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Pediatric Surgery during the COVID-19 pandemic

World Journal of Clinical pediatrics 2020年第2期9卷 7-16页

作者： Aikaterini Dedeilia Stepan M Esagian Ioannis A Ziogas Dimitrios Giannis Ioannis Katsaros GeorgiosTsoulfas surgery Working Group Society of Junior DoctorsAthens 15123Greece National and Kapodistrian University of Athens Athens 15772Greece Department of surgery Division of Hepatobiliary Surgery and Liver TransplantationVanderbilt University Medical CenterNashvilleTN 37232United States Institute of Health Innovations and Outcomes Research the Feinstein Institute forΜedical ResearchManhassetNY 11030United States Department of surgery Metaxa Cancer HospitalPiraeus 18537Greece First Department of surgery Aristotle University of ThessalonikiThessaloniki 54622Greece

The coronavirus disease 2019(COVID-19)pandemic has had a major impact on Pediatric Surgery.The infection is often asymptomatic and atypical in children,while overlapping presentations with other infectious diseases generate additional diagnostic challenges.The high probability of missed pediatric cases and the invasive nature of surgery generate great concern for widespread transmission in this setting.Current guidelines suggest that triage of cases should be made on a case-by-case basis by a multidisciplinary team of experts.Decisionmaking can be assisted by classifying cases as elective,urgent,or an emergency according to the risks of delaying their surgical management.A workflow diagram should ideally guide the management of all cases from admission to discharge.When surgery is necessary,all staff should use appropriate personal protective equipment,and high-risk practices,such as aerosol-generating tools or procedures,should be avoided if possible.Furthermore,carefully designed organizational protocols should be established to minimize transmission while ensuring the uninterrupted operation of Pediatric Surgery units.For example,surgical teams can be divided into small weekly rotating groups,and healthcare workers should be continuously monitored for COVID-19 symptoms.Additionally,team protocols in the operating room can optimize communication and improve adherence to personal protective equipment use.Isolated operating rooms,pediatric intensive care units,and surgical wards should be specifically designed for suspected or confirmed COVID-19 cases.Finally,transportation of patients should be minimal and follow designated short routes.All these measures can help mitigate the effects of the COVID-19 pandemic on Pediatric Surgery units.

关键词： Pediatric Surgery COVID-19 SARS-CoV-2 Coronavirus Emergency surgery Personal protective equipment

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Cancellation Causes of Elective Surgical Procedures in a Major Pediatric Surgery Department

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Open Journal of pediatrics 2022年第1期12卷 131-136页

作者： Salsabil Mohamed Sabounji Mbaye Fall Cheikh Seye Mouhamadou Mansour Diene Gabriel Ngom Pediatric Surgery Department Albert Royer Children’s Hospital Dakar Senegal Pediatric Surgery Department Aristide Le Dantec Hospital Dakar Senegal Pediatric Surgery Department Heinrich Lubke Hospital Diourbel Senegal

Introduction: Cancellation of surgical operation is a surgical operation registered in the official schedule the day before or added to the list after and not carried out on the operating day. The purpose of this work was to determine the causes of cancellation of elective surgical operations in a major Pediatric Surgery department in Senegal. Patients and methods: It was a prospective and descriptive study of 278 patients scheduled during a period of 13 weeks. The study took place between April 3rd, 2017, and January 31st, 2018. Mean age was 2.9 years with extremes of 3 days and 15 years. The age group of 29 days to 30 months was the most represented (62.2%). Sex ratio was 1.41. Causes of cancellation were categorized into administrative and organizational causes, patient-related causes and staff-related causes. Results: Cancellation rate was 29.4%. Patient-related causes were most common (51.2%). Upper Respiratory tract infection (URTI) was commonest reason within this category (57.5%). Organizational causes (28.1%) came second and were mainly represented by the unavailability of the operating room (60.8%) related to breakdowns of anesthesia equipment. Finally, staff-related causes (20.7%) were due for most to the unavailability of the anesthesiologist (12 cases/17). Conclusion: Majority of causes that led to cancellation of elective surgical operations in our Pediatric Surgery department are related to intercurrent illnesses affecting the patient, in particular URTI.

关键词： Cancellation Elective surgery URTI Pediatric Surgery Surgical Procedures

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Pterygium Popliteal Syndrome Concerning a Case in the Pediatric Surgery Department of the Donka National Hospital (Conakry CHU)

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Open Journal of pediatrics 2022年第1期12卷 162-169页

作者： Balla Keita Mamadou Alpha Toure Mohamed Lamie Sacko Mamadou Madiou Barry Mamadou Karamba Kaba Daniel Agbo-Panzo Pediatric Surgery Department CHU Donka Conakry Guinea Gamal Abdel Nasser University of Conakry Conakry Guinea Plastic surgery Department CHU Donka Conakry Guinea

Introduction: Popliteal pterygium syndrome is a rare birth defect, combining craniofacial, genitourinary and musculoskeletal abnormalities. It is an autosomal dominant disease caused by a mutation in the IRF6 gene. We report in this observation the 1st Guinean case corrected by the surgical method as well as a review of the literature for a diagnostic and therapeutic approach. Patient and observation: We present the case of a 7-day old male newborn weighing 2700 g who was received for bilateral cleft lip and palate, lower lip fossa or sinuses, bilateral popliteal pterygium, and triangular skin fold above the hallux. The patient underwent several surgical procedures aimed at correcting these abnormalities. The correction of the pterygium of the lower limbs was ensured by excision of the fibrous band, the tenoplasty in z of the calcaneal tendon on the right side and the skin plasty in z in series then immobilized by plaster splints. The immediate postoperative follow-up was straightforward. Conclusion: Popliteal pterygium syndrome is a rare congenital malformation, the diagnosis is primarily clinical. Early soft tissue lengthening surgery and serial z-skin plasty provide better correction of the knee pterygium. Correct correction of facial abnormalities gives the child a better appearance. The management of this syndrome is multidisciplinary.

关键词： Popliteal Pterygium Congenital Malformation Genetic Disease Pediatric Surgery Multidisciplinary Team

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Epidemiological Aspects of Diseases Seen in Pediatric Surgery Consultation at the Kara Teaching Hospital

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Open Journal of pediatrics 2021年第4期11卷 646-655页

作者： Missoki Azanlédji Boume Kwami Edem Edoh Bikor Ouro-Bagna Tchagbele Kokou Agbekogni Réné Ségbedji Komi Deladem Azoumah Gamédzi Komlatsè Akakpo-Numado Pediatric Surgery Department in Kara Teaching Hospital Kara Togo Pediatric Surgery Department in Campus Teaching Hospital Lomé Togo pediatric Department in Kara Teaching Hospital Kara Togo

Background: Pediatric Surgery in developing countries faces serious problems of inadequate infrastructures and equipment. Since July 2019, a new department was created in the north of Togo. It is in this context that ... 详细信息

Background: Pediatric surgery in developing countries faces serious problems of inadequate infrastructures and equipment. Since July 2019, a new department was created in the north of Togo. It is in this context that this study is initiated, with the aim of taking stock of the epidemiological distribution of pediatric surgical diseases. Material and methods: This was a retrospective and descriptive study over a period of eighteen months, from October 30, 2019 to April 30, 2021. It took place in the pediatric surgery department of the Kara teaching hospital. It concerns pathologies seen at the consultation in the department collected in consultation register. Epidemiological parameters were studied. Results: In eighteen (18) months, two hundred and fifty-nine children, were seen in pediatric surgery consultation at the Kara Teaching Hospital. The annual frequency of consultations was 172.66. The monthly frequency was 14.39. The average age of the children was 4.56 years with extremes of 2 days and 15 years. There were 194 boys (74.90%) and 65 girls (25.10%). At the consultation, whatever the reason, the examination was normal in 17 children and 242 children had abnormalities. Two hundred and twelve children (81.85%) had each one abnormality and 30 children (11.58%) had each at least two. A total of 298 diseases were reported in the 242 children. These were 218 congenital diseases (73.15%) dominated by urological abnormalities with 37.16% of cases and 80 acquired diseases (26.85%). Acquired diseases were for 26.85% and dominated by limb trauma and infectious pathologies including chronic osteomyelitis. Conclusion: Pathologies seen in Pediatric Surgery consultation were

关键词： Pediatric Surgery Congenital Malformation Children

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Optimal timing for plastic surgical procedures for common congenital anomalies:A review

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World Journal of Clinical pediatrics 2024年第2期13卷 38-61页

作者： Aakanksha Goel Arun Goel Divine Aesthetic surgery New Delhi 110048India Department of Plastic surgery Lok Nayak Hospital and Associated Maulana Azad Medical CollegeNew Delhi 110002India

Apart from listening to the cry of a healthy newborn,it is the declaration by the attending paediatrician in the labour room that the child is normal which brings utmost joy to parents.The global incidence of children born with congenital anomalies has been reported to be 3%-6%with more than 90%of these occurring in low-and middle-income group countries.The exact percentages/total numbers of children requiring surgical treatment cannot be estimated for several reasons.These children are operated under several surgical disciplines,viz,paediatric-,plastic reconstructive,neuro-,cardiothoracic-,orthopaedic surgery etc.These conditions may be life-threatening,e.g.,trachea-oesophageal fistula,critical pulmonary stenosis,etc.and require immediate surgical intervention.Some,e.g.,hydrocephalus,may need intervention as soon as the patient is fit for surgery.Some,e.g.,patent ductus arteriosus need‘wait and watch’policy up to a certain age in the hope of spontaneous recovery.Another extremely important category is that of patients where the operative intervention is done based on their age.Almost all the congenital anomalies coming under care of a plastic surgeon are operated as elective surgery(many as multiple stages of correction)at appropriate ages.There are advantages and disadvantages of intervention at different ages.In this article,we present a review of optimal timings,along with reasoning,for surgery of many of the common congenital anomalies which are treated by plastic surgeons.Obstetricians,paediatricians and general practitioners/family physicians,who most often are the first ones to come across such children,must know to guide the parents appropriately and convincingly impress upon the them as to why their child should not be operated immediately and also the consequences of too soon or too late.

关键词： Plastic surgery Congenital anomalies pediatric plastic surgery Facial cleft Microtia Vascular anomalies Syndactyly Hypospadias Optimal timing Pediatric Surgery

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Observation of the effects of three methods for reducing perineal swelling in children with developmental hip dislocation

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World Journal of Clinical Cases 2020年第20期8卷 4719-4725页

作者： Ling Wang Ning Wang Mei-Ying He Hai-Lun Liu Xian-Qiang Wang Department of Pediatric Surgery Chinese PLA General HospitalBeijing 100853China

BACKGROUND Developmental dysplasia of the hip is a developmental abnormality of the hip joint that results from hypoplasia during birth and continues to deteriorate after birth.AIM To observe the effects of magnesium sulfate wet compress,iodophor wet compress,and ice compress on reducing postoperative perineal swelling in children with developmental hip dislocation to provide effective nursing interventions in the clinic.METHODS A total of 120 children with hip dislocation after surgery in a third-class A hospital from January 2018 to January 2020 were randomly divided into four groups,the magnesium sulfate wet compress group,iodophor wet compress group,ice compress group and the control group.Data such as height,weight,age,duration of surgery,intraoperative blood loss,postoperative body temperature,swelling duration,pain score,and incidence of blisters were collected and analyzed.RESULTS There were no significant differences in height,weight,age,duration of surgery,intraoperative blood loss,and postoperative body temperature among the four groups of children.Statistical differences were observed between the intervention groups and the control group(P<0.05).CONCLUSION All three methods significantly reduced postoperative perineal swelling in children with developmental hip dislocation,reduced the duration of postoperative perineal swelling,reduced pain,and improved the quality of care.

关键词： Pediatric Surgery Developmental hip dislocation pediatric care Postoperative complications Perineal swelling

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Incidence trends and survival prediction of hepatoblastoma in children:a population-based study

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Cancer Communications 2019年第1期39卷 564-572页

作者： Jincheng Feng Georgios Polychronidis Ulrike Heger Giovanni Frongia Arianeb Mehrabi Katrin Hoffmann Department of General Visceral and Transplant SurgeryUniversity of HeidelbergIm Neuenheimer Feld 11069120 HeidelbergGermany Department of Pediatric Surgery University of HeidelbergIm Neuenheimer Feld 11069120 HeidelbergGermany

Background:Hepatoblastoma is a rare disease that nevertheless accounts for the majority of liver malignancies in children.Due to limited epidemiological data,therapy for hepatoblastoma tends to be individualized.This study aimed to evaluate incidence trends of hepatoblastoma and to develop a nomogram to predict the survival of children with newly diagnosed hepatoblastoma on a population-based level.Methods:Individuals up to 18 years of age with hepatoblastoma recorded in 18 registries of the Surveillance,Epi-demiology,and End Results(SEER)database between 2004 and 2015 were examined.Joinpoint regression analyses were applied to assess incidence trends in annual percentage change(APC).Multivariable Cox regression was used to identify factors associated with overall survival(OS).A nomogram was constructed to predict OS in individual cases based on independent predictors.Concordance index(C-index)and calibration curves were used to evaluate predic-tive performance.Results:Between 2004 and 2015,hepatoblastoma incidence increased significantly(APC,2.2%;95%confidence interval[CI]0.5%to 3.8%,Psurgery were independent predictors for short OS.Distant disease at presentation was found not to be an independent factor of survival.The nomogram had a C-index of 0.79(95%CI 0.74-0.84)with appropriate calibration curve fitting.Conclusions:We constructed a nomogram that integrates common factors associated with survival for hepatoblas-toma patients.It provides accurate prognostic prediction for children with hepatoblastoma.

关键词： Hepatoblastoma Liver surgery Liver transplantation Pediatric Surgery SEER Incidence Overall survival Nomogram

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Surgical treatment of multiple magnet ingestion in children:A singlecenter study

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World Journal of Clinical Cases 2020年第23期8卷 5988-5998页

作者： Duo-Te Cai Qiang Shu Shu-Hao Zhang Jia Liu Zhi-Gang Gao Department of General surgery the Children’s Hospital of Zhejiang University School of MedicineHangzhou 310051Zhejiang ProvinceChina Department of General surgery National Clinical Research Center for Child HealthHangzhou 310051Zhejiang ProvinceChina Department of Pediatric Surgery the Children’s Hospital of Zhejiang University School of MedicineHangzhou 310058Zhejiang ProvinceChina Department of Pediatric Surgery National Clinical Research Center for Child HealthHangzhou 310058Zhejiang ProvinceChina Department of Ear Noseand Throat Surgerythe Children’s Hospital of Zhejiang University School of MedicineHangzhou 310051Zhejiang ProvinceChina

BACKGROUND Since 2017,the number of magnet ingestion cases has increased year over year in our hospital.Almost all of the ingested magnetic foreign bodies were magnetic beads,and most of the patients experienced intestinal perforations,causing substantial damage.AIM To summarize our experience with surgical treatment of multiple magnet ingestion in children.METHODS The data for general surgeries were collected from January 2010 to April 2020,and the clinical characteristics,treatment methods,and outcomes were summarized and analyzed.Several typical cases were selected and discussed.RESULTS Fifty-six cases of ingested magnetic foreign bodies were collected,of which 47 were magnetic beads.The average patient age was 4.7±3.0 years old.The number of ingested magnetic foreign bodies ranged from 2 to 73.There were 26 cases with symptoms at the time of admission,including two cases of shock.Thirteen patients were discharged successfully following conservative treatment and 43 were treated by surgery.Laparotomy was the main method of operation.Laparoscopy was used in four cases,of which three were converted to open surgery,and one was treated successfully using surgery through the navel.Postoperative complications occurred in seven cases,incision infections were observed in six,and adhesive ileus was observed in one.CONCLUSION Clinicians need to summarize their experiences with treating magnetic foreign body ingestions in detail and carry out clinical research to reduce the damage to children.

关键词： Children Magnetic foreign body Pediatric Surgery Intestinal perforation Buckyball Magnetic bead

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Peritoneovaginal Duct and Nück’s Duct Persistence in Children at Campus Teaching Hospital in Lomé(Togo)

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Open Journal of pediatrics 2022年第1期12卷 137-147页

作者： Missoki Azanlédji Boume Kwami Edem Edoh Bikor Oswaldo Enatonta Ayidedji Wandote Yawa Sesime Sanni Dédé Virginie Teko Telly Bailo Kante Yvon Arnold Ngassam Gamédzi Komlatsè Akakpo-Numado Pediatric Surgery Department Kara Teaching Hospital Kara Togo Pediatric Surgery Department Campus Teaching Hospital Lomé Togo

Introduction: Peritoneovaginal duct (PVD) and Nück duct (ND) include several abnormalities with many clinical entities that are at the cause of a variety of symptoms. These are frequent in pediatric surgeon practice and could lead to serious complications. The aim of our work was to describe the epidemiological, diagnostic and therapeutic aspects of pathologies of PVD or ND in our conditions after the first five years of surgical activities of our pediatric department. Material and Methods: This was a retrospective and descriptive study, carried out on the files of children, aged zero to 15 years, presenting PVD or ND pathology, operated in the service, over a period of 4 years (2016 to 2019). Results were classified good, medium or bad. Results: During the study period, among the 865 children operated in Pediatric Surgery, 164 children were found for PVD and ND pathologies (18.95%). The average age was 5.3 years old. There were 152 boys (92.68%) and 12 girls (7.32%). The reason for consultation was inguinal or inguino-scrotal swelling in 99.3% of the children. The right side was affected in 58.5% of cases. In boys, there were inguinal hernias (27.5%), inguinoscrotal hernias (30.3%), hydroceles (36.9%) and cysts (5.3%). In girls, there were inguinal hernias (91.7%) and 1 ovarian hernia (8.3%). The umbilical hernia was associated with these pathologies in 39 cases. Treatment was conventional closure of the PVD or ND. With an average follow-up of 2.5 years (range 3 months and 3.5 years), the results were good in all cases. Conclusion: Pathologies of PVD or ND took an important place in the activities of the Pediatric Surgery department. Management by conventional surgery has given good results in all cases. Early treatment of these pathologies helps prevent complications.

关键词： Peritoneovaginal Duct Nück Duct Hernia Hydrocele Cord Cyst Pediatric Surgery

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Practice of pediatric Spinal Anesthesia in a Country with Limited Means: Example of Togo

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Open Journal of Anesthesiology 2023年第2期13卷 32-45页

作者： Essohanam Tabana Mouzou Sarakawabalo Assenouwe Pikabalo Tchetike Eyram Yoan Makafui Amekoudi Tchaa Hodabalo Towoezim Resuscitation Anesthesia Department at the Kara-CHU Kara Togo CHU-Sylvanus Olympio Anesthesia Resuscitation Department in Lome Lome Togo Medical Resuscitation and Nephrology Service of the CHU-Kara Kara Togo CHU-Kara Traumatology Department Kara Togo

Introduction: The practice of spinal anesthesia in Pediatric Surgery is declining, especially in countries with limited means. What about in our context? Objective: To evaluate the practice of spinal anesthesia in Pediatric Surgery in Togo. Framework and method of study: This was a prospective study from November 2017 to May 2018 in Pediatric Surgery at CHU SO de Lomé, in the operating room and hospital ward of CHU Kara. The surgical, anesthesiological and evolutionary aspects of the patients were analyzed. Results: Sixty children were selected for the study who had an indication for sub-umbilical surgery. The male sex was predominant (73.3%). 47 (78.30%) patients were operated on for scheduled surgery. Hernia repair was the most performed surgical intervention (43.30%). The mean duration of the surgery was 78 ± 35.9 minutes. Most of the patients were ASA 1 (98.30%). The local anesthetic used was 0.5% isobaric Bupivacaine. Fentanyl was the predominant adjuvant (55%). The most widely used lumbar puncture needle was 25 Gauge with 75 millimeters in length (63.30%). Diazepam was the most widely used sedative (50%). The predominant spinal anesthesia protocol was spinal anesthesia alone (60%). Only one patient had hypotension (1.70%). Conclusion: The fairly satisfactory pediatric spinal anesthesia in Togo remains poorly performed. Its promotion involves the training of anesthesia practitioners and the strengthening of the technical platform.

关键词： Pediatric Surgery Spinal Anesthesia Togo

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