Sameh Tlili, Malak Boughdir, Aida Daib, Youssef Hellal, Ehsen Ben Brahim, Nejib Kaabar, Rabiaa Ben Abdallah
Abstract Mesenchymal hamartomas of the liver is considered a benign tumour, although it provides significant challenges in the diagnosis and operative management. Clinical features, laboratory results and radiographic imaging are often non-specific and inconclusive. Thus, it is still difficult to differentiate from malignant lesion without pathological examination. While this tumour is usually diagnosed in the first 2 years of life, few cases in older children have been reported and most of them are case reports. In this article, we want to report our clinical evaluation, results of image diagnosis, surgical procedure and the follow-up simultaneously we discuss the possible differential diagnosis of such a case at this age.
{"title":"Mesenchymal Hamartoma of the Liver Incidentally Discovered in a 4 Year Old Girl: Management and Treatment","authors":"Sameh Tlili, Malak Boughdir, Aida Daib, Youssef Hellal, Ehsen Ben Brahim, Nejib Kaabar, Rabiaa Ben Abdallah","doi":"10.4103/ajps.ajps_95_21","DOIUrl":"https://doi.org/10.4103/ajps.ajps_95_21","url":null,"abstract":"Abstract Mesenchymal hamartomas of the liver is considered a benign tumour, although it provides significant challenges in the diagnosis and operative management. Clinical features, laboratory results and radiographic imaging are often non-specific and inconclusive. Thus, it is still difficult to differentiate from malignant lesion without pathological examination. While this tumour is usually diagnosed in the first 2 years of life, few cases in older children have been reported and most of them are case reports. In this article, we want to report our clinical evaluation, results of image diagnosis, surgical procedure and the follow-up simultaneously we discuss the possible differential diagnosis of such a case at this age.","PeriodicalId":7519,"journal":{"name":"African Journal of Paediatric Surgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135611224","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}
Ram Samujh, Nitin James Peters, Palak Singhai, Nandita Kakkar Bharadwaj
Abstract Background: Transanal endorectal pull-through (TEPT) is a well-established operation for the management of rectosigmoid and short-segment Hirschsprung’s disease (HD). A well-performed contrast enema (CE) is an essential road map for the surgeon when attempting the TEPT. We looked at the surgicopathological–radiological correlations and technical considerations of this procedure and discussed our experience over a decade. TEPT essentially relies on radiological mapping of the disease correlating with intraoperative and pathological findings. Some investigators opine that the radiological correlation of the transition zone (rTZ) with the pathological transition zone (pTZ) is accurate whereas others disagree. We review our experience in managing HD patients with TEPT, in terms of pre-operative workup and operative and pathological considerations. Materials and Methods: A retrospective study was done in a single unit, from January 2010 to January 2020. Forty-seven patients who met the inclusion criteria such as short-segment HD and uncomplicated HD underwent CE before surgery. The patients included in the review underwent a primary TEPT. For each patient, we identified the radiological transition zone (rTZ) on the contrast enema, the gross transition zone (gTZ) on intraoperatively visual examination, the frozen section transition zone (fTZ) on intraoperative analysis of the frozen section specimens (fTZ), and the pathological transition zone (pTZ) on permanent paraffin blocks of the specimens. We determined the strength of correlation of the rTZ, the gTZ and the fTZ with reference to the pTZ. Results: Forty-seven patients underwent single-stage transanal pull-through. There were 40 males. There were 8 neonates, 20 infants and 19 children (>12 months of age). The mean age at diagnosis was 8.7 days (3–20 days) for the neonates, 5.11 months (2–12 months) for the infants and 4.3 years (1.5–9 years) for children. In our study, 85% correlation was noted between the rTZ and the pTZ (tb = 0.362, P = 0.006). There was an excellent correlation between the intraoperative gTZ, fTZ and the pTZ in all patients except one (97.8%, tb = 0.942, P < 0.001). Conclusions: The TEPT is a feasible option to manage carefully selected patients with rectosigmoid HD. The presence of robust support from pathology and a properly carried out CE are essential parameters to be considered before successfully undertaking these operations. The functional outcomes of TEPT are comparable with other procedures for HD with the added advantage of it being a scar-less and a stoma-less approach.
背景:经肛门直肠内牵引(TEPT)是治疗直肠乙状结肠和短段巨结肠病(HD)的一种成熟的手术方法。一个良好的对比灌肠(CE)是外科医生在尝试TEPT时必不可少的路线图。我们研究了该手术的外科病理-放射学相关性和技术考虑，并讨论了我们十多年来的经验。TEPT主要依赖于与术中和病理结果相关的疾病的放射成像。一些研究者认为过渡区(rTZ)与病理过渡区(pTZ)的放射学相关性是准确的，而另一些研究者则不同意。我们从术前检查、手术和病理考虑方面回顾了我们治疗HD患者TEPT的经验。材料和方法:2010年1月至2020年1月，在单个单位进行回顾性研究。47例符合短段HD和无并发症HD等纳入标准的患者术前接受了CE治疗。纳入本综述的患者均接受了原发性TEPT。对于每位患者，我们确定了造影剂灌肠上的放射过渡区(rTZ)，术中视觉检查的大体过渡区(gTZ)，术中冷冻切片标本(fTZ)分析的冷冻切片过渡区(fTZ)，以及标本永久石蜡块上的病理过渡区(pTZ)。我们根据pTZ确定了rTZ, gTZ和fTZ的相关强度。结果:47例患者行一期经肛门拉通术。有40名男性。新生儿8例，婴幼儿20例，12月龄儿童19例。新生儿平均诊断年龄为8.7天(3-20天)，婴儿平均诊断年龄为5.11个月(2-12个月)，儿童平均诊断年龄为4.3岁(1.5-9岁)。在我们的研究中，rTZ和pTZ之间的相关性为85% (tb = 0.362, P = 0.006)。除1例患者外，其余患者术中gTZ、fTZ与pTZ均有极好的相关性(97.8%，tb = 0.942, P <0.001)。结论:对于精心挑选的直肠乙状结肠HD患者，TEPT是一种可行的选择。在成功进行这些手术之前，病理学的有力支持和正确执行的CE是必须考虑的基本参数。TEPT的功能结果与HD的其他手术相当，其额外的优势是无疤痕和无气孔。
{"title":"Single-stage Transanal Endorectal Pull-Through for Hirschsprung’s Disease: A Retrospective Study of Surgico-pathological Correlations and Technical Considerations","authors":"Ram Samujh, Nitin James Peters, Palak Singhai, Nandita Kakkar Bharadwaj","doi":"10.4103/ajps.ajps_76_22","DOIUrl":"https://doi.org/10.4103/ajps.ajps_76_22","url":null,"abstract":"Abstract Background: Transanal endorectal pull-through (TEPT) is a well-established operation for the management of rectosigmoid and short-segment Hirschsprung’s disease (HD). A well-performed contrast enema (CE) is an essential road map for the surgeon when attempting the TEPT. We looked at the surgicopathological–radiological correlations and technical considerations of this procedure and discussed our experience over a decade. TEPT essentially relies on radiological mapping of the disease correlating with intraoperative and pathological findings. Some investigators opine that the radiological correlation of the transition zone (rTZ) with the pathological transition zone (pTZ) is accurate whereas others disagree. We review our experience in managing HD patients with TEPT, in terms of pre-operative workup and operative and pathological considerations. Materials and Methods: A retrospective study was done in a single unit, from January 2010 to January 2020. Forty-seven patients who met the inclusion criteria such as short-segment HD and uncomplicated HD underwent CE before surgery. The patients included in the review underwent a primary TEPT. For each patient, we identified the radiological transition zone (rTZ) on the contrast enema, the gross transition zone (gTZ) on intraoperatively visual examination, the frozen section transition zone (fTZ) on intraoperative analysis of the frozen section specimens (fTZ), and the pathological transition zone (pTZ) on permanent paraffin blocks of the specimens. We determined the strength of correlation of the rTZ, the gTZ and the fTZ with reference to the pTZ. Results: Forty-seven patients underwent single-stage transanal pull-through. There were 40 males. There were 8 neonates, 20 infants and 19 children (>12 months of age). The mean age at diagnosis was 8.7 days (3–20 days) for the neonates, 5.11 months (2–12 months) for the infants and 4.3 years (1.5–9 years) for children. In our study, 85% correlation was noted between the rTZ and the pTZ (tb = 0.362, P = 0.006). There was an excellent correlation between the intraoperative gTZ, fTZ and the pTZ in all patients except one (97.8%, tb = 0.942, P < 0.001). Conclusions: The TEPT is a feasible option to manage carefully selected patients with rectosigmoid HD. The presence of robust support from pathology and a properly carried out CE are essential parameters to be considered before successfully undertaking these operations. The functional outcomes of TEPT are comparable with other procedures for HD with the added advantage of it being a scar-less and a stoma-less approach.","PeriodicalId":7519,"journal":{"name":"African Journal of Paediatric Surgery","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135611222","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 : 2023-01-01DOI: 10.4103/ajps.ajps_127_23
Soham Bandyopadhyay, Kokila Lakhoo
Historically, hundreds of thousands of children worldwide with surgical conditions would go untreated due to a lack of access to appropriate care. In particular, the burden of paediatric surgical conditions in Africa was vast and the healthcare professionals with the skills to treat them were severely limited. However, the 21st century has seen substantial improvements in paediatric surgical care across the African continent. With the rise of dedicated associations, a focus on education, infrastructure development and local research, the face of paediatric surgery in Africa is transforming. This article sheds light on these significant advancements and organisations driving this progress. Associations and societies have been pivotal in the advancements of paediatric surgery within Africa. Notably, the Pan African Paediatric Surgery Association and the West African College of Surgeons have spearheaded the improvement of surgical care for children in resource-limited settings. These organisations have provided a much-needed platform to unite paediatric surgeons from across the continent.[1] Together with national paediatric surgery associations, this has fostered an environment of knowledge sharing, collaboration and advocacy, which ultimately have improved surgical standards and patient care. The enhanced focus on education and training has been a key driver in improving paediatric surgical care. In the past, sending trainees from low-and-middle-income countries (LMICs) to high-income countries (HICs) was the primary model used to address the shortage of trained paediatric surgeons. However, over time, this approach has evolved into locally driven accreditation and training programmes. For example, in 2007, BethanyKids became the first site in East Africa to provide training in paediatric surgery accredited by the College of Surgeons of East, Central and Southern Africa.[2] These local programmes have been pivotal in equipping aspiring paediatric surgeons with the necessary skills and knowledge for this specialised field contextualised to local needs. The inclusion of paediatric surgery in medical school curricula and the introduction of Master of Medicine programmes in paediatric surgery at African Universities have also played crucial roles in helping develop local expertise, reducing dependency on foreign-trained professionals and ensuring sustainable development of paediatric surgical care contextualised to different African countries’ needs. The adoption of digital learning during the COVID-19 pandemic also shows potential for long-term supplementation of traditional educational methodologies, particularly as internet access in Africa proliferates. The momentum garnered through these educational initiatives and associations has translated into the development of robust infrastructure and a skilled workforce in paediatric surgery. Non-governmental organisations such as Kids Operating Room, Smile Train and Operation Smile have significantly con
{"title":"Emerging Optimism in Paediatric Surgery in Africa","authors":"Soham Bandyopadhyay, Kokila Lakhoo","doi":"10.4103/ajps.ajps_127_23","DOIUrl":"https://doi.org/10.4103/ajps.ajps_127_23","url":null,"abstract":"Historically, hundreds of thousands of children worldwide with surgical conditions would go untreated due to a lack of access to appropriate care. In particular, the burden of paediatric surgical conditions in Africa was vast and the healthcare professionals with the skills to treat them were severely limited. However, the 21st century has seen substantial improvements in paediatric surgical care across the African continent. With the rise of dedicated associations, a focus on education, infrastructure development and local research, the face of paediatric surgery in Africa is transforming. This article sheds light on these significant advancements and organisations driving this progress. Associations and societies have been pivotal in the advancements of paediatric surgery within Africa. Notably, the Pan African Paediatric Surgery Association and the West African College of Surgeons have spearheaded the improvement of surgical care for children in resource-limited settings. These organisations have provided a much-needed platform to unite paediatric surgeons from across the continent.[1] Together with national paediatric surgery associations, this has fostered an environment of knowledge sharing, collaboration and advocacy, which ultimately have improved surgical standards and patient care. The enhanced focus on education and training has been a key driver in improving paediatric surgical care. In the past, sending trainees from low-and-middle-income countries (LMICs) to high-income countries (HICs) was the primary model used to address the shortage of trained paediatric surgeons. However, over time, this approach has evolved into locally driven accreditation and training programmes. For example, in 2007, BethanyKids became the first site in East Africa to provide training in paediatric surgery accredited by the College of Surgeons of East, Central and Southern Africa.[2] These local programmes have been pivotal in equipping aspiring paediatric surgeons with the necessary skills and knowledge for this specialised field contextualised to local needs. The inclusion of paediatric surgery in medical school curricula and the introduction of Master of Medicine programmes in paediatric surgery at African Universities have also played crucial roles in helping develop local expertise, reducing dependency on foreign-trained professionals and ensuring sustainable development of paediatric surgical care contextualised to different African countries’ needs. The adoption of digital learning during the COVID-19 pandemic also shows potential for long-term supplementation of traditional educational methodologies, particularly as internet access in Africa proliferates. The momentum garnered through these educational initiatives and associations has translated into the development of robust infrastructure and a skilled workforce in paediatric surgery. Non-governmental organisations such as Kids Operating Room, Smile Train and Operation Smile have significantly con","PeriodicalId":7519,"journal":{"name":"African Journal of Paediatric Surgery","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135784276","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 : 2023-01-01DOI: 10.4103/ajps.ajps_128_23
Adesoji Oludotun Ademuyiwa
As the saying goes: ‘The only constant thing in life is change’. In line with this mantra, there are bound to be changes in the structure and processes of the African Journal of Paediatric Surgery (AJPS). In order to keep up with the surging in flow of articles and to ensure the quality assurance processes of editorial oversight and peer-review process, the Editorial Board has now decided to have assistant editors to man different subspecialties of paediatric surgery for greater editorial efficiency. At the moment, specialties such as gastroenterology, urology, cardiothoracic surgery, oncology and hepatobiliary will be covered. These changes will be reflected in the Editorial Board composition in subsequent issues. In a similar vein, and due to prevailing economic realities chiefly due to the high cost of publishing and the dwindling value of the Nigerian currency, the board has come to the painful but necessary decision to adjust the article processing charges upwards starting from 1st January 2024. Articles accepted before this date will be charged according to the current charges. Consequently, from 1st January 2024, the article processing charges after acceptance of manuscript will now be $250.00. Similarly, the authors are to determine if they want their articles published in colour for the print versions of the journal. Such services will now be offered at a rate of $50.00/page. These charges must be paid before article can be moved to production. In this last edition of AJPS for this volume, Bandyopadhyay and Lakhoo[1] in an invited Editorial give a bird’s eye view of the evolution of paediatric surgery on the African continent and how efforts of paediatric surgeons and their associations are impacting positively on the outcome of children who require surgery. There are also other reviews, original articles and case reports in this issue that forms an interesting reading to our audience.
{"title":"Editorial Changes and Charges","authors":"Adesoji Oludotun Ademuyiwa","doi":"10.4103/ajps.ajps_128_23","DOIUrl":"https://doi.org/10.4103/ajps.ajps_128_23","url":null,"abstract":"As the saying goes: ‘The only constant thing in life is change’. In line with this mantra, there are bound to be changes in the structure and processes of the African Journal of Paediatric Surgery (AJPS). In order to keep up with the surging in flow of articles and to ensure the quality assurance processes of editorial oversight and peer-review process, the Editorial Board has now decided to have assistant editors to man different subspecialties of paediatric surgery for greater editorial efficiency. At the moment, specialties such as gastroenterology, urology, cardiothoracic surgery, oncology and hepatobiliary will be covered. These changes will be reflected in the Editorial Board composition in subsequent issues. In a similar vein, and due to prevailing economic realities chiefly due to the high cost of publishing and the dwindling value of the Nigerian currency, the board has come to the painful but necessary decision to adjust the article processing charges upwards starting from 1st January 2024. Articles accepted before this date will be charged according to the current charges. Consequently, from 1st January 2024, the article processing charges after acceptance of manuscript will now be $250.00. Similarly, the authors are to determine if they want their articles published in colour for the print versions of the journal. Such services will now be offered at a rate of $50.00/page. These charges must be paid before article can be moved to production. In this last edition of AJPS for this volume, Bandyopadhyay and Lakhoo[1] in an invited Editorial give a bird’s eye view of the evolution of paediatric surgery on the African continent and how efforts of paediatric surgeons and their associations are impacting positively on the outcome of children who require surgery. There are also other reviews, original articles and case reports in this issue that forms an interesting reading to our audience.","PeriodicalId":7519,"journal":{"name":"African Journal of Paediatric Surgery","volume":"136 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135611011","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 : 2020-11-01DOI: 10.1093/med/9780198798699.003.0012
This chapter covers other specialties that can overlap with paediatric surgery. It covers, therefore, gynaecology, cleft lip and palate surgery, otorhinolaryngology, orthopaedics, cardiology, neurosurgery, and vascular malformations. Among the specific subjects within are labial adhesions and ovarian cysts; choanal atresia, dermoid cysts, obstructive sleep apnoea, tonsillitis, laryngomalacia, airway foreign bodies and tracheostomy; the ‘limping child’, developmental dysplasia of the hip and slipped capital femoral epiphysis; cardiac failure and arrhythmias in children, and endocarditis; ventricular shunts, hydrocephalus, traumatic brain injury, brain tumours and abscesses; and finally haemangiomas and vascular tumours. The sections are written by specialists in the field with the non-specialist in mind.
{"title":"Associated specialties","authors":"","doi":"10.1093/med/9780198798699.003.0012","DOIUrl":"https://doi.org/10.1093/med/9780198798699.003.0012","url":null,"abstract":"This chapter covers other specialties that can overlap with paediatric surgery. It covers, therefore, gynaecology, cleft lip and palate surgery, otorhinolaryngology, orthopaedics, cardiology, neurosurgery, and vascular malformations. Among the specific subjects within are labial adhesions and ovarian cysts; choanal atresia, dermoid cysts, obstructive sleep apnoea, tonsillitis, laryngomalacia, airway foreign bodies and tracheostomy; the ‘limping child’, developmental dysplasia of the hip and slipped capital femoral epiphysis; cardiac failure and arrhythmias in children, and endocarditis; ventricular shunts, hydrocephalus, traumatic brain injury, brain tumours and abscesses; and finally haemangiomas and vascular tumours. The sections are written by specialists in the field with the non-specialist in mind.","PeriodicalId":7519,"journal":{"name":"African Journal of Paediatric Surgery","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83928186","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 : 2020-11-01DOI: 10.1093/med/9780198798699.003.0013
This chapter looks at a new aspect of paediatric surgery: that of global paediatric surgery and the provision of surgical services in constrained settings, with a focus on populations that are ordinarily neglected and vulnerable. It outlines challenges that give rise to disparities in outcome, such as lack of human resources, infrastructure, and equipment, as well as potential solutions. We have included individual sections from areas falling under the umbrella term global paediatric surgery to highlight variation and contrast different needs and requirements. So, specifics of paediatric surgery in regions, such as West Africa, East Africa, South Africa, and India are highlighted.
{"title":"Tropical and overseas surgery","authors":"","doi":"10.1093/med/9780198798699.003.0013","DOIUrl":"https://doi.org/10.1093/med/9780198798699.003.0013","url":null,"abstract":"This chapter looks at a new aspect of paediatric surgery: that of global paediatric surgery and the provision of surgical services in constrained settings, with a focus on populations that are ordinarily neglected and vulnerable. It outlines challenges that give rise to disparities in outcome, such as lack of human resources, infrastructure, and equipment, as well as potential solutions. We have included individual sections from areas falling under the umbrella term global paediatric surgery to highlight variation and contrast different needs and requirements. So, specifics of paediatric surgery in regions, such as West Africa, East Africa, South Africa, and India are highlighted.","PeriodicalId":7519,"journal":{"name":"African Journal of Paediatric Surgery","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80253360","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 : 2019-11-01DOI: 10.1093/med/9780199699476.003.0021
R. Corbridge, N. Steventon
This chapter describes and illustrates key common operations in the paediatric patient. These include circumcision, the drainage of soft tissue abscesses, common nerve injuries, open and laparoscopic inguinal hernia repair, orchidopexy and scrotal exploration, laparotomy, minimally invasive access, pyloromyotomy, laparoscopic fundoplication, appendicectomy, intestinal anastomosis and stomas, and thoracotomy and thoracoscopy. The aim was to include a structured approach to guide the junior trainee in their performance—given that all operations no matter how complex they appear initially are simply a series of steps which when taken together lead to a logical whole. Though obviously not common, the principles behind robotic surgery are described.
{"title":"Common operations","authors":"R. Corbridge, N. Steventon","doi":"10.1093/med/9780199699476.003.0021","DOIUrl":"https://doi.org/10.1093/med/9780199699476.003.0021","url":null,"abstract":"This chapter describes and illustrates key common operations in the paediatric patient. These include circumcision, the drainage of soft tissue abscesses, common nerve injuries, open and laparoscopic inguinal hernia repair, orchidopexy and scrotal exploration, laparotomy, minimally invasive access, pyloromyotomy, laparoscopic fundoplication, appendicectomy, intestinal anastomosis and stomas, and thoracotomy and thoracoscopy. The aim was to include a structured approach to guide the junior trainee in their performance—given that all operations no matter how complex they appear initially are simply a series of steps which when taken together lead to a logical whole. Though obviously not common, the principles behind robotic surgery are described.","PeriodicalId":7519,"journal":{"name":"African Journal of Paediatric Surgery","volume":"121 1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89402198","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}
This chapter covers the general considerations in safely and effectively performing paediatric surgery. It starts with the ethical and legal requirements, including withdrawal of treatment, treating children in the Jehovah’s Witness faith, and safeguarding. It then outlines evidence-based medicine, including meta-analysis, statistics, and reporting trials. Transport of the sick child, anaesthesia, analgesia, intensive care, sepsis, and the use of antibiotics in children are all covered. Day-case surgery, from its history to indications, pre- and postoperative care, and proper documentation, is described. Pre-assessment, care of the neurologically impaired child, basics of vascular access and radiology, and nutrition in the surgical patient are all covered.
{"title":"General considerations","authors":"Kate E. Huntley","doi":"10.7312/hunt91144-004","DOIUrl":"https://doi.org/10.7312/hunt91144-004","url":null,"abstract":"This chapter covers the general considerations in safely and effectively performing paediatric surgery. It starts with the ethical and legal requirements, including withdrawal of treatment, treating children in the Jehovah’s Witness faith, and safeguarding. It then outlines evidence-based medicine, including meta-analysis, statistics, and reporting trials. Transport of the sick child, anaesthesia, analgesia, intensive care, sepsis, and the use of antibiotics in children are all covered. Day-case surgery, from its history to indications, pre- and postoperative care, and proper documentation, is described. Pre-assessment, care of the neurologically impaired child, basics of vascular access and radiology, and nutrition in the surgical patient are all covered.","PeriodicalId":7519,"journal":{"name":"African Journal of Paediatric Surgery","volume":"105 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"1931-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78750387","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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