Abstract:
PURPOSE:Recently, gas amniodistension has been advocated for fetoscopic surgery to employ ergonomics similar to laparoscopy. However, neither the optimal type of gas nor its physiological influence on the fetus have been clearly outlined yet. This study investigates the impact of helium (HE) vs nitrous oxide (N2O) on fetal goats during fetoscopy. METHODS:We insufflated either HE or N2O in 12 pregnant goats (15 fetuses; HE = 7, N2O = 8), then increased the pressures from 0, 4, 7, to 10 mm Hg in 30-minute intervals and recorded the fetal and maternal vital parameters. Finally, whole-body computed tomography to asses for intracorporeal gas was performed. RESULTS:All fetuses survived. Mean fetal vital signs showed no significant differences between HE or N2O at specific pressure levels. In detail, HE/N2O at 0 vs 10 mm Hg caused a fetal temperature decrease (32.9 degrees C/33.2 degrees C vs 32 degrees C/32.5 degrees C), heart rate increase in the N2O group (100/102 vs 102/121 beats per minute), and no significant change in arterial pressure (45.8/48.3 vs 53.7/46.7 mm Hg). The PO2 was adequate (3.7/3.3 vs 3.7/2.9 kPa), whereas the pH remained unchanged (7.4/7.3 vs 7.3/7.3). However, fetal pCO2 was elevated in the N2O group before insufflation (5.5/7.2 vs 6.8/8.0 kPa) owing to maternal hypoventilation (maternal PCO2: 4.9/5.8 vs 5.0/5.4 kPa), correction of which was slower in the fetus than in the maternal animal. Computed tomography ruled out intracorporeal gas accumulation. CONCLUSION:Neither HE nor N2O impose significant physiological harm for the fetus. Heating of the gas and maternal anesthesia seem essential. Considering the potential teratogenicity of N2O, however, HE could be the favorable environment for fetoscopic procedures under gas amniodistension.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Till H,Yeung CK,Bower W,Shi Y,Tian Q,Chu W,Yip HY,Tse Jdoi
10.1016/j.jpedsurg.2007.02.026subject
Has Abstractpub_date
2007-07-01 00:00:00pages
1255-8issue
7eissn
0022-3468issn
1531-5037pii
S0022-3468(07)00129-7journal_volume
42pub_type
杂志文章abstract::MURCS association is rare, first described by Duncan in 1979, including nonrandom association of Mullerian duct aplasia or hypoplasia (MU), renal agenesis or ectopy (R), and cervicothoracic somite dysplasia. A 5-year-old girl was admitted to the clinic with a complaint of anteriorly located anus. Physical and radiolog...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2003.50060
更新日期:2003-02-01 00:00:00
abstract:PURPOSE:We previously demonstrated that patients with pectus excavatum (PE) have significantly decreased chest wall motion at the pectus defect compared with the rest of the chest vs unaffected individuals and use abdominal respiratory contributions to compensate for decreased upper chest wall motion. We hypothesize th...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2011.10.038
更新日期:2012-01-01 00:00:00
abstract::A 12 yr old black male presented with a 3 day history of left inguinal and testicular pain associated with nausea, vomiting, and fever. Left groin exploration demonstrated a markedly inflammed patent process vaginalis containing purulent exudate. Concomitant abdominal exploration demonstrated a perforated gangrenous a...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(77)90417-1
更新日期:1977-10-01 00:00:00
abstract::Fetal medicine is developing rapidly and aims to improve the outcome for fetuses with congenital anomalies. Fetal endoscopic tracheal occlusion (FETO) has been developed for fetuses with congenital diaphragmatic hernia to counterbalance the compression of the lung by the abdominal viscera, preserving the pulmonary mat...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2011.01.027
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND/PURPOSE:This study aims to elucidate the clinical presentation, the effectiveness of investigations, and treatment of foreign body ingestion in children and to formulate an algorithm of management. METHODS:The records of children admitted to a single institution who had a history of foreign body ingestion o...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(99)90106-9
更新日期:1999-10-01 00:00:00
abstract::The authors report on two adults who had jejunal dilatation after having had resection for jejunal atresia in the neonatal period. Both patients presented 20 years after the initial procedure, with severe iron deficiency anemia, marked jejunal dilatation proximal to the old anastomotic site (which was not narrowed), a...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(94)90238-0
更新日期:1994-12-01 00:00:00
abstract:BACKGROUND:Rhabdoid tumors (RTs) of the liver are rare, aggressive and nonsecreting malignancies occurring mainly during the first year of life. Definition of RT relies on characteristic morphology and on the inactivation of the SMARCB1 tumor suppressor gene. The aim of this study was to analyze clinical data, treatmen...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2017.09.005
更新日期:2018-03-01 00:00:00
abstract::Unilateral cryptorchidism was induced in newborn Wistar rat pups. Using DNA flow cytometry to compare scrotal testes of control and cryptorchid animals, there was a significant difference decrease in the haploid cell population in cryptorchid animals from 40 days of age. Orchidopexy was performed at 30 days (at the ti...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(91)90994-5
更新日期:1991-04-01 00:00:00
abstract::Although infestation with Ascaris lumbricoides causes various intestinal complications, massive gastrointestinal bleeding is rare. The authors report on 2 infants who presented with massive hematemesis. In the first patient, a gastroduodenoscopy was performed. Roundworms were found adhering to an oozing duodenal ulcer...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(03)00584-0
更新日期:2003-11-01 00:00:00
abstract:BACKGROUND:Persistent hyperinsulinemic hypoglycemia of infancy (PHHI) is considered the most common cause of persistent neonatal hypoglycemia. Management of PHHI involves use of medical agents and its failure is an indication of surgical intervention. Traditionally, an open pancreatectomy was the standard of care but r...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2008.10.120
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND/PURPOSE:Thyroid nodules are rare in children. The need to uncover malignancy is the most challenging dilemma in management. The aim of this report was to determine whether management of pediatric thyroid nodules has changed in the era of fine-needle aspiration (FNA) cytology. METHODS:Twenty-four children wi...
journal_title:Journal of pediatric surgery
pub_type: 临床试验,杂志文章
doi:10.1016/s0022-3468(98)90174-9
更新日期:1998-08-01 00:00:00
abstract::The authors report on 3-year-old-girl with neuroblastoma complicated by severe hypertension and cardiac failure. She had cardiomegaly and pleural and pericardial effusions. Echocardiogram showed left ventricular hypertrophy and decrease of the left ventricular ejection fraction to 0.36 (normal > .40). Abdominal comput...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(96)90051-2
更新日期:1996-12-01 00:00:00
abstract::Marine envenomations are the statistical price that humankind pays for intruding into the aquatic domain. Individual risk can be reduced by knowledge and prudence. If envenomations do occur, lives can be saved, complications prevented, and convalescence facilitated by knowledge of and interest in these fascinating cre...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/0022-3468(95)90622-3
更新日期:1995-01-01 00:00:00
abstract::Congenital hernias arising in the subcostal region are rare. We describe a case of a former preterm infant, born with congenitally fused right 11th and 12th ribs and a protuberant mass in the right subcostal region. This mass was associated with a small fascial defect and herniation of abdominal contents. At operation...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2009.12.008
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND/PURPOSE:Prenatal tracheal occlusion (TO) has been shown to accelerate lung growth in animal models and models of pulmonary hypoplasia. However, these models may not mimic early events in human congenital diaphragmatic hernia (CDH). The authors previously have developed a model of TO in the rat. The purpose o...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2001.20683
更新日期:2001-02-01 00:00:00
abstract::In an experimental study, 18 dogs underwent total colectomy, mucosal proctectomy, and endorectal ileal pullthrough with ileoanal anastomosis. In 6 dogs, no internal reservoir was constructed (NR). In 6 additional dogs, an S-shaped ileal reservoir (SR) was constructed immediately above the peritoneal reflection. In 6 o...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(82)80128-0
更新日期:1982-10-01 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 embryogenesis of many congenital tracheoesophageal abnormalities has been elucidated poorly, mainly because of an incomplete understanding of the normal mechanism of separation of the primitive foregut into the trachea and esophagus. There has been controversy about the existence and significance...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(98)90604-2
更新日期:1998-11-01 00:00:00
abstract::A 10-year-old boy presented with features of Cushing's syndrome. Investigations, including ultrasound scan and computed tomography scans, demonstrated a right adrenal tumor. The tumor was excised and histologically found to be an encapsulated adrenal adenoma. Surgical excision is the treatment of choice for adrenal tu...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/s0022-3468(98)90335-9
更新日期:1998-04-01 00:00:00
abstract::Since 1978, six boys with prostatic rhabdomyosarcoma have been treated at our institution. Three had localized disease and were managed by initial biopsy, vincristine, actinomycin-D, and cyclophosphamide (VAC) chemotherapy, and bladder-sparing surgery with or without irradiation. Further combination chemotherapy ("pul...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(89)80196-4
更新日期:1989-10-01 00:00:00
abstract::Twelve patients with gastroesophageal reflux following repair of esophageal atresia are presented. Reflux produced recurrent stricture, failure to thrive, repeated pneumonitis, and in one patient, respiratory arrest and nearly death. Treatment consists of positional therapy or fundoplication operation both of which se...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(77)90007-0
更新日期:1977-06-01 00:00:00
abstract::Whole bowel irrigation was used in 24 patients ages 8 to 17 yr, mean 13 yr, in preparation for colonoscopy (18), colon surgery (2), therapeutic irrigation for treatment of drug overdose (2), and constipation (2). An average of 9 liters warm, normal saline with added KCL (5 mEq/liter) was infused through a nasogastric ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(82)80486-7
更新日期:1982-08-01 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::Aberrant migration of thymic tissue occurs with ectopic thymus in the mediastinum, base of the skull, tracheal bifurcation, and cervical region. A recent review of the literature showed a total of 76 reported cases of aberrant thymus or thymic cysts in patients who presented with primary neck masses. We report three a...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/0022-3468(90)90764-z
更新日期:1990-11-01 00:00:00
abstract:PURPOSE:To describe a simplified surgical technique for the treatment of primary and secondary obstructed megaureters in children by laparoscopic extravesical ureteral reimplantation (LEUR) and evaluate the short-term outcomes. METHODS:Prospective study of children with primary and secondary megaureters treated at our...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2019.05.028
更新日期:2020-03-01 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::Dilatation with a balloon catheter was successfully employed for 9 focal intestinal strictures which occurred in 5 infants following necrotizing enterocolitis. Eight of the 9 strictures were located in defunctionalized colon distal to an enterostomy; no infant had clinical intestinal obstruction. Because the dilatatio...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(85)80014-2
更新日期:1985-12-01 00:00:00
abstract:BACKGROUND:The American College of Surgeons Committee on Trauma (ACS-COT) view over- and undertriage rates based on trauma team activation (TTA) criteria as surrogate markers for quality trauma patient care. Undertriage occurs when classifying patients as not needing a TTA when they do. Over-triage occurs when a TTA is...
journal_title:Journal of pediatric surgery
pub_type: 临床试验,杂志文章
doi:10.1016/j.jpedsurg.2016.04.010
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:Congenital diaphragmatic hernia (CDH) affects 1 in 3000 live births. Modern management strategies include delayed repair of the diaphragm to permit pre-operative optimization of cardiorespiratory status. We describe a cohort of neonates in whom early emergency operative intervention was required for potentia...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2016.09.012
更新日期:2016-12-01 00:00:00
abstract::Between 1989 and 1994 six infants underwent aortopexy for symptomatic tracheomalacia via an anterior mediastinal window. This approach avoids a thoracotomy by using a small transverse incision over the second and third intercostal spaces followed by subchondral excision of these costal cartilages to expose the mediast...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(97)90004-x
更新日期:1997-05-01 00:00:00