Pediatric surgery international
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Pediatr. Surg. Int. · Jul 2012
ReviewThe timing of ostomy closure in infants with necrotizing enterocolitis: a systematic review.
The optimal timing of ostomy closure is a matter of debate. We performed a systematic review of outcomes of early ostomy closure (EC, within 8 weeks) and late ostomy closure (LC, after 8 weeks) in infants with necrotizing enterocolitis. ⋯ Evidence that supports early or late closure is scarce and the published articles are of poor quality. There is no significant difference between EC versus LC in the complication rate. This systematic review supports neither early nor late ostomy closure.
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Pediatr. Surg. Int. · Jul 2012
Case ReportsPediatric bilateral spontaneous pneumothoraces in monozygotic twins.
Primary spontaneous pneumothorax from subpleural bleb disease is an uncommon occurrence in pediatric patients. This is a rare case of monozygotic twins presenting at alternating intervals with a single-sided spontaneous pneumothorax, only to have it surgically corrected, and to present later with a subsequent contralateral pneumothorax. A review of familial spontaneous pneumothoraces occurring in children was queried for congenital or genetic syndromes. ⋯ While they are rare, some congenital syndromes have been identified. The HLA haplotype A2 B40, the gene encoding folliculin, Alph-1-antitrypsin, Marfan's syndrome, Ehlers-Danlos syndrome and Birt-Hogg-Dube syndrome have all been associated with familial spontaneous pneumothoraces. Physicians need to counsel family members to ensure appropriate observation and expedited treatment is not delayed.
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Pediatr. Surg. Int. · Jul 2012
Case ReportsExtracorporeal membrane oxygenation promotes survival in children with trauma related respiratory failure.
Extracorporeal membrane oxygenation (ECMO), which is used for cardiopulmonary support in many non-trauma settings, may also be of use in pediatric patients with traumatic lung injury by allowing the lung to rest and heal. We have utilized ECMO to support three multitrauma pediatric patients with posttraumatic respiratory failure in the past 2 years. We sought to review our experience at a level 1 tertiary care children's hospital in this patient population. Our outcomes along with the limited number of pediatric trauma patients previously reported in the literature suggest that ECMO may be safely and effectively used to manage respiratory failure in this patient population.