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Gastric transposition as a valid surgical option for esophageal replacement in pediatric patients:experience from three Italian medical centers

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Gastroenterology Report 2017年第1期5卷 47-51,I0002页

作者： Rossella Angotti Francesco Molinaro Carmine Noviello Giovanni Cobellis Ascanio Martino Carmine Del Rossi Adrian Bianchi Mario Messina Division of Pediatric surgery Department of MedicineSurgical and Neurological SciencesUniversity of SienaSienaItaly Pediatric surgery Unit Academic Salesi Children HospitalMarche Polytechnic UniversityAnconaItaly Department of Pediatric surgery University of ParmaParmaItaly Neonatal and paediatric Reconstructive surgery Royal Manchester Children’s HospitalManchesterUK

Background:Esophageal replacement in children is an option that is confined to very few situations including long-gap esophageal atresia and esophageal strictures unresponsive to other therapies(peptic or caustic ingestion).The purpose of our work was to describe the experience of gastric transposition in three Italian ***:This is a retrospective *** data were extrapolated from a prospective *** included all patients who had undergone gastric transposition in the last 15 ***:In the 15-year period,eight infants and children(3 males and 5 females)underwent gastric transposition for esophageal *** patients had long-gap esophageal atresia,and two had caustic esophageal *** were no deaths in the *** patients had an early postoperative complication:two had a self-limited salivary fistula at three weeks,and one(a patient with jejunostomy)had a jejunal perforation treated *** late complication,anastomotic stricture,was recorded that required two endoscopic *** median follow-up was 60 months(range:18–144 months).At final clinical follow-up,six patients had no eating problems,and two patients had some difficulties with eating(jejunostomy in situ),but they underwent logopedic therapy with improved *** patients had an increase in body weight and height ***:Our small study reports the clinical experience of three Italian centers in which gastric transposition was performed with excellent results,both in terms of surgical technique(simplicity,reproducibility,complication rate)and clinical follow-up(good oral feeding of young patients,normal social life and regular growth curves).

关键词： gastric transposition children esophageal atresia caustic ingestion

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Use of laparoscopy as the initial surgical approach of impalpable testes:10-year experience

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World Journal of Clinical Pediatrics 2015年第4期4卷 155-159页

作者： Kin Wai Edwin Chan Kim Hung Lee Hei Yi Vicky Wong Siu Yan Bess Tsui Yuen Shan Wong Kit Yi Kristine Pang Jennifer Wai Cheung Mou Yuk Him Tam Division of paediatric surgery and paediatric Urology Department of Surgerythe Prince of Wales Hospitalthe Chinese University of Hong Kong

AIM: To review the experience in the management of impalpable testes using laparoscopy as the initial approach and the need for inguinal ***: From January 2004 to June 2014, 339 patients with undescended testes underwent operation in our institute. Fifty patients(15%) had impalpable testes. All children with impalpable testes underwent initial laparoscopy. A retrospective review was conducted on this group of patients and the outcome was ***: Forty children had unilateral impalpable testis. Ten children had bilateral impalpable testes. Thirty-one children(78%) in the unilateral group underwent subsequent inguinal exploration while 4 children(40%) in the bilateral group underwent inguinal exploration(P < 0.05). Orchidopexy was performed in 16 children(40%) in the unilateral group and 9 children(90%) in the bilateral group(P < 0.05). Regarding the 24 children with unilateral impalpable testis and underwent orchidectomy for testicular nubbin(n = 19) or atrophic testes(n = 2) or has vanishing testes(n = 3); contralateral testicular hypertrophy was noticed in 10(41%). No intra-operative complication was encountered. Two children after staged Fowler-Stephensprocedure and 1 child after inguinal orchidopexy had atrophic ***: The use of laparoscopy in children with impalpable testes is a safe procedure and can guide the need for subsequent inguinal exploration. Children with unilateral impalpable testis were associated with an increased need for inguinal exploration after laparoscopy. Orchidopexies could be performed successfully in 90% of children with bilateral impalpable testes.

关键词： Laparoscopy Impalpable Testis Inguinal

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Changes of smooth muscle contractile filaments in small bowel atresia

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World Journal of Gastroenterology 2012年第24期18卷 3099-3104页

作者： Stefan Gfroerer Henning Fiegel Priya Ramachandran Udo Rolle Roman Metzger Department of paediatric surgery Goethe-University Frankfurt60590 FrankfurtGermany Kanchi Kamakoti Childs Trust Hospital Chennai 600034India Department of paediatric surgery University of Leipzig04317 LeipzigGermany

AIM:To investigate morphological changes of intestinal smooth muscle contractile fibres in small bowel atresia ***:Resected small bowel specimens from small bowel atresia patients(n = 12) were divided into three sections(proximal,atretic and distal).Standard histology hematoxylin-eosin staining and enzyme immunohistochemistry was performed to visualize smooth muscle contractile markers-smooth muscle actin(SMA) and desmin using conventional paraffin sections of the proximal and distal *** bowel from agematched patients(n = 2) undergoing Meckel's diverticulum resection served as ***:The smooth muscle coat in the proximal bowel of small bowel atresia patients was thickened compared with control tissue,but the distal bowel was *** of smooth muscle contractile fibres SMA and desmin within the proximal bowel was slightly reduced compared with the distal bowel and control *** were no major differences in the architecture of the smooth muscle within the proximal bowel and the distal *** proximal and distal bowel in small bowel atresia patients revealed only minimal differences regarding smooth muscle morphology and the presence of smooth muscle contractile filament ***:Changes in smooth muscle contractile filaments do not appear to play a major role in postoperative motility disorders in small bowel atresia.

关键词： Small bowel atresia Enteric nervous sys-tem Smooth muscle Motility disorder

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Migration of the distal ventriculoperitoneal shunt catheter into the stomach with or without trans-oral extrusion:A systematic literature review and meta-analysis

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World Journal of Clinical Pediatrics 2023年第5期12卷 331-349页

作者： Rajendra Kumar Ghritlaharey Department of paediatric surgery Gandhi Medical College and AssociatedKamla Nehru and Hamidia HospitalsBhopal 462001Madhya PradeshIndia

BACKGROUND Intra-gastric migration of the distal ventriculoperitoneal shunt(VPS)catheter clinically presenting with or without trans-oral extrusion is one of the rare complications of VPS catheter *** To identify the demographics,clinical presentation,clinical findings,and results of surgical therapy offered for the treatment of intra-gastric migration of the distal VPS catheter,clinically presented with or without trans-oral *** An online search was performed for the extraction/retrieval of the published/available literature pertaining to the above-mentioned VPS *** were searched from PubMed,PMC(PubMed Central),ResearchGate,and Google Scholar databases using various terminology relating to the VPS *** first case of migration of a VPS catheter into the stomach was reported in the year 1980,and the data were retrieved from 1980 to December *** were categorized into two groups;Group A:Cases who had migration of the distal VPS catheter into the stomach and clinically presented with trans-oral extrusion of the same,and Group B:Cases who had migration of the distal VPS catheter into the stomach,but presented without trans-oral *** A total of n=46 cases(n=27;58.69%male,and n=19;41.3%females)were recruited for the systematic *** A included n=32,and Group B n=14 *** hydrocephalus was the indication for the primary VPS insertion for approximately half of the(n=22)*** sixty percent(n=27)of them were children≤5 years of age at the time of the diagnosis of the complication mentioned *** seventy-two percent(n=33)cases,this complication was detected within 24 mo after the VPS insertion/last shunt *** diagnosis was evident for the entire group A *** diagnostic modalities were used to confirm the diagnosis for Group B *** surgical procedures were offered for the management of the complication in n=43 cases of both *** two

关键词： Complication Extrusion Hydrocephalus Migration Protrusion Stomach Shunt revision Ventriculoperitoneal shunt Ventriculoperitoneal shunt complications

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Cystic meconium peritonitis with jejunoileal atresia:Is it associated with unfavorable outcome?

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World Journal of Clinical Pediatrics 2017年第1期6卷 40-44页

AIM To compare the outcome between patients with jejunoileal atresia(JIA) associated with cystic meconium peritonitis(CMP) and patients with isolated JIA(JIA without CMP).METHODS A retrospective study was conducted for all neonates with JIA operated in our institute from January 2005 to January *** including the gestation age,sex,birth weight,age at operation,the presence of associated syndrome was *** outcome including the type of operation performed,operative time,the need for reoperation and mortality were *** demographics and the outcome between the 2 groups were *** During the study period,53 neonates had JIA underwent operation in our *** neonates(32%) were associated with *** was no statistical difference on the demographics in the two *** with CMP had earlier operation than patients with isolated JIA(mean 1.4 d vs 3 d,P = 0.038).Primaryanastomosis was performed in 16 patients(94%) with CMP and 30 patients(83%) with isolated JIA(P = 0.269).Patients with CMP had longer operation(mean 190 min vs 154 min,P = 0.004).There were no statistical difference the need for reoperation(3 vs 6,P = 0.606) and mortality(2 vs 1,P = 0.269) between the two *** Primary intestinal anastomosis can be performed in94% of patients with JIA associated with *** patients with CMP had longer operative time,the mortality and reoperation rates were low and were comparable to patients with isolated JIA.

关键词： Meconium Peritonitis Atresia Jejunoileal

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Hepatocyte cryopreservation:Is it time to change the strategy?

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World Journal of Gastroenterology 2010年第1期16卷 1-14页

作者： Xavier Stéphenne Mustapha Najimi Etienne M Sokal Catholic University of Louvain and St Luc Clinics Paediatric Department(HPED)PEDI unitLaboratory of Paediatric Hepatology and Cell Therapy

Liver cell transplantation presents clinical benefit in patients with inborn errors of metabolism as an alternative,or at least as a bridge,to orthotopic liver *** success of such a therapeutic approach remains limited by the quality of the transplanted *** remains the best option for long-term storage of hepatocytes,providing a permanent and sufficient cell ***, isolated adult hepatocytes are poorly resistant to such a process,with a significant alteration both at the morphological and functional ***,the aim of the current review is to discuss the state of the art regarding widely-used hepatocyte cryopreservation protocols,as well as the assays performed to analyse the post-thawing cell quality both in vitro and in vivo. The majority of studies agree upon the poor quality and efficiency of cryopreserved/thawed hepatocytes as compared to freshly isolated *** ice formation or exposure to hyperosmotic solutionsremains the main phenomenon of cryopreservation process,and its effects on cell quality and cell death induction will be *** increased knowledge and understanding of the cryopreservation process will lead to research strategies to improve the viability and the quality of the cell suspensions after *** strategies,such as vitrification,will be discussed with respect to their potential to significantly improve the quality of cell suspensions dedicated to liver cell-based therapies.

关键词： Hepatocyte Cryopreservation Quality Mitochondria Intracellular ice formation

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Longitudinal Evaluation of Right Ventricle Function after Right Ventricle-Pulmonary Artery Shunt ***-Taussig Shunt

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Congenital Heart Disease 2021年第1期16卷 27-37页

作者： Nunzia Borrelli Jolanda Sabatino Martina Avesani Josefa Paredes Manjit Josen Alain Fraisse Paolo Guccione Guido Michielon Giovanni Di Salvo paediatric Cardiology Department Royal Brompton HospitalLondonSW36NPUK paediatric Cardiology Department Bambino GesùPaediatric HospitalRome00165Italy Cardiology Department “Magna Graecia”UniversityCatanzaro88100Italy paediatric Cardiology Department University of PaduaPadua35128Italy

Background:Still little is known about the impact on right ventricle function of the 2 main approaches to Norwood palliation in Hypoplastic left heart syndrome,the right ventricle-pulmonary artery shunt(RVPAS)and the modified Blalock-Taussig shunt(mBTS).Methods:The cohort included 27 patients with Hypoplastic left heart syndrome(10 in the mBTS group,17 in the RVPAS group).Longitudinal strain,tricuspid annulus peak systolic excursion and fractional area change were evaluated before Norwood and in four different breakpoints in the steady-state after Norwood procedure(30-days,90-days,140-days and 200-days after Norwood).Results:No significant differences were found in all standard echocardiographic functional parameters between the two groups at any ***,when we compared right ventricle function before and after Norwood procedure,longitudinal strain significantly improved in mBTS group compared to pre-surgical assessment(after 90-days:mBTS+27,35%±43,47 ***-8,20%±25,25,p=0,03;after 200-days:mBTS+10.19%±36.58 ***-21.64%±30.43,p=0.04).Conclusion:The mBTS group,which did not receive any ventriculotomy,showed a significant increase in right ventricle longitudinal strain during *** data support the use of longitudinal strain in Hypoplastic left heart syndrome evaluation and may suggest potential value in terms of cardiac mechanics in using mBTS,preserving the right ventricle integrity.

关键词： Hypoplastic left heart syndrome speckle tracking echocardiography congenital heart disease

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Low SARS-CoV-2 seroprevalence but high perception of risk among healthcare workers at children’s hospital before second pandemic wave in Germany

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World Journal of Pediatrics 2021年第5期17卷 484-494页

作者： Marietta Neumann Annette Aigner Eileen Rossow David Schwarz Maria Marschallek Jorg Steinmann Ralf Stucker Ingo Koenigs Philippe Stock Department of paediatrics Altona Children's HospitalUniversitat HamburgAltonaer KinderkrankenhausBleickenallee 3822763 HamburgGermany Corporate Member of Freie Universitat Berlin and Humboldt-Universitat Zu Berlin Institute of Biometry and Clinical Epidermiology BerlinCharite-Universitatsmedizin BerlinBerlinGermany Department of Neonatology and paediatric Intensive Care Medicine Altona Children's HospitalHamburgGermany Department of paediatric surgery Altona Children's HospitalHamburgGermany Labor Dr.Fenner and Colleagues Hamburg.Germany Department of paediatric Orthopaedics Altona Children's HospitalHamburgGermany Department of paediatric surgery University Medical Centre Hamburg Eppendorf(UKE)HamburgGermany Department of paediatrics Altona Children's HospitalHamburgGermany

Background Healthcare workers are considered a particularly high-risk group during the coronavirus disease 2019(COVID-19)*** workers in paediatries are a unique subgroup:they come into frequent contact with children,who often experience few or no symptoms when infected with severe acute respiratory syndrome coronavirus 2(SARS CoV-2)and,therefore,may transmit the disease to unprotected *** Germany,no studies exist evaluating the risk of COVID-19 to healthcare workers in paediatric *** We tested the staff at a large children's hospital in Germany for immunoglobulin(Ig)G antibodies against the nucle-ocapsid protein of SARS CoV-2 in a period between the first and second epidemic wave in *** used a questionnaire to assess each individual's exposure risk and his/her own perception of having already been infected with *** We recruited 619 participants from all sectors,clinical and non-clinical,constituting 70%of the entire *** seroprevalence of SARS CoV-2 antibodies was 0.325%(95%confidence interval 0.039-I.168).Self-perceived risk of a previ-ous SARS-CoV-2 infection decreased with age(odds ratio,0.81;95%confidence interval,0.70-0.93).Having experienced symptoms more than doubled the odds of a high self-perceived risk(odds ratio,2.18;95%confidence interval,1.59--3.00).There was no significant difference in self perceived risk between men and *** Seroprevalence was low among healtheare workers at a large children's hospital in Germany before the second epidemic wave,and it was far from a level that confers herd ***-perceived risk of infection is often overestimated.

关键词： Health personnel SARS CoV-2 Seroepidemiologic studies Pediatrics

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A NEW MODIFICATION OF TRANSANAL SOAVE PULL-THROUGH PROCEDURE FOR HIRSCHSPRUNG’S DISEASE

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Chinese Medical Journal 2006年第1期119卷 37-42页

作者： LI Ai-wu ZHANG Wen-tong LI Fu-hai CUI Xin-hai DUAN Xiang-sheng Department of paediatric surgery Qilu Hospital Shandong University Ji＇nan 250012 China

Background One stage transanal Soave pull-through procedure （TSPP） is a recent popular operation in the treatment of Hirschsprung＇s disease （HD）. With no visible scar and a short hospital stay, it is well accepted by surgeons and mothers. In the conventional Soave procedure, a long rectal muscular cuff left for anocolic anastomosis might increase the incidence of postoperative enterocolitis and constipation. This study presents a modified transanal Soave pull-through procedure （MTSPP） which includes an oblique mucosectomy and an oblique anastomosis with a short split muscular cuff.. Methods A review of two groups of HD patients was made： 112 underwent conventional transanal Soave procedure from 1999 to 2001 （group 1） and 140 underwent modified transanal Soave procedure from 2002 to 2004 （group 2）. A comparison was made between the two groups on operative data and postoperative complications. The data included： age at the operation, operating time, blood loss, time to feeds and hospital stay, occurrence of postoperative enterocolitis or constipation, need for anal dilatation, postoperative bowel function and perianal skin problems. Results There was no significant difference between two groups with respect to age, gender, length of colon resected, operating time, blood loss and hospital stay. However occurrence of postoperative enterocolitis, constipation, anastomotic stricture and time needed for anal dilatation were evidently less in group 2 （MTSPP）. The mean operating time in group 1 was （106 ± 39） minutes with a range of 60 to 170 minutes; in group 2 was （101 ± 36） minutes with a range of 66 to 190 minutes. The average length of the bowel resected in group 1 was （24 ± 7） cm, range 15 to 58 cm; in group 2 was （26 ± 8） cm, range 15 to 70 cm. Two patients, one in each group, required laparoscopic assistance because of long aganglionic colon. Another patient in group 2 required laparotomy because of total colonic aganglionosis. Postoperative complications in grou

关键词： transanal pull-through Hirschsprung's disease Soave modified procedure

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Efficacy,Safety and Characteristics of the Amplatzer Vascular Plug II and IV Utilization for Various Percutaneous Occlusions in Children under 10 Years

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Congenital Heart Disease 2022年第4期17卷 421-436页

作者： Hugues Lucron Alban-Elouen Baruteau Caroline Ovaert Ali Houeijeh Mélanie Brard Patrice Guerin François Bourlon Claire Dauphin Saskia Tuttle Maha Tagorti Rishika Banydeen François Godart Antilles-Guyane M3C paediatric Cardiology Center University Hospital of MartiniqueFort-de-FranceFrance L’institut du Thorax INSERMCNRSUNIV NantesCHU NantesNantesFrance Department of paediatric Cardiology and Pediatric Cardiac surgery University Hospital of NantesNantesFrance Department of paediatric and Congenital Heart Disease University Hospital of MarseilleMarseilleFrance Department of paediatric and Congenital Heart Disease University Hospital of Lille-Nord de FranceLilleFrance Department of paediatric and Congenital Heart Disease Cardiothoracic Center of MonacoMonaco Department of paediatric and Congenital Heart Disease University Hospital of Clermont-FerrandClermont-FerrandFrance Clinical Research Department CHU Martinique(University Hospital of Martinique)Fort-de-FranceFrance

Objectives:We aim to describe the efficacy,safety,and characteristics of the Amplatzer Vascular Plug(AVP)II and IV“off-label”use for multiple cardiovascular occlusions in children under 10 ***:Observational retrospective multicenter(2007–2020,6 centers)review of paediatric procedures using AVP II or ***:A total of 125 children(49.6%aged≤1 year,147 lesions)underwent 136 successive procedures(success rate:98.5%)using 169 devices(109 AVP IV,60 AVP II).The mean device diameter was 7.7±3.2 mm(4–20 mm).The median AVP size to vessel diameter ratio was 1.3(0–2).The median age and weight at implantation were 1.0 year(0.01–9.98)and 8.4 kg(1–69).Procedures were heterogeneous(55 patent ductus arteriosus(PDA),28 collaterals,18 sequestrations,22 arteriovenous/veinovenous/coronary fistulas,6 vertical veins,6 conduits,5 ventricular septal defects,7 miscellaneous).Day 1 and 6-month occlusion rates were respectively 94.8%and 98.5%.Major adverse events(MAE)occurred in 5.2%of cases(no procedure-related deaths),and more frequently in weight≤5 kg(p=0.01),younger patients(p=0.03)during PDA closure(p=0.02)of tubular types(p=0.02)using larger devices(p=0.03)and AVP II(p=0.003).Independent predictor of MAE risk was a higher AVP diameter to patient weight ratio(Odds-ratio:2.33,95%confidence interval 1.31–4.13,p=0.004,optimal cut off:1.45).Conclusions:Both AVPs are safe and effective for percutaneous occlusions in children under *** devices represent an alternative“off label”use for well selected paediatric patients.

关键词： Amplatzer vascular plug(AVP)II and IV cardiovascular occlusions off-label use children under 10 years efficacy safety

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