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J Minim Access Surg ; 2020 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-31929221


Background: Enteric duplication is a congenital anomaly with varied clinical presentation that requires surgical resection for definitive treatment. Ileocaecal (IC) duplications are duplications located at the IC junction, not clearly identified in all the published series. The reported treatment is IC resection and ileocolic anastomosis. The purpose of our study was to present our experience in successfully resection of IC duplication by laparoscope, thus avoiding bowel resection in children. Materials and Methods: A retrospective review was conducted of medical records of 15 patients with diagnosis of IC duplication, treated in the Department of Paediatric Surgery of our hospital, within the period from November 2013 to September 2018. Results: Laparoscopic resection of IC duplication was successfully performed in all children without bowel resection. The operation time was 50-90 min (55 ± 10 min), and the post-operative hospitalization time was 5-7 days (average, 6 days). The 15 patients were followed up for 6-12 months (average, 10 months). No recurrence was found by abdominal ultrasound examination. The wound had small scars with good appearance of umbilicus. Conclusions: The laparoscopic approach allows for confirming the diagnosis and accurately defining the exact site of duplication, as well as for effective and safe treatment. Laparoscopic excision of IC duplication without bowel resection is a safe option and is worth promoting.

Medicine (Baltimore) ; 97(42): e12863, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30334996


RATIONALE: Hepatic hemangioma is the third most common pediatric tumor, and it is rare in the neonatal period. This case study presents a rare case of hepatic hemangioma found in a neonate. PATIENT CONCERNS: A girl who was 18 days of age with the emergence of jaundice and an abdominal mass was admitted for physical examination in the local department. DIAGNOSES: An ultrasound showed that the hepatic left lobe was about 9 cm × 7 cm × 7 cm in size. A CT scan indicated a giant hemangioma in the hepatic left lobe. MRI detected a lesion measuring about 92 mm × 71 mm × 68 mm. INTERVENTIONS: The patient was treated with propranolol 3.5 mg PO bid (body weight 3.8 kg) after 1 week of admission for 4 weeks, but the mass did not appear to regress. Surgery was then performed successfully. OUTCOMES: The patient recovered well without recurrence beyond one year. LESSONS: Imaging strategies and prenatal diagnosis are vital for the diagnosis of infantile hepatic hemangioma. Propranolol is effective in both cutaneous and hepatic multifocal and diffuse hemangioma. Adequate treatment time is necessary to cure the disease. The role of propranolol in massive hepatic hemangioma remains uncertain and needs further investigation.

Hemangioma/diagnóstico , Neoplasias Hepáticas/diagnóstico , Antagonistas Adrenérgicos beta/uso terapêutico , Feminino , Hemangioma/cirurgia , Humanos , Recém-Nascido , Fígado/patologia , Neoplasias Hepáticas/cirurgia , Imagem por Ressonância Magnética , Propranolol/uso terapêutico , Tomografia Computadorizada por Raios X , Ultrassonografia
Cancer Manag Res ; 10: 2125-2139, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30050323


Background and aim: Several dysregulated microRNAs (miRNAs) have been implicated in the pathogenesis of cholangiocarcinoma (CCA); however, small sample sizes and invariable research designs are limitations, hindering a thorough analysis of miRNAs as diagnostic and prognostic tools for CCA. This study aimed to systematically summarize the clinical value of miRNAs in human CCA both for all available miRNAs and single miRNA with multiple researches. Methods: Pooled parameters included the area under the curve (AUC), sensitivity, specificity, and hazard ratios (HRs) to separately determine overall diagnostic and prognostic performance. Subgroup and sensitivity analyses were performed only in the event of heterogeneity. Thirty-four studies including 12 diagnostic studies and 22 prognostic studies were eligible for inclusion in this meta-analysis. Results: We observed that miR-21, miR-26, miR-483, miR-106a, miR-150, miR-192, and miR-194 were employed for distinguishing patients with CCA from healthy controls. Pooled sensitivity, specificity, and AUC were 0.82 (95% confidence interval [CI] 0.77-0.86), 0.83 (95% CI 0.75-0.89), and 0.88 (95% CI 0.85-0.91), respectively. Abnormal expression of miR-21, miR-26a, miR-192, miR-200c, miR-221, miR-29a, miR-191, miR-181c, miR-34a, miR-106a, miR-203, and miR-373 in patients was confirmed to associate with poor survival rate. Pooled HRs and 95% CIs were calculated using STATA, resulting in the pooled HR of 1.47 (95% CI 0.91-2.37) for overall survival (OS), 0.67 (95% CI 0.16-2.81) for disease-free survival (DFS), 2.31 (95% CI 1.59-3.36) for progression-free survival (PFS), and 2.68 (95% CI 0.88-8.15) for relapse-free survival (RFS). Thus, CCA patients with dysregulated miRNA expression were confirmed to have shorter OS, DFS, PFS, and RFS. Data regarding the diagnostic and prognostic roles of miR-21 suggested pooled diagnostic results of miR-21 for sensitivity, specificity, and AUC were 0.85 (95% CI 0.76-0.91), 0.92 (95% CI 0.81-0.97), and 0.93 (95% CI 0.91-0.95), respectively, suggesting better diagnostic performance of miR-21 compared with other miRNAs. Meanwhile, pooled prognostic result of miR-21 for HR was 1.88 (95% CI 1.41-2.51), indicating miR-21 could more appropriately predict shorter OS in patients with CCA. Conclusion: miRNAs may provide a new approach for clinical application, and miR-21 may be a promising biomarker for diagnosis and prognosis of CCA.

Medicine (Baltimore) ; 97(17): e0583, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29703052


RATIONALE: Annular pancreas (AP) is recognized as a cause of duodenal obstruction in children, while children with Meckel's diverticulum (MD) are usually asymptomatic. Here we present a rare case with both AP and MD, which was identified by abdominal exploration during diamond-shaped duodenoduodenostomy. PATIENT CONCERNS: A "double-bubble" sign was found by ultrasound at 35 week of pregnancy. After 39 weeks of pregnancy, the male patient was transferred to the Department of General Surgery, Children's Hospital of Soochow University because of a suspected duodenal stenosis. DIAGNOSES: Preoperative abdominal X-ray examination indicated "double-bubble" sign. AP was confirmed by exploratory surgery, with an MD located 30 cm above the ileocecal valve. INTERVENTIONS: Diamond-shaped duodenoduodenostomy and a wedge resection of the intestine with end-to-end anastomosis were performed OUTCOMES:: The patient recovered and his appetite was good without vomiting. LESSONS: Our experience demonstrates that abdominal exploration is essential for children with gastrointestinal malformations.

Diverticulite/cirurgia , Duodenostomia/métodos , Divertículo Ileal/cirurgia , Pâncreas/anormalidades , Pancreatopatias/cirurgia , Anastomose Cirúrgica/métodos , Diverticulite/congênito , Humanos , Recém-Nascido , Masculino , Divertículo Ileal/complicações , Pâncreas/cirurgia , Pancreatopatias/congênito