Abstract：
AIM:Buried Bumper (BB) is a complication of percutaneous endoscopic gastrostomy (PEG) that leads to tube dysfunction and major morbidity. Although many techniques have been described to manage BB, none are universally adopted, and laparotomy remains the mainstay. We introduce a novel endoscopic technique in paediatric surgery that avoids laparotomy. METHODS:A retrospective review of medical records of patients who presented with BB to Cambridge University Hospital, UK, between January 2012 and June 2018 was done. Data collected included: demographics, tube size and type, interval between insertion and diagnosis of BB, hospital stay, technique used, and postoperative complications. The technique involved using an endoscopic snare passed from inside the stomach lumen through the PEG lumen to the outside, guided if required by a stiff nylon thread if no part of the PEG was visible, grasping the PEG tube externally after cutting it short, followed by a retrograde pull to remove the buried tube via the mouth. MAIN RESULTS:Fifteen BBs were found in ten patients. Median patient age was 5.25 years (1.2-16.6). Median time between gastrostomy insertion and diagnosis of BB was 9 months (1-32). Twelve BBs were removed endoscopically with no postoperative complications. Patients had a replacement inserted through the original track and were discharged within 24 h. Two underwent laparotomies performed by surgeons unfamiliar with endoscopic technique, and one was converted to laparotomy owing to inability to transverse an encrusted and closed PEG tube lumen. CONCLUSION:Endoscopic retrograde BB removal is a safe, easy, and quick technique with minimal complications. We strongly advocate widespread adoption of the technique before considering a laparotomy. LEVEL OF EVIDENCE:Treatment study: Level IV.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Goneidy A,Malakounides G,Aslam Adoi
10.1016/j.jpedsurg.2018.10.084subject
Has Abstractpub_date
2019-02-01 00:00:00pages
263-265issue
2eissn
0022-3468issn
1531-5037pii
S0022-3468(18)30744-9journal_volume
54pub_type
杂志文章abstract：:The location anomaly of the verumontanum has not been described in the literature. We confirmed that the verumontanum was located either in the sphincteric or bulbous urethra in 61 of 477 patients with hypospadias (12.8%) through endoscopic examination and urethorgraphy. There was a patient with bilateral cryptorchidi...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(91)90157-o
更新日期：1991-07-01 00:00:00
abstract：:Intrapericardial diaphragmatic hernia is a very rare phenotype of neonatal diaphragmatic hernia which is thought to be caused by the developmental failure of the septum transversum. There have been only 10 cases reported since 1980, and among them, only 2 cases were diagnosed in fetal life. We herein report a new case...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2005.07.044
更新日期：2005-11-01 00:00:00
abstract：BACKGROUND:Single-incision laparoscopic surgery (SILS) has been successfully performed in children using 5-mm reticulating instruments. There are, however, few reports investigating the use of conventional instruments in SILS in the pediatric population. METHODS:We conducted a retrospective review of all consecutive c...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2010.08.036
更新日期：2010-12-01 00:00:00
abstract：:Translational research (TR) bridges discovery to clinical delivery. All TR also requires the development of an intervention. Classical 'bench to bedside' TR is responsible for many important advances, but cannot account for many others, which begin with clinical observations. My personal involvement in TR has ranged f...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2014.10.023
更新日期：2015-01-01 00:00:00
abstract：BACKGROUND:Serial transverse enteroplasty (STEP) lengthens and tapers dilated bowel. Redilation of the STEP segment occurs in some patients with intestinal failure. The feasibility of a repeat STEP procedure in a pig model is evaluated. METHODS:Six pigs underwent reversal of an intestinal segment distal to the ligamen...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2006.08.015
更新日期：2006-12-01 00:00:00
abstract：:Although the protracted use of total parenteral nutrition (TPN) in infants is known to predispose to cholestasis, which in certain instances may not be reversible, failure to understand the pathogenesis of this condition has hindered the development of an effective medical treatment. That surgical treatment may revers...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(85)80042-7
更新日期：1985-12-01 00:00:00
abstract：:The clinical and radiographic presentation of infants with type III posterior urethral valves help to distinguish them from patients with the more common type I valves. The diaphragmatic valvular obstruction may make catheterization impossible. Percutaneous cystography can confirm the diagnosis and allow for short-ter...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章,评审
doi：10.1016/0022-3468(94)90530-4
更新日期：1994-01-01 00:00:00
abstract：:The offspring of pregnant Sprague-Dawley rats exposed to nitrofen on gestational day 9.5 develop left-sided congenital diaphragmatic hernia (CDH). Twenty-four hours after treatment, on day 10.5, supravital staining with Nile blue sulfate and histological examination showed bilateral excessive cell death in cervical so...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(95)90589-8
更新日期：1995-02-01 00:00:00
abstract：:An electromyogram (EMG) of the external and sphincter (EAS) was obtained both before and after surgery in five patients with Hirschsprung's disease and eight normal control patients. The EMG, evoked by the transrectal stimulation of the pudendal nerve, was recorded at both the sacral and anal regions to investigate th...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(97)90084-1
更新日期：1997-01-01 00:00:00
abstract：BACKGROUND/PURPOSE:VACTERL syndrome is a common surgical condition affecting the development of many midaxial organs. The etiology, embryology, and pathogenesis of the VACTERL syndrome are not known. The authors report here new mouse models of VACTERL syndrome involving the Sonic hedgehog (Shh) signaling pathway. METH...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1053/jpsu.2001.20722
更新日期：2001-02-01 00:00:00
abstract：PURPOSE:The purpose of this study was to determine if early, acute appendicitis in children can be safely and effectively managed with antibiotics alone. METHODS:A retrospective review was performed of children (<18 yrs) treated non-operatively (NOM) for early, acute appendicitis since May 2012. These were compared to...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2014.02.071
更新日期：2014-05-01 00:00:00
abstract：:In August 1996, a 7-year-old boy was crushed from behind into the steering wheel of a go-cart, suffering a tear of his right innominate artery into the aortic arch, a 2-inch tear of the posterior trachea into left main bronchus, and 2 4-inch tears in the esophagus. These were all repaired on cardiopulmonary bypass thr...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1053/jpsu.2002.29451
更新日期：2002-01-01 00:00:00
abstract：:Esophageal polyps are rare in children, whereas colorectal juvenile polyps are common. An 11-year-old boy with an esophageal colonic interposition for an esophageal stricture secondary to caustic injury was found to have a polypoid mass in the interposed colon. Fiberoptic endoscopic removal with diathermy was performe...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(98)90024-0
更新日期：1998-09-01 00:00:00
abstract：:The most common site of teratomas in neonates is in the sacrococcygeal region. Herein the authors describe a congenital teratoma, and to their knowledge it is the first reported case of vulvar site in a newborn. Tumor was removed on the fourth day of life, and she was completely normal 18 months after the operation. B...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1053/jpsu.2001.22302
更新日期：2001-04-01 00:00:00
abstract：:During the last 5 years, over 1,500 minor lacerations in children were treated in the emergency room of Nahariya Regional Hospital, by the adhesive "Hystoacryl Blue," with gratifying results. The method, its advantages, and special precautions are described. ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(88)80195-7
更新日期：1988-04-01 00:00:00
abstract：BACKGROUND:Orthotopic liver transplantation (OLT) is the only treatment option for unresectable hepatoblastoma (HB) and hepatocellular carcinoma (HCC) in children. Aggregated outcomes of OLT for these hepatic malignancies have not been evaluated in the United Network for Organ Sharing national database. PURPOSE:The pu...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2005.10.091
更新日期：2006-01-01 00:00:00
abstract：:The purpose of this study was to evaluate the significance and direction of shunts at the level of the foramen ovale or ductus arteriosus in full-term newborns with neonatal respiratory failure who were placed on extracorporeal membrane oxygenation (ECMO). A decrease in left ventricular dimension was expected when inf...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(89)80581-0
更新日期：1989-09-01 00:00:00
abstract：:A choledochopancreatic end-to-side ductal anastomosis was successfully performed in 40 puppies as an experimental animal model of choledochopancreatic elongated common channel disorders. Follow-up periods were up to 1 year after surgery. Fusiform dilatation was developed in all puppies. The dilatation was completed wi...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(84)80439-x
更新日期：1984-04-01 00:00:00
abstract：BACKGROUND/PURPOSE:Nitric oxide (NO) is an important cell-signaling molecule, and its generators, nitric oxide synthases, are expressed temporospatially in fetal rat lung. Recently, NO has been reported to modulate branching of the fetal rat lung lobe in vitro. We designed this study to evaluate the effect of NO on the...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2004.09.007
更新日期：2005-01-01 00:00:00
abstract：:From 1964 to 1985 inclusive, gastric tubes have been constructed in 36 infants and children to replace a congenitally defective esophagus or an esophagus with acquired irreparable damage. This report reviews our entire series to date covering a 21-year experience. There were 24 boys and 12 girls ranging in age from 3 ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(87)80021-0
更新日期：1987-01-01 00:00:00
abstract：INTRODUCTION:Necrotizing enterocolitis (NEC) has been a long-recognized complication of prematurity, but there is a paucity of studies on term infants. We sought to characterize the clinical presentation and outcomes of full term (FT) infants with NEC and compare these to our experience with preterm (PT) neonates. MET...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2019.02.046
更新日期：2019-06-01 00:00:00
abstract：PURPOSE:To identify factors associated with firearm injury (FI) and willingness to enroll in a violence intervention program amongst pediatric victims of violence. METHODS:Cross-sectional study of victims of violence age 6-19 years presenting to a children's hospital emergency department from 2014 to 2017. Participant...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2020.06.025
更新日期：2020-06-24 00:00:00
abstract：:In some children, contrast radiography and endoscopy fail to confirm suspected Crohn's disease, or fail to evaluate the extent of disease. This report documents seven cases in which laparoscopy was used to look for creeping mesenteric fat involving the small intestine, a pathological finding reported only for Crohn's ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(96)90150-5
更新日期：1996-06-01 00:00:00
abstract：:The benefit of extracorporeal membrane oxygenation (ECMO) in cases of high-risk congenital diaphragmatic hernia (CDH) was studied by comparing pre-ECMO (1987-1990) and post-ECMO (1991-1994) 3-month survival statistics. Fifty-five CDH patients who presented in respiratory distress within 6 hours after birth were referr...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(95)90408-5
更新日期：1995-10-01 00:00:00
abstract：:Percutaneous aspiration and tetracycline sclerosis is a safe but temporary therapy of large splenic cysts in children. Between 1985 and 1987, three girls with splenic cysts were seen. Their ages ranged from 5 to 14 years, and the cysts were from 8 to 16 cm in diameter. Despite their large size, all were asymptomatic a...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(89)80711-0
更新日期：1989-07-01 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：BACKGROUND/PURPOSE:The management of patients with a giant omphalocele remains a difficult problem. In this study, the authors described a new surgical approach for delayed closure of ventral hernia--the Lazaro da Silva's technique--in conservatively treated patients. METHODS:Ventral hernias of 11 conservatively treat...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2004.03.064
更新日期：2004-07-01 00:00:00
abstract：BACKGROUND:Recently, concerns have been raised over delays that result from transferring patients to designated trauma centers. This study aimed to assess whether transfer status had an impact on pediatric trauma outcomes. METHODS:Using a local 1996-2014 pediatric trauma database containing 1541 patients, the followin...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2016.02.035
更新日期：2016-05-01 00:00:00
abstract：PURPOSE:To present the long-term outcomes of appendicovesicostomy using the Mitrofanoff principle for end-stage Wolfram bladder dysfunction as an alternative to clean intermittent self-catheterization (CIC) per urethra mainly following blindness. METHODS:Twelve Wolfram patients presenting with bilateral hydroureterone...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2014.09.058
更新日期：2015-07-01 00:00:00
abstract：BACKGROUND/PURPOSE:The training of general surgeons in pediatric surgery is an important educational role of pediatric surgeons (PS). The authored surveyed this training process and the related expectations and perceptions of competence. METHODS:The authors surveyed all practicing members of the Canadian Association o...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1053/jpsu.2001.22941
更新日期：2001-05-01 00:00:00
