Abstract：
BACKGROUND/PURPOSE:There have been few studies documenting the effect of subspecialty training on outcomes after appendectomy in children. Some studies have suggested a better outcome in patients managed by pediatric surgeons as compared with general surgeons. METHODS:We studied the effect of subspecialty training on clinical outcome and negative appendectomy rate after pediatric appendectomy. Children less than 19 years in Ontario who underwent appendectomy were identified. Outcomes were compared between pediatric and general surgeons. Subanalyses were conducted for the age groups 0 to 5, 6 to 12, and 13 to 18 years. RESULTS:Over 8 years, 24,019 children underwent appendectomy with a preoperative diagnosis of appendicitis. Of these, 21,027 had appendicitis. General surgeons performed 81.2% of the operations. Negative appendectomy rates were 8.3% and 13.4% (P < .0001) in the pediatric and general surgeon groups, respectively. Children operated on by pediatric surgeons were younger (10.5 +/- 3.6 vs 12.8 +/- 3.8; P < .05), more likely to be perforated (36.6% vs 32.0%; P < .0001), and had a longer postoperative stay (3.8 vs 3.0 days; P < .0001). There was no difference between groups with respect to wound infection or readmission rate when age and perforation status were accounted for. CONCLUSIONS:Pediatric surgeons performed significantly fewer negative appendectomies than general surgeons. Although pediatric surgeons kept their patients longer in the hospital, their patients' wound infection and readmission rates were not different from that of the patients of general surgeons.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Somme S,To T,Langer JCdoi
10.1016/j.jpedsurg.2006.09.044subject
Has Abstractpub_date
2007-01-01 00:00:00pages
221-6issue
1eissn
0022-3468issn
1531-5037pii
S0022-3468(06)00682-8journal_volume
42pub_type
杂志文章abstract：PURPOSE:The mortality rate for pediatric trauma patients cared for in adult trauma centers has been shown, by means of TRISS methodology, not to differ significantly from that of the Major Trauma Outcome Study (MTOS). The question remains, however, whether the outcome of injured children is better in a designated pedia...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(96)90322-x
更新日期：1996-01-01 00:00:00
abstract：BACKGROUND:Neurodevelopmental dysfunction is one of the most disabling outcomes for congenital diaphragmatic hernia (CDH) survivors and may have a long lasting impact in adult life. AIM:To evaluate to which extent being born with CDH has an impact on the educational level and socioeconomic status as a proxy for neuroc...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2019.12.018
更新日期：2020-11-01 00:00:00
abstract：:We describe 3 children with dilatation of the intrahepatic bile duct, who had anomalous junctions of the cystic duct, 2 high and 1 low, without pancreaticobiliary maljunction. They were all male, and underwent excision of the gallbladder and the extrahepatic bile duct followed by a Roux-en-Y hepaticojejunostomy as a d...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2006.08.025
更新日期：2006-12-01 00:00:00
abstract：:In addition to pulmonary hypoplasia and an altered pulmonary vascular bed, the abnormal lung development caused by congenital diaphragmatic hernia (CDH) is associated with an impairment in the pulmonary surfactant system. The aim of this study was to correlate fetal serum cortisol and triiodothyronine (T3) levels, kno...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(94)90380-8
更新日期：1994-06-01 00:00:00
abstract：:The plan for cervical lymph node biopsy should include special maneuvers for recognition of patients with lymphadenitis due to atypical mycobacteria, since these children need extensive operations. The diagnosis should be suspected in children less than 3 yr old with lymphadenopathy present for several months and no e...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(82)80116-4
更新日期：1982-10-01 00:00:00
abstract：:The aims of this experiment were: (1) to establish a reovirus type 3-induced murine model of biliary atresia/neonatal hepatitis that as far as possible corresponds to the human disease; (2) to demonstrate that the disease is histologically similar to the human disease, and to investigate the natural history of reoviru...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(92)90380-p
更新日期：1992-07-01 00:00:00
abstract：BACKGROUND:A significant number of children with short bowel syndrome experience intestinal failure-associated liver disease. We recently demonstrated accelerated hepatic steatosis after 50% small bowel resection (SBR) in mice. Since SBR is associated with alterations in the gut microbiome, the purpose of this study wa...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2017.03.026
更新日期：2017-06-01 00:00:00
abstract：:Gastric teratoma is a rare, benign tumor. The 47th case, reported here, is the first in which an abdominothoracic localization has been found. ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(83)80112-2
更新日期：1983-06-01 00:00:00
abstract：BACKGROUND:The management of giant omphaloceles (GO) can be quite difficult when there is absence of abdominal domain. Coverage with delayed closure has been described. We present a technique to create an adequate peritoneal domain. METHODS:This is a retrospective review of our experience using an intraperitoneal tiss...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2005.12.013
更新日期：2006-04-01 00:00:00
abstract：:Central venous occlusion in children is a challenging problem that can occur after a central venous catheter insertion. Long-term catheter-related complications include sepsis and venous thrombosis with consequent loss of central access. We describe 2 cases of children younger than 1 year who were dependent on a centr...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2008.01.076
更新日期：2008-06-01 00:00:00
abstract：BACKGROUND:The treatment of incidentally encountered asymptomatic Meckel diverticulum (MD) is controversial. We evaluated whether the macroscopic appearance correlates with clinical features, histopathological findings, future complications, and management decisions. METHODS:Patients who underwent MD resection at a si...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2015.08.066
更新日期：2016-07-01 00:00:00
abstract：:Intradural extension of a sacrococcygeal teratoma (SCT) is extremely rare and only well-documented in presacral tumors that have been associated with a familial history, anorectal stenosis, and sacral dysraphism. This case documents the extension of a type I SCT into the dural sac with attachment to the filum terminal...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(93)90322-c
更新日期：1993-06-01 00:00:00
abstract：:Abdominoscrotal hydrocele is a very rare finding, especially in infants. The authors describe the case of a 7-month-old boy presenting an abdominoscrotal mass, the diagnosis of which was made by sonography and which was excised totally through an extensive inguinal incision. ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(86)80118-x
更新日期：1986-11-01 00:00:00
abstract：:A case report of a 3-year-old girl with Kabuki make-up syndrome (KMS) associated with anovestibular fistula is presented. To our knowledge, 62 patients with KMS have been reported in the literature, three of whom were described as having an anorectal anomaly. Including the present patient, all four KMS patients were f...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(92)90523-a
更新日期：1992-12-01 00:00:00
abstract：BACKGROUND/PURPOSE:Intestinal damage (ID) is closely related to morbidity and mortality in gastroschisis. This study was performed to determine the intraamniotic substances that may correlate ID and also to verify their time course levels that would be useful for determining when ID starts in gastroschisis. METHODS:In...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2007.05.027
更新日期：2007-10-01 00:00:00
abstract：BACKGROUND:Tracheal occlusion (TO) promotes fetal lung growth through an increase in intraluminal pressure. Although evidence suggests that fetal TO (FETO) decreases the occurrence of pulmonary hypertension in severe congenital diaphragmatic hernia, controversies on its effect on the pulmonary circulation remain. There...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2012.08.024
更新日期：2013-03-01 00:00:00
abstract：BACKGROUND:Investigation of the value of scrotal Doppler ultrasound (DUS) in the diagnosis of acute scrotum and its impact on the treatment strategy was undertaken. METHOD:Seventy-nine children (mean age, 9.2 years) with acute scrotum were prospectively studied. The protocol included history, clinical examination, scr...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2006.04.026
更新日期：2006-08-01 00:00:00
abstract：BACKGROUND:Sclerotherapy is a commonly utilized treatment for rectal prolapse in children. This study systematically evaluates the effectiveness and complications of various sclerosing agents in treating pediatric rectal prolapse. METHODS:After protocol registration (CRD-42018088980), multiple databases were searched....
journal_title：Journal of pediatric surgery
pub_type： 杂志文章,meta分析
doi：10.1016/j.jpedsurg.2019.01.033
更新日期：2019-05-01 00:00:00
abstract：OBJECTIVE:This study sought to summarize the experience of diagnosis and treatment of tracheobronchial foreign bodies in children to effectively reduce complications and mortality. METHODS:The medical records of 1024 pediatric patients admitted to our hospital from January 1997 to September 2011 and diagnosed with cli...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2012.07.036
更新日期：2012-11-01 00:00:00
abstract：:Survival has improved dramatically for children with extrahepatic biliary atresia (EHBA), but optimal surgical management remains controversial. We have studied 28 infants born between June 1981, and April 1988, who underwent Kasai's portoenterostomy as primary surgical treatment. Those with evidence of subsequent hep...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(05)80182-4
更新日期：1990-01-01 00:00:00
abstract：:A newborn infant with aganglionosis of the entire colon and terminal ileum also had congenital lip pits and a submucous cleft palate. These anomalies may be added to the growing list of conditions associated with Hirschsprung's disease. ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(79)90010-1
更新日期：1979-04-01 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：PURPOSE:To determine whether hemodynamically significant bleeding occurs after pediatric femur fractures. METHOD:A retrospective chart review was performed; demographic and injury data were collected for all patients with the diagnosis of femur fracture over a 30-month period at a level/ pediatric trauma center. Inclu...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(96)90827-1
更新日期：1996-10-01 00:00:00
abstract：BACKGROUND/PURPOSE:We aim to justify the need for surgical intervention in our patients with childhood small bowel intussusceptions (SBIs) and review the current concepts in childhood SBI. MATERIALS AND METHODS:We retrospectively reviewed the clinical charts of all patients with surgically confirmed SBI between July 1...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2005.12.028
更新日期：2006-04-01 00:00:00
abstract：:Osteomyelitis in children commonly occurs in the long bones such as the femur, tibia, and humerus. It is rarely found in the ribs, occurring in less than 1% of children with osteomyelitis. Thirteen cases of rib osteomyelitis were reported in the literature, of which, 11 were caused by Staphylococcus aureus. Pediatric ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2004.06.033
更新日期：2004-10-01 00:00:00
abstract：BACKGROUND:Gastroschisis and omphalocele are congenital abdominal wall defects (AWD). Atrazine and nitrates are common agricultural fertilizers. METHODS:The Centers for Disease Control and Prevention natality data set was used to collect data for patients with AWD born between January 1990 and December 2002. Similar d...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2007.01.027
更新日期：2007-06-01 00:00:00
abstract：:Abnormalities of the pulmonary vasculature are well documented in cases of congenital diaphragmatic hernia (CDH). Vascular endothelial growth factor (VEGF), an angiogenic factor, is a recently described endothelial cell-specific growth factor. Myosin heavy chain (MHC) isoforms such as SMemb, SM1 and SM2 are important ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(97)90588-1
更新日期：1997-03-01 00:00:00
abstract：BACKGROUND/PURPOSE:Medial layer hypertrophy of hepatic arterial branches may be associated with biliary atresia (BA) pathogenesis. This study aimed at evaluating medial layer thickness in hepatic arterial branches at portoenterostomy and liver transplantation. METHODS:The authors evaluated 1274 arterial branches both ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2004.12.002
更新日期：2005-04-01 00:00:00
abstract：PURPOSE:Although occasionally difficult, distinguishing abdominal neuroblastoma (NBL) from Wilms tumor (WT) at presentation is important, as surgical management differs significantly. We reviewed our 20-year experience (1987-2006) treating patients with NBL, focusing on those with an initial diagnosis of WT, to determi...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2008.02.047
更新日期：2008-06-01 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
