Pub Date : 2020-03-15DOI: 10.3760/CMA.J.ISSN.0253-3006.2020.03.019
Min Du, S. Zheng
Biliary atresia (BA) is a severe life-threatening pediatric hepatobiliary condition. Kasai portoenterostomy acts as a first-line treatment for BA. Around 60% of BA patients develop such postoperative complications as cholangitis, intestinal obstruction, anastomotic stricture, bile leakage and gastrointestinal bleeding, etc. And around one half of them develop cirrhosis and liver failure within 2-5 years and liver transplantation is often required. Sequential combination of Kasai portoenterostomy and liver transplantation significantly improves the prognosis. This review summarized the latest domestic and international researches of surgical treatments for BA from the perspectives of operative age, surgical techniques, intra/extra-abdominal Kasai, mini-invasive versus open Kasai, redo Kasai and liver transplantation, etc. Key words: Biliary atresia; Operation; Liver transplantation
{"title":"Recent advances in the researches of surgical treatments for biliary atresia","authors":"Min Du, S. Zheng","doi":"10.3760/CMA.J.ISSN.0253-3006.2020.03.019","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-3006.2020.03.019","url":null,"abstract":"Biliary atresia (BA) is a severe life-threatening pediatric hepatobiliary condition. Kasai portoenterostomy acts as a first-line treatment for BA. Around 60% of BA patients develop such postoperative complications as cholangitis, intestinal obstruction, anastomotic stricture, bile leakage and gastrointestinal bleeding, etc. And around one half of them develop cirrhosis and liver failure within 2-5 years and liver transplantation is often required. Sequential combination of Kasai portoenterostomy and liver transplantation significantly improves the prognosis. This review summarized the latest domestic and international researches of surgical treatments for BA from the perspectives of operative age, surgical techniques, intra/extra-abdominal Kasai, mini-invasive versus open Kasai, redo Kasai and liver transplantation, etc. \u0000 \u0000Key words: \u0000Biliary atresia; Operation; Liver transplantation","PeriodicalId":10157,"journal":{"name":"Chinese Journal of Pediatric Surgery","volume":"19 1","pages":"276-280"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83466125","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 : 2020-02-22DOI: 10.3760/CMA.J.CN421158-20200216-00077
Tianqi Zhu, Da-wei He, J. Zhan, Yajun Chen, Xinghai Yang, Yifei Duan, Zhi-bao Lv, K. Dong, Song Yu, Libing Zhang, Weibing Tang
{"title":"Expert consensus on the diagnosis and treatment of diseases of pediatric surgery under COVID-19","authors":"Tianqi Zhu, Da-wei He, J. Zhan, Yajun Chen, Xinghai Yang, Yifei Duan, Zhi-bao Lv, K. Dong, Song Yu, Libing Zhang, Weibing Tang","doi":"10.3760/CMA.J.CN421158-20200216-00077","DOIUrl":"https://doi.org/10.3760/CMA.J.CN421158-20200216-00077","url":null,"abstract":"","PeriodicalId":10157,"journal":{"name":"Chinese Journal of Pediatric Surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88613053","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 : 2020-02-22DOI: 10.3760/CMA.J.CN421158-20200216-00076
Haibin Wang, X. Duan, Xue-qiang Yan, R. Sun, Xin Liu, Si-ju Ji
{"title":"A case of novel coronavirus pneumonia complicated with acute appendicitis in children","authors":"Haibin Wang, X. Duan, Xue-qiang Yan, R. Sun, Xin Liu, Si-ju Ji","doi":"10.3760/CMA.J.CN421158-20200216-00076","DOIUrl":"https://doi.org/10.3760/CMA.J.CN421158-20200216-00076","url":null,"abstract":"","PeriodicalId":10157,"journal":{"name":"中华小儿外科杂志","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74601016","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 : 2020-02-15DOI: 10.3760/CMA.J.ISSN.0253-3006.2020.02.005
Moudong Wu, Jin-pu Peng, Huixia Zhou, X. Zhan, Yuangui Yang, Daniel Wang, Nini An
Objective To compare the efficacy of gas-bladder laparoscopic Cohen procedure versus laparoscopic extravesical ureterovesical replantation for malformation of vesicoureteral junction in children. Methods From February 2014 to August 2019, gas-bladder laparoscopic Cohen procedure (n=17) and laparoscopic extravesical ureterovesical replantation under submucosal tunnel (n=14) were performed for unilateral malformation of vesicoureteral junction.Detailed clinical data were reviewed, including operative duration, postoperative time of intravenous antibiotic, postoperative hematuria time, length of urethral catheterization, postoperative hospitalization and hospital expenditure.A comparative study of major clinical parameters was performed. Results The mean operative duration of both groups was (194±46) and (152±52) min, the mean hospitalization stay was(8.1±1.1) and (6.4±1.2) days and the mean postoperative hematuria time was (3.2±0.7) and (1.5±1.1) days respectively.All of the above parameters had significant differences.The postoperative antibiotic dosing time was (5.6±1.1) and (5.2±1.2) days, the average time of indwelling catheter was(6.3±1.3) and (5.5±1.2) days and the mean hospital expenditure was(23357.2±4638.5) and (21194±3518.2) yuan respectively.No statistical differences existed in the above parameters.There was no conversion into open surgery in either groups.After a follow-up period of 3-12 months, the preoperative symptoms disappeared.For 13 cases in gas-bladder laparoscopic Cohen group, ultrasound showed that hydronephrosis disappeared and ureter normalized (n=10). The outcomes were postoperative urinary tract infection (n=1), mild ureteral dilation (n=1) and ureteral reflux II (n=1); For 11 cases in laparoscopic extravesical ureterovesical replantation group, ultrasound showed that hydronephrosis disappeared and ureter normalized (n=10). There was mild ureteral dilation (n=1) without ureteral reflux. Conclusions Clinical efficacies of both procedures are definite for obstruction of vesicoureteral junction in children.As compared with gas-bladder laparoscopic Cohen procedure, laparoscopic extravesical ureterovesical replantation is less time-consuming and more mini-invasive and recovers faster. Key words: Urinary bladder; Laparoscopes; Ureteral reimplantation
{"title":"Comparison of clinical efficacy between gas-bladder laparoscopic Cohen procedure versus laparoscopic extravesical ureterovesical replantation for malformation of vesicoureteral junction","authors":"Moudong Wu, Jin-pu Peng, Huixia Zhou, X. Zhan, Yuangui Yang, Daniel Wang, Nini An","doi":"10.3760/CMA.J.ISSN.0253-3006.2020.02.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-3006.2020.02.005","url":null,"abstract":"Objective \u0000To compare the efficacy of gas-bladder laparoscopic Cohen procedure versus laparoscopic extravesical ureterovesical replantation for malformation of vesicoureteral junction in children. \u0000 \u0000 \u0000Methods \u0000From February 2014 to August 2019, gas-bladder laparoscopic Cohen procedure (n=17) and laparoscopic extravesical ureterovesical replantation under submucosal tunnel (n=14) were performed for unilateral malformation of vesicoureteral junction.Detailed clinical data were reviewed, including operative duration, postoperative time of intravenous antibiotic, postoperative hematuria time, length of urethral catheterization, postoperative hospitalization and hospital expenditure.A comparative study of major clinical parameters was performed. \u0000 \u0000 \u0000Results \u0000The mean operative duration of both groups was (194±46) and (152±52) min, the mean hospitalization stay was(8.1±1.1) and (6.4±1.2) days and the mean postoperative hematuria time was (3.2±0.7) and (1.5±1.1) days respectively.All of the above parameters had significant differences.The postoperative antibiotic dosing time was (5.6±1.1) and (5.2±1.2) days, the average time of indwelling catheter was(6.3±1.3) and (5.5±1.2) days and the mean hospital expenditure was(23357.2±4638.5) and (21194±3518.2) yuan respectively.No statistical differences existed in the above parameters.There was no conversion into open surgery in either groups.After a follow-up period of 3-12 months, the preoperative symptoms disappeared.For 13 cases in gas-bladder laparoscopic Cohen group, ultrasound showed that hydronephrosis disappeared and ureter normalized (n=10). The outcomes were postoperative urinary tract infection (n=1), mild ureteral dilation (n=1) and ureteral reflux II (n=1); For 11 cases in laparoscopic extravesical ureterovesical replantation group, ultrasound showed that hydronephrosis disappeared and ureter normalized (n=10). There was mild ureteral dilation (n=1) without ureteral reflux. \u0000 \u0000 \u0000Conclusions \u0000Clinical efficacies of both procedures are definite for obstruction of vesicoureteral junction in children.As compared with gas-bladder laparoscopic Cohen procedure, laparoscopic extravesical ureterovesical replantation is less time-consuming and more mini-invasive and recovers faster. \u0000 \u0000 \u0000Key words: \u0000Urinary bladder; Laparoscopes; Ureteral reimplantation","PeriodicalId":10157,"journal":{"name":"Chinese Journal of Pediatric Surgery","volume":"72 1","pages":"118-122"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85840923","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 : 2020-02-15DOI: 10.3760/CMA.J.ISSN.0253-3006.2020.02.010
Jinshan Zhang, Long Li
Objective To explore the effectiveness and feasibility of laparoscopic ligation of splenic vessels for hereditary spherocytosis in children. Methods From May 2015 to April 2018, seventeen children with hereditary spherocytosis underwent laparoscopic ligation of splenic vessels.The mean follow-up period was 19.8(3-38) months.The volume of spleen was measured by AW VolumeShare5 preoperatively and postoperatively. Results Laparoscopic ligation of splenic vessels was successfully performed in all patients.The average operative duration was 115(60-180) min.No intraoperative blood transfusion was offered and the mean length of hospitalization was 7(5-9) days.Red blood cell, platelet and hemoglobin significantly increased postoperatively (P 1 year (P=0.004). The mean index of splenic infarction was 0.53(0.31-0.99). No postoperative blood transfusion was offered. Conclusions Laparoscopic ligation of splenic vessels is effective for hereditary spherocytosis in children.However, the long-term prognosis shall be re-evaluated in future study. Key words: Laparoscopes; Ligation of splenic vessels; Child; Hereditary spherocytosis
{"title":"Laparoscopic ligation of splenic vessels for hereditary spherocytosis in children","authors":"Jinshan Zhang, Long Li","doi":"10.3760/CMA.J.ISSN.0253-3006.2020.02.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-3006.2020.02.010","url":null,"abstract":"Objective \u0000To explore the effectiveness and feasibility of laparoscopic ligation of splenic vessels for hereditary spherocytosis in children. \u0000 \u0000 \u0000Methods \u0000From May 2015 to April 2018, seventeen children with hereditary spherocytosis underwent laparoscopic ligation of splenic vessels.The mean follow-up period was 19.8(3-38) months.The volume of spleen was measured by AW VolumeShare5 preoperatively and postoperatively. \u0000 \u0000 \u0000Results \u0000Laparoscopic ligation of splenic vessels was successfully performed in all patients.The average operative duration was 115(60-180) min.No intraoperative blood transfusion was offered and the mean length of hospitalization was 7(5-9) days.Red blood cell, platelet and hemoglobin significantly increased postoperatively (P 1 year (P=0.004). The mean index of splenic infarction was 0.53(0.31-0.99). No postoperative blood transfusion was offered. \u0000 \u0000 \u0000Conclusions \u0000Laparoscopic ligation of splenic vessels is effective for hereditary spherocytosis in children.However, the long-term prognosis shall be re-evaluated in future study. \u0000 \u0000 \u0000Key words: \u0000Laparoscopes; Ligation of splenic vessels; Child; Hereditary spherocytosis","PeriodicalId":10157,"journal":{"name":"Chinese Journal of Pediatric Surgery","volume":"114 1","pages":"145-149"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86793513","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 : 2020-02-15DOI: 10.3760/CMA.J.ISSN.0253-3006.2020.02.006
Huihuang Xu, Zhixian Xiao, Di Xu, Shan-chang Lin
Objective To evaluate the clinical efficacy of modified air bladder laparoscope with Cohen ureteral replantation for terminal ureteral stenosis. Methods From January 2018 to May 2019, retrospective analysis was performed for 12 children with terminal ureteral stenosis undergoing modified gas bladder laparoscopic Cohen ureteral retransplantation. There were 8 boys and 4 girls with an average age of (3.0±2.2)(1.2-9.5) years. The involved side was left (n=9) and right (n=3). Ureteral stent was inserted into ostium ureteris via transurethral route after gas bladder creating. Ureteral stricture was resected. After transurethral replacement of stent tube, the silicone tube for chemotherapy was implanted at the involved ureteral side. The ends of stent and silicone tubes were sutured with traction. With precision cutting and forming, double J tube core was placed for Cohen ureteral reimplantation. After operation, urine routine, ultrasound of urinary system, excretive cystourethrography (VCUG), magnetic resonance urography (MRU), diuretic nephrogram and static renal imaging were performed regularly for evaluating such parameters as hydronephrosis, ureteral dilatation or stenosis, ureteral reflux and renal function. Results All 12 cases were successfully operated without switching into open surgery. The average operative duration was (99.0±16.1)(75-125) min, the average indwelling period of catheter (7.0±1.5)(5-10) days, the average indwelling period of bladder fistula (12.3±1.3)(10-14) days, the average postoperative hospital stay (9.5±2.8)(6-15) days and the average postoperative follow-up period (10.4±2.8)(6-16) months. At Month 6 postoperatively, renal pelvic anterioposterior diameter [(0.49±0.21) vs (1.35±0.32)cm]and maximal ureteral diameter [(0.66±0.21) vs (1.77±0.33) cm]of the involved side shrank markedly as compared with pre-operation. The differences were statistically significant (P<0.05). Renal static imaging indicated higher or unchanged renal function of the involved side. Diuretic renography revealed no mechanical obstruction curve, no back pain or urinary tract infections. One case of degree I reflux resolved after conservative measures. None was reoperated. Conclusions Modified gas bladder laparoscopic Cohen ureteral replantation is both safe and effective for ureteral terminal stenosis. It may simplify surgical procedures, shorten operative duration and recover quickly postoperatively. Key words: Child; Laparoscopes; Terminal ureteral stricture; Ureteral reimplantation
{"title":"Modified gas bladder laparoscopic Cohen ureteral replantation for terminal ureteral stenosis","authors":"Huihuang Xu, Zhixian Xiao, Di Xu, Shan-chang Lin","doi":"10.3760/CMA.J.ISSN.0253-3006.2020.02.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-3006.2020.02.006","url":null,"abstract":"Objective \u0000To evaluate the clinical efficacy of modified air bladder laparoscope with Cohen ureteral replantation for terminal ureteral stenosis. \u0000 \u0000 \u0000Methods \u0000From January 2018 to May 2019, retrospective analysis was performed for 12 children with terminal ureteral stenosis undergoing modified gas bladder laparoscopic Cohen ureteral retransplantation. There were 8 boys and 4 girls with an average age of (3.0±2.2)(1.2-9.5) years. The involved side was left (n=9) and right (n=3). Ureteral stent was inserted into ostium ureteris via transurethral route after gas bladder creating. Ureteral stricture was resected. After transurethral replacement of stent tube, the silicone tube for chemotherapy was implanted at the involved ureteral side. The ends of stent and silicone tubes were sutured with traction. With precision cutting and forming, double J tube core was placed for Cohen ureteral reimplantation. After operation, urine routine, ultrasound of urinary system, excretive cystourethrography (VCUG), magnetic resonance urography (MRU), diuretic nephrogram and static renal imaging were performed regularly for evaluating such parameters as hydronephrosis, ureteral dilatation or stenosis, ureteral reflux and renal function. \u0000 \u0000 \u0000Results \u0000All 12 cases were successfully operated without switching into open surgery. The average operative duration was (99.0±16.1)(75-125) min, the average indwelling period of catheter (7.0±1.5)(5-10) days, the average indwelling period of bladder fistula (12.3±1.3)(10-14) days, the average postoperative hospital stay (9.5±2.8)(6-15) days and the average postoperative follow-up period (10.4±2.8)(6-16) months. At Month 6 postoperatively, renal pelvic anterioposterior diameter [(0.49±0.21) vs (1.35±0.32)cm]and maximal ureteral diameter [(0.66±0.21) vs (1.77±0.33) cm]of the involved side shrank markedly as compared with pre-operation. The differences were statistically significant (P<0.05). Renal static imaging indicated higher or unchanged renal function of the involved side. Diuretic renography revealed no mechanical obstruction curve, no back pain or urinary tract infections. One case of degree I reflux resolved after conservative measures. None was reoperated. \u0000 \u0000 \u0000Conclusions \u0000Modified gas bladder laparoscopic Cohen ureteral replantation is both safe and effective for ureteral terminal stenosis. It may simplify surgical procedures, shorten operative duration and recover quickly postoperatively. \u0000 \u0000 \u0000Key words: \u0000Child; Laparoscopes; Terminal ureteral stricture; Ureteral reimplantation","PeriodicalId":10157,"journal":{"name":"中华小儿外科杂志","volume":"70 1","pages":"123-127"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75944999","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 : 2020-02-15DOI: 10.3760/CMA.J.ISSN.0253-3006.2020.02.009
Xin-ke Xu, Yanping Xie, Jun-liang Li, Cheng Chen, Lin Jinrong, Yu Hongyao, Fangcheng Li
Objective To summarize the surgical treatments of epilepsy caused by Sturge-Weber syndrome in children. Methods A total of 8 children with Sturge-Weber syndrome were operated from January 2016 to June 2018.There were 2 boys and 6 girls with an average age of 26.25(5-48) months.The age group was under 3 years (n=7) and above 3 years (n=1). The average disease course was 8.98 months (2 days to 2 years). Detailed analysis was performed for disease course, seizure types, imaging findings, electroencephalography (EEG) profiles, surgical timing, surgical approaches, postoperative status of epileptic control and complications, etc.And preoperative evaluations of symptoms, imaging findings, EEG profiles and cognitive functions were also conducted. Results Lobectomy (n=3) and functional hemispherectomy (n=5) were performed.Postoperative outcomes were intracranial infection (n=2), subcutaneous effusion (n=2), lowered muscle strength of contralateral extremity (n=5) and no obvious change (n=3). During a follow-up period of 6 to 30 months, there was no instance of seizure.Based upon the Engel's grade, all children were Grade I and there was no mortality.Muscle strength of contralateral extremity all recovered to preoperative levels at Month 3 postoperatively.Cognitive function evaluations indicated that 8 children had varying degrees of improvement. Conclusions As a common neurocutaneous syndrome in children, Sturge-Weber syndrome is usually characterized as drug-resistant epilepsy.Early surgical intervention is an effective treatment of improving the cognitive function of epileptic children. Key words: Sturge-Weber syndrome; Epilepsy; Surgical treatment; Child
{"title":"Surgical treatment of epilepsy caused by Sturge-Weber syndrome in children","authors":"Xin-ke Xu, Yanping Xie, Jun-liang Li, Cheng Chen, Lin Jinrong, Yu Hongyao, Fangcheng Li","doi":"10.3760/CMA.J.ISSN.0253-3006.2020.02.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-3006.2020.02.009","url":null,"abstract":"Objective \u0000To summarize the surgical treatments of epilepsy caused by Sturge-Weber syndrome in children. \u0000 \u0000 \u0000Methods \u0000A total of 8 children with Sturge-Weber syndrome were operated from January 2016 to June 2018.There were 2 boys and 6 girls with an average age of 26.25(5-48) months.The age group was under 3 years (n=7) and above 3 years (n=1). The average disease course was 8.98 months (2 days to 2 years). Detailed analysis was performed for disease course, seizure types, imaging findings, electroencephalography (EEG) profiles, surgical timing, surgical approaches, postoperative status of epileptic control and complications, etc.And preoperative evaluations of symptoms, imaging findings, EEG profiles and cognitive functions were also conducted. \u0000 \u0000 \u0000Results \u0000Lobectomy (n=3) and functional hemispherectomy (n=5) were performed.Postoperative outcomes were intracranial infection (n=2), subcutaneous effusion (n=2), lowered muscle strength of contralateral extremity (n=5) and no obvious change (n=3). During a follow-up period of 6 to 30 months, there was no instance of seizure.Based upon the Engel's grade, all children were Grade I and there was no mortality.Muscle strength of contralateral extremity all recovered to preoperative levels at Month 3 postoperatively.Cognitive function evaluations indicated that 8 children had varying degrees of improvement. \u0000 \u0000 \u0000Conclusions \u0000As a common neurocutaneous syndrome in children, Sturge-Weber syndrome is usually characterized as drug-resistant epilepsy.Early surgical intervention is an effective treatment of improving the cognitive function of epileptic children. \u0000 \u0000 \u0000Key words: \u0000Sturge-Weber syndrome; Epilepsy; Surgical treatment; Child","PeriodicalId":10157,"journal":{"name":"中华小儿外科杂志","volume":"1 1","pages":"140-144"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78608404","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 : 2020-02-15DOI: 10.3760/CMA.J.ISSN.0253-3006.2020.02.011
Guangxian Yang, Liwen Yi, Ji-Feng Xiang, Jinhua Wang, Xicheng Deng
Objective To explore the optimal surgical strategy for children with pectus excavatum (PE) and concurrent congenital heart defect (CHD). Methods From July 2007 to May 2018, retrospective reviews were conducted for medical records of 17 children undergoing simultaneous repair of PE with concurrent CHD.There were 10 boys and 7 girls with an average age of (4.5±2.7)(1-12.7) years and an avergae body weight of (14.5±5.2)(7.5-27.5) kg.There were simple ventricular septum defect (VSD, n=4), simple atrial septum defect (ASD, n=8), VSD & ASD (n=3), VSD & ASD & patent ductus arteriosus (PDA, n=1) and VSD with pulmonary hypertension (n=1). For repairing PE, open sternal elevation was performed with liberating tissue from posterior sternum, lifting sternum by wires, Nuss plating and a custom-made sternal lifting device.CHD was corrected by open heart surgery via cardiopulmonary bypass or transcatheter closure under echocardiography or radiology-guided percutaneous intervention. Results Among them, the operations led to satisfactory repair of both conditions without serious complications.All parents and children were satisfied with postoperative chest appearances.The mean duration of hospitalization was (13.6±4.8)(8-25) days.The postoperative complications were delayed wound healing (n=2) and minimal left pleural effusion (n=1). There was no occurrence of such severe complications as surgical mortality, major hemorrhage, chest organ injuries or implant rejection. Conclusions According to the characteristics of patients, individualized approaches are selected for correcting PE and concurrent CHD.Both safe and effective, such a strategy avoids the risks of multiple operations and anesthesia and the outcomes are satisfactory. Key words: Funnel chest; Heart diseases, congenital; Child
{"title":"Simultaneous surgical strategy for pectus excavatum and concurrent congenital heart defects in children","authors":"Guangxian Yang, Liwen Yi, Ji-Feng Xiang, Jinhua Wang, Xicheng Deng","doi":"10.3760/CMA.J.ISSN.0253-3006.2020.02.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-3006.2020.02.011","url":null,"abstract":"Objective \u0000To explore the optimal surgical strategy for children with pectus excavatum (PE) and concurrent congenital heart defect (CHD). \u0000 \u0000 \u0000Methods \u0000From July 2007 to May 2018, retrospective reviews were conducted for medical records of 17 children undergoing simultaneous repair of PE with concurrent CHD.There were 10 boys and 7 girls with an average age of (4.5±2.7)(1-12.7) years and an avergae body weight of (14.5±5.2)(7.5-27.5) kg.There were simple ventricular septum defect (VSD, n=4), simple atrial septum defect (ASD, n=8), VSD & ASD (n=3), VSD & ASD & patent ductus arteriosus (PDA, n=1) and VSD with pulmonary hypertension (n=1). For repairing PE, open sternal elevation was performed with liberating tissue from posterior sternum, lifting sternum by wires, Nuss plating and a custom-made sternal lifting device.CHD was corrected by open heart surgery via cardiopulmonary bypass or transcatheter closure under echocardiography or radiology-guided percutaneous intervention. \u0000 \u0000 \u0000Results \u0000Among them, the operations led to satisfactory repair of both conditions without serious complications.All parents and children were satisfied with postoperative chest appearances.The mean duration of hospitalization was (13.6±4.8)(8-25) days.The postoperative complications were delayed wound healing (n=2) and minimal left pleural effusion (n=1). There was no occurrence of such severe complications as surgical mortality, major hemorrhage, chest organ injuries or implant rejection. \u0000 \u0000 \u0000Conclusions \u0000According to the characteristics of patients, individualized approaches are selected for correcting PE and concurrent CHD.Both safe and effective, such a strategy avoids the risks of multiple operations and anesthesia and the outcomes are satisfactory. \u0000 \u0000 \u0000Key words: \u0000Funnel chest; Heart diseases, congenital; Child","PeriodicalId":10157,"journal":{"name":"Chinese Journal of Pediatric Surgery","volume":"26 1","pages":"150-155"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80684993","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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