Abstract:
BACKGROUND/PURPOSE:Modified Heller esophagomyotomy has become the initial treatment of choice for esophageal achalasia in children. However, only limited and not objective data are currently available on the long-term results of modified Heller limited esophagomyotomy (LEM). This retrospective study was undertaken to objectively assess the long-term results of LEM in childhood esophageal achalasia. METHODS:Medical records of 15 patients with a median age of 9.5 years (range, 6-13 years) who underwent an LEM without an antireflux procedure from January 1991 to December 2005 were reviewed. Clinical scores, barium esophagogram, flexible upper alimentary endoscopy, 24-hour esophageal pH monitoring, and esophageal manometry before and 0.5 to 15 years after surgery were analyzed. RESULTS:An excellent to good outcome was observed in 14 (93.3%) patients. One patient (6.7%) required reoperation 8 months after surgery because of persistent dysphagia. The late barium esophagogram showed a significant decrease (from 4.2 +/- 0.95 to 2.4 +/- 1.1 cm, P < .01) of esophageal diameter, as compared with preoperative values. Only 1 patient had grade II esophagitis on flexible upper alimentary endoscopy. Twenty-four- hour esophageal pH monitoring showed an abnormal acid exposure in 1 patient. The late esophageal manometry showed a significant decrease (from 31.7 +/- 7.9 to 7.8 +/- 3.7 mm Hg; < .05) of lower esophageal sphincter (LES) pressure, and only insignificant increase (from 18.8 +/- 6.2 to 21.4 +/- 8.4 mm Hg; NS) of amplitude of esophageal contractions over preoperative values. CONCLUSIONS:Transabdominal LEM without an antireflux procedure is an effective and safe treatment of esophageal achalasia in children because of its long-term high rate of symptoms relief and low incidence of postoperative complications, despite the lack of esophageal motility restoration to normal.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Vaos G,Demetriou L,Velaoras C,Skondras Cdoi
10.1016/j.jpedsurg.2008.02.074subject
Has Abstractpub_date
2008-07-01 00:00:00pages
1262-9issue
7eissn
0022-3468issn
1531-5037pii
S0022-3468(08)00268-6journal_volume
43pub_type
杂志文章abstract:PURPOSE:The physical finding of a thickened spermatic cord as indicator of an inguinal hernia in children is well documented. This thickening has been attributed to the presence of a hernia sac. Based on our clinical observations, cremasteric fibers appeared thickened in the presence of an inguinal hernia. The authors ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(99)90002-7
更新日期:1999-09-01 00:00:00
abstract:PURPOSE:The adrenal cortex is a critical component of the hypothalamic-pituitary-adrenal/gonadal axis that coordinates the stress response and maintains homeostasis. The authors hypothesize that adrenal cortical cells can be transplanted in adrenal insufficiency states to regenerate the adrenal cortex. METHODS:Murine ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2004.08.006
更新日期:2004-12-01 00:00:00
abstract::Kaposiform hemangioendothelioma is a rare locally aggressive vascular tumor that usually manifests during early childhood. Typically the lesion presents with skin, soft tissue and bone involvement and is characterized histologically by ill-defined nodularity and the presence of spindle cells with resemblance to Kaposi...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2016.03.014
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND/PURPOSE:Total colonic aganglionosis with ileal involvement is estimated at 1 case in 50,000 living births. This pathology has a very variable prognosis, and patients often need long-term parenteral nutrition. The aim of this study is to define prognostic factors for this disease. METHODS:This is a retrospec...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2002.29430
更新日期:2002-01-01 00:00:00
abstract::Experimental aganglionosis was produced successfully in a colonic segment proximal to the peritoneal reflection by intraluminal filling under tension of the colorectum of rats with 0.01% corrosive sublimate in normal saline solution. Where the length of aganglionic segment was more than 3 cm, ileus appeared and megaco...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(75)80089-3
更新日期:1975-12-01 00:00:00
abstract:BACKGROUND:There is ongoing debate concerning the use of peritoneal irrigation in the setting of complicated appendicitis (CA) in children. Our aim was to conduct a prospective randomized controlled trial for the treatment of CA during a laparoscopic appendicectomy in children. METHODS:Following ethical approval (REC1...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jpedsurg.2019.08.039
更新日期:2019-12-01 00:00:00
abstract::Traumatic solid organ injuries are easily recognizable on computed tomography (CT) scans and usually are treated nonoperatively. Small bowel injuries may be difficult to diagnose and require prompt operation. This study was done to assess the role of clinical examination versus diagnostic tests in evaluating these inj...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(96)90113-x
更新日期:1996-08-01 00:00:00
abstract::Because postoperative apnea and bradycardia in premature infants following inguinal herniorrhaphy remains a concern, outpatient repair has not been recommended. We have been performing outpatient inguinal herniorrhaphy in premature infants and the present study reviews our experience. Between 1985 and 1990, 1,294 outp...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(92)90313-v
更新日期:1992-02-01 00:00:00
abstract:PURPOSE:To better characterize firearm violence in urban youth, the authors investigated the circumstances and outcome of shootings among youths under 17 years of age. METHODS:A retrospective case review was undertaken of all patients under 17 years of age treated for a gunshot wound at two adjoining level I Trauma Ce...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/s0022-3468(97)90375-4
更新日期:1997-07-01 00:00:00
abstract::Current research calculates the time between development of new evidence-based knowledge into established clinical practice as 17 years. This is the knowledge translation gap. The factors influencing this delay are multiple, but it is clear across the history of medicine that knowledge from new, well-constructed studi...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jpedsurg.2020.02.042
更新日期:2020-05-01 00:00:00
abstract:INTRODUCTION:Appendicitis is the most common pediatric emergent surgical condition, with 77,000 American pediatric admissions costing $680 million US annually. Diagnosing appendicitis can be challenging. The prospective Quality Assurance and performance improvement project for suspected aPPEndicitis (QAPPE) study imple...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2020.09.006
更新日期:2020-09-24 00:00:00
abstract::A full-term baby boy with a segmental defect of the ileal musculature associated with terminal ileal and biliary atresia is presented. The newborn had a dilated loop of the ileum 30 cm proximal to the ileal atretic site. Pathological study results showed absence of the intestinal musculature with relatively intact muc...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(98)90101-4
更新日期:1998-03-01 00:00:00
abstract:BACKGROUND/PURPOSE:Multisystem organ failure (MSOF) is a major cause of morbidity and mortality in the critically ill patient. Animal models of endotoxin-induced sepsis were used to develop therapeutic regimens, which thus far have failed in clinical trials. Because multiple etiologies of MSOF affect the intestine, the...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2004.11.045
更新日期:2005-03-01 00:00:00
abstract::Bilateral fetal rhabdomyomatous nephroblastoma is a rare variant of Wilms' Tumor. The authors report the evolution over 48 months of a 10-month-old baby with bilateral nephroblastoma for which a left nephrectomy was initially performed. A right kidney tumor was enucleated preserving the kidney. The transformation of t...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1053/jpsu.2003.50151
更新日期:2003-04-01 00:00:00
abstract:BACKGROUND:Tension gastrothorax develops when the stomach herniated through a congenital diaphragmatic defect into the thorax is massively distended by trapped air. The authors present 5 cases and discuss the diagnostic and therapeutic management. CASE REPORTS:Four children, aged 3, 4, 6, and 13 months, presented with...
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::Three patients with a congenital anovestibular/perineal fistula were treated at the Montreal Children's Hospital. Two females (one of East Indian and the other of Japanese origin) had anovestibular fistulae that became symptomatic in the first few months of life. The third patient, a boy of Korean descent, presented a...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(89)80245-3
更新日期:1989-02-01 00:00:00
abstract:PURPOSE:The purpose of the study was to compare outcomes after partial vs complete fundoplication in patients with prior esophageal atresia repair. METHODS:All patients undergoing fundoplication following esophageal atresia repair at a tertiary care pediatric hospital from 1987 to 2006 were retrospectively reviewed. A...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2011.02.018
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND/PURPOSE:Thoracoscopic repair has recently been attempted in newborns with esophageal atresia (EA), but it remains unclear whether thoracoscopic dissection reduces pathological gastroesophageal reflux. We investigated the influence of a thoracoscopic approach on esophageal motor function in patients with EA. ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2009.07.049
更新日期:2009-12-01 00:00:00
abstract::The offspring of pregnant Sprague-Dawley rats exposed to nitrofen on gestational day 9.5 develop left-sided congenital diaphragmatic hernia (CDH). Twenty-four hours after treatment, on day 10.5, supravital staining with Nile blue sulfate and histological examination showed bilateral excessive cell death in cervical so...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(95)90589-8
更新日期:1995-02-01 00:00:00
abstract::A rare case of VACTEL syndrome with antenatally diagnosed duodenal atresia is reported. We performed one-staged radial surgery for the esophageal atresia with tracheoesophageal fistula and duodenal atresia. The prognosis of VACTEL syndrome with duodenal atresia is very poor. This is the first reported case cured opera...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(89)80104-6
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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.2020.02.053
更新日期:2020-06-01 00:00:00
abstract:PURPOSE:In October 2000, our institution implemented a clinical practice guideline (CPG) utilizing selective computed tomography (CT) and ultrasound scan (US) for the evaluation of children with suspected appendicitis. The authors sought to determine surgical outcomes and diagnostic accuracy in the CPG period. METHODS...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2003.11.015
更新日期:2004-03-01 00:00:00
abstract::In the Soave procedure for Hirschsprung's disease, the mucosectomy of the aganglionic segment of colon is performed transabdominally. The authors describe an innovative modification of the standard Soave procedure, in which a transanal mucosectomy is performed as the abdominal incision is made. The transanal mucosecto...
journal_title:Journal of pediatric surgery
pub_type: 临床试验,杂志文章
doi:10.1016/s0022-3468(96)90249-3
更新日期:1996-09-01 00:00:00
abstract::Fetus-in-fetu (FIF) is a rare congenital condition in which a vertebrate fetus is incorporated within its twin. The authors report the case of a newborn boy with prenatal ultrasonographic diagnosis of intraabdominal mass, provoking compression of the left kidney. Plain abdominal radiography, ultrasonography, and compu...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jpedsurg.2003.12.029
更新日期:2004-04-01 00:00:00
abstract::There are several reported cases of late presentations of right diaphragmatic hernia with early- as well as late-onset group B streptococcal (GBS) infections. The authors describe the first case of late-onset left diaphragmatic hernia with late onset GBS infection in a preterm infant. The diagnosis was prompted by a d...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2002.32918
更新日期:2002-06-01 00:00:00
abstract::A small subset of cystic fibrosis (CF) patients develop pulmonary disease primarily limited to one lobe or lung segment requiring prolonged recurrent hospitalizations with intensive medical therapy. Although surgery has been advocated for patients who do not respond to medical therapy, very little is known about crite...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(91)90003-c
更新日期:1991-06-01 00:00:00
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/PURPOSE:Congenital esophageal stenosis (CES) is a rare condition that is associated with various foregut symptoms. The aim of the current study was to investigate esophageal motor function in pediatric patients with isolated CES. METHODS:Four boys with CES (age, 3 weeks to 4 years old) were studied before t...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2003.08.020
更新日期:2003-12-01 00:00:00
abstract::A three and one-half-year-old girl and a 12-year-old boy presented with features of the two clinical presentations of Castleman's disease or giant lymph node hyperplasia. The girl presented with anemia, fever, night sweats, hypergammaglobulinemia, and a palpable abdominal mass. Her symptoms were consistent with those ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(86)80385-2
更新日期:1986-08-01 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