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European journal of pediatric surgery : official j... 22건

  1. [해외논문]   Erratum to: Current Management of Congenital Pulmonary Airway Malformations: A “European Pediatric Surgeons' Association” Survey   SCIE

    Morini, Francesco (Department of Medical and Surgical Neonatology, Bambino Gesu Children's Research Hospital, Rome, Italy ) , Zani, Augusto (Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada ) , Conforti, Andrea (Department of Medical and Surgical Neonatology, Bambino Gesu Children's Research Hospital, Rome, Italy ) , van Heurn, Ernest (Department of Pediatric Surgery, AMC/VUMC, Amsterdam, The Netherlands ) , Eaton, Simon (Department of Pediatric Surgery, University College London Institute of Child Health, London, United Kingdom ) , Puri, Prem (Department of Paediatric Surgery, National Children's Research Centre, Dublin, Ireland ) , Rintala, Risto (Department of Paediatric Surgery, Hospital for Children and Adolescents, Helsinki, Finland ) , Lukac, Marija (Division of Medicine, Department of Pediatric Surgery, Belgrade, Serbia ) , Kuebler, Joachim (Department of Pediatric Surgery, Hannover Medical School, Hannover, Niedersachsen, Germany ) , Friedmacher, Florian (National Children's Research Centre, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland ) , Wijnen, Rene (Department of Pediatric Surgery, Sophia Children's Hospital,) , Tovar, Juan , Pierro, Agostino , Bagolan, Pietro
    European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al.] = Zeitschrift für Kinderchirurgie v.28 no.1 ,pp. e1 - e1 , 2018 , 0939-7248 ,

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

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  2. [해외논문]   Current Management of Congenital Pulmonary Airway Malformations: A “European Pediatric Surgeons' Association” Survey   SCIE

    Morini, Francesco (Department of Medical and Surgical Neonatology, Bambino Gesu Children's Research Hospital, Rome, Italy ) , Zani, Augusto (Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada ) , Conforti, Andrea (Department of Medical and Surgical Neonatology, Bambino Gesu Children's Research Hospital, Rome, Italy ) , van Heurn, Ernest (Department of Pediatric Surgery, AMC/VUMC, Amsterdam, The Netherlands ) , Eaton, Simon (Department of Pediatric Surgery, University College London Institute of Child Health, London, United Kingdom ) , Puri, Prem (Department of Paediatric Surgery, National Children's Research Centre, Dublin, Ireland ) , Rintala, Risto (Department of Paediatric Surgery, Hospital for Children and Adolescents, Helsinki, Finland ) , Lukac, Marija (Division of Medicine, Department of Pediatric Surgery, Belgrade, Serbia ) , Kuebler, Joachim (Department of Pediatric Surgery, Hannover Medical School, Hannover, Niedersachsen, Germany ) , Friedmacher, Florian (National Children's Research Centre, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland ) , Wijnen, Rene (Department of Pediatric Surgery, Sophia Children's Hospital,) , Tovar, Juan , Pierro, Agostino , Bagolan, Pietro
    European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al.] = Zeitschrift für Kinderchirurgie v.28 no.1 ,pp. 001 - 005 , 2018 , 0939-7248 ,

    초록

    Aim To define current management of congenital pulmonary airway malformation (CPAM). Methods A total of 181 European Pediatric Surgeons' Association members (91% senior) from 48 countries completed an online questionnaire. Main Results Prenatal: 93% respondents work in centers with prenatal diagnosis facilities, and 27% in centers offering in utero surgery. Prenatal counseling is performed by 86% respondents, 22% of whom see >10 cases per year. Risk of single pre-/postnatal complications is deemed low ( Postnatal: 75% respondents operate on asymptomatic patients, 18% before 6 months of age, 62% between 6 and 12 months of age, and 20% after 12 months of age. Risk of infection (86%), cancer (63%), and symptoms development (62%) are indications for surgery in asymptomatic CPAM. Sixty-three percent prefer a thoracotomy. Lobectomy is the preferred procedure (58% respondents). Motivations against surgery include lesion Conclusion Current pre- and postnatal management of CPAM lacks uniformity, particularly for surgical indication, timing, and approach. Efforts should be made toward standardization. Risk of CPAM-associated cancer is not clear.

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  3. [해외논문]   Management of Polypoid Gallbladder Lesions in Children: A Multicenter Study   SCIE

    Ballouhey, Quentin (Department of Pediatric Surgery, Hôpital des Enfants, Toulouse, France ) , Binet, Auré (Department of Pediatric Surgery, CHU Tours, Tours, France ) , lien (Department of Pediatric Surgery, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, Rhône-Alpes, France ) , Varlet, Franç (Department of Pediatric Surgery, Centre Hospitalier Universitaire de Limoges, Limoges, Limousin, France ) , ois (Department of Pediatric Surgery, Centre Hospitalier Universitaire de Lyon, Lyon, Rhône-Alpes, France ) , Baudry, Manon (Department of Pediatric Surgery, CHU Marseille, Marseille, France ) , Dubois, Ré (Department of Pediatric Surgery, Centre Hospitalier Universitaire d'Angers, Angers, Pays de la Loire, France ) , mi (Department of Pediatric Surgery, Centre Hospitalier Universitaire de Toulouse, Toulouse, Midi-Pyrénées, France ) , Hé (Department of Pediatric Surgery, Centre Hospitalier Universitaire de Rennes, Rennes, Bretagne, France ) , ry, Gé (Department of Pediatric Surgery, CHRU de Brest, Brest, Bretagne, France ) , raldine (Department of Pediatric Surgery, Ho) , Podevin, Guillaume , Abbo, Olivier , Arnaud, Alexis , Barras, Marc , Guerin, Florent , Reinberg, Olivier , Piolat, Christian , Fourcade, Laurent
    European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al.] = Zeitschrift für Kinderchirurgie v.28 no.1 ,pp. 006 - 011 , 2018 , 0939-7248 ,

    초록

    Introduction Polypoid lesions of the gallbladder (PLG) are relatively common in adults, while they are very rare in children. The use of high-quality ultrasonography leads to increased detection of PLG, although less than 20 pediatric cases of primary PLG have been reported in the literature. The aim of this study was to address the experience of PLG management in children. Materials and Methods A retrospective multicenter review of children with ultrasonographically defined PLG between 2006 and 2016 was performed. The data from 12 pediatric surgery centers were compiled for this purpose. Results Eighteen patients (mean age: 10.4 ± 4.1 years) were included and managed according to each center's protocols. Cholecystectomy was performed for nine symptomatic patients. Histopathology conclusively revealed four tubular and five papillary adenomas, with a median size of 12 mm (ranging from 3 to 35 mm). Nine asymptomatic children were monitored by sonography over a 24-month (ranging from 12 to 66 months) follow-up period. The median PLG size was 7 mm (ranging from 3 to 9 mm). Two lesions disappeared after 1 and 2 years of follow-up, respectively. None of the patients developed symptoms or malignant transformation. Conclusion This report confirms appropriate use of a conservative approach with annual clinical and ultrasound follow-up for small-sized and isolated PLG in children given the absence of malignancy and potential vanishing entities. Surgical treatment should be considered in case of lesions larger than 10 mm in size or when they are associated with symptoms.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

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  4. [해외논문]   A Single-Center Experience with Dynamic Compression Bracing for Children with Pectus Carinatum   SCIE

    Poola, Ashwini (Department of Surgery, Children's Mercy Hospital, Kansas City, Missouri, United States ) , Pierce, Amy (Department of Surgery, Children's Mercy Hospital, Kansas City, Missouri, United States ) , Orrick, Beth (Department of Surgery, Children's Mercy Hospital, Kansas City, Missouri, United States ) , Peter, Shawn (Department of Surgery, Center for Prospective Clinical Trials, Children's Mercy Hospital, Kansas City, Missouri, United States ) , Snyder, Charles (Department of Surgery, Children's Mercy Hospital, Kansas City, Missouri, United States ) , Juang, David (Department of Surgery, Children's Mercy Hospital, Kansas City, Missouri, United States ) , Aguayo, Pablo (Department of Surgery, Children's Mercy Hospital, Kansas City, Missouri, United States ) , Fraser, Jason (Department of Surgery, Children's Mercy Hospital, Kansas City, Missouri, United States ) , Holcomb III, George (Department of Surgery, Children's Mercy Hospital, Kansas City, Missouri, United States)
    European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al.] = Zeitschrift für Kinderchirurgie v.28 no.1 ,pp. 012 - 017 , 2018 , 0939-7248 ,

    초록

    Objective Bracing for pectus carinatum (PC) has emerged as an alternative to surgical correction. However, predictive factors for bracing remain poorly understood, as much of the data have been reported from small series. Materials and Methods We reviewed a prospective dataset in patients with PC who underwent dynamic compression bracing (DCB) from July 2011 to July 2016. Bracing was initiated in patients > 10 years of age with a significant PC and desire for bracing. Data were analyzed for those observed two or more times after the brace was fitted to the patient. Results A total of 503 patients were evaluated for PC and 340 (68%) underwent DCB. Eighty-five percent were males with an average age of 14 ± 2 years. There was a positive correlation of age with pressure of initial correction (PIC, r = 0.2). One patient underwent operative correction as the initial therapy. Two hundred seventeen patients had two or more visits after the patient was fitted for the brace. The mean PIC in this cohort was 4 psi (range: 1.5-7.8), and the median duration of bracing in this group was 16 months (IQR: 7-23 months). One hundred three patients (47%) achieved complete correction after an average bracing time of 7.5 months and were then placed in the retainer mode. Thirty patients successfully completed bracing therapy and required an average of 23 months of therapy (2 months-4 years). No patient recurred after bracing was completed, but one failed bracing and required operative correction. Complications included mechanical problems (8%), skin complications (10%), complaints of tightness (3%), and pain (2%). Conclusion DCB has both early and lasting effects in the correction of PC with minimal complications. Predictive factors for successful resolution of the PC include increased duration of DCB and lower initial PIC.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  5. [해외논문]   Non-operative Management for Uncomplicated Appendicitis: An Option to Consider   SCIE

    Abbo, Olivier (Department of Pediatric Surgery, Children's Hospital CHU Toulouse, Toulouse, France ) , Trabanino, Carmen (Department of Pediatric Surgery, Children's Hospital CHU Toulouse, Toulouse, France ) , Pinnagoda, Kalitha (Department of Pediatric Surgery, Children's Hospital CHU Toulouse, Toulouse, France ) , Ait Kaci, Amir (Department of Pediatric Surgery, Children's Hospital CHU Toulouse, Toulouse, France ) , Carfagna, Luana (Department of Pediatric Surgery, Children's Hospital CHU Toulouse, Toulouse, France ) , Mouttalib, Sofia (Department of Pediatric Surgery, Children's Hospital CHU Toulouse, Toulouse, France ) , Combelles, Sophie (Department of Radiology, Hopital des Enfants, Toulouse, Midi-Pyrénées, France ) , Vial, Julie (Department of Pediatric Surgery, Children's Hospital CHU Toulouse, Toulouse, France ) , Galinier, Philippe (Department of General Surgery, Children's Hospital CHU Toulouse, Toulouse, France)
    European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al.] = Zeitschrift für Kinderchirurgie v.28 no.1 ,pp. 018 - 021 , 2018 , 0939-7248 ,

    초록

    Aim The main goal of our study was to assess a 7 days long course of antibiotics for acute uncomplicated appendicitis. Materials and Methods From March 2014 to November 2015, all patients diagnosed with acute appendicitis have been considered to be treated by only antibiotics. Inclusion criteria included clinical (tenderness), biological (C-reactive protein [CRP] 6 mm). All patients were treated with intravenous amoxicillin and clavulanic acid (100 mg/kg/day) for 2 days (six doses). At the end of the treatment, clinical and paraclinical examinations included blood samples at day 7 and ultrasound (US) scan at 3 months. Results A total of 166 patients were treated and followed up prospectively during the study period. Mean age at diagnosis was 10.8 ± 0.6 years. All children, but four were discharged with a clinical improvement after 48 hours and six intravenous antibiotics injection according to our protocol. Four children required surgery during the initial hospitalization period. Initial ultrasound scan showed a mean diameter of 7.85 ± 1.6 mm, with inflamed fat in 124 patients (74.7%). At Day 7, the diameter was 5.2 ± 1.6 mm (p During a median follow-up of 18.8 months (3.5-18), 22 patients (13.25%) had to be managed for a novel episode of acute appendicitis after a median period of 138 days (13-270). None had to be managed for a complicated appendicitis. Conclusion Non-operative treatment (NOT) is a safe alternative for the management of uncomplicated acute appendicitis in children. Further study should be conducted to determine relapse risk factors.

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  6. [해외논문]   Outcomes of Esophageal Replacement: Gastric Pull-Up and Colonic Interposition Procedures   SCIE

    Bradshaw, Catherine (Department of Paediatric Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom ) , Sloan, Keren (Department of Paediatric Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom ) , Morandi, Anna (Department of Paediatric Surgery, Red Cross War Memorial Children's Hospital and Institute of Child Health, Cape Town, Western Cape Province, South Africa ) , Lakshminarayanan, Bhanumathi (Department of Paediatric Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom ) , Cox, Sharon (Department of Paediatric Surgery, Red Cross War Memorial Children's Hospital and Institute of Child Health, Cape Town, Western Cape Province, South Africa ) , Millar, Alastair (Department of Paediatric Surgery, Red Cross War Memorial Children's Hospital and Institute of Child Health, Cape Town, Western Cape Province, South Africa ) , Numanoglu, Alp (Department of Paediatric Surgery, Red Cross War Memorial Children's Hospital and Institute of Child Health, Cape Town, Western Cape Province, South Africa ) , Lakhoo, Kokila (Department of Paediatric Surgery, Oxford Univ)
    European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al.] = Zeitschrift für Kinderchirurgie v.28 no.1 ,pp. 022 - 029 , 2018 , 0939-7248 ,

    초록

    Aim No consensus exists about the optimal surgical technique for esophageal replacement. This study reports the surgical outcomes for the gastric pull-up and the colonic interposition procedures. Materials and Methods A retrospective review of children undergoing esophageal replacement surgery between January 2001 and June 2015 across four different pediatric surgery centers was conducted. Data collected included indications, epidemiology, surgical technique, complications, and outcomes. Patients were divided into group A, those that had a gastric pull-up procedure and group B, those that had a colonic interposition procedure. Results In total, 50 patients were included; 29 in group A and 21 in group B. Indications included esophageal atresia, caustic ingestion, and infective esophageal stricture. The median age at the time of surgery was 13 months. The mean length of follow-up was 5.2 years. Three patients died giving a mortality rate of 6%; 2 in group A and 1 in group B. In both groups, early postoperative complications included infective complications, such as wound infections, sepsis, and pneumonia (11), anastomotic leak (7), and respiratory complications (7). Late complications included adhesive bowel obstruction (2), anastomotic strictures (4), redundancy (1), and jejunostomy problems (1). Septic complications and anastomotic strictures occurred more frequently in group B. Further surgery was needed in eight patients; this was significantly higher in group B. Full oral feeding was achieved within 6 months in 91.5%. Conclusion The gastric pull-up and colonic interposition have comparable mortality and outcomes. The colonic interposition was associated with a higher rate of early septic complications, anastomotic strictures, and need for further surgery.

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    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  7. [해외논문]   Appendiceal Intussusception: A Diagnostic Challenge   SCIE

    Samuk, Inbal (Department of Pediatric Surgery, Schneider Children's Medical Center of Israel, Sackler Faculty of Medicine, Tel Aviv University, Petah Tikva, Israel ) , Nica, Adriana (Department of Pediatric Surgery, Schneider Children's Medical Center of Israel, Sackler Faculty of Medicine, Tel Aviv University, Petah Tikva, Israel ) , Lakovski, Yaniv (Department of Radiology, Schneider Children's Medical Center of Israel, Sackler Faculty of Medicine, Tel Aviv University, Petah Tikva, Israel ) , Freud, Enrique (Department of Pediatric Surgery, Schneider Children's Medical Center of Israel, Sackler Faculty of Medicine, Tel Aviv University, Petah Tikva, Israel)
    European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al.] = Zeitschrift für Kinderchirurgie v.28 no.1 ,pp. 030 - 033 , 2018 , 0939-7248 ,

    초록

    Introduction Appendiceal intussusception is a rare condition in children characterized by an invagination of the appendix into the cecum to various degrees. The treatment is appendectomy; however since symptoms are not specific, clinical diagnosis is challenging and frequently only intraoperative. We present a series of five patients with appendiceal intussusception and discuss features that may direct the pediatric surgeon to achieve early recognition and provide optimal treatment. Materials and Methods The database of a tertiary medical center was retrospectively reviewed for all patients treated for appendiceal intussusception during the period from January 1995 to January 2016. Data collected by chart review included demographics, clinical characteristics, imaging studies, surgical technique, and outcome. The findings were analyzed by descriptive statistics. Results This series included five patients (two females and three males) with ages ranging between 27 and 42 months (mean: 35.2). Patients presented with intermittent abdominal pain (IAP, all five patients), alternate vomiting (three of five patients), alternate diarrhea (two of five patients), fever (two of five patients), and rectal bleeding (one of five patients). The average length of symptoms was 22.6 days. Eighteen diagnostic studies were performed, including abdominal ultrasound for all patients, barium enema for three patients with secondary ileocolic intussusception, and abdominal computed tomography (CT) for one patient. The average number of studies per patient was 3.6. In surgery, the appendiceal intussusception was found to be complete in four patients, whereas it was partial in the remaining patient. In all patients, appendectomy was performed with resection of a small rim of cecal wall due to marked congestion and edema in an attempt to decrease recurrence. Conclusion The mainstay of clinical presentation is intermittent abdominal pain while patients may be completely asymptomatic between attacks. Appendiceal intussusception may act as a leading point to ileocolic intussusception and is frequently concealed by it. The treatment is appendectomy. Both pediatric surgeons and radiologists should be aware of this occurrence to provide adequate management and avoid complications.

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    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  8. [해외논문]   Advantages of Cardiac Magnetic Resonance Imaging for Severe Pectus Excavatum Assessment in Children   SCIE

    Dore, Mariela (Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain ) , Triana Junco, Paloma (Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain ) , Bret, Monserrat (Department of Pediatric Radiology, Hospital Universitario La Paz, Madrid, Spain ) , Gomez Cervantes, Manuel (Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain ) , Muñ (Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain ) , oz Romo, Martha (Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain ) , Jimenez Gomez, Javier (Department of Pediatric Radiology, Hospital Universitario La Paz, Madrid, Spain ) , Perez Vigara, Ana (Department of Pediatric Radiology, Hospital Universitario La Paz, Madrid, Spain ) , Parron Pajares, Manuel (Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain ) , Luis Encinas, Jose (Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain ) , Hernandez, Francisco (Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain ) , Martinez, Leopoldo (Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain ) , Lopez Santamaria, Manuel (Department of Pediatric Surgery, H) , De La Torre, Carlos
    European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al.] = Zeitschrift für Kinderchirurgie v.28 no.1 ,pp. 034 - 038 , 2018 , 0939-7248 ,

    초록

    Aim Cardiac function can be impaired in patients with pectus excavatum (PE) due to anatomic and dynamic compression of the heart. Efforts for radiation dose reduction in imaging techniques have allowed cardiac magnetic resonance imaging (c-MRI) to play a major role in PE assessment. The aim of our study is to describe the findings of c-MRI 18 months after we changed the PE assessment protocol from chest computed tomography to c-MRI. Patients and Methods Since mid-2015 all patients with severe PE (suspected Haller's index > 3.2) were assessed with inspiratory and expiratory c-MRI. A retrospective analysis of these patients was performed evaluating the following parameters: (1) Radiologic PE indexes (Haller's, correction and asymmetry indexes; and sternal rotation) and (2) cardiac function (including left and right ventricle ejection fraction). Results A total of 20 patients met the inclusion criteria. Dynamic imaging showed a significant difference during inspiration and expiration of the Haller's index 3.85 (range: 3.17-7.3) versus 5.10 (range: 3.85-10.8) (p Conclusion Initial results show that PE assessment by c-MRI allows a radiation-free image of the chest wall deformity during the entire breathing process. Also, it permitted the evaluation of the influence of sternum impingement on cardiac function. These findings allowed us a careful surgical evaluation and preoperative planning.

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  9. [해외논문]   Pitfalls in Diagnosis of Early-Onset Inflammatory Bowel Disease   SCIE

    Dore, Mariela (Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain ) , Triana Junco, Paloma (Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain ) , Sá (Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain ) , nchez Galá (Department of Pediatric Gastroenterology, Hospital Universitario La Paz, Madrid, Spain ) , n, Alba (Department of Pediatric Gastroenterology, Hospital Universitario La Paz, Madrid, Spain ) , Prieto, Gerardo (Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain ) , Ramos, Esther (Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain ) , Muñ (Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain ) , oz Romo, Martha (Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain ) , Gó (Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain) , mez Cervantes, Manuel , Herná , ndez, Francisco , Martí , nez, Leopoldo , Ló , pez Santamarí , a, Manuel
    European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al.] = Zeitschrift für Kinderchirurgie v.28 no.1 ,pp. 039 - 043 , 2018 , 0939-7248 ,

    초록

    Aim The onset of inflammatory bowel disease (IBD) in patients younger than the age of 5 years is rare. Moreover, when there is exclusive colonic inflammation, diagnosis can be challenging. Our aim was to describe the difficulties and pitfalls in the diagnosis of early-onset IBD (eoIBD) and their repercussions in treatment decisions. Patients and Methods Patients with eoIBD (Crohn's disease [CD], ulcerative, and unclassified colitis) treated at our center between 1990 and 2016 were studied retrospectively. Demographic, clinical, medical, and surgical treatment data were analyzed. Results A total of 19 patients were diagnosed with eoIBD at 21 (1-46) months of age. Bloody diarrhea, growth failure, and abdominal pain were present in 90, 42, and 16%, respectively. After 9 (1-62) months from the onset, patients were classified as ulcerative colitis (nine), CD (two), and unclassified colitis (eight). Unresponsiveness to medical treatment was observed in 10 and prompted surgical assessment. A partial colectomy was performed in one, and nine underwent a total colectomy (one end stoma and eight ileoanal anastomosis [IAA]). At least one surgical complication occurred in 80% and ultimately six patients with an IAA required an end stoma. Overtime, final diagnosis of 5 out of the 10 surgical patients changed due to biopsy findings, unresponsiveness to medical treatment, or extraintestinal and perianal manifestations. After a 12-year (1-22) follow-up, 57.9% of the diagnoses of all patients were modified. Conclusion EoIBD poses a challenge due to ambiguous presentation and absence of specific diagnostic tests. Surgical evaluation is often needed and surgeons must be mindful of possible initial misdiagnosis, in addition to short- and long-term outcomes before deciding aggressive surgical measures as well as intestinal reconstruction.

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  10. [해외논문]   Initiation of Enteral Feeding After Necrotizing Enterocolitis   SCIE

    Hock, Alison (Division of General and Thoracic Surgery, Translational Medicine Program, SickKids - The Hospital for Sick Children, Toronto, Ontario, Canada ) , Chen, Yong (Division of General and Thoracic Surgery, Translational Medicine Program, SickKids - The Hospital for Sick Children, Toronto, Ontario, Canada ) , Miyake, Hiromu (Division of General and Thoracic Surgery, Translational Medicine Program, SickKids - The Hospital for Sick Children, Toronto, Ontario, Canada ) , Koike, Yuhki (Division of General and Thoracic Surgery, Translational Medicine Program, SickKids - The Hospital for Sick Children, Toronto, Ontario, Canada ) , Seo, Shogo (Division of General and Thoracic Surgery, Translational Medicine Program, SickKids - The Hospital for Sick Children, Toronto, Ontario, Canada ) , Pierro, Agostino (Division of General and Thoracic Surgery, Translational Medicine Program, SickKids - The Hospital for Sick Children, Toronto, Ontario, Canada)
    European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al.] = Zeitschrift für Kinderchirurgie v.28 no.1 ,pp. 044 - 050 , 2018 , 0939-7248 ,

    초록

    Introduction Management of necrotizing enterocolitis (NEC) consists of cessation of enteral feeding, intravenous antibiotic administration, and supportive treatment. There is no evidence-based recommendation regarding when to restart feeding after a NEC episode. We performed a systematic review and meta-analysis to examine the effect of timing of enteral feeding reinitiation on NEC recurrence. Methods MEDLINE, Embase, Google scholar, and Cochrane databases were searched. Human studies evaluating enteral feeding timing with a primary outcome of NEC recurrence were included. A total of 2,257 titles or abstracts were screened, and 47 full-text articles were analyzed. A systematic review and meta-analysis comparing NEC recurrence and other associated outcomes between early ( 5 days) initiation of enteral feeding after NEC were performed according to the PRISMA statement. The meta-analysis data were analyzed using RevMan 5.3 to estimate odds ratios (ORs) with 95% confidence intervals (CIs). Results Two retrospective observational studies met the inclusion criteria, comprising 56 cases in which enteral feeding was started early and 35 cases of delayed enteral feeding initiation. There were no randomized controlled trials (RCTs). The recurrence rates of NEC were unchanged between early (5.4%) and delayed (8.6%) enteral feeding groups (pooled OR = 0.61; 95% CI: 0.12-3.16; p = 0.56; I 2 = 0%). Catheter-related sepsis (pooled OR = 0.20; 95% CI: 0.01-3.29; p = 0.26; I 2 = 67%) and post-NEC stricture (pooled OR = 0.28; 95% CI: 0.07-1.18; p = 0.08; I 2 = 23%) rates were not different between early and delayed enteral feeding groups. Conclusion Initiating early enteral feeding, within 5 days of NEC diagnosis, is not associated with adverse outcomes, including NEC recurrence. In addition, catheter-related sepsis and post-NEC stricture rates were unchanged between early and delayed enteral feeding groups after NEC. However, the quality of the evidence from the review of literature is suboptimal. A further RCT is needed to confirm these results.

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