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Pediatric Surgery International (Online First™)
Does necrotizing enterocolitis affect growth and neurodevelopmental outcome in very low birth weight infants?
Tue, 24 Jan 2012 12:27:17 -0000
Abstract Aim To evaluate the effect of necrotizing enterocolitis (NEC) on growth and neurodevelopmental outcome. Patients and methods Neurodevelopmental outcome of 20 of 39 surviving very low birthweight infants (VLBW) diagnosed with NEC between 2007 and 2009 was compared with 40 control infants matched for gestational age and year of admission. Follow-up studies were performed at 18 and 24 months of corrected age. Bayley Scales of Infant Development-Second Edition scale was used for neurodevelopmental assessment. Results At 18–24 months corrected age, body weight, body length, and head circumference did not differ significantly between the NEC and without NEC groups. The median mental developmental index (62 vs. 75, p = 0.008) and psychomotor developmental index points (72 vs. 91.5, p = 0.002) were lower in infants with NEC compared to without NEC, respectively. Although the rate of neurodevelopmental impairment was slightly higher in infants with NEC, there were no differences between the groups according to the frequency of minimal impairment and cerebral palsy. Growth or neurodevelopmental outcome did not differ between the NEC survivors with and without surgery. Conclusion Necrotizing enterocolitis has affected neurodevelopmental outcome but not growth in VLBW infants at 18–24 months of corrected age. Both those treated medically or requiring surgery need close neurodevelopmental follow-up for the first years of life. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s00383-012-3051-4Authors Dilek Dilli, Department of Neonatology, Zekai Tahir Burak Maternity and Teaching Hospital, Ankara, TurkeyZeynep Eras, Department of Developmental Pediatrics, Zekai Tahir Burak Maternity and Teaching Hospital, Ankara, TurkeyHülya Özkan Ulu, Zekai Tahir Burak Maternity and Teaching Hospital, Ankara, TurkeyUğur Dilmen, Department of Neonatology, Zekai Tahir Burak Maternity and Teaching Hospital, Ankara, TurkeyEvrim Durgut Şakrucu, Department of Developmental Pediatrics, Zekai Tahir Burak Maternity and Teaching Hospital, Ankara, Turkey Journal Pediatric Surgery InternationalOnline ISSN 1437-9813Print ISSN 0179-0358
Therapeutic outcome and prognosis in young patients with papillary and follicular thyroid cancer
Tue, 24 Jan 2012 12:27:15 -0000
Abstract Background Papillary and follicular thyroid cancer is a common malignancy in young patients, and the incidence of this cancer has been increasing. The aims of this study are to assess the clinical characteristics of papillary and follicular thyroid cancer in young patients and evaluate the long-term therapeutic outcomes and prognostic factors for cancer mortality and recurrence. Methods We performed a retrospective analysis of 116 patients aged ≤20 years who underwent thyroidectomy and a mean follow-up of 11.1 ± 0.6 years. Results There were 28 (24.1%) patients classified into the residual cancer or relapse groups. The progression-free survival rate for the young patients was lower than that of the patients between 20 and 45 years of age; however, the difference between the thyroid cancer survival rates was not statistically different. Two of the 28 patients died of thyroid cancer. Thirteen patients who showed relapsed underwent 131I whole-body scan; 6 of the 13 patients were diagnosed with distant metastases to the lung and 1 was diagnosed with distant metastases to the bones. Among the young patients, the 5- and 10-year progression-free survival rates were 79.1 and 73.4%, respectively, and the corresponding cancer survival rates were 99.1, and 96.5%, respectively. Conclusion The progression-free survival in young patients with papillary and follicular thyroid cancer was lower than the patients of age 20–45 years; otherwise, cancer survival was higher than age group over or equal to 45 years. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s00383-012-3054-1Authors Chung-Huei Huang, Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, 5, Fu-Shin St., Taoyuan Hsien, Kweishan County, Taiwan, ROCTzu-Chieh Chao, Department of General Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan Hsien, Taiwan, ROCChuen Hseuh, Department of Pathology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan Hsien, Taiwan, ROCKun-Ju Lin, Department of Nuclear Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan Hsien, Taiwan, ROCTsung-Ying Ho, Department of Nuclear Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan Hsien, Taiwan, ROCShu-Fu Lin, Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, 5, Fu-Shin St., Taoyuan Hsien, Kweishan County, Taiwan, ROCJen-Der Lin, Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, 5, Fu-Shin St., Taoyuan Hsien, Kweishan County, Taiwan, ROC Journal Pediatric Surgery InternationalOnline ISSN 1437-9813Print ISSN 0179-0358
The use of Onyx for embolization of peripheral vascular malformations in pediatric patients
Tue, 24 Jan 2012 07:28:25 -0000
Abstract Purpose The management of congenital peripheral vascular malformations (VMs) can present a difficult therapeutic challenge. Endovascular transcatheter embolization of peripheral VMs is widely accepted as a first therapeutic option for many VMs. However, data describing the use of Onyx are limited in children with peripheral VMs. Our aim is to retrospectively evaluate the results of transcatheter arterial embolization with Onyx for peripheral VMs in children. Materials and methods We analyzed clinical and imaging records of 16 patients who underwent 25 embolization procedures by using Onyx for peripheral VMs. In eight cases, embolization procedures were performed once; in seven cases, twice; and in one case, thrice. Results Embolization was technically complete in 4 patients and incomplete in 12 patients. Clinically, complete success was achieved in nine patients, and partial success was achieved in six patients. In one patient, reflux to the anterior and posterior tibial arteries caused peripheral ischemia, and the patient was referred to undergo plastic surgery. There were no complications in the other 15 patients. Conclusion With future studies to better characterize the safety profile of this agent in peripheral vasculature, embolization with Onyx may become a valuable treatment option for peripheral VMs in pediatric patients. Content Type Journal ArticleCategory Original ArticlePages 1-11DOI 10.1007/s00383-012-3052-3Authors Murat Cantasdemir, Department of Interventional Radiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, TurkeyFatih Gulsen, Department of Interventional Radiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, TurkeySerdar Solak, Department of Interventional Radiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, TurkeyGokce Yalcin Gulsen, Department of Interventional Radiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, TurkeyFatih Kantarci, Department of Interventional Radiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, TurkeyFuruzan Numan, Department of Interventional Radiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey Journal Pediatric Surgery InternationalOnline ISSN 1437-9813Print ISSN 0179-0358
Magnetic compression gastrostomy in the rat
Tue, 24 Jan 2012 07:28:25 -0000
Abstract Purpose Magnetic compression anastomosis is used for gastrointestinal, biliary, and urinary anastomoses. We have developed a simple magnetic compression gastrostomy technique in rats. Methods Animals were randomized into two groups (n = 12 each): magnetic gastrostomy (MG) and surgical gastrostomy (SG) (control). In the MG group, a magnetic insertion catheter was coupled with the first magnetic ball and introduced transorally into the stomach. A second magnetic ball was placed subcutaneously into the left upper quadrant. The two magnetic balls (4 mm) were strongly coupled together. On postoperative day (PD) 20 (MG group) and PD10 (SG group), rats were killed, gastrostomies were evaluated macroscopically and histopathologically, and mechanical burst testing was performed. Results Two animals died due to suspected leaks. Macroscopic evaluation indicated no gastrostomy canal in one rat in each group. Mild adhesion was observed in two rats in the MG group. Moderate adhesion was observed in all rats in the SG group. No significant differences were observed in burst pressure between the two groups (means: MG group, 143 mmHg, n = 9; SG group, 159 mmHg, n = 8). Conclusions Magnetic compression gastrostomy can be performed easily in rats, and may be developed in future as a simple alternative to some gastrostomy procedures in humans. Content Type Journal ArticleCategory Original ArticlePages 1-4DOI 10.1007/s00383-012-3053-2Authors Ibrahim Uygun, Department of Pediatric Surgery and Pediatric Urology, Medical Faculty of Dicle University, 21280 Diyarbakir, TurkeyMehmet Hanifi Okur, Department of Pediatric Surgery and Pediatric Urology, Medical Faculty of Dicle University, 21280 Diyarbakir, TurkeyHasan Cimen, Department of Pediatric Surgery and Pediatric Urology, Medical Faculty of Dicle University, 21280 Diyarbakir, TurkeyAysenur Keles, Department of Pathology, Medical Faculty of Dicle University, 21280 Diyarbakir, TurkeyOzben Yalcin, Department of Pathology, Hospital of Children, 21280 Diyarbakir, TurkeyHayrettin Ozturk, Department of Pediatric Surgery and Pediatric Urology, Medical Faculty of Abant Izzet Baysal University, 14280 Bolu, TurkeySelcuk Otcu, Department of Pediatric Surgery and Pediatric Urology, Medical Faculty of Dicle University, 21280 Diyarbakir, Turkey Journal Pediatric Surgery InternationalOnline ISSN 1437-9813Print ISSN 0179-0358
Urinary incontinence in children: botulinum toxin is a safe and effective treatment option
Sat, 14 Jan 2012 16:42:38 -0000
Abstract Purpose This study’s aim was to assess the use of intravesical injection of botulinum neurotoxin type A (BoNT-A) as a treatment of overactive bladder (OAB) in children. Methods A 6-year retrospective study of children who received BoNT-A for OAB was performed. Treatment outcome was classified as complete success (CS), partial success (PS) or treatment failure (TF). Results Of the 57 patients who received BoNT-A treatment for OAB, 35 were males. CS occurred in 74.2% of males and 54.5% of females. PS was achieved in 20% of males and 18.2% of females. TF occurred in 2.9% of males and 22.7% of females. Anticholinergics had previously been used and had been effective in 58.6% and 83.3% of males and females. Significant side effects to medications were experienced in 12 (41.4%) males and 4 (22.2%) females. Of these, BoNT-A achieved CS in seven (53.3%) males and two (50%) females and PS in three (25%) males and one (25%) female. BoNT-A was successful in seven (58.3%) males and two (66.7%) females where anticholinergics were ineffective. Conclusions BoNT-A has a role in a carefully selected subgroup of children with overactive bladder symptoms including those with medication side effects and treatment compliance issues. It may have a role in patients who do not respond to conventional therapy. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s00383-011-3039-5Authors Dermot Thomas McDowell, Department of Paediatric Urology, Our Lady’s Hospital for Sick Children, Crumlin, Dublin 12, IrelandDamien Noone, Department of Paediatric Nephrology, Our Lady’s Hospital for Sick Children, Crumlin, Dublin 12, IrelandFarhan Tareen, Department of Paediatric Urology, Our Lady’s Hospital for Sick Children, Crumlin, Dublin 12, IrelandMary Waldron, Department of Paediatric Nephrology, Our Lady’s
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Does necrotizing enterocolitis affect growth and neurodevelopmental outcome in very low birth weight infants?
Tue, 24 Jan 2012 12:27:17 -0000
Abstract Aim To evaluate the effect of necrotizing enterocolitis (NEC) on growth and neurodevelopmental outcome. Patients and methods Neurodevelopmental outcome of 20 of 39 surviving very low birthweight infants (VLBW) diagnosed with NEC between 2007 and 2009 was compared with 40 control infants matched for gestational age and year of admission. Follow-up studies were performed at 18 and 24 months of corrected age. Bayley Scales of Infant Development-Second Edition scale was used for neurodevelopmental assessment. Results At 18–24 months corrected age, body weight, body length, and head circumference did not differ significantly between the NEC and without NEC groups. The median mental developmental index (62 vs. 75, p = 0.008) and psychomotor developmental index points (72 vs. 91.5, p = 0.002) were lower in infants with NEC compared to without NEC, respectively. Although the rate of neurodevelopmental impairment was slightly higher in infants with NEC, there were no differences between the groups according to the frequency of minimal impairment and cerebral palsy. Growth or neurodevelopmental outcome did not differ between the NEC survivors with and without surgery. Conclusion Necrotizing enterocolitis has affected neurodevelopmental outcome but not growth in VLBW infants at 18–24 months of corrected age. Both those treated medically or requiring surgery need close neurodevelopmental follow-up for the first years of life. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s00383-012-3051-4Authors Dilek Dilli, Department of Neonatology, Zekai Tahir Burak Maternity and Teaching Hospital, Ankara, TurkeyZeynep Eras, Department of Developmental Pediatrics, Zekai Tahir Burak Maternity and Teaching Hospital, Ankara, TurkeyHülya Özkan Ulu, Zekai Tahir Burak Maternity and Teaching Hospital, Ankara, TurkeyUğur Dilmen, Department of Neonatology, Zekai Tahir Burak Maternity and Teaching Hospital, Ankara, TurkeyEvrim Durgut Şakrucu, Department of Developmental Pediatrics, Zekai Tahir Burak Maternity and Teaching Hospital, Ankara, Turkey Journal Pediatric Surgery InternationalOnline ISSN 1437-9813Print ISSN 0179-0358
Therapeutic outcome and prognosis in young patients with papillary and follicular thyroid cancer
Tue, 24 Jan 2012 12:27:15 -0000
Abstract Background Papillary and follicular thyroid cancer is a common malignancy in young patients, and the incidence of this cancer has been increasing. The aims of this study are to assess the clinical characteristics of papillary and follicular thyroid cancer in young patients and evaluate the long-term therapeutic outcomes and prognostic factors for cancer mortality and recurrence. Methods We performed a retrospective analysis of 116 patients aged ≤20 years who underwent thyroidectomy and a mean follow-up of 11.1 ± 0.6 years. Results There were 28 (24.1%) patients classified into the residual cancer or relapse groups. The progression-free survival rate for the young patients was lower than that of the patients between 20 and 45 years of age; however, the difference between the thyroid cancer survival rates was not statistically different. Two of the 28 patients died of thyroid cancer. Thirteen patients who showed relapsed underwent 131I whole-body scan; 6 of the 13 patients were diagnosed with distant metastases to the lung and 1 was diagnosed with distant metastases to the bones. Among the young patients, the 5- and 10-year progression-free survival rates were 79.1 and 73.4%, respectively, and the corresponding cancer survival rates were 99.1, and 96.5%, respectively. Conclusion The progression-free survival in young patients with papillary and follicular thyroid cancer was lower than the patients of age 20–45 years; otherwise, cancer survival was higher than age group over or equal to 45 years. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s00383-012-3054-1Authors Chung-Huei Huang, Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, 5, Fu-Shin St., Taoyuan Hsien, Kweishan County, Taiwan, ROCTzu-Chieh Chao, Department of General Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan Hsien, Taiwan, ROCChuen Hseuh, Department of Pathology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan Hsien, Taiwan, ROCKun-Ju Lin, Department of Nuclear Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan Hsien, Taiwan, ROCTsung-Ying Ho, Department of Nuclear Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan Hsien, Taiwan, ROCShu-Fu Lin, Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, 5, Fu-Shin St., Taoyuan Hsien, Kweishan County, Taiwan, ROCJen-Der Lin, Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, 5, Fu-Shin St., Taoyuan Hsien, Kweishan County, Taiwan, ROC Journal Pediatric Surgery InternationalOnline ISSN 1437-9813Print ISSN 0179-0358
The use of Onyx for embolization of peripheral vascular malformations in pediatric patients
Tue, 24 Jan 2012 07:28:25 -0000
Abstract Purpose The management of congenital peripheral vascular malformations (VMs) can present a difficult therapeutic challenge. Endovascular transcatheter embolization of peripheral VMs is widely accepted as a first therapeutic option for many VMs. However, data describing the use of Onyx are limited in children with peripheral VMs. Our aim is to retrospectively evaluate the results of transcatheter arterial embolization with Onyx for peripheral VMs in children. Materials and methods We analyzed clinical and imaging records of 16 patients who underwent 25 embolization procedures by using Onyx for peripheral VMs. In eight cases, embolization procedures were performed once; in seven cases, twice; and in one case, thrice. Results Embolization was technically complete in 4 patients and incomplete in 12 patients. Clinically, complete success was achieved in nine patients, and partial success was achieved in six patients. In one patient, reflux to the anterior and posterior tibial arteries caused peripheral ischemia, and the patient was referred to undergo plastic surgery. There were no complications in the other 15 patients. Conclusion With future studies to better characterize the safety profile of this agent in peripheral vasculature, embolization with Onyx may become a valuable treatment option for peripheral VMs in pediatric patients. Content Type Journal ArticleCategory Original ArticlePages 1-11DOI 10.1007/s00383-012-3052-3Authors Murat Cantasdemir, Department of Interventional Radiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, TurkeyFatih Gulsen, Department of Interventional Radiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, TurkeySerdar Solak, Department of Interventional Radiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, TurkeyGokce Yalcin Gulsen, Department of Interventional Radiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, TurkeyFatih Kantarci, Department of Interventional Radiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, TurkeyFuruzan Numan, Department of Interventional Radiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey Journal Pediatric Surgery InternationalOnline ISSN 1437-9813Print ISSN 0179-0358
Magnetic compression gastrostomy in the rat
Tue, 24 Jan 2012 07:28:25 -0000
Abstract Purpose Magnetic compression anastomosis is used for gastrointestinal, biliary, and urinary anastomoses. We have developed a simple magnetic compression gastrostomy technique in rats. Methods Animals were randomized into two groups (n = 12 each): magnetic gastrostomy (MG) and surgical gastrostomy (SG) (control). In the MG group, a magnetic insertion catheter was coupled with the first magnetic ball and introduced transorally into the stomach. A second magnetic ball was placed subcutaneously into the left upper quadrant. The two magnetic balls (4 mm) were strongly coupled together. On postoperative day (PD) 20 (MG group) and PD10 (SG group), rats were killed, gastrostomies were evaluated macroscopically and histopathologically, and mechanical burst testing was performed. Results Two animals died due to suspected leaks. Macroscopic evaluation indicated no gastrostomy canal in one rat in each group. Mild adhesion was observed in two rats in the MG group. Moderate adhesion was observed in all rats in the SG group. No significant differences were observed in burst pressure between the two groups (means: MG group, 143 mmHg, n = 9; SG group, 159 mmHg, n = 8). Conclusions Magnetic compression gastrostomy can be performed easily in rats, and may be developed in future as a simple alternative to some gastrostomy procedures in humans. Content Type Journal ArticleCategory Original ArticlePages 1-4DOI 10.1007/s00383-012-3053-2Authors Ibrahim Uygun, Department of Pediatric Surgery and Pediatric Urology, Medical Faculty of Dicle University, 21280 Diyarbakir, TurkeyMehmet Hanifi Okur, Department of Pediatric Surgery and Pediatric Urology, Medical Faculty of Dicle University, 21280 Diyarbakir, TurkeyHasan Cimen, Department of Pediatric Surgery and Pediatric Urology, Medical Faculty of Dicle University, 21280 Diyarbakir, TurkeyAysenur Keles, Department of Pathology, Medical Faculty of Dicle University, 21280 Diyarbakir, TurkeyOzben Yalcin, Department of Pathology, Hospital of Children, 21280 Diyarbakir, TurkeyHayrettin Ozturk, Department of Pediatric Surgery and Pediatric Urology, Medical Faculty of Abant Izzet Baysal University, 14280 Bolu, TurkeySelcuk Otcu, Department of Pediatric Surgery and Pediatric Urology, Medical Faculty of Dicle University, 21280 Diyarbakir, Turkey Journal Pediatric Surgery InternationalOnline ISSN 1437-9813Print ISSN 0179-0358
Urinary incontinence in children: botulinum toxin is a safe and effective treatment option
Sat, 14 Jan 2012 16:42:38 -0000
Abstract Purpose This study’s aim was to assess the use of intravesical injection of botulinum neurotoxin type A (BoNT-A) as a treatment of overactive bladder (OAB) in children. Methods A 6-year retrospective study of children who received BoNT-A for OAB was performed. Treatment outcome was classified as complete success (CS), partial success (PS) or treatment failure (TF). Results Of the 57 patients who received BoNT-A treatment for OAB, 35 were males. CS occurred in 74.2% of males and 54.5% of females. PS was achieved in 20% of males and 18.2% of females. TF occurred in 2.9% of males and 22.7% of females. Anticholinergics had previously been used and had been effective in 58.6% and 83.3% of males and females. Significant side effects to medications were experienced in 12 (41.4%) males and 4 (22.2%) females. Of these, BoNT-A achieved CS in seven (53.3%) males and two (50%) females and PS in three (25%) males and one (25%) female. BoNT-A was successful in seven (58.3%) males and two (66.7%) females where anticholinergics were ineffective. Conclusions BoNT-A has a role in a carefully selected subgroup of children with overactive bladder symptoms including those with medication side effects and treatment compliance issues. It may have a role in patients who do not respond to conventional therapy. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s00383-011-3039-5Authors Dermot Thomas McDowell, Department of Paediatric Urology, Our Lady’s Hospital for Sick Children, Crumlin, Dublin 12, IrelandDamien Noone, Department of Paediatric Nephrology, Our Lady’s Hospital for Sick Children, Crumlin, Dublin 12, IrelandFarhan Tareen, Department of Paediatric Urology, Our Lady’s Hospital for Sick Children, Crumlin, Dublin 12, IrelandMary Waldron, Department of Paediatric Nephrology, Our Lady’s
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