Abstract:
BACKGROUND:Inguinal hernia repair (IHR) is a common operation in preterm and term infants. Recently, spinal anesthesia (SA) has been proposed as an alternative to avoid exposure to general anesthesia (GA) during early life. The aim of this study was to compare surgical outcomes of open IHR performed under SA versus GA in neonates and infants, and to detect criteria to predict the success or failure of SA. MATERIALS AND METHODS:This is a 6-year, single center, nonrandomized interventional study (2013-2019). SA was performed with 0.5% bupivacaine. GA was given using propofol, fentanyl, sevoflurane, and laryngeal mask. Patient demographics, operative time, intraoperative events related to surgery or anesthesia, and complications were analyzed at short and long-term follow-up. RESULTS:68 infants (78 IHR) and 37 infants (44 IHR) received SA and GA at the discretion of the anesthesiologist, respectively. SA failure rate was 9%, and positively correlated with weight at surgery (p = 0.001; rp = 0.38). Conversion from SA to GA occurred in 4 (6%) patients owing to prolonged operative time (43.75 ± 4.8 vs 23.02 ± 11.3 min; p = 0.0006). There were no differences regarding operative time and intra- and postoperative complications among the two groups at mean follow-up of 18.53 ± 21.9 months. CONCLUSIONS:This pilot study confirms that SA is safe, effective and not detrimental to surgical outcome of neonates and infants undergoing IHR. Additionally, it may help further define what patients may have a successful SA. Our experience suggests that SA is especially suitable in infants weighing <4000 g, and conversion to GA correlates with prolonged operative time. LEVEL OF EVIDENCE:Level II.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Ceccanti S,Cervellone A,Pesce MV,Cozzi DAdoi
10.1016/j.jpedsurg.2020.09.064subject
Has Abstractpub_date
2020-10-08 00:00:00eissn
0022-3468issn
1531-5037pii
S0022-3468(20)30713-2pub_type
杂志文章abstract::The authors recently managed a case of combined pure esophageal, duodenal, biliary, and pancreatic ductal atresia in a fetus and newborn with Trisomy 21. The authors present a case report and review of the literature, emphasizing the prenatal radiographic features of the combined lesions and the high incidence of asso...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1053/jpsu.2000.6049
更新日期:2000-05-01 00:00:00
abstract:PURPOSE:We sought to compare the presentation, management, and outcomes in gastric adenocarcinoma cancer for pediatric and adult patients. METHODS:Using the 2004 to 2014 National Cancer Database (NCDB), patients ≤21 years (pediatric) were retrospectively compared to >21 years (adult). Chi-squared tests were used to co...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2019.01.048
更新日期:2019-05-01 00:00:00
abstract::Bile ducts of Luschka (also called supravesicular ducts) are small bile ducts in the gallbladder bed. Although they do not drain any liver parenchyma, they can be a source of bile leak or biliary peritonitis after cholecystectomy in both adults and children, as shown in this case report. As a reminder, variations of b...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2003.08.008
更新日期:2003-11-01 00:00:00
abstract::A three-month-old boy was referred to our facility for the treatment of a right impalpable testis, left inguinal hernia, and penoscrotal hypospadias with asymmetric external genitalia. The left gonad was palpated in the left scrotum. The chromosomal study revealed a normal male 46, XY karyotype. Operative findings sho...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2012.09.053
更新日期:2012-12-01 00:00:00
abstract::Mesenchymal hamartomas of the thorax are known as rare dysontogenetic tumorous non-neoplastic lesions. The juvenile active ossifying fibroma (JAOF) also is considered as a benign tumor like lesion of the mesenchymal connective tissue. The authors report the cases of 2 siblings-a 2-year-old girl with a hamartoma of the...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2002.35043
更新日期:2002-09-01 00:00:00
abstract::The authors report on 3-year-old-girl with neuroblastoma complicated by severe hypertension and cardiac failure. She had cardiomegaly and pleural and pericardial effusions. Echocardiogram showed left ventricular hypertrophy and decrease of the left ventricular ejection fraction to 0.36 (normal > .40). Abdominal comput...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(96)90051-2
更新日期:1996-12-01 00:00:00
abstract:BACKGROUND/PURPOSE:Although the precise pathogenesis for the destruction of the intrahepatic biliary tract in a patient with biliary atresia (BA) is still unclear, it is known that progressive destruction of the intrahepatic biliary tract is responsible for poor long-term outcome after surgical treatment. In this study...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2004.07.010
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND/AIM:Cryptorchidism, or undescended testis (UDT) occurs in 1%-4% of newborn males and leads to a risk of infertility and testicular malignancy. Recent research suggests that infertility and malignancy in UDT may be caused by abnormal development of the neonatal germ cells, or gonocytes, which normally transfo...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2019.06.023
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Congenital megacolon is eponymously named after Harold Hirschsprung, who accurately described the clinical features in 1886. Recent research revealed that this condition is perhaps well known for centuries before him. AIM:This article is intended to examine if ancient Hindu surgeons knew about congenital me...
journal_title:Journal of pediatric surgery
pub_type: 传,历史文章,杂志文章
doi:10.1016/j.jpedsurg.2011.07.007
更新日期:2011-11-01 00:00:00
abstract::There are compelling physiologic arguments for correcting certain malformations before birth. Although fetal surgery has been successful in sheep and lower animals, it has proven difficult in primates because the gravid uterus is exquisitely sensitive to induction of preterm labor and abortion. Because the feasibility...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(82)80193-0
更新日期:1982-04-01 00:00:00
abstract::Intestinal failure (IF) results from a critical reduction in the functional intestinal mass resulting in dependence on total parenteral nutrition (TPN) for growth and survival. Short bowel syndrome (SBS) is the most common cause of intestinal failure in pediatrics. Following resection, the small bowel undergoes adapta...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2013.04.011
更新日期:2013-06-01 00:00:00
abstract::Hepatic artery injuries sustained as a result of blunt abdominal trauma are rare. This case represents the first reported hepatic artery transection and the second hepatic artery injury described in children. Hepatic artery injuries are associated with high mortality, and their management is complex and controversial....
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jpedsurg.2006.05.001
更新日期:2006-09-01 00:00:00
abstract:BACKGROUND/PURPOSE:The cremaster muscles (CM) associated with undescended testis reveal neurogenic alterations that mainly affect type 2 fibers. The ultrastructure of CM has been evaluated to define if further evidence to explain the alterations could be identified. METHODS:CM of 8 boys with inguinal hernia and 8 boys...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2001.22285
更新日期:2001-04-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate whether partial hepatectomy (PH) enhances the growth of implanted intrahepatic and subcutaneous tumor and whether octreotide (OCT) can alter tumor growth. METHODS:Ninety-one ACI rats (125 g) underwent a laparotomy; 51 had a 66% PH and 40 were controls. Morris hepatoma 39...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(97)90385-7
更新日期:1997-07-01 00:00:00
abstract:BACKGROUND:Standardization of surgical instrument trays and doctor preference cards (DPC) are known to reduce the cost of adult surgical cases. The practice in pediatric surgery may be more complex owing to a wide range of patient age, leading to difficulty with practice implementation and loss of potential financial s...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jpedsurg.2020.05.010
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND/PURPOSE:To evaluate growth and development in children with anorectal malformations and to analyze effects of type of malformation and comorbidities. METHODS:Non-syndromal children with anorectal malformations were prospectively evaluated at 0.5, 1, 2, and 5 years. Biometrics were obtained at all visits. Me...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2012.09.068
更新日期:2013-04-01 00:00:00
abstract:AIM:Extrahepatic portal vein obstruction (EPVO) is a common cause of portal hypertension in children and can lead to life-threatening bleeding, thrombocytopenia, and coagulation disorders. Mesoportal bypass (MPB) restores normal physiologic portal flow to the liver and corrects portal hypertension. There is, however, l...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2009.08.019
更新日期:2010-01-01 00:00:00
abstract:PURPOSE:Ingrown toenails in children are a common problem with a high recurrence rate. The objective of this retrospective data review was to compare simple excision of the nail matrix with excision plus phenol (EPP) application in the treatment of ingrown toenails. METHODS:The charts of 69 children who underwent surg...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2004.09.051
更新日期:2005-01-01 00:00:00
abstract::Myasthenia gravis is rare in childhood. In the last 12 years, we have treated eight children under 16 years of age for this disease. There were six girls and two boys, a ratio of 3:1. Age of presentation of symptoms ranged from 10 to 16 years (mean 11 3/4). There was no significant family history and there were no sig...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(83)80354-6
更新日期:1983-10-01 00:00:00
abstract:BACKGROUND:In the intestine, Wnt proteins are powerful regulators of cell proliferation, differentiation, and adhesion. Mutations of the adenomatous polyposis coli (APC) gene elevate nuclear beta-catenin and provoke intestinal tumor formation. We sought to determine whether Wnt signaling is involved in adaptive respons...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2005.03.021
更新日期:2005-06-01 00:00:00
abstract:BACKGROUND:Adults with traumatic brain injury (TBI) who present hypertensive suffer worse outcomes and increased mortality compared to normotensive patients. The purpose of this study is to determine if age-adjusted hypertension on presentation is associated with worsened outcomes in pediatric TBI. METHODS:A retrospec...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2019.06.008
更新日期:2020-04-01 00:00:00
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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.2012.10.015
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Rhomboid excision with Limberg flap (RELF) repair has been shown to be effective in the management of pilonidal disease (PD) in adults. Wide excision allows complete removal of diseased tissue, and the rotational flap allows tensionless coverage as well as helps flatten the natal crease, which is believed to...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2008.11.033
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND/PURPOSE:Cervical cysts in neonates are recognized as rare branchial remnants. This term includes many different derivatives of the branchial cleft and sinus. METHODS:A retrospective review was performed in seven neonates with lateral cervical cysts seen at a single institution between 1975 and 1996. Two pat...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(98)90547-4
更新日期:1998-07-01 00:00:00
abstract::A 13-year-old child was admitted with abdominal pain suggesting acute appendicitis, but with some atypical findings. A computed tomography scan showed an inflamed appendix and fecalith in the central abdomen, and malrotation. These striking images both established the diagnoses and were useful in planning the operativ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2006.12.059
更新日期:2007-05-01 00:00:00
abstract:BACKGROUND/PURPOSE:Gastroesophageal reflux (GER) is increasingly reported after surgical repair of congenital diaphragmatic hernia (CDH) and eventration. The aim of this study was to test the hypothesis that transdiaphragmatic pressure gradients are increased and that the antireflux barrier is weakened after plication ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(97)90309-2
更新日期:1997-09-01 00:00:00
abstract::As a result of our experience and a review of the literature, early investigation by endoscopic retrograde cholangiopancreaticography (ERCP) and surgical intervention is recommended in chronic relapsing pancreatitis in childhood. ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(91)90905-9
更新日期:1991-02-01 00:00:00
abstract::Pilomatrixoma is a benign tumor of hair follicles that usually occurs as a single tumor and appears in the head and neck region, extremities, and trunk. The authors present a case of pilomatrixoma with multifocal localization. Simple excision of lesions is the recommended procedure, and recurrence usually is rare. ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2002.34496
更新日期:2002-08-01 00:00:00
abstract:BACKGROUND:Management of asymptomatic congenital pulmonary airway malformations remains controversial when addressing the optimal timing of surgical resection. Neonatal resection is advocated by some based on the theory that earlier lobectomy results in greater compensatory lung growth. We examined whether age at lobec...
journal_title:Journal of pediatric surgery
pub_type: 临床试验,杂志文章
doi:10.1016/j.jpedsurg.2012.01.037
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND/PURPOSE:The U.S. has an alarming rate of firearm injuries. Racial disparities among victims and predictors of outcomes are not well established. Our objective was to assess costs, length of stay (LOS), and inpatient mortality among nonfatal and fatal pediatric firearm injuries that required hospitalization. ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2020.02.021
更新日期:2020-08-01 00:00:00