Abstract:
PURPOSE:The mortality rate for pediatric trauma patients cared for in adult trauma centers has been shown, by means of TRISS methodology, not to differ significantly from that of the Major Trauma Outcome Study (MTOS). The question remains, however, whether the outcome of injured children is better in a designated pediatric trauma center (DPTC). The authors' hypothesis is that outcome is better at a DPTC. METHODS:The records of 1,797 children (0 to 15 years of age) admitted to a DPTC between 1987 and 1993 were reviewed. TRISS methodology was used to calculate probability of survival for outcome comparison with the MTOS. The data also was compared with outcome in relation to the admitting Glasgow Coma Score (GCS) reported in the National Pediatric Trauma Registry (NPTR). RESULTS:The outcome of all children at this DPTC had a Z score of +1.4199 (P > .1). The Z score of children admitted because of penetrating trauma (PT, n = 460) did not differ significantly from that of the MTOS. However, the children admitted because of blunt trauma (BT, n = 1,337) had a Z score of +3.3501 (M score = .90), which is significantly better than that of the MTOS (P < .001). The BT population with an ISS of > or = 9 (n = 149) had a Z score of +2.8686 (P < .005) (M = .95). By GCS comparison, the BT group had a outcome similar to that reported in the NPTR. Head injury was the cause of death for 26 (84%) of the 31 PT deaths and 20 (83%) of the 24 BT deaths (three of the remaining four had associated severe head injury). Only 1 of 24 (4%) BT liver injuries and 5 (21%) of 24 BT splenic injuries required surgical intervention. This low incidence of liver and splenic surgical invention is similar to that reported by other DPTCs, but for children treated at adult centers the rates are 37% to 58% and 43% to 53% for liver & splenic surgical intervention, respectively. CONCLUSION:Children with BT have a significantly better outcome at a DPTC; the outcome for children with PT does not differ. Successful nonoperative treatment of blunt abdominal injuries is more likely to occur at a DPTC than at adult trauma centers "with pediatric committment." Thus, children with blunt injuries should be taken to a DPTC, when available.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Hall JR,Reyes HM,Meller JL,Loeff DS,Dembek Rdoi
10.1016/s0022-3468(96)90322-xsubject
Has Abstractpub_date
1996-01-01 00:00:00pages
72-6; discussion 76-7issue
1eissn
0022-3468issn
1531-5037pii
S0022-3468(96)90322-Xjournal_volume
31pub_type
杂志文章abstract::Tracheal agenesis is a rare and usually lethal congenital malformation of the forgut. Although some infants can be resuscitated with an intra-esophageal intubation temporarily, long-term airway management is difficult because of the collapsing airway. We report a long-term survivor with tracheal agenesis in whom a Gor...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2008.06.013
更新日期:2008-10-01 00:00:00
abstract::A model of the isolated bowel segment (IBS, Iowa Model II) was successfully created in experimental animals using a new surgical technique we developed. The IBS is completely free of its mesenteric attachment, yet its viability is preserved. The technique consists of two staged procedures: (1) initial enteropexy betwe...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(91)91036-x
更新日期:1991-12-01 00:00:00
abstract:AIM:The aim of the study was to evaluate the morbidity rate of stoma in children diagnosed with chronic intestinal pseudoobstruction (CIPO) and try to determine risk factors. MATERIAL AND METHODS:Twenty-two children (65%) of 34 referred to our center between 1988 and 2008 had a stoma. They were compared with 22 other ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jpedsurg.2010.06.022
更新日期:2010-11-01 00:00:00
abstract::Reduced-size liver transplantation has been recognized as a powerful modality in alleviating the global donor shortage in pediatric liver transplantation. We describe, for the first time, a technique for revascularizing reduced-size grafts which has not been patterned after adult revascularization techniques. This rev...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(93)90698-k
更新日期:1993-07-01 00:00:00
abstract:BACKGROUND:The inguinoscrotal stage of testicular descent is characterized by an increase in cell density and collagen fibers as the gubernaculum undergoes cell division and increases Extracellular Matrix (ECM) activity. Rats that lack the enzyme Adamts16, a known ECM proteinase, develop cryptorchidism postnatally and ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2019.12.019
更新日期:2020-09-01 00:00:00
abstract::Histopathologic alterations in the intestinal mucosa after ischemic injury have been extensively described in the literature, but these descriptions have primarily been qualitative in nature. The purpose of this study was twofold: (1) to establish parameters obtained by computerized digital image analysis that would b...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(95)90761-0
更新日期:1995-06-01 00:00:00
abstract:BACKGROUND:With the increasing number of open surgical procedures shifting to laparoscopy, laparoscopic suturing and knot tying are becoming integral parts of the skills that any laparoscopist must acquire. It is the most difficult step in laparoscopic surgery, especially in single incision pediatric endosurgery (SIPES...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpedsurg.2014.02.082
更新日期:2014-06-01 00:00:00
abstract::Histopathological study of the remnant of extrahepatic bile ducts in 40 cases of so-called uncorrectable biliary atresia, upon which we operated the last three years, has been performed. The histological findings of the remnant were classified into three types. Only two cases were found to have type 1a ducts in the po...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(77)90291-3
更新日期:1977-02-01 00:00:00
abstract:AIM:The objective of this study is to compare laparoscopy-assisted pull-through (LPT) and open pull-through (OPT) for Hirschsprung's disease with special reference to postoperative fecal continence. METHODS:Thirteen OPT patients (1991-1996) were reviewed retrospectively, and 22 LPT (1997-2002) were reviewed prospectiv...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2007.08.033
更新日期:2007-12-01 00:00:00
abstract:BACKGROUND/PURPOSE:Multisystem organ failure (MSOF) is a major cause of morbidity and mortality in the critically ill patient. Animal models of endotoxin-induced sepsis were used to develop therapeutic regimens, which thus far have failed in clinical trials. Because multiple etiologies of MSOF affect the intestine, the...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2004.11.045
更新日期:2005-03-01 00:00:00
abstract:BACKGROUND:We examine the mechanism of aortic lengthening in a novel rodent model of tissue expander stimulated lengthening of arteries (TESLA). METHODS:A rat model of TESLA was examined with a single stretch stimulus applied at the time of tissue expander insertion with evaluation of the aorta at 2, 4 and 7day time p...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2015.09.008
更新日期:2016-04-01 00:00:00
abstract:PURPOSE:Forme fruste choledochal cyst (FFCC) is a choledochal cyst that has minimal or no dilatation of the extrahepatic bile duct (EHBD) and is associated with pancreaticobiliary malunion (PBMU). The authors reviewed the long-term outcome of their patients with FFCC. METHODS:Inpatient and outpatient records of 281 pa...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2003.08.026
更新日期:2003-12-01 00:00:00
abstract::Anatomically, diaphragmatic agenesis (DA) is the most extreme form of congenital diaphragmatic defect, but clinically it has not been defined separately from Bochdalek's hernia (BH). Between 1986 and 1992, the authors treated 55 neonates who had diaphragmatic defects. Forty-eight of these cases presented within 24 hou...
journal_title:Journal of pediatric surgery
pub_type: 临床试验,杂志文章
doi:10.1016/0022-3468(95)90599-5
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:Neurodevelopmental dysfunction is one of the most disabling outcomes for congenital diaphragmatic hernia (CDH) survivors and may have a long lasting impact in adult life. AIM:To evaluate to which extent being born with CDH has an impact on the educational level and socioeconomic status as a proxy for neuroc...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2019.12.018
更新日期:2020-11-01 00:00:00
abstract::Fraternal twins with identical left-sided foramen of Morgagni hernias are described. The occurrence of this rare type of congenital diaphragmatic hernia in twins suggests that genetic factors play a role in the formation of this lesion. ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2005.01.014
更新日期:2005-04-01 00:00:00
abstract:BACKGROUND:To minimize cardiac perforation during the minimally invasive repair of pectus excavatum (MIRPE), several surgeons have suggested using a suction device to intraoperatively lift the sternum. Whether or not this technique is effective for all PE patients is not yet known. As such, our aim was to quantify the ...
journal_title:Journal of pediatric surgery
pub_type: 临床试验,杂志文章
doi:10.1016/j.jpedsurg.2017.04.016
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:Laparoscopic inguinal hernia repair techniques close the internal ring with a suture. Concern has been raised whether or not the testicular vessels are compromised with this technique. This study was undertaken to evaluate pre- and postoperative testicular perfusion and to compare it with healthy controls. ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2007.09.033
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Sclerotherapy is a commonly utilized treatment for rectal prolapse in children. This study systematically evaluates the effectiveness and complications of various sclerosing agents in treating pediatric rectal prolapse. METHODS:After protocol registration (CRD-42018088980), multiple databases were searched....
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,meta分析
doi:10.1016/j.jpedsurg.2019.01.033
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Near-infrared spectroscopy (NIRS) is a noninvasive technique for monitoring tissue oxygenation and perfusion. The aim of this study was to evaluate cerebral and splanchnic NIRS changes in CDH operated infants enrolled into the VICI trial and therefore randomized for ventilatory modalities. MATERIALS AND MET...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2015.07.021
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVE:This study sought to summarize the experience of diagnosis and treatment of tracheobronchial foreign bodies in children to effectively reduce complications and mortality. METHODS:The medical records of 1024 pediatric patients admitted to our hospital from January 1997 to September 2011 and diagnosed with cli...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2012.07.036
更新日期:2012-11-01 00:00:00
abstract::Prevention and treatment of allograft rejection remain the major issues in clinical small bowel transplantation. New strategies for manipulating immune responses using more powerful immunosuppressive agents continue to be evaluated. The fetal small bowel from BALB/c (H-2d) or C3H/He (H-2k) mice was transplanted into t...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(95)90349-6
更新日期:1995-07-01 00:00:00
abstract::Omphalopagus twins were separated in the first 48 hours of life. Preoperative evaluation did not disclose either their conjoined intestines or their conjoined biliary tract; intraoperative evaluation, including an operative cholangiogram, was required to determine if separation was possible. The intestines were divide...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(89)80598-6
更新日期:1989-09-01 00:00:00
abstract:BACKGROUND/PURPOSE:Chronic or recurring enterocolitis is a rare but perplexing complication of Hirschsprung's disease affecting especially patients with altered immune defense such as those with Down's syndrome. Sodium cromoglycate (SCG) is a nonabsorbable mast cell stabilizing agent that has been documented to be effe...
journal_title:Journal of pediatric surgery
pub_type: 临床试验,杂志文章
doi:10.1053/jpsu.2001.24732
更新日期:2001-07-01 00:00:00
abstract::Giant cavernous hemangiomas in newborns and infants can present with life-threatening complications. Although some modes of therapy are effective, there is a significant associated morbidity and mortality. The author reports two cases of complicated giant cavernous hemangiomas treated successfully with intermittent pn...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(87)80004-0
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND/PURPOSE:Little is known about the long-term psychosocial functioning of children with esophageal atresia (EA). The physical, psychological, and social functioning of children with EA was studied using standardized assessment procedures, and relations between medical and social background variables and outcom...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(99)90485-2
更新日期:1999-03-01 00:00:00
abstract::During the 15 years from 1970 to 1984, 38 infants, all with cystic fibrosis, were treated for meconium ileus at The Montreal Children's Hospital and Ste-Justine Hospital for Children. Thirteen patients (34%) had complicated meconium ileus that included 7 perforations (2 colon, 5 ileum), 4 volvulus, and 2 atresia with ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(86)80362-1
更新日期:1986-09-01 00:00:00
abstract:BACKGROUND/PURPOSE:Postoperative unplanned readmissions are costly and decrease patient satisfaction; however, little is known about this complication in pediatric surgery. The purpose of this study was to determine rates and predictors of unplanned readmission in a multi-institutional cohort of pediatric surgical pati...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2016.11.043
更新日期:2017-08-01 00:00:00
abstract::Fifty-six patients with a pathological lesion at the leadpoint of their intussusception were encountered at the Royal Children's Hospital, Melbourne, over a 16-year period. The most common lesions were Meckel's diverticula, followed by small bowel polyps, lymphosarcomas, and duplication cysts. Age at presentation was ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(90)90353-b
更新日期:1990-06-01 00:00:00
abstract:INTRODUCTION:Early elective delivery of antenatally diagnosed gastroschisis has been proposed as a strategy to minimize postnatal morbidity. This hypothesis was tested by analyzing outcome in relationship to gestational age and birth weight at delivery. METHODS:Single-center retrospective review of infants born with g...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2006.12.034
更新日期:2007-05-01 00:00:00
abstract:PURPOSE:The objective of this study is to use anorectal manometry for functional assessment of early postoperative results after corrective surgery for anorectal malformations (ARMs) in children and compare manometric observations with age-matched controls. Parents were counseled and management strategies were planned ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2010.04.012
更新日期:2010-09-01 00:00:00