Pub Date : 2015-12-01DOI: 10.13029/JKAPS.2015.21.2.24
T. Lee, Y. Cho, Soo-Hong Kim, Hae-Young Kim
Purpose: The duplication of gastrointestinal tract has been known to be a rare condition and two different forms, cystic and tubular type. This study was conducted to examine its clinical characteristics, especially cystic enteric duplication which was detected antenatally or postnatally. Methods: There were 13 patients, who confirmed as cystic enteric duplication after operation between July 1996 and June 2015. Clinical data, including a gender, age at operation, presenting symptoms, diagnostic modalities, locations of lesion, and results of surgical treatment, were reviewed retrospectively according to cases detected antenatally and postnatally. Results: Five cases were included in antenatal diagnosis group and 8 cases in postnatal diagnosis group. Both groups show slightly common in female and the lesion most common in ileum. Antenatal diagnosis group shows 2 males and 3 females and the mean age at operation was 12±52 days (range, 5 to 90 days). They received operation regardless of symptom. Postnatal group shows 3 males and 5 females and the mean age at operation was 462.5±777.0 days (range, 4 days to 6 years). Moreover, 6 patients (75.0%) were age before 2 years. They usually presented abdominal pain with vomiting. Conclusion: Cystic enteric duplication could present symptoms at any time during childhood, mainly before 2 years old, and so a proper management should be considered when suspect it. Although it is uncommon, surgical management including a minimal invasive procedure could be attempted despite the neonatal period.
{"title":"Cystic Enteric Duplication: Prenatally and Postnatally Diagnostic Group","authors":"T. Lee, Y. Cho, Soo-Hong Kim, Hae-Young Kim","doi":"10.13029/JKAPS.2015.21.2.24","DOIUrl":"https://doi.org/10.13029/JKAPS.2015.21.2.24","url":null,"abstract":"Purpose: The duplication of gastrointestinal tract has been known to be a rare condition and two different forms, cystic and tubular type. This study was conducted to examine its clinical characteristics, especially cystic enteric duplication which was detected antenatally or postnatally. Methods: There were 13 patients, who confirmed as cystic enteric duplication after operation between July 1996 and June 2015. Clinical data, including a gender, age at operation, presenting symptoms, diagnostic modalities, locations of lesion, and results of surgical treatment, were reviewed retrospectively according to cases detected antenatally and postnatally. Results: Five cases were included in antenatal diagnosis group and 8 cases in postnatal diagnosis group. Both groups show slightly common in female and the lesion most common in ileum. Antenatal diagnosis group shows 2 males and 3 females and the mean age at operation was 12±52 days (range, 5 to 90 days). They received operation regardless of symptom. Postnatal group shows 3 males and 5 females and the mean age at operation was 462.5±777.0 days (range, 4 days to 6 years). Moreover, 6 patients (75.0%) were age before 2 years. They usually presented abdominal pain with vomiting. Conclusion: Cystic enteric duplication could present symptoms at any time during childhood, mainly before 2 years old, and so a proper management should be considered when suspect it. Although it is uncommon, surgical management including a minimal invasive procedure could be attempted despite the neonatal period.","PeriodicalId":164943,"journal":{"name":"Journal of Korean Association of Pediatric Surgeons","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126052039","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 : 2015-06-01DOI: 10.13029/JKAPS.2015.21.1.7
J. Kwak, Eugene J. Won, Eun-Hwa Choi, Sung-Eun Jung, Hyun Young Kim
Abdominal actinomycosis is a rare and chronic progressive disease, especially in children. Clinically, it has non-specific symptoms and diagnostic findings as well as low prevalence, making it very difficult to diagnose prior to intraoperative pathological confirmation. For this reason, abdominal actinomycosis is commonly misdiagnosed as appendicitis. After the histopathological diagnosis of abdominal actinomycosis is made, patients should be administered an appropriate antibiotic such as penicillin. Here we describe a case of appendiceal actinomycosis in an 18-year-old girl who was initially diagnosed with acute appendicitis.
{"title":"Periappendiceal Actinomycosis Presenting as Acute Appendicitis","authors":"J. Kwak, Eugene J. Won, Eun-Hwa Choi, Sung-Eun Jung, Hyun Young Kim","doi":"10.13029/JKAPS.2015.21.1.7","DOIUrl":"https://doi.org/10.13029/JKAPS.2015.21.1.7","url":null,"abstract":"Abdominal actinomycosis is a rare and chronic progressive disease, especially in children. Clinically, it has non-specific symptoms and diagnostic findings as well as low prevalence, making it very difficult to diagnose prior to intraoperative pathological confirmation. For this reason, abdominal actinomycosis is commonly misdiagnosed as appendicitis. After the histopathological diagnosis of abdominal actinomycosis is made, patients should be administered an appropriate antibiotic such as penicillin. Here we describe a case of appendiceal actinomycosis in an 18-year-old girl who was initially diagnosed with acute appendicitis.","PeriodicalId":164943,"journal":{"name":"Journal of Korean Association of Pediatric Surgeons","volume":"76 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116176941","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 : 2015-06-01DOI: 10.13029/JKAPS.2015.21.1.1
Kyoung Eun Kim, Hyon Hui Lee, M. Chung, Woon-won Kim, S. Nam
Purpose: Long time total parenteral nutrition (TPN) can induce irreversible liver damage. In this study, we investigated the associated factors of parenteral nutrition associated cholestasis (PNAC) in neonates. Methods: We retrospectively reviewed 227 neonates (male:female=110:117) those who had received TPN over 2 weeks from March 2010 to February 2014. PNAC was defined as direct bilirubin was higher than 2.0 mg/dL without any cause except TPN. Results: Overall incidence was 28.6%. PNAC was frequently developed in younger gestational age with lower birth weight. Episodes of sepsis, underlying bronchopulmonary dysplasia, history of necrotizing enterocolitis, and experience of gastrointestinal surgery increase the incidence of PNAC. PNAC was directly associated the duration of TPN and long period to full enteral feeding, reaching 60 and 150 mL/kg/day. Overall mortality rate was 9.7%. It was higher in PNAC group despite PNAC was not the primary cause of death. All survivors were recovered from cholestasis with encourage of enteral nutrition. Conclusion: PNAC in neonate was associated with younger gestational ages and lower birth weights, duration of TPN, or who experienced sepsis, necrotizing enterocolitis, gastrointestinal surgery or bronchopulmonary dysplasia.
{"title":"Associated Factors with Parenteral Nutrition Associated Cholestasis in Neonates","authors":"Kyoung Eun Kim, Hyon Hui Lee, M. Chung, Woon-won Kim, S. Nam","doi":"10.13029/JKAPS.2015.21.1.1","DOIUrl":"https://doi.org/10.13029/JKAPS.2015.21.1.1","url":null,"abstract":"Purpose: Long time total parenteral nutrition (TPN) can induce irreversible liver damage. In this study, we investigated the associated factors of parenteral nutrition associated cholestasis (PNAC) in neonates. Methods: We retrospectively reviewed 227 neonates (male:female=110:117) those who had received TPN over 2 weeks from March 2010 to February 2014. PNAC was defined as direct bilirubin was higher than 2.0 mg/dL without any cause except TPN. Results: Overall incidence was 28.6%. PNAC was frequently developed in younger gestational age with lower birth weight. Episodes of sepsis, underlying bronchopulmonary dysplasia, history of necrotizing enterocolitis, and experience of gastrointestinal surgery increase the incidence of PNAC. PNAC was directly associated the duration of TPN and long period to full enteral feeding, reaching 60 and 150 mL/kg/day. Overall mortality rate was 9.7%. It was higher in PNAC group despite PNAC was not the primary cause of death. All survivors were recovered from cholestasis with encourage of enteral nutrition. Conclusion: PNAC in neonate was associated with younger gestational ages and lower birth weights, duration of TPN, or who experienced sepsis, necrotizing enterocolitis, gastrointestinal surgery or bronchopulmonary dysplasia.","PeriodicalId":164943,"journal":{"name":"Journal of Korean Association of Pediatric Surgeons","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123962130","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 : 2015-06-01DOI: 10.13029/JKAPS.2015.21.1.14
Y. Lone, M. Bawa, J. Sundaram, Kln Rao
Although Meckel’s diverticulum is the most common vitellointestinal duct (VID) anomaly, patent vitellointestinal duct (PVID) is the most common symptomatic embryological defect. Patient may present with the anomaly itself or due to complications like intestinal obstruction secondary to volvulus, intussusception or adhesions. Prolapse occurs if the diverticulum is wide-mouthed enough to allow bowel to come out or due to increased intra-abdominal pressure like cry or cough. Bowel prolapse through PVID is rare and double prolapse of proximal as well as distal loop in a newborn is extremely rare. Omphalocele with prolapsing bowel through PVID as found in our index case is even rarer in literature. The pediatric surgeon should be familiar with these varied manifestations in the newborn because the prolapsed bowel can progress to gangrene and complications if not identified and operated upon early.
{"title":"Omphalocele with Double Prolapse of Ileum through Patent Vitellointestinal Duct: A Rare Presentation","authors":"Y. Lone, M. Bawa, J. Sundaram, Kln Rao","doi":"10.13029/JKAPS.2015.21.1.14","DOIUrl":"https://doi.org/10.13029/JKAPS.2015.21.1.14","url":null,"abstract":"Although Meckel’s diverticulum is the most common vitellointestinal duct (VID) anomaly, patent vitellointestinal duct (PVID) is the most common symptomatic embryological defect. Patient may present with the anomaly itself or due to complications like intestinal obstruction secondary to volvulus, intussusception or adhesions. Prolapse occurs if the diverticulum is wide-mouthed enough to allow bowel to come out or due to increased intra-abdominal pressure like cry or cough. Bowel prolapse through PVID is rare and double prolapse of proximal as well as distal loop in a newborn is extremely rare. Omphalocele with prolapsing bowel through PVID as found in our index case is even rarer in literature. The pediatric surgeon should be familiar with these varied manifestations in the newborn because the prolapsed bowel can progress to gangrene and complications if not identified and operated upon early.","PeriodicalId":164943,"journal":{"name":"Journal of Korean Association of Pediatric Surgeons","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127895415","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 : 2014-12-01DOI: 10.13029/JKAPS.2014.20.2.48
J. Cho, W. M. Kang, S. Ahn
Purpose: Currently the substantial clinical benefits of single-port laparoscopic appendectomy (SLA) over conventional three-port laparoscopic appendectomy (CLA) are equivocal. The aim of this study was to compare surgical outcomes between SLA and CLA in children with acute appendicitis. Methods: A single blind prospective randomized single center study was performed to compare the surgical outcomes of SLA and CLA. A total of 105 patients were randomized and various parameters were analyzed, 52 patients with SLA and 53 patients with CLA between July 2013 and March 2014. Patients with sonographically confirmed acute appendicitis were randomly assigned to receive either SLA or CLA. The outcome measurements were operating time, wound complication, and intraperitoneal morbidities, postoperative pain score and cosmetic result score. Results: Operating time is significantly longer in SLA (70.4±26.7 minutes vs. 58.0±23.4 minutes; p=0.016). There were no significant differences in the postoperative wound complication rate and intraperitoneal morbidities between two groups. There were no significant differences in postoperative resting pain score (6.6±2.5 vs. 6.3±2.5; p=0.317) and activity pain score (6.9±2.4 vs. 6.3±2.5; p=0.189), and the cosmetic result score (9.2±1.1 vs. 9.1±1.4; p=0.853). Conclusion: Although SLA would be a safe and feasible procedure in children, SLA could not demonstrate the clear benefit over CLA.
目的:目前，单孔腹腔镜阑尾切除术(SLA)相对于传统三孔腹腔镜阑尾切除术(CLA)的临床效益尚不明确。本研究的目的是比较急性阑尾炎患儿SLA和CLA的手术效果。方法:采用单盲、前瞻性、随机、单中心研究，比较SLA和CLA的手术效果。在2013年7月至2014年3月期间，随机选取105例患者进行各项参数分析，其中52例为SLA, 53例为CLA。超声确诊的急性阑尾炎患者被随机分配接受SLA或CLA治疗。结果测量为手术时间、伤口并发症、腹腔内发病率、术后疼痛评分和美容结果评分。结果:两组手术时间明显延长(70.4±26.7 min vs. 58.0±23.4 min);p = 0.016)。两组术后伤口并发症发生率及腹腔内并发症发生率无显著差异。两组术后静息疼痛评分(6.6±2.5∶6.3±2.5;P =0.317)和活动疼痛评分(6.9±2.4∶6.3±2.5;P =0.189)，美容效果评分(9.2±1.1∶9.1±1.4;p = 0.853)。结论:虽然在儿童中SLA是安全可行的手术，但SLA不能显示出明显优于CLA的优势。
{"title":"Surgical Outcomes of Single-port Laparoscopic Appendectomy versus Conventional Laparoscopic Appendectomy in Children: Preliminary Report of a Prospective Randomized Trial","authors":"J. Cho, W. M. Kang, S. Ahn","doi":"10.13029/JKAPS.2014.20.2.48","DOIUrl":"https://doi.org/10.13029/JKAPS.2014.20.2.48","url":null,"abstract":"Purpose: Currently the substantial clinical benefits of single-port laparoscopic appendectomy (SLA) over conventional three-port laparoscopic appendectomy (CLA) are equivocal. The aim of this study was to compare surgical outcomes between SLA and CLA in children with acute appendicitis. Methods: A single blind prospective randomized single center study was performed to compare the surgical outcomes of SLA and CLA. A total of 105 patients were randomized and various parameters were analyzed, 52 patients with SLA and 53 patients with CLA between July 2013 and March 2014. Patients with sonographically confirmed acute appendicitis were randomly assigned to receive either SLA or CLA. The outcome measurements were operating time, wound complication, and intraperitoneal morbidities, postoperative pain score and cosmetic result score. Results: Operating time is significantly longer in SLA (70.4±26.7 minutes vs. 58.0±23.4 minutes; p=0.016). There were no significant differences in the postoperative wound complication rate and intraperitoneal morbidities between two groups. There were no significant differences in postoperative resting pain score (6.6±2.5 vs. 6.3±2.5; p=0.317) and activity pain score (6.9±2.4 vs. 6.3±2.5; p=0.189), and the cosmetic result score (9.2±1.1 vs. 9.1±1.4; p=0.853). Conclusion: Although SLA would be a safe and feasible procedure in children, SLA could not demonstrate the clear benefit over CLA.","PeriodicalId":164943,"journal":{"name":"Journal of Korean Association of Pediatric Surgeons","volume":"78 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121823519","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 : 2014-12-01DOI: 10.13029/JKAPS.2014.20.2.58
S. Nam, Yun-Jung Lim, Y. Kim
Palpable inguinal mass in children should be differentiated from inguinal hernia, hydrocele, lymph node, and tumor. Though using ultrasonography, fatty tumor would be misdiagnosed as incarcerated inguinal hernia containing fatty component. We experienced the huge inguinal lipoblastoma in 5-year-old girl mimicking recurrent incarcerated hernia. Laparoscopic exploration revealed it was not incarcerated hernia but well demarcated bulging mass from abdominal wall. Mass was about 10×4×3 cm and extended from internal inguinal ring to saphenous opening. It was near total excised because of right external iliac vein injury. Pathologically, it was proven as lipoblastoma containing mature adipocyte with lipoblast and fibrous septa. Postoperatively, we noticed a segmental thrombotic occlusion of external iliac vein. After 1 year, she has no symptom related to occluded vessel. The remained lipoblastoma showed no interval change. Even lipoblastoma has a good prognosis with low recurrence rate, we need careful follow-up.
{"title":"Inguinal Lipoblastoma Mimicking Recurrent Inguinal Hernia","authors":"S. Nam, Yun-Jung Lim, Y. Kim","doi":"10.13029/JKAPS.2014.20.2.58","DOIUrl":"https://doi.org/10.13029/JKAPS.2014.20.2.58","url":null,"abstract":"Palpable inguinal mass in children should be differentiated from inguinal hernia, hydrocele, lymph node, and tumor. Though using ultrasonography, fatty tumor would be misdiagnosed as incarcerated inguinal hernia containing fatty component. We experienced the huge inguinal lipoblastoma in 5-year-old girl mimicking recurrent incarcerated hernia. Laparoscopic exploration revealed it was not incarcerated hernia but well demarcated bulging mass from abdominal wall. Mass was about 10×4×3 cm and extended from internal inguinal ring to saphenous opening. It was near total excised because of right external iliac vein injury. Pathologically, it was proven as lipoblastoma containing mature adipocyte with lipoblast and fibrous septa. Postoperatively, we noticed a segmental thrombotic occlusion of external iliac vein. After 1 year, she has no symptom related to occluded vessel. The remained lipoblastoma showed no interval change. Even lipoblastoma has a good prognosis with low recurrence rate, we need careful follow-up.","PeriodicalId":164943,"journal":{"name":"Journal of Korean Association of Pediatric Surgeons","volume":"413 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115933712","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 : 2014-12-01DOI: 10.13029/JKAPS.2014.20.2.33
H. Kim, D. Kim, S. Kim, J. Namgoong, Jihee Hwang
Purpose: The purpose of this study was to compare the diagnostic accuracy of the non-invasive diagnostic methods and rectal suction biopsy for the detection of Hirschsprung disease (HD). Methods: We reviewed diagnostic methods and results retrospectively in patients who underwent anorectal manometry, barium enema and rectal suction biopsy for the diagnosis of HD at Asan Medical Center from January 2000 to December 2012. Results: There were 97 patients (59 neonates and 38 infants) in the study period. The overall accuracy of anorectal manometry for the diagnosis of HD was 71.1% and its sensitivity was 51.4% (48.1% in neonate and 62.5% in infant, respectively) and its overall specificity was 82.3% (81.3% in neonate and 83.3% in infant, respectively). The Overall accuracy of barium enema was 66.0% (72.8% in neonate and 55.3% in infant, respectively) and specificity of barium enema was 53.2% (56.3% in neonate and 50.0% in infant, respectively). These results were lower than those of anorectal manometry. The overall sensitivity of barium enema was 88.6% (92.6% in neonate and 75.0% in infant, respectively) and it was higher than the sensitivity of anorectal manometry. Histological studies confirmed HD in 35 patients, in one of whom the suction biopsy showed negative finding. Conclusion: Accuracy of non-invasive methods for diagnosis of HD in our study is lower than those in previous study, so we need to improve the quality of diagnostic tools in our hospital. We conclude that the rectal suction biopsy is the most accurate test for diagnosing HD, so the biopsy to confirm the diagnosis of the HD is very important.
{"title":"How Reliable Are Diagnostic Methods of Hirschsprung Disease","authors":"H. Kim, D. Kim, S. Kim, J. Namgoong, Jihee Hwang","doi":"10.13029/JKAPS.2014.20.2.33","DOIUrl":"https://doi.org/10.13029/JKAPS.2014.20.2.33","url":null,"abstract":"Purpose: The purpose of this study was to compare the diagnostic accuracy of the non-invasive diagnostic methods and rectal suction biopsy for the detection of Hirschsprung disease (HD). Methods: We reviewed diagnostic methods and results retrospectively in patients who underwent anorectal manometry, barium enema and rectal suction biopsy for the diagnosis of HD at Asan Medical Center from January 2000 to December 2012. Results: There were 97 patients (59 neonates and 38 infants) in the study period. The overall accuracy of anorectal manometry for the diagnosis of HD was 71.1% and its sensitivity was 51.4% (48.1% in neonate and 62.5% in infant, respectively) and its overall specificity was 82.3% (81.3% in neonate and 83.3% in infant, respectively). The Overall accuracy of barium enema was 66.0% (72.8% in neonate and 55.3% in infant, respectively) and specificity of barium enema was 53.2% (56.3% in neonate and 50.0% in infant, respectively). These results were lower than those of anorectal manometry. The overall sensitivity of barium enema was 88.6% (92.6% in neonate and 75.0% in infant, respectively) and it was higher than the sensitivity of anorectal manometry. Histological studies confirmed HD in 35 patients, in one of whom the suction biopsy showed negative finding. Conclusion: Accuracy of non-invasive methods for diagnosis of HD in our study is lower than those in previous study, so we need to improve the quality of diagnostic tools in our hospital. We conclude that the rectal suction biopsy is the most accurate test for diagnosing HD, so the biopsy to confirm the diagnosis of the HD is very important.","PeriodicalId":164943,"journal":{"name":"Journal of Korean Association of Pediatric Surgeons","volume":"204 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129058576","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 : 2014-12-01DOI: 10.13029/JKAPS.2014.20.2.43
Jong Woo Lee, D. Kim, S. Kim, J. Namgoong, Jihee Hwang
Purpose: Hypertrophic pyloric stenosis (HPS) is known to be one of the most common cause of surgery for infants and pyloromyotomy was considered to the standard treatment. There has been an ongoing debate about whether laparoscopic pyloromyotomy (LP) or open pyloromyotomy (OP) is the best option for treating HPS. The aim of this study is to evaluate safety and effectiveness of LP by comparing the clinical results of both surgical strategies performed by single surgeon. Methods: Between January 2000 and December 2013, 60 patients who underwent pyloromyotomy at Asan Medical Center performed by a surgeon were followed: open-supraumbilical incision (n=36) and LP (n=24). The parameters included sex, age and body weight at operation. Clinical outcomes included operation time, time to full feeding, postoperative hospital stay, and postoperative complications. Results: There were no significant differences in characteristics, postoperative hospital stay between the two groups. Time to full feeding was shorter in LP (OP 24.5 hours vs. LP 19.8 hours; p=0.063). In contrast, the mean operation time was longer in LP (OP 37.5 minutes vs. LP 43.5 minutes; p=0.072). Complications such as perforation of mucosal layer (OP 1 vs. LP 0) and wound problems (OP 2 vs. LP 0) were found to be not worse in laparoscopic group as compared with open group. Conclusion: There has no difference both laparoscopic and open-supraumbilical incision in terms of postoperative hospital stay, time to full feeds and frequency of complications.
目的:肥厚性幽门狭窄(HPS)是婴儿手术最常见的原因之一，幽门肌切开术被认为是标准的治疗方法。关于腹腔镜幽门切开术(LP)还是开放式幽门切开术(OP)是治疗幽门切开术的最佳选择一直存在争议。本研究的目的是通过比较两种手术策略的临床结果来评估LP的安全性和有效性。方法:对2000年1月至2013年12月在峨山医疗中心行幽门肌切开术的60例患者进行随访:切开脐上切口(36例)和LP(24例)。这些参数包括性别、年龄和手术时的体重。临床结果包括手术时间、完全喂养时间、术后住院时间和术后并发症。结果:两组患者的特点、术后住院时间无显著差异。LP到完全喂养的时间较短(OP 24.5小时vs LP 19.8小时);p = 0.063)。相比之下，LP组的平均手术时间更长(OP 37.5分钟vs LP 43.5分钟;p = 0.072)。并发症如粘膜穿孔(OP 1 vs. LP 0)和伤口问题(OP 2 vs. LP 0)在腹腔镜组与开放组相比没有更严重。结论:腹腔镜与脐上切开在术后住院时间、饱食时间、并发症发生频率等方面无明显差异。
{"title":"Comparison of Pyloromyotomy with Supraumbilical Incision and Laparoscopic Pyloromyotomy for Hypertrophic Pyloric Stenosis Performed by a Single Surgeon","authors":"Jong Woo Lee, D. Kim, S. Kim, J. Namgoong, Jihee Hwang","doi":"10.13029/JKAPS.2014.20.2.43","DOIUrl":"https://doi.org/10.13029/JKAPS.2014.20.2.43","url":null,"abstract":"Purpose: Hypertrophic pyloric stenosis (HPS) is known to be one of the most common cause of surgery for infants and pyloromyotomy was considered to the standard treatment. There has been an ongoing debate about whether laparoscopic pyloromyotomy (LP) or open pyloromyotomy (OP) is the best option for treating HPS. The aim of this study is to evaluate safety and effectiveness of LP by comparing the clinical results of both surgical strategies performed by single surgeon. Methods: Between January 2000 and December 2013, 60 patients who underwent pyloromyotomy at Asan Medical Center performed by a surgeon were followed: open-supraumbilical incision (n=36) and LP (n=24). The parameters included sex, age and body weight at operation. Clinical outcomes included operation time, time to full feeding, postoperative hospital stay, and postoperative complications. Results: There were no significant differences in characteristics, postoperative hospital stay between the two groups. Time to full feeding was shorter in LP (OP 24.5 hours vs. LP 19.8 hours; p=0.063). In contrast, the mean operation time was longer in LP (OP 37.5 minutes vs. LP 43.5 minutes; p=0.072). Complications such as perforation of mucosal layer (OP 1 vs. LP 0) and wound problems (OP 2 vs. LP 0) were found to be not worse in laparoscopic group as compared with open group. Conclusion: There has no difference both laparoscopic and open-supraumbilical incision in terms of postoperative hospital stay, time to full feeds and frequency of complications.","PeriodicalId":164943,"journal":{"name":"Journal of Korean Association of Pediatric Surgeons","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121651216","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 : 2014-12-01DOI: 10.13029/JKAPS.2014.20.2.23
Chang Hun Lee, Y. Boo, Eun Hee Lee
Purpose: Laparoscopic hernia repair in children is still controversial. The aim of this study was to report our long-term results of the laparoscopic hernia technique, which is based on the same surgical principles as conventional open herniotomy. Methods: Five hundred fourteen pediatric patients with inguinal hernia were included in this study under informed consent. All patients underwent a laparoscopic technique of sac transection and intracorporeal ligation. The asymptomatic contralateral inguinal ring was routinely explored and repaired if a patient had patent processus vaginalis on the contralateral side. Patients were prospectively followed for 5 years. Those who were lost to follow-up were excluded from the study. Perioperative complications and recurrences were evaluated. Results: The mean follow-up period was 29 months. Mean operation time was 27.5 minutes. Forty one percent of the patients had contralateral patent processus vaginalis. Only one hernia recurred (0.19%). We had one case of contralateral metachronous hernia (0.21%) during follow-up period. Conclusion: The long-term follow-up results of our study revealed that laparoscopic hernia sac transection and ligation can be a safe and effective alternative for conventional herniorraphy.
{"title":"Long-term Outcome of Laparoscopic Hernia Sac Transection and Intracorporeal Ligation in Children: A Single Center Cohort Study","authors":"Chang Hun Lee, Y. Boo, Eun Hee Lee","doi":"10.13029/JKAPS.2014.20.2.23","DOIUrl":"https://doi.org/10.13029/JKAPS.2014.20.2.23","url":null,"abstract":"Purpose: Laparoscopic hernia repair in children is still controversial. The aim of this study was to report our long-term results of the laparoscopic hernia technique, which is based on the same surgical principles as conventional open herniotomy. Methods: Five hundred fourteen pediatric patients with inguinal hernia were included in this study under informed consent. All patients underwent a laparoscopic technique of sac transection and intracorporeal ligation. The asymptomatic contralateral inguinal ring was routinely explored and repaired if a patient had patent processus vaginalis on the contralateral side. Patients were prospectively followed for 5 years. Those who were lost to follow-up were excluded from the study. Perioperative complications and recurrences were evaluated. Results: The mean follow-up period was 29 months. Mean operation time was 27.5 minutes. Forty one percent of the patients had contralateral patent processus vaginalis. Only one hernia recurred (0.19%). We had one case of contralateral metachronous hernia (0.21%) during follow-up period. Conclusion: The long-term follow-up results of our study revealed that laparoscopic hernia sac transection and ligation can be a safe and effective alternative for conventional herniorraphy.","PeriodicalId":164943,"journal":{"name":"Journal of Korean Association of Pediatric Surgeons","volume":"108 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131840822","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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