Pub Date : 2014-12-01DOI: 10.13029/JKAPS.2014.20.2.38
E. Jwa, S. Kim, D. Kim, Jihee Hwang, J. Namgoong, I. Kim
Purpose: Gastroschisis and omphalocele are major anterior abdominal wall defects. The purpose of this study was to analyze the clinical differences and mortalities of gastroschisis and omphalocele in Asan Medical Center. Methods: A retrospective review of the medical records was conducted of 103 cases of gastroschisis and omphalocele from September 1989 to February 2013 in Asan Medical Center in Korea. Results: There were 43 cases (41.7%) of gastroschisis and 60 cases (58.3%) of omphalocele. There was a female predominance in both gastroschisis (60.5%) and omphalocele (58.3%). The average gestational age at delivery was 36.7±0.4 weeks for both groups. The mean birth weights were 2,381.9±80.6 g for gastroschisis and 2,779.4±82.8 g for omphalocele (p=0.001). Mean maternal ages in the gastroschisis and omphalocele groups were 27.5±0.7 years and 30.5±0.7 years, respectively (p=0.002). Associated malformations were documented in 13 infants (30.2%) with gastroschisis and 46 infants (76.7%) with omphalocele (p<0.001). All of gastroschisis patients except one underwent surgery including 31 primary repairs and 11 staged repairs. Fifty-two infants with omphalocele underwent surgery−primary repair in 41 infants and staged repair in 11 infants. Among 103 cases, 19 cases (18.4%) expired. Mortality rates of gastroschisis and omphalocele were 23.3% (10/43 cases) and 15.0% (9/60 cases), respectively (p=0.287). The main causes of death were abdominal compartment syndrome (6/10 cases) in gastroschisis, respiratory failure (4/9 cases) and discharge against medical advice (4/9 cases) in omphalocele. Conclusion: Gastroschisisis was associated with younger maternal age and lower birth weight than omphalocele. Associated malformations were more common in omphalocele. The mortality rates did not make a statistical significance. This might be the improvement of treatment of cardiac anomalies, because no patient died from cardiac dysfunction in our study. Furthermore, abdominal compartment syndrome might be the main cause of death in gastroschisis.
目的:腹裂和脐膨出是腹壁主要的前壁缺损。本研究旨在分析峨山医疗中心胃裂与脐膨出的临床差异及病死率。方法:回顾性分析1989年9月至2013年2月在韩国峨山医院收治的103例胃裂及脐膨出患者的病历资料。结果:胃裂43例(41.7%)，脐膨出60例(58.3%)。腹裂(60.5%)和脐膨出(58.3%)均以女性为主。两组平均胎龄为36.7±0.4周。胃裂的出生体重为2381.9±80.6 g，脐膨出的出生体重为2779.4±82.8 g (p=0.001)。腹裂组和脐膨出组产妇平均年龄分别为27.5±0.7岁和30.5±0.7岁(p=0.002)。胃裂患儿13例(30.2%)，脐膨出患儿46例(76.7%)(p<0.001)。所有胃裂患者除1例外均行手术，其中31例为一期修复，11例为分期修复。52名患有脐膨出的婴儿接受了手术- 41名婴儿进行了一次修复，11名婴儿进行了分阶段修复。103例中有19例(18.4%)过期。胃裂和脐膨出的死亡率分别为23.3%(10/43例)和15.0%(9/60例)(p=0.287)。胃裂的主要死亡原因为腹膜隔室综合征(6/10)，脐膨出的主要死亡原因为呼吸衰竭(4/9)和不遵医嘱出院(4/9)。结论:与脐膨出相比，腹裂与产妇年龄小、出生体重低有关。相关畸形在脐膨出中更为常见。死亡率没有统计学意义。这可能是心脏异常治疗的进步，因为在我们的研究中没有患者死于心功能障碍。此外，腹隔室综合征可能是胃裂的主要死亡原因。
{"title":"The Prognosis of Gastroschisis and Omphalocele","authors":"E. Jwa, S. Kim, D. Kim, Jihee Hwang, J. Namgoong, I. Kim","doi":"10.13029/JKAPS.2014.20.2.38","DOIUrl":"https://doi.org/10.13029/JKAPS.2014.20.2.38","url":null,"abstract":"Purpose: Gastroschisis and omphalocele are major anterior abdominal wall defects. The purpose of this study was to analyze the clinical differences and mortalities of gastroschisis and omphalocele in Asan Medical Center. Methods: A retrospective review of the medical records was conducted of 103 cases of gastroschisis and omphalocele from September 1989 to February 2013 in Asan Medical Center in Korea. Results: There were 43 cases (41.7%) of gastroschisis and 60 cases (58.3%) of omphalocele. There was a female predominance in both gastroschisis (60.5%) and omphalocele (58.3%). The average gestational age at delivery was 36.7±0.4 weeks for both groups. The mean birth weights were 2,381.9±80.6 g for gastroschisis and 2,779.4±82.8 g for omphalocele (p=0.001). Mean maternal ages in the gastroschisis and omphalocele groups were 27.5±0.7 years and 30.5±0.7 years, respectively (p=0.002). Associated malformations were documented in 13 infants (30.2%) with gastroschisis and 46 infants (76.7%) with omphalocele (p<0.001). All of gastroschisis patients except one underwent surgery including 31 primary repairs and 11 staged repairs. Fifty-two infants with omphalocele underwent surgery−primary repair in 41 infants and staged repair in 11 infants. Among 103 cases, 19 cases (18.4%) expired. Mortality rates of gastroschisis and omphalocele were 23.3% (10/43 cases) and 15.0% (9/60 cases), respectively (p=0.287). The main causes of death were abdominal compartment syndrome (6/10 cases) in gastroschisis, respiratory failure (4/9 cases) and discharge against medical advice (4/9 cases) in omphalocele. Conclusion: Gastroschisisis was associated with younger maternal age and lower birth weight than omphalocele. Associated malformations were more common in omphalocele. The mortality rates did not make a statistical significance. This might be the improvement of treatment of cardiac anomalies, because no patient died from cardiac dysfunction in our study. Furthermore, abdominal compartment syndrome might be the main cause of death in gastroschisis.","PeriodicalId":164943,"journal":{"name":"Journal of Korean Association of Pediatric Surgeons","volume":"122 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":"133853250","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.2014.20.2.28
HeyenMary Jo, Y. Boo, Eun Hee Lee, Ji Sung Lee
Purpose: Laparoscopic appendectomy (LA) has become a gold standard for children even in complicated appendicitis. The purpose of this study was to compare the postoperative surgical site infection rates between laparoscopic and open appendectomy (OA) group in pediatric complicated appendicitis. Methods: A total of 1,158 pediatric patients (age ≤15 years) underwent operation for appendicitis over a period of 8 years. Among these patients, 274 patients (23.7%) were diagnosed with complicated appendicitis by radiologic, operative and pathologic findings, and their clinical outcomes were retrospectively analyzed. Results: Of the 274 patients with complicated appendicitis, 108 patients underwent LA and 166 patients underwent OA. Patients in the LA group returned to oral intake earlier (1.9 days vs. 2.7 days; p＜0.01) and had a shorter hospital stay (5.0 days vs. 6.3 days; p＜0.01). However, rate of postoperative intra-abdominal infection (organ/space surgical site infection) was higher in the LA group (LA 15/108 [13.9%] vs. OA 12/166 [7.2%]; p＜0.01). Readmission rate was also higher in the LA group (LA 9/108 [8.3%] vs. OA 3/166 [1.8%]; p＜0.01). Conclusion: The minimally invasive laparoscopic technique has more advantages compared to the open procedure in terms of hospital stay and early recovery. However, intra-abdominal infection and readmission rates were higher in the laparoscopy group. Further studies should be performed to evaluate high rate of organ/space surgical infection rate of laparoscopic procedure in pediatric complicated appendicitis.
目的:腹腔镜阑尾切除术(LA)已成为儿童复杂阑尾炎的金标准。本研究的目的是比较腹腔镜和开放式阑尾切除术(OA)组在小儿复杂性阑尾炎术后手术部位的感染率。方法:回顾性分析8年来1158例年龄≤15岁的小儿阑尾炎手术患者。其中经影像学、手术及病理诊断为复杂性阑尾炎的患者274例(23.7%)，回顾性分析其临床结局。结果:274例合并阑尾炎患者中，LA 108例，OA 166例。LA组患者恢复口服摄入较早(1.9天vs 2.7天;P <0.01)且住院时间较短(5.0天比6.3天;p < 0.01)。然而，LA组术后腹腔内感染(器官/间隙手术部位感染)发生率更高(LA 15/108 [13.9%] vs OA 12/166 [7.2%];p < 0.01)。LA组再入院率也较高(LA 9/108 [8.3%] vs OA 3/166 [1.8%];p < 0.01)。结论:微创腹腔镜手术在住院时间和早期恢复方面优于开放手术。然而，腹腔内感染和再入院率在腹腔镜组较高。腹腔镜手术治疗小儿复杂性阑尾炎的脏器/间隙手术感染率高的原因有待进一步研究。
{"title":"Comparison of Surgical Infection and Readmission Rates after Laparoscopy in Pediatric Complicated Appendicitis","authors":"HeyenMary Jo, Y. Boo, Eun Hee Lee, Ji Sung Lee","doi":"10.13029/JKAPS.2014.20.2.28","DOIUrl":"https://doi.org/10.13029/JKAPS.2014.20.2.28","url":null,"abstract":"Purpose: Laparoscopic appendectomy (LA) has become a gold standard for children even in complicated appendicitis. The purpose of this study was to compare the postoperative surgical site infection rates between laparoscopic and open appendectomy (OA) group in pediatric complicated appendicitis. Methods: A total of 1,158 pediatric patients (age ≤15 years) underwent operation for appendicitis over a period of 8 years. Among these patients, 274 patients (23.7%) were diagnosed with complicated appendicitis by radiologic, operative and pathologic findings, and their clinical outcomes were retrospectively analyzed. Results: Of the 274 patients with complicated appendicitis, 108 patients underwent LA and 166 patients underwent OA. Patients in the LA group returned to oral intake earlier (1.9 days vs. 2.7 days; p＜0.01) and had a shorter hospital stay (5.0 days vs. 6.3 days; p＜0.01). However, rate of postoperative intra-abdominal infection (organ/space surgical site infection) was higher in the LA group (LA 15/108 [13.9%] vs. OA 12/166 [7.2%]; p＜0.01). Readmission rate was also higher in the LA group (LA 9/108 [8.3%] vs. OA 3/166 [1.8%]; p＜0.01). Conclusion: The minimally invasive laparoscopic technique has more advantages compared to the open procedure in terms of hospital stay and early recovery. However, intra-abdominal infection and readmission rates were higher in the laparoscopy group. Further studies should be performed to evaluate high rate of organ/space surgical infection rate of laparoscopic procedure in pediatric complicated appendicitis.","PeriodicalId":164943,"journal":{"name":"Journal of Korean Association of Pediatric Surgeons","volume":"1 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":"132978920","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.2014.20.2.65
S. Nam, Yun-Jung Lim
Congenital duodenal obstruction is a one of the emergent surgical conditions in neonates. Almost of them were diagnosed with double-bubble sign in prenatal ultrasonography. However, partial obstruction caused from duodenal web could be overlooked. We reported a duodenal web in early childhood. A three-year-old girl visited at our pediatric clinic for constipation. She had been showed non-bilious vomiting after weaning meal since 6 months old of her age, but her weight was relevant for 50-75 percentile of growth curve. Barium enema was initially checked, but any abnormal finding was not found. We noticed the severely distended stomach and 1st portion of duodenum. Upper gastrointestinal series revealed partial obstruction in 2nd portion of duodenum. After laparotomy, we found the transitional zone of duodenum and identified a duodenal web via duodenotomy. We performed duodeno-duodenostomy without any injury of ampulla of Vater. She was recovered uneventfully. During 6 months after operation, she does well without any gastrointestinal symptoms or signs, such as vomiting or constipation.
{"title":"Duodenal Obstruction due to Duodenal Web in Three-year-old Girl: A Case Report","authors":"S. Nam, Yun-Jung Lim","doi":"10.13029/JKAPS.2014.20.2.65","DOIUrl":"https://doi.org/10.13029/JKAPS.2014.20.2.65","url":null,"abstract":"Congenital duodenal obstruction is a one of the emergent surgical conditions in neonates. Almost of them were diagnosed with double-bubble sign in prenatal ultrasonography. However, partial obstruction caused from duodenal web could be overlooked. We reported a duodenal web in early childhood. A three-year-old girl visited at our pediatric clinic for constipation. She had been showed non-bilious vomiting after weaning meal since 6 months old of her age, but her weight was relevant for 50-75 percentile of growth curve. Barium enema was initially checked, but any abnormal finding was not found. We noticed the severely distended stomach and 1st portion of duodenum. Upper gastrointestinal series revealed partial obstruction in 2nd portion of duodenum. After laparotomy, we found the transitional zone of duodenum and identified a duodenal web via duodenotomy. We performed duodeno-duodenostomy without any injury of ampulla of Vater. She was recovered uneventfully. During 6 months after operation, she does well without any gastrointestinal symptoms or signs, such as vomiting or constipation.","PeriodicalId":164943,"journal":{"name":"Journal of Korean Association of Pediatric Surgeons","volume":"40 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":"134106268","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.2014.20.2.53
H. Park, Soo-Hong Kim, Sung-Eun Jung, S. Lee, K. Park, Ji Won Lee, H. Kang, H. Shin, Hae Woon Baek, Hyun Young Kim
Hwon Ham Park, Soo-Hong Kim, Sung-Eun Jung, Seong-Cheol Lee, Kwi-Won Park, Ji Won Lee, Hyoung Jin Kang, Hee Young Shin, Hae Woon Baek, Hyun-Young Kim Department of Pediatric Surgery, Seoul National University Children’s Hospital, Seoul, Department of Pediatrics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Department of Pathology, Seoul National University Children’s Hospital, Seoul, Department of Pediatric Surgery, Pusan National University Children’s Hospital, Yangsan, Korea
{"title":"Clinical Feature of Neonatal Neuroblastoma: Comparison of Outcome between Diagnosed Prenatally and at Postpartum Group","authors":"H. Park, Soo-Hong Kim, Sung-Eun Jung, S. Lee, K. Park, Ji Won Lee, H. Kang, H. Shin, Hae Woon Baek, Hyun Young Kim","doi":"10.13029/JKAPS.2014.20.2.53","DOIUrl":"https://doi.org/10.13029/JKAPS.2014.20.2.53","url":null,"abstract":"Hwon Ham Park, Soo-Hong Kim, Sung-Eun Jung, Seong-Cheol Lee, Kwi-Won Park, Ji Won Lee, Hyoung Jin Kang, Hee Young Shin, Hae Woon Baek, Hyun-Young Kim Department of Pediatric Surgery, Seoul National University Children’s Hospital, Seoul, Department of Pediatrics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Department of Pathology, Seoul National University Children’s Hospital, Seoul, Department of Pediatric Surgery, Pusan National University Children’s Hospital, Yangsan, Korea","PeriodicalId":164943,"journal":{"name":"Journal of Korean Association of Pediatric Surgeons","volume":"96 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":"125148086","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.2014.20.2.62
S. Kim, Soo-Ah Lim, M. Lee
Gallbladder stones in children are not common without underlying hemolytic diseases or other risk factors like obesity. Ceftriaxone, a third generation cephalosporin, is known to make biliary precipitations that can be mistaken for biliary stones. We here report two children with biliary pseudolithiasis with different treatment modalities. One child was mistaken for symptomatic gallbladder stones and underwent elective laparoscopic cholecystectomy, while the other child, after thorough history taking on the ceftriaxone medication, was suspected of biliary pseudolithiasis and was treated conservatively. Both children had the history of usage of ceftriaxone in previous hospitals for infectious diseases. The ceftriaxone history of the first child was missed before the surgery. When gallbladder stones are found in children without any underlying diseases, specific history taking of the usage of ceftriaxone seems to be absolutely required. In this case, immediate interruption of the antibiotic could resolve the episode and avoid unnecessary surgical procedure.
{"title":"Biliary Pseudolithiasis in Children: To Avoid Unnecessary Surgical Procedure","authors":"S. Kim, Soo-Ah Lim, M. Lee","doi":"10.13029/JKAPS.2014.20.2.62","DOIUrl":"https://doi.org/10.13029/JKAPS.2014.20.2.62","url":null,"abstract":"Gallbladder stones in children are not common without underlying hemolytic diseases or other risk factors like obesity. Ceftriaxone, a third generation cephalosporin, is known to make biliary precipitations that can be mistaken for biliary stones. We here report two children with biliary pseudolithiasis with different treatment modalities. One child was mistaken for symptomatic gallbladder stones and underwent elective laparoscopic cholecystectomy, while the other child, after thorough history taking on the ceftriaxone medication, was suspected of biliary pseudolithiasis and was treated conservatively. Both children had the history of usage of ceftriaxone in previous hospitals for infectious diseases. The ceftriaxone history of the first child was missed before the surgery. When gallbladder stones are found in children without any underlying diseases, specific history taking of the usage of ceftriaxone seems to be absolutely required. In this case, immediate interruption of the antibiotic could resolve the episode and avoid unnecessary surgical procedure.","PeriodicalId":164943,"journal":{"name":"Journal of Korean Association of Pediatric Surgeons","volume":"32 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":"123890640","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 : 2014-06-01DOI: 10.13029/JKAPS.2014.20.1.17
H. Ha, Jayun Cho, Jinyoung Park
The aim of this study was to identify the risk factor related to the need for operative treatment and avoid unnecessary non-operative management for intussusception in children. We retrospectively reviewed medical records of patient treated for intussusception at our institution between January 2006 and January 2013. Clinical features such as gender, age, seasonal variation, symptoms and signs, treatment results were analyzed. Univariate and multivariate analyses including a chi-square test for categorical variables and logistic regression analysis were performed. During the study period, 356 patients were treated for intussusception. 328 (92.1%) was treated successfully by the non-operative pneumoreduction, and 28 (7.9%) required operative management. On univariate analysis, risk factors which were related to the need for operative treatment were age, vomiting, bloody stool, lethargy, and symptoms duration. A logistic regression analysis in order to assess for independent predictors of operative treatment was performed. Age (＜6 vs ≥12 months) (OR 4.713, 95% CI 1.198∼18.539, p=0.027) and symptoms duration longer than 48 hours (OR 4.534, 95% CI 1.846∼11.137, p=0.001) were significantly associated with a requirement for operative treatment. We conclude that younger age and a longer duration of symptoms (≥ 48 hours) are the independent risk factor related to the need for operative treatment for intussusception. Early surgical intervention or transfer to a hospital with pediatric surgical capabilities should be considered for patients with these findings.
本研究的目的是确定与儿童肠套叠需要手术治疗相关的危险因素，避免不必要的非手术治疗。我们回顾性地回顾了2006年1月至2013年1月间我院收治的肠套叠患者的医疗记录。分析患者的性别、年龄、季节变化、症状体征、治疗效果等临床特征。单因素和多因素分析包括分类变量卡方检验和逻辑回归分析。在研究期间，356例患者接受了肠套叠治疗。328例(92.1%)通过非手术减压治疗成功，28例(7.9%)需要手术治疗。单因素分析显示，与手术治疗相关的危险因素为年龄、呕吐、便血、嗜睡和症状持续时间。为了评估手术治疗的独立预测因素，进行了逻辑回归分析。年龄(<6个月vs≥12个月)(OR 4.713, 95% CI 1.198 ~ 18.539, p=0.027)和症状持续时间超过48小时(OR 4.534, 95% CI 1.846 ~ 11.137, p=0.001)与手术治疗需求显著相关。我们得出结论，年龄较小和症状持续时间较长(≥48小时)是肠套叠需要手术治疗的独立危险因素。对于出现上述症状的患者，应考虑早期手术干预或转院至具有儿科外科能力的医院。
{"title":"Risk Factors Associated with the Need for Operative Treatment of Intussusception in Children","authors":"H. Ha, Jayun Cho, Jinyoung Park","doi":"10.13029/JKAPS.2014.20.1.17","DOIUrl":"https://doi.org/10.13029/JKAPS.2014.20.1.17","url":null,"abstract":"The aim of this study was to identify the risk factor related to the need for operative treatment and avoid unnecessary non-operative management for intussusception in children. We retrospectively reviewed medical records of patient treated for intussusception at our institution between January 2006 and January 2013. Clinical features such as gender, age, seasonal variation, symptoms and signs, treatment results were analyzed. Univariate and multivariate analyses including a chi-square test for categorical variables and logistic regression analysis were performed. During the study period, 356 patients were treated for intussusception. 328 (92.1%) was treated successfully by the non-operative pneumoreduction, and 28 (7.9%) required operative management. On univariate analysis, risk factors which were related to the need for operative treatment were age, vomiting, bloody stool, lethargy, and symptoms duration. A logistic regression analysis in order to assess for independent predictors of operative treatment was performed. Age (＜6 vs ≥12 months) (OR 4.713, 95% CI 1.198∼18.539, p=0.027) and symptoms duration longer than 48 hours (OR 4.534, 95% CI 1.846∼11.137, p=0.001) were significantly associated with a requirement for operative treatment. We conclude that younger age and a longer duration of symptoms (≥ 48 hours) are the independent risk factor related to the need for operative treatment for intussusception. Early surgical intervention or transfer to a hospital with pediatric surgical capabilities should be considered for patients with these findings.","PeriodicalId":164943,"journal":{"name":"Journal of Korean Association of Pediatric Surgeons","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124487886","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 : 2014-06-01DOI: 10.13029/JKAPS.2014.20.1.1
Dy Kim, IS Kim, H.Y. Kim, S. Nam, Kw Park, W. Park, Yj Park, JH Park, JY Park, JS Park, YJ Boo, Jm Seo, J. Seol, Jt Oh, N. Lee, MD Lee, JH Jang, K. Jung, SY Jung, S. Jung, SM Jung, Ey Jung, Jh Jung, Mj Cho, Kj J. Choi, Sjn Choi, So Choi, Sh Choi, YM Choi, J. Hong
tussusceptions (83.9%), pyloromyotomy (90.3%), fundoplication (96.8%), biopsy and corrective surgery of Hirschsprung’s disease (93.5%/90.3%), imperforate anus (77.4%), congenital diaphragmatic hernia (80.6%), and esophageal atresia (74.2%). The MIS procedures with more than 70% were lung resection (100%), cholecystectomy (100%), appendectomy (96.2%), ovarian torsion (86.7%), fundoplication (86.8%), hiatal hernia repair (82.6%), and splenectomy (71.4%). The MIS procedures with less than 30% were congenial diaphragmatic hernia reapir (29.6%), esophageal atresia (26.2%), correction of malroatation (24.4%), inguinal hernia repair (11.4%), anorectal malformation (6.8%), Kasai operation (3.6%).
{"title":"Minimal Invasive Surgery: A National Survey of Its Members by the Korean Association of Pediatric Surgeons","authors":"Dy Kim, IS Kim, H.Y. Kim, S. Nam, Kw Park, W. Park, Yj Park, JH Park, JY Park, JS Park, YJ Boo, Jm Seo, J. Seol, Jt Oh, N. Lee, MD Lee, JH Jang, K. Jung, SY Jung, S. Jung, SM Jung, Ey Jung, Jh Jung, Mj Cho, Kj J. Choi, Sjn Choi, So Choi, Sh Choi, YM Choi, J. Hong","doi":"10.13029/JKAPS.2014.20.1.1","DOIUrl":"https://doi.org/10.13029/JKAPS.2014.20.1.1","url":null,"abstract":"tussusceptions (83.9%), pyloromyotomy (90.3%), fundoplication (96.8%), biopsy and corrective surgery of Hirschsprung’s disease (93.5%/90.3%), imperforate anus (77.4%), congenital diaphragmatic hernia (80.6%), and esophageal atresia (74.2%). The MIS procedures with more than 70% were lung resection (100%), cholecystectomy (100%), appendectomy (96.2%), ovarian torsion (86.7%), fundoplication (86.8%), hiatal hernia repair (82.6%), and splenectomy (71.4%). The MIS procedures with less than 30% were congenial diaphragmatic hernia reapir (29.6%), esophageal atresia (26.2%), correction of malroatation (24.4%), inguinal hernia repair (11.4%), anorectal malformation (6.8%), Kasai operation (3.6%).","PeriodicalId":164943,"journal":{"name":"Journal of Korean Association of Pediatric Surgeons","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124229806","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 : 2014-06-01DOI: 10.13029/JKAPS.2014.20.1.12
Eunsook Choi, H. G. Lee, Soojinna Choi, S. Chung
Foreign body ingestion is a common problem among paediatric populations. Most of the ingested foreign bodies spontaneously pass through the gastrointestinal tract, but approximately less then 10% of them remain without being discharged, and trigger complications. Therefore, proper evaluation and treatment according to the situation is required. In this study, clinical progress and complications were analyzed according to the clinical features and treatment in children who ingested foreign bodies. Among pediatric patients under 18 who were admitted to Chonnam National University Hospital after ingesting foreign bodies between January 2008 to June 2012, only the patients who had their foreign body in the gastrointestinal tract were included in this study. Based on medical records, age, type of foreign body, time spent till admission, and whether the endoscopy was done or not, complication were researched retrospectively. According to symptoms and plain abdomen X-ray findings, treatment was chosen and conducted among endoscopy, observation and emergency operation. Among 273 patients, 9 (3.3%) of them had surgical removal. Seven (2.6%) of them had an emergency operation on the day of admission, and the rest 2 (0.7%) had operation during observation. Removal through initial endoscopic approach was tried in 157 (57.5%) patients. Eleven (70.8%) of them had their foreign body removed at the initial trial, and 5 (4.9%) of them at the second trial. Among 109, who were on observation status, 9 (8.3%) of them needed endoscopic removal, and 2 (1.8%) of them suffered from surgical removal. It is thought to be better to approach slowly considering the type, size and symptoms in foreign body ingestion of pediatric patients, rather than immediate and invasive removal.
{"title":"Clinical Analysis of Foreign Bodies in Gastrointestinal Tract in Children","authors":"Eunsook Choi, H. G. Lee, Soojinna Choi, S. Chung","doi":"10.13029/JKAPS.2014.20.1.12","DOIUrl":"https://doi.org/10.13029/JKAPS.2014.20.1.12","url":null,"abstract":"Foreign body ingestion is a common problem among paediatric populations. Most of the ingested foreign bodies spontaneously pass through the gastrointestinal tract, but approximately less then 10% of them remain without being discharged, and trigger complications. Therefore, proper evaluation and treatment according to the situation is required. In this study, clinical progress and complications were analyzed according to the clinical features and treatment in children who ingested foreign bodies. Among pediatric patients under 18 who were admitted to Chonnam National University Hospital after ingesting foreign bodies between January 2008 to June 2012, only the patients who had their foreign body in the gastrointestinal tract were included in this study. Based on medical records, age, type of foreign body, time spent till admission, and whether the endoscopy was done or not, complication were researched retrospectively. According to symptoms and plain abdomen X-ray findings, treatment was chosen and conducted among endoscopy, observation and emergency operation. Among 273 patients, 9 (3.3%) of them had surgical removal. Seven (2.6%) of them had an emergency operation on the day of admission, and the rest 2 (0.7%) had operation during observation. Removal through initial endoscopic approach was tried in 157 (57.5%) patients. Eleven (70.8%) of them had their foreign body removed at the initial trial, and 5 (4.9%) of them at the second trial. Among 109, who were on observation status, 9 (8.3%) of them needed endoscopic removal, and 2 (1.8%) of them suffered from surgical removal. It is thought to be better to approach slowly considering the type, size and symptoms in foreign body ingestion of pediatric patients, rather than immediate and invasive removal.","PeriodicalId":164943,"journal":{"name":"Journal of Korean Association of Pediatric Surgeons","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129081243","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 : 2014-06-01DOI: 10.13029/JKAPS.2014.20.1.7
D. Park, N. Lee
The present study compared the postoperative analgesic effects of ilioinguinal and iliohypogastric nerve block with infiltration of local anesthetics (bupivacaine) into the wound in children after inguinal hernia repair. Ninety children below 7 years old who were scheduled elective inguinal hernia repair were randomly allocated into one of three groups. The patients in nerve block (NB) group, ilioinguinal and iliohypogastric nerve block was done with 0.5 mL/kg of 0.25% bupivacaine. The patients in infiltration of local anesthetics (LI) group, 0.5 mL/kg of 0.25% bupivacaine was infiltrated into the wound after surgery. The patients in control group were allocated as a Control group. Postoperative pain was assessed at 1, 3, 5, and 24 hours after operation with FLACC scale and additional analgesic consumption were counted. The three groups were not significantly different in age, sex, body weight, and duration of operation. Pain scores at 1 hour and 3 hours after operation were significantly higher in Control group than in NB group and LI group (p<0.01), whereas there were no difference between NB group and LI group. The rescue analgesics administration was significantly higher in Control group (n=11) than in NB group (n=6) and LI group (n=7) (p<0.05). There were 2 cases of transient femoral nerve palsy in NB group. Both of ilioinguinal and iliohypogastric nerve block and infiltration of local anesthetics into the wound provided effective postoperative analgesia in early postoperative period following inguinal hernia repair in children. But no difference between the two methods. Technically, infiltration of local anesthetics into the wound was easier and safer than ilioinguinal and iliohypogastric nerve block.
{"title":"A Comparison between Ilioinguinal and Iliohypogastric Nerve Block and Infiltration of Local Anesthetics for Postoperative Pain after Inguinal Herniorrhaphy in Children","authors":"D. Park, N. Lee","doi":"10.13029/JKAPS.2014.20.1.7","DOIUrl":"https://doi.org/10.13029/JKAPS.2014.20.1.7","url":null,"abstract":"The present study compared the postoperative analgesic effects of ilioinguinal and iliohypogastric nerve block with infiltration of local anesthetics (bupivacaine) into the wound in children after inguinal hernia repair. Ninety children below 7 years old who were scheduled elective inguinal hernia repair were randomly allocated into one of three groups. The patients in nerve block (NB) group, ilioinguinal and iliohypogastric nerve block was done with 0.5 mL/kg of 0.25% bupivacaine. The patients in infiltration of local anesthetics (LI) group, 0.5 mL/kg of 0.25% bupivacaine was infiltrated into the wound after surgery. The patients in control group were allocated as a Control group. Postoperative pain was assessed at 1, 3, 5, and 24 hours after operation with FLACC scale and additional analgesic consumption were counted. The three groups were not significantly different in age, sex, body weight, and duration of operation. Pain scores at 1 hour and 3 hours after operation were significantly higher in Control group than in NB group and LI group (p<0.01), whereas there were no difference between NB group and LI group. The rescue analgesics administration was significantly higher in Control group (n=11) than in NB group (n=6) and LI group (n=7) (p<0.05). There were 2 cases of transient femoral nerve palsy in NB group. Both of ilioinguinal and iliohypogastric nerve block and infiltration of local anesthetics into the wound provided effective postoperative analgesia in early postoperative period following inguinal hernia repair in children. But no difference between the two methods. Technically, infiltration of local anesthetics into the wound was easier and safer than ilioinguinal and iliohypogastric nerve block.","PeriodicalId":164943,"journal":{"name":"Journal of Korean Association of Pediatric Surgeons","volume":"97 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117320535","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 : 2013-12-01DOI: 10.13029/JKAPS.2013.19.2.130
B. S. Park, J. Sul
{"title":"Primary Laparoscopic-Assisted Endorectal Pull-Through for Hirschsprung's Disease","authors":"B. S. Park, J. Sul","doi":"10.13029/JKAPS.2013.19.2.130","DOIUrl":"https://doi.org/10.13029/JKAPS.2013.19.2.130","url":null,"abstract":"","PeriodicalId":164943,"journal":{"name":"Journal of Korean Association of Pediatric Surgeons","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132029894","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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