Abstract:
BACKGROUND/PURPOSE:In contrast with adult patients in whom surgical closure of the defect is preferred, nonoperative treatment has been the usual approach for esophageal perforation (EP) in children. This report aims to assess whether this strategy stands the passage of time. METHODS:We reviewed retrospectively the charts of 17 patients aged 5.3 +/- 0.9 years (mean +/- SD) treated at our institution for EP between 1991 and 2001. RESULTS:Nineteen episodes of EP were caused by stricture dilation in 9 cases, foreign body extraction in 3, and blunt trauma and sclerosis of varices in 2 cases each. The remaining child had multiple gastrointestinal perforations in the course of chemotherapy for leukemia. Vigorous treatment, consisting of nasopharyngeal aspiration, wide spectrum antibiotics, prompt drainage of effusions and either parenteral or infraesophageal nutritition, was implemented immediately after diagnosis. Perforations were closed without direct surgery in 18 of 19 episodes (16 of 17 children). One or more pleural drains were inserted in 12 cases, and pericardial drainage was required once. Seven gastrostomies, 2 jejunostomies, and one esophagostomy were performed. Several major abdominal operations were necessary to repair concomitant lesions in a child who sustained severe blunt abdominal trauma and in the patient with leukemic perforations. All patients survived, and all recovered esophageal function. However, 2 with intractable lye strictures ultimately required esophageal replacement. The only patient in whom a direct approach for esophageal necrosis due to variceal endosclerosis was unavoidable, lost her organ and had a retrosternal colonic interposition after a successful portosystemic shunt. Excluding patients with other concomitant lesions and the patient who underwent surgery, median length of stay was 11 days (range, 6 to 47). CONCLUSIONS:Prompt and aggressive nonoperative treatment of esophageal perforations in children allows survival with conservation of the organ in most cases and remains, in the authors' hands, the first therapeutic choice at this age.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Martinez L,Rivas S,Hernández F,Avila LF,Lassaletta L,Murcia J,Olivares P,Queizán A,Fernandez A,López-Santamaría M,Tovar JAdoi
10.1016/jpsu.2003.50183subject
Has Abstractpub_date
2003-05-01 00:00:00pages
685-9issue
5eissn
0022-3468issn
1531-5037pii
S0022346803000277journal_volume
38pub_type
杂志文章abstract:BACKGROUND/PURPOSE:Extrapleural pneumonectomy (EPP) is an en bloc resection of the pleura, lung, diaphragm, and pericardium. EPP in the pediatric population has not been reported in the literature. We report our experience of using EPP in children to treat a variety of malignancies that involve the pleural surface. ME...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2006.05.063
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND:The management of malrotation in patients with congenital abdominal wall defects has varied among surgeons. We were interested in investigating the risk of midgut volvulus in patients with gastroschisis and omphalocele to help determine if these patients may benefit from undergoing a Ladd procedure. METHODS...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpedsurg.2016.10.014
更新日期:2017-01-01 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:Ultrasound (US) evaluation of some fetal anomalies provides limited information. Anatomic details that affect prognosis and selection for fetal therapy, such as liver herniation and pulmonary hypoplasia in congenital diaphragmatic hernia (CDH) and airway patency in giant neck masses, may be difficult to deli...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(98)90315-3
更新日期:1998-04-01 00:00:00
abstract::Percutaneous aspiration and tetracycline sclerosis is a safe but temporary therapy of large splenic cysts in children. Between 1985 and 1987, three girls with splenic cysts were seen. Their ages ranged from 5 to 14 years, and the cysts were from 8 to 16 cm in diameter. Despite their large size, all were asymptomatic a...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(89)80711-0
更新日期:1989-07-01 00:00:00
abstract:PURPOSE:The aim of this study was to survey graduates of a university general surgical residency training program to determine factors that influenced their selection of a specialty field. METHODS:A 39-item questionnaire was mailed to 86 graduates of a university general surgery program who matriculated from 1975 to 1...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2001.28842
更新日期:2001-12-01 00:00:00
abstract::A 15-day male neonate presented with postprandial nonbilious vomiting. Barium meal suggested pyloric obstruction. Ultrasound of the stomach after saline loading revealed an echogenic antral valve. Subsequent laparotomy confirmed the ultrasound findings. Excision of the valve resulted in excellent recovery. To our know...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2006.01.002
更新日期:2006-04-01 00:00:00
abstract:INTRODUCTION:The overwhelming burden of pediatric surgical need in humanitarian settings has prompted mutual interest between humanitarian organizations and pediatric surgeons. To assess adequate fit, we correlated pediatric surgery fellowship case mix and load with acute pediatric surgical relief efforts in conflict a...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2019.11.012
更新日期:2020-10-01 00:00:00
abstract:AIM:Subcutaneous entomophthoromycosis (EM) is an uncommon fungal infection of childhood. This article is intended to draw the attention of pediatric surgeons to the fact that EM can mimic soft-tissue tumor. METHODS:It is a retrospective review of 16 children treated for subcutaneous EM between 2000 and 2013. RESULTS:...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2014.11.031
更新日期:2015-07-01 00:00:00
abstract::Congenital microgastria is an extremely uncommon dysplasic condition of the newborn stomach. With only 26 well-documented accounts of this anomaly reported in the literature, its treatment and long-term outcome have not been well elucidated. Herein, the authors report on a newborn with multiple congenital anomalies wh...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(94)90228-3
更新日期:1994-12-01 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:PURPOSE:Feeding tube access with an antireflux procedure is frequently necessary in children with severe neurological deficits. Fundoplication in this particular group of patients has many complications and a reported failure rate of 40% to 50%. Recently, the use of a feeding Roux-en-Y jejunostomy has been advocated in...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(97)90713-2
更新日期:1997-04-01 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::In 2015, the Truth and Reconciliation Commission called for health care institutions to address structural barriers that affect Indigenous families seeking health care in Canada. Pediatric care centers in Canada have failed to adequately address these, resulting in continued negative and life-threatening impacts on In...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jpedsurg.2020.01.029
更新日期:2020-05-01 00:00:00
abstract::A case report of a neonate with pulmonary arteriovenous malformation is described. The anomaly was prenatally diagnosed, and family history was positive for Rendu-Osler-Weber syndrome. Because neurologic symptoms developed during the second week of life, surgical resection was deemed the best curative option to avoid ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2005.11.043
更新日期:2006-02-01 00:00:00
abstract:AIM:The aim of this study was to investigate whether racial disparities in healthcare exist within a New Zealand pediatric surgical outreach service in a high indigenous Māori population. METHODOLOGY:This retrospective study assessed all pediatric surgical procedures performed within a secondary center in New Zealand ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2018.02.037
更新日期:2018-05-01 00:00:00
abstract::A model of the isolated bowel segment (IBS, Iowa Model II) was successfully created in experimental animals using a new surgical technique we developed. The IBS is completely free of its mesenteric attachment, yet its viability is preserved. The technique consists of two staged procedures: (1) initial enteropexy betwe...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(91)91036-x
更新日期:1991-12-01 00:00:00
abstract:BACKGROUND/PURPOSE:The formation of congenital chordee penis in patients with or without hypospadias is multifactorial and not completely clear. In most cases, after release of all known causes of chordee, "residual" penile curvature can persist. The authors discuss the etiopathogenetic mechanisms of congenital chordee...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2002.35006
更新日期:2002-09-01 00:00:00
abstract::Six cases of prepyloric antral diaphragm were encountered at Children's Hospital Medical Center of Akron between 1965 and 1985, with approximately 150 cases reported in the literature during this time. In our series, a delay from onset of symptoms to treatment existed for a period of 4 months to 6 years. We suggest th...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(87)80597-3
更新日期:1987-10-01 00:00:00
abstract:BACKGROUND:The safety of the laparoscopic treatment of intestinal malrotation remains controversial. This study compared the outcomes of laparoscopic and open surgical treatment of intestinal malrotation. METHODS:A multicentric retrospective study included pediatric cases of intestinal malrotation operated on between ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2020.08.014
更新日期:2020-12-01 00:00:00
abstract::Extrahepatic portal hypertension was induced in rats by portal venous constriction. Portal pressures on the fourth postconstriction day were significantly elevated in PVC rats when compared to control rats. Splenoportograms showed decreased hepatic flow and venous collaterals. Histologic sections showed gastric mucosa...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(75)90363-2
更新日期:1975-10-01 00:00:00
abstract:PURPOSE:Despite advances in neonatal care of congenital diaphragmatic hernia (CDH), a significant variation exists in the mortality rates reported by individual centers. Center experience (reflected by case volume) may contribute to this variation in outcome. The aim of the study was to determine whether CDH mortality ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpedsurg.2009.01.023
更新日期:2009-05-01 00:00:00
abstract::Although microtia occurs in only 1:7000 to 8000 births, this major congenital ear deformity can result in significant psychological trauma for the affected child. Reconstruction of this complex deformity represents one of the greatest challenges to the reconstructive surgeon. Based on the pioneering work of Tanzer and...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(84)80271-7
更新日期:1984-08-01 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:The study investigates the diagnostic value of calretinin immunohistochemical staining (CIS) on rectal suction biopsies (RSB) in Hirschsprung's disease (HD). METHODS:A prospective study was conducted at Children's Hospital 2 in Ho Chi Minh City, Vietnam, from January through December 2015. Patients suspecte...
journal_title:Journal of pediatric surgery
pub_type: 临床试验,杂志文章
doi:10.1016/j.jpedsurg.2016.09.027
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Near-infrared spectroscopy (NIRS) is a noninvasive technique for monitoring tissue oxygenation and perfusion. The aim of this study was to evaluate cerebral and splanchnic NIRS changes in CDH operated infants enrolled into the VICI trial and therefore randomized for ventilatory modalities. MATERIALS AND MET...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2015.07.021
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND/PURPOSE:Considerable debate surrounds the choice of technique for the removal of esophageal coins: endoscopic extraction versus dislodgement with a Foley balloon versus dislodgement using bougienage. The "penny-pincher" (PP) technique was developed as an alternative, incorporating the main advantages of thes...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(00)90024-1
更新日期:2000-02-01 00:00:00
abstract:BACKGROUND/PURPOSE:Abdominal compartment syndrome (ACS) is the cardiac, pulmonary, and renal dysfunction that occurs as a result of elevated intraabdominal pressure. The authors present their experience with patch abdominoplasty (PA) in pediatric patients as a means to treat and prevent ACS. METHODS:The charts of pati...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2000.6027
更新日期:2000-05-01 00:00:00
abstract:BACKGROUND/PURPOSE:Percutaneous endoscopic gastrostomy has become a common technique to provide nutritional support to handicapped children with swallowing disorders; however, this technique is sometimes associated with serious complications. We report a novel method of 1-trocar laparoscopy-aided gastrostomy with speci...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2006.08.010
更新日期:2006-12-01 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