European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift für Kinderchirurgie
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Comparative Study
Health-related quality of life in children and adolescents undergoing surgery for pectus excavatum.
This study evaluated health-related quality of life (HRQoL) in children and adolescents undergoing cosmetic surgery for pectus excavatum (PE) compared to a group of healthy children. ⋯ HRQol was significantly better in the Intervention Group compared to healthy controls at the same age. In five subscales Self-Esteem, Behavior, Emotional Role, Mental Health and Family Activities, the PE group had a better HRQoL.
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The endogenous opioid beta-endorphin is a known indicator of stress and pain. Opioid anesthesia during operation may prevent postoperative beta-endorphin hypersecretion. We examine the effect on serum beta-endorphin of both preoperative stress and stress of operation under opioids in neonates, infants and preschool children. In order to eliminate the effect of hospitalization anxiety we compared with inpatients of similar age with non-surgical disease. ⋯ Fentanyl/propofol anesthesia, supplemented by postoperative morphine where necessary, protects from surgical stress and postoperative pain, as denoted by no postoperative increase of beta-endorphin in all age groups. Preschool children, who exhibit increased emotional perception, have explicitly high serum beta-endorphin before and after surgery. Preoperative preparation programs might be worthy in this age group. Neonates show a moderate but still significantly high response of beta-endorphin to stress, retained after operation. In contrast, infants tolerated stress better (not increased beta-endorphin pre- and post-operatively).
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Comparative Study
Adhesional small bowel obstruction following anti-reflux surgery in children--comparison of 232 laparoscopic and open fundoplications.
Adhesions are a major cause of morbidity following abdominal surgery. There is debate whether laparoscopic abdominal surgery results in a lower incidence of adhesional small bowel obstruction (ASBO) compared with the equivalent open procedure. The aim of this study was to study the incidence of ASBO following laparoscopic and open anti-reflux surgery. ⋯ ASBO is a serious complication following any abdominal surgery. The data from this study indicate that the risk of ASBO following laparoscopic fundoplication is negligible. Although there is a suggestion that the risk of ASBO is lower following laparoscopic fundoplication compared with open fundoplication, there was no significant difference between the two groups as Ladd's procedure was performed in 2 of the open cases.
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The use of extracorporeal membrane oxygenation (ECMO) has increased since its inception. As this modality gained wider acceptance, its application in a variety of disease states has increased. ⋯ Various reports in the literature have compared VV ECMO and VA ECMO. We present a review of the literature with regard to both physiology and clinical application.