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A Single Center Experience of Management of Hepatocellular Carcinoma in Children and Adolescents 儿童和青少年肝细胞癌的单中心治疗经验
Pub Date : 2017-12-01 DOI: 10.13029/JKAPS.2017.23.2.24
Young-min Song, S. H. Lee, Koo Hh, K. Sung, S. Lee
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引用次数: 0
Unusual Giant Arteriovenous Malformation in Jejunum: A Case Report 空肠异常巨大动静脉畸形1例
Pub Date : 2017-12-01 DOI: 10.13029/JKAPS.2017.23.2.52
DongJa Kim, J. Goo
Polypoid or tumorous arteriovenous malformation (AVM) of small intestine is rare and can be misdiagnosed as other tumorous conditions. We experienced a rare case of giant jejunal AVM in a 15-year-old boy, who complained of intense abdominal pain. Ultrasonography and contrast-enhanced CT revealed a 13.5-cm-sized multiseptated cystic mass arising in small intestine, which was mimicking submucosal tumor. It was successfully treated by surgical resection. The specimen showed a multilobulated outbulging submucosal mass in jejunum. Histopathologic evalulation confirmed AVM located in the submucosa, muscularis propria and subserosa. This case is the largest AVM of small intestine among which has ever been reported.
小肠息肉样或肿瘤性动静脉畸形(AVM)是罕见的,可误诊为其他肿瘤条件。我们经历了一个罕见的病例巨大空肠AVM在一个15岁的男孩,谁抱怨强烈的腹痛。超声及增强CT示小肠内一13.5 cm大小的多隔性囊性肿块,似粘膜下肿瘤。经手术切除成功治疗。标本显示空肠黏膜下多分叶膨出肿块。组织病理学检查证实AVM位于粘膜下、固有肌层和浆膜下。本病例是迄今为止报道的最大的小肠AVM。
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引用次数: 0
Anterior Anorectocolonic Tubular Duplication Presenting as Rectovestibular Fistula in an Infant 婴儿肛门直肠结肠前管重复表现为直肠前庭瘘
Pub Date : 2017-12-01 DOI: 10.13029/JKAPS.2017.23.2.55
Ja-Young Kim, J. Youn, Soo-Hong Kim, Hyun Young Kim, Sung-Eun Jung, K. Park
Anorectal duplications account for only 5% of gastrointestinal duplications, and cases with involvement of the anal canal are much rarer. Nearly all anorectal duplications are posterior to the rectum; duplications located anterior to the normal rectum are highly unusual, and only a few cases have been reported. We report the case of an anterior anorectocolonic duplication presenting as a rectovaginal fistula in a 2-month-old infant. After diagnosis, the duplication was excised completely without further intestinal complications.
肛肠复制仅占胃肠道复制的5%,累及肛管的病例更为罕见。几乎所有的肛肠复制都在直肠后方;位于正常直肠前部的重复是非常罕见的,只有少数病例被报道过。我们报告的情况下,前肛门直肠结肠复制表现为直肠阴道瘘在一个2个月大的婴儿。诊断后,复制完全切除,没有进一步的肠道并发症。
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引用次数: 1
Early Experience of Pediatric Thoracoscopic Surgery Performed by a Pediatric Surgeon 由一名儿科外科医生进行的儿童胸腔镜手术的早期经验
Pub Date : 2017-12-01 DOI: 10.13029/JKAPS.2017.23.2.29
J. Cheun, Ji-Won Han, J. Youn, Hee-Beom Yang, Chaeyoun Oh, Hyun Young Kim, Sung-Eun Jung
Purpose: Minimally invasive surgery (MIS) in abdomen and thorax has been widely accepted for pediatric diseases. Thoracoscopic surgery has the advantage of less pain, better cosmetic outcomes and less musculoskeletal sequelae in comparison to open surgery. We would like to share our initial experience with thoracoscopic surgery performed by one pediatric surgeon. Methods: We performed a retrospective review of patients who underwent thoracoscopic surgery by one pediatric surgeon between April 2010 and August 2017 in Department of Pediatric Surgery, Seoul National University Children’s Hospital. Results: There were totally 18 cases; 8 cases for esophageal atresia, 3 cases for congenital diaphragm hernia, 2 cases for diaphragm eventration, 2 cases for esophageal duplication cyst, 2 cases for pleural mass and 1 case for esophageal bronchus. At the operation, median age was 9.5 months (range, 0-259 months) and median body weight was 9.4 kg (range, 1.9-49.4 kg). Median operative time was 157.5 minutes (range, 45-335 minutes). There was no case of open conversion and 2 cases of minor leakage at anastomosis site in case of esophageal atresia. Median follow-up month was 5 months (range, 0-87 months). During follow-up, 4 cases of esophageal atresia showed anastomosis site narrowing and average 2.5 times (range, 1-5 times) of esophageal balloon dilatation was done. Conclusion: We performed thoracoscopic surgery in case of esophageal, diaphragm disease and pleural mass. Thoracoscopic surgery can be an effective and feasible option of treatment for well-selected pediatric patients of intra-thoracic disease including esophagus, diaphragm and mediastinum disease.
目的:腹部和胸部的微创手术已被广泛接受用于儿科疾病。与开放手术相比,胸腔镜手术的优点是疼痛更少,美容效果更好,肌肉骨骼后遗症更少。我们想和大家分享一下由一位儿科外科医生进行胸腔镜手术的初步经验。方法:我们对2010年4月至2017年8月在首尔国立大学儿童医院儿科外科接受一名儿科外科医生胸腔镜手术的患者进行回顾性分析。结果:共18例;食管闭锁8例,先天性膈疝3例,膈膨出2例,食管重复囊肿2例,胸膜肿块2例,食管支气管1例。手术时中位年龄为9.5个月(范围0 ~ 259个月),中位体重为9.4 kg(范围1.9 ~ 49.4 kg)。中位手术时间157.5分钟(范围45-335分钟)。食管闭锁时吻合口轻微渗漏2例,无开放性转换。中位随访月为5个月(范围0 ~ 87个月)。随访中4例食管闭锁出现吻合口狭窄,平均食管球囊扩张2.5次(范围1 ~ 5次)。结论:食道、横膈膜疾病及胸膜肿块均行胸腔镜手术治疗。胸腔镜手术是一种有效可行的治疗方法,适用于经筛选的儿童食管、横膈膜和纵隔疾病等胸内疾病。
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引用次数: 0
Thyroid Cancer in Pediatric Age: A Single Institution Experience 甲状腺癌在儿童年龄:单一机构的经验
Pub Date : 2017-12-01 DOI: 10.13029/JKAPS.2017.23.2.42
Hyo-Cheol Kim, Ji-Won Han, J. Youn, Hee-Beom Yang, Chaeyoun Oh, Hyun Young Kim, Sung-Eun Jung, K. Park
Purpose: Thyroid cancer is a rare disease in pediatric population, but its incidence rate is increasing. The aim of this report is to present a single institution experience of pediatric thyroid cancer and to identify clinical features, predisposing factors, and postoperative course of pediatric thyroid cancer. Methods: We retrospectively reviewed 35 pediatric patients who underwent operation due to thyroid cancer at Seoul National University Children’s Hospital between May 1997 and January 2017. The median follow-up period was 70 months (range, 5-238 months). Results: The mean age at operation was 12.0±5.91 years and 27 patients were female. The underlying conditions in patients included history of chemoradiotherapy for previous other malignancies (n=4), hypothyroidism (n=3), history of chemotherapy (n=2), family history of thyroid cancer (n=1) and history of radiation therapy (n=1). The initial symptoms were palpable neck mass (n=21) and incidental findings (n=11). Total thyroidectomy (n=30) or unilateral lobectomy (n=5) were performed. There were 15 postoperative complications including transient hypocalcemia in 14 patients and Horner’s syndrome in 1 patient. The most common pathologic cell type was papillary thyroid cancer (n=29). Extrathyroid extension and lymph node invasion were found in 25 patients and 27 patients, respectively. Thirteen patients showed multifocality. During follow-up period, 5 patients underwent additional operation because of tumor recurrence in lymph nodes. Lung metastasis was detected in 3 patients at the time of diagnosis and in 3 patients during follow-up period. The mortality rate was zero and mean disease-free survival was 83.7±47.9 months. Conclusion: Pediatric thyroid cancer has lower mortality rate and recurrence rate as seen in this study despite the advanced stage at diagnosis. A thorough follow-up of patients with an underlying condition such as history of chemoradiotherapy and understanding new pediatric guideline can be helpful to maximize patients’ survival and prognosis.
目的:甲状腺癌是一种罕见的儿科疾病,但发病率呈上升趋势。本报告的目的是介绍儿童甲状腺癌的单一机构经验,并确定儿童甲状腺癌的临床特征、易感因素和术后病程。方法:回顾性分析1997年5月至2017年1月在首尔国立大学儿童医院因甲状腺癌接受手术的35例儿童患者。中位随访期为70个月(范围5-238个月)。结果:平均手术年龄12.0±5.91岁,女性27例。患者基础条件包括既往其他恶性肿瘤放化疗史(n=4)、甲状腺功能减退(n=3)、化疗史(n=2)、甲状腺癌家族史(n=1)和放疗史(n=1)。最初症状为可触及的颈部肿块(n=21)和偶然发现(n=11)。行甲状腺全切除术(n=30)或单侧肺叶切除术(n=5)。术后并发症15例,其中短暂性低血钙14例,霍纳综合征1例。最常见的病理细胞类型是甲状腺乳头状癌(n=29)。甲状腺外展25例,淋巴结浸润27例。13例患者表现为多灶性。随访期间,有5例患者因淋巴结肿瘤复发而追加手术。3例患者在诊断时发现肺转移,3例患者在随访期间发现肺转移。死亡率为零,平均无病生存期为83.7±47.9个月。结论:本研究显示,尽管儿童甲状腺癌的诊断阶段较晚,但其死亡率和复发率较低。对有基础疾病的患者进行彻底的随访,如放化疗史和了解新的儿科指南,有助于最大限度地提高患者的生存和预后。
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引用次数: 0
A Case Report of Gardner-Associated Fibroma in 19-Month-Old Girl 19月龄女童加德纳相关纤维瘤1例报告
Pub Date : 2017-12-01 DOI: 10.13029/JKAPS.2017.23.2.59
Ho Lee, Ji-Won Han, J. Youn, Hyun Young Kim
Gardner-associated fibroma (GAF) is a benign lesion of soft tissue which has recently been described and is exceedingly rare in children. GAF is associated with adenomatous polyposis coli gene mutation, familial adenomatous polyposis and desmoid. We report a case of patient with soft tissue tumor on her lower back which was turned out to be GAF. The patient was a 19-month-old female who visited out-patient clinic with palpable mass on her lower back and we performed surgical excision. The tumor was located at subcutaneous and we excised the tumor including surrounding soft tissue. She discharged without any complication on surgery day. The pathologic report showed dense collagenous tissue with spindle cell and adipose tissue, suggestive of GAF. We are planning to check gene study and to perform endoscopy and abdominal ultrasonography for at the age of 4.
加德纳相关纤维瘤(GAF)是一种最近被描述的软组织良性病变,在儿童中极为罕见。GAF与大肠腺瘤性息肉病基因突变、家族性腺瘤性息肉病和硬纤维瘤有关。我们报告一个病人的软组织肿瘤在她的下背部,原来是GAF。患者是一名19个月大的女性,她因下背部可触及肿块而去门诊就诊,我们进行了手术切除。肿瘤位于皮下,我们切除了肿瘤及周围软组织。手术当天出院,无任何并发症。病理报告显示胶原组织致密,有梭形细胞和脂肪组织,提示GAF。我们计划在4岁时进行基因检查,并进行内窥镜检查和腹部超声检查。
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引用次数: 0
Hernia of Umbilical Cord with Segmental Dilatation of Ileum: Cause or Effect? 脐疝伴回肠节段性扩张:原因还是影响?
Pub Date : 2017-06-01 DOI: 10.13029/JKAPS.2017.23.1.9
S. Hegde, M. Bawa
Received: December 27, 2016, Accepted: May 4, 2017 Correspondence: Monika Bawa, Department of Pediatric Surgery, Advanced Pediatric Center, Post Graduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh 160012, India. Tel: +91-172-2755352, Fax: +91-172-2744401, E-mail: monikabawa@hotmail.com Copyright © 2017 Korean Association of Pediatric Surgeons. All right reserved. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. INTRODUCTION
收稿日期:2016年12月27日,收稿日期:2017年5月4日。通讯作者:Monika Bawa,高级儿科中心,医学教育与研究研究生院(PGIMER), 12区,昌迪加尔160012,印度。电话:+ 911-172-2755352,传真:+ 911-172-2744401,E-mail: monikabawa@hotmail.com版权所有©2017韩国儿科外科协会。版权所有。这是一篇在知识共享署名非商业许可(http://creativecommons.org/licenses/by-nc/4.0)条款下发布的开放获取文章,该许可允许在任何媒体上不受限制的非商业使用、分发和复制,前提是正确引用原创作品。介绍
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引用次数: 0
A Case of Extramedullary Hematopoiesis Associated with Congenital Dyserythropoietic Anemia 髓外造血合并先天性促红细胞生成性贫血1例
Pub Date : 2017-06-01 DOI: 10.13029/JKAPS.2017.23.1.1
Won-Ho Han, Chaeyoun Oh, Ji-Won Han, J. Youn, Hyun Young Kim, Sung-Eun Jung
It has been known that extramedullary hematopoiesis occurring after birth can be developed in various diseases, and it is often found in hematologic diseases. Among these, congenital dyserythropoietic anemia is a rare disease characterized with increase of ineffective hematopoiesis and morphological abnormalities of erythroblasts. In congenital dyserythropoietic anemia, extramedullary hematopoiesis is very rare and only a few cases have been reported. Although treatment is not required if there is no symptom in extramedullary hematopoiesis, surgery or radiation therapy is effective in case that there is symptom or unresponsive anemia despite blood transfusion. This case report is about surgical treatment for extramedullary hematopoiesis in 23-year-old patients diagnosed of congenital dyserythropoietic anemia.
众所周知,出生后发生的髓外造血可在各种疾病中发展,常见于血液学疾病。其中,先天性促红细胞增生性贫血是一种罕见的疾病,其特征是造血功能低下增加和红细胞形态异常。在先天性促红细胞生成性贫血中,髓外造血是非常罕见的,只有少数病例被报道。虽然髓外造血无症状不需要治疗,但如果有症状或输血后无反应性贫血,手术或放射治疗是有效的。本病例报告是关于手术治疗髓外造血的23岁患者诊断为先天性促红细胞生成性贫血。
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引用次数: 0
Familial Isolated Anorectal Malformation: A Case Report 家族性孤立性肛肠畸形1例报告
Pub Date : 2017-06-01 DOI: 10.13029/JKAPS.2017.23.1.12
Jinyoung Park
There have been a few reports of familial anorectal malformations extending over more than one generation. We experienced a case of a family with 3 members spanning 2 generations affected with isolated low type anorectal malformations. They had same low type of anorectal malformations. In all 3 patients, a perianal anoplasty was performed.
有一些报道家族性肛肠畸形延续超过一代。我们经历了一个家庭的3名成员跨越2代影响孤立低型肛肠畸形。他们有相同的低类型肛肠畸形。3例患者均行肛周肛管成形术。
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引用次数: 0
“Intraluminal” Pyloric Duplication: A Case Report “腔内”幽门重复1例报告
Pub Date : 2017-06-01 DOI: 10.13029/JKAPS.2017.23.1.15
Kyeong Deok Lee, Y. Kato, Geoffrey J. Lane, A. Yamataka
We report a neonatal case of “intraluminal” pyloric duplication cyst, causing gastric obstruction after birth. Endoscopy revealed a submucosal cystic lesion approximately 15 mm in size arising from the anterior and inferior surfaces of the pylorus obliterating the pyloric canal. After laparotomy, intraoperative cholangiography was performed, which documented no communication between the cyst and the bilio-pancreatic duct. Gastrotomy was performed transversally over the antrum, and the cyst delivered through the incision. The cyst was incised, the upper part of the cyst wall removed, and a mucosectomy performed on the inner cyst wall of the lower part. The mucosa and muscle of the margin of the cyst were approximated. At follow up of 10 months, the patient is well without any sign of gastric obstruction.
我们报告一例新生儿“腔内”幽门重复囊肿,出生后引起胃梗阻。内窥镜显示一粘膜下囊性病变,大小约15mm,起源于幽门的前、下表面,覆盖幽门管。剖腹手术后行术中胆道造影,发现囊肿与胆胰管未连通。经胃窦横切胃,囊肿经切口取出。切开囊肿,切除上部囊肿壁,对下部囊肿内壁行粘膜切除术。囊肿边缘的粘膜和肌肉已接近。随访10个月,患者无任何胃梗阻症状。
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引用次数: 1
期刊
Journal of Korean Association of Pediatric Surgeons
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