Abstract:
BACKGROUND/PURPOSE:Constipation is a major complication in patients who have undergone posterior sagittal anorectoplasty (PSARP) operation for a high anorectal malformation. Overflow incontinence is the main cause of fecal soiling in these patients. The aim of this study was to outline the natural history of constipation in patients with high anorectal malformations and relate this to the functional outcome at the end of the patient's growth period. METHODS:The study group consisted of 22 pubertal or postpubertal patients (median age 15; range, 13 to 25) with high or intermediate anorectal malformations repaired by PSARP procedure. The patients have been followed-up since birth. Constipation was defined as a need to use medical treatment or diet to ensure bowel emptying. Continence was classified as follows: grade 1, no soiling in any circumstances; grade 2, staining less than once a week, no fecal accidents; grade 3, staining more than once a week, no fecal accidents; grade 4, daily soiling or accidents, need for regular enemas, or the antegrade colonic enema procedure. All patients underwent anorectal manometry and magnetic resonance imaging of the spine and spinal cord. RESULTS:At the time of the study 2 (9%) of the 22 study group patients had constipation, but 15 (68%) had been constipated before puberty. Eleven patients (50%) were fully continent (grade 1) without constipation. Six of those had a history of constipation associated soiling. Three patients (14%) had occasional staining (grade 2) and no constipation. Two of them had been constipated with significant soiling before the onset of puberty. In the 5 (22%) patients with frequent staining (grade 3) the degree of soiling had decreased after the disappearance of constipation. Two of the 3 patients with poor outcome (grade 4) require regular enemas for recalcitrant constipation. Spinal cord anomalies were detected in 4 and abnormal sacrum in 15 patients. Of the anorectal manometric parameters, only the force of voluntary sphincter squeeze correlated with the functional result. CONCLUSION:In the majority of patients who underwent PSARP procedure for high anorectal malformation, constipation disappears at adolescence, and this is associated with improved fecal continence outcome.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Rintala RJ,Lindahl HGdoi
10.1053/jpsu.2001.25766subject
Has Abstractpub_date
2001-08-01 00:00:00pages
1218-21issue
8eissn
0022-3468issn
1531-5037pii
S0022-3468(01)33052-Xjournal_volume
36pub_type
杂志文章abstract:PURPOSE:Intestinal abnormalities are sometimes seen during antenatal testing; however, the postnatal importance of these findings has not been well established. We evaluated whether abnormal intestinal appearance on fetal ultrasound (US) was ultimately related to neonatal outcome. METHODS:Fetal US examinations from 20...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2008.10.010
更新日期:2009-01-01 00:00:00
abstract::We present the first case of Wilms' tumor, pancreatic islet cell carcinoma, and pheochromocytoma affecting the same individual. This case underscores the importance of repeat biopsies in patients with multiple neoplasms to confirm the diagnosis and guide management. ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jpedsurg.2007.11.006
更新日期:2008-03-01 00:00:00
abstract:AIM OF THE STUDY:Management of isolated intestinal perforation (IIP) poses a challenge for the pediatric surgeon. Intestinal resection and primary anastomosis is considered to be as good as the classical approach, namely, intestinal diversion by ileostomy. However, few reports compare primary anastomosis and ileostomy ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2016.02.086
更新日期:2016-08-01 00:00:00
abstract:PURPOSE:Children treated for perforated appendicitis can have significant morbidity. Management often includes looking for and draining postoperative fluid collections. We sought to determine if drainage hastens recovery. METHODS:Children with perforated appendicitis treated with appendectomy from 2006 to 2009 were re...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2011.03.043
更新日期:2011-06-01 00:00:00
abstract::In an attempt to investigate the causes of common bile duct dilatation (CBDD), activity of the pancreatic enzymes in bile aspirated from the dilated duct during laparotomy was measured in 24 children with CBDD. The reasoning behind this is the fact that the existence of activated pancreatic enzymes, namely raised acti...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(93)90673-9
更新日期:1993-04-01 00:00:00
abstract:BACKGROUND:Premature rupture of membranes (PROM) remains a significant complication of fetal surgery. Rates of 40% to 100% have been reported after both open and endoscopic fetal surgery. We describe a technique of endoscopic port insertion and removal that minimizes trauma to the membranes. METHODS:Twenty-seven conse...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2006.01.006
更新日期:2006-05-01 00:00:00
abstract:AIM:The aim the study was to review our experience and determine the effectiveness of peritoneovenous shunts in the management of persistent ascites. METHODS:A retrospective review of all patients who had a peritoneovenous shunt inserted for persistent ascites in our institution over 32 years (1977-2010) was performed...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2010.11.006
更新日期:2011-02-01 00:00:00
abstract::A case of complete epispadiac urethral duplication is reported. The epispadiac opening was at the base of the penis. This case is unusual because the anatomy was otherwise normal and the incontinence was intermittent. ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(87)80442-6
更新日期:1987-02-01 00:00:00
abstract:BACKGROUND/PURPOSE:Microgastria and postgastrectomy morbidities are substantial. The authors hypothesized a functional living tissue-engineered stomach could function as a replacement alternative. METHODS:Stomach organoid units, mesenchymal cores surrounded by epithelia, were isolated from neonatal and adult rats and ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(03)00386-5
更新日期:2003-09-01 00:00:00
abstract:BACKGROUND/PURPOSE:The management of patients with a giant omphalocele remains a difficult problem. In this study, the authors described a new surgical approach for delayed closure of ventral hernia--the Lazaro da Silva's technique--in conservatively treated patients. METHODS:Ventral hernias of 11 conservatively treat...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2004.03.064
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND:Histopathologic findings of advanced neuroblastoma after intensive induction chemotherapy have not been studied well. METHODS:In the present study, all of the surgical specimens from 19 patients who had advanced abdominal neuroblastoma and were pretreated intensively with the protocol of the Study Group of ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(97)90467-x
更新日期:1997-11-01 00:00:00
abstract:BACKGROUND:Severe blunt hepatic injury in children is associated with a high mortality rate. Although nonoperative management has become the treatment of choice for mild to moderate liver trauma, there is no consensus as to the optimal treatment for the most severe hepatic injuries in children. METHODS:A statewide tra...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2001.24720
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:A reliable metric of technical proficiency is indispensable to the training of fellows and residents. The purpose of this study was to determine whether cumulative sum (Cusum) has predictive validity in laparoscopic training. We hypothesized that Cusum would be a better predictor of technical ability in fund...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2015.10.049
更新日期:2016-04-01 00:00:00
abstract:PURPOSE:In October 2000, our institution implemented a clinical practice guideline (CPG) utilizing selective computed tomography (CT) and ultrasound scan (US) for the evaluation of children with suspected appendicitis. The authors sought to determine surgical outcomes and diagnostic accuracy in the CPG period. METHODS...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2003.11.015
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:In addition to trauma center levels and types, trauma volume may be an important factor impacting outcomes in severe pediatric trauma. METHODS:All severely injured pediatric patients treated at adult trauma centers were identified from the National Trauma Data Bank. All qualifying centers were stratified in...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2017.01.066
更新日期:2017-11-01 00:00:00
abstract::The Nuss procedure is a surgical repair technique for pectus excavatum with fewer delayed complications reported in the current literature. We report the case of a 23-year-old male who presented after a syncopal episode during activity. Further evaluation demonstrated a fibrous band causing severe right ventricle outf...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2011.12.002
更新日期:2012-03-01 00:00:00
abstract:AIM:Antenatal screening has led to early detection of posterior urethral valves (PUV). However, despite early intervention, a proportion of children will develop chronic renal insufficiency. We studied the trend of serum creatinine following urinary tract decompression during the neonatal period in infants as a possibl...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2012.11.016
更新日期:2013-02-01 00:00:00
abstract::Hepatic artery injuries sustained as a result of blunt abdominal trauma are rare. This case represents the first reported hepatic artery transection and the second hepatic artery injury described in children. Hepatic artery injuries are associated with high mortality, and their management is complex and controversial....
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jpedsurg.2006.05.001
更新日期:2006-09-01 00:00:00
abstract:BACKGROUND:Mortality and morbidity of congenital tracheal stenosis (CTS) remain high. The aim of this study was to determine the factors predicting 12-month survival and 2-month successful extubation after tracheoplasty in patients with CTS. METHODS:Retrospective chart reviews were conducted in patients with CTS under...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2017.12.017
更新日期:2018-11-01 00:00:00
abstract::The embryological development of the hepatobiliary bud presupposes that biliary and duodenal malformations are often associated. On the other hand, the association of biliary atresia with more distal small bowel malformations, possibly due to a vascular accident, seems to be fortuitous. We herewith report such a case ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(83)80534-x
更新日期:1983-04-01 00:00:00
abstract::A case of colonic duplication producing chronic constipation in a 8-year-old boy is presented. Barium enema studies demonstrated a long tubular shape of duplication that branched out from the lower part of descending colon. Successful surgical treatment was achieved by excision of the duplication with a portion of adj...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(99)90022-2
更新日期:1999-09-01 00:00:00
abstract::The authors report the case of lower cervical/upper thoracic esophageal duplication associated with an obstructing esophageal web. This presented in the newborn period as an esophageal atresia. Initial resection of the web and closure of the fistula were performed. The duplication was excised electively at 2 months of...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/s0022-3468(96)90424-8
更新日期:1996-07-01 00:00:00
abstract:BACKGROUND:Transumbilical laparoscopic-assisted appendectomy (TULA) is a single incision technique that exteriorizes the appendix through the umbilicus. The aim of this study was to compare the surgical outcomes of TULA with SILA in pediatric appendicitis. METHODS:A retrospective review of medical records between Apri...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2015.12.013
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND/PURPOSE:Chylothorax is a frequent complication in congenital diaphragmatic hernia (CDH) infants and is associated with significant morbidity. The optimal treatment strategy remains unclear. We hypothesize that octreotide decreases chylous effusions in infants with CDH. METHODS:This is a retrospective study ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2013.05.064
更新日期:2013-11-01 00:00:00
abstract::There is no definitive treatment of hepatoblastoma. Except for radical resection, the prognosis of unresectable cases remains pessimistic. Therefore, the development of new anticancer drugs for this tumor is urgently needed. Using the human hepatoblastoma cell line (c-HB-3) we demonstrated that horse anti-alpha-fetopr...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(84)80107-4
更新日期:1984-10-01 00:00:00
abstract::Chronic idiopathic intestinal pseudoobstruction (CIIP) is a disorder of alimentary tract motility with onset of symptoms in adolescence or young adulthood, characterized by recurring attacks of abdominal pain, distention, vomiting, and constipation often leading to malnutrition and death. Starting with an adolescent p...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(79)80253-5
更新日期:1979-12-01 00:00:00
abstract:BACKGROUND/PURPOSE:The aim of this study is to investigate the effect of zinc aspartate (ZA) pretreatment on ischemia-reperfusion (I/R) injury and blood and tissue antioxidant enzyme activity early after unilateral testicular torsion-detorsion (T/D). METHODS:Forty prepubertal male Sprague-Dawley rats (weight 160 to 22...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2003.09.013
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND/PURPOSE:Congenital esophageal stenosis (CES) is a rare condition that is associated with various foregut symptoms. The aim of the current study was to investigate esophageal motor function in pediatric patients with isolated CES. METHODS:Four boys with CES (age, 3 weeks to 4 years old) were studied before t...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2003.08.020
更新日期:2003-12-01 00:00:00
abstract:BACKGROUND/PURPOSE:Our approach to full-thickness anorectal prolapse has transitioned to laparoscopic suture rectopexy (LSRP). The purpose of this study was to describe the indications, technique, and postoperative outcomes for LSRP. METHODS:Rectopexy was performed using 3 or 4 laparoscopic ports. Redundant rectum was...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2010.06.006
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND/PURPOSE:Tracheobronchial ruptures in blunt thoracic trauma in children are rare. The aim of this study was to suggest the means of an early diagnosis and a conservative management as often as possible. METHODS:Sixteen cases of tracheobronchial ruptures by blunt thoracic trauma were observed over 26 years in...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(99)90328-7
更新日期:1999-12-01 00:00:00