Abstract:
BACKGROUND:Prenatal diagnosis and outcome of right congenital diaphragmatic hernia (RCDH) are far less well known than the more common left CDH (LCDH). In addition, onset of RCDH beyond the neonatal period with a spectrum of atypical symptoms is not unusual. A retrospective analysis of RCDH treated at a single center over 18 years has been reviewed with regard to outcome after the introduction of a new treatment protocol for CDH. METHODS:All charts of patients with CDH between 1987 and 2004 were reviewed. Twenty-nine patients with RCDH were identified. The patients were divided into 2 historical groups: group 1, from 1987 to 1998 (16 patients), and group 2, from 1999 to 2004 (13 patients). From 1999, at the Department of Pediatric Surgery of Padua, the management of a baby born with CDH has been standardized and includes planned delivery at term, high-frequency oscillatory ventilation since birth, inhaled nitric oxide if required, extracorporeal membrane oxygenation as a "last resort," and delayed repair once the infant is hemodynamically stable. Patients with either prenatal diagnosis of RCDH or early onset of symptoms (<6 hours of life) were considered "high risk," and those with late onset (>6 hours) were considered "low risk." RESULTS:Of 29 patients, prenatal diagnosis was available in 8 (27.5%) and major associated malformations in 8 patients (27.5%). Eight (50%) of 16 cases from group 1 and 9 (69.2%) of 13 cases from group 2 were high-risk patients. There was a trend in favor of a higher survival among high-risk patients from group 2 (25% vs 44%), although this was not statistically significant. As expected, all low-risk patients survived (P = .0001). Plain thorax x-ray was diagnostic in 23 (82.1%) cases, initially normal in 3, not performed in 1, and misinterpreted as right lower lobe pneumonia in 2. At operation, the prosthetic patch was required in 2 (9%) of 22 cases and the peritoneal sac was found in 4 (13.7%). CONCLUSIONS:(1) The rate of prenatal diagnosis of RCDH was low and remained stable throughout the examined period. (2) The introduction of a treatment protocol, using high-frequency oscillatory ventilation since birth, improved the survival of high-risk patients with RCDH, although the data did not reach statistical significance. (3) The majority (75%) of low-risk patients presented beyond the first week of life with a variety of aspecific gastrointestinal or respiratory symptoms that accounted for initial misdiagnosis. (4) Even in these cases, the outcome was excellent.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Midrio P,Gobbi D,Baldo V,Gamba Pdoi
10.1016/j.jpedsurg.2006.10.044subject
Has Abstractpub_date
2007-03-01 00:00:00pages
517-21issue
3eissn
0022-3468issn
1531-5037pii
S0022-3468(06)00803-7journal_volume
42pub_type
杂志文章abstract::Over a period of 18 months, we have inserted 20 Port-a-Caths in 19 children between the ages of 8 1/2 months and 18 years. The smallest child weighed 7 k. Three others weighed less than 12 k. The indication in all cases except two was the administration of cancer chemotherapy. The devices have been in use for periods ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(87)80625-5
更新日期:1987-08-01 00:00:00
abstract::Varicella (chickenpox) affects approximately 90,000 children each year. Although most cases resolve, some develop necrotizing soft tissue infections secondary to group A streptococcus and staphylococcus. Delay in diagnosis is common. At the time of initial presentation, the need for surgical intervention is not always...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(96)90103-7
更新日期:1996-08-01 00:00:00
abstract:PURPOSE:The objectives of this study were to evaluate mortality rates in very low birth weight (VLBW) infants with surgical necrotizing enterocolitis (NEC) by level of available surgical resources and to determine the effect of hospital transfer on mortality. METHODS:Mortality among 4328 VLBW neonates with surgical NE...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2016.02.051
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:The employment of fluorescence imaging has gained popularity in many fields of adult surgery where it has demonstrated great potentials to improve both surgical and oncological outcomes while minimizing anesthetic time and lowering health-care costs. However, the clinical application of fluorescence-guided s...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jpedsurg.2020.08.004
更新日期:2020-08-15 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:BACKGROUND/PURPOSE:Laparoscopy has kindled an interest in minimally invasive surgery in infants. To combine improved cosmesis with the advantages of open exposure, we adopted the transumbilical approach for laparotomy in babies up to 26 months of age. METHODS:Only hemodynamically stable babies were considered candidat...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(03)00131-3
更新日期:2003-06-01 00:00:00
abstract::This article reviews of the current evidence-based treatment standards for children with Wilms tumor. In this article, a summary of recently completed clinical trials by the Children's Oncology Group is provided, the current diagnostic evaluation and surgical standards are discussed, and the surgical impact on current...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jpedsurg.2018.09.005
更新日期:2019-03-01 00:00:00
abstract::Traumatic abdominal wall hernia (TAWH) from high speed mechanism is a unique finding in adult trauma, and exceedingly rare in pediatrics. The majority of reports are of low-speed "handlebar" hernias associated with direct injury by bicycle handlebars. We report a series of three pediatric patients in motor vehicle col...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2013.02.039
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND/PURPOSE:The etiology of idiopathic gastric perforation (IGP) in neonates is unclear. Interstitial cells of Cajal (ICC) express tyrosine kinase receptor C-kit, and act as gastrointestinal pacemaker cells. Stem cell factor (SCF) is a C-kit ligand and plays an important role in immune system homeostasis in the ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2000.5940
更新日期:2000-05-01 00:00:00
abstract::Seventy-two new cases of Hirschsprung's disease were seen between 1980 and 1985. Twenty-six patients (36%) developed the clinical features of enterocolitis and, of nine patients who died, colitis was the immediate cause of death in six. Histologic material was available from 20 patients with colitis; this showed nonsp...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(87)80341-x
更新日期:1987-03-01 00:00:00
abstract:BACKGROUND:In adults, the gold standard for surgical repair of an inguinal hernia is a mesh repair, whereas, in children, the standard is high ligation of the hernia sac. However, adolescents represent a "gray zone" between children and adults, and there is no consensus on the most appropriate operation for inguinal he...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2020.11.006
更新日期:2020-11-13 00:00:00
abstract:BACKGROUND:A genetic tendency to develop latex IgE responses in children with spina bifida has been suggested, but their degree of exposure to latex as well as the route and chronology for sensitization can be different from those of other children with multiple surgeries. The aim was to study the influence of the type...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2005.01.009
更新日期:2005-04-01 00:00:00
abstract:INTRODUCTION:Community hospitals commonly obtain computed tomographic (CT) imaging of pediatric trauma patients before triaging to a level I pediatric trauma center (PTC). This practice potentially increases radiation exposure when imaging must be duplicated after transfer. METHODS:A retrospective review of our level ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2008.08.061
更新日期:2008-12-01 00:00:00
abstract::Idiopathic adnexal torsion threatens ovarian function. The best ways to maximize ovarian salvage have not been stressed widely. The authors describe 2 girls who illustrate the benefit of untwisting the torsion, limiting resection and performing bilateral gonadopexy to prevent both ipsilateral recurrence and contralate...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2000.0350624
更新日期:2000-04-01 00:00:00
abstract:BACKGROUND:The continually rising incidence of soft tissue abscesses in children has prompted us to seek an alternative to the traditional open incision and drainage (I&D) that would minimize the pain associated with packing during dressing changes and eliminate the need for home nursing care. STUDY DESIGN:A retrospec...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2010.08.019
更新日期:2011-03-01 00:00:00
abstract::A 1-year-old girl presented with fever, asthenia, and splenomegaly with hypersplenism. Abdominal ultrasound scan and magnetic resonance imaging showed multiple nodular cystic masses in an enlarged spleen. The histological examination of the resected spleen showed a novel type of vascular tumor called littoral cell ang...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(00)90225-2
更新日期:2000-03-01 00:00:00
abstract:PURPOSE:Several case series have described successful utilization of extracorporeal membrane oxygenation (ECMO) for the treatment of pediatric burn patients with respiratory failure. This study examines the Extracorporeal Life Support Organization registry experience in the treatment of these patients. METHODS:The Ext...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpedsurg.2010.02.106
更新日期:2010-06-01 00:00:00
abstract::Significant macrofistulae between arteries and veins of congenital origin may result in the extremes of life-threatening hemorrhage or simply a cosmetically displeasing mass. The most helpful diagnostic aid is that of adequate arteriography both to determine the size, location, and extent of the fistulae. After adequa...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(77)80003-1
更新日期:1977-04-01 00:00:00
abstract::A 95% pancreatectomy became the treatment of choice for persistent hyperinsulinemic hypoglycemia of the neonate (PHHN, Nesidioblastosis) at the author's institution, when lesser resections failed to prevent hypoglycemia in 25% to 50% of cases. With few outcome data available in the literature, the authors reviewed the...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(97)90207-4
更新日期:1997-02-01 00:00:00
abstract::Lipoblastoma of the greater omentum is an extremely rare benign tumor with less than 10 cases reported in the available literature. We report an unusual case of a 10-month-old girl with a giant omental lipoblastoma that composed 20% of her total body weight (1480 g, 17 x 12 x 16 cm). Complete excision of the tumor was...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jpedsurg.2007.02.031
更新日期:2007-06-01 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::The authors report the first case of orthotopic liver transplantation in a pediatric patient in whom packed red blood cell transfusion was not required. This has obvious advantages in avoiding the infectious complications of transfusion. Our patient required 3 U of fresh frozen plasma for treatment of preexisting coag...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(93)90096-4
更新日期:1993-12-01 00:00:00
abstract::This study aimed to determine whether laparoscopic splenectomy is more advantageous than open splenectomy in pediatric patients. Data from 61 patients treated between June 1983 and September 1994 were reviewed. Length of hospitalization, hospital costs, operating time, and postoperative complications were evaluated. F...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(96)90330-9
更新日期:1996-01-01 00:00:00
abstract:PURPOSE:Synovial sarcoma (SS) often metastasizes to the lung; however, the indications for and outcomes of pulmonary metastasectomy have not been evaluated in pediatric/adolescent patients. METHODS:The records of pediatric patients (age <22years) with pathologically confirmed SS and pulmonary metastasis treated betwee...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2012.09.042
更新日期:2013-04-01 00:00:00
abstract::This study was undertaken to search for a rational basis for the use of anal dilatation and internal sphincterotomy as the treatment for chronic intractable constipation in children. Sixteen children, age 5 months to 13 years, who had constipation resistant to conservative treatment were compared with 39 age-matched c...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(97)90395-x
更新日期:1997-07-01 00:00:00
abstract:METHODS:From 1983 to 1996, 31 children with caustic esophageal strictures were seen at Bambino Gesù Children's Hospital; they were all treated conservatively except for two cases complicated by tracheoesophageal fistula. The remaining 29 patients were divided into three groups depending on the treatment, which was modi...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(98)90361-x
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND/PURPOSE:Glicentin stimulates growth of normal and atrophic small bowel mucosa; the mechanisms for this trophic effect of glicentin are not completely known. The purpose of this study was to determine whether the trophic effect of glicentin is mediated by mechanism involving luminal or nonluminal factors and ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2003.50126
更新日期:2003-04-01 00:00:00
abstract::Endodermal sinus tumors occur in the gonads and in a variety of extragonadal locations, particularly as the malignant component of sacral teratomas. Light and electron microscopic studies as well as the presence of alpha fetoprotein support the concept that these lesions arise from germ cells that migrate from the ext...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(82)80452-1
更新日期:1982-12-01 00:00:00
abstract::Neonates presenting with perineal masses are uncommon. When encountered, most perineal masses are anorectal malformations, sacrococcygeal teratomas, rectal prolapse, or duplication cysts. We present an otherwise healthy newborn with a patent anal canal and a pedunculated anal mass. The mass was initially believed to b...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2007.06.021
更新日期:2007-09-01 00:00:00
abstract::Since the first successful repair of a complete laryngotracheoesophageal cleft (LTEC) to the carina in 1982, three newborn infants were observed with a particularly difficult variant in which the cleft extends beyond the carina into the mainstem bronchi. This type IV LTEC creates a long common tracheoesophagus, whose ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(91)90844-j
更新日期:1991-08-01 00:00:00