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1.
Pediatr Surg Int ; 39(1): 148, 2023 Mar 07.
Article in English | MEDLINE | ID: mdl-36881201

ABSTRACT

OBJECTIVE: Our goal was to compare laparoscopic portoenterostomy versus open portoenterostomy for the treatment of biliary atresia. MATERIALS AND METHODS: Using the databases EMBASE, PubMed, and Cochrane, we carried out a thorough literature search up to 2022. Studies comparing laparoscopic and open surgery for the treatment of biliary atresia were included. RESULTS: Twenty-three studies comparing laparoscopic portoenterostomy (LPE) (n = 689) and open portoenterostomy (OPE) (n = 818) were considered appropriate for meta-analysis. Age at surgery time was lower in the LPE group than OPE group (I2 = 84%), (WMD - 4.70, 95% CI - 9.14 to - 0.26; P = 0.04). Significantly decreased blood loss (I2 = 94%), (WMD - 17.85, 95% CI - 23.67 to - 12.02; P < 0.00001) and time to feed were found in the laparoscopic group (I2 = 97%), (WMD - 2.88, 95% CI - 4.71 to - 1.04; P = 0.002). Significantly decreased operative time was found in the open group (I2 = 85%), (WMD 32.52, 95% CI 15.65-49.39; P = 0.0002). Weight, transfusion rate, overall complication rate, cholangitis, time to drain removal, length of stay, jaundice clearance, and two-year transplant-free survival were not significantly different across the groups. CONCLUSIONS: Laparoscopic portoenterostomy provides advantages regarding operative bleeding and the time to begin feeding. No differences in remain characteristics. Based on the data presented to us by this meta-analysis, LPE is not superior to OPE in terms of overall results.


Subject(s)
Biliary Atresia , Cholangitis , Laparoscopy , Humans , Biliary Atresia/surgery , Portoenterostomy, Hepatic , Databases, Factual
2.
Pediatr Surg Int ; 37(6): 807-813, 2021 Jun.
Article in English | MEDLINE | ID: mdl-33856512

ABSTRACT

BACKGROUND: The aim of this study was to present our experience in the use of crystallized phenol (CP) to treat pediatric patients with 'simple' and complex' Pilonidal sinus disease (PSD). MATERIALS AND METHODS: Patients who underwent CP treatment in between January 2015 and January 2020 were evaluated retrospectively, using prospectively collected data. The patients were divided into simple and complicated groups. The groups were assigned depending on the number of sinuses and clinical presentation. The groups were compared in terms of age, sex, number of sessions, cost analysis, body mass index (BMI), recurrence, time resolution, cosmetic results, results /improvement, and complications. RESULTS: This study included 54 patients: 28 (52%) girls and 26 (48%) boys. The mean number of sinuses was 2.4. Symptoms included discharge in 50 (92%) patients, and pain in 42 (78%) patients. Fifty (93%) patients experienced mild pain during the procedure, whereas four (7%) patients had moderate pain. The mean number of CP sessions was 2.9; mean numbers of CP sessions were 2.2 and 4.2 in the Simple and Complicated groups. In total, 5 of 54 patients (9%) had recurrence.At the end of treatment, therapeutic success was achieved in 49 of 54 (91%) patients: 31 of 33 (94%) patients in the Simple group and 18 of 21 patients (86%) in the complicated group. The mean treatment cost for the whole cohort was $17.40. One patient (2%) presented with moderate skin burns. Cosmesis was deemed acceptable by patients, although there was evidence of minor skin burns following the procedure. CONCLUSIONS: The findings showed that the CP procedure was advantageous for treatment of PSD, because it was minimally invasive, cost-effective, provided good cosmesis, and had a high success rate and low complication rate. Furthermore, it did not require prior examination, and could be performed under local anesthesia. Therefore, the CP procedure may be useful as a first-line treatment option in children with PSD.


Subject(s)
Phenol/therapeutic use , Pilonidal Sinus/drug therapy , Adolescent , Child , Cohort Studies , Female , Humans , Male , Recurrence , Retrospective Studies , Sclerosing Solutions/therapeutic use , Treatment Outcome
5.
Pediatr Surg Int ; 32(11): 1067-1073, 2016 Nov.
Article in English | MEDLINE | ID: mdl-27666540

ABSTRACT

AIM: The objective of the present study was to evaluate the diagnostic methods, concomitant organ injuries, factors affecting mortality and morbidity, treatment methods, and outcomes of patients treated for traumatic gastrointestinal (GI) perforation. MATERIALS AND METHODS: We conducted a retrospective review of the medical records of 96 patients who had been treated for GI perforation between January 2000 and October 2015. Data were collected and organised according to the following categories: general patient information, age, gender, hospitalisation period, trauma mechanisms, concomitant injuries, radiological assessment, diagnosis and treatment methods, treatment forms, and complications. The cases were divided into two groups, blunt and penetrating traumas, and the patients within each group were compared. Colorectal trauma cases were not included in this study. Patients suspected of a GI perforation were assessed by standing plain abdominal radiograph (SPAR) and ultrasound scan (US). Patients who had a normal SPAR, and showed free or viscous fluid in the abdomen on US underwent computed tomography (CT) scanning. Surgery was performed if patients displayed free air in the abdomen on a SPAR or CT scan, showed viscous fluid without any additional injury, provided normal radiological images but displayed signs of peritonitis, or were clinically unstable. The patients were scored according to the Injury Severity Score (ISS) system. RESULTS: In total, 96 patients, with an average age of 10.3 ± 4 years (1-17 years) and diagnosed with a GI perforation, were reviewed retrospectively. The patients included 88 (91 %) males and 8 (9 %) females. The presence of free air on SPAR was detected in 42 (52 %) patients, whereas no free air was detected in 39 (48 %) patients. Non-specific significant findings were detected in 45 (76 %) out of 59 patients by USS, and in 78 % of patients by CT (viscous fluid, fluid, free air). The most affected organ was the ileum, which was detected in 37 (39 %) patients. Primary repair was performed on 71 (74 %) patients, while resection was performed on 22 (23 %); 3 (3 %) patients underwent an ostomy. Ten (10 %) patients experienced complications and five (5 %) patients died. The ISS scores for blunt and penetrating traumas were 14, 15 and no significant difference was detected between the scores (p > 0.05). CONCLUSIONS: Although the complication rate for patients with penetrating trauma was higher than for those with blunt trauma, the rate of mortality increased in patients with blunt trauma. Free air may not be detected by SPAR even if a GI perforation exists. Since diagnostic challenges may increase the rate of mortality and morbidity in GI perforations, we believe that a combination of radiological imaging and rapid abdominal examination is important in cases where SPAR cannot detect free air.


Subject(s)
Abdominal Injuries/surgery , Intestinal Perforation/surgery , Wounds, Nonpenetrating/surgery , Wounds, Penetrating/surgery , Abdominal Injuries/diagnostic imaging , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Intestinal Perforation/diagnostic imaging , Male , Retrospective Studies , Tomography, X-Ray Computed , Treatment Outcome , Ultrasonography , Wounds, Nonpenetrating/complications , Wounds, Nonpenetrating/diagnostic imaging , Wounds, Penetrating/diagnostic imaging
6.
Pediatr Surg Int ; 32(1): 97-9, 2016 Jan.
Article in English | MEDLINE | ID: mdl-26527581

ABSTRACT

Infantile fibrosarcoma is a very rare soft tissue tumor that originates most commonly in the body and extremities. We present a neonate with an infantile fibrosarcoma that originated in the ileocecal region and was detected incidentally without symptoms. This is the first case of fibrosarcoma reported in the ileocecal region.


Subject(s)
Cecal Neoplasms/diagnosis , Cecal Neoplasms/surgery , Fibrosarcoma/diagnosis , Fibrosarcoma/surgery , Ileal Neoplasms/diagnosis , Ileal Neoplasms/surgery , Cecal Neoplasms/congenital , Cecum/diagnostic imaging , Cecum/pathology , Cecum/surgery , Diagnosis, Differential , Fibrosarcoma/congenital , Humans , Ileal Neoplasms/congenital , Ileum/diagnostic imaging , Ileum/pathology , Ileum/surgery , Infant, Newborn , Magnetic Resonance Imaging , Male , Ultrasonography
7.
Pediatr Surg Int ; 32(6): 559-63, 2016 Jun.
Article in English | MEDLINE | ID: mdl-26857478

ABSTRACT

BACKGROUND: There are insufficient data on pre-screening for pancreatic pseudocysts (PC) following pancreatic trauma. This study investigated the use of radiological and laboratory testing for predicting the development of pancreatic pseudocysts after trauma. MATERIALS AND METHODS: The clinical records of all pediatric patients presenting with pancreatic trauma between January 2003 and December 2014 were reviewed retrospectively. Patients with American Association for the Surgery of Trauma (AAST) scores of Grade 3-5 were enrolled. The patients were divided into groups that developed [Group 1 (n = 20)] and did not develop [Group 2 (n = 18)] PC. The patients were evaluated in terms of their baseline characteristics, additional injuries, Injury Severity Score (ISS), pancreatic injury site, blood amylase levels 2 h and 10-15 days after the trauma, clinical presentation, and duration of intensive care unit (ICU) stay. FINDINGS: We followed 38 patients. Of the patients in Group 1, 70 % had an injury to the tail of the pancreas. The ISS trauma scores and durations of hospitalization and ICU stay were significantly greater in Group 2 (p < 0.05). The mean blood amylase level on Day 1 was 607 U/L (range 183-801 U/L) in Group 1 and 314 U/L (range 25-631 U/L) in Group 2; the respective levels on Day 10 were 838 U/L (range 123-2951 U/L) and 83.2 U/L (range 35-164 U/L). The serum amylase levels were significantly higher (p < 0.001) in Group 1 than in Group 2 on Days 1 and 10. Four patients developed complications and two patients died. CONCLUSION: Pancreatic pseudocyst formation is more likely in patients with AAST Grade 3 pancreatic injury, also serum amylase levels ten times greater than normal 2 h after the trauma, and persistently elevated serum amylase levels 10-15 days following the trauma.


Subject(s)
Abdominal Injuries/complications , Pancreatic Pseudocyst/etiology , Wounds, Nonpenetrating/complications , Abdominal Injuries/diagnosis , Adolescent , Child , Female , Humans , Injury Severity Score , Male , Pancreas/surgery , Pancreatic Pseudocyst/diagnosis , Retrospective Studies , Tomography, X-Ray Computed , Wounds, Nonpenetrating/diagnosis
8.
Pediatr Radiol ; 45(1): 55-61, 2015 Jan.
Article in English | MEDLINE | ID: mdl-25064187

ABSTRACT

BACKGROUND: Acoustic radiation force impulse (ARFI) imaging is a promising method for noninvasive evaluation of the renal parenchyma. OBJECTIVE: To investigate the contribution of ARFI quantitative US elastography for the detection of renal damage in kidneys with and without vesicoureteral reflux (VUR). MATERIALS AND METHODS: One hundred seventy-six kidneys of 88 children (46 male, 42 female) who had been referred for voiding cystourethrography and 20 healthy controls were prospectively investigated. Patients were assessed according to severity of renal damage on dimercaptosuccinic acid (DMSA) scintigraphy. Ninety-eight age- and gender-matched healthy children constituted the control group. Quantitative shear wave velocity (SWV) measurements were performed in the upper and lower poles and in the interpolar region of each kidney. DMSA scintigraphy was performed in 62 children (124 kidneys). Comparisons of SWV values of kidneys with and without renal damage and/or VUR were done. RESULTS: Significantly higher SWV values were found in non-damaged kidneys. Severely damaged kidneys had the lowest SWV values (P < 0.001). High-grade (grade V-IV) refluxing kidneys had the lowest SWV values, while non-refluxing kidneys had the highest values (P < 0.05). Significant negative correlations were found between the mean quantitative US elastography values and DMSA scarring score (r = -0.788, P < 0.001) and VUR grade (r = -0.634, P < 0.001). SWV values of the control kidneys were significantly higher than those of damaged kidneys (P < 0.05). CONCLUSION: Our findings suggest decreasing SWV of renal units with increasing grades of vesicoureteric reflux, increasing DMSA-assessed renal damage and decreasing DMSA-assessed differential function.


Subject(s)
Acute Kidney Injury/diagnostic imaging , Elasticity Imaging Techniques/methods , Image Interpretation, Computer-Assisted/methods , Kidney/diagnostic imaging , Vesico-Ureteral Reflux/diagnostic imaging , Acute Kidney Injury/etiology , Adolescent , Child , Female , Humans , Infant , Male , Reproducibility of Results , Sensitivity and Specificity , Vesico-Ureteral Reflux/complications
9.
J Pak Med Assoc ; 64(7): 826-7, 2014 Jul.
Article in English | MEDLINE | ID: mdl-25255595

ABSTRACT

Meckel's diverticulum (MD) is a congenital disorder of the gastrointestinal tract that is usually asymptomatic. Perforation of an MD by foreign bodies is an extremely rare cause of acute abdomen in children. We present a rare case of perforation of an MD in a child after eating melon seeds. The patient was treated successfully with segmental resection and primary anastomosis and had an uneventful postoperative recovery.


Subject(s)
Foreign Bodies/complications , Intestinal Perforation/etiology , Meckel Diverticulum , Child , Cucurbitaceae , Foreign Bodies/surgery , Humans , Ileum/injuries , Ileum/surgery , Intestinal Perforation/surgery , Male , Meckel Diverticulum/surgery , Seeds
10.
J Pediatr Surg ; : 161934, 2024 Sep 14.
Article in English | MEDLINE | ID: mdl-39307596

ABSTRACT

OBJECTIVE: This study aims to evaluate the safety and efficacy of platelet-rich plasma (PRP) as an adjuvant to crystallized phenol (CP) in treating pediatric pilonidal sinus disease (PSD). METHODS: A single-center randomized controlled trial was conducted at Istanbul Esenyurt Hospital. Eighty-seven patients aged 0-18 were randomly assigned to two groups: the CP group (n = 42) and the CP + PRP group (n = 45). Upon arrival at the clinic, patients began a regimen of manual shaving and, if necessary, laser epilation every 6-8 weeks. For those with pilonidal abscesses, incision, drainage, and antibiotics were given. The treatment area was sterilized and numbed with local anesthesia. Hair removal and curettage were performed, followed by the application of crystallized phenol. In CP + PRP group, PRP injections were also administered. The procedure concluded with wound dressing and thorough disinfection. The study was registered https://clinicaltrials.gov/ (NCT06324656). RESULTS: The CP + PRP group demonstrated significantly shorter healing times (19.4 ± 7.88 days) compared to the CP group (30.7 ± 12.9 days) (p < 0.001). The cosmetic score was higher in the CP + PRP group (7.42 ± 1.61) than in the CP group (6.11 ± 1.88, p = 0.001). CP + PRP group had lower VAS scores at measured all-time points after applications (p < 0.05 for each). Complications were comparable between the groups, with no significant differences in bleeding, infections, or skin burns (p > 0.05 for each comparison). No difference was found between groups in terms of total complication rate (p = 0.398). The success rate was higher in CP + PRP group (98%; n = 44) compared to CP group (86%; n = 36) (p = 0.039). Recurrence rates were lower in CP + PRP group (2%; n = 1) than CP group (14%; n = 6) (p = 0.039). CONCLUSION: The autologous PRP injection in pediatric PSD is safe. The addition of PRP to CP treatment for pediatric PSD significantly improves healing time, cosmetic outcomes, and overall success rates without increasing complication rates. This combined approach offers a promising alternative for effective and efficient treatment of PSD in children. TYPE OF THE STUDY: Randomized controlled trial. LEVEL OF EVIDENCE: Level I.

11.
J Pediatr Surg ; 59(6): 1089-1093, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38220555

ABSTRACT

OBJECTIVE: Our goal was to compare single-incision laparoscopic percutaneous and cystoscope forceps-assisted Morgagni hernia repair techniques. MATERIALS AND METHODS: A total of 40 patients were allocated to two groups, each with 20 patients. Group 1: Single incision (port) laparoscopic surgical percutaneous Morgagni hernia repair (with a 5 mm Storz laparoscopic scope entered through the umbilicus). Group 2: Single incision (port) laparoscopic surgical percutaneous Morgagni hernia repair (with an 11 Fr [3.6 mm] cystoscope entered through the umbilicus + using forceps + sac plication, and sac cauterization). In Group 1; the sac was not removed. In group 2; we advanced the forceps through the cystoscope, caught the sac, pushed the needle through the sac, plicated the sac, and then cauterized the sac with Bugbee electrode. RESULTS: Of the 40 patients, 70 % (n = 28) were male. The symptoms at admission included repeated chest infections (40 %), dyspnea (30 %), vomiting (22 %), and abdominal pain (22 %). No difference was found between groups in terms of age, gender symptomatology, or associated anomalies. The operation time was shorter in group 2 compared to group 1 (p < 0.05; 25 min vs 40 min). Although there was one recurrence in Group 1, no recurrence was reported in Group 2. The recurrence incidence did not differ between groups (p > 0.05). CONCLUSIONS: Cystoscope-assisted repair of Morgagni hernia was found to be superior in terms of safety and shorter operation time. LEVEL OF EVIDENCE: Type III. TYPE OF THE STUDY: Retrospective study.


Subject(s)
Herniorrhaphy , Laparoscopy , Humans , Female , Laparoscopy/methods , Male , Herniorrhaphy/methods , Herniorrhaphy/instrumentation , Hernias, Diaphragmatic, Congenital/surgery , Child , Treatment Outcome , Operative Time , Child, Preschool , Surgical Instruments , Retrospective Studies
12.
J Pediatr Surg ; : 161933, 2024 Sep 14.
Article in English | MEDLINE | ID: mdl-39358072

ABSTRACT

BACKGROUND: We conducted a systematic review and meta-analysis to evaluate the safety and effectiveness of laparoscopic surgery (LS) compared to open surgery (OS) for congenital duodenal obstruction (CDO). METHODS: We conducted a literature review to find studies comparing LS and OS in neonates with CDO. A meta-analysis was conducted to systematically compile and compare factors, including surgical duration, time of feeding initiation, hospital length of stay (LOS), and postoperative complications. RESULTS: Eleven studies with 1615 patients (LS: 338, OS: 1277) met inclusion criteria. Operative time was observed to be much shorter in the OS group (I2 = 97%); weighted mean difference (WMD) 60.29; 95% confidence interval (CI): 30.29 to 90.28; p < 0.0001). The LS group had a significantly shorter time to initiate feeding (I2 = 0%; WMD -3.38, 95% CI: -4.35 to -2.41; p < 0.00001), shorter time to full feeding (I2 = 0%; WMD -3.64, 95% CI: -5.06 to -2.22; p < 0.00001), and shorter LOS (I2 = 52%; WMD -3.42, 95% CI: -5.75 to -1.08; p = 0.004). There were no significantly differences in the rates of anastomotic leak (I2 = 24%; OR 0.76, 95% CI: 0.12 to 4.67; p = 0.76), anastomotic stricture (I2 = 0%; OR 1.12, 95% CI: 0.39 to 3.20; p = 0.83), postoperative ileus (I2 = 0%; OR 0.60, 95% CI: 0.21 to 1.74; p = 0.34), and overall complications between the groups (I2 = 59%; OR 0.86, 95% CI: 0.42 to 1.74; p = 0.68). The LS group, however, had a significantly decreased frequency of wound infection (I2 = 0%; OR 0.26, 95% CI: 0.08 to 0.82; p = 0.02). CONCLUSION: Despite certain limitations in our analysis, the laparoscopic approach was associated with comparable postoperative outcomes. LEVELS OF EVIDENCE: 2a. TYPE OF THE STUDY: Meta analysis.

13.
Pediatr Surg Int ; 29(6): 571-4, 2013 Jun.
Article in English | MEDLINE | ID: mdl-23417545

ABSTRACT

PURPOSE: Amyand's hernia is a very rare type of hernia and is characterised by the presence of a vermiform appendix in the inguinal hernia sac. It may present as a tender inguinal or inguinoscrotal swelling, and is usually misdiagnosed as an irreducible or strangulated inguinal hernia. This is a presentation of our experiences with these unusual hernias. METHODS: This study conducted a retrospective analysis of 21 patients with Amyand's hernias operated on at our institution between April 2007 and February 2011. The age and sex distributions of the patients, the types of hernias, and preoperative diagnostic tests were evaluated. RESULTS: Twenty patients were male (95.3 %) and one was female (4.7 %). The median age was 20.3 months (ranging from 2 months to 10 years). In nine patients, the conditions were diagnosed using ultrasonographic (USG) imaging preoperatively. Nine of the 21 patients underwent emergency operations. The 12 remaining patients were operated on after preparations were completed. The operative findings included 12 normal appendixes, five inflamed appendixes, one perforated appendix, and three hernias whose inner hernia sac surface was adhered to the appendix. Nine patients underwent inguinal hernia repair with appendectomy, and 12 patients had hernia repair without an appendectomy. Recurring hernias and appendicitis were not detected in any patients within the follow-up time. CONCLUSIONS: Although a routine appendectomy is not required for a normal-looking appendix, in a case where the inflammatory status of the appendix adheres to the surface of the hernia sac, an appendectomy is required. We believe that USG examination in the diagnosis of Amyand's hernias can provide additional contribution.


Subject(s)
Appendectomy/methods , Appendix/diagnostic imaging , Hernia, Inguinal/epidemiology , Herniorrhaphy/methods , Appendix/surgery , Child , Child, Preschool , Diagnosis, Differential , Female , Follow-Up Studies , Hernia, Inguinal/diagnostic imaging , Hernia, Inguinal/surgery , Humans , Incidence , Infant , Male , Retrospective Studies , Turkey/epidemiology , Ultrasonography
14.
Ann Ital Chir ; 94: 231-239, 2023.
Article in English | MEDLINE | ID: mdl-37530047

ABSTRACT

BACKGROUND/PURPOSE: This study analyzed factors that affect mortality in patients surgically treated for EA, then explored the long-term problems encountered by these patients. MATERIALS AND METHODS: Among 252 patients with EA who were either diagnosed, treated, and subsequently followed at the Department of Pediatric Surgery, Dicle University Medical Faculty Hospital, or were treated surgically elsewhere but followed at our center, between January 2010 and January 2020,214 patients were included in the study. RESULTS: Early complications:One or more early complications were observed in 132(62.5%) of the 211 patients who underwent surgical EA repair. The most common early complication was AS, which developed in 106(50.2%) patients. Anastomosis leakage. Was detected in 48 (22.7%) patients. Late complications: The late findings of 161 patients who underwent definitive surgery and had a mean follow-up period of 68 months (range, 6-120 months) were evaluated. The most common late complication was GER. MORTALITY: Of the 214 patients in our study, 63(29.4%) died, including 48(76.2%) during the early period after the first surgery. Of the 10(15.9%) patients who died during the late period. CONCLUSION: In our study, the most common early complication was anastomotic stenosis in patients with esophageal atresia. We recommend balloon dilation in the treatment of anastomotic stenosis.Gastroesophageal reflux is the most common long-term complication. Most of these can be treated conservatively and medically. The association of low birth weight, cardiac anomalies, prematurity and VACTERL increased mortality in patients with esophageal atresia in our study. KEY WORDS: Esophageal Atresia, Morbidity, Late Period, Mortality, Tracheoesophageal Fistula.


Subject(s)
Esophageal Atresia , Gastroesophageal Reflux , Tracheoesophageal Fistula , Humans , Child , Tracheoesophageal Fistula/surgery , Tracheoesophageal Fistula/complications , Esophageal Atresia/surgery , Esophageal Atresia/complications , Constriction, Pathologic/etiology , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Postoperative Complications/surgery , Anastomotic Leak/etiology , Gastroesophageal Reflux/surgery , Gastroesophageal Reflux/etiology , Anastomosis, Surgical/adverse effects , Retrospective Studies , Treatment Outcome
15.
Ulus Travma Acil Cerrahi Derg ; 29(12): 1344-1350, 2023 Dec.
Article in English | MEDLINE | ID: mdl-38073455

ABSTRACT

BACKGROUND: This study aimed to investigate whether Passiflora Incarnata (PI) has a protective effect against ischemia-reperfu-sion (IR)-induced oxidative and inflammatory ovarian damage. METHODS: The effects of PI on ovarian ischemia-reperfusion injury were investigated in female Wistar albino rats. The animals were randomly divided into three groups: Group 1 (sham), Group 2 (IR), and Group 3 (IR+PI). RESULTS: The mean levels of Malondialdehyde (MDA), Myeloperoxidase (MPO), and Total Oxidant Status (TOS) were higher in the IR group (p=0.025, p<0.001, and p=0.016, respectively). The Total Antioxidant Status (TAS) levels were lower in the IR group (p=0.005). Immunostaining revealed significant differences across the groups for Tumor necrosis factor-alpha (TNF-α): 13.84%, 49.51%, and 22.51% for Groups 1, 2, and 3, respectively (p<0.01). Bax: 10.53%, 46.74%, and 26.46% for Groups 1, 2, and 3, respectively (p<0.01). Annexin V: 12.24%, 44.86%, and 23.28% for Groups 1, 2, and 3, respectively (p<0.01). The mean scores for hemorrhage, inflammation, follicular degeneration, and congestion showed significant variations among the groups, all registering p<0.001. CONCLUSION: Passiflora Incarnata exhibited antioxidant, anti-inflammatory, and anti-apoptotic properties, promoting cell survival, histologically protecting ovarian tissue, and ameliorating IR injury by reducing oxidative stress.


Subject(s)
Passiflora , Reperfusion Injury , Humans , Rats , Female , Animals , Antioxidants/pharmacology , Rats, Wistar , Ovarian Torsion , Oxidative Stress , Reperfusion Injury/drug therapy , Reperfusion Injury/prevention & control , Reperfusion Injury/pathology , Ischemia
16.
Urol Res ; 40(6): 751-5, 2012 Dec.
Article in English | MEDLINE | ID: mdl-22825747

ABSTRACT

We reviewed our 6 years of experience with endoscopic holmium: yttrium aluminum garnet (YAG) laser lithotripsy for treatment of urinary stones in different locations in 111 children. A retrospective review was performed on endoscopic holmium: YAG laser lithotripsy procedures performed to treat stones in children between March 2006 and March 2012. In total, 120 laser lithotripsy procedures were performed to treat 131 stones in 111 children (80 males and 31 females; age range, 11 months to 16 years; median age, 6 years). Stones were located in the kidney in 48 cases (36.7 %), ureter in 52 (39.7 %), bladder in 21 (16.0 %), and urethra in 10 (7.6 %). Stone size ranged from 4 to 30 mm (mean, 12.8 mm), and anesthesia duration was 10-170 min (mean, 56 min). Forty-four ureters required balloon dilation, and 61 double J stents were inserted. Follow-up ranged from 3 to 75 months (mean, 35 months). Complete stone clearance was achieved at the end of the procedure in 102 (91.9 %) patients (age < 7 years, 93.3 % vs. age ≥ 7 years, 90.2 %; p > 0.05). The success rate was 81.3 % for kidney stones (<10 mm, 90.9 % vs. ≥ 10 mm, 78.4 %; p > 0.05) and 100 % for the ureter, bladder, and urethral stones. Overall success rate with extracorporeal shockwave lithotripsy was 100 %. No major complications were encountered during or after the procedures. These results confirm the effectiveness and safety of holmium laser lithotripsy for treating all urinary stone locations in children of all ages.


Subject(s)
Cystoscopy , Lasers, Solid-State/therapeutic use , Lithotripsy, Laser/methods , Ureteroscopy , Urinary Calculi/therapy , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Lithotripsy, Laser/adverse effects , Male , Retrospective Studies
17.
Pediatr Surg Int ; 28(5): 529-32, 2012 May.
Article in English | MEDLINE | ID: mdl-22270732

ABSTRACT

PURPOSE: Magnetic compression anastomosis is used for gastrointestinal, biliary, and urinary anastomoses. We have developed a simple magnetic compression gastrostomy technique in rats. METHODS: Animals were randomized into two groups (n = 12 each): magnetic gastrostomy (MG) and surgical gastrostomy (SG) (control). In the MG group, a magnetic insertion catheter was coupled with the first magnetic ball and introduced transorally into the stomach. A second magnetic ball was placed subcutaneously into the left upper quadrant. The two magnetic balls (4 mm) were strongly coupled together. On postoperative day (PD) 20 (MG group) and PD10 (SG group), rats were killed, gastrostomies were evaluated macroscopically and histopathologically, and mechanical burst testing was performed. RESULTS: Two animals died due to suspected leaks. Macroscopic evaluation indicated no gastrostomy canal in one rat in each group. Mild adhesion was observed in two rats in the MG group. Moderate adhesion was observed in all rats in the SG group. No significant differences were observed in burst pressure between the two groups (means: MG group, 143 mmHg, n = 9; SG group, 159 mmHg, n = 8). CONCLUSIONS: Magnetic compression gastrostomy can be performed easily in rats, and may be developed in future as a simple alternative to some gastrostomy procedures in humans.


Subject(s)
Gastrostomy/methods , Magnetics , Anastomosis, Surgical , Animals , Prostheses and Implants , Prosthesis Design , Random Allocation , Rats , Statistics, Nonparametric
18.
Ulus Travma Acil Cerrahi Derg ; 26(6): 927-931, 2020 11.
Article in English | MEDLINE | ID: mdl-33107956

ABSTRACT

BACKGROUND: In this study, we aimed to present the results of patients treated for esophageal leakage with a different conservative approach. METHODS: Ninety-eight patients with esophageal atresia and tracheoesophageal fistula (EA) who underwent surgery in our clinic between February 2013 and January 2018 were retrospectively reviewed in this study. Patients' anastomosis leakage, gestational week, gender, body weight, referral date, recovery time and stenosis were recorded. After leakage detection, the nasogastric catheter was fluoroscopically converted into a nasojejunal catheter using a guidewire and feeding continued. RESULTS: Anastomotic leakage developed in 18 (18.3%) patients. The average gestational age at birth was 35.4 weeks; the patients included ten girls and eight boys of average weight 2.41 kg; the average referral period was 2.1 days after birth and the average time of surgery was 2.4 days after birth. The average recovery time was 21.1 days (range: 8-60 days). Eight patients developed stenosis that recovered with dilatation. CONCLUSION: Our findings suggest that our conservative treatment approach, which uses a nasojejunal catheter, is an effective method that would reduce complications, enable earlier feeding, and reduce the cost compared to other treatment approaches.


Subject(s)
Anastomosis, Surgical/adverse effects , Anastomotic Leak/surgery , Esophageal Atresia/surgery , Tracheoesophageal Fistula/surgery , Female , Humans , Infant, Newborn , Male , Retrospective Studies
19.
Exp Clin Transplant ; 17(5): 644-647, 2019 10.
Article in English | MEDLINE | ID: mdl-28411361

ABSTRACT

OBJECTIVES: In this paper, the results of liver transplant due to hepatoblastoma in 10 pediatric patients at Istanbul Sisli Memorial Hospital Transplantation Center are presented. MATERIALS AND METHODS: We retrospectively evaluated medical records of pediatric patients diagnosed with hepatoblastoma and who underwent liver transplant at our clinic between January 2009 and March 2014. We examined age, weight, chemotherapy regimen, graft type for liver transplant, duration of hospital stay, complications, follow-up duration, and survival information. RESULTS: The median age of the 10 patients included in our study was 13.5 months (range, 8-120 mo), and the median weight was 10 kg (range, 6.5-30 kg). Two of the patients were twins. Five patients had pretreatment extent of disease III (centrally placed cases), and five had pretreatment extent of disease IV hepatoblastoma. Preoperative chemotherapy was given to 7 patients as cisplatin plus doxorubicin and to 3 patients per the International Childhood Liver Tumors Strategy Group 3 High-Risk Protocol at external centers. These protocols were administered according to treatment center preference. Nine patients received transplants from living donors. Two grafts were right lobes, and 7 were left lateral segments. In the remaining patient, a whole liver was received from a deceased donor. The histopathologic subgroups were epithelial in 5 patients, with others being of mixed type. Postoperative complications occurred in 3 patients as infection, intra-abdominal fluid collection, and acute rejection. The median follow-up was 32 months. One patient died because of lung metastasis within 9 months after transplant. CONCLUSIONS: Centers should offer liver transplant to patients with centrally located tumors. For centers that have an insufficient number of deceased donors, living-donor liver transplant with optimal planning and early treatment can be performed.


Subject(s)
Hepatoblastoma/surgery , Liver Neoplasms/surgery , Liver Transplantation , Child , Child, Preschool , Female , Humans , Infant , Male , Retrospective Studies , Treatment Outcome
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