Abstract:
OBJECTIVE:Our objective was to analyze performance of noninvasive markers for significant esophageal varices in relation to outcomes of endoscopic surveillance and primary prophylaxis in biliary atresia (BA). METHODS:This was a prospective follow-up study of a national cohort of BA patients born between 1989 and 2017, including 72 consecutive patients who underwent variceal surveillance endoscopies. The risk for developing significant varices (grade ≥ 2) and variceal bleeding was compared between successful (postoperative total bilirubin ≤34 μmol/L) and failed portoenterostomy (PE) patients. AUROC analyses and Wilcoxon signed ranks test were used to assess accuracy of noninvasive measures to predict the presence of significant varices after successful PE. RESULTS:In total, 72 patients underwent 471 endoscopies during 427 follow-up years. Among 45 successful PE patients (63%), varices appeared later [at median age 1.6 (0.7-14) vs. 0.8 (0.4-1.9) years] and bled less often [7% vs. 41%, p < 0.001 for both] than after failed PE. Liver biochemistry, stiffness, and predictive scores showed poor accuracy for the presence of significant varices. After failed PE, lowered plasma albumin concentration predicted varices with an AUROC of 0.69 (95% CI 0.52-0.85, p = 0.030). After successful PE the varices prediction rule with AUROC 0.72 (95% CI 0.64-0.79) was the most accurate predictor. Individual predictors showed no meaningful changes between the two consecutive endoscopies leading to discovery of varices. CONCLUSION:Accurate targeting of endoscopies based on noninvasive predictors remains difficult during primary variceal prophylaxis protocol in BA. The differing prognoses after successful and failed PE should be considered in variceal surveillance and future studies. TYPE OF STUDY:Diagnostic/prognosis study. LEVEL OF EVIDENCE:Level II.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Lampela H,Hukkinen M,Kosola S,Jahnukainen T,Pakarinen MPdoi
10.1016/j.jpedsurg.2020.06.017subject
Has Abstractpub_date
2020-12-01 00:00:00pages
2662-2667issue
12eissn
0022-3468issn
1531-5037pii
S0022-3468(20)30437-1journal_volume
55pub_type
杂志文章abstract:PURPOSE:The aim of this study was to investigate the prenatal courses and management of abdominal surgical diseases. METHODS:Of the 327 patients registered with our fetal treatment board since March 2002, 83 fetuses referred to the surgical department were enrolled for the current study. The prenatal diagnosis, sequen...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2004.08.039
更新日期:2004-12-01 00:00:00
abstract:BACKGROUND/PURPOSE:This study was performed to assess the long-term follow-up of five patients who underwent one-stage ileoendorectal pull-through with right colon onlay patch for total colonic aganglionosis (TCA) at Kaiser Permanente Medical Center. METHODS:A retrospective review of inpatient and outpatient charts an...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(97)90447-4
更新日期:1997-11-01 00:00:00
abstract:PURPOSE:To better characterize firearm violence in urban youth, the authors investigated the circumstances and outcome of shootings among youths under 17 years of age. METHODS:A retrospective case review was undertaken of all patients under 17 years of age treated for a gunshot wound at two adjoining level I Trauma Ce...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/s0022-3468(97)90375-4
更新日期:1997-07-01 00:00:00
abstract:PURPOSE:SIX2 and CITED1 are transcriptional regulators that specify self-renewing nephronic progenitor cells of the embryonic kidney. We hypothesized that SIX2, which promotes and maintains this stem cell population, and CITED1 remain active in Wilms' tumor (WT). METHODS:To evaluate expression domains and the pathogen...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2012.03.034
更新日期:2012-06-01 00:00:00
abstract::The authors report a case of neonatal neuroblastoma mimicking Altman type III sacrococcygeal teratoma. A newborn male infant delivered after a normal pregnancy was found to have an extremely large sacrococcygeal mass. Imaging studies strongly suggested Altman type III sacrococcygeal teratoma. On the 10th day after the...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2004.11.016
更新日期:2005-03-01 00:00:00
abstract::Most appendiceal carcinoids (ACs) in children present without lymph node metastasis. Lymph node metastasis is rarely present when primary tumor diameter exceeds 1 cm. We present the extraordinary case of an AC with a primary tumor diameter of 0.7 cm and infiltration of the mesentery, as well as 1 positive lymph node o...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2010.07.025
更新日期:2010-11-01 00:00:00
abstract::It is generally accepted that a circulatory disorder of the bowel during the embryonic stage of development plays an important part in the occurrence of atresias of the small bowel and colon, with the exception of the septal types of atresia. In most cases, the cause of this disorder is not known. An experimental stud...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(80)80404-0
更新日期:1980-02-01 00:00:00
abstract:BACKGROUND/PURPOSE:The purpose of this study was to review the authors' 25-year experience with redo pull-through procedures for Hirschsprung's disease including surgical technique and long-term outcome. METHODS:From 1974 to now, over 325 patients with Hirschsprung's disease have been treated at C.S. Mott Children's H...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2000.6853
更新日期:2000-06-01 00:00:00
abstract:BACKGROUND:Guidelines for evaluating the cervical spine in pediatric trauma patients recommend cervical spine CT (CSCT) when plain radiographs suggest an injury. Our objective was to compare usage of CSCT between a pediatric trauma center (PTC) and referral general emergency departments (GEDs). METHODS:Patient data fr...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2013.10.006
更新日期:2014-02-01 00:00:00
abstract::The combination of megacystis with microcolon and severe intestinal hypoperistalsis constitutes a rarely encountered syndrome in neonates. Of 16 previously reported cases, 14 have occurred in females and all but one have been fatal. Various forms of intestinal diversions have been unsuccessful. Aganglionosis has been ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(85)80122-6
更新日期:1985-06-01 00:00:00
abstract::Cytokines are immunoregulatory molecules that are important mediators of the host response to stress and infection. Infants and children undergoing major surgery are particularly at risk of developing sepsis and have altered metabolic responses to surgical stress compared to adults. We have investigated the temporal s...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(92)90553-j
更新日期:1992-08-01 00:00:00
abstract:PURPOSE:The purpose of the study is to study the natural course of undescended testes after inguinoscrotal surgery. METHODS:From 2003-2010, 24 boys were observed with 26 undescended testes after inguinoscrotal surgery; 12 had previously undergone inguinal hernia repair and 12 orchidopexy. Spontaneous descent was await...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2013.06.016
更新日期:2013-12-01 00:00:00
abstract::Loss of a retrieval line for repeated esophageal dilations for caustic esophageal stricture may result in inability to dilate these strictures. We describe a simple means for retrieving such a line once it has been removed. ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(88)80145-3
更新日期:1988-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The association of growth retardation and hypospadias is well established. Fetal testosterone secretion is under the influence of placental human chorionic gonadotropin during first 14 weeks of gestation. We hypothesized that placental insufficiency may disrupt the supply of nutrients and human c...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2007.10.046
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:The treatment of incidentally encountered asymptomatic Meckel diverticulum (MD) is controversial. We evaluated whether the macroscopic appearance correlates with clinical features, histopathological findings, future complications, and management decisions. METHODS:Patients who underwent MD resection at a si...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2015.08.066
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND/PURPOSE:Pediatric sarcomas have a poor prognosis, recur frequently, and are not effectively treated by currently available therapy. Immunotherapy is a promising treatment modality; however, to be successful, immune tolerance must be overcome. CD4+CD25+ T cells are immunosuppressive. The authors hypothesize t...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2004.02.049
更新日期:2004-06-01 00:00:00
abstract:BACKGROUND/PURPOSE:Laparoscopic Appendectomy (LA) is a safe procedure in adults resulting in shorter hospitalization and sooner return to activity. The relative merits of LA and open appendectomy (OA) are evaluated in this first prospective and randomized study in children. METHODS:A total of 129 children with appendi...
journal_title:Journal of pediatric surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1053/jpsu.2002.30841
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND/PURPOSE:The proposed benefits of laparoscopic inguinal hernia repair in the pediatric population include less postoperative pain, smaller scars, and easier access to the contralateral groin. This is countered by slightly higher recurrence rates reported in some series. These differences are attributable to v...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2011.03.022
更新日期:2011-08-01 00:00:00
abstract::Kasai operation for biliary atresia (BA) and living-related liver transplantation (LRLT) for failed Kasai cases have been performed by the same team in our hospital. Outcome of the treatment for BA in the pretransplantation and posttransplantation era in our institution were compared. As the "pre" group, 35 children f...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(97)90682-5
更新日期:1997-08-01 00:00:00
abstract::Surgical experience with 9 patients with chronic pancreatitis is reviewed. Vague, atypical abdominal pain and obstructive jaundice were the most common form of presentation. Serum amylase was elevated in less than half the patients. Ultrasound, ERCP, and operative cholangiopancreatography were the most helpful studies...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(82)80468-5
更新日期:1982-12-01 00:00:00
abstract:PURPOSE:The purpose of this study was to compare the predication accuracy of a newly described postnatally-based clinical prediction model to fetal imaging-based predictors of mortality for infants with CDH. METHODS:We performed a retrospective review of all CDH patients treated at a comprehensive fetal care center fr...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2015.10.009
更新日期:2016-01-01 00:00:00
abstract::The effect of whole bowel irrigation (WBI) with a polyethylene glycol electrolyte lavage solution (PEG-ELS; 27 children) was compared to the WBI with two electrolytic solutions: normal saline with added potassium chloride (NS; 25 children) and Ringer's injection (RI; 29 children). The PEG-ELS required less volume and ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(88)80423-8
更新日期:1988-08-01 00:00:00
abstract:BACKGROUND/PURPOSE:After surgical repair of congenital small bowel atresias, intestinal motility disorders often are observed. These may be caused by changes in the enteric nervous system (ENS) secondary to obstruction. To assess these changes, small bowel atresias were induced experimentally in chick embryos. METHODS...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2002.32267
更新日期:2002-05-01 00:00:00
abstract:BACKGROUND:Conventionally, an adult's standard of a 40-cm loop is adopted in Roux-Y hepatojejunostomy (RYHJ) in choledochal cyst (CDC) in children, irrespective of patient size. The redundant length of the jejunal limb may lead to complications. We compared the outcome of an individualized short Roux loop with the stan...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jpedsurg.2009.12.022
更新日期:2010-04-01 00:00:00
abstract::Three infants with progressive upper esophageal stenosis had bilateral vocal fold paralysis. The patients were apparently normal at birth and without neurologic abnormality. Cricopharyngeal myotomy, followed by serial dilatations, relieved esophageal stenosis and restored the swallowing function. Vocal fold mobility, ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2004.07.022
更新日期:2004-11-01 00:00:00
abstract::In gastroschisis, the eviscerated fetal bowel frequently is damaged and this results in hypoperistalsis and malabsorption. The mechanistic link that ties gastroschisis-induced intestinal damage to dysfunction may be nitric oxide (NO) and the enzyme responsible for producing it, NO synthase. Using a fetal rabbit model,...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(96)90083-4
更新日期:1996-08-01 00:00:00
abstract:BACKGROUND/PURPOSE:Diaphragmatic agenesis (DA) is a distinct clinical entity with poorer survival rate compared with patients with posterolateral diaphragmatic hernia. The large defect in DA is repaired frequently with a synthetic patch in the neonatal period. Well-known, long-term complications include recurrent herni...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2001.27937
更新日期:2001-11-01 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:BACKGROUND/PURPOSE:Considerable debate surrounds the choice of technique for the removal of esophageal coins: endoscopic extraction versus dislodgement with a Foley balloon versus dislodgement using bougienage. The "penny-pincher" (PP) technique was developed as an alternative, incorporating the main advantages of thes...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(00)90024-1
更新日期:2000-02-01 00:00:00
abstract:INTRODUCTION:Bacterial intestinal translocation plays an important role in neonatal sepsis. We aimed to elucidate the importance of such translocation in causing central line associated blood stream infection (CLABSI) in patients undergoing gastrointestinal surgery (GIS). METHODS:Using a database of pediatric patients...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2020.02.012
更新日期:2020-08-01 00:00:00