Abstract:
BACKGROUND:Delaying surgery for infants with CDH until they achieve clinical stability is common practice. Stability, however, is inconsistently defined, and many infants fail to reach pre-established criteria. We sought to determine if infants undergoing surgery without meeting pre-established criteria could achieve meaningful survival. METHODS:All infants in the CAPSNet database were analyzed (2005-2010). Patients undergoing operative repair were divided into two groups based on whether they met strict (FiO2<0.40, conventional ventilation, preductal saturation >92%, no inotropes or vasodilators), or lenient (FiO2 <0.60, conventional ventilation, preductal saturation >88%, no vasodilators) criteria. Univariate analyses were performed comparing characteristics of those who survived after surgery (N=273) with those who did not (N=21). RESULTS:294 patients (85%) survived to surgery. Predictors of post-operative survival included prenatal liver position (p=0.003), preoperative oxygen requirements (p=0.008), preoperative inotropes (p<0.0001), and non-conventional ventilation (p=0.004). Infants meeting strict criteria had increased survival (99%; p<0.0001). Infants meeting lenient criteria constituted 70% of survivors. Nearly one-third of survivors met neither strict nor lenient criteria. CONCLUSIONS:Infants with CDH can achieve good survival even when criteria for pre-operative stability are not met. We suggest that all infants should be repaired even if lenient criteria for ventilatory, inotrope, or vasodilator requirements are not achieved.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Beres AL,Puligandla PS,Brindle ME,CAPSNet.doi
10.1016/j.jpedsurg.2013.02.002subject
Has Abstractpub_date
2013-05-01 00:00:00pages
919-23issue
5eissn
0022-3468issn
1531-5037pii
S0022-3468(13)00092-4journal_volume
48pub_type
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2001.24754
更新日期:2001-07-01 00:00:00
abstract:OBJECTIVES:In recent years laparoscopic fundoplication is increasingly performed in pediatric surgery. The aim of this study was to compare the long-term outcomes between open and laparoscopic Thal fundoplication in children. METHODS:This retrospective study includes children who underwent a Thal fundoplication betwee...
journal_title:Journal of pediatric surgery
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(99)90116-1
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpedsurg.2012.01.052
更新日期:2012-05-01 00:00:00
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2000.18322
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abstract:PURPOSE:The aim of this study was to investigate the structural characteristics and the expression of a group of neuropeptides in the esophagus of patients with congenital esophageal atresia and tracheoesophageal fistula (EA-TEF), as well to elucidate the roles of these neuropeptides in the pathogenesis of postoperativ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2007.03.050
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abstract:BACKGROUND/PURPOSE:We compared direct hospital costs and indirect costs to the family associated with immediate appendectomy or initial nonoperative management for perforated appendicitis in children. METHODS:From June 2009 through May 2010, 61 prospectively identified families completed a cost diary, documenting the ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2012.03.024
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章,meta分析,评审
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更新日期:2014-05-01 00:00:00
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(96)90165-7
更新日期:1996-11-01 00:00:00
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(96)90061-5
更新日期:1996-12-01 00:00:00
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2003.50082
更新日期:2003-03-01 00:00:00
abstract::There is no definitive treatment of hepatoblastoma. Except for radical resection, the prognosis of unresectable cases remains pessimistic. Therefore, the development of new anticancer drugs for this tumor is urgently needed. Using the human hepatoblastoma cell line (c-HB-3) we demonstrated that horse anti-alpha-fetopr...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(84)80107-4
更新日期:1984-10-01 00:00:00
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(88)80345-2
更新日期:1988-12-01 00:00:00
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jpedsurg.2005.07.047
更新日期:2005-11-01 00:00:00
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(97)90713-2
更新日期:1997-04-01 00:00:00
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2012.10.024
更新日期:2013-01-01 00:00:00
abstract::The surgical repair of "very high" undescended testes may bring about testicular atrophy, as a result of impaired vascular supply, whether caused unintentionally by extensive dissection, or deliberately when the Fowler-Stephens operation is employed. In this experimental study, improvement of the vascular supply by me...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(96)90239-0
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章,多中心研究
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更新日期:2014-01-01 00:00:00
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(92)90368-h
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2014.09.038
更新日期:2014-12-01 00:00:00
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(79)80268-7
更新日期:1979-12-01 00:00:00
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(94)90015-9
更新日期:1994-07-01 00:00:00
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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
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
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(97)90598-4
更新日期:1997-03-01 00:00:00
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2003.50021
更新日期:2003-01-01 00:00:00
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2007.04.012
更新日期:2007-09-01 00:00:00
abstract::Of 156 children undergoing elective inguinal herniotomy under general anesthesia, 81 also had a regional nerve block using Bupivacaine. All were treated as outpatients and recovery was assessed by postanesthetic room nurses and by interrogating the parents as to the child's behavior at home. It was concluded that the ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(80)80757-3
更新日期:1980-08-01 00:00:00