Pediatric surgery international
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Pediatr. Surg. Int. · Nov 2015
Comparative StudyLocal anesthetic wound infusion versus standard analgesia in paediatric post-operative pain control.
Local anesthetic wound infusion has shown promising results in adults. Its use in children is limited to some centers and there are only a few prospective trials in this group of patients. ⋯ Continuous subfascial bupivacaine infusion is reliable, safe and effective in paediatric post-operative pain control with considerably reduced opiate requirements.
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Pediatr. Surg. Int. · Oct 2015
Hepatic ductoplasty and hepaticojejunostomy to treat narrow common hepatic duct during laparoscopic surgery for choledochal cyst.
We describe a novel technique for laparoscopic hepatic ductoplasty and hepaticojejunostomy in choledochal cyst with a narrow common hepatic duct. After complete cyst excision, a longitudinal incision was made in the anterior wall of the narrow common hepatic duct to enlarge the anastomotic opening. ⋯ Anchoring of the anterior wall provided a good field of view for creating the anastomosis, and the lumen of the anastomotic region was also secured. We believe that our technique is feasible and useful when the duct size is small.
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Pediatr. Surg. Int. · Sep 2015
ReviewRectal suction biopsy for the diagnosis of Hirschsprung's disease: a systematic review of diagnostic accuracy and complications.
Rectal suction biopsy (RSB) combined with acetylcholinesterase (AChE) staining is currently the gold standard for the diagnosis of Hirschsprung's disease (HD). However, some pathologists are still reluctant to diagnose HD in RSBs as it requires thick submucosal tissue to confirm the absence of ganglion cells. Furthermore, insufficient specimens and adverse events have been reported. The objective of this study was to determine the diagnostic accuracy and incidence of complications of RSBs in patients suspected of HD based on a systematic review of the published literature. ⋯ RSB combined with AChE staining is a simple, safe and accurate method for the diagnosis of HD. The risk for RSB-related complications is higher in newborns and infants.
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The incidence in appendicitis and the appendectomy rate are different between boys and girls. This study aimed to further evaluate appendicitis in children from a gender perspective. Gender differences in presentation, perioperative care, and outcome after appendectomy were examined. ⋯ In children with appendicitis, there are some gender differences. Girls had negative appendectomies more often, despite having more preoperative imaging and they had operative complications more frequently, despite having less frequent perforations. Boys had a higher frequency of perforation even though their time to appendectomy equaled that of girls. These findings and the reasons behind them must be further studied.
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Pediatr. Surg. Int. · Sep 2015
Intussusception patients older than 1 year tend to have early recurrence after pneumatic enema reduction.
To identify age risk factors of early recurrent intussusception after pneumatic enema reduction. Management opinions are proposed. ⋯ Intussusception patients older than 1 year tend to have greater early recurrence rate after pneumatic enema reduction; 92.1% of the early recurrent cases happened in 48 h. There is no need to hospitalize patients after pneumatic enema reduction. A repeat pneumatic enema is a good choice before surgical approach.