European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift für Kinderchirurgie
-
Aim of the study was to provide an age-adapted rehabilitation protocol for flexor tendon repairs of children and to evaluate a patient series accordingly. ⋯ The rehabilitation protocol provided in this study allows an age-adapted early mobilization of children's hands after flexor tendon injuries. It respects age-specific limitations in rehabilitation and takes a child's superior healing capacity compared to adults into account. The good results and the very low complication rate observed in the present series suggest that the extra effort of early mobilization may be justified.
-
Placing a ventriculo-peritoneal shunt in children with hydrocephalus is the standard of care. Many of these children will require revision of this portion of the shunt for a variety of reasons. Previously, it was thought that in a child with multiple previous ventriculo-peritoneal shunt (VPS) revisions, laparoscopy was contraindicated. This study aims to show that laparoscopy can be used safely and effectively in children with multiple previous ventriculo-peritoneal shunt surgeries. ⋯ Laparoscopic placement of the peritoneal portion of a ventriculo-peritoneal shunt can be done safely and effectively in children with multiple previous VPS revisions due to improved visualization and placement of the shunt tip in a virgin area of the abdomen. Additionally, any known or unknown complications from previous VPS surgeries can be corrected with the laparoscopic approach. When combined with the reduction in pain, shorter hospital stay, and fewer immediate and future complications, this is the procedure of choice for patients requiring revision VPS surgeries in our hospital.
-
Fractures of the proximal tibia are infrequent during childhood and adolescence. However, intra-articular fractures, growth plate separations and metaphyseal fractures do appear. ⋯ Although proximal tibial injuries are rare, they frequently seem to appear bilaterally after inadequate trauma. A causal connection to morphological changes prior to physeal closure can be assumed.
-
Comparative Study
Double-Y pyloromyotomy: a new technique for the surgical management of infantile hypertrophic pyloric stenosis.
Many innovations and approaches have been tried for the surgical management of infantile hypertrophic pyloric stenosis (IHPS) since Ramstedt's first successful surgery almost one hundred years ago. We define here a new technique focusing on the pylorus which may offer better results for this common condition. ⋯ The double-Y pyloromyotomy (Alayet's pyloromyotomy) seems to be a good technique for the surgical management of IHPS. It offered a better functional outcome in terms of postoperative vomiting during the first postoperative week and weight gain during the first 10 days in our initial series while having a safety profile similar to Ramstedt's pyloromyotomy.
-
The effects on gastric motility following Nissen fundoplication in children are poorly documented. Some paediatric surgeons advocate additional procedures at the same time as fundoplication, such as a pyloroplasty, to enhance gastric emptying. The aim of this study was to determine whether laparoscopic Nissen fundoplication without pyloroplasty affects gastric emptying. ⋯ There were 4 males and 4 females; mean age at surgery was 3.3 +/- 3.0 years. Mean gastric emptying time was 59 +/- 17 min prior to laparoscopic Nissen fundoplication and 45 +/- 4 min following surgery (p = 0.03). Gastric emptying was accelerated in all except one patient. Gastric emptying for liquids is accelerated following Nissen fundoplication in children. Procedures aimed at improving gastric emptying time such as pyloroplasty or pyloromyotomy might not be justified at the time of laparoscopic Nissen fundoplication.