Pub Date : 2019-11-15DOI: 10.3760/CMA.J.ISSN.0253-3006.2019.11.019
Yangyang Yao, Tianyou Li
Osteogenesis imperfecta (OI) is a congenital hereditary connective tissue disease caused by mesenchymal tissue hypoplasia and collagen formation disorder.Fragile bones often lead to repeated fractures along with long-bone deformities and scoliosis.The surgical objective is to fix fractures, correct long-bone deformities, boost the strength of fragile bones and treat scoliosis.Although some efficacies have been achieved, there is no uniform standard and controversies focus upon the timing and choice of surgical approaches.Through summarizing the relevant articles over the last two decades, this review discussed the development and current status of surgery for OI, summarized the achievements and controversies of surgery for long-bone deformity and scoliosis and introduced the implication of weight-loss surgery for OI. Key words: Osteogenesis imperfecta; Surgical procedures, operative; Weight-loss surgery
{"title":"Current status of surgery for osteogenesis imperfecta","authors":"Yangyang Yao, Tianyou Li","doi":"10.3760/CMA.J.ISSN.0253-3006.2019.11.019","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-3006.2019.11.019","url":null,"abstract":"Osteogenesis imperfecta (OI) is a congenital hereditary connective tissue disease caused by mesenchymal tissue hypoplasia and collagen formation disorder.Fragile bones often lead to repeated fractures along with long-bone deformities and scoliosis.The surgical objective is to fix fractures, correct long-bone deformities, boost the strength of fragile bones and treat scoliosis.Although some efficacies have been achieved, there is no uniform standard and controversies focus upon the timing and choice of surgical approaches.Through summarizing the relevant articles over the last two decades, this review discussed the development and current status of surgery for OI, summarized the achievements and controversies of surgery for long-bone deformity and scoliosis and introduced the implication of weight-loss surgery for OI. \u0000 \u0000 \u0000Key words: \u0000Osteogenesis imperfecta; Surgical procedures, operative; Weight-loss surgery","PeriodicalId":10157,"journal":{"name":"中华小儿外科杂志","volume":"23 1","pages":"1052-1056"},"PeriodicalIF":0.0,"publicationDate":"2019-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85032483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-15DOI: 10.3760/CMA.J.ISSN.0253-3006.2019.11.013
Chengchao Lyu, Sheng-lin Le, Jiangyu Zhang, Peng Li, Jingzi Xiao
Objective To report one case of congenital laparoscopic choledochal cyst with postoperative chylous ascites and review the relevant literatures of this disease for enhancing its clinician awareness. Methods One 14-day boy was hospitalized due to 4-month prenatal ultrasonic finding of hilar mass of liver with persistent jaundice.After admission, liver function examination showed that alanine aminotransferase 110 U/L, aspartate aminotransferase 180 U/L, total bilirubin 310.9 μmol/L and direct bilirubin 183.0 μmol/L.Preoperative ultrasonography, magnetic resonance cholangiopancreatography (MRCP) and intraoperative angiography revealed choledochal cyst.After preoperative examinations, laparoscopic choledochal cyst resection and Roux-Y hepaticojejunostomy were performed.The databases of PubMed, Medline, Springer Link, Cochrane Library, CNKD and Wanfang were searched for such keywords as chylous ascites, choledochal cyst and neonatal.Four cases of choledochal cyst complicated with chylous ascites were reported in both Chinese and English up until October 2018. Results Chylous ascites became resolved after 3-week conservative treatments of fasting, total parenteral nutrition and octreotide.During a 6-month follow-up period, he grew healthily without a relapse.Four cases of choledochal cyst complicated with postoperative chylous ascites were reviewed in the literature.All of them were treated conservatively.One child received only dietary treatment due to a low amount of celiac drainage (20 ml). The maximal celiac drainage was 350 ml and treatment duration lasted from 15 days to 4 weeks.All children recovered and were discharged. Conclusions Congenital laparoscopic choledochal cyst with postoperative chylous ascites is a rare disease.However, its prognosis is excellent if it is diagnosed timely and treated properly. Key words: Chylous ascites; Choledochal cyst; Infant, newborn
{"title":"One case of congenital laparoscopic choledochal cyst with postoperative chylousascites and a retrospective literature review","authors":"Chengchao Lyu, Sheng-lin Le, Jiangyu Zhang, Peng Li, Jingzi Xiao","doi":"10.3760/CMA.J.ISSN.0253-3006.2019.11.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-3006.2019.11.013","url":null,"abstract":"Objective \u0000To report one case of congenital laparoscopic choledochal cyst with postoperative chylous ascites and review the relevant literatures of this disease for enhancing its clinician awareness. \u0000 \u0000 \u0000Methods \u0000One 14-day boy was hospitalized due to 4-month prenatal ultrasonic finding of hilar mass of liver with persistent jaundice.After admission, liver function examination showed that alanine aminotransferase 110 U/L, aspartate aminotransferase 180 U/L, total bilirubin 310.9 μmol/L and direct bilirubin 183.0 μmol/L.Preoperative ultrasonography, magnetic resonance cholangiopancreatography (MRCP) and intraoperative angiography revealed choledochal cyst.After preoperative examinations, laparoscopic choledochal cyst resection and Roux-Y hepaticojejunostomy were performed.The databases of PubMed, Medline, Springer Link, Cochrane Library, CNKD and Wanfang were searched for such keywords as chylous ascites, choledochal cyst and neonatal.Four cases of choledochal cyst complicated with chylous ascites were reported in both Chinese and English up until October 2018. \u0000 \u0000 \u0000Results \u0000Chylous ascites became resolved after 3-week conservative treatments of fasting, total parenteral nutrition and octreotide.During a 6-month follow-up period, he grew healthily without a relapse.Four cases of choledochal cyst complicated with postoperative chylous ascites were reviewed in the literature.All of them were treated conservatively.One child received only dietary treatment due to a low amount of celiac drainage (20 ml). The maximal celiac drainage was 350 ml and treatment duration lasted from 15 days to 4 weeks.All children recovered and were discharged. \u0000 \u0000 \u0000Conclusions \u0000Congenital laparoscopic choledochal cyst with postoperative chylous ascites is a rare disease.However, its prognosis is excellent if it is diagnosed timely and treated properly. \u0000 \u0000 \u0000Key words: \u0000Chylous ascites; Choledochal cyst; Infant, newborn","PeriodicalId":10157,"journal":{"name":"中华小儿外科杂志","volume":"131 1","pages":"1020-1024"},"PeriodicalIF":0.0,"publicationDate":"2019-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90790558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-15DOI: 10.3760/CMA.J.ISSN.0253-3006.2019.11.006
L. Zeng, Yidong Huang, Xue Ma, Xue Li, Zhibo Zhang
Objective To explore the causes and managements of recurrent ventral curvature after hypospadias repair. Methods From January 2009 to January 2019, retrospective reviews were performed for 115 consecutive patients in health information system with recurrent ventral curvature after hypospadias repairing.Among them, 28 patients underwent hypospadias repair with a median age of 35 (30-99) months.The median penile bending angle was 45°(30°-80°). Beside recurrent ventral curvature, there were also urethral fistula (n=17), dehiscent urethral orifice (n=3), urethral stricture (n=1), urethral diverticulum (n=3) and urethral diverticulum, dehiscent urethral orifice & urethral fistula after Duckett urethroplasty (n=1). Among 87 patients undergoing hypospadias repair at other hospitals, the median age was 62 (46-168) months and the median penile bending angle 52°(45°-90°). Beside recurrent ventral curvature, other concurrent conditions included urethral fistula (n=13), dehiscent urethral orifice (n=3), urethral dehiscence (n=10), urethral stricture (n=19), urethral diverticulum (n=12), urethral fistula/stricture (n=15), urethral stricture/diverticulum (n=10), urethral fistula/diverticulum & dehiscent urethral orifice (n=3) and urethral fistula/diverticulum/stricture (n=2). Results All of them underwent redo hypospadias operations at our hospital.Among 28 patients from our hospital, recurrent ventral curvature was corrected by Nesbit dorsal tunica albuginea placation (n=18), transecting constructed neourethra (n=9) and transecting constructed neourethra & Nesbit dorsal tunica albuginea placation (n=1). Urethral complications were corrected simultaneously.The median follow-up period was 28 (6-60) months.There was no recurrent ventral curvature except for mild curvature (10°) in 1 child.Three cases of urethral fistula achieved satisfactory outcomes after re-operation.There was no urethral stricture/diverticulum.The urinary flow rate was examined at 6 months post-operation and the maximal urinary flow rate was 8.7 ml/s with an average of (5.4-16.5) ml/s.Among 87 patients from other hospitals, recurrent ventral curvature was corrected by degloved penis, releasing ventral fibrous tissue and removing ventral scar tissue(n=12). Recurrent ventral curvature were corrected by Nesbit dorsal tunica albuginea placation (n=18), transecting constructed neourethra (n=35), transecting constructed neourethra & Nesbit dorsal tunica albuginea placation (n=20) and transecting constructed neourethra & dorsal tunica albuginea patch by tunica vaginalis (n=2). Urethral complications were corrected simultaneously (n=84) while 3 patients required staged buccal mucosa graft urethroplasty because of no material available.The mean follow-up period was 37 (6-48) months.There was no onset of recurrent ventral curvature except for mild curvature (5°-10°) in 6 patients.Urethral fistula recurred in 12 children.Except for 1 case awaiting fistula repair, the remainder achieved sati
{"title":"A 10-year summary of recurrent ventral curvature after hypospadias repair","authors":"L. Zeng, Yidong Huang, Xue Ma, Xue Li, Zhibo Zhang","doi":"10.3760/CMA.J.ISSN.0253-3006.2019.11.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-3006.2019.11.006","url":null,"abstract":"Objective \u0000To explore the causes and managements of recurrent ventral curvature after hypospadias repair. \u0000 \u0000 \u0000Methods \u0000From January 2009 to January 2019, retrospective reviews were performed for 115 consecutive patients in health information system with recurrent ventral curvature after hypospadias repairing.Among them, 28 patients underwent hypospadias repair with a median age of 35 (30-99) months.The median penile bending angle was 45°(30°-80°). Beside recurrent ventral curvature, there were also urethral fistula (n=17), dehiscent urethral orifice (n=3), urethral stricture (n=1), urethral diverticulum (n=3) and urethral diverticulum, dehiscent urethral orifice & urethral fistula after Duckett urethroplasty (n=1). Among 87 patients undergoing hypospadias repair at other hospitals, the median age was 62 (46-168) months and the median penile bending angle 52°(45°-90°). Beside recurrent ventral curvature, other concurrent conditions included urethral fistula (n=13), dehiscent urethral orifice (n=3), urethral dehiscence (n=10), urethral stricture (n=19), urethral diverticulum (n=12), urethral fistula/stricture (n=15), urethral stricture/diverticulum (n=10), urethral fistula/diverticulum & dehiscent urethral orifice (n=3) and urethral fistula/diverticulum/stricture (n=2). \u0000 \u0000 \u0000Results \u0000All of them underwent redo hypospadias operations at our hospital.Among 28 patients from our hospital, recurrent ventral curvature was corrected by Nesbit dorsal tunica albuginea placation (n=18), transecting constructed neourethra (n=9) and transecting constructed neourethra & Nesbit dorsal tunica albuginea placation (n=1). Urethral complications were corrected simultaneously.The median follow-up period was 28 (6-60) months.There was no recurrent ventral curvature except for mild curvature (10°) in 1 child.Three cases of urethral fistula achieved satisfactory outcomes after re-operation.There was no urethral stricture/diverticulum.The urinary flow rate was examined at 6 months post-operation and the maximal urinary flow rate was 8.7 ml/s with an average of (5.4-16.5) ml/s.Among 87 patients from other hospitals, recurrent ventral curvature was corrected by degloved penis, releasing ventral fibrous tissue and removing ventral scar tissue(n=12). Recurrent ventral curvature were corrected by Nesbit dorsal tunica albuginea placation (n=18), transecting constructed neourethra (n=35), transecting constructed neourethra & Nesbit dorsal tunica albuginea placation (n=20) and transecting constructed neourethra & dorsal tunica albuginea patch by tunica vaginalis (n=2). Urethral complications were corrected simultaneously (n=84) while 3 patients required staged buccal mucosa graft urethroplasty because of no material available.The mean follow-up period was 37 (6-48) months.There was no onset of recurrent ventral curvature except for mild curvature (5°-10°) in 6 patients.Urethral fistula recurred in 12 children.Except for 1 case awaiting fistula repair, the remainder achieved sati","PeriodicalId":10157,"journal":{"name":"中华小儿外科杂志","volume":"9 1","pages":"981-987"},"PeriodicalIF":0.0,"publicationDate":"2019-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72660604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-15DOI: 10.3760/CMA.J.ISSN.0253-3006.2019.11.012
Lei Wu, Mingman Zhang, Ying-cun Li, Wanyi Zhou
Objective To explore the surgical approaches for pancreatic duct stones in children. Methods The clinical data were retrospectively analyzed for 8 surgical children with pancreatic duct stones from 2016 to 2017.There were 3 boys and 5 girls with a median age of 11.2 (8-13.8) years.All of them were clinically diagnosed by abdominal computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP). Results There was no case of mortality.No such early complications as pancreatic leakage, abdominal infection or anastomotic bleeding occurred.During an average follow-uPperiod of 18.12 (8-28) months, there was no manifestation of pancreatic internal/external secretion dysfunction such as diabetes and steatorrhea.Abdominal pain was completely relieved postoperatively.Three cases of occasional and no abdominal pain and 5 cases respectively.Postoperative stone residue and stone recurrence were 1 case and 1 cases respectively. Conclusions Large diameter pancreatic duct incision and Roux-en-Y pancreaticojejunostomy are efficacious for pancreatic duct stones in children. Key words: Child; Pancreatic duct stones; Pancreaticojejunostomy
{"title":"Surgical treatments of pancreatic duct stones in children","authors":"Lei Wu, Mingman Zhang, Ying-cun Li, Wanyi Zhou","doi":"10.3760/CMA.J.ISSN.0253-3006.2019.11.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-3006.2019.11.012","url":null,"abstract":"Objective \u0000To explore the surgical approaches for pancreatic duct stones in children. \u0000 \u0000 \u0000Methods \u0000The clinical data were retrospectively analyzed for 8 surgical children with pancreatic duct stones from 2016 to 2017.There were 3 boys and 5 girls with a median age of 11.2 (8-13.8) years.All of them were clinically diagnosed by abdominal computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP). \u0000 \u0000 \u0000Results \u0000There was no case of mortality.No such early complications as pancreatic leakage, abdominal infection or anastomotic bleeding occurred.During an average follow-uPperiod of 18.12 (8-28) months, there was no manifestation of pancreatic internal/external secretion dysfunction such as diabetes and steatorrhea.Abdominal pain was completely relieved postoperatively.Three cases of occasional and no abdominal pain and 5 cases respectively.Postoperative stone residue and stone recurrence were 1 case and 1 cases respectively. \u0000 \u0000 \u0000Conclusions \u0000Large diameter pancreatic duct incision and Roux-en-Y pancreaticojejunostomy are efficacious for pancreatic duct stones in children. \u0000 \u0000 \u0000Key words: \u0000Child; Pancreatic duct stones; Pancreaticojejunostomy","PeriodicalId":10157,"journal":{"name":"中华小儿外科杂志","volume":"48 1","pages":"1015-1019"},"PeriodicalIF":0.0,"publicationDate":"2019-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85162809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-15DOI: 10.3760/CMA.J.ISSN.0253-3006.2019.11.007
Chen Chenjun, D. Juan, Zhu Haobo, W. Lixia, Gu Yunfei
Objective To explore the role of International Neuroblastoma Staging System (INSS) or International Neuroblastoma Risk Group Staging System (INGRSS) in peripheral neuroblastic tumors. Methods From 2006 to 2018, a retrospective analysis was performed for 108 peripheral neuroblastictumors (pNT) children.There were 62 boys and 46 girls.All of them were operated and pathological examinations conducted.However, 4 s/Ms staged cases were excluded.Analyses were performed with regards to age, weight distribution, pathological results, INSS/INRGSS stage, neuron-specific enolase (NSE), lactate dehydrogenase (LDH), lesion size, image-defined risk factors (IDRFs), operative duration and tumor index.The relationship between stage and complete removal was explored. Results No statistically significant inter-gender difference existed in the distribution between tumors and the age of neuroblastoma (NB) was younger.The specific pathologies were NB (n=68), ganglioneuroblastoma (GNB, n=30) and ganglioneuroma (GN, n=10). No significant difference existed in the distribution of INSS/INRGSS staging.NSE and LDH values of pNTs with diameters >5 cm and L2 & M phases spiked sharply.The number of IDRFs was higher in NB than GNB.And pNT patients with diameters >10 cm, stages L2 & M and positive IDRFs had a longer operative duration and a lower probability of complete resection. Conclusions The preoperative evaluations of INSS/INRGSS staging for pNT offer more advantages than INSS staging alone.It may guide the choice of specific treatments.The presence or absence of IDRFs is an important factor for a complete removal of tumors. Key words: Neuroblastoma; Peripheral neuroblastictumors; Ganglioneuroblastoma; Ganglioneuroma
{"title":"Clinical value of INSS/INRGSS staging of peripheral neuroblastictumors in children","authors":"Chen Chenjun, D. Juan, Zhu Haobo, W. Lixia, Gu Yunfei","doi":"10.3760/CMA.J.ISSN.0253-3006.2019.11.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-3006.2019.11.007","url":null,"abstract":"Objective \u0000To explore the role of International Neuroblastoma Staging System (INSS) or International Neuroblastoma Risk Group Staging System (INGRSS) in peripheral neuroblastic tumors. \u0000 \u0000 \u0000Methods \u0000From 2006 to 2018, a retrospective analysis was performed for 108 peripheral neuroblastictumors (pNT) children.There were 62 boys and 46 girls.All of them were operated and pathological examinations conducted.However, 4 s/Ms staged cases were excluded.Analyses were performed with regards to age, weight distribution, pathological results, INSS/INRGSS stage, neuron-specific enolase (NSE), lactate dehydrogenase (LDH), lesion size, image-defined risk factors (IDRFs), operative duration and tumor index.The relationship between stage and complete removal was explored. \u0000 \u0000 \u0000Results \u0000No statistically significant inter-gender difference existed in the distribution between tumors and the age of neuroblastoma (NB) was younger.The specific pathologies were NB (n=68), ganglioneuroblastoma (GNB, n=30) and ganglioneuroma (GN, n=10). No significant difference existed in the distribution of INSS/INRGSS staging.NSE and LDH values of pNTs with diameters >5 cm and L2 & M phases spiked sharply.The number of IDRFs was higher in NB than GNB.And pNT patients with diameters >10 cm, stages L2 & M and positive IDRFs had a longer operative duration and a lower probability of complete resection. \u0000 \u0000 \u0000Conclusions \u0000The preoperative evaluations of INSS/INRGSS staging for pNT offer more advantages than INSS staging alone.It may guide the choice of specific treatments.The presence or absence of IDRFs is an important factor for a complete removal of tumors. \u0000 \u0000 \u0000Key words: \u0000Neuroblastoma; Peripheral neuroblastictumors; Ganglioneuroblastoma; Ganglioneuroma","PeriodicalId":10157,"journal":{"name":"中华小儿外科杂志","volume":"30 1","pages":"988-992"},"PeriodicalIF":0.0,"publicationDate":"2019-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87444900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-15DOI: 10.3760/CMA.J.ISSN.0253-3006.2019.11.018
Bing Li, Wei-bing Chen, Shunlin Xia, Xiaomin Wang
{"title":"Thoracoscopic repairing of anastomotic fistula with pedicled pleural flap after esophageal atresia surgery: one case report","authors":"Bing Li, Wei-bing Chen, Shunlin Xia, Xiaomin Wang","doi":"10.3760/CMA.J.ISSN.0253-3006.2019.11.018","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-3006.2019.11.018","url":null,"abstract":"","PeriodicalId":10157,"journal":{"name":"Chinese Journal of Pediatric Surgery","volume":"9 1","pages":"1050-1051"},"PeriodicalIF":0.0,"publicationDate":"2019-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73668722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To explore the value of ultrasonic scan for predicting mortality in children with congenital diaphragmatic hernia (CDH). Methods Sixty-eight hospitalized CDH neonates were recruited and retrospectively analyzed from January 2010 to May 2017.Ultrasonic markers including sidedness of hernia, thoracic herniation of liver, thoracic herniation of stomach, diagnostic timing, presence of associated congenital anomalies, lung-to-head ratio (LHR) and observed/expected lung-to-head ratio (O/E LHR) were analyzed.And logistic regression analysis was performed for determining the independent predictors for mortality. Results The overall mortality rate was 39.7%(27/68). Differences existed in mortality between children with an intrathoracic liver, associated congenital anomalies and prenatally diagnosed as compared with those with an ectopic liver without anomalies and diagnosed postnatally (P 0.05). The mortality of patients with LHR≤1.4 was 50% higher than that with LHR >1.4 (P 45% (P<0.05). The area under the ROC curve for predicting mortality by LHR was 0.936 (95% CI, 0.837-1.000) and O/E LHR 0.880 (95% CI, 0.745-1.000). The value of LHR and O/E LHR for predicting mortality was not significantly different (z=0.044, P=0.483). Logistic multivariate regression analysis indicated that prenatal diagnosis, thoracic herniation of liver and associated congenital anomalies were independent predictors for mortality with odd ratios of 10.534, 8.843 and 11.234 respectively (P<0.05). Conclusions Ultrasound may become a useful tool of predicting the prognosis of CDH. Key words: Diaphragmatic hernia, congenital; Ultrasonography; Prognosis
{"title":"Value of ultrasound in predicting the prognosis of congenital diaphragmatic hernia","authors":"Zhou Lin, Ye Wanding, Zheng Jinjue, Zhao Qifeng, Cheng Xianwei, Wu Daozhu","doi":"10.3760/CMA.J.ISSN.0253-3006.2019.11.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-3006.2019.11.009","url":null,"abstract":"Objective \u0000To explore the value of ultrasonic scan for predicting mortality in children with congenital diaphragmatic hernia (CDH). \u0000 \u0000 \u0000Methods \u0000Sixty-eight hospitalized CDH neonates were recruited and retrospectively analyzed from January 2010 to May 2017.Ultrasonic markers including sidedness of hernia, thoracic herniation of liver, thoracic herniation of stomach, diagnostic timing, presence of associated congenital anomalies, lung-to-head ratio (LHR) and observed/expected lung-to-head ratio (O/E LHR) were analyzed.And logistic regression analysis was performed for determining the independent predictors for mortality. \u0000 \u0000 \u0000Results \u0000The overall mortality rate was 39.7%(27/68). Differences existed in mortality between children with an intrathoracic liver, associated congenital anomalies and prenatally diagnosed as compared with those with an ectopic liver without anomalies and diagnosed postnatally (P 0.05). The mortality of patients with LHR≤1.4 was 50% higher than that with LHR >1.4 (P 45% (P<0.05). The area under the ROC curve for predicting mortality by LHR was 0.936 (95% CI, 0.837-1.000) and O/E LHR 0.880 (95% CI, 0.745-1.000). The value of LHR and O/E LHR for predicting mortality was not significantly different (z=0.044, P=0.483). Logistic multivariate regression analysis indicated that prenatal diagnosis, thoracic herniation of liver and associated congenital anomalies were independent predictors for mortality with odd ratios of 10.534, 8.843 and 11.234 respectively (P<0.05). \u0000 \u0000 \u0000Conclusions \u0000Ultrasound may become a useful tool of predicting the prognosis of CDH. \u0000 \u0000 \u0000Key words: \u0000Diaphragmatic hernia, congenital; Ultrasonography; Prognosis","PeriodicalId":10157,"journal":{"name":"Chinese Journal of Pediatric Surgery","volume":"192 1","pages":"998-1001"},"PeriodicalIF":0.0,"publicationDate":"2019-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82086429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-15DOI: 10.3760/CMA.J.ISSN.0253-3006.2019.10.016
Zhi-lin Xu, Wei Fan, Long Wang
{"title":"Application of associating liver partition and portal vein ligation for staged hepatectomy for infantile hepatic tumor: a case report","authors":"Zhi-lin Xu, Wei Fan, Long Wang","doi":"10.3760/CMA.J.ISSN.0253-3006.2019.10.016","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-3006.2019.10.016","url":null,"abstract":"","PeriodicalId":10157,"journal":{"name":"Chinese Journal of Pediatric Surgery","volume":"13 1","pages":"944-946"},"PeriodicalIF":0.0,"publicationDate":"2019-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75431673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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