Pediatric surgery international
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To compare total extra-pleura Nuss procedure with classical Nuss, and evaluate the efficacies and safety of thoracoscopic total extra-pleural approach of Nuss procedure for correction of pectus excavatum in children. ⋯ Extra-pleura Nuss procedure under thoracoscopic guidance is a safe and less traumatic procedure for the correction of pectus excavatum. It is not only superior in postoperative recovery and pleural cavity protection, but also results in fewer complications than the intrapleural procedures.
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Pediatr. Surg. Int. · Jul 2015
National trends in therapeutic approaches and outcomes for pediatric appendicitis: a Taiwanese nationwide cohort study.
To define the pattern of therapeutic approaches for pediatric appendicitis and compare their benefits in Taiwan, we analyzed a research-oriented dataset released by the Bureau of National Health Insurance in Taiwan through the Collaboration Center for Health Information Application (CCHIA) to document the impact of the rise of laparoscopic treatment on outcomes. ⋯ Our study demonstrated that young age and perforated appendicitis can affect postoperative IAA and PBO. LA appeared beneficial in reducing the length of hospitalization and postoperative IAA, but had an increasing risk of PBO. Although laparoscopic approach for pediatric appendectomy is increasing in our country, the different hospital levels and pediatric surgeon's laparoscopic experience must be evaluated in further study.
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Hospital readmission rates are used as a metric of the quality of patient care in adults. Readmission data is lacking for pediatric surgical patients. The objective of this study is to evaluate our institution's 30-day unexpected pediatric surgical readmission data to identify potentially preventable readmissions. ⋯ Analysis of pediatric surgical readmission data may assist hospitals in focusing quality of care and cost effectiveness strategies. Development of coordination of care strategies and discharge planning involving both pediatric surgical teams and pediatric hospitalists/specialists may reduce pediatric surgical readmission rates.
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Pediatr. Surg. Int. · May 2015
ReviewTransabdominal electrical stimulation (TES) for the treatment of slow-transit constipation (STC).
Slow-transit constipation (STC) is a newly described subtype of intractable constipation in children which we originally identified with deficiency of substance P in axons supplying the proximal colonic muscle. When nuclear transit studies became available, the patients were found to have slow proximal colonic transit, and responded to antegrade enemas. ⋯ We began testing whether transcutaneous electrical stimulation (TES) could improve motility and symptoms, and over several trials have now shown that TES is remarkably effective in treating children with STC, with long-lasting effects. TES holds promise for treating STC, as well as a range of gastrointestinal motility disorders.
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Pediatr. Surg. Int. · May 2015
Multicenter StudyMinimally invasive repair of pectus excavatum: analyzing contemporary practice in 50 ACS NSQIP-pediatric institutions.
Minimally invasive repair of pectus excavatum (MIRPE) is a well-established procedure. However, morbidity rate varies widely among institutions, and the incidence of major complications remains unknown. ⋯ This analysis of a large prospective multicenter dataset demonstrates that major complications following MIRPE are uncommon in contemporary practice. Wound infection is the most common complication and the main cause of hospital readmission. Targeted quality improvement initiative should be focused on perioperative strategy to further reduce wound occurrences and hospital readmission.