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Flexible bronchoscopy for foreign body aspiration in children:A single-centre experience

World Journal of Clinical Pediatrics 2024年第2期13卷 127-134页

作者： Aleh Sautin Kirjl Marakhouski Aleh Pataleta Kirill Sanfirau Diagnostic Division Republican Scientific and Practical Centre of Paediatric SurgeryMinsk 220013Belarus

BACKGROUND The technological evolution of bronchoscopy has led to the widespread adoption of flexible techniques and their use for both diagnostic and therapeutic ***,there is an active debate regarding the comparative efficacy and safety of rigid vs flexible bronchoscopy in the treatment of foreign body *** To evaluate our experience with tracheobronchial foreign body extraction using flexible bronchoscopy and provide a literature *** This was a single-centre retrospective ***-four patients were enrolled between January 2017 and January *** records of patients aged below 18 years who were admitted to authors’affiliated institution with a suspected diagnosis of foreign body aspiration were collected from hospital’s database to Microsoft Excel *** were analysed using MedCalc Statistical *** Patient ages varied from 9 months to 11 *** median age was 23.5 months,95%confidence interval(CI)*** observed age clustering in children with foreign body aspiration at our institution with three age subgroups:(1)0-25 months;(2)40-60 months;and(3)120-140 *** expectancy of an organic tracheobronchial foreign body was significantly higher in 0-25 months subgroup than that in older ones when subgroups 40-60 and 120-140 months were combined together(odds ratio=10.0,95%CI:1.44-29.26,P=0.0197).Successful foreign body extraction was performed in all *** to a rigid bronchoscope was not required in any of the *** major complications(massive bleeding,tracheobronchial tree perforation,or asphyxia)were *** Flexible bronchoscopy is an effective and safe method for tracheobronchial foreign body extraction in children.

关键词： Foreign body aspiration Tracheobronchial foreign body paediatric bronchoscopy Flexible bronchoscopy Rigid bronchoscopy

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Optimizing prediction models for pancreatic fistula after pancreatectomy:Current status and future perspectives

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World Journal of Gastroenterology 2024年第10期30卷 1329-1345页

作者： Feng Yang John A Windsor De-Liang Fu Department of Pancreatic Surgery Huashan HospitalShanghai Medical CollegeFudan UniversityShanghai 200040China surgical and Translational Research centre Faculty of Medical and Health SciencesUniversity of AucklandAuckland 1142New Zealand

Postoperative pancreatic fistula(POPF)is a frequent complication after pancre-atectomy,leading to increased morbidity and *** prediction models for POPF has emerged as a critical focus in surgical *** over sixty models following pancreaticoduodenectomy,predominantly reliant on a variety of clinical,surgical,and radiological parameters,have been documented,their predictive accuracy remains suboptimal in external validation and across diverse *** models after distal pancreatectomy continue to be pro-gressively reported,their external validation is eagerly ***,POPF prediction after central pancreatectomy is in its nascent stage,warranting urgent need for further development and *** potential of machine learning and big data analytics offers promising prospects for enhancing the accuracy of prediction models by incorporating an extensive array of variables and optimizing algorithm ***,there is potential for the development of personalized prediction models based on patient-or pancreas-specific factors and postoperative serum or drain fluid biomarkers to improve accuracy in identifying individuals at risk of *** the future,prospective multicenter studies and the integration of novel imaging technologies,such as artificial intelligence-based radiomics,may further refine predictive *** these issues is anticipated to revolutionize risk stratification,clinical decision-making,and postoperative management in patients undergoing pancre-atectomy.

关键词： Pancreatic fistula Pancreaticoduodenectomy Distal pancreatectomy Central pancreatectomy Prediction model Machine learning Artificial intelligence

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Traumatic Diaphragmatic Hernia in Children: A Case Report

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surgical Science 2024年第3期15卷 111-117页

作者： Lucienne Irène Patricia Ondima Rhodia Hélène Bosseba Missengue Nuptia Erica Akobande Cardinale Princilia Okiemy Niendet Jean-Claude Mieret Caryne Mboutol-Mandavo Department of Pediatric Surgery Marien Ngouabi University Brazzaville Congo Department of paediatric Surgery Hospital and University Centre (HUC) Brazzaville Congo

Introduction: Traumatic diaphragmatic hernia is a rare condition in children complicating closed or penetrating trauma to the abdomen and thorax. We report the case of an 11-year-old girl with a traumatic diaphragmatic hernia. Case Presentation: An 11-year-old girl was seen in the paediatric surgery department for a thoracolumbar spine deformity and intermittent chest pain. These symptoms occurred after a domestic accident involving a fall from a low wall onto the thoracolumbar spine 5 months previously. The diagnosis was suggested by the presence of a left hemithoracic hydroaera and confirmed by a thoraco-abdominal CT scan. surgical exploration revealed a linear rupture of the entire left hemi-diaphragm with herniation of the stomach, small intestine, cecum, transverse colon and omentum. We performed a double-layer suture of the diaphragmatic rupture with a non-absorbable suture without edge rejuvenation after the reduction of the hernia. The outcome was favourable with normal postoperative radiographs at one year follow-up. Conclusion: Traumatic diaphragmatic hernia, although uncommon and difficult to diagnose, is a condition that is relatively easy to manage surgically, even if it is discovered late. In all cases of trauma to the thoracolumbar spine, regular follow-up and repeat X-rays are necessary if pain persists.

关键词： Hernia Diaphragm Trauma Child Case Report

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Large Conventional Osteosarcoma of the Proximal Humerus in a 13-Year-Old Child: Case Report

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Open Journal of Pediatrics 2024年第2期14卷 297-304页

作者： Lucienne Irène Patricia Ondima Rhodia Hélène Bosseba Missengue Cardinale Princilia Okiemy Niendet Nuptia Erica Akobande Jean Claude Mieret Caryne Mboutol-Mandavo Redy Atipo Galloye Judith Nsondé Malanda Jennifer Mave Sirimé Ngandzo Fabien Mouamba Faculty of Health Sciences Marien Ngouabi University Brazzaville Congo paediatric Surgery Department Brazzaville University Hospital Centre Brazzaville Congo Department of General Surgery Brazzaville University Hospital Centre Brazzaville Congo Carcinology Department Brazzaville University Hospital Centre Brazzaville Congo Anatomo-Pathology Laboratory Brazzaville University Hospital Centre Brazzaville Congo

Introduction: Osteosarcoma is the most common primary malignant bone tumor in children. It is highly aggressive and has a poor prognosis. A late presentation modifies and makes difficult the management affecting the survival of children. We report the case of a large conventional osteosarcoma in a 13-year-old girl. Case Presentation: Adolescent girl admitted for painful swelling of the left shoulder with absolute functional impotence of the thoracic limb and severe anemia. The painful swelling was thought to have been caused by a minor trauma that had occurred six months previously. The patient’s general condition was poor, and she presented with a large, shiny, painful mass over the shoulder and upper 2/3 of the left arm, measuring 28 cm long by 28 cm wide and 57 cm in circumference, and a large fistulous axillary adenopathy. CT scan showed a tumour lesion of the left humerus with liver and lung metastases, raising suspicion of osteogenic osteosarcoma. The tumor was classified according to TNM staging: T2N1M1(a + b). Management was modified when uncontrolled bleeding developed. It consisted of an extended amputation of the left thoracic limb. Pathological analysis showed a high-grade conventional osteosarcoma. Quality improvement was obtained for thirty days, followed by the onset of dyspnea. The evolution was towards death at forty days post-operatively. Conclusion: Osteosarcoma is a highly aggressive cancer. Delayed treatment leads to a fatal outcome. Early diagnosis is one of the challenges to be met in order to improve survival.

关键词： Osteosarcoma Child Conventional Case Report

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Epidemiological and Clinical Profile and Immediate Outcome of Neonates Transferred from the Maternity Unit to the Neonatology Unit of the CSREF in Commune V of Bamako District, Mali

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Open Journal of Pediatrics 2024年第3期14卷 547-557页

作者： Maimouna Kante Ya Traoré Balilé Harber Beydari Mamadou Traoré Issiaka Koné Diéneba Sacko Maimouna Haidara Korotoumou Bamba Assitan Farota Abdoulaye Kassogué Mohamed Diarra Dramane Touré Abdoul Salam Diarra Leyla Maïga Dicko Fatoumata paediatric Ward CSR&#233f CV Bamako Mali paediatric Ward of Nianankoro Fomba Hospital S&#233gou Mali paediatric Ward of Kalaban CoroCSREF Bamako Mali Pediatric Department of the Mopti Reference Health Center Mopti Mali National centre for Scientific and Technological Research Bamako Mali paediatrics Department Mohamed VI Perinatal Clinic Bamako Mali Department of paediatrics Gabriel Tour&#233 University Hospital Bamako Mali

Introduction: Neonatal mortality remains a major public health concern. According to the World Health Organisation (WHO), the number of newborns dying each year has fallen from 5 million in 1990 to 2.4 million in 2019. The aim of our study was to describe the main morbid conditions and their lethality in newborns admitted to the paediatric ward of the CSREF in Commune V. Methodology: We conducted a 12-month prospective descriptive and analytical study from August 2020 to July 2021. Results: During the 12 months of the study, out of 2654 neonates admitted to hospital, 216 met our inclusion criteria, i.e. 8%. Newborns admitted in the first few hours of life represented 99.54% of cases. Full-term newborns accounted for 65.74% of the total. Forty-eight percent of newborns had hypothermia on admission. The most common diagnosis was asphyxia in 55.56% of cases, followed by neonatal infection in 27.78% and prematurity in 10.65%. Death was recorded in 22.2% of cases. Asphyxia was the main cause of neonatal death, followed by prematurity in our context. Conclusion: Improving the prognosis of newborn babies will require a thorough understanding of neonatal pathologies and the implementation of a pre- and perinatal prevention policy.

关键词： Newborns Morbidity Mortality

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Breast Cancer in a Supernumerary Breast at the Yaoundé Gynaeco-Obstetric and paediatric Hospital: About a Case

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Advances in Breast Cancer Research 2024年第3期13卷 43-48页

作者： Michel Auguste Mouelle Sarah Gaëlle Adiang Esther Meka Isidore Tompeen Christelle Djapa Claude Hector Mbia Yann Eng Julius Sama Dohbit Zacharie Sando Oncology Department of the Yaound Gynaeco-Obstetric and paediatric Hospital Yaound Cameroon Faculty of Medicine and Biomedical Sciences of Yaound University of Yaound I Yaound Cameroon Obstetrics and Gynaecology Department of the Yaound Gynaeco-Obstetric and paediatric Hospital Yaound Cameroon Radiology and Medical Imaging Department of the Yaound Gynaeco-Obstetric and paediatric Hospital Yaound Cameroon Pathology Department of the Yaound Gynaeco-Obstetric and paediatric Hospital Yaound Cameroon

Accessory or ectopic breast tissue is an anomaly in the development of the breast. It is a rare condition that occurs along the embryological mammary line. In less than 1% of all breast cancers, supernumerary breast cancer is reported, with the axillary location being the most common in 60% to 90% of cases. Cancerous degeneration of this supernumerary breast tissue can pose a dual diagnostic and therapeutic problem. We report the case of locally advanced adenocarcinoma in a right supernumerary breast. This is a 75-year-old, grand-multiparous, postmenopausal, and known hypertensive patient on treatment. Family history was remarkable for brain cancer in her sister and oesophageal cancer in her mother. She consulted for a mass in the right axillary cavity on supernumerary breast evolving for a year. Clinical examination revealed a large, fixed, budding and haemorrhagic-ulcerated mass of the right axilla, with long axis measuring about 15 cm. There was as wella supernumerary breast on the left, but without particularity. A soft tissue ultrasound showed a large hypoechoicmass in the right axillary region of 116 mm with areas of central necrobiosis. Morphologically, the breasts were normal. A breast MRI revealed a subcutaneous mass in the right axillary cavity with skin ulceration and satellite lymphadenopathy. The extension assessment revealed liver metastases, and a biopsy of the mass revealed a breast adenocarcinoma. The case was the subject of a multidisciplinary consultation meeting following which a wide excision of the mass was indicated. The histo-pathology analysis results of the surgical specimen were in favour of a triple negative papillary adenocarcinoma. After a post-operative multidisciplinary consultation meeting, adjuvant chemotherapy was indicated. The development of supernumerary breasts depends on hormones, just like normal breasts. Breast cancer in accessory breast tissue is quite rare with the incidence being 6%. The most common pathology is invasive

关键词： Adjuvant Chemotherapy Papillary Adenocarcinoma Surgery Supernumerary Breast Treatment of Supernumerary Breast Cancer

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Infant’s Sigh Breathing Matters—The Role of the Hering-Breuer Deflation Reflex in Bronchial Decongestion

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Open Journal of Therapy and Rehabilitation 2024年第3期12卷 197-212页

作者： Karine Truflandier Kevin Albert Jean-Jacques Moraine Department of Cardio-Pulmonary Physiotherapy Hpital de La Tour Meyrin Switzerland paediatric Intensive Care Unit Centre Hospitalier Universitaire Sainte-Justine Montral Canada Laboratoire des Sciences de la Motricit Universit Libre de Bruxelles Brussel Belgium

Background: The prolonged slow expiratory (PSE) technique can induce sigh breaths related to the Hering-Breuer reflex in *** is a specific chest physiotherapy technique often used in children to help with the clearance of secretions, reduce pulmonary obstruction and decrease ventilatory effort. Purpose: The main objective of this review was to synthesize and clarify the existing knowledge of the physiological mechanism behind the Hering-Breuer reflex and its utility in the PSE technique. The secondary objective was to provide an overview of PSE which is probably the main mechanical feature for mucus clearance in infants and to identify gaps and any further research required. Method: A comprehensive literature search was performed using PubMed/MEDLINE and Ovid EMBASE, from 1968 to January 2024, using search terms relating to “Interaction of Hering-Breuer reflex and chest physiotherapy therapy, sigh breath in infants and prolonged slow expiration technique” to create an overview of the advances and gaps in current knowledge of PSE. Result: The data obtained following treatment with PSE maneuvers in infants with histories of recurrent wheezing shows that the presence of sighs could be the main active principle of treatment. Conclusion: Changes in volume induced by PSE technique and, effects from crying may stimulate the Hering-Breuer deflation reflex and sighs in turn improving alveolar ventilation as well as lung volume in infants.

关键词： Hering-Breuer (HB) Reflex Sigh Breath Infants Prolonged Slow Expiration Technique Large Volume Chest Physiotherapy

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Ethical frontiers in liver transplantation

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World Journal of Transplantation 2024年第4期14卷 50-60页

作者： Hoi Pong Nicholas Wong Surya Varma Selvakumar Pei Yi Loh Jovan Yi Jun Liau Matthias Yi Quan Liau Vishalkumar Girishchandra Shelat Lee Kong Chian School of Medicine Nanyang Technological UniversitySingapore 308232Singapore Department of General Surgery Tan Tock Seng HospitalSingapore 308433Singapore surgical Science Training centre Tan Tock Seng HospitalSingapore 308433Singapore

Liver transplantation represents a pivotal intervention in the management of end-stage liver disease,offering a lifeline to countless *** significant strides in surgical techniques and organ procurement,ethical dilemmas and de-bates continue to underscore this life-saving *** the ethical terrain surrounding this complex procedure is hence *** the nuances of ethical principles of justice,autonomy and beneficence that underpin transplant protocols worldwide,we explore the modern challenges that plaques the world of liver *** investigate the ethical dimensions of organ transplantation,focusing on allocation,emerging technologies,and decision-making ***,Scopus,Web of Science,Embase and Central were searched from database inception to February 29,2024 using the following key-words:“liver transplant”,“transplantation”,“liver donation”,“liver recipient”,“organ donation”and“ethics”.Information from relevant articles surrounding ethical discussions in the realm of liver transplantation,especially with regards to organ recipients and allocation,organ donation,transplant tourism,new age technologies and developments,were *** the definition of death to the long term follow up of organ recipients,liver transplantation has many ethical *** new transplant techniques,societal acceptance and perceptions also play a pivotal ***,religious and regional factors including but not limited to beliefs,wealth and accessibility are extremely influential in public at-titudes towards donation,xenotransplantation,stem cell research,and adopting artificial *** and addressing these perspectives whilst upholding bioethical principles is essential to ensure just distribution and fair allocation of *** regulatory oversight for ethical sourcing of organs,ensuring good patient selection and transplant techniques,and high-quality long-term surveillance to mitiga

关键词： “liver transplant” “transplan-tation” “liver donation” “liver recipient” “organ donation”and“ethics”

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Should we perform decompressive laparotomy during severe acute pancreatitis with intra-abdominal hypertension below 25 mmHg:Only the gut knows

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World Journal of Gastrointestinal Surgery 2024年第5期16卷 1470-1473页

作者： Thibault Vieille Melissa Crotet Celia Turco Paul Monasterolo Hadrien Winiszewski Gael Piton Medical Intensive Care Unit Besancon University HospitalBesancon 25000France Intensive Care Unit Vesoul HospitalVesoul 70000France Department of Digestive surgical Oncology-Liver Transplantation Unit Besancon University HospitalBesancon 25000France Inserm UMRS-938 Centre de Recherche Saint-Antoine(CRSA)Sorbonne UniversitéParis 10041NY212France Intensive Care Unit Nord Franche Comte HospitalTrevenans 90400France

We suggest that during severe acute pancreatitis(SAP)with intra-abdominal hypertension,practitioners should consider decompressive laparotomy,even with intra-abdominal pressure(IAP)below 25 ***,in this setting,non-occlusive mesenteric ischemia(NOMI)may occur even with IAP below this cutoff and lead to transmural necrosis if abdominal perfusion pressure is not promptly *** report our experience of 18 critically ill patients with SAP having undergone decompressive laparotomy of which one third had NOMI while IAP was mostly below 25 mmHg.

关键词： Acute pancreatitis Abdominal compartment syndrome Decompressive laparotomy Mesenteric ischemia Intra-abdominal pressure Abdominal perfusion pressure

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Laparoscopic management of remnant gall bladder with stones: Lessons from a tertiary care centre's experience

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Laparoscopic, Endoscopic and Robotic Surgery 2024年第1期7卷 27-33页

作者： Gilbert Samuel Jebakumar Jeevanandham Muthiah Loganathan Jayapal R.Santhosh Kumar Siddhesh Tasgaonkar K.S.Santhosh Anand J.K.A.Jameel Sudeepta Kumar Swain K.J.Raghunath Prasanna Kumar Reddy Tirupporur Govindaswamy Balachandar Department of surgical Gastroenterology Apollo HospitalsChennai 600006India Department of General Surgery Apollo HospitalsChennai 600006India Department of Minimal Access Surgery Apollo HospitalsChennai 600006India

Objective:Laparoscopic cholecystectomy is currently the gold standard for treating symptomatic gallstone *** its success,approximately 10%of patients may experience persistent biliary symptoms,leading to the post-cholecystectomy syndrome.A remnant gallbladder with cystic duct or bile duct stones is one of the causes of this *** objective of this study was to shed light on the clinical manifestations,evaluation,therapeutic strategies,and outcomes associated with laparoscopic management of symptomatic remnant ***:This was a retrospective study,conducted over a five-year period(January 2017 to December 2022)at Apollo Hospitals in South *** patients who underwent laparoscopic completion cholecystectomy for a remnant gall bladder were *** following data were collected:patient demographics,symptoms,preoperative investigations,intraoperative details and post operative ***:In total,36 patients were included and *** majority of patients were male(25,69.4%),with a mean age of 50.7±12.1 *** most common presentation was pain in the upper abdomen or right upper quadrant region(24,66.7%).The laparoscopic approach was attempted in all patients,with a success rate of 94.4%.Two patients required conversion to open *** fistula to the colon was observed in one *** was observed in 7 patients(19.4%),and stone clearance was successfully achieved using endoscopic retrograde cholangiopancreatography in all patients ***:Incomplete gall bladder removal either intentionally or unintentionally leaves a remnant gall bladder that is at risk for stone formation and *** who have this clinical entity with symptoms require a redo or complete cholecystectomy,a complex procedure associated with certain *** study highlights the feasibility and safety of laparoscopic completion cholecystectomy for the management of remnant gallbladder

关键词： Remnant gall bladder Stump cholecystitis Subtotal cholecystectomy Laparoscopic completion cholecystectomy

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