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Foreign Body Inside the Tunnel: A Rare Cause of Acute Cubital Tunnel Syndrome 隧道内异物:急性肘管综合征的罕见病因
IF 0.9 Q4 SURGERY Pub Date : 2019-10-01 DOI: 10.1055/s-0039-1696951
G. Yildiran, M. Sutcu, O. Akdağ, Z. Tosun
Abstract Foreign bodies are common entities found in hand surgery practice. However, they are a very rare cause of the acute cubital tunnel syndrome. A 48-year-old male patient was consulted for cubital tunnel symptoms after 2-day unconscious state in the intensive care unit. The ulnar nerve was explored, a piece of glass was removed inside the cubital tunnel, and the nerve was repaired. However, compression neuropathy symptoms due to the acute trauma are interesting. Nerve laceration with a foreign body should be considered in acute-onset cubital tunnel syndrome, in which the foreign body history of a trauma patient cannot be determined explicitly.
摘要异物是手外科手术中常见的异物。然而,它们是急性肘管综合征的一种非常罕见的病因。一名48岁男性患者在重症监护室昏迷2天后,因肘管症状接受咨询。对尺神经进行了探查,在肘管内取出一块玻璃,并对神经进行了修复。然而,急性创伤引起的压迫性神经病症状是令人感兴趣的。急性发作肘管综合征应考虑伴有异物的神经撕裂伤,在该综合征中,创伤患者的异物史无法明确确定。
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引用次数: 1
Ossified Spinal Meningioma: A Case Report and a Review of the Literature 骨化性脊膜瘤1例报告并文献复习
IF 0.9 Q4 SURGERY Pub Date : 2019-10-01 DOI: 10.1055/s-0039-1697634
M. Taha, A. Alawamry, H. Abdel-aziz
Abstract Ossified spinal meningiomas are a rare form of spinal tumors. These tumors increase surgical morbidities due to their hard consistency and strong adhesion to the neural tissue and relatively narrow surgical space. Here, the authors describe the clinical findings, surgical strategies, and histological findings of a patient with an ossified meningioma. Preoperative diagnosis of these tumors can prevent surgical morbidities. Total resection can be curative with the application of meticulous microsurgical techniques.
摘要骨化性脊膜瘤是一种罕见的脊柱肿瘤。这些肿瘤由于其坚硬的一致性和对神经组织的强粘附性以及相对狭窄的手术空间而增加了手术发病率。在此,作者描述了一例骨化性脑膜瘤患者的临床表现、手术策略和组织学表现。这些肿瘤的术前诊断可以预防手术并发症。全切除可以通过应用细致的显微外科技术来治愈。
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引用次数: 8
Sports-Related Pediatric Facial Trauma: Analysis of Facial Fracture Pattern and Concomitant Injuries 运动相关的儿童面部创伤:面部骨折模式和伴随损伤的分析
IF 0.9 Q4 SURGERY Pub Date : 2019-10-01 DOI: 10.1055/s-0039-1697627
Andrew A. Dobitsch, N. Oleck, Farrah C. Liu, Jordan N. Halsey, Ian C Hoppe, Edward S. Lee, M. Granick
Abstract Objective Sports-related injuries, such as facial fractures, are potentially debilitating and may lead to long-term functional and aesthetic deficits in a pediatric patient. In this study, we analyze sports-related facial fractures in the urban pediatric population in an effort to characterize patterns of injury and improve management strategies and outcomes. Methods Retrospective chart review was performed for all facial fractures resulting from sports injuries in the pediatric population at a level-1 trauma center (University Hospital, Newark, NJ). Results Seventeen pediatric patients were identified as having sustained a fracture of the facial skeleton due to sports injury. Mean age was 13.9 years old. A total of 29 fractures were identified. Most common fracture sites included the orbit (n = 12), mandible (n = 5), nasal bone (n = 5), and zygomaticomaxillary complex (n = 3). The most common concomitant injuries included skull fracture (n = 3), intracranial hemorrhage (n = 4), and traumatic brain injury (n = 4). One patient was intubated upon arrival to the emergency department. Hospital admission was required in 13 patients, 4 of which were admitted to an intensive care setting. Nine patients required operative intervention. Mean length of hospital stay was 2.4 days. No patients were expired. Conclusions Sports-related facial fractures are potentially debilitating injuries in the pediatric population. Analysis of fracture pattern and concomitant injuries is imperative to develop effective management strategies and prevention techniques.
抽象目标 与运动相关的损伤,如面部骨折,可能会使儿童衰弱,并可能导致儿童患者的长期功能和审美缺陷。在这项研究中,我们分析了城市儿科人群中与运动相关的面部骨折,以确定损伤模式,并改进管理策略和结果。方法 在一级创伤中心(新泽西州纽瓦克大学医院)对儿科人群中因运动损伤导致的所有面部骨折进行了回顾性图表审查。后果 17名儿童患者被确认为因运动损伤导致面部骨骼骨折。平均年龄13.9岁。共发现29处骨折。最常见的骨折部位包括眼眶(n = 12) ,下颌骨(n = 5) ,鼻骨(n = 5) ,和颧颌复合体(n = 3) 。最常见的合并损伤包括颅骨骨折(n = 3) ,颅内出血(n = 4) 和创伤性脑损伤(n = 4) 。一名患者在到达急诊室时进行了插管。13名患者需要入院治疗,其中4人入住重症监护室。9名患者需要手术干预。平均住院时间为2.4天。没有患者过期。结论 在儿科人群中,与运动相关的面部骨折可能会使人衰弱。分析骨折模式和伴随损伤对于制定有效的管理策略和预防技术至关重要。
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引用次数: 12
Huge Retroperitoneal Dermoid: A Presentation 巨大腹膜后皮样:一种表现
IF 0.9 Q4 SURGERY Pub Date : 2019-10-01 DOI: 10.1055/s-0039-1697630
Tanweerul Huda, M. Singh
Abstract Teratoma can be defined as a true neoplasm that contains tissues that either are foreign to the primary site of origin or are histologically diverse and represent more than one of the embryonic germ layers. A 20-year-old female patient presented with chief complaints of swelling in the right upper abdomen since childhood and back pain for the past 4 years. Per abdomen, examination revealed a lump of around 15 cm in size in the right hypochondrial region extending to the epigastric region. Contrast-enhanced computed tomography abdomen revealed a 14.3 × 14.1 × 17.4 cm well-defined heterogeneously hypoattenuating nonenhancing complex cystic mass with focal areas of calcifications and fat attenuation in retroperitoneum. The patient was taken up for exploratory laparotomy and a tumor was found in the retroperitoneum, retrocavally and was excised with due care. Histopathological examination features were suggestive of mature cystic teratoma. The postoperative stay was uneventful.
摘要畸胎瘤可以被定义为一种真正的肿瘤,它包含的组织要么是原发部位的外来组织,要么是组织学上的多样性组织,代表了多个胚胎胚层。一名20岁的女性患者,自童年以来主要表现为右上腹部肿胀和过去4年的背痛。检查发现每个腹部有大约15个肿块 在延伸到上腹部的右侧疑病症区域中的大小为cm。腹部增强型计算机断层扫描显示14.3 × 14.1 × 17.4 cm明确的不均匀低衰减非增强性复杂囊性肿块,腹膜后有钙化和脂肪衰减的局灶性区域。患者接受了剖腹探查术,在腹膜后、腔静脉后发现肿瘤,并在适当的护理下切除。组织病理学检查特征提示为成熟囊性畸胎瘤。术后的住院时间很平静。
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引用次数: 1
Predictive Factors for Postoperative Outcome in Children with Jejunoileal Atresia 儿童空肠回肠闭锁术后预后的预测因素
IF 0.9 Q4 SURGERY Pub Date : 2019-10-01 DOI: 10.1055/s-0039-1697628
Charlotta Jarkman, M. Salö
Abstract Background Jejunoileal atresia is a relatively rare congenital gastrointestinal requiring surgery and long postoperative care. The postoperative outcome is affected by many factors and this study focuses on finding predictors for time to full enteral feeding, length of hospital stay (LOH), and postoperative complications. Methods This was a retrospective study of all children operated for isolated jejunoileal atresia between 2001 and 2017 at a tertiary center of pediatric surgery. Independent variables regarding demographical-, operative-, and postoperative data were abstracted. Primary outcome was time to full enteral feeding, LOH, and postoperative complications in terms of reoperation or central line complication. Any significant variables from the univariate analysis were further analyzed with logistic regression and presented as odds ratio with 95% confidence interval. Results After exclusion because of concomitant gastroschisis (n = 1), and death before discharge (n = 2), 47 patients were further analyzed (49% boys, 53% premature). No significant differences could be seen in the univariate analysis between children with short and long time (median > 17 days) to full enteral nutrition. Patients with longer LOH (median >32 days) had significantly lower birth weight compared with those with shorter LOH; median 2,550 g versus 2,980 g (p = 0.04). Patients with a central line complication had significantly longer median time to full enteral feeding (median 27 vs. 12 days, p = 0.03), and significantly longer median LOH (median 43 vs. 21 days, p = 0.03), but these parameters were not significant in a multivariate analysis. No significant results were found regarding reoperation. Conclusion Low birth weight seems associated with an increased LOH in children operated on for jejunoileal atresia, and central line complications seem related to the duration with central line in this group. The small cohort may constitute a power problem in this study and further research regarding the included variables may reveal more potential predictors for the postoperative outcome.
背景空肠回肠闭锁是一种较为罕见的先天性胃肠道疾病,需要手术治疗和长期的术后护理。术后结果受许多因素影响,本研究的重点是寻找完全肠内喂养时间、住院时间(LOH)和术后并发症的预测因素。方法回顾性研究2001年至2017年在某三级儿科外科中心接受孤立性空肠回肠闭锁手术的所有儿童。有关人口统计学、手术和术后数据的独立变量被抽象。主要预后指标为肠内喂养时间、LOH、再手术或中心静脉并发症方面的术后并发症。单因素分析的显著变量进一步进行逻辑回归分析,并以95%置信区间的优势比表示。结果在排除合并胃裂(n = 1)和出院前死亡(n = 2)后,对47例患者进行进一步分析,其中男孩49%,早产儿53%。在单变量分析中,短时间和长时间(中位> - 17天)给予充分肠内营养的儿童之间没有显著差异。与LOH较短的患者相比,LOH较长(中位>32天)的患者出生体重明显较低;中位数2550 g vs 2980 g (p = 0.04)。中心静脉并发症患者达到完全肠内喂养的中位时间明显更长(中位27天vs. 12天,p = 0.03),中位LOH明显更长(中位43天vs. 21天,p = 0.03),但这些参数在多变量分析中不显著。再手术无明显结果。结论低出生体重可能与空肠回肠闭锁患儿LOH升高有关,该组患儿中央线并发症与中央线使用时间有关。在本研究中,小队列研究可能存在功率问题,对纳入变量的进一步研究可能会揭示更多潜在的术后预后预测因素。
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引用次数: 2
Early Surgical Repair of Bile Duct Injuries following Laparoscopic Cholecystectomy: The Sooner the Better 腹腔镜胆囊切除术后胆管损伤的早期外科修复:越早越好
IF 0.9 Q4 SURGERY Pub Date : 2019-10-01 DOI: 10.1055/s-0039-1697633
M. Battal, P. Yazıcı, O. Bostanci, O. Karatepe
Abstract Background We aimed to investigate the outcomes of the immediate surgical repair of bile duct injuries (BDIs) following laparoscopic cholecystectomy. Materials and Methods Between January 2012 and May 2017, patients, who underwent immediate surgical repair (within 72 hours) for postcholecystectomy BDI, by the same surgical team expert in hepatobiliary surgery, were enrolled into the study. Data collection included demographics, type of BDI according to the Strasberg classification, time to diagnosis, surgical procedures, and outcome. Results There were 13 patients with a mean age of 43 ± 12 years. Classification of BDIs were as follows: type E in six patients (46%), type D in three patients (23%), type C in two (15%), and types B and A in one patient each (7.6%). Mean time to diagnosis was 22 ± 15 hours. Surgical procedures included Roux-en-Y hepaticojejunostomy for all six patients with type-E injury, primary repair of common bile duct for three patients with type-D injury, and primary suturing of the fistula orifice was performed in two cases with type-C injury. Other two patients with type-B and -A injury underwent removal of clips which were placed on common bile duct during index operation and replacing of clips on cystic duct where stump bile leakage was observed probably due to dislodging of clips, respectively. Mean hospital stay was 6.6 ± 3 days. Morbidity with a rate of 30% (n = 4) was observed during a median follow-up period of 35 months (range: 6–56 months). Mortality was nil. Conclusion Immediate surgical repair of postcholecystectomy BDIs in selected patients leads to promising outcome.
摘要背景 我们旨在研究腹腔镜胆囊切除术后胆管损伤(BDI)的即时手术修复的结果。材料和方法 2012年1月至2017年5月期间,患者接受了即时手术修复(72 小时)进行胆囊切除术后BDI,由肝胆外科的同一外科团队专家参与该研究。数据收集包括人口统计学、根据Strasberg分类的BDI类型、诊断时间、手术程序和结果。后果 共有13名患者,平均年龄43岁 ± 12年。BDI的分类如下:E型6例(46%),D型3例(23%),C型2例(15%),B型和A型各1例(7.6%)。平均诊断时间为22 ± 15 小时。外科手术包括对所有6名E型损伤患者进行Roux-en-Y肝肠造口术,对3名D型损伤患者实施胆总管一期修复,对2名C型损伤患者施行瘘口一期缝合。另外两名B型和A型损伤的患者分别在索引手术中移除了放置在胆总管上的夹子,并更换了囊性管上的夹子。囊性管中观察到残端胆汁渗漏,可能是由于夹子移位。平均住院时间为6.6 ± 3天。发病率为30%(n = 4) 中位随访期为35个月(范围:6-56个月)。死亡率为零。结论 在选定的患者中,胆囊切除术后BDIs的即时手术修复可带来有希望的结果。
{"title":"Early Surgical Repair of Bile Duct Injuries following Laparoscopic Cholecystectomy: The Sooner the Better","authors":"M. Battal, P. Yazıcı, O. Bostanci, O. Karatepe","doi":"10.1055/s-0039-1697633","DOIUrl":"https://doi.org/10.1055/s-0039-1697633","url":null,"abstract":"Abstract Background We aimed to investigate the outcomes of the immediate surgical repair of bile duct injuries (BDIs) following laparoscopic cholecystectomy. Materials and Methods Between January 2012 and May 2017, patients, who underwent immediate surgical repair (within 72 hours) for postcholecystectomy BDI, by the same surgical team expert in hepatobiliary surgery, were enrolled into the study. Data collection included demographics, type of BDI according to the Strasberg classification, time to diagnosis, surgical procedures, and outcome. Results There were 13 patients with a mean age of 43 ± 12 years. Classification of BDIs were as follows: type E in six patients (46%), type D in three patients (23%), type C in two (15%), and types B and A in one patient each (7.6%). Mean time to diagnosis was 22 ± 15 hours. Surgical procedures included Roux-en-Y hepaticojejunostomy for all six patients with type-E injury, primary repair of common bile duct for three patients with type-D injury, and primary suturing of the fistula orifice was performed in two cases with type-C injury. Other two patients with type-B and -A injury underwent removal of clips which were placed on common bile duct during index operation and replacing of clips on cystic duct where stump bile leakage was observed probably due to dislodging of clips, respectively. Mean hospital stay was 6.6 ± 3 days. Morbidity with a rate of 30% (n = 4) was observed during a median follow-up period of 35 months (range: 6–56 months). Mortality was nil. Conclusion Immediate surgical repair of postcholecystectomy BDIs in selected patients leads to promising outcome.","PeriodicalId":44614,"journal":{"name":"Surgery Journal","volume":"5 1","pages":"e154 - e158"},"PeriodicalIF":0.9,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0039-1697633","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49421115","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}
引用次数: 12
Comparative Study of 0.2% Glyceryl Trinitrate Ointment for Pain Reduction after Hemorrhoidectomy Surgery 0.2%三硝酸甘油软膏减轻痔切除术后疼痛的比较研究
IF 0.9 Q4 SURGERY Pub Date : 2019-10-01 DOI: 10.1055/s-0039-3400532
S. Vahabi, S. Beiranvand, A. Karimi, M. Moradkhani
Abstract Context Hemorrhoid is one of the most common diseases in both, men and women, affecting half of the world's population over the age of 50. Aims The aim of this study was to evaluate the analgesic effects of local ointment of glyceryl trinitrate ointment (GTN) after hemorrhoidectomy. Methods and Materials In this randomized double-blind, placebo-controlled study, the patients were grouped as the treatment, that is GTN, and placebo (P) group. After surgery, 0.2% gelatin GTN ointment (250 mg), and P ointment (n = 20 for each group) were applied topically on 1 cm on the anus using a standard ruler, three times a week in respective groups. visual analog scale was used to assess the intensity of the pain and complications of the drugs were observed at 6, 12, 18, and 24 hours. Statistical Analysis Used Data and questionnaires were analyzed statistically using SPSS17 software and results were recorded in the tabular form. Results Six hours after the application of the ointment, no significant difference was found among the groups, however, after 12, 18, and 24 hours significant reduction in pain was seen in GTN group, which was least after 18 hours. The mean values of the total pain score in the first 24 hours after surgery in the GTN group were 3.15 and 5.45 in the P group which were statistically significant. Nonetheless, headache was significantly increased in the GTN group. Conclusion Simple and safe topical GTN ointment can reduce the pain after hemorrhoidectomy, leading to the reduced need of other analgesics.
摘要背景痔疮是男性和女性最常见的疾病之一,影响着世界50岁以上人口的一半。目的评价痔切除术后局部应用三硝酸甘油软膏(GTN)的镇痛效果。方法与材料本研究采用随机双盲、安慰剂对照,将患者分为治疗组,即GTN组和安慰剂(P)组。术后用标准尺局部涂抹0.2%明胶GTN软膏(250 mg)和P软膏(每组n = 20)于肛门1 cm处,每组每周3次。分别于6、12、18、24小时观察疼痛程度及药物并发症。采用SPSS17软件对数据和问卷进行统计分析,结果以表格形式记录。结果GTN组在用药6 h后疼痛程度无显著性差异,但GTN组在用药12、18、24 h后疼痛程度均有显著减轻,且以用药18 h后疼痛程度最小。GTN组术后24小时总疼痛评分平均值为3.15,P组为5.45,差异有统计学意义。尽管如此,GTN组的头痛明显增加。结论简单、安全的外用GTN软膏可减轻痔切除术后疼痛,减少其他镇痛药的使用。
{"title":"Comparative Study of 0.2% Glyceryl Trinitrate Ointment for Pain Reduction after Hemorrhoidectomy Surgery","authors":"S. Vahabi, S. Beiranvand, A. Karimi, M. Moradkhani","doi":"10.1055/s-0039-3400532","DOIUrl":"https://doi.org/10.1055/s-0039-3400532","url":null,"abstract":"Abstract Context Hemorrhoid is one of the most common diseases in both, men and women, affecting half of the world's population over the age of 50. Aims The aim of this study was to evaluate the analgesic effects of local ointment of glyceryl trinitrate ointment (GTN) after hemorrhoidectomy. Methods and Materials In this randomized double-blind, placebo-controlled study, the patients were grouped as the treatment, that is GTN, and placebo (P) group. After surgery, 0.2% gelatin GTN ointment (250 mg), and P ointment (n = 20 for each group) were applied topically on 1 cm on the anus using a standard ruler, three times a week in respective groups. visual analog scale was used to assess the intensity of the pain and complications of the drugs were observed at 6, 12, 18, and 24 hours. Statistical Analysis Used Data and questionnaires were analyzed statistically using SPSS17 software and results were recorded in the tabular form. Results Six hours after the application of the ointment, no significant difference was found among the groups, however, after 12, 18, and 24 hours significant reduction in pain was seen in GTN group, which was least after 18 hours. The mean values of the total pain score in the first 24 hours after surgery in the GTN group were 3.15 and 5.45 in the P group which were statistically significant. Nonetheless, headache was significantly increased in the GTN group. Conclusion Simple and safe topical GTN ointment can reduce the pain after hemorrhoidectomy, leading to the reduced need of other analgesics.","PeriodicalId":44614,"journal":{"name":"Surgery Journal","volume":"5 1","pages":"e192 - e196"},"PeriodicalIF":0.9,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0039-3400532","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44138850","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}
引用次数: 16
Gastrointestinal Stromal Tumors of Small Intestine 小肠胃肠道间质瘤
IF 0.9 Q4 SURGERY Pub Date : 2019-07-01 DOI: 10.1055/s-0039-1694704
Tanweerul Huda, M. Singh
Abstract Gastrointestinal stromal tumor (GIST) is defined as mesenchymal tumors of the gastrointestinal tract expressing proto-oncogene protein CD117. They are the most common sarcomatous tumors of the gastrointestinal tract. GISTs are presumed to arise from interstitial cells of Cajal or gastrointestinal pacemaker cells which control gut motility. They have unpredictable biological behavior. Prognosis is dependent on tumor size as well as mitotic count. Radical surgical excision is the treatment of choice. They rarely metastasize to lymph nodes. Imatinib therapy is used as an adjuvant therapy. The follow-up of patients postsurgery is not standardized.
胃肠道间质瘤(GIST)是一种表达原癌基因蛋白CD117的胃肠道间质肿瘤。它们是胃肠道最常见的肉瘤性肿瘤。胃肠道间质瘤被认为是由控制肠道运动的Cajal间质细胞或胃肠道起搏器细胞引起的。它们具有不可预测的生物行为。预后取决于肿瘤大小和有丝分裂计数。根治性手术切除是治疗的首选。它们很少转移到淋巴结。伊马替尼治疗被用作辅助治疗。患者术后随访不规范。
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引用次数: 10
Erratum: Trapeziometacarpal Joint Arthroplasty of the Thumb without Osseous Tunnels and Carpal Tunnel Release via a Radial Approach; Technique, and Results 经桡骨入路无骨隧道的拇指斜方腕关节置换术和腕隧道松解术;技术与结果
IF 0.9 Q4 SURGERY Pub Date : 2019-07-01 DOI: 10.1055/s-0039-1700493
C. Chan, Efraín Farías Cisneros, T. Tsai
[This corrects the article DOI: 10.1055/s-0039-1697635.].
[这更正了文章DOI:10.1055/s-0039-1697635.]。
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引用次数: 0
Children with Hirschsprung's Disease and Syndromes with Cognitive Dysfunction: Manifestations, Treatment, and Outcomes 儿童先天性巨结肠和认知功能障碍综合征的表现、治疗和结果
IF 0.9 Q4 SURGERY Pub Date : 2019-07-01 DOI: 10.1055/s-0039-1696730
Josefine Hedbys, J. Hasserius, C. Granéli, E. Arnbjörnsson, Kristine Hagelsteen, P. Stenström
Abstract Introduction To assess differences in initial symptoms, treatments, and bowel function between children with Hirschsprung's disease (HD) with or without a cognitive dysfunction (CD). Materials and Methods The study included children with HD who underwent transanal endorectal pull-through. A retrospective chart review was performed to collect data on patient characteristics, diagnosis, and treatment. Data on bowel symptoms in children older than 4 years without a colostomy were compiled during a cross-sectional, patient-reported follow-up. Results Fifty-three children with HD were included; of these, 12 (23%) had CD. The median birth weight was lower, frequency of vomiting as the presenting symptom was lower, and time until the first contact with a pediatric surgeon was higher in children with CD than in those without (3,295 vs. 3,623 g, p = 0.013; 28 vs. 66%, p = 0.02; and 4 days vs. 1 day, p = 0.048, respectively). At follow-up, 5 (15%) of 33 children aged over 4 years had CD. More children without CD had some ability to hold back defecation and sense the urge to defecate than those with CD (p = 0.002 and p = 0.001, respectively). Conclusion HD children who have CD present with different initial symptoms, have a delay in the first consultation with a pediatric surgeon, and experience poorer bowel function outcomes than HD children without CD. Therefore, HD children with CD should receive special attention in both clinical practice and research.
摘要简介 评估伴有或不伴有认知功能障碍(CD)的先天性巨结肠(HD)患儿在初始症状、治疗和肠功能方面的差异。材料和方法 这项研究包括接受经肛门直肠内牵引的HD儿童。进行了回顾性图表审查,以收集有关患者特征、诊断和治疗的数据。4岁以上未进行结肠造口的儿童的肠道症状数据是在横断面随访中汇编的,患者报告了随访情况。后果 53名HD儿童被纳入研究;其中,12名(23%)患有CD。患有CD的儿童的中位出生体重较低,出现症状时呕吐的频率较低,第一次接触儿科医生的时间比没有CD的儿童高(3295对3623 g、 p = 0.013;28%对66%,p = 0.02;4天对1天,p = 0.048)。在随访中,33名4岁以上儿童中有5名(15%)患有CD。与患有CD的儿童相比,没有CD的儿童有更多的抑制排便和感觉排便冲动的能力(p = 0.002和p = 0.001)。结论 患有CD的HD儿童表现出不同的初始症状,第一次咨询儿科外科医生的时间延迟,并且与没有CD的HD孩子相比,肠功能结果较差。因此,患有CD的高清孩子在临床实践和研究中都应该受到特别关注。
{"title":"Children with Hirschsprung's Disease and Syndromes with Cognitive Dysfunction: Manifestations, Treatment, and Outcomes","authors":"Josefine Hedbys, J. Hasserius, C. Granéli, E. Arnbjörnsson, Kristine Hagelsteen, P. Stenström","doi":"10.1055/s-0039-1696730","DOIUrl":"https://doi.org/10.1055/s-0039-1696730","url":null,"abstract":"Abstract Introduction To assess differences in initial symptoms, treatments, and bowel function between children with Hirschsprung's disease (HD) with or without a cognitive dysfunction (CD). Materials and Methods The study included children with HD who underwent transanal endorectal pull-through. A retrospective chart review was performed to collect data on patient characteristics, diagnosis, and treatment. Data on bowel symptoms in children older than 4 years without a colostomy were compiled during a cross-sectional, patient-reported follow-up. Results Fifty-three children with HD were included; of these, 12 (23%) had CD. The median birth weight was lower, frequency of vomiting as the presenting symptom was lower, and time until the first contact with a pediatric surgeon was higher in children with CD than in those without (3,295 vs. 3,623 g, p = 0.013; 28 vs. 66%, p = 0.02; and 4 days vs. 1 day, p = 0.048, respectively). At follow-up, 5 (15%) of 33 children aged over 4 years had CD. More children without CD had some ability to hold back defecation and sense the urge to defecate than those with CD (p = 0.002 and p = 0.001, respectively). Conclusion HD children who have CD present with different initial symptoms, have a delay in the first consultation with a pediatric surgeon, and experience poorer bowel function outcomes than HD children without CD. Therefore, HD children with CD should receive special attention in both clinical practice and research.","PeriodicalId":44614,"journal":{"name":"Surgery Journal","volume":"5 1","pages":"e103 - e109"},"PeriodicalIF":0.9,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0039-1696730","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44048403","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}
引用次数: 3
期刊
Surgery Journal
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