Abstract：
:It has been assumed that only 10% of medical interventions are supported by solid scientific evidence. The aim of this study was to determine the type of research evidence supporting operations in a tertiary referral paediatric surgical unit. All patients admitted over a 4-week period to two surgical firms were enrolled in the study. All major operations carried out on each patient since birth were evaluated. Patients for whom a diagnosis was not reached were excluded. A bibliographic database (MEDLINE) was used to search for the articles published between January 1986 and December 1995 on the analysed operations. The type of evidence supporting the operations was classified as follows: I=evidence from randomised controlled trials (RCTs); II=self-evident intervention (obvious effectiveness not requiring RCTs); III=evidence from prospective and/or comparative studies; IV=evidence from follow-up studies and/or retrospective case series; and V=intervention without substantial evidence for or against results of randomised trials. Seventy operations (32 individual types) were performed on 49 patients (1-5 operations/patient); 18 (26%) were supported by RCTs (type of evidence I). Two patients (3%) received a self-evident intervention (type II); 48 operations (68%) were based on non-randomised prospective or retrospective studies (type III=13%; type IV=55%). Two patients (3%) received an operation not supported by or against convincing scientific evidence (type V). A significant proportion of operations in paediatric surgery is supported by RCTs. However, the vast majority of these trials were conducted on adult patients. Sixty-eight per cent of the operations were based on prospective follow-up studies or retrospective case series, which may not represent solid scientific evidence. More RCTs are needed in paediatric surgery.
journal_name
Pediatr Surg Intjournal_title
Pediatric surgery internationalauthors
Baraldini V,Spitz L,Pierro Adoi
10.1007/s003830050332subject
Has Abstractpub_date
1998-07-01 00:00:00pages
331-5issue
5-6eissn
0179-0358issn
1437-9813journal_volume
13pub_type
杂志文章abstract：:A 6-year-old girl presented with intractable constipation. On investigation, she was found to have an association of anorectal stenosis, anterior sacral defect, and anterior meningocoele (Currarino's triad). The meningocoele was excised and a Duhamel pull-through procedure performed after resection of a massively dist...
journal_title：Pediatric surgery international
pub_type： 杂志文章,评审
doi：10.1007/s003830050362
更新日期：1998-07-01 00:00:00
abstract：INTRODUCTION AND OBJECTIVES:Snodgrass tubularized incised plate urethroplasty and 2 modifications were evaluated in 75 hypospadiacs (distal and midpenile). PATIENTS AND METHODS:The initial 25 patients (group A), underwent Snodgrass tubularized incised plate urethroplasty. In the next 25 patients (group B), the urethra...
journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-004-1148-0
更新日期：2004-03-01 00:00:00
abstract：:Colonic atresia and choledochal cyst are rare congenital abnormalities and there are few cases of their coexistence reported in the literature. We report a case of choledochal cyst and colonic atresia in a term neonate. Our prenatal ultrasonographic and intraoperative findings support the idea that these two entities ...
journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-008-2280-z
更新日期：2009-01-01 00:00:00
abstract：:The purpose of this report was to analyze the patients requiring preoperative extracorporeal membrane oxygenation (ECMO) as the most critical group of patients with congenital diaphragmatic hernia (CDH) and to identify any special features. Over the past 11 years, out of 72 neonates with CDH admitted before 24 h of ag...
journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s003830050428
更新日期：1998-11-01 00:00:00
abstract：:The functional outcome and factors influencing improvement after pyeloplasty for ureteropelvic junction (UPJ) obstruction are still debated. This retrospective study was aimed at evaluating the factors associated with functional improvement in symptomatic unilateral hydronephrosis (HDN). Patients (n = 68) who underwen...
journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s003830100604
更新日期：2001-09-01 00:00:00
abstract：PURPOSE:The clinical application of autologous tissue-engineered skin analogs is an important strategy to cover large skin defects. Investigating biological dynamics, such as reinnervation after transplantation, is essential to improve the quality of such skin analogs. Previously, we have examined that our skin substit...
journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-016-3978-y
更新日期：2016-12-01 00:00:00
abstract：:We present a neonate with gastroschisis and evidence of bile aspiration in utero, who developed severe respiratory distress that did not respond to postnatal intensive respiratory care. Although rare, a newborn with gastroschisis may develop severe respiratory distress due to bile aspiration in utero. Given the poor o...
journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-008-2223-8
更新日期：2008-10-01 00:00:00
abstract：:Inflammatory bowel disease (IBD) in children can cause significant impairment in linear growth, and delay in pubertal onset. The aim of this study was to assess the impact of surgery on linear growth in children with Crohn's disease (CD) who were resistant to medical therapy, and had documented evidence of growth impa...
journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-006-1664-1
更新日期：2006-04-01 00:00:00
abstract：PURPOSE:Congenital lung abnormalities are rare malformations increasingly detected early by prenatal ultrasound. Whether management of these frequently asymptomatic lesions should be surgical or conservative is an unresolved issue. The necessary prospective studies are limited by the absence of a widely accepted practi...
journal_title：Pediatric surgery international
pub_type： 杂志文章,评审
doi：10.1007/s00383-017-4062-y
更新日期：2017-06-01 00:00:00
abstract：:Despite the increasing incidence of gastroschisis, the cause remains unknown. Genetic factors may contribute to bowel anomalies as demonstrated by cases of gastroschisis in twins and siblings, and other types of bowel anomalies in twins. Atresia of the colon represents one of the rarest causes of neonatal intestinal o...
journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-009-2353-7
更新日期：2009-05-01 00:00:00
abstract：:We examined immunohistochemically the expression and localisation of synapse-associated proteins, syntaxin (SNT) and synaptotagmin (STG) in the entire resected specimens of colon obtained at the time of pull-through operation from 15 patients with Hirschsprung's disease (HD) and 6 age-matched controls. Both antibodies...
journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s003830050408
更新日期：1998-10-01 00:00:00
abstract：:Atypical mycobacterial disease is common in children in Australia. Over 22 years, records were kept prospectively by the senior author. The diagnosis was confirmed in 118 patients, either by culture or by the combination of a positive skin test plus typical histology. There were 46 boys and 72 girls with a median age ...
journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-002-0840-1
更新日期：2002-12-01 00:00:00
abstract：:The embryogenesis of a previously unreported mesothelial pouch containing a Meckel's diverticulum is presented. ...
journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/BF01076960
更新日期：1997-07-01 00:00:00
abstract：:Liver transplantation (LT) for malignancy has had disappointing long-term results due to tumour recurrence. Ex-vivo dissection and auto-transplantation have had poor results when the tumor was obstructing bile ducts. Advances in liver surgery have made extensive liver resection safer, but cases of "unresectable" tumou...
journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s003830000531
更新日期：2001-07-01 00:00:00
abstract：:Bronchogenic cyst (BC), which develops from abnormal budding of the tracheal diverticulum or ventral foregut, is a congenital bronchopulmonary malformation. Localization of the BC varies depending on the level of the abnormal budding. Thoracic or abdominal-sited diaphragmatic lesions are the rarest presentations of th...
journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-008-2187-8
更新日期：2008-08-01 00:00:00
abstract：:The goal of this article is to review the status of cultured epithelial autografts in clinical practice with particular focus on the pediatric subset of patients. The current indications include massive deep burns (>60 - 70% total body surface area), resurfacing-type postburn scar revisions, and skin defect coverage f...
journal_title：Pediatric surgery international
pub_type： 杂志文章,评审
doi：10.1007/BF01258705
更新日期：1997-09-01 00:00:00
abstract：PURPOSE:Bicycling is a well-liked sporting activity in which many children participate, and bicycle accidents are one of the most common causes of abdominal injuries in children. We evaluated the characteristics and outcomes of abdominal injuries due to bicycle accidents in children. PATIENTS AND METHODS:This study wa...
journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-013-3279-7
更新日期：2013-05-01 00:00:00
abstract：PURPOSE:Cervicothoracic and apical thoracic neuroblastoma pose unique surgical challenges. We report our experience with the trapdoor anterior thoracotomy (TAT) approach to overcome these difficulties. METHODS:Retrospective review of our centre's neuroblastoma database was conducted. Patients who underwent TAT at our ...
journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-020-04692-2
更新日期：2020-08-01 00:00:00
abstract：:We review a single surgeon and surgical centre's experience with congenital cystic adenomatoid malformation of the lung (CCAML) in relation to clinical spectrum, operative experience, and postoperative course. A retrospective hospital record review was done on surgically treated cases of CCAML over a 10-year period, f...
journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-004-1225-4
更新日期：2004-07-01 00:00:00
abstract：PURPOSE:To identify potential metabolic biomarkers for distinguishing malignant and benign thyroid nodules in children and adolescents using a metabolomics approach. METHODS:A total of 96 consecutive patients (median age 14.29 ± 2.31 years, range 9-18 years) who underwent thyroidectomy and 40 healthy controls were enr...
journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-019-04584-0
更新日期：2020-02-01 00:00:00
abstract：:Bronchogenic cysts are congenital malformations of the tracheobronchial tree. We describe a 20-month-old male who presented with persistent non-bilious emesis; manometry and imaging were consistent with esophageal achalasia. During a planned laparoscopic Heller myotomy, an intramural bronchogenic cyst was discovered i...
journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-016-3994-y
更新日期：2017-01-01 00:00:00
abstract：AIM:We assessed continence after scope-assisted anorectovaginoplasty (SARVP) for female anorectal malformation (FARM). METHODS:Five FARM cases were assessed; cases 1 and 2: cloacal malformation; case 3: urogenital sinus, and rectovestibular fistula (RF); case 4: RF, absent vagina, and sacral anomaly; case 5: covered c...
journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-012-3141-3
更新日期：2012-09-01 00:00:00
abstract：:To determine which laser can be used for a vascular lesion, the different working mechanisms of the individual lasers must first be understood. The localization and diameter of the vessels to be treated define whether a certain laser is appropriate for that lesion. For teleangiectasias and port-wine stains the pulsed-...
journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/BF00497797
更新日期：1996-06-01 00:00:00
abstract：:True duplicate exstrophy is a rare and interesting congenital anomaly. We are adding a case to the previously reported seven cases in the world literature. ...
journal_title：Pediatric surgery international
pub_type： 杂志文章,评审
doi：10.1007/s003830000557
更新日期：2002-03-01 00:00:00
abstract：OBJECTIVE:For esophagus tissue engineering, isolation and proliferation of esophageal epithelial cells (EEC) is a pre-requisite for scaffold seeding to create constructs. The aim of this study was to sort EEC expressing cytokeratin markers and their proliferative subpopulations; also, to investigate the viability of di...
journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-009-2512-x
更新日期：2010-01-01 00:00:00
abstract：:Single-system ureteral ectopia (UE) encompasses a spectrum of malformations involving the bladder trigone, ureter, and kidney. The clinical presentation is variable, and both diagnostic and therapeutic problems are common. Reduced renal function in these patients may result from primary dysplasia, obstruction, vesicou...
journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s003830000414
更新日期：2000-01-01 00:00:00
abstract：:Primary omental torsion (POT), is a rare cause of acute abdomen commonly affecting obese male adults, whereas it is extremely rare in children. In this retrospective study, we present our experience regarding the management of five children with POT and discuss the diagnostic and therapeutic implications of this entit...
journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-007-1961-3
更新日期：2007-09-01 00:00:00
abstract：:Incarcerated inguinal hernias in infants are commonly encountered. Reduction with intravenous sedation using morphine and related drugs carries risks of apnoea and/or respiratory arrest, especially in small, ex-premature babies who have an increased incidence of incarceration and thus opiate use is best avoided. Cauda...
journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-005-1534-2
更新日期：2005-09-01 00:00:00
abstract：BACKGROUND:The natural history of patients with antenatally diagnosed congenital cystic adenomatoid malformation of the lung (CCAM) is still fully unknown. In symptomatic patients with respiratory distress, an operation is performed during the neonatal period. However, in asymptomatic patients, the optimal timing of th...
journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-009-2431-x
更新日期：2009-09-01 00:00:00
abstract：:Congenital lung lesions are diagnosed antenatally in the majority of cases. Postnatal management includes chest radiography and CT-scanning, followed by either surgical resection or CT surveillance. Pre-operatively, lesions are often "labelled" as CCAM (and the Stocker classification incorrectly applied), sequestratio...
journal_title：Pediatric surgery international
pub_type： 杂志文章
doi：10.1007/s00383-008-2201-1
更新日期：2008-09-01 00:00:00
