Journal of pediatric surgery
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Multicenter Study Comparative Study
Comparison of intraabdominal abscess formation after laparoscopic and open appendicectomies in children.
Although laparoscopic appendicectomy (LA) is an accepted alternative to the open appendicectomy (OA) approach, it has been suggested that there is a higher incidence of intraabdominal abscesses (IAAs). Our aim was to determine the incidence of IAA in 3 pediatric surgical centers routinely practicing both techniques. ⋯ This large retrospective study shows that the technique of appendicectomy does not appear to affect the incidence of IAAs. Patients with complicated appendicitis are more likely to develop an IAA regardless of technique.
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Multicenter Study Comparative Study
Does age affect the outcomes and management of pediatric appendicitis?
Although it is recognized that younger children have higher appendiceal perforation rates, little is known about the effect of age on postoperative morbidity. The purpose of this study was to determine whether age affects the outcome and management of pediatric appendicitis. ⋯ Although older children had a higher risk of abscess drainage, younger children were more likely to have perforated appendicitis, be readmitted, and have longer LOH. Management of appendicitis differed according to age. Laparoscopic appendectomy was more frequently performed in older children, whereas the youngest children were more likely to be treated nonoperatively.
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Multicenter Study Comparative Study
Minimally invasive repair of congenital diaphragmatic hernia.
Operative approach, including minimally invasive surgery (MIS) in the repair of congenital diaphragmatic hernia (CDH), is variable among institutions. The short-term recurrent hernia rate is not well described. We evaluated the in-hospital recurrence rate of MIS repairs of infants with CDH from the Congenital Diaphragmatic Hernia Registry. ⋯ Minimally invasive techniques appear to have a significant higher recurrent hernia rate, with thoracoscopy being the highest. Although adjusted for patch repair, other factors with regard to disease severity may contribute to differences in outcomes among centers. This study is limited to short-term recurrence during initial hospitalization.
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Review Multicenter Study
Utility of amylase and lipase as predictors of grade of injury or outcomes in pediatric patients with pancreatic trauma.
Grade of injury, serum amylase, and lipase are markers used to assess pancreatic injury. It is unclear how amylase and lipase relate to grade of injury or predict outcome. We hypothesize that serum amylase and lipase are good predictors of grade of injury and outcomes in patients with pancreatic trauma. ⋯ There seems to be limited value for repetitive routine amylase and lipase levels in the management of pediatric trauma patients with pancreatic injury.
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Multicenter Study Comparative Study
Extracorporeal membrane oxygenation as a lifesaving modality in the treatment of pediatric patients with burns and respiratory failure.
Several case series have described successful utilization of extracorporeal membrane oxygenation (ECMO) for the treatment of pediatric burn patients with respiratory failure. This study examines the Extracorporeal Life Support Organization registry experience in the treatment of these patients. ⋯ Extracorporeal membrane oxygenation can be a lifesaving modality for pediatric burn patients with respiratory failure. Survival is comparable to the reported survival of non-burn-related pulmonary failure pediatric patients requiring ECMO.