Pub Date : 2020-02-15DOI: 10.3760/CMA.J.ISSN.0253-3006.2020.02.018
Hongyan Li, Siyu Yan, Yanran Duan, P. Yin
In recent years, real-world study has become a common concern of global regulatory agencies, pharmaceutical manufacturers and academic circles. In domains where randomized controlled trials are difficult to conduct, such as pediatric surgery, real-world study acts as an alternative of obtaining clinical evidences. This systematic review introduces basic concepts, study designs and statistical analysis methods of real-world study. Besides the application value and practical instructions of real-world study for pediatric surgery, it provides reference for pediatric surgeons to understand and conduct real-world study correctly. Key words: Real-world study; Pediatric surgery; Randomized controlled trial
{"title":"Real world research and its application in clinical research of pediatric surgery","authors":"Hongyan Li, Siyu Yan, Yanran Duan, P. Yin","doi":"10.3760/CMA.J.ISSN.0253-3006.2020.02.018","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-3006.2020.02.018","url":null,"abstract":"In recent years, real-world study has become a common concern of global regulatory agencies, pharmaceutical manufacturers and academic circles. In domains where randomized controlled trials are difficult to conduct, such as pediatric surgery, real-world study acts as an alternative of obtaining clinical evidences. This systematic review introduces basic concepts, study designs and statistical analysis methods of real-world study. Besides the application value and practical instructions of real-world study for pediatric surgery, it provides reference for pediatric surgeons to understand and conduct real-world study correctly. \u0000 \u0000 \u0000Key words: \u0000Real-world study; Pediatric surgery; Randomized controlled trial","PeriodicalId":10157,"journal":{"name":"Chinese Journal of Pediatric Surgery","volume":"15 1","pages":"183-186"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81816435","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.0253-3006.2020.02.012
Yuan F. Liu, Gong Chen, Shan Zhen, K. Dong
Objective To explore the clinical features and treatments of children with type Ⅳa choledochal cysts. Methods From January 2015 to December 2017, a total of 135 children of choledochal cysts with complete clinical records were recruited.The clinical Todani types were Ⅰ(n=96), Ⅱ(n=9), Ⅲ(n=1) and Ⅳ (n=29). Based upon inclusion criteria, they were divided into group A (type-Ⅳa, n=29), group B [type I with intrahepatic bile duct dilatation (BDD), n=36] and group C (type Ⅰ with extrahepatic bile duct dilatation, n=56). Retrospective analyses were performed for clinical symptoms, imaging findings, surgical procedures and prognoses. Results A total of 121 cases were collected.Girls were more than boys in all groups and there was no inter-group statistical difference.According to the criteria of magnetic resonance cholangiopancreatography (MRCP), the detection rate of ultrasound was 30.7% (20/65). All ultrasonic reports suggested the presence of anterior primary hepatic hilum space-occupying lesions and choledochectasia.Twenty-five patients (20.7%) had preoperative pancreatitis.Seven children were re-operated due to anastomotic stenosis (n=4), intestinal obstruction (n=1), small intestinal adhesion obstruction (n=1) and biliary fistula (n=1). And three cases improved after anti-inflammation treatment.During postoperative follow-ups, BDD peristed in 4 cases.Two of them without discomforts received conservative therapy.Another two were re-operated and BDD disappeared within 1 month. Conclusions Stricture of bile duct in hepatic hilum should be treated aggressively during surgery.Most children with type Ⅳa choledochal cysts have a favorable prognosis and aggressive partial hepatectomy is not recommended during initial surgery.Preoperative acute pancreatitis is not a contraindication of radical surgery. Key words: Choledochal cyst; Diagnosis; Surgical procedures, operative; Child
{"title":"Surgical treatment of type IVa choledochal cysts in children","authors":"Yuan F. Liu, Gong Chen, Shan Zhen, K. Dong","doi":"10.3760/CMA.J.ISSN.0253-3006.2020.02.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-3006.2020.02.012","url":null,"abstract":"Objective \u0000To explore the clinical features and treatments of children with type Ⅳa choledochal cysts. \u0000 \u0000 \u0000Methods \u0000From January 2015 to December 2017, a total of 135 children of choledochal cysts with complete clinical records were recruited.The clinical Todani types were Ⅰ(n=96), Ⅱ(n=9), Ⅲ(n=1) and Ⅳ (n=29). Based upon inclusion criteria, they were divided into group A (type-Ⅳa, n=29), group B [type I with intrahepatic bile duct dilatation (BDD), n=36] and group C (type Ⅰ with extrahepatic bile duct dilatation, n=56). Retrospective analyses were performed for clinical symptoms, imaging findings, surgical procedures and prognoses. \u0000 \u0000 \u0000Results \u0000A total of 121 cases were collected.Girls were more than boys in all groups and there was no inter-group statistical difference.According to the criteria of magnetic resonance cholangiopancreatography (MRCP), the detection rate of ultrasound was 30.7% (20/65). All ultrasonic reports suggested the presence of anterior primary hepatic hilum space-occupying lesions and choledochectasia.Twenty-five patients (20.7%) had preoperative pancreatitis.Seven children were re-operated due to anastomotic stenosis (n=4), intestinal obstruction (n=1), small intestinal adhesion obstruction (n=1) and biliary fistula (n=1). And three cases improved after anti-inflammation treatment.During postoperative follow-ups, BDD peristed in 4 cases.Two of them without discomforts received conservative therapy.Another two were re-operated and BDD disappeared within 1 month. \u0000 \u0000 \u0000Conclusions \u0000Stricture of bile duct in hepatic hilum should be treated aggressively during surgery.Most children with type Ⅳa choledochal cysts have a favorable prognosis and aggressive partial hepatectomy is not recommended during initial surgery.Preoperative acute pancreatitis is not a contraindication of radical surgery. \u0000 \u0000 \u0000Key words: \u0000Choledochal cyst; Diagnosis; Surgical procedures, operative; Child","PeriodicalId":10157,"journal":{"name":"Chinese Journal of Pediatric Surgery","volume":"1 1","pages":"156-161"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81006038","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.0253-3006.2020.02.019
Jianan Chen, Linghua Ji, W. Ge, H. Xian
As a rare cause of acute abdominal pain in children, omental torsion (OT) refers to omental twisting around a pivotal point, usually in a clockwise direction, causing omental edema, ischemia and eventual necrosis.Up to 80% of OT cases presented with right-sided abdominal pain and tenderness.It is frequently misdiagnosed in children due to similar symptoms and signs.Furthermore, radiology and ultrasound have poor sensitivity, specificity and accuracy of diagnosing.On computed tomography (CT), a whirl sign of a fatty mass with concentric linear strands in greater omentum highly hints at a diagnosis of OT.With a wider application of high-quality ultrasound, CT and CT MPR, OT is increasingly diagnosed by imaging examinations.However, operation has remained an important method for diagnosing OT.Predominant treatments include conservative medical treatment and laparoscopic surgical intervention.Laparoscopic resection of OT is vital for diagnosing and treating OT.Due to the risk of recurrence and a lack of conclusive diagnostic method, conservative treatments require extended follow-ups.If the diagnosis remains inconclusive or conservative treatments fail, laparoscopic removal surgical intervention should be performed immediately. Key words: Omental torsion; Acute pain; Greater omentum
{"title":"Recent advances in the diagnosis and treatment of omental torsion in children","authors":"Jianan Chen, Linghua Ji, W. Ge, H. Xian","doi":"10.3760/CMA.J.ISSN.0253-3006.2020.02.019","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-3006.2020.02.019","url":null,"abstract":"As a rare cause of acute abdominal pain in children, omental torsion (OT) refers to omental twisting around a pivotal point, usually in a clockwise direction, causing omental edema, ischemia and eventual necrosis.Up to 80% of OT cases presented with right-sided abdominal pain and tenderness.It is frequently misdiagnosed in children due to similar symptoms and signs.Furthermore, radiology and ultrasound have poor sensitivity, specificity and accuracy of diagnosing.On computed tomography (CT), a whirl sign of a fatty mass with concentric linear strands in greater omentum highly hints at a diagnosis of OT.With a wider application of high-quality ultrasound, CT and CT MPR, OT is increasingly diagnosed by imaging examinations.However, operation has remained an important method for diagnosing OT.Predominant treatments include conservative medical treatment and laparoscopic surgical intervention.Laparoscopic resection of OT is vital for diagnosing and treating OT.Due to the risk of recurrence and a lack of conclusive diagnostic method, conservative treatments require extended follow-ups.If the diagnosis remains inconclusive or conservative treatments fail, laparoscopic removal surgical intervention should be performed immediately. \u0000 \u0000 \u0000Key words: \u0000Omental torsion; Acute pain; Greater omentum","PeriodicalId":10157,"journal":{"name":"Chinese Journal of Pediatric Surgery","volume":"134 1","pages":"187-189"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77084217","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.0253-3006.2020.02.014
Feng Liu, Jianlei Geng, H. Ren, Yan-fang Dong, Bobo Niu, Zan Wang, Kuo Xing, Zhiguang Zhang, Huizhong Niu
Objective To explore the value of transanal ileal drainage tube for terminal ileal atresia and to examine its effect on postoperative nutrition. Methods From January 2014 to December 2017, clinical data were retrospectively analyzed for 25 children with intestinal atresia within 5 cm of ileum at terminal ileum .According to different surgical approaches, they were divided into control (n=13) and observation (n=12) groups.In control group, ileocecal resection was performed.And proximal ileum and distal colon were anastomosed.In observation group, ileocecal plexus was preserved and anal canal created near anastomosis.The proximal end was 15(10-20) cm.All cases underwent simultaneous abdominal drainage.The operative duration, efficacy, postoperative nutrition and gastrointestinal function of two groups were compared. Results Twelve children in observation group and 13 in control group recovered successfully.There were no complications such as anastomotic leakage and residual abscess in abdominal cavity.Three cases in observation group and 7 in control group were hospitalized for postoperative complications and no reoperation was performed.The average operative duration of observation group was higher than that of control group [(115.2±18.1) vs (105.3±16.9) min, (P 0.05)]. No statistical significance existed.A statistically significant difference existed between observation group (12.6±2.4 days) and control group (14.8±2.8 days) (P<0.05). The average hospital stay observation group (16.1±2.4 days) and control group (18.7±3.6 days). The difference was statistically significant(P<0.05). At 15 days postoperatively, pre-albumin and albumin levels were observed (113.8±8.7, 31.8±4.3 g/L). Both were significantly higher than those of control group (107.5±5.1, 28.1±3.3 g/L) (P<0.05). The difference was statistically significant; pre-albumin and albumin levels at Day 30 postoperatively (117.5±7.4 vs 38.1±3.8 g/L). Both were significantly higher than those of control group (111.4±6.0 vs 34.1±3.4). The difference was statistically significant(P<0.05). Conclusions For atresia <5 cm away from ileocecal area, transanal catheter is utilized for reaching the proximal end of anastomosis and direct anastomosis may preserve ileocecal area and lower the nutrition-related complications.This simple procedure has a definite efficacy.It is worthy of wider clinical applications. Key words: Drainage tube; Ileum; Infant, newborn; Intestinal atresia
目的探讨经肛门回肠引流管在回肠终末闭锁中的应用价值，并观察其对术后营养的影响。方法回顾性分析2014年1月至2017年12月25例回肠末端5 cm以内肠闭锁患儿的临床资料，根据手术入路不同分为对照组(n=13)和观察组(n=12)。对照组行回盲切除。回肠近端与结肠远端吻合。观察组保留回盲神经丛，近吻合处造肛管。近端15(10-20)cm。所有病例均行腹腔引流术。比较两组患者手术时间、疗效、术后营养及胃肠功能。结果观察组12例患儿康复，对照组13例患儿康复。术后无吻合口漏、腹腔残余脓肿等并发症。观察组3例，对照组7例，均因术后并发症住院，无再次手术。观察组患者平均手术时间明显高于对照组[(115.2±18.1)vs(105.3±16.9)min，差异有统计学意义(P < 0.05)]。无统计学意义。观察组(12.6±2.4 d)与对照组(14.8±2.8 d)比较，差异有统计学意义(P<0.05)。观察组平均住院时间(16.1±2.4 d)，对照组平均住院时间(18.7±3.6 d)。差异有统计学意义(P<0.05)。术后15 d观察术前白蛋白和白蛋白水平(113.8±8.7、31.8±4.3 g/L)。两者均显著高于对照组(107.5±5.1、28.1±3.3 g/L) (P<0.05)。差异有统计学意义;术后第30天白蛋白水平(117.5±7.4 vs 38.1±3.8 g/L)。两者均显著高于对照组(111.4±6.0 vs 34.1±3.4)。差异有统计学意义(P<0.05)。结论对于距离回盲区<5 cm的闭锁，采用经肛门导管到达吻合近端，直接吻合可保留回盲区，减少营养相关并发症。这个简单的程序有一定的效果。值得临床推广应用。关键词:引流管;回肠;婴儿,新生;肠闭锁
{"title":"Application of transanal drainage tube for intestinal occlusion of neonatal ileum","authors":"Feng Liu, Jianlei Geng, H. Ren, Yan-fang Dong, Bobo Niu, Zan Wang, Kuo Xing, Zhiguang Zhang, Huizhong Niu","doi":"10.3760/CMA.J.ISSN.0253-3006.2020.02.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-3006.2020.02.014","url":null,"abstract":"Objective \u0000To explore the value of transanal ileal drainage tube for terminal ileal atresia and to examine its effect on postoperative nutrition. \u0000 \u0000 \u0000Methods \u0000From January 2014 to December 2017, clinical data were retrospectively analyzed for 25 children with intestinal atresia within 5 cm of ileum at terminal ileum .According to different surgical approaches, they were divided into control (n=13) and observation (n=12) groups.In control group, ileocecal resection was performed.And proximal ileum and distal colon were anastomosed.In observation group, ileocecal plexus was preserved and anal canal created near anastomosis.The proximal end was 15(10-20) cm.All cases underwent simultaneous abdominal drainage.The operative duration, efficacy, postoperative nutrition and gastrointestinal function of two groups were compared. \u0000 \u0000 \u0000Results \u0000Twelve children in observation group and 13 in control group recovered successfully.There were no complications such as anastomotic leakage and residual abscess in abdominal cavity.Three cases in observation group and 7 in control group were hospitalized for postoperative complications and no reoperation was performed.The average operative duration of observation group was higher than that of control group [(115.2±18.1) vs (105.3±16.9) min, (P 0.05)]. No statistical significance existed.A statistically significant difference existed between observation group (12.6±2.4 days) and control group (14.8±2.8 days) (P<0.05). The average hospital stay observation group (16.1±2.4 days) and control group (18.7±3.6 days). The difference was statistically significant(P<0.05). At 15 days postoperatively, pre-albumin and albumin levels were observed (113.8±8.7, 31.8±4.3 g/L). Both were significantly higher than those of control group (107.5±5.1, 28.1±3.3 g/L) (P<0.05). The difference was statistically significant; pre-albumin and albumin levels at Day 30 postoperatively (117.5±7.4 vs 38.1±3.8 g/L). Both were significantly higher than those of control group (111.4±6.0 vs 34.1±3.4). The difference was statistically significant(P<0.05). \u0000 \u0000 \u0000Conclusions \u0000For atresia <5 cm away from ileocecal area, transanal catheter is utilized for reaching the proximal end of anastomosis and direct anastomosis may preserve ileocecal area and lower the nutrition-related complications.This simple procedure has a definite efficacy.It is worthy of wider clinical applications. \u0000 \u0000 \u0000Key words: \u0000Drainage tube; Ileum; Infant, newborn; Intestinal atresia","PeriodicalId":10157,"journal":{"name":"Chinese Journal of Pediatric Surgery","volume":"112 1","pages":"166-170"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87168051","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.0253-3006.2020.02.021
Guofeng Zhang, Heying Yang, Jiexiong Feng, Beibei Sun
{"title":"Minutes of National Multicenter Workshop on Pediatric General Surgery","authors":"Guofeng Zhang, Heying Yang, Jiexiong Feng, Beibei Sun","doi":"10.3760/CMA.J.ISSN.0253-3006.2020.02.021","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-3006.2020.02.021","url":null,"abstract":"","PeriodicalId":10157,"journal":{"name":"Chinese Journal of Pediatric Surgery","volume":"15 1","pages":"192-192"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84499482","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.0253-3006.2020.02.017
Teng Long, Cheng-yong Yang, Yuan Yang, Huiya Shi, Y. Xiong, Chuang-xi Liu
{"title":"Multiple and gigantic intracranial subdural empyema of parafalx in children: a case report and literature review","authors":"Teng Long, Cheng-yong Yang, Yuan Yang, Huiya Shi, Y. Xiong, Chuang-xi Liu","doi":"10.3760/CMA.J.ISSN.0253-3006.2020.02.017","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-3006.2020.02.017","url":null,"abstract":"","PeriodicalId":10157,"journal":{"name":"中华小儿外科杂志","volume":"1 1","pages":"180-182"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84278584","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.0253-3006.2020.02.015
Yiding Shen, D. Tang, De-hua Wu, Yong Huang, C. Tao, Guangjie Chen, Lei Gao, Xiaohao Wang, W. Ru, Linfeng Zhu
Objective To explore the efficacies and outcomes of standardized tubularized incised plate (TIP) urethroplasty for pediatric hypospadias. Methods A total of 447 hypospadias children with a median age of 21(5-176) months were recruited.There were 175 cases (39%) aged under 18 months and 272 cases (61%) aged above 18 months.The clinical types were distal (n=160, 36%), middle (n=216, 48%) and proximal (n=71, 16%). There were 281 cases (63%) in senior group and 166 cases (37%) in junior group.The differences of postoperative complications among different anatomical types were analyzed.Chi-square test was employed for analyzing and comparing the differences of postoperative complications among children of different age groups and the differences of postoperative complications among physicians of different seniority using standardized surgical procedures.Age, anatomical factors and seniority of physicians were included.And binary logistic regression analysis was performed for analyzing the influencing factors of operative success rate. Results All operations were performed successfully.There was no postoperative onset of urethral skin fistula, urethral stricture, urethral diverticulum, penile curvature or penile occultation.The incidence of surgical complications varied among children with different anatomical types.Eight cases (5%) of distal penis type had the lowest level and the difference was statistically significant as compared with another two types (P=0.000). No significant difference existed in the incidence of postoperative complications among physicians with different seniority (P>0.05). No significant difference existed in the incidence of postoperative complications among children of different age groups (P>0.05). Binary logistic regression analysis indicated that operative success rate or value of physicians with different seniority was 0.902 (0.508-1.604) and the difference was not statistically significant (P=0.726). Conclusions TIP is effective for children with hypospadias of all ages.The success rate of distal operation is relatively high and it is convenient for training pediatric urologists. Key words: Hypospadias; Postoperative complications; Child
{"title":"Clinical application of standardized tubularized incised plate urethroplasty for pediatric hypospadias","authors":"Yiding Shen, D. Tang, De-hua Wu, Yong Huang, C. Tao, Guangjie Chen, Lei Gao, Xiaohao Wang, W. Ru, Linfeng Zhu","doi":"10.3760/CMA.J.ISSN.0253-3006.2020.02.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-3006.2020.02.015","url":null,"abstract":"Objective \u0000To explore the efficacies and outcomes of standardized tubularized incised plate (TIP) urethroplasty for pediatric hypospadias. \u0000 \u0000 \u0000Methods \u0000A total of 447 hypospadias children with a median age of 21(5-176) months were recruited.There were 175 cases (39%) aged under 18 months and 272 cases (61%) aged above 18 months.The clinical types were distal (n=160, 36%), middle (n=216, 48%) and proximal (n=71, 16%). There were 281 cases (63%) in senior group and 166 cases (37%) in junior group.The differences of postoperative complications among different anatomical types were analyzed.Chi-square test was employed for analyzing and comparing the differences of postoperative complications among children of different age groups and the differences of postoperative complications among physicians of different seniority using standardized surgical procedures.Age, anatomical factors and seniority of physicians were included.And binary logistic regression analysis was performed for analyzing the influencing factors of operative success rate. \u0000 \u0000 \u0000Results \u0000All operations were performed successfully.There was no postoperative onset of urethral skin fistula, urethral stricture, urethral diverticulum, penile curvature or penile occultation.The incidence of surgical complications varied among children with different anatomical types.Eight cases (5%) of distal penis type had the lowest level and the difference was statistically significant as compared with another two types (P=0.000). No significant difference existed in the incidence of postoperative complications among physicians with different seniority (P>0.05). No significant difference existed in the incidence of postoperative complications among children of different age groups (P>0.05). Binary logistic regression analysis indicated that operative success rate or value of physicians with different seniority was 0.902 (0.508-1.604) and the difference was not statistically significant (P=0.726). \u0000 \u0000 \u0000Conclusions \u0000TIP is effective for children with hypospadias of all ages.The success rate of distal operation is relatively high and it is convenient for training pediatric urologists. \u0000 \u0000 \u0000Key words: \u0000Hypospadias; Postoperative complications; Child","PeriodicalId":10157,"journal":{"name":"中华小儿外科杂志","volume":"12 1","pages":"171-175"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84812772","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.0253-3006.2020.02.008
Shuai Song, Sujia Wu, Zhen Wang, W. Zhang, Yong‐cheng Hu, Guo-chuan Zhang, Yang Yao, Wenjian Wang, Xiu-chun Yu
Objective To explore the relevant influencing factors of clinical prognosis of children aged ≤14 years with extremity osteosarcoma. Methods A retrospective analysis was performed for medical records of children aged ≤14 years with extremity osteosarcoma admitted into seven bone cancer treatment centers in China from June 2000 to October 2017.The general data, surgical stage, preoperative biopsy, regimen/number of chemotherapy, surgical approach, recurrence, metastasis and survival prognosis were recorded.A Kaplan-Meier method was employed for plotting survival curve and calculating survival rate.A log-rank analysis was performed for determining the prognostic factors related to survival rate.And Cox model multivariate analysis was employed for identifying independent prognostic factors. Results There were 73 boys and 74 girls.They had a 3- and 5- year overall survival rates of 65% and 53%, with a median overall survival of 103 months (95%CI: 92.8 to 128.5), a 3/5-year disease-free survival rates of 46% and 38% and a median disease-free survival of 33 months (95%CI: 71.9 to 104.3). They were around knee joint (n=123) and outside knee joint (n=24). The Enneking surgical stage was Ⅱ (n=139) and Ⅲ (n=8). There were extremity salvage (n=128) and amputation (n=19). The chemotherapy was standard (n=78) and non-standard (n=69). The 5-year overall survival rates of standard and non-standard chemotherapy groups were 62% and 43.8% respectively.The 5-year disease-free survival rates were 50.2% and 31.6% respectively.There were no recurrence or metastasis (n=75), simple recurrence (n=13), simple metastasis (n=41) and multiple metastases (n=18, including recurrence & metastasis). The 5-year overall survival rate was 88%, 51.3%, 21.4% and 0 respectively.Univariate analysis showed that standard chemotherapy, Enneking surgical stage, frequency of postoperative adjuvant chemotherapy, recurrence and metastasis were the relevant influencing factors of survival and prognosis of children with extremity osteosarcoma (P 0.05). Cox regression multivariate analysis showed that standard chemotherapy, recurrence and metastasis were independent influencing factors of survival and prognosis of children with extremity osteosarcoma (P<0.05). Conclusions Standard neoadjuvant chemotherapy and effective control of recurrence and metastasis can improve the survival rate and prognosis of children with extremity osteosarcoma.Non-standard chemotherapy .Recurrence and metastasis adversely affect the prognosis of patients. Key words: Osteosarcoma; Limb; Child; Multicenter study; Prognosis
{"title":"A multi-center retrospective analysis of clinical prognosis in children with extremity osteosarcoma","authors":"Shuai Song, Sujia Wu, Zhen Wang, W. Zhang, Yong‐cheng Hu, Guo-chuan Zhang, Yang Yao, Wenjian Wang, Xiu-chun Yu","doi":"10.3760/CMA.J.ISSN.0253-3006.2020.02.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-3006.2020.02.008","url":null,"abstract":"Objective \u0000To explore the relevant influencing factors of clinical prognosis of children aged ≤14 years with extremity osteosarcoma. \u0000 \u0000 \u0000Methods \u0000A retrospective analysis was performed for medical records of children aged ≤14 years with extremity osteosarcoma admitted into seven bone cancer treatment centers in China from June 2000 to October 2017.The general data, surgical stage, preoperative biopsy, regimen/number of chemotherapy, surgical approach, recurrence, metastasis and survival prognosis were recorded.A Kaplan-Meier method was employed for plotting survival curve and calculating survival rate.A log-rank analysis was performed for determining the prognostic factors related to survival rate.And Cox model multivariate analysis was employed for identifying independent prognostic factors. \u0000 \u0000 \u0000Results \u0000There were 73 boys and 74 girls.They had a 3- and 5- year overall survival rates of 65% and 53%, with a median overall survival of 103 months (95%CI: 92.8 to 128.5), a 3/5-year disease-free survival rates of 46% and 38% and a median disease-free survival of 33 months (95%CI: 71.9 to 104.3). They were around knee joint (n=123) and outside knee joint (n=24). The Enneking surgical stage was Ⅱ (n=139) and Ⅲ (n=8). There were extremity salvage (n=128) and amputation (n=19). The chemotherapy was standard (n=78) and non-standard (n=69). The 5-year overall survival rates of standard and non-standard chemotherapy groups were 62% and 43.8% respectively.The 5-year disease-free survival rates were 50.2% and 31.6% respectively.There were no recurrence or metastasis (n=75), simple recurrence (n=13), simple metastasis (n=41) and multiple metastases (n=18, including recurrence & metastasis). The 5-year overall survival rate was 88%, 51.3%, 21.4% and 0 respectively.Univariate analysis showed that standard chemotherapy, Enneking surgical stage, frequency of postoperative adjuvant chemotherapy, recurrence and metastasis were the relevant influencing factors of survival and prognosis of children with extremity osteosarcoma (P 0.05). Cox regression multivariate analysis showed that standard chemotherapy, recurrence and metastasis were independent influencing factors of survival and prognosis of children with extremity osteosarcoma (P<0.05). \u0000 \u0000 \u0000Conclusions \u0000Standard neoadjuvant chemotherapy and effective control of recurrence and metastasis can improve the survival rate and prognosis of children with extremity osteosarcoma.Non-standard chemotherapy .Recurrence and metastasis adversely affect the prognosis of patients. \u0000 \u0000 \u0000Key words: \u0000Osteosarcoma; Limb; Child; Multicenter study; Prognosis","PeriodicalId":10157,"journal":{"name":"中华小儿外科杂志","volume":"25 1","pages":"133-139"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90788072","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.0253-3006.2020.02.020
Meng He, Wei-ping Zhang, Q. Shu
{"title":"Minutes of XV National Annual Congress of Pediatric Surgery, Branch of Pediatric Surgery, Chinese Medical Association","authors":"Meng He, Wei-ping Zhang, Q. Shu","doi":"10.3760/CMA.J.ISSN.0253-3006.2020.02.020","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-3006.2020.02.020","url":null,"abstract":"","PeriodicalId":10157,"journal":{"name":"中华小儿外科杂志","volume":"20 1","pages":"190-191"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82623989","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 summarize the clinical features of congenital gastric wall muscular defect and explore the role of laparoscopy in its early diagnosis and treatment prior to gastric rupture in neonates. Methods Clinical parameters of two neonates with congenital gastric wall muscular defect undergoing laparoscopy in 2018 were analyzed.There were 1 3-day-old full-term boy and 1 4-day-old premature girl with a gestational age of 38+ 2 and 34 weeks and a body weight of 2540 and 1800 grams.Both cases were characterized by abdominal distension and self-defecation.All infection parameters were normal.Abdominal radiology indicated a giant gastric bubble and gastrointestinal decompression was ineffective.Upper gastroenterography showed decreased gastric peristalsis and obstruction of contrast media through pylorus.During laparoscopic exploration, congenital gastric wall muscular defect was confirmed without perforation.Then laparoscopic gastric wall repair was performed. Results There was no obvious sign of postoperative infection or anastomotic leakage.At Week 1 post-operatively, upper gastroenterography showed that both gastric wall shape and peristalsis ability were normal.After gradual feeding, there was no vomiting or other discomforts before discharging.The database searches of CNKI, Wanfang, CQVIP, Pubmed, Clinicalkey and Google Scholar up until December 2018 yielded no report of laparoscopy in early diagnosis and treatment of congenital gastric wall muscular defect prior to gastric rupture. Conclusions For doubtful cases congenital gastric wall muscular defect with imaging evidence of decreased gastric peristalsis, an exploration of laparoscopy is recommended.And laparoscopy lowers the risks of such serious complications as septicemia and infectious shock after gastric rupture. Key words: Laparoscopes; Gastric wall muscular defect, congenital; Infant, newborn
{"title":"Early diagnosis and laparoscopic treatment of congenital gastric wall muscular defect","authors":"Baohong Zhao, Hongxia Ren, Xiao-bing Sun, Xiao-xia Wu, Yuanyuan Jin, Wenyue Liu, Liang Zhao, Hui Zhang, Xue Sun, Xin Guo","doi":"10.3760/CMA.J.ISSN.0253-3006.2020.02.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-3006.2020.02.013","url":null,"abstract":"Objective \u0000To summarize the clinical features of congenital gastric wall muscular defect and explore the role of laparoscopy in its early diagnosis and treatment prior to gastric rupture in neonates. \u0000 \u0000 \u0000Methods \u0000Clinical parameters of two neonates with congenital gastric wall muscular defect undergoing laparoscopy in 2018 were analyzed.There were 1 3-day-old full-term boy and 1 4-day-old premature girl with a gestational age of 38+ 2 and 34 weeks and a body weight of 2540 and 1800 grams.Both cases were characterized by abdominal distension and self-defecation.All infection parameters were normal.Abdominal radiology indicated a giant gastric bubble and gastrointestinal decompression was ineffective.Upper gastroenterography showed decreased gastric peristalsis and obstruction of contrast media through pylorus.During laparoscopic exploration, congenital gastric wall muscular defect was confirmed without perforation.Then laparoscopic gastric wall repair was performed. \u0000 \u0000 \u0000Results \u0000There was no obvious sign of postoperative infection or anastomotic leakage.At Week 1 post-operatively, upper gastroenterography showed that both gastric wall shape and peristalsis ability were normal.After gradual feeding, there was no vomiting or other discomforts before discharging.The database searches of CNKI, Wanfang, CQVIP, Pubmed, Clinicalkey and Google Scholar up until December 2018 yielded no report of laparoscopy in early diagnosis and treatment of congenital gastric wall muscular defect prior to gastric rupture. \u0000 \u0000 \u0000Conclusions \u0000For doubtful cases congenital gastric wall muscular defect with imaging evidence of decreased gastric peristalsis, an exploration of laparoscopy is recommended.And laparoscopy lowers the risks of such serious complications as septicemia and infectious shock after gastric rupture. \u0000 \u0000 \u0000Key words: \u0000Laparoscopes; Gastric wall muscular defect, congenital; Infant, newborn","PeriodicalId":10157,"journal":{"name":"中华小儿外科杂志","volume":"25 1","pages":"162-165"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90606590","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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