Abstract:
BACKGROUND:Pectus excavatum (PE) is the most common chest well deformity seen in children. In 1997, the Miniature Access Pectus Excavatum repair (MAPER) was presented by Nuss et al, adding a new option for PE repair. This operation entails placing a custom bent metal bar across the chest to mechanically raise the sternum and remodel the cartilage. The authors have added modifications to Nuss' original description of this operation in an attempt to optimize technique, minimize complications, and improve outcomes. METHODS:The authors have performed 52 MAPERs with an average operating time of 106 minutes, average length of stay of 3.9 days, and return to normal activities of 2 to 6 weeks. Modifications to Nuss' original description include preoperative evaluation consisting of an echocardiogram and pulmonary function tests (PFTs; with and without exercise and with and without bronchodilators), abandoning the use of routine preoperative computed tomography (CT) scans, the use of unilateral positive pressure insufflation of the hemithorax to provide visualization, and anesthesia using an epidural pain catheter (intraoperative and postoperative for 3 days). Intraoperatively, we use a 70 degrees thoracoscope for optimal visualization, and we have modified their location for optimal visualization. Additionally, the bars are secured with surgical wire, not absorbable suture, to avoid bar slippage. RESULTS:Postoperatively, we leave our bars in for 3 years and have had no recurrences. Furthermore, these patients require significant support during the time their bars are in place and occasionally require reoperation to fix symptomatic problems with their bar. CONCLUSIONS:Since the first description of the MAPER was presented more than 5 years ago, the operative treatment of PE has changed dramatically. The authors feel that the MAPER is superior to the open technique, and with the modifications they have implemented, complications have been minimized, and long-term results have been improved.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Zallen GS,Glick PLdoi
10.1016/j.jpedsurg.2004.01.046subject
Has Abstractpub_date
2004-05-01 00:00:00pages
685-9issue
5eissn
0022-3468issn
1531-5037pii
S0022346804000648journal_volume
39pub_type
杂志文章abstract:PURPOSE:To determine the impact in clinical outcomes of pediatric idiopathic intussusceptions from hospital experience and designation as children's hospitals (CH) and non-children's hospitals (NCH) in the US. METHODS:A retrospective study was performed on 1263 children with idiopathic intussusception, 2 months to 3 y...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2008.10.050
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Open Ladd's procedure is the gold standard for the correction of intestinal malrotation and laparoscopic approach remains controversial. This study aimed to evaluate our experience in laparoscopic management of malrotation. METHODS:Single center retrospective study including patients who underwent a laparos...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2018.09.023
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND/PURPOSE:Central hepatoblastomas (CHBL) involving liver segments (IV + V) or (IV + V + VIII) are in contact with the portal bifurcation. Their resection may be achieved by central hepatectomy (CH) with thin resection margins on both sides of the liver pedicle, by extended right or left hepatectomy with thin r...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2009.09.025
更新日期:2010-03-01 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/PURPOSE:Percutaneous endoscopic gastrostomy (PEG) is of great benefit to a defined population of children, but gastrostomy has been implicated in causation or exacerbation of gastroesophageal reflux (GER). The aim of this study was to quantitatively and qualitatively analyze the effect of PEG on GER. METHOD...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2002.30267
更新日期:2002-02-01 00:00:00
abstract::The authors report on 2 patients with congenital chylous ascites who underwent successful lymphatic duct ligation after a laparoscopic lymphoid dye test. Fetal ascites had been detected in both cases, and both babies were born with marked abdominal swelling. Given that conservative treatment by medium-chain triglyceri...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2001.27973
更新日期:2001-11-01 00:00:00
abstract::The authors used a conservative approach to treat focal nodular hyperplasia of the liver (FNH) and were interested in the long-term results of different therapeutic approaches in order to establish the most appropriate treatment. A review of the literature was conducted, and 31 pediatric case reports were identified i...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/0022-3468(95)90162-0
更新日期:1995-11-01 00:00:00
abstract::Traditionally, gastrointestinal contrast studies have been the mainstay of evaluating infantile gastrointestinal problems. Because of technological advancements, good ultrasonography (USG) machines can provide high-resolution images with graphic anatomical clarity, especially in infants and children and thus change th...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2009.05.019
更新日期:2009-10-01 00:00:00
abstract:PURPOSE:Necrotizing enterocolitis (NEC) in very low birth weight infants is a risk factor for developmental delay. To our knowledge, there are no studies published investigating the neurodevelopmental outcome of patients with NEC comparing surgically treated and conservatively treated patients versus match paired contr...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2018.01.006
更新日期:2018-08-01 00:00:00
abstract:PURPOSE:The aim of the study was to report the experience with renal cell carcinoma (RCC) in children. MATERIALS AND METHODS:We conducted a retrospective study on renal adenocarcinoma cases treated in our center between 1993 and 2008. The age limit was established at 15 years. We collected data on personal history, di...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2009.02.073
更新日期:2009-09-01 00:00:00
abstract:BACKGROUND:Adults with traumatic brain injury (TBI) who present hypertensive suffer worse outcomes and increased mortality compared to normotensive patients. The purpose of this study is to determine if age-adjusted hypertension on presentation is associated with worsened outcomes in pediatric TBI. METHODS:A retrospec...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2019.06.008
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND/PURPOSE:Since the discovery of the cystic fibrosis transmembrane regulator (CFTR) gene, cystic fibrosis has been an attractive target for gene therapy. Postnatal gene transfer in the respiratory epithelium has been difficult and particularly inefficient in the submucosal gland cells, the target cells for CFT...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2002.33843
更新日期:2002-07-01 00:00:00
abstract:PURPOSE:Pediatric surgeon performed bedside ultrasound (PSPBUS) is a targeted examination that is diagnostic or therapeutic. The aim of this paper is to review literature involving PSPBUS. METHODS:PSPBUS practices reviewed in this paper include central venous catheter placement, physiologic assessment (volume status a...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jpedsurg.2018.04.040
更新日期:2018-11-01 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:BACKGROUND/PURPOSE:Adnexal torsion is a serious condition that frequently may result in ovarian removal, and there always is a risk of castration if the contralateral ovary undergo torsion as well. In this study, the authors present their experience with adnexal torsion in 15 children and describe a catastrophic event,...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1053/jpsu.2002.36195
更新日期:2002-11-01 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:No straightforward theoretical descriptions explaining the discrepant incidences of metachronous contralateral hernia and positive contralateral patent processus vaginalis (cPPV) exist. The indications for contralateral groin repair are still not clearly defined. METHODS:During laparoscopic herniorr...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2007.11.010
更新日期:2008-08-01 00:00:00
abstract:BACKGROUND/PURPOSE:The association of intrahepatic biliary cysts in biliary atresia (BA) after hepatic portoenterostomy has drawn the attention of many pediatric surgeons and has become an important subject in clinical management, but the incidence and causes of this association are not well known. METHODS:During the ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(99)90012-x
更新日期:1999-09-01 00:00:00
abstract:BACKGROUND/PURPOSE:In neonates receiving extracorporeal membrane oxygenation (ECMO), platelet activation and dysfunction occur with the release of matrix metalloproteinase (MMP)-2, which stimulates platelet aggregation. Because inhaled nitric oxide (NO) reduces pulmonary hypertension and inhibits platelet aggregation, ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2003.50116
更新日期:2003-04-01 00:00:00
abstract::A new surgical technique for the treatment of total colonic aganglionosis is described. Preservation of the right colon and the ileocecal valve is possible by performing an end-to-back anastomosis between a prececal short ileum segment and the uneffected ileum, and by creating a side-to-side anastomosis between an iso...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(93)90128-8
更新日期:1993-12-01 00:00:00
abstract:BACKGROUND:The likelihood of a lead point as the cause of ileocolic intussusception increases as children get older. This study looks at whether a different management strategy should be employed in older patients. METHODS:7 year multi-institutional retrospective study of intussusception in patients aged <12 years. R...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpedsurg.2014.09.078
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:The association between indomethacin administration and bowel perforation in premature infants is well known. The goal of this study was to examine possible risk factors for this complication. METHODS:Fifteen cases of indomethacin-associated bowel perforation occurred from 1993 to 1996. All had a birth weig...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(99)90495-5
更新日期:1999-03-01 00:00:00
abstract:BACKGROUND:Within the adult population, there exist numerous validated risk stratification tools aimed at predicting postoperative outcomes using preoperative and intraoperative parameters. However, similar tools for the pediatric population are scarce. We previously developed and reported on a scoring system to predic...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2013.04.017
更新日期:2013-10-01 00:00:00
abstract::Two infants with unusual bronchopulmonary malformations associated with congenital diaphragmatic hernia (CDH) are presented. One infant had extralobular sequestration and cystic adenomatoid malformation of the lower lobe, in addition to a left-sided CDH. The second infant had a laryngotracheoesophageal cleft extending...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(95)90772-6
更新日期:1995-06-01 00:00:00
abstract::It is well known that the persistence of alterations in the normal embryological development of branchial arches can lead to preauricular and cervical fistulas within a family. However, until 1970, there were no reports of dysplasia affecting the branchial, otic, and renal systems (BOR syndrome) with dominant autosomi...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(93)90086-z
更新日期:1993-12-01 00:00:00
abstract:BACKGROUND:The ideal colostomy type for patients with anorectal malformations (ARM) is undetermined. We performed a systematic review and meta-analysis of short-term complications comparing loop and divided colostomies. METHODS:After review registration (PROSPERO: CRD42016036481), multiple databases were searched for ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jpedsurg.2017.01.044
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Rhomboid excision with Limberg flap (RELF) repair has been shown to be effective in the management of pilonidal disease (PD) in adults. Wide excision allows complete removal of diseased tissue, and the rotational flap allows tensionless coverage as well as helps flatten the natal crease, which is believed to...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2008.11.033
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND/PURPOSE:In 1996, the glial cell line-derived neurotrophic factor (GDNF) was identified as one of the ligands of the RET transmembrane receptor. In the same year, GDNF mutations were found in association with RET protooncogene mutations in Hirschsprung patients. Mutations in GDNF per se are thought neither ne...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(98)90371-2
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:A variety of prosthetic materials are used in the pediatric population for abdominal and chest wall reconstruction. Pediatric experience of non-cross-linked porcine acellular dermal matrix is limited to patients following liver transplantation. We review our outcomes in patients in whom this matrix was used....
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2015.10.083
更新日期:2016-03-01 00:00:00
abstract::Benign small bowel tumors are rare and usually present in late adult life. Because of its raity, a case of benign leiomyoma of the small bowel presenting with distal small bowel obstruction in childhood is reported, with a discussion of the principles of management. ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(79)80022-6
更新日期:1979-08-01 00:00:00