Abstract：
BACKGROUND/PURPOSE:Ongoing debate surrounds the future provision of general paediatric surgery. The aim of this study was to compare outcomes for childhood appendicitis managed in a district general hospital (DGH) and a regional paediatric surgical unit (RU). METHODS:Data collected retrospectively for a 2-year period in a DGH were compared with data collected prospectively for 1 year in an RU, where appendicitis management is guided by a care pathway. Children aged 6 to 15 years were included. RESULTS:Four hundred and two patients were included (DGH ,196; RU, 206). There were more cases of gangrenous/perforated appendicitis in the RU (P < .0001). In the DGH, fewer patients received preoperative antibiotics (P < .0001) or underwent preoperative pain scoring (P < .0001). When adjusted for case mix, the relative risk of complications for a child managed at the DGH was 1.76 (95% confidence interval, 1.44-2.16; P < .0001) and that of readmission was 1.76 (95% confidence interval, 1.43-2.16; P < .0001) when compared with the RU. CONCLUSIONS:Patients with appendicitis managed in the DGH had a higher risk of complications and readmission. However, this appears to be related to the use of a care pathway at the RU. Introduction of a care pathway in the DGH may improve outcomes and thus support the ongoing provision of general paediatric surgery.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Collins HL,Almond SL,Thompson B,Lacy D,Greaney M,Baillie CT,Kenny SEdoi
10.1016/j.jpedsurg.2009.10.079subject
Has Abstractpub_date
2010-02-01 00:00:00pages
300-2issue
2eissn
0022-3468issn
1531-5037pii
S0022-3468(09)00878-1journal_volume
45pub_type
杂志文章abstract：:Persistence and dilation of the embryologic thyroglossal tract gives rise to the condition of thyroglossal duct cyst. Although these cysts have an embryologic origin, there is rarely a history of inheritance. A search of the literature shows only two family reports, which includes a total of nine patients. We report o...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(91)90420-x
更新日期：1991-01-01 00:00:00
abstract：BACKGROUND:The main aim of the present study was to investigate how fecal incontinence might influence different aspects of quality of life (QOL) in children and adolescents with anorectal malformations (ARMs). We considered both the influence of fecal incontinence at time 1 of the study and the influence of fecal inco...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2012.01.068
更新日期：2012-07-01 00:00:00
abstract：PURPOSE:Pulmonary hypoplasia remains the principal cause of high morbidity and mortality in patients with congenital diaphragmatic hernia (CDH). The precise mechanisms causing lung hypoplasia remains unclear. Aquaporins (AQPs) are reported to constitute a family of water channels that facilitate membrane water permeabi...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2006.10.029
更新日期：2007-02-01 00:00:00
abstract：:A lateral skin-flap perineoplasty has been used in 15 patients born with an absent anal canal. The aim behind the introduction of this modification was the prevention of mucosal prolapse. On early assessment, this has been achieved in 11 of the cases. This represents a 50% improvement on our previous results. ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(84)80108-6
更新日期：1984-10-01 00:00:00
abstract：PURPOSE:Ionizing radiation is used for the insertion of surgically implanted venous access devices (SIVADs) with children at the highest risk of cumulative radiation effects from these procedures. This study examines the radiation dose in a pediatric population during intraoperative radiological screening. METHODS:A r...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章,评审
doi：10.1016/j.jpedsurg.2015.04.017
更新日期：2015-07-01 00:00:00
abstract：:Left-sided colonic obstruction in the neonate traditionally is managed with a multistaged defunctioning colostomy and resection. In adults, one-stage primary anastomosis has become increasingly popular with the use of on-table antegrade colonic lavage. In infants, and especially in premature neonates, enterostomies po...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1053/jpsu.2002.36205
更新日期：2002-11-01 00:00:00
abstract：BACKGROUND:If creating an obstructive uropathy early in glomerulogenesis produces MCDK (Multicystic Dysplastic Kidney), then a very early obstruction may produce Potter's Syndrome (PS) with oligohydramnios. METHODS:Fetal lambs at 50 days' gestation underwent urethral and urachal ligation using fine SILASTIC (Dow Corni...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1053/jpsu.2000.18305
更新日期：2000-11-01 00:00:00
abstract：BACKGROUND:Necrotizing enterocolitis (NEC) is classically a disease of prematurity, with less reported regarding morbidity and mortality of this disease among other infants. METHODS:Data were prospectively collected from 2009 to 2015 at 252 Vermont Oxford Network member centers on neonates with birth weight>2500g admi...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2017.10.028
更新日期：2017-10-12 00:00:00
abstract：BACKGROUND:Hirschsprung disease (HSCR, Online Mendelian Inheritance in Man 142623) is a typical developmental disorder of the enteric nervous system in which ganglion cells fail to innervate the lower gastrointestinal tract during embryonic development. SOX10 gene is involved in the normal development of the enteric ne...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2011.05.017
更新日期：2011-10-01 00:00:00
abstract：:The authors describe the case of an inhaled foreign body unusually located in the pericardium. An initial chest skiagram was misinterpreted leading to a negative bronchoscopy. Correct anatomic localization of the foreign body only was established at surgical exploration, despite preoperative computerized tomography sc...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1053/jpsu.2001.23980
更新日期：2001-06-01 00:00:00
abstract：:Thirty-nine children and adolescents with a solitary nodule of the thyroid gland were seen over a 16-yr period and 35 had their nodules removed surgically. All of the patients had preoperative thyroid scintiscans, of which 27 showed a cold nodule. The most common cause of solitary thyroid nodules was follicular adenom...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(82)80001-8
更新日期：1982-06-01 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:Multiple endocrine neoplasia 2A (MEN 2A) is a genetic syndrome manifesting as medullary thyroid carcinoma (MTC), hyperparathyroidism, and pheochromocytoma. Multiple endocrine neoplasia 2A results from mutations in the RET proto-oncogene. Hirschsprung disease (HSCR) is a rare manifestation of MEN 2A and has b...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2007.09.043
更新日期：2008-01-01 00:00:00
abstract：BACKGROUND/PURPOSE:Understanding the true nature of the disease provided the basis for appropriate surgery for Hirschsprung's disease some 60 years ago. Nevertheless, surgical outcome remains unsatisfactory. Advances in diagnosis and treatment will depend on the elucidation of the pathogenesis and disease heterogeneity...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章,评审
doi：10.1016/j.jpedsurg.2015.10.021
更新日期：2016-01-01 00:00:00
abstract：BACKGROUND/AIM:Nitrofen induces heart hypoplasia together with congenital diaphragmatic hernia (CDH) in rats. Intracellular oxidative stress might be one of the mechanisms of action of the teratogen, and vitamin A has been shown to reverse in part these effects when administered simultaneously or shortly after it. This...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2005.05.009
更新日期：2005-08-01 00:00:00
abstract：PURPOSE:Safety profile of different gastrostomy procedures in small children has not been well studied. This study was conducted to investigate whether complication and mortality rates differ between surgical gastrostomy (G-tube) and percutaneous endoscopic gastrostomy (PEG) in infants and neonates. METHODS:In this re...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2017.01.008
更新日期：2017-09-01 00:00:00
abstract：:This report describes the surgical management of 2 children with fusiform choledochal cysts who had accessory hepatic ducts (AHD) identified during excisional surgery for fusiform choledochal cysts (CC). Two children presenting with a triad of recurrent jaundice, fever, and abdominal pain were investigated and found t...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1053/jpsu.2001.24767
更新日期：2001-07-01 00:00:00
abstract：PURPOSE:Urologic complications are an underappreciated sequelae of the mass effect of sacrococcygeal teratoma (SCT) and its resection. The goal of this study was to evaluate the incidence and severity of urologic complications in patients with SCT. METHODS:A retrospective review of patients with a prenatal diagnosis o...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2011.03.045
更新日期：2011-06-01 00:00:00
abstract：:A choledochocele (type 3 choledochal cyst) is rarely observed in children. A 6-year-old boy experienced abdominal pain approximately 6 times in the previous 5 months. Magnetic resonance cholangiopancreatography findings revealed a small cyst in the distal common bile duct. An endoscopic examination was performed, and ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2009.03.042
更新日期：2009-08-01 00:00:00
abstract：:The embryological development of the hepatobiliary bud presupposes that biliary and duodenal malformations are often associated. On the other hand, the association of biliary atresia with more distal small bowel malformations, possibly due to a vascular accident, seems to be fortuitous. We herewith report such a case ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(83)80534-x
更新日期：1983-04-01 00:00:00
abstract：:Cervical teratomas are uncommon lesions usually diagnosed at birth but occasionally reported in older children and adults. During a 58-year span, nine cervical teratomas were identified at our institution (four previously reported): three stillborns with giant tumors; five live newborns; and one adult with a malignant...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章,评审
doi：10.1016/s0022-3468(88)80373-7
更新日期：1988-06-01 00:00:00
abstract：:There were 125 children with a strong clinical suspicion of gastroesophageal reflux and/or aspiration evaluated with gastroesophageal scintigrams. We found this examination to be more sensitive than the standard barium radiography and highly specific in detecting aspiration of gastric contents. This procedure is simpl...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(81)80334-x
更新日期：1981-04-01 00:00:00
abstract：:Data from 31 infants with gastrointestinal perforation were analyzed to determine the microorganisms usually present in the peritoneum and blood, and the antibiotic susceptibility of those organisms. Multimicrobial contamination of the peritoneal cavity was present in over one-half of the patients and 23% were found t...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(80)80775-5
更新日期：1980-08-01 00:00:00
abstract：BACKGROUND/PURPOSE:Long-term sequelae caused by associated anomalies or respiratory and gastrointestinal disorders are common after the repair of esophageal atresia (EA). The aim of this study was to assess the effect of these sequelae on the health-related quality of life (HRQoL) of patients with EA. METHODS:A questi...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2004.10.014
更新日期：2005-02-01 00:00:00
abstract：:Solitary nonparasitic cyst of the liver (SNPCL) is rare in children. Although there are several hypotheses regarding the pathogenesis, the true origin of SNPCL remains unknown. The authors present an infant with a huge SNPCL in whom the epithelial markers, CA19-9, DU-PAN-2, and SPan-1, were elevated in the serum and c...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2005.08.039
更新日期：2005-12-01 00:00:00
abstract：PURPOSE:In oncology practice, angioembolization has been reported for tumor reduction before surgery, treatment of life-threatening conditions, and for palliative care. Nevertheless, the overall experience with angioembolization for the treatment of tumors is limited. We report our experience in 7 nonvascular solid ped...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2009.04.037
更新日期：2009-09-01 00:00:00
abstract：BACKGROUND:Conventionally, an adult's standard of a 40-cm loop is adopted in Roux-Y hepatojejunostomy (RYHJ) in choledochal cyst (CDC) in children, irrespective of patient size. The redundant length of the jejunal limb may lead to complications. We compared the outcome of an individualized short Roux loop with the stan...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jpedsurg.2009.12.022
更新日期：2010-04-01 00:00:00
abstract：BACKGROUND/PURPOSE:The purpose of this study was to examine the natural history and outcomes of prenatally diagnosed lung masses that appear to undergo complete regression before birth. METHODS:An IRB-approved retrospective review was performed on 100 consecutive fetuses with a congenital lung malformation at a single...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2015.03.025
更新日期：2015-06-01 00:00:00
abstract：BACKGROUND/PURPOSE:Previous reports of laparoscopic repair of Morgagni hernias in children have involved relatively complex laparoscopic techniques. This report describes a simpler method of repair that we have applied to 4 children. METHODS:Four children with retrosternal (Morgagni) hernias underwent primary laparosc...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/jpsu.2003.50163
更新日期：2003-05-01 00:00:00
abstract：:Swyer-James-Macleod syndrome (SJMS) is a rare, complex disease characterized by unilateral hyperlucent lung or lobe owing to loss of pulmonary vasculature and alveolar hyperdistention. Treatment is generally conservative, and surgical management is rare. In fact, only 4 reports on surgically treated children with SJMS...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章,评审
doi：10.1016/j.jpedsurg.2011.12.011
更新日期：2012-04-01 00:00:00
