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(95)90562-6
更新日期:1995-02-01 00:00:00
abstract::Lipoblastoma is a rare benign mesenchymal tumor of embryonal fat that occurs almost exclusively in infants and children. Although lipoblastomas can affect any part of the body, only 5 cases affecting the scrotum have previously been reported. We present a case of an intrascrotal lipoblastoma with a novel karyotype. ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2009.10.093
更新日期:2010-01-01 00:00:00