Abstract:
PURPOSE:The aim of this study was to evaluate the outcomes of reconstruction of all cloacal exstrophy cases seen by the authors from 1974 to 1999. METHODS:A retrospective chart review and personal follow-up was conducted on all 50 patients, who ranged in age from newborn to 35 years. Thirty-eight were secondary cases, 12 were primary (no previous surgery). Twenty-eight (56%) were genetic boys; 6 were raised as boys and 22 as girls. Forty patients underwent extensive reconstructive surgery; 6 await reconstruction, and 4 were seen only in consultation. For urinary continence, 21 had bladder neck narrowing, 7 received a bowel nipple, and 12 had a Mitrofanoff catheterizable conduit on the abdominal wall, using tapered intestine in 8, ureter in 3 and the appendix in 1. Four patients had a urostomy. Bladder augmentation was performed in 35 patients (18 with stomach, 11 small bowel, and 6 with both). Twenty-five patients had pull-through of their colon to the perineum. Thirty-two have had a vagina constructed. Forty-seven of the 50 patients had spinal cord tethering, and most underwent neurosurgical release. RESULTS:Overall survival rate was 98%; 1 patient died preoperatively at another institution. Acceptable bowel continence was achieved with enema washouts in 19 of 25 pullthroughs; 4 failed and were reversed. One case is too recent to judge. Of 40 reconstructed cases, 31 were dry, 3 had slight leakage, and 1 is too early to evaluate. Five had enough leakage to require further surgery. CONCLUSIONS:The once hopeless anomaly of cloacal exstrophy is treatable with extensive reconstructive surgery. Continence of urine (mainly by catheterization) and stool (mainly by enema washouts) is achievable in most. The hindgut, including the cecum and the usually rudimentary distal colon, should be saved and used as colon, not for urinary or vaginal reconstruction. In genetic boys, the authors continue to believe that gender assignment should depend on the likelihood for reconstructing an adequate phallus.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Lund DP,Hendren WHdoi
10.1053/jpsu.2001.20009subject
Has Abstractpub_date
2001-01-01 00:00:00pages
68-75issue
1eissn
0022-3468issn
1531-5037pii
S0022-3468(01)29053-8journal_volume
36pub_type
杂志文章abstract:BACKGROUND/PURPOSE:The laparoscopic treatment of pediatric appendicitis remains controversial, particularly in complicated cases (gangrene and perforation). This study evaluates outcomes of open (OA) and laparoscopic appendectomy (LA). METHODS:The 391 cases of pediatric appendectomy performed between January 1998 and ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2002.32255
更新日期:2002-05-01 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::Rhabdomyoma is a rare benign tumor of striated muscle origin. Two distinct histologic groups, adult and fetal type, are recognized. So far only 66 cases of extracardiac rhabdomyomas (37 fetal and 29 adult) have been documented in the literature reviewed. The present report details a case of adult rhabdomyoma of the es...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(87)80490-6
更新日期:1987-11-01 00:00:00
abstract::This article reports an experience on subemergent separation of xyphoomphaloischiopagus tetrapus conjoined twins in the newborn period when survival of one of the twins was threatened by a severely malformed counterpart. ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(89)80555-x
更新日期:1989-12-01 00:00:00
abstract:UNLABELLED:With the need for physicians to help control the rising cost of health care, consideration should be made, when appropriate, to shift more expensive inpatient care (IPC) to the less costly home care (HC) setting. The management of ruptured appendicitis (RA) includes appendectomy and intravenous (IV) antibiot...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(94)90327-1
更新日期:1994-02-01 00:00:00
abstract:BACKGROUND/PURPOSE:The treatment of children with Hirschsprung's disease beginning in the proximal jejunum remains a challenge for the pediatric surgeon. These patients need a definitive parenteral nutrition, which could lead to a liver impairment. The goal of this work is to assess the quality of life after combined l...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2003.50072
更新日期:2003-03-01 00:00:00
abstract:BACKGROUND/PURPOSE:Patients with hypoplastic left heart syndrome (HLHS) experience a higher risk for complications from gastroesophageal reflux, prompting frequent need for fundoplication. Patients between stage I and II palliation ("interstage") are at particularly high operative risk because of the parallel nature of...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2015.10.013
更新日期:2016-01-01 00:00:00
abstract::Duplications of the alimentary tract are spherical or tubular structures lined by epithelium similar to intestine that are firmly attached to or share the wall of the alimentary tract and have a common blood supply with the adjacent segment of the bowel. Completely isolated duplication cysts are an extremely rare vari...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2009.03.041
更新日期:2009-07-01 00:00:00
abstract::Bilateral Wilms' tumor patients, who experience local recurrence after maximal multimodality therapy, present a difficult surgical problem. The role of surgery in the management of these patients has changed from ablation to preservation of renal tissue, with bilateral nephrectomy as a last resort. Two children who ha...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(90)90382-j
更新日期:1990-04-01 00:00:00
abstract::Selective angiography of the testicular artery was performed in 12 boys (age 3-14 yr) with nonpalpable testis. The angiographic, operative, and microscopic findings are described. True aplasia was diagnosed in seven patients. In three patients previously operated upon, the second exploration was facilitated by angiogr...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(78)80324-8
更新日期:1978-10-01 00:00:00
abstract:OBJECTIVE:Intercellular adhesion molecule (ICAM) expression in liver and bile duct remnant is a feature of the inflammatory component of biliary atresia (BA). Circulating levels of such soluble adhesion molecules (SAM) should reflect intrahepatic disease and would prove a useful adjunct in the evaluation of BA. STUDY ...
journal_title:Journal of pediatric surgery
pub_type: 临床试验,杂志文章
doi:10.1016/j.jpedsurg.2005.05.050
更新日期:2005-09-01 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:PURPOSE:Cholecystokinin stimulated HIDA (CCK-HIDA) has been used to identify patients with biliary dyskinesia and select patients likely to benefit from cholecystectomy. The appropriate use of this study in children remains controversial and this study aims to better understand the utility of this test. METHODS:Childr...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2020.03.020
更新日期:2020-12-01 00:00:00
abstract::There is increasing evidence to suggest that reactive oxygen and nitrogen species play a role in the pathogenesis of renal ischemia-reperfusion (I/R) injury. This study was designed to determine the possible protective effects of trapidil treatment against oxidative and nitrosative tissue injury of kidney induced by I...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2006.05.064
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND/PURPOSE:Trauma centers (TC) are certified based on widely accepted criteria. These specific criteria rarely are scrutinized individually. The purpose of this study was to analyze the individual components of a pediatric trauma center for their effect on outcome. METHODS:Members of the National Pediatric Tra...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/s0022-3468(99)90392-5
更新日期:1999-05-01 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::Inflammatory cloacogenic polyp (ICP) is a rare lesion arising in the region of the anorectal transitional zone. It is likely caused by occult internal prolapse. Most cases reported in the literature are in the adult population. This is a report of ICP in four children. Awareness of this entity in children is important...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(95)90137-x
更新日期:1995-04-01 00:00:00
abstract::Ten surgical neonates with postoperative intractable diarrhea and secondary weight loss were treated with combination cholestyramine and paregoric therapy. Within 3-5 days all infants except two showed significant clinical improvement with a decreasing number of stools, an increase in the consistency of the stool, and...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(76)90105-6
更新日期:1976-10-01 00:00:00
abstract:PURPOSE:The aim of this study was to evaluate, using Doppler ultrasonography, the effects of different hernia repair techniques on testicular perfusion in the pediatric age group. METHODS:This study was based on a prospective clinical trial of 72 pediatric patients over 2 years of age with unilateral inguinal hernia. ...
journal_title:Journal of pediatric surgery
pub_type: 临床试验,杂志文章
doi:10.1016/j.jpedsurg.2012.03.044
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:The EXIT (ex utero intrapartum treatment) procedure, although initially designed for reversal of tracheal occlusion in fetuses with congenital diaphragmatic hernias (CDH), has been adapted to treat a variety of fetal conditions. METHODS:A retrospective chart review of all consecutive EXIT procedures since 1...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2002.30839
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND/PURPOSE:The authors have shown previously that surgical specimens from infants with acute necrotizing enterocolitis (NEC) show upregulation of inducible nitric oxide (NO) synthase (iNOS) and interferon-gamma mRNA. However, the contribution of other inflammatory cytokines such as interleukin-8 (IL-8), IL-11, ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2001.25726
更新日期:2001-08-01 00:00:00
abstract::In the Soave procedure for Hirschsprung's disease, the mucosectomy of the aganglionic segment of colon is performed transabdominally. The authors describe an innovative modification of the standard Soave procedure, in which a transanal mucosectomy is performed as the abdominal incision is made. The transanal mucosecto...
journal_title:Journal of pediatric surgery
pub_type: 临床试验,杂志文章
doi:10.1016/s0022-3468(96)90249-3
更新日期:1996-09-01 00:00:00
abstract::Enterocolitis (EC) remains the most serious complication of Hirschsprung's disease (HD). The aetiology of EC is uncertain. Ischemic and bacterial causes, and recently rotavirus infection, have been suggested to explain the occurrence of EC. The gut has an abundance of neuroendocrine (NE) cells which modulate gut funct...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(93)90520-u
更新日期:1993-08-01 00:00:00
abstract::The authors retrospectively review their experience in children with the latest addition to the postoperative analgesic armamentarium: interpleural analgesia (IPA). IPA was used in 14 children following thoracotomy. There were 9 boys and 5 girls. Patients varied in age from 2 months to 17 years 4 months (mean +/- SEM ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(93)90432-k
更新日期:1993-11-01 00:00:00
abstract::The nutritional and metabolic complications following intestinal resection and ileostomy for necrotizing enterocolitis (NEC) in low birth weight preterm infants often necessitate repeated prolonged hospitalization for salt and water imbalance and reliance on total parentaral nutrition (TPN). The traditional concerns a...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(87)80432-3
更新日期:1987-02-01 00:00:00
abstract::The prenatal sonographic detection of esophageal atresia (EA) has been possible for more than a decade and relies on the finding of a small or absent fetal stomach bubble associated with maternal polyhydramnios. The aims of this study were to assess the accuracy of this technique and to determine whether the outcome o...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(95)90480-8
更新日期:1995-09-01 00:00:00
abstract:BACKGROUND:Mucosal atrophy and bowel shortening are the hallmark of proximal intestinal diversion for extensive necrotizing enterocolitis (NEC) or Thiry-Vella fistulas (TVF), in which the ends of a defunctionalized loop of intestine are exteriorized as stomas. Recombinant human interleukin-11 (rhIL-11) is a pleiotropic...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2000.7826
更新日期:2000-07-01 00:00:00
abstract:PURPOSE:"Upside-down" kidney placement has been reported as an acceptable alternative in cases of technical difficulty in kidney transplantation but there are few reports in the pediatric population. The aim of our study is to analyze whether the placement of the upside-down kidney could affect graft outcome or produce...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2020.09.019
更新日期:2020-09-30 00:00:00
abstract::Neutropenic enterocolitis (NE) is a clinicopathologic condition characterized by bowel wall inflammation, which can proceed to necrosis and perforation. It is mostly seen in neutropenic patients with leukemia who undergo induction treatment with chemotherapy. Most often the cecum is involved. The authors present a 12-...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2001.24754
更新日期:2001-07-01 00:00:00
abstract::Following pancreatic trauma, loss of uninjured parenchyma as a result of surgical management is expected, and atrophy of parenchyma following nonoperative management has been described. While endocrine insufficiency as a sequela of pancreatic trauma has been reported in adults, it is not a described entity in children...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2012.11.030
更新日期:2013-02-01 00:00:00