Abstract:
AIM OF THE STUDY:Management of isolated intestinal perforation (IIP) poses a challenge for the pediatric surgeon. Intestinal resection and primary anastomosis is considered to be as good as the classical approach, namely, intestinal diversion by ileostomy. However, few reports compare primary anastomosis and ileostomy as IIP treatment. In our institution we favored primary anastomosis as first line treatment whenever patient's condition permitted. Our purpose is to retrospectively compare the outcomes of preterm infants treated with primary anastomosis or ileostomy during a laparotomy in which an IIP was found. METHOD:We identified all newborns who had abdominal operations for IIP from 2000 through 2013. Patients with extensive necrotizing entorocolitis and comorbidities were excluded, as well as those who died in the first 24h. Demographics, type of treatment and complications were reviewed. Major complications included the need for an urgent reoperation, development of late NEC and death. RESULTS:Twenty-three patients with a median gestational age (GA) of 27weeks and median birth weight (BW) of 883g had receive two types of treatment: group I included 9 patients who had intestinal resection of the affected bowel and ileostomy; group PA consisted of 14 patients who had intestinal resection and primary anastomosis. The decision to perform PA or I was based on the surgeon's judgment, in the absence of a specific protocol. There were no significant differences in GA and BW between both groups. Overall mortality was 30.4%. However mortality was restricted to group PA (n=7 cases; 50%) (p=0.019). Most major complications occurred in group PA (71% vs. 11%, p=0.029). There were six cases of late NEC, all in group PA (p=0.048), and four of those patients died. Other than the type of treatment, no differences could be identified between both groups. CONCLUSION:Preterm newborns with IIP are at a higher risk for developing life-threatening complications if treated with primary anastomosis than with ileostomy.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
de Haro Jorge I,Prat Ortells J,Albert Cazalla A,Muñoz Fernández E,Castañón García-Alix Mdoi
10.1016/j.jpedsurg.2016.02.086subject
Has Abstractpub_date
2016-08-01 00:00:00pages
1251-4issue
8eissn
0022-3468issn
1531-5037pii
S0022-3468(16)00197-4journal_volume
51pub_type
杂志文章abstract:BACKGROUND/PURPOSE:Asphyxiating thoracic dystrophy (ATD) can occur years after a Ravitch-type repair of pectus excavatum, resulting in debilitating alteration in pulmonary function (PFT). An operation was devised to attempt repair of this deformity. METHODS:After institutional review board approval, the records of 10 ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2004.09.039
更新日期:2005-01-01 00:00:00
abstract::In order to examine surgical factors predictive of fatal outcome in patients presenting with histologically verified rhabdomyosarcoma of the urinary bladder, we performed a retrospective analysis of cases presenting between the years 1970 and 1985 and treated by protocol. Twenty-five patients were identified and data ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(90)90220-4
更新日期:1990-10-01 00:00:00
abstract:PURPOSE:The commonly cited ages at presentation of many pediatric conditions have been based largely on single center or outdated epidemiologic evidence. Thus, we sought to examine the ages at presentation of common pediatric surgical conditions using cases from large national databases. METHODS:A retrospective analys...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpedsurg.2014.01.039
更新日期:2014-06-01 00:00:00
abstract:PURPOSE:The aim of this study was to elucidate the urodynamic features of patients with Y-type urethral duplication. METHODS:Patients with Y-type urethral duplication were retrospectively analyzed. Clinical presentation, urodynamic findings, surgical methods, and treatment outcomes were reviewed. RESULTS:From 2014 to...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2017.06.001
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Hyperparathyroidism (HPT) in children is rare and surgical management is supported only by limited evidence. METHODS:Retrospective case series of all children under the age of 16 years who underwent parathyroidectomy (PTx) between 1978 and 2012. RESULTS:We identified 29 children who had surgery for HPT. Si...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2014.05.032
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND/PURPOSE:Haddad syndrome (HS) is a very rare disease considered a form of neurocristopathy. It is characterized by a combination of congenital central hypoventilation syndrome (CCHS) and Hirschsprung's disease (HD). We report the clinical features and disease progression of HS to provide better care for HS pa...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2019.01.066
更新日期:2020-03-01 00:00:00
abstract::New techniques of 2-D sonography and radionucleotide Disofenin scanning allowed noninvasive evaluation of thoracoomphalopagus Siamese twins and successful separation at four days of age. Twin girls joined at the lower sternum and upper abdomen and weighing 15 lbs, were transferred at five hours of age after caesarian-...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(83)80184-5
更新日期:1983-08-01 00:00:00
abstract:BACKGROUND/PURPOSE:Monocarboxylate transporters (MCTs) are crucial for the maintenance of intracellular pH homeostasis in developing fetal lungs. MCT1/4 is strongly expressed by epithelial airway cells throughout lung branching morphogenesis. Functional inhibition of MCT1/4 in fetal rat lung explants has been shown to ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2016.02.050
更新日期:2016-06-01 00:00:00
abstract::Every year in the United States, 1.6 to 3.8 million concussions occur secondary to injuries sustained during sports and recreational activities. Major advances have been made in terms of identifying specific clinical profiles following concussion. Nevertheless, there are continued misunderstandings regarding this inju...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2016.10.011
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND/PURPOSE:Necrotizing enterocolitis (NEC) represents one of the gravest complications in premature infants and carries significant morbidity and mortality. There is a great need for improved diagnostic methods to reduce the severity and incidence of NEC. The aim of the study was to investigate if intraluminal ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2012.03.086
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND/PURPOSE:Currently, the reason for hepatobiliary dysfunction associated with long-term total parenteral nutrition (TPN) is much debated and still unclear. No agreement can be achieved about whether bacteriotoxins and sepsis, enteral starvation, consequences of abdominal operations, or the TPN solution itself ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(98)90189-0
更新日期:1998-05-01 00:00:00
abstract:BACKGROUND:Single visit surgery (SVS) consists of same-day pre-operative assessment and operation with telephone post-operative follow-up. This reduces family time commitment to 1 hospital trip rather than 2-3. We began SVS for ambulatory patients with clear surgical indications in 2013. We sought to determine family s...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2017.10.021
更新日期:2017-10-10 00:00:00
abstract::Undifferentiated embryonic liver sarcoma (UELS) is a rare highly malignant neoplasm that predominantly occurs in children between 5 and 10 years of age. The typical radiologic appearance on ultrasound and computed tomography of UELS shows a large septated mass having combined cystic and solid components. These radiogr...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2011.07.006
更新日期:2011-11-01 00:00:00
abstract::Thromboembolic events in the pediatric age group occur most commonly in neonates, and newborns of diabetic mothers are particularly at risk. We report a newborn with right renal vein and inferior vena cava thrombosis who apparently embolized across the foramen ovale antenatally with resultant right brachial artery occ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(91)90024-n
更新日期:1991-06-01 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
abstract:OBJECTIVE:In children, the diagnosis “acute appendicitis” is difficult. In 2010, a new Dutch appendicitis guideline was published with the goal to reduce the negative appendectomy rate. The guideline recommended mandatory imaging (ultrasound first and CT or MRI when inconclusive) before surgery. This study examines whe...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2018.02.050
更新日期:2018-10-01 00:00:00
abstract:PURPOSE:Functional bowel outcome in patients with anorectal malformation often is poor. For fecal incontinence resulting from sphincter dysfunction, biofeedback (BFB) training appears to be effective. The aim of study was to investigate the bowel function in incontinent children treated for ARM, using a clinical score,...
journal_title:Journal of pediatric surgery
pub_type: 临床试验,杂志文章
doi:10.1016/j.jpedsurg.2015.03.068
更新日期:2015-10-01 00:00:00
abstract:PURPOSE:The aim of this study was to identify and qualify the ethical dilemmas faced by pediatric surgery trainees. METHODS:An online survey was sent to pediatric surgery trainees graduating between 2005 and 2008. Consent was obtained, and study investigators were blinded to the identity of the respondents during data...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2008.02.016
更新日期:2008-06-01 00:00:00
abstract:BACKGROUND:The continually rising incidence of soft tissue abscesses in children has prompted us to seek an alternative to the traditional open incision and drainage (I&D) that would minimize the pain associated with packing during dressing changes and eliminate the need for home nursing care. STUDY DESIGN:A retrospec...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2010.08.019
更新日期:2011-03-01 00:00:00
abstract:BACKGROUND:Regarding the complications associated with short bowel syndrome (SBS), progressive liver failure is one of the most severe complications known to occur: Although several studies have suggested that many factors interactively influence this clinical condition we investigated the relationship between hepatic ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2005.06.037
更新日期:2005-10-01 00:00:00
abstract::The records of 207 patients evaluated and treated for breast abnormalities during a 10-yr period were reviewed. Patients ranged in age from 1 wk through 16 yr. Seventy-eight per cent were female. Operative procedures were performed in 134 patients (64%). Most common diagnoses were fibroadenoma, premature thelarche, an...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(76)80187-x
更新日期:1976-06-01 00:00:00
abstract:BACKGROUND/PURPOSE:The aim of this study was to review the authors' surgical experience in pediatric pulmonary hydatid disease focusing on clinical presentation, parenchyma saving operations, and long-term results. METHODS:One hundred twenty-two children with pulmonary hydatid cyst were treated surgically over the las...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2000.19219
更新日期:2000-12-01 00:00:00
abstract::A lateral pancreaticojejunostomy (LPJ), also known as the Puestow procedure, is a complex procedure performed for chronic pancreatitis when the pancreatic duct is dilated and unable to drain properly. Traditionally, these procedures are performed with open surgery. A minimally invasive approach to the LPJ using rigid ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2011.03.003
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND/PURPOSE:Trauma centers (TC) are certified based on widely accepted criteria. These specific criteria rarely are scrutinized individually. The purpose of this study was to analyze the individual components of a pediatric trauma center for their effect on outcome. METHODS:Members of the National Pediatric Tra...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/s0022-3468(99)90392-5
更新日期:1999-05-01 00:00:00
abstract::In 1976, we presented our experience in the surgical management of patients with peripheral congenital arteriovenous fistulae (CAVF). This report updates our experience and specifically describes subsequent experience with intraarterial embolization therapy. Twenty-six infants and children with CAVFs have been treated...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(05)80098-3
更新日期:1992-06-01 00:00:00
abstract:PURPOSE:It has been suggested that routine division of short gastric vessels (SGVs) results in a more "floppy" Nissen fundoplication leading to improved outcomes, that is, less dysphagia and lower incidences of recurrent gastroesophageal reflux disease (GERD). The aim of this retrospective study was to assess whether l...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2005.10.016
更新日期:2006-01-01 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::Most babies born with congenital diaphragmatic hernia (CDH) die after birth. The natural course of CDH in the human fetus is not known. We found 94 cases of fetal CDH in the records of surgeons and obstetricians surveyed in the United States and Canada. We found the following: (1) prenatal diagnosis of CDH is accurate...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(85)80219-0
更新日期:1985-08-01 00:00:00
abstract:BACKGROUND/PURPOSE:The aim of this study was to review evidence-based literature addressing pertinent questions about venous thromboembolism (VTE) after traumatic injury in children. METHODS:Data were obtained from English-language articles identified through Pubmed published from 1995 until November 2012, and from bi...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jpedsurg.2013.02.059
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:The impact of perioperative care interventions on postreconstructive complications and short-term colorectal outcome in patients with anorectal malformation (ARM) type rectovestibular fistula is unknown. METHODS:An ARM-Net consortium multicenter retrospective cohort study was performed including 165 patient...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpedsurg.2019.03.008
更新日期:2019-08-01 00:00:00