Abstract：
INTRODUCTION:Variation in access to care has a significant impact on the disease management process and outcomes. Variable access to care might have similar effects on the management of Hirschsprung disease (HD). However, such variation has not been highlighted. MATERIALS AND METHODS:All patients referred to 3 academic centers (ACs) with HD were reviewed. Patient presentations, referral patterns, timing, and type of surgical intervention were compared between patients born in AC and those born in non-AC. Babies born with major congenital anomalies (MCAs) or total colonic HD were excluded. RESULTS:Between 1998 and 2011, 129 patients were identified. After excluding 30 patients, 99 were split into 20 inborn patients (AC) and 79 outborn patients. Outborn patients more often presented with constipation (95% vs 65%, P = .001), whereas inborn patients presented with feeding intolerance or vomiting (75% vs 39%, P = .004). Outborn patients were diagnosed and had their pull-through (PT) at an older median age (in days) of 186 (1-2621) vs 4.5 (1-451) (P = .001) and 345 (11-2757) vs 92 (3-928) (P = .001), respectively. Moreover, inborn patients were more likely to undergo primary PT (75% vs 46%, P = .02) and avoid bowel diversion (95% vs 66%, P = .02). CONCLUSION:Variation in access to care can have a significant impact on the quality of care delivery in HD. Limited access to AC is associated with staged PT in addition to delay in the diagnosis and management.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Al-Jazaeri A,Al-Shanafey S,Zamakhshary M,Al-Jarbou W,Hajr E,Breakeit M,Qutob Sdoi
10.1016/j.jpedsurg.2012.01.052subject
Has Abstractpub_date
2012-05-01 00:00:00pages
952-5issue
5eissn
0022-3468issn
1531-5037pii
S0022-3468(12)00121-2journal_volume
47pub_type
杂志文章,多中心研究abstract：:The disappearance of intraperitoneal free air after pediatric laparotomy has been the subject of much talk and speculation, but little scientific publication. Moreover, there is no unanimous opinion as to the "correct" time of disappearance of such postoperative free air. Eighty-eight pediatric surgical patients rangi...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(85)80233-5
更新日期：1985-08-01 00:00:00
abstract：:Nissen fundoplication results in closure of the tracheoesophageal fistula (TEF) without the necessity for a thoracic operation by preventing both the reflux of gastric contents into the lungs through the distal TEF, and leakage of air into the stomach of less than 30 cm H2O intrapulmonary pressure. This procedure can ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(86)80375-x
更新日期：1986-09-01 00:00:00
abstract：BACKGROUND:The purpose of this study is to characterize the epidemiology, injury patterns, outcomes and trends of non-accidental trauma (NAT) in the United States using a large national database. METHODS:Children <15 years presenting after NAT were identified in the 2007-2014 National Trauma Databank research datasets...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2019.03.024
更新日期：2020-04-01 00:00:00
abstract：BACKGROUND:Though patients with progressive familial intrahepatic cholestasis (PFIC) typically require liver transplantation, initial surgical treatment includes partial biliary diversion (PBD) to relieve jaundice-associated pruritus. This study was undertaken to describe long-term PFIC outcome data, which are currentl...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2010.02.010
更新日期：2010-05-01 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：BACKGROUND/PURPOSE:The aim of this study was to determine early prognostic indicators for the prediction of long-term survival rate and timing of the liver transplantation after the Kasai operation. METHODS:A retrospective chart study was performed on 142 patients with biliary atresia (BA). The patients were divided i...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1053/jpsu.2000.7765
更新日期：2000-07-01 00:00:00
abstract：:Eleven patients have been followed from 1 to 6 yr after diagnosis and treatment during infancy of partially obstructing antral web. Seven had surgical correction, six with web excision and pyloroplasty. Four were treated nonoperatively with antispasmodics and small curd formula. Five of the seven operated infants had ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(80)80006-6
更新日期：1980-04-01 00:00:00
abstract：BACKGROUND:Ultrasound (US) evaluation of some fetal anomalies provides limited information. Anatomic details that affect prognosis and selection for fetal therapy, such as liver herniation and pulmonary hypoplasia in congenital diaphragmatic hernia (CDH) and airway patency in giant neck masses, may be difficult to deli...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(98)90315-3
更新日期：1998-04-01 00:00:00
abstract：PURPOSE:American Pediatric Surgical Association (APSA) committees send monthly email blasts to members with links to peer-reviewed publications. This study assesses the utilization of this service. METHODS:Email-opening and click-through rates were analyzed from 5/2012 to 4/2017 and compared to APSA and industry stand...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章,评审
doi：10.1016/j.jpedsurg.2018.06.020
更新日期：2019-04-01 00:00:00
abstract：:Cardiopulmonary resuscitation (CPR) occasionally is necessary in the operating-room setting. In such instances, it may be difficult to perform CPR if the patient is in the prone position. Although the supine position is optimal for CPR, it may not be feasible because of the risks of damage to craniospinal structures. ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(94)90208-9
更新日期：1994-12-01 00:00:00
abstract：:In pediatric surgical practice, finding of the vermiform appendix in an inguinal hernia sac is not that uncommon; however, a perforation is rare. There are only a few case reports of a perforated appendix with periappendicular abscess in the inguinal hernial sac in a neonate. We report an unusual case of inguinal hern...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2007.11.031
更新日期：2008-04-01 00:00:00
abstract：:There are compelling physiologic arguments for correcting certain malformations before birth. Although fetal surgery has been successful in sheep and lower animals, it has proven difficult in primates because the gravid uterus is exquisitely sensitive to induction of preterm labor and abortion. Because the feasibility...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(82)80193-0
更新日期：1982-04-01 00:00:00
abstract：:A 13-year-old girl with multiple genitourinary malformations, incomplete bladder exstrophy, urethral duplication with single bladder, septate vagina, and total urinary incontinence is presented. Prior to admission she had undergone surgery for teratoma and calculi of the bladder and partial fecal incontinence. A conti...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(90)90534-g
更新日期：1990-12-01 00:00:00
abstract：:The development of hydrops fetalis and maternal mirror syndrome in the setting of fetal sacrococcygeal teratoma (SCT) carries a grave prognosis. Fetal surgery is not typically offered for hydropic fetuses beyond 26 weeks of gestational age. Few options exist for these families, and they are typically counseled to cont...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2008.04.010
更新日期：2008-08-01 00:00:00
abstract：BACKGROUND/PURPOSE:The role of serum gamma-glutamyl transpeptidase (GGT) levels in predicting clinical outcomes after Kasai portoenterostomy (KPE) is unknown. This study analyzed whether postoperative GGT along with the aspartate aminotransferase-to-platelet ratio index (APRi) predicted prognosis of biliary atresia (BA...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2017.10.001
更新日期：2018-03-01 00:00:00
abstract：BACKGROUND:Histopathologic findings of advanced neuroblastoma after intensive induction chemotherapy have not been studied well. METHODS:In the present study, all of the surgical specimens from 19 patients who had advanced abdominal neuroblastoma and were pretreated intensively with the protocol of the Study Group of ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(97)90467-x
更新日期：1997-11-01 00:00:00
abstract：BACKGROUND/PURPOSE:Papillary cystic neoplasms are rare pancreatic tumors that typically present in women in their third decade of life. Few cases have been reported in children. METHODS/RESULTS:The authors report on three pediatric patients: a 10-year-old boy, an 11-year-old girl, and a 14-year-old girl. The authors h...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章,评审
doi：10.1016/s0022-3468(98)90655-8
更新日期：1998-06-01 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：AIM:Inadequate androgen activity is a likely cause of cryptorchidism in humans, affecting inguinoscrotal testicular descent. Flutamide, a nonsteroidal antiandrogen, produces cryptorchidism in rats. We aimed to determine the anatomical and histologic effects of flutamide. METHODS:Time-mated Sprague-Dawley female rats w...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2009.07.072
更新日期：2009-12-01 00:00:00
abstract：BACKGROUND/PURPOSE:To date, there are hardly any data on the treatment costs of infantile short bowel syndrome (SBS), despite growing interest in evidence-based and cost-effective medicine. Therefore, the aim of the study was to evaluate resource consumption and costs, next to studying nutritional and growth outcomes, ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2009.08.009
更新日期：2010-03-01 00:00:00
abstract：:The authors discuss a case of hereditary angioneurotic edema in a child presenting with recurrent episodes of colocolic intussusception, each successfully reduced by air enema. Although additional manifestations of vasogenic edema are potential risks of the procedure, these were not encountered. ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2004.03.075
更新日期：2004-07-01 00:00:00
abstract：BACKGROUND:Advances in neonatal intensive care have improved the survival of the extremely premature infant. However, survival at less than 25 weeks' gestational age remains tenuous, with intestinal perforation presenting a significant mortality. METHODS:During an 18-month period from 1995 to 1996, nine patients weigh...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(98)90465-1
更新日期：1998-02-01 00:00:00
abstract：:The problem of diagnosis of peptic ulcer in children was analysed in a series of 50 consecutive cases. Atypical symptomatology occurred frequently and resulted in errors in diagnosis in six instances: perforated ulcer was misdiagnosed as appendicitis in five and bleeding ulcer was misdiagnosed as Meckel's diverticulit...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(86)80642-x
更新日期：1986-01-01 00:00:00
abstract：:The management of a large proboscoid umbilical hernia presents challenging problems to the surgeon. As children and parents are concerned with the appearance of the actual hernia they are also intensely interested in the postsurgical result. Presented is a simple one-stage umbilicoplasty that allows repair of the fasc...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(87)80587-0
更新日期：1987-10-01 00:00:00
abstract：PURPOSE:Pyriform sinus fistula (PSF) is very rare. It is difficult to make an accurate diagnosis preoperatively. The aim of this study is to summarize the characteristics of clinical and radiologic presentations in neonates and children with PSF and to assess which examination is more helpful for diagnosis. METHODS:A ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2017.08.006
更新日期：2017-11-01 00:00:00
abstract：INTRODUCTION:We aimed to compare and contrast these main surgical procedures for ARM in terms of structural outcome through pelvic MRI & functional outcome through Kelly's scoring. MATERIAL AND METHOD:A prospective study was conducted from August 2011 to July 2013 including all the cases of ARM managed in single stage...
journal_title：Journal of pediatric surgery
pub_type： 临床试验,杂志文章
doi：10.1016/j.jpedsurg.2015.09.003
更新日期：2016-03-01 00:00:00
abstract：:A 7.5-year-old boy was admitted to our department with left undescended testis. On surgical exploration, the vas deferens and epididymis were normal in appearance in its route to the scrotum, but no obvious testis or testis-like structure was identified. Exploration was extended to the abdominal cavity via the process...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2011.08.015
更新日期：2011-12-01 00:00:00
abstract：BACKGROUND/PURPOSE:Human immunodeficiency virus (HIV) disease is an increasingly common infection in children in sub-Sahara Africa. Rectal fistulation is one such condition with which these patients present to the paediatric surgeon. This appeared to be an exclusively female condition until 2 male patients were treated...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1053/jpsu.2003.50011
更新日期：2003-01-01 00:00:00
abstract：PURPOSE:This study reviews adrenocortical tumors in children to determine factors that significantly affect outcome. METHODS:An institutional review board-approved retrospective review from 1976 to 2005 identified 23 patients younger than 19 years old with histologic confirmation of adrenocortical carcinoma (ACC) and ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2007.12.022
更新日期：2008-05-01 00:00:00
abstract：OBJECTIVE:This study aims to evaluate the effect of bladder diverticula (BD) on bladder function using a rabbit model, based on urodynamic findings. METHODS:A total of 32 New Zealand white rabbits were randomly assigned to four groups: (1) sham surgery; (2) a single, 1-cm-diameter BD; (3) a single, large, 3-cm-diamete...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2016.02.087
更新日期：2016-09-01 00:00:00
