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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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State of Shock: Epidemiological, Etiological and Therapeutic Aspects at the pediatric unit of the Medical and surgical Emergencies of the Donka National Hospital

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Open Journal of pediatrics 2019年第4期9卷 302-308页

作者： Diallo Mohamed Lamine Barry Ibrahima Koolo Camara Emmanuel Ondima Hermann Laurent Marion Sossouadouno Elisabeth Sita Diallo Saliou Bella Emergencies pediatric Donka National Hospital Conakry Guinea Institute of Nutrition and Child Health (INSE) Donka National Hospital Conakry Guinea pediatric Department Donka National Hospital Conakry Guinea

Introduction: The objective of this study was to write the epidemiological, etiological and therapeutic aspects of shock in children in the paediatric medico-surgical emergency unit of the National Donka Hospital. Method: This was a forward-looking, descriptive 6-month study, including all children aged 0 to 15 who were received in the paediatric medico-surgical emergency unit at The Donka National Hospital, where the shock diagnosis was retained and the patients received care. Results: In our study, 26 out of 1123 patients were received in a state of shock. Hypovolemic shock was more common at 24 (92%). Vascular filling by Ringer’s milk was the basic treatment. The 6 to 11 month age group was the most affected and the sex-ratio M/F was 1.6. The acute febrile gastroenteritis and dehydration status were the most frequent causes. The outcome was favorable in 25 patients (96%). Conclusion: Rapid and effective management would improve the vital and functional prognosis of children in shock.

关键词： Choc Children Urgences Paediatrics Donka

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pediatric Cardiac surgical Patterns of Practice and Outcomes in Europe and China:An Analysis of the European Congenital Heart Surgeons Association Congenital Heart Surgery Database

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Congenital Heart Disease 2021年第1期16卷 17-25页

作者： Claudia Herbst Haibo Zhang Renjie Hu Jürgen Hörer Masamichi Ono Vladimiro Vida Tjark Ebels Andrzej Kansy Jeffrey P.Jacobs Zdzislaw Tobota Bohdan Maruszewski Department of Surgery Division of Cardiac Surgery and Pediatric Heart CenterMedical University ViennaViennaAustria Department of pediatric Cardiothoracic Surgery Shanghai Children’s Medical CenterShanghai Jiaotong University School of MedicineShanghaiChina Department for Congenital and pediatric Heart Surgery German Heart Center MunichTechnische Universität MünchenDivision for Congenital and Pediatric Heart SurgeryUniversity Hospital of MunichLudwig-Maximilians-UniversitätMunichGermany pediatric and Cardiac Surgery unit Department of Cardio Thoracic Vascular Sciences and Public HealthUniversity of PaduaPaduaItaly Department of Cardiothoracic Surgery University Medical Center GroningenGroningenThe Netherlands Cardiothoracic Surgery Amsterdam University Medical CenterAmsterdamThe Netherlands pediatric Cardiothoracic Surgery Children’s Memorial Health InstituteWarsawPoland St.Petersburg FLUSA

Background:The European Congenital Heart Surgeons Association(ECHSA)Congenital Heart Surgery Database(CHSD)was founded in 1999 and is open for worldwide *** current dataset includes a large amount of surgical data from both Europe and *** purpose of this analysis is to compare patterns of practice and outcomes among pediatric congenital heart defect surgeries in Europe and China using the ***:We examined all European(125 centers,58,261 operations)and Chinese(13 centers,23,920 operations)data in the ECHSA-CHSD from *** mortality,postoperative length of stay,median patient age and weight were calculated for the ten benchmark operations for China and Europe,***:Benchmark procedure distribution frequencies differed between Europe and *** China,ventricular septal defect repair comprised approximately 70%of procedures,while Norwood operations comprised less than one percent of all *** cardiac procedures were rare in China *** procedures in STAT mortality category 1,Chinese centers had lower operative mortality rates,while procedures in categories 3 and 5 mortality is lower in European *** mortality over the time period decreased from 3.89%to 1.64%for the whole cohort,with a sharper decline in *** drop coincides with an increase of submitted procedures over this ***:Chinese centers had higher programmatic volume of congenital heart surgeries,while European centers have a more complex case *** for patients with functionally univentricular heart was performed less commonly in *** comparison of patterns of practice and outcomes demonstrate opportunities for continuing bidirectional transcontinental collaboration and quality improvement.

关键词： Outcomes congenital heart surgery China Europe database

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Indications and results of renal biopsy in children:a 36-year experience

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World Journal of pediatrics 2018年第2期14卷 127-133页

作者： Luisa Santangelo Giuseppe Stefano Netti Paolo Giordano Vincenza Carbone Marida Martino Diletta Domenica Torres Michele Rossini Anna Maria Di Palma Loreto Gesualdo Mario Giordano unit of pediatric Nephrology and Dialysis Pediatric Hospital"GiovanniⅩⅩⅢ"BariItaly Clinical Pathology Department of Medical and Surgical SciencesUniversity of FoggiaFoggiaItaly unit of Nephrology Dialysis and TransplantationDepartment of Emergency and OrganTransplantationUniversity"Aldo Moro"BariItaly

Background This study was conducted to investigate retrospectively the indications for renal biopsy(RB)in native kidneys and to analyze pathological findings in a single tertiary pediatric hospital in Southern Italy for the last 36 *** All patients who underwent RB at our hospital from 1979 to 2014 were *** renal tissue specimens were studied under light and immunofluorescent microscopy,while electron microscopy was performed only for specific clinical *** The study group included 213 patients(female 43.2%)who underwent 225 percutaneous native kidney *** age was 10.4 years(range 0.6-24 years).The most frequent indication for RB was nephrotic syndrome(44.4%),fol-lowed by proteinuria(27.6%),asymptomatic hematuria(17.3%)and acute kidney injury(9.8%).Gross hematuria appeared after biopsy in less than 5%of the patients,but none of them needed blood *** renal tissue sample was obtained in 95.5%of the renal *** glomerulonephritis(GN)was the most common finding(61.4%),followed by secondary GN(21.4%),tubulointerstitial diseases(3.7%)and hereditary nephropathy(2.8%),while in 10.7%of the cases,normal renal tissues were *** to histopathological diagnosis,the most common causes of primary GN were IgA nephropathy(20.9%),followed by minimal change disease(18.1%)and focal segmental glomerulosclerosis(11.6%).Conclusions The epidemiology of glomerular disease in our single-center cohort is similar to that shown in other national and international ***,our study shows that percutaneous ultrasound-guided RB is a safe,reliable and effec-tive technique in children.

关键词： Epidemiology Glomerular diseases Nephropathy pediatric patients Renal biopsy

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Adolescent male genitalia dissatisfaction:a surgical perspective

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Asian Journal of Andrology 2022年第2期24卷 176-179页

作者： Nicola Zampieri Ilaria Dando Francesco Saverio Camoglio Woman and Child Hospital Pediatric Surgical UnitUniversity of VeronaVerona 37100Italy Department of Neurosciences Biomedicine and Movement SciencesBiochemistry SectionUniversity of VeronaVerona 37100Italy

Genital dissatisfaction is well known in female and *** is known about male adolescents and their genital *** aim of this study was to investigate and report the role of surgery in male adolescents to improve the evaluation of their *** considered all patients treated for external genital pathology in the period of *** and exclusion criteria were *** underwent an evaluation test before and after *** the study period,137 patients were treated,and at the end of the study,98 cases were considered for *** most frequent pathologies were webbed penis and penile curvature.A postoperative score improvement was noted and patients with concealed penis and webbed penis showed a better postoperative *** was considered an important factor associated with a worse preoperative *** of the external genitalia is important in adolescents,and it is an understudied *** may be associated with a worse evaluation of one’s genital and should be clinically considered to avoid related social problems in ***,cosmetic genital surgery should be considered even in male adolescents.

关键词： adolescent esthetic genital dissatisfaction surgery

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Transumbilical laparoscopic-assisted appendectomy in children: Clinical and surgical outcomes

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World Journal of Gastrointestinal Endoscopy 2014年第4期6卷 101-104页

作者： Zampieri Nicola Scirè Gabriella Mantovani Alberto Camoglio Francesco Saverio pediatric surgical unit Department of Surgical SciencesUniversity of Verona

The aim of this paper is to present and describe tran-sumbilical laparoscopic-assisted appendectomy in chil-dren, focusing on its technical aspects and clinical andsurgical outcomes. The surgical charts of all patientsaged between 0 and 14 years treated with transumbili-cal laparoscopic-assisted appendectomy admitted tothe authors' institution from January 2009 to Septem-ber 2013 with a diagnosis of suspected appendicitis fol-lowing clinical, laboratory and ultrasound findings werereviewed. Operating time, intraoperative findings, needfor conversion or for additional trocars, and surgicacomplications were reported. During the study period,120 patients aged between 6 and 14 years(mean age:9.9 years), 73 females(61%) and 47 males(39%),were treated with transumbilical laparoscopic-assistedappendectomy. There were 37 cases of hyperemicappendicitis(subserosal and retrocecal), 74 cases ofphlegmonous appendicitis and 9 cases of perforatedgangrenous appendicitis. It was not possible to estab-lish a correlation between grade of appendicitis andmean operating time(P > 0.05). Eleven cases(9%)needed the use of one additional trocar, while 8 pa-tients(6%) required conversion to the standard laparo-scopic technique with the use of two additional trocars. No patient was converted to the open technique. Tran-sumbilical laparoscopic-assisted appendectomy is a safe technique in children and it could be used by surgeons who want to approach other minimally invasive tech-niques.

关键词： Appendectomy Children Minimally invasive surgery Transumbilical Procedure

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There is no association between K469E ICAM-1 gene polymorphism and biliary atresia

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World Journal of Gastroenterology 2005年第31期11卷 4886-4890页

作者： Paisam Vejchapipat Naruemol Jirapanakom Nutchanart Thawornsuk Apiradee Theamboonlers Voranush Chongsrisawat Soottiporn Chittmittrapap Yong Poovorawan pediatric Surgery unit Center of Excellence in Viral Hepatitis Research

AIM： To determine whether there was an association between inter-cellular adhesion molecule-1 （ICAM-1） gene polymorphism and biliary atresia （BA）, and to investigate the relationship between serum soluble ICAM-1 （sICAM-1） and clinical outcome in BA patients after surgical treatment, METHODS： Eighty-three BA patients and 115 normal controls were genotyped. K469EICAM-1 polymorphism was analyzed using PCR assay. Serum sICAM-1 was determined using ELISA rnebhod from 72 BA patients. In order to evaluate the association between these variables and their clinical outcome, the patients were categorized into two groups： patients without jaundice and those with persistent jaundice. RESULTS： There were no significant differences between BA patients and controls in terms of gender, K469E ICAM-1 genotypes, and alleles. The proportion of patients having serum sICAM-1 ≥3 500 ng/mL in persistent jaundice group was significantly higher than that in the other group. In addition, there was no association between K469EICAM-1 polymorphism and the status of jaundice in BA patients after Kasai operation. CONCLUSION： ICAM-1 possibly plays an important and active role in the disease progression. However, the process is not associated with genetic variation of K469E ICAM-1 polymorphism.

关键词： Biliary atresia Adhesion molecule ICAM-1

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Evaluation of the regional distribution of the pediatric surgery workforce and surgical load in Brazil

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World Journal of pediatric Surgery 2023年第2期6卷 85-91页

作者： Joaquim Bustorff-Silva Marcio Lopes Miranda Amanda Rosendo Ayla Gerk Antonio Goncalves Oliveira-filho pediatric Surgery State University of Campinas Medical SchoolCampinasBrazilPediatric SurgeryState University of Campinas Medical SchoolCampinasBrazil Medicine Pontificia Universidad Católica ArgentinaBuenos AiresArgentina

Objective The purpose of this study is to examine the regional distribution of the pediatric surgery workforce and the expected local demand for pediatric surgical procedures in *** We collected data on the pediatric surgical workforce,surgical volume,Gross Domestic Product per capita,and mortality for gastrointestinal tract malformations(MGITM)across the different regions of Brazil for *** Data from the Federal Medical Council reported 1515 pediatric surgery registries in Brazil,corresponding to 1414 pediatric surgeons(some pediatric surgeons are registered in more than one state),or 2.4 pediatric surgeons per 100000 children 14 years of age and *** were 828 men and 586 *** mean age was 51.5±12.8 years,and the mean time from graduation was 3.4±5.7 *** is a higher concentration of pediatric surgeons in the wealthier Central-West,South,and Southeast *** surgical volume ranged from 88 to 245 operations/year(average 146 operations/year)depending on the *** these,only nine(6.1%)were high-complexity(including neonatal)*** tended to be higher in the poorer North and Northeast regions than in other regions of *** Our findings suggest significant disparities in the surgical workforce and workload across Brazil related to socioeconomic *** with an increased surgical workforce were associated with lower *** average number of complex operations performed annually by each pediatric surgeon was considerably *** investment and well-defined health policies are imperative to enhance the quality of surgical care in the different regions of Brazil.

关键词： pediatric operations distribution

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One step minilaparotomy-assisted transmesenteric portal vein recanalization combined with transjugular intrahepatic portosystemic shunt placement: A novel surgical proposal in pediatrics

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World Journal of Gastroenterology 2017年第15期23卷 2811-2818页

作者： Gloria Pelizzo Pietro Quaretti Lorenzo Paolo Moramarco Riccardo Corti Marcello Maestri Giulio Iacob Valeria Calcaterra Department of Clinical SurgicalDiagnostic and Pediatric SciencesUniversity of Pavia pediatric Surgery unit Ospedale dei Bambini“G.di Cristina”Istituto Mediterraneo di Eccellenza Pediatrica unit of Interventional Radiology Fondazione IRCCS Policlinico San Matteo Radiology Department IRCCS Policlinico San Matteo Foundation Department of Surgery IRCCS Policlinico San Matteo Foundation pediatric unit Department of Maternal and Children's HealthFondazione IRCCS Policlinico San Matteo Department of Internal Medicine and Therapeutics University of Pavia

Transjugular intrahepatic portosystemic shunt(TIPS) placement is a standard procedure for the treatment of portal hypertension complications. When this conventional approach is not feasible, alternative procedures for systemic diversion of portal blood have been proposed. A one-step interventional approach, combining minilaparotomy-assisted transmesenteric(MAT) antegrade portal recanalization and TIPS, is described in an adolescent with recurrent esophageal varice bleeding and portal cavernoma(PC). A 16-yearold girl was admitted to our unit because of repeated bleeding episodes over a short period of time due to esophageal varices in the context of a PC. A portal vein recanalization through an ileocolic vein isolation with the MAT approach followed by TIPS during the same session was performed. In the case of failed portal recanalization, this approach, would also be useful for varice endovascular embolization. Postoperative recovery was uneventful. Treatment consisting of propanolol, enoxaparin and a proton pump inhibitor was prescribed after the procedure. One month post-op, contrast enhanced computed tomography confirmed the patency of the portal and intrahepatic stent grafts. No residual peritoneal fluid was detected nor opacification of the large varices. Endoscopy showed good improvement of the varices. Doppler ultrasound confirmed the accelerated flow in the portal stent and hepatopetal flow inside the intrahepatic portal branches. Three months post-op, TIPS maintained its hourglass shape despite a slight expansion. Portal hypertension and life threatening conditions related to PC would benefit from one-step portal recanalization. MAT-TIPS is feasible and safe for the treatment of PC even in children. This minimally invasive procedure avoids or delays surgical treatment or re-transplantation when necessary in pediatric patients.

关键词： Portal cavernoma pediatrics Transjugular intrahepatic portosystemic shunt Minilaparotomy-assisted transmesenteric

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Ambulatory clinical parameters and sleep respiratory events in a group of obese children unselected for respiratory problems

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World Journal of pediatrics 2017年第6期13卷 577-583页

作者： Marco Zaffanello Giorgio Piacentini Angelo Pietrobelli Cristiano Fava Giuseppe Lippi Claudio Maffeis Emma Gasperi Luana Nosetti Sara Bonafini Angela Tagetti Franco Antoniazzi Department of surgical Sciences DentistryGynecology and PediatricsPediatric Division Department of Medicine Section of General Medicine and Hypertension Department of Neuroscience Biomedicine and MovementChemistry and Clinical Microscopy Section University of VeronaVeronaItaly pediatric Diabetes and Metabolic Disorders unit Department of pediatrics University of InsubriaVareseItaly

Background:Obstructive sleep apnea in children is frequently due to tonsil and adenoid *** study aimed to investigate the relationship between ambulatory clinical parameters and sleep respiratory events in obese ***:We carried out a prospective respiratory sleep study between 2013 and *** obstruction,tonsils enlargement and palate position were subjectively *** attention deficit hyperactivity disorder (ADHD) rating scale for parents was also *** polygraph study was performed using a portable ambulatory ***:Forty-four obese children were consecutively recruited into this *** sleep respiratory disturbance was showed in 31.8 % of patients;18.2% previously had an adeno (tonsillectomy).In 50% of these obese children,both apnea-hypopnea index and oxygen desaturation index showed polygraph abnormal *** rating scale for parents scores were positive in 9.1% of ***:We found a high rate of mild sleep respiratory disturbance and ADHD-like symptoms referred by *** respiratory disturbance was not totally cured by ***,otorhinolaryngology variables were not able to explain mild sleep respiratory disturbance.

关键词： actigraphy obesity obstructive sleep apnea upper respiratory tract obstruction

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