Assuntos
Carcinoma Hepatocelular/diagnóstico por imagem , Doença de Depósito de Glicogênio Tipo I/complicações , Neoplasias Hepáticas/diagnóstico por imagem , Adolescente , Biomarcadores/sangue , Carcinoma Hepatocelular/sangue , Carcinoma Hepatocelular/etiologia , Carcinoma Hepatocelular/cirurgia , Feminino , Fundoplicatura/métodos , Hepatectomia/métodos , Humanos , Neoplasias Hepáticas/sangue , Neoplasias Hepáticas/etiologia , Neoplasias Hepáticas/cirurgia , Precursores de Proteínas/sangue , Protrombina , Resultado do Tratamento , Ultrassonografia/métodosRESUMO
This is the first case report describing a laparoscopic fundoplication in a child with an intrathecal Baclofen pump which was inserted because of severe spasticity secondary to cerebral palsy. The child had symptoms of gastroesophageal reflux with recurrent episodes of aspiration pneumonia. These were managed with a gastrostomy and conservative therapy with no success. The presence of an intrathecal Baclofen pump makes abdominal surgery challenging and carries the risk of pump infection with its associated sequelae. However, we performed a successful laparoscopic fundoplication with no intraoperative complications and the child was asymptomatic at 18 months follow-up.
Assuntos
Baclofeno , Paralisia Cerebral , Fundoplicatura , Refluxo Gastroesofágico , Laparoscopia , Paralisia Cerebral/complicações , Criança , Refluxo Gastroesofágico/complicações , Refluxo Gastroesofágico/tratamento farmacológico , Refluxo Gastroesofágico/cirurgia , HumanosRESUMO
PURPOSE: Treatment strategies and clinical outcomes of subglottic stenosis (SGS) in children are varied due to the degree and range of stenotic lesions. The optimal surgical procedure for SGS in children is still under debate. The aim of this study was to evaluate the clinical outcomes of our anterior-posterior cricoid (APC) split technique combined with long-term T-tube stenting for grade II or III SGS in children. METHODS: A retrospective chart review of children with SGS between January 2011 and December 2016 was conducted. APC split was performed via open procedure under rigid bronchoscopy. After splitting, a silastic T-tube was inserted as a stent and removed 6 months postoperatively. RESULTS: Seven children underwent APC split during the period. All children had undergone previous tracheostomy, and APC split was performed when the children were 3-9 years old without any intraoperative complications. Median duration of T-tube stenting was 11 months, and all children were decannulated successfully. There were T-tube-related complications, including two tube-tip granulation that required intervention and one accidental T-tube removal. CONCLUSION: APC split is a technically simple and reproducible procedure, and it could be employed as an optimal procedure for SGS in children.
Assuntos
Cartilagem Cricoide/cirurgia , Laringoestenose/cirurgia , Stents , Broncoscopia/métodos , Criança , Pré-Escolar , Cartilagem Cricoide/diagnóstico por imagem , Remoção de Dispositivo , Feminino , Humanos , Laringoestenose/diagnóstico por imagem , Masculino , Período Pós-Operatório , Estudos Retrospectivos , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
OBJECTIVE: Pericatheter leakage is a catheter-related complication of peritoneal dialysis (PD). To prevent pericatheter leakage, a modified technique of PD catheter insertion with fibrin glue was performed in 19 children. METHODS: At the time of PD catheter insertion, as much fibrin glue as possible was injected into the subcutaneous tissue along the tunneled segment of the catheter and then the skin was compressed. RESULTS: There was no occurrence of pericatheter leakage and full PD could be initiated 1 day (median) after implantation. CONCLUSIONS: This technique prevented pericatheter leakage completely even in smaller-weight infants and will enable initiation of full PD with no break-in period.