Journal of pediatric surgery
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Comparative Study
Pediatric American College of Surgeons National Surgical Quality Improvement Program: feasibility of a novel, prospective assessment of surgical outcomes.
The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) provides validated assessment of surgical outcomes. This study reports initiation of an ACS NSQIP Pediatric at 4 children's hospitals. ⋯ These data represent the first multiinstitutional prospective assessment of specialty-specific surgical outcomes in children. The ACS NSQIP Pediatric is poised for institutional expansion and future development of risk-adjusted models.
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Comparative Study
A critical review of premature infants with inguinal hernias: optimal timing of repair, incarceration risk, and postoperative apnea.
This study evaluated the optimal timing for repair, incarceration risk, and postoperative apnea rate in premature infants with inguinal hernias. ⋯ There is minimal risk of postoperative apnea for premature infants undergoing elective inguinal hernia repair. The risk of incarceration in premature infants discharged from the NICU with a known hernia is low. Herniorrhaphy before discharge from the NICU was associated with a prolonged hospital stay.
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Stump appendicitis is a delayed complication of incomplete appendectomy. Reinflammation of possible residual appendiceal tissue should be considered in patients with right lower quadrant pain and a surgical history of appendectomy. In this report, we present 3 cases of stump appendicitis in children.
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Comparative Study
Extrahepatic portal vein thrombosis after umbilical catheterization: is it a good choice for Rex shunt?
Extrahepatic portal vein thrombosis (EHPVT) is an important cause of portal hypertension in children. Rex shunt has been used successfully to treat these patients. ⋯ The Rex shunt should be considered in the treatment of children with idiopathic EHPVT experiencing repeated gastrointestinal bleeding episodes refractory to endoscopic treatment. Nevertheless, the role of this operation for children with post-umbilical catheterization EHPVT is yet to be clearly evaluated.
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Comparative Study
Surgical intervention in the setting of parenteral nutrition-associated cholestasis may exacerbate liver injury.
This study compares postoperative markers of liver injury in patients receiving intravenous fish oil (IFO) with parenteral nutrition (PN)-associated cholestasis (PNAC) to patients with resolved PNAC. ⋯ Operations before PNAC resolution may be associated with an increased postoperative DB, possibly reflecting an exacerbation of liver injury. Operations post-PNAC resolution on IFO had a comparatively low incidence of postoperative cholestasis recurrence. Excepting clinical indication otherwise, it may be advisable to delay surgical intervention in the setting of PNAC in certain cases.