Abstract:
PURPOSE:The Malone appendicostomy, for antegrade enemas, has improved the quality of life for many children with fecal incontinence. In patients whose appendix has been removed, a neo-appendix can be created. We describe our approach and experience with this procedure as an option for surgeons managing children with fecal incontinence. METHODS:The procedure involves creating a transverse flap of cecum that receives its blood supply by a transverse mesenteric branch. This flap is then tubularized around a feeding tube. The surrounding colon is plicated around the neo-appendix to prevent leakage of stool. The tip of the flap is then anastomosed to the deepest portion of the umbilicus. We reviewed our experience with this procedure, including results and complications. IRB approval was obtained. RESULTS:Eighty patients required a neo-appendicostomy. Sixty-six patients (82%) had an anorectal malformation, four had spina bifida, and ten had other diagnoses. The reasons for not having an appendix available included: "incidental" appendectomy (34, 42.5%), use of the appendix for a Mitrofanoff procedure (20, 25%), and Ladd's procedure (5, 6%). In fifteen patients (19%) we could find no appendix and assume that it was removed previously. Following neoappendicostomy, nine patients (11%) developed a stricture, and seven patients had leakage (9%). In 2004, we modified the appendiceal-umbilical anastomosis and among these patients, only one patient (3%) developed a stricture, compared with eight patients (18%) without the modification. All seven patients with leakage were within the first forty cases. No patient in the last forty cases had a leakage. CONCLUSIONS:In patients with the potential for fecal incontinence, the appendix should be preserved. In patients without an appendix, the neo-appendicostomy is a valuable tool for fecally incontinent patients. We have found that the V-V anastomosis had a reduced rate of stricture, and the rate of leakage seems to be related to surgical experience.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Chatoorgoon K,Pena A,Lawal T,Hamrick M,Louden E,Levitt MAdoi
10.1016/j.jpedsurg.2011.03.059subject
Has Abstractpub_date
2011-06-01 00:00:00pages
1243-9issue
6eissn
0022-3468issn
1531-5037pii
S0022-3468(11)00274-0journal_volume
46pub_type
杂志文章abstract::Mesenchymal hamartoma of the liver is the second most common benign liver tumor of childhood. Ultrasonography demonstrates a cystic lesion that may be very large. Computed tomographic scan will further establish the location and its relationship to vascular anatomy. Most will be amenable to gross total resection with ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2008.09.029
更新日期:2009-02-01 00:00:00
abstract::End-to-end anastomosis has become the standard technique for repair of esophageal atresia with distal tracheoesophageal fistula. End-to-side anastomosis with ligation of the fistula in continuity has also been advocated. For over 25 years both methods have been used in this hospital. The purpose of this report is to c...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(91)90998-9
更新日期:1991-04-01 00:00:00
abstract::Rhabdomyosarcoma is the most common childhood sarcoma, whereas, primary pararectal rhabdomyosarcoma is very rare. To date, four pediatric and eight adult cases have been reported. In children, the tumor presents as a perianal polypoid mass, often initially misdiagnosed. Formerly a very lethal sarcoma, rhabdomyosarcoma...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(86)80080-x
更新日期:1986-02-01 00:00:00
abstract::Children requiring surgical intervention for pancreatic disease may be at risk long term for exocrine insufficiency and glucose intolerance. Pediatric surgeons must balance the need to perform adequate surgical resection while preserving as much normal pancreatic parenchyma as possible. Neoplasms of the middle pancrea...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2006.12.023
更新日期:2007-04-01 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::We report two cases of total colonic aganglionosis in which the ileocecal valve and right colon were preserved. The aganglionic ileal segment is removed leaving behind only a very short prececal remnant, which is anastomosed end-to-back to the remaining ileum. An ileal loop (of approximately 20 cm in length) is isolat...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(89)80401-4
更新日期:1989-05-01 00:00:00
abstract:PURPOSE:Treatment of pediatric papillary thyroid cancer (p-PTC) often follows adult guidelines, including total thyroidectomy for tumors >1cm. This study examined the association between operation type and overall survival (OS) for tumors >1cm in size in the pediatric population. METHODS:Patients ≤ 21 years of age wit...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2015.03.031
更新日期:2015-06-01 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:BACKGROUND:Perceptions toward surgical innovations are critical to the social processes that drive technology adoption. This study aims to capture attitudes of early adopter pediatric surgeons toward robotic technologies in order to clarify 1) specific features that are driving appeal, 2) limiting factors that are acti...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2014.05.017
更新日期:2014-10-01 00:00:00
abstract::Inflammatory cloacogenic polyp (ICP) is a rare lesion arising in the region of the anorectal transitional zone. It is likely caused by occult internal prolapse. Most cases reported in the literature are in the adult population. This is a report of ICP in four children. Awareness of this entity in children is important...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(95)90137-x
更新日期:1995-04-01 00:00:00
abstract::The authors report a case of neuronal intestinal dysplasia in a 6-year-old girl. The disease is characterized by hyperplastic ganglia throughout the large and small intestine, associated with severe constipation. To better understand the pathophysiology of this disease the authors investigated the histopathologic, ult...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(93)90124-4
更新日期:1993-12-01 00:00:00
abstract::Polyps of urethra as well as those in an anterior urethra in a male neonate are a rare abnormality, hence this publication. They usually present as either obstructive urinary symptoms in males or as an intralabial mass in females (Raviv G, Leibovitch I, Hanani J, et al., Hematuria and voiding disorders in children cau...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2005.07.051
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:Research in biliary atresia has been hindered by lack of a suitable animal model. Lampreys are primitive vertebrates with distinct larval and adult life cycle stages. During metamorphosis the biliary system of the larval lamprey disappears. Lamprey metamorphosis has been proposed as a model for biliary atres...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2009.10.017
更新日期:2010-01-01 00:00:00
abstract::A 4-year-old well boy was seen because of an asymptomatic left testicle undescended since birth; the testis was not palpable and the right side was normal. After an episode of left lower quadrant and left hip area pain, with some bladder symptoms and left leg limping, a work-up including a CAT scan showed a calcified ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(87)80637-1
更新日期:1987-09-01 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::Metabolic alkalosis is regarded as the "classical" electrolyte abnormality occurring with hypertrophic pyloric stenosis (HPS) but recent experience suggests that atypical electrolyte findings frequently occur and delay establishing the correct diagnosis. The records of 65 infants with HPS treated by pyloromyotomy duri...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(83)80188-2
更新日期:1983-08-01 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:BACKGROUND/PURPOSE:The aim of this study was to determine the preliminary impact of work hour regulations on pediatric surgical training. METHODS:An anonymous survey was sent to all program directors (PDs) and fellows to identify changes in pediatric surgery fellowship programs. RESULTS:Ninety-three percent of progra...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2004.09.014
更新日期:2005-01-01 00:00:00
abstract::A girl with vertically acquired HIV infection presented with a 6-month history of dyspnea and chest pain. Computed tomography of the thorax showed a heterogenous mass measuring 13 × 9 × 17 cm located in the anterior mediastinum. Complete surgical resection was accomplished with no complications. The final diagnosis wa...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2011.06.009
更新日期:2011-09-01 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:We sought to examine the long-term clinical success rates of a bowel management program (BMP) for children with severe constipation or fecal incontinence. METHODS:A single center review was conducted of children (≤18 years) enrolled in a BMP and followed in a colorectal specialty clinic (2011-2017). All patien...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2019.10.062
更新日期:2020-03-01 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::The natural history of a rare parotid tumor, the sialoblastoma (embryoma) is reported. It is a blastematous neoplasm said to recapitulate the epithelial differentiation of a gland at various stages of development. The tumor grew in a period of 5 years (from shortly after birth until it was excised) to a firm asymptoma...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(99)90338-x
更新日期:1999-12-01 00:00:00
abstract::Most appendiceal carcinoids (ACs) in children present without lymph node metastasis. Lymph node metastasis is rarely present when primary tumor diameter exceeds 1 cm. We present the extraordinary case of an AC with a primary tumor diameter of 0.7 cm and infiltration of the mesentery, as well as 1 positive lymph node o...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2010.07.025
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:Chronic infection of ingrown toenails may lead to exogenous osteomyelitis. Therefore, plain x-rays are commonly taken in children with significant inflammation. We evaluated the preoperative radiologic findings and their clinical significance, especially with regard to exogenic osteomyelitis. PATIENTS AND M...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2009.05.032
更新日期:2009-11-01 00:00:00
abstract::Cytokines are immunoregulatory molecules that are important mediators of the host response to stress and infection. Infants and children undergoing major surgery are particularly at risk of developing sepsis and have altered metabolic responses to surgical stress compared to adults. We have investigated the temporal s...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(92)90553-j
更新日期:1992-08-01 00:00:00
abstract::Irreversible ligation of the right common carotid artery and right internal jugular vein is usual in venoarterial extracorporeal membrane oxygenation (ECMO) for treatment of severe respiratory failure in neonates. Vessel ligation with ECMO may magnify risks of cerebral hemorrhage or infarction (CHI) and adversely affe...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(92)90099-s
更新日期:1992-01-01 00:00:00
abstract::Stomal prolapse is a common complication of colostomies and, if severe, may affect the timing of the definitive procedure. A simple technique for postreduction bowel fixation without stomal revision is presented. The reduced bowel is attached to the parietal peritoneum using a "U" type suture a few centimeters from th...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(85)80017-8
更新日期:1985-12-01 00:00:00
abstract:BACKGROUND:Several factors are implicated in transabdominal testicular descent, including insulinlike factor 3 (INSL3) hormone and Müllerian-inhibiting substance (MIS). A transgene insertional mutation found on chromosome 5 in the mouse, known as crsp, causes deletion of a transmembrane G protein-coupled receptor gene,...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2003.08.047
更新日期:2003-12-01 00:00:00
abstract:PURPOSE:Initial Children's Oncology Group (COG) management for Wilms' tumor (WT) consists of primary nephroureterectomy with lymph node sampling. While this provides accurate staging to define further treatment, it may result in intraoperative spill (IOS), which is associated with higher recurrence rates and therefore ...
journal_title:Journal of pediatric surgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.jpedsurg.2012.10.015
更新日期:2013-01-01 00:00:00