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The outcomes of specific surgically correctable congenital gastro-intestinal malformations at a tertiary level neonatal intensive care unit in South Africa 南非一家三级新生儿重症监护病房对可通过手术矫正的特定先天性胃肠道畸形的治疗结果
Q4 Medicine Pub Date : 2023-12-31 DOI: 10.47338/jns.v13.1250
Ilhaam Abrahams, Lizelle Van Wyk, C. de Vos
Background: The outcome of neonates with congenital surgically correctable gastro-intestinal (GIT) malformations is poorly described in low middle income countries. Methods: A 5-year retrospective descriptive analysis of neonates admitted to a tertiary level neonatal intensive care unit (NICU), with congenital, surgically correctable GIT malformations, was performed. The primary outcome was the 30-day postoperative mortality as well as survival to 1 year. Secondary outcomes included patient demographics, clinical presentation as well as the burden of disease in our study population. Results: Eighty-four neonates met study criteria. The mean gestational age was 35 weeks (SD 3.19) and birthweight 2518g (SD 789.3). The most common congenital malformations were intestinal atresia (39%) followed by omphaloceles (21%). Associated systemic malformations were common (39%). The majority of neonates (88%) underwent surgery at a median age of 2 days (IQR 1.5-5). Ventilation was required in 19% of neonates preoperatively and 65% postoperatively. Full feeds were achieved at a median age of 13 days (IQR 9-18) after surgery. The 30 day-postoperative survival rate was 97% with a survival to discharge or transfer of 86%. Data for one year survival was available for 80% of neonates with a one-year survival rate of 75%. Conclusion: The 30-day postoperative survival was high in neonates with congenital, surgically correctable GIT malformations. Outcomes and burden on the healthcare system was dependent on the type of lesion. With early diagnosis and referral to a tertiary centre, good outcomes can be achieved. Neonates with congenital GIT malformations should have long term follow up to monitor growth and neurodevelopment as well as to address the high mortality post discharge.
背景:在中低收入国家,对患有可通过手术矫正的先天性胃肠道(GIT)畸形的新生儿的预后描述很少。研究方法:对中低收入国家中患有先天性胃肠道畸形的新生儿进行为期五年的回顾性描述分析:对一家三级医院新生儿重症监护室(NICU)收治的患有先天性可手术矫正胃肠道畸形的新生儿进行了为期 5 年的回顾性描述分析。主要结果是术后30天的死亡率和1年的存活率。次要结果包括患者的人口统计学特征、临床表现以及研究人群的疾病负担。研究结果84名新生儿符合研究标准。平均胎龄为 35 周(SD 3.19),出生体重为 2518 克(SD 789.3)。最常见的先天性畸形是肠闭锁(39%),其次是卵圆孔畸形(21%)。伴发的全身畸形也很常见(39%)。大多数新生儿(88%)在中位年龄 2 天(IQR 1.5-5)时接受手术。19%的新生儿术前需要通气,65%的新生儿术后需要通气。术后完全进食的中位年龄为 13 天(IQR 9-18)。术后 30 天的存活率为 97%,出院或转院后的存活率为 86%。80%的新生儿获得了一年存活数据,一年存活率为 75%。结论患有可通过手术矫正的先天性胃、消化道畸形的新生儿术后 30 天存活率很高。结果和医疗系统的负担取决于病变的类型。只要及早诊断并转诊至三级医疗中心,就能取得良好的疗效。患有先天性胃、消化道畸形的新生儿应接受长期随访,以监测生长和神经发育情况,并解决出院后死亡率高的问题。
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引用次数: 0
Gastric perforation in neonates: Our experience 新生儿胃穿孔:我们的经验
Q4 Medicine Pub Date : 2023-12-31 DOI: 10.47338/jns.v13.1242
F. Sharafeddin, Brandon Edelbach, Alexandra Vacaru, Georgi D Mladenov, D. Moores, Yogen Singh, Andrei Radulescu
Background: Neonatal gastric perforation (NGP) is a life-threatening condition with a high mortality rate. It accounts for 7% of all gastrointestinal tract (GIT) perforations. The number of NGP cases has been increasing due to the rise in premature and low birth weight neonates. In this study, we present our experience with gastric perforation in neonates. Methods: This retrospective study analyzed all cases of gastric perforation in neonates that were treated at Loma Linda University Medical Center's Neonatal Intensive Care Unit (NICU) between the years 2000 and 2023. The study looked at several variables including patient demographics, birth weight, age at admission and surgery, comorbidities, use of non-steroidal anti-inflammatory drugs (NSAIDs) and steroids, and mortality rate. Results: We treated 15 patients with neonatal gastric perforation (NGP) during the study tenure. The median age at admission was 2 days, with 67% admitted within that timeframe. Surgery occurred at a median age of 5.5 days, and the median birth weight was 2.075 kg, with 26.67% below 1 kg. Males comprised 67%, and 60% had patent ductus arteriosus. Steroids were given to 46.66%, and 30-day mortality was 26.67%, with higher rates among males. Idiopathic cases were common, with notable etiologies including ischemia, necrosis, and congenital anomalies. Primary surgical repair was the main modality, and perforations occurred at various locations. Two cases had necrotizing enterocolitis. Six patients had favorable outcomes, while others experienced mild to moderate complications. Conclusion: Our research supports the idea that males have a worse outcome in terms of both prevalence and survival rates in neonatal gastric perforation (NGP) patients. However, our findings did not confirm the notion that NGP mortality risk is higher in neonates with low birth weight. We also discovered that the median time between admission and surgery in our study group was 1.5 days, emphasizing the importance of early detection of NGP in neonates. Early diagnosis can lead to better decision-making regarding treatment options and surgical intervention.
背景:新生儿胃穿孔(NGP)是一种危及生命的疾病,死亡率很高。它占所有胃肠道(GIT)穿孔病例的 7%。由于早产儿和低出生体重新生儿的增加,NGP 病例的数量也在不断增加。在本研究中,我们介绍了新生儿胃穿孔的经验。方法:这项回顾性研究分析了 2000 年至 2023 年期间在洛马琳达大学医学中心新生儿重症监护室(NICU)接受治疗的所有新生儿胃穿孔病例。研究调查了多个变量,包括患者的人口统计学特征、出生体重、入院和手术时的年龄、合并症、非甾体抗炎药(NSAID)和类固醇的使用情况以及死亡率。结果:在研究期间,我们共收治了15名新生儿胃穿孔(NGP)患者。入院时的中位年龄为 2 天,67% 的患者在 2 天内入院。手术时间中位数为 5.5 天,出生体重中位数为 2.075 千克,其中 26.67% 低于 1 千克。男性占 67%,60% 患有动脉导管未闭。46.66%的患儿使用了类固醇,30天死亡率为26.67%,男性患儿的死亡率更高。特发性病例很常见,主要病因包括缺血、坏死和先天性畸形。初次手术修复是主要方式,穿孔发生在不同部位。两例患者出现坏死性小肠结肠炎。六名患者的治疗效果良好,其他患者则出现了轻度至中度并发症。结论:我们的研究支持这样一种观点,即在新生儿胃穿孔(NGP)患者中,男性在发病率和存活率方面都较差。然而,我们的研究结果并未证实出生体重低的新生儿患 NGP 的死亡风险更高。我们还发现,在我们的研究小组中,从入院到手术的中位时间为 1.5 天,这强调了早期发现新生儿 NGP 的重要性。早期诊断可为治疗方案和手术干预提供更好的决策依据。
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引用次数: 0
Oropharyngeal teratoma in a newborn: A case report 新生儿口咽畸胎瘤:病例报告
Q4 Medicine Pub Date : 2023-12-05 DOI: 10.47338/jns.v12.1187
Dania Bouguermouh, Said Boutemeur, Fatma Hamel
Background: Facial teratomas are rare congenital tumors in the craniocervical region. They constitute only 2-5% of all childhood teratomas.Case Presentation: This report presents a case of an oral teratoma in an infant, attached to the palate and extending sublingually on the right side, along with a cleft palate. The patient underwent successful surgical excision on the 17th day of life performed by a team of pediatric and maxillofacial surgeons.Conclusion: The case emphasizes the importance of interdisciplinary coordination for the management of facial teratomas, involving maxillofacial and pediatric surgeons, neonatologists, anesthesiologists, and obstetrics specialists.
背景:面部畸胎瘤是发生在颅颈部的罕见先天性肿瘤。它们仅占所有儿童畸胎瘤的2-5%。病例介绍:本报告报告一例婴幼儿口腔畸胎瘤,附着于上颚并向右侧舌下延伸,同时伴有腭裂。在一组儿科和颌面外科医生的帮助下,患者在出生后的第17天接受了成功的手术切除。结论:该病例强调了面部畸胎瘤管理的跨学科协调的重要性,涉及颌面部和儿科外科医生,新生儿科医生,麻醉师和产科专家。
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引用次数: 0
Neonatal gastric perforation in Twins: Two distinct cases 双胞胎新生儿胃穿孔:两个不同的病例
Q4 Medicine Pub Date : 2023-11-30 DOI: 10.47338/jns.v12.1224
Sergey Klyuev, Sergey Yurievich Gorodkov, Igor Vladimirovich Goremykin, Vyacheslav Germanovich Masevkin
Background: Neonatal gastric perforation (NGP) is an uncommon but fatal condition. The exact cause of NGP remains unclear, although some cases have been linked to medical interventions. NGP is rarely reported in twins. Case Presentation: Herein we report two cases of gastric perforation in twins. The first baby was one of the 34-week preterm twins that developed abdominal distension and respiratory distress on the third day of life. While the other baby was one of the 32-week preterm twins that too developed abdominal distension and respiratory distress. Both had gastric perforations that needed surgical repair. One baby died of sepsis while the other neonate had a stormy postoperative course, which was managed with meticulous monitoring and multidisciplinary management, and discharged in good clinical condition. Conclusion: Clinical cases demonstrate that successful management of NGP requires a multidisciplinary approach, including timely surgical intervention, meticulous postoperative care, and close monitoring of complications.
背景:新生儿胃穿孔(NGP)是一种不常见但致命的疾病。尽管有些病例与医疗干预有关,但NGP的确切病因仍不清楚。双胞胎患 NGP 的报道很少。病例介绍:我们在此报告两例双胞胎胃穿孔病例。第一个婴儿是34周早产双胞胎中的一个,在出生后第三天出现腹胀和呼吸困难。另一个婴儿是早产 32 周的双胞胎之一,也出现了腹胀和呼吸困难。两个婴儿都有胃穿孔,需要手术修补。其中一名婴儿死于败血症,而另一名新生儿的术后过程则是一波三折,经过精心监测和多学科管理后,临床状况良好,顺利出院。结论临床病例表明,成功治疗 NGP 需要采用多学科方法,包括及时的手术干预、细致的术后护理和对并发症的密切监测。
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引用次数: 0
Transanal pull-through for Hirschsprung disease in neonates: A single-center experience 经肛门牵引术治疗新生儿先天性巨结肠疾病:单中心经验
Q4 Medicine Pub Date : 2023-11-14 DOI: 10.47338/jns.v12.1220
Nahla Kechiche, Sahla Sellami, Dorsaf Makhlouf, Rachida Lamiri, Nahla Hmidi, Seifeddine Zayani, Amine Ksia, Lassaad Sahnoun, Mongi Mekki, Mohssen Belguith
Background: Transanal pull-through for the treatment of Hirschsprung disease in the neonatal period remains debatable. This study reported our experience with transanal pull-through in neonates. Methods: We reviewed medical records of neonates with Hirschsprung disease treated in our department with transanal pull-through between the years 2010 and 2016. Results: Of the 40 included patients, 31 were male neonates, and 9 were female. The mean age at the time of surgery was 13 days. The mean operative time was 136 minutes. The level of aganglionosis was rectal in 8 cases, rectosigmoid in 19 cases, descending colon in 7 cases, splenic flexure in 3 cases, transverse colon in 2 cases, and ascending colon in one case. A combined abdominal approach was used in 11 patients. There were no intraoperative complications. Major complications were noted in 4 cases: anastomotic leakage in 3 cases of whom one succumbed 3 days postoperatively; and bowel perforation in one case. The most common late postoperative complication was fecal soiling encountered in 25% of cases. Two among 29 patients who reached the age of continence remain incontinent. Conclusion: Transanal pull-through in neonates has similar outcomes and complications to those of infants and children. Therefore this procedure can be safely employed in neonates however we recommend that the treating team should have an ample learning curve for this procedure in infants.
背景:经肛门牵引术治疗新生儿期巨结肠疾病仍有争议。本研究报告了我们对新生儿经肛门拉通的经验。方法:回顾2010年至2016年在我科经肛拉通术治疗的先天性先天性巨结肠患儿病历。结果:40例新生儿中,男婴31例,女婴9例。手术时的平均年龄为13天。平均手术时间为136分钟。神经节病发生在直肠8例,直肠乙状结肠19例,降结肠7例,脾屈曲3例,横结肠2例,升结肠1例。11例患者采用联合腹部入路。无术中并发症。4例出现严重并发症:吻合口瘘3例,1例术后3 d死亡;还有一例肠穿孔。最常见的术后晚期并发症是粪便污染,占25%。29例达到尿失禁年龄的患者中有2例仍然尿失禁。结论:新生儿经肛牵引术的结局和并发症与婴儿和儿童相似。因此,该手术可以安全地用于新生儿,但我们建议治疗团队应该对婴儿的该手术有充分的学习曲线。
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引用次数: 0
Algorithm for failure to pass meconium since birth in neonates 新生儿出生后未能排出胎便的算法
Q4 Medicine Pub Date : 2023-10-22 DOI: 10.47338/jns.v12.1241
Muhammad Zaeem Khalid, Jamal Yousaf, Muhammad Hanzlah Shabbir
Journal of Neonatal Surgery is a peer-reviewed and open-access electronic journal. Only a few journals are being published on Neonatal Surgery especially from a developing country, which justifies the need of a new journal on this subject.
《新生儿外科杂志》是一本同行评议和开放获取的电子期刊。只有少数期刊正在出版,特别是来自发展中国家的新生儿外科,这证明需要一本关于这一主题的新期刊。
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引用次数: 0
Giant axillary macrocystic lymphatic malformation in a newborn 新生儿巨大腋窝大囊淋巴畸形
Q4 Medicine Pub Date : 2023-10-04 DOI: 10.47338/jns.v12.1219
Chipo-Tinomuda Nyamukapa, David Msuya, Alex Mremi, Abbas Mohamedali, Jay Lodhia
Journal of Neonatal Surgery is a peer-reviewed and open-access electronic journal. Only a few journals are being published on Neonatal Surgery especially from a developing country, which justifies the need of a new journal on this subject.
《新生儿外科杂志》是一本同行评议和开放获取的电子期刊。只有少数期刊正在出版,特别是来自发展中国家的新生儿外科,这证明需要一本关于这一主题的新期刊。
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引用次数: 0
Extrathoracic esophageal elongation with Foker technique in patients with Type-A esophageal atresia. A case series Foker技术在A型食管闭锁患者胸外食管延长术中的应用。案例系列
Q4 Medicine Pub Date : 2023-09-06 DOI: 10.47338/jns.v12.1221
Mei-Chun Lin, Verónica Polit-Guerrero, Jimmy Andrade-Montesdeoca, Daniel Acosta-Farina, Vicente Salinas-Salinas, Daniel E. Acosta
Background: Long-gap esophageal atresia (EA) is not amenable to primary anastomosis though the goal of surgical treatment is to restore the patency in the native esophagus; the Foker technique is one of the methods that can accomplish it.Case Presentation: This case series consists of three patients who presented with a type-A long-gap EA. Extrathoracic esophageal elongation was achieved using the Foker technique. During the first stage, we utilized pledgeted sutures reinforced with titanium clips for elongation that began five days after the surgery. As the elongation progressed, and the gap between esophageal pouches decreased, we restored the continuity of the esophagus. On follow-up, all patients needed pneumatic dilatation of the esophagus.Conclusion: The Foker technique successfully restored the esophageal continuity using the native esophagus in our patients with esophageal atresia.
背景:尽管外科治疗的目的是恢复天然食管的通畅性,但长间隙食管闭锁(EA)不适合一期吻合;Foker技术是可以做到这一点的方法之一。病例介绍:本病例系列由三名出现a型长间隙电针的患者组成。使用Foker技术实现胸外食管延长。在第一阶段,我们使用钛夹加固的纱布缝合线进行延长,该缝合线在手术后五天开始。随着延伸的进行,食道袋之间的间隙减小,我们恢复了食道的连续性。在随访中,所有患者都需要气动食管扩张术。结论:Foker技术在食管闭锁患者中成功地利用天然食管恢复了食管的连续性。
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引用次数: 0
Duodenal atresia, annular pancreas, and situs inversus totalis- rare association in a newborn: A case report 新生儿十二指肠闭锁、环状胰腺和总内翻位的罕见关联:一例报告
Q4 Medicine Pub Date : 2023-09-05 DOI: 10.47338/jns.v12.1218
Gogan Mvlsb, KT Lafia, Amoussou Cam, CS Metchihoungbé, Dossou Mgis, MA Fiogbé, L. S. Boris
Background: Simultaneous occurrence of duodenal atresia, annular pancreas, and situs inversus totalis is an exceedingly rare clinical condition. This may pose management-related challenges to the treating surgeon.Case Presentation: We report a case with a preoperative diagnosis of duodenal atresia and situs inversus. Intraoperatively, an annular pancreas encircling the duodenum was found. Instead of duodenoduodenostomy, a duodenojejunal anastomosis was performed. The postoperative course remained uneventful. The patient is doing fine on a 6-month follow-up.Conclusion: The simultaneous presence of multiple anomalies in this patient prompted us to utilize an alternative approach to relieve the duodenal obstruction. This report highlights the importance of tailoring surgical decisions based on the individualized needs of the patient.
背景:十二指肠闭锁、环状胰腺和总内翻位同时发生是一种极为罕见的临床情况。这可能会给治疗外科医生带来与管理相关的挑战。病例介绍:我们报告一例术前诊断为十二指肠闭锁和内翻位的病例。术中发现一个环绕十二指肠的环状胰腺。取而代之的是十二指肠-十二指肠吻合术,而是十二指肠-空肠吻合术。术后的过程仍然平静。该患者在6个月的随访中表现良好。结论:该患者同时存在多种异常,促使我们采用替代方法来缓解十二指肠梗阻。本报告强调了根据患者的个性化需求定制手术决策的重要性。
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引用次数: 0
Gastric pneumatosis in a preterm infant: A case report 早产儿胃肺病1例
Q4 Medicine Pub Date : 2023-08-28 DOI: 10.47338/jns.v12.1209
Paramesh Sreekumar, Prince Raj, A. Dey, E. Shatla, M. Corbally
Background: Gastric pneumatosis is a rare condition characterized by the presence of intramural gas in the stomach wall. It is uncommon in infants and is usually caused by proximal intestinal obstruction or necrotizing enterocolitis, a serious condition typically seen in preterm babies.Case Presentation: An extremely preterm baby born at 23 weeks of gestation weighing 640 grams, with bronchopulmonary dysplasia and other comorbidities like patent ductus arteriosus, staph aureus sepsis, developed abdominal distension and non-bilious vomiting at 4 months of age. X-ray abdomen revealed gastric pneumatosis.  The condition was managed with conservative measures.Conclusion: Gastric pneumatosis secondary to necrotizing enterocolitis is uncommon in infants and needs prompt evaluation and management to prevent further deterioration.
背景:胃积气是一种罕见的胃壁内有气体的情况。它在婴儿中并不常见,通常由近端肠梗阻或坏死性小肠结肠炎引起,这是一种常见于早产儿的严重疾病。病例介绍:一名妊娠23周时出生的极早产儿,体重640克,患有支气管肺发育不良和其他合并症,如动脉导管未闭、金黄色葡萄球菌败血症,在4个月大时出现腹胀和非胆汁性呕吐。腹部X光片显示胃积气。这种情况是用保守的措施控制的。结论:坏死性小肠结肠炎继发的胃积气在婴儿中并不常见,需要及时评估和治疗以防止进一步恶化。
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引用次数: 0
期刊
Journal of Neonatal Surgery
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