Abstract:
BACKGROUND:The minimally invasive repair of pectus excavatum (MIRPE) has been widely accepted and has become a viable alternative to the open Ravitch technique. MIRPE has evolved over time with some advocating that a safe repair can be accomplished without direct visualization utilizing thoracoscopy. The MIRPE with and without a thoracoscopic approach has not been previously analyzed from a nationwide database to determine differences in safety and short-term outcomes. METHODS:The American College of Surgeons National Surgical Quality Improvement Program-Pediatric (NSQIP-P) 2012-2015 database was used in identifying patients that had MIRPE using Current Procedural Terminology (CPT) codes and ICD-9CM/ICD-10CM postoperative diagnosis codes. Outcomes of interest were readmissions, reoperations, complications, cardiothoracic injury, operative time, and duration of hospital stay after surgery for MIRPE with and without thoracoscopy. Descriptive statistics, simple and multivariable logistic regressions, Fisher's exact, and Wilcoxon rank sum test were used to determine any differences in 30-day postoperative outcomes. RESULTS:There were 1569 MIRPE cases included. 15.9% (N=249) of MIRPE were done without thoracoscopy. There were no significant differences with the use of thoracoscopy compared to without thoracoscopy in the rate of readmissions (2.5 vs 4.8%; p=0.06), reoperations (1.4 vs 2.0%; p=0.57), postoperative complications (2.6% vs 3.2%; p=0.52), and cardiothoracic injuries (0.2% vs 0.0%; p=1.00). Unadjusted odds ratios (ORs) for readmission and reoperation comparing MIRPE with thoracoscopy to MIRPE without thoracoscopy were 0.51 (p<0.05) and 0.71 (p=0.50), respectively. Adjusted ORs were 0.49 (p=0.04) and 0.71 (p=0.50), respectively. There were no reported deaths, but two cardiothoracic injuries were recorded in the group with thoracoscopy. MIRPE with thoracoscopy was associated with longer operative time (mean 13.0min; p=0.00) and longer hospital stay (mean 0.37days; p<0.01) compared to MIRPE without thoracoscopy. No data were available for the severity of the pectus defect. CONCLUSION:MIRPE has a low adverse event rate with no difference in reoperations, postoperative complications, and cardiothoracic injuries with or without the use of thoracoscopy. There may be a higher rate of readmissions in the nonthoracoscopic group. While the technique used remains the surgeon's decision, the use of thoracoscopy may be unnecessary and is at an added cost. TYPE OF STUDY:Treatment study (retrospective comparative study). LEVEL OF EVIDENCE:Level III.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Tetteh O,Rhee DS,Boss E,Alaish SM,Garcia AVdoi
10.1016/j.jpedsurg.2018.02.089subject
Has Abstractpub_date
2018-06-01 00:00:00pages
1230-1233issue
6eissn
0022-3468issn
1531-5037pii
S0022-3468(18)30174-Xjournal_volume
53pub_type
杂志文章abstract:PURPOSE:The aim of this study was to examine the feasibility, safety, and short-term outcome of complete one-stage repair of high imperforate anus in the newborn boy. METHODS:A retrospective review was conducted of five full-term male infants who underwent posterior sagittal anorectoplasty without a colostomy within t...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(99)90382-2
更新日期:1999-05-01 00:00:00
abstract::Esophageal resection or replacement has become the standard therapy for severe esophageal strictures chiefly because less aggressive methods generally have failed. We hereby report our experience with 12 consecutive infants and children who have been managed successfully by means of Stamm gastrostomy and string-guided...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(89)80529-9
更新日期:1989-08-01 00:00:00
abstract::A 4-year-old girl presented with a history and examination results suggestive of peritonitis. Exploration of abdomen was done with suspicion of enteric perforation, which showed long ileal trichobezoar with perforation of .5-cm diameter. The stomach was devoid to any fragment of bezoar. There was no history of hair ea...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(92)90352-8
更新日期:1992-04-01 00:00:00
abstract:INTRODUCTION:Intraabdominal abscesses are a common complication after appendectomy, especially in children. In this study, we describe the incidence and course of this complication in relation to the cultured pathogens found in intraabdominal abscesses. METHODS:The charts of all patients between 1 and 18 years of age ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2011.08.004
更新日期:2012-03-01 00:00:00
abstract:PURPOSE:The mode of Helicobacter pylori spread is not well defined. Urea breath test (UBT) is an accurate and noninvasive method for H pylori detection. This study evaluates the role of intrafamilial spread of H pylori using UBT. METHODS:The family members of 16 Hpylori-positive and 16 negative (control) children conf...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2000.18349
更新日期:2000-11-01 00:00:00
abstract::This is a personal account of the emergence of the British Association of Paediatric Surgeons (BAPS), one of the oldest of the specialty associations. It was formed in 1953 by like-minded professionals from around the UK, and its first meeting was held in and around the Hospital for Sick Children, London, in the summe...
journal_title:Journal of pediatric surgery
pub_type: 历史文章,杂志文章,评审
doi:10.1016/j.jpedsurg.2013.11.032
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:Children with intractable functional constipation (FC) may eventually require surgery, often guided by motility testing. However, there are no evidence-based guidelines for the surgical management of intractable FC in children. AIM:To assess the diagnostic and surgical approach of pediatric surgeons and ped...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2016.05.023
更新日期:2016-10-01 00:00:00
abstract::The presence of juvenile polyps with resulting bleeding and abdominal pain has traditionally been considered a benign, self-limiting process which would resolve with age. The dictum that these polyps were usually solitary, were found predominantly in the rectosigmoid area, and were without malignant potential has been...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(93)90162-e
更新日期:1993-09-01 00:00:00
abstract:PURPOSE:Eighteen cases of pyogenic liver abscess (PLA) admitted at JIPMER hospital, South India, over a 6-year period were analyzed to document the clinical profile and to evaluate the management of PLA among children. METHODS:Records of all these patients were reviewed for presenting signs and symptoms, any associate...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(98)90081-1
更新日期:1998-03-01 00:00:00
abstract::The authors report on two adults who had jejunal dilatation after having had resection for jejunal atresia in the neonatal period. Both patients presented 20 years after the initial procedure, with severe iron deficiency anemia, marked jejunal dilatation proximal to the old anastomotic site (which was not narrowed), a...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(94)90238-0
更新日期:1994-12-01 00:00:00
abstract::Sacrococcygeal teratoma (SCT) is being diagnosed before birth with increasing frequency. We were recently consulted about management of a 22-week fetus with SCT and reviewed our experience (6 cases) and the literature. We found that most fetal SCT present from 22 to 34 weeks gestation with a uterus enlarged by the tum...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(86)80404-3
更新日期:1986-07-01 00:00:00
abstract::This is a commentary on the manuscript by Vacek J, Davis T, and Many B, et al., titled "A Baseline Assessment of Enhanced Recovery Protocol Implementation at Pediatric Surgery Practices Performing Inflammatory Bowel Disease Surgeries". ...
journal_title:Journal of pediatric surgery
pub_type: 评论,杂志文章
doi:10.1016/j.jpedsurg.2020.06.020
更新日期:2020-10-01 00:00:00
abstract:PURPOSE:The congenital central alveolar hypoventilation syndrome (CCAHS), also known as Ondine curse, is characterized by the absence of adequate autonomic control of respiration. The purpose of our study is to review our 20-year experience with diaphragmatic pacing as a treatment modality for CCAHS. METHODS:After obt...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2007.12.013
更新日期:2008-05-01 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::Persistent Mullerian duct structures and crossed testicular ectopia were found in two phenotypically normal, unrelated males, with 46,XY karyotype, during routine herniorrhaphy. In each case, the vascular supply to the ectopic testis originated from the appropriate ipsilateral side. The clinical significance and genet...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(90)90367-i
更新日期:1990-06-01 00:00:00
abstract:BACKGROUND:The safety of the laparoscopic treatment of intestinal malrotation remains controversial. This study compared the outcomes of laparoscopic and open surgical treatment of intestinal malrotation. METHODS:A multicentric retrospective study included pediatric cases of intestinal malrotation operated on between ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2020.08.014
更新日期:2020-12-01 00:00:00
abstract::The prime goal in the management of infants with short gut syndrome is the smooth transition from total parenteral alimentation to total gastrointestinal alimentation. Such transition is dependent upon early feeding to actively promote the intestinal mucosal hyperplasia that is the key to eventual oral alimentation. A...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(81)80678-1
更新日期:1981-06-01 00:00:00
abstract:BACKGROUND:Laparoscopic techniques have been applied to restorative proctocolectomy since the early 2000's. We have employed a technique for laparoscopic-assisted total proctocolectomy (TPC) and ileal pouch anal anastomosis (IPAA) for the treatment of children with ulcerative colitis (UC). METHODS:We retrospectively r...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2012.08.031
更新日期:2013-07-01 00:00:00
abstract::A 10-year-old boy presented with features of Cushing's syndrome. Investigations, including ultrasound scan and computed tomography scans, demonstrated a right adrenal tumor. The tumor was excised and histologically found to be an encapsulated adrenal adenoma. Surgical excision is the treatment of choice for adrenal tu...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/s0022-3468(98)90335-9
更新日期:1998-04-01 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::A 7 and one-half yr-old girl developed bacteremia from S. marcescens following debanding of the pulmonary artery and closure of multiple ventricular septal defects with a Dacron patch and multiple Teflon pledgets. The site of entry was probably a radial arterial catheter left in place for 8 days. Infection was eradica...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/s0022-3468(75)80098-4
更新日期:1975-12-01 00:00:00
abstract:PURPOSE:To assess the diagnostic accuracy of limited abdominal ultrasound (US) examination for midgut volvulus (MGV) and to evaluate how clinical practice has changed in a free-standing children's hospital leading to the near obsolescence of upper GI (UGI) studies for the diagnosis of MGV. MATERIALS AND METHODS:All pa...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2020.04.012
更新日期:2020-12-01 00:00:00
abstract:INTRODUCTION:When creating a continent catheterizable channel (CCC) the choice of bowel segment used as the conduit should be tempered with the morbidity associated with it. The split-appendix technique allows the creation of both a urinary and fecal CCC without the need for a bowel anastomosis. However, there is conce...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2020.11.002
更新日期:2020-11-13 00:00:00
abstract:PURPOSE:The aim of this study was to report the clinical presentation, mode of diagnosis, and treatment of patients with anterior urethral valves (AUV), a rare congenital anomaly causing infravesical obstruction in children. METHODS:Three patients with anterior urethral valves were admitted in the Pediatric Urology Un...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2000.0350556
更新日期:2000-04-01 00:00:00
abstract::This report is of a 2-month-old child with spontaneous perforation of the common bile duct diagnosed by 99m-Tc disofenin nuclear hepatobiliary imaging. Of the agents available, the radiopharmaceutical properties of this compound allow the most accurate, safe, high-resolution imaging of the hepatobiliary tree in the di...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(86)90027-8
更新日期:1986-12-01 00:00:00
abstract::Pediatric vascular injuries are rare but can be difficult to diagnose and challenging to manage. We present our experience with computed tomographic angiography in 3 pediatric patients with vascular injuries secondary to blunt trauma. Computed tomographic angiography is noninvasive, fast, rapidly available in most cen...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2007.10.063
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:Aggressive chemotherapy/radiotherapy for cancer may cause gonadal failure in young female survivors. The putative aim of ovarian tissue cryopreservation is to restore fertility by transplantation of a patient's frozen-thawed ovarian tissue or, further into the future, by in vitro maturation of frozen-thawed ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2006.12.041
更新日期:2007-05-01 00:00:00
abstract:BACKGROUND/PURPOSE:The need for transitional care has gained increased focus in the treatment of patients with congenital colorectal disorders. We aimed to acquire in-depth knowledge about the experiences of adult patients with Hirschsprung's disease (HD) and their suggestions for transitional care. METHODS:Binational...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2020.05.015
更新日期:2020-05-16 00:00:00
abstract::Controversy exists over the best method and technique of repair of oesophageal atresia and diaphragmatic hernia. Open surgical repairs have a long established history of over 60 years of experience. Set against this has been a series of successful thoracoscopic repairs of both congenital anomalies reported over the pa...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jpedsurg.2014.11.008
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:Tension gastrothorax develops when the stomach herniated through a congenital diaphragmatic defect into the thorax is massively distended by trapped air. The authors present 5 cases and discuss the diagnostic and therapeutic management. CASE REPORTS:Four children, aged 3, 4, 6, and 13 months, presented with...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2005.05.079
更新日期:2005-09-01 00:00:00