The aim of this paper is to present and describe tran-sumbilical laparoscopic-assisted appendectomy in chil-dren, focusing on its technical aspects and clinical andsurgical outcomes. The surgical charts of all patient...The aim of this paper is to present and describe tran-sumbilical laparoscopic-assisted appendectomy in chil-dren, focusing on its technical aspects and clinical andsurgical outcomes. The surgical charts of all patientsaged between 0 and 14 years treated with transumbili-cal laparoscopic-assisted appendectomy admitted tothe authors' institution from January 2009 to Septem-ber 2013 with a diagnosis of suspected appendicitis fol-lowing clinical, laboratory and ultrasound findings werereviewed. Operating time, intraoperative findings, needfor conversion or for additional trocars, and surgicacomplications were reported. During the study period,120 patients aged between 6 and 14 years(mean age:9.9 years), 73 females(61%) and 47 males(39%),were treated with transumbilical laparoscopic-assistedappendectomy. There were 37 cases of hyperemicappendicitis(subserosal and retrocecal), 74 cases ofphlegmonous appendicitis and 9 cases of perforatedgangrenous appendicitis. It was not possible to estab-lish a correlation between grade of appendicitis andmean operating time(P > 0.05). Eleven cases(9%)needed the use of one additional trocar, while 8 pa-tients(6%) required conversion to the standard laparo-scopic technique with the use of two additional trocars. No patient was converted to the open technique. Tran-sumbilical laparoscopic-assisted appendectomy is a safe technique in children and it could be used by surgeons who want to approach other minimally invasive tech-niques.展开更多
Giant gastroschisis could be a surgical challenge concerning the abdominal wall reconstruction. Many techniques have been described for both primary or staged closure but sometimes neither of them is succesful in all ...Giant gastroschisis could be a surgical challenge concerning the abdominal wall reconstruction. Many techniques have been described for both primary or staged closure but sometimes neither of them is succesful in all patients. We are presenting the combined use of Vacuum Assisted Closure (VAC) and Platelet-Rich Plasma (PRP) to improve the result in this difficult case. The use of VAC device is a well known procedure in the treatment of adult difficult wounds closure. It consists of a sponge applied directly on the abdominal wall defect, covered with a transparent dressing and connected to a controlled continuous negative pressure system [1]. Platelet-rich plasma (PRP) is an autologous concentration of human platelets in a small volume of plasma. Due to this combination it provides multiple growth and healing factors actively secreted by platelets which have been shown to begin and accelerate wound healing [2] [3]. The association between VAC and PRP was effective in the shrinkage and reduction of the abdominal defect. Fifteen months after the removal of the VAC device the fascia appears competent with a cutaneus scar that will need a plastic correction in the future. The VAC should be considered as a helpful and effective device in case of complicated giant gastroschisis or omphalocele when traditional treatment is not sufficient.展开更多
Anderson-Hynes dismembered ureteropyeloplasty has been the gold standard surgical treatment for ureteropelvic junction obstruction (UPJO) caused either by crossing renal vessel or by a stenotic junction in children. N...Anderson-Hynes dismembered ureteropyeloplasty has been the gold standard surgical treatment for ureteropelvic junction obstruction (UPJO) caused either by crossing renal vessel or by a stenotic junction in children. Nowadays it is still discussed which could be the best surgical approach. All the techniques actually used have the goal to improve functional outcome and to reach better results in terms of reducing traumatic damage, postoperative pain and therefore reduction of hospitalization. We are presenting our experience in the treatment of UPJO by open dismembered pyeloplasty with a minimal invasive approach using the Alexis®(Applied Medical, Rancho Santa Margherita, CA) autostatic wound retractor.展开更多
Genital dissatisfaction is well known in female and adults.Less is known about male adolescents and their genital satisfaction.The aim of this study was to investigate and report the role of surgery in male adolescent...Genital dissatisfaction is well known in female and adults.Less is known about male adolescents and their genital satisfaction.The aim of this study was to investigate and report the role of surgery in male adolescents to improve the evaluation of their genitalia.We considered all patients treated for external genital pathology in the period of adolescence.Inclusion and exclusion criteria were created.Patients underwent an evaluation test before and after surgery.During the study period,137 patients were treated,and at the end of the study,98 cases were considered for analysis.The most frequent pathologies were webbed penis and penile curvature.A postoperative score improvement was noted and patients with concealed penis and webbed penis showed a better postoperative outcome.Overweight was considered an important factor associated with a worse preoperative score.Evaluation of the external genitalia is important in adolescents,and it is an understudied problem.Overweight may be associated with a worse evaluation of one’s genital and should be clinically considered to avoid related social problems in adulthood.Therefore,cosmetic genital surgery should be considered even in male adolescents.展开更多
We read with pleasure the article written by Dang et al.^(1)and the authors should be noted for the large case series reported.Testicular torsion is one of the causes of acute scrotum,in all age groups.Even in adults,...We read with pleasure the article written by Dang et al.^(1)and the authors should be noted for the large case series reported.Testicular torsion is one of the causes of acute scrotum,in all age groups.Even in adults,testicular torsion is dificult to diagnose,so it is necessary to perform a surgical exploration.Some diseases such as testicular cancer must be considered when treating a patient with testicular torsion.Radiological investigations sometimes help us in the diagnosis,but surgery is always necessary to exclude testicular damage.A long-term follow-up is always necessary to evaluate testicular function and viability.展开更多
文摘The aim of this paper is to present and describe tran-sumbilical laparoscopic-assisted appendectomy in chil-dren, focusing on its technical aspects and clinical andsurgical outcomes. The surgical charts of all patientsaged between 0 and 14 years treated with transumbili-cal laparoscopic-assisted appendectomy admitted tothe authors' institution from January 2009 to Septem-ber 2013 with a diagnosis of suspected appendicitis fol-lowing clinical, laboratory and ultrasound findings werereviewed. Operating time, intraoperative findings, needfor conversion or for additional trocars, and surgicacomplications were reported. During the study period,120 patients aged between 6 and 14 years(mean age:9.9 years), 73 females(61%) and 47 males(39%),were treated with transumbilical laparoscopic-assistedappendectomy. There were 37 cases of hyperemicappendicitis(subserosal and retrocecal), 74 cases ofphlegmonous appendicitis and 9 cases of perforatedgangrenous appendicitis. It was not possible to estab-lish a correlation between grade of appendicitis andmean operating time(P > 0.05). Eleven cases(9%)needed the use of one additional trocar, while 8 pa-tients(6%) required conversion to the standard laparo-scopic technique with the use of two additional trocars. No patient was converted to the open technique. Tran-sumbilical laparoscopic-assisted appendectomy is a safe technique in children and it could be used by surgeons who want to approach other minimally invasive tech-niques.
文摘Giant gastroschisis could be a surgical challenge concerning the abdominal wall reconstruction. Many techniques have been described for both primary or staged closure but sometimes neither of them is succesful in all patients. We are presenting the combined use of Vacuum Assisted Closure (VAC) and Platelet-Rich Plasma (PRP) to improve the result in this difficult case. The use of VAC device is a well known procedure in the treatment of adult difficult wounds closure. It consists of a sponge applied directly on the abdominal wall defect, covered with a transparent dressing and connected to a controlled continuous negative pressure system [1]. Platelet-rich plasma (PRP) is an autologous concentration of human platelets in a small volume of plasma. Due to this combination it provides multiple growth and healing factors actively secreted by platelets which have been shown to begin and accelerate wound healing [2] [3]. The association between VAC and PRP was effective in the shrinkage and reduction of the abdominal defect. Fifteen months after the removal of the VAC device the fascia appears competent with a cutaneus scar that will need a plastic correction in the future. The VAC should be considered as a helpful and effective device in case of complicated giant gastroschisis or omphalocele when traditional treatment is not sufficient.
文摘Anderson-Hynes dismembered ureteropyeloplasty has been the gold standard surgical treatment for ureteropelvic junction obstruction (UPJO) caused either by crossing renal vessel or by a stenotic junction in children. Nowadays it is still discussed which could be the best surgical approach. All the techniques actually used have the goal to improve functional outcome and to reach better results in terms of reducing traumatic damage, postoperative pain and therefore reduction of hospitalization. We are presenting our experience in the treatment of UPJO by open dismembered pyeloplasty with a minimal invasive approach using the Alexis®(Applied Medical, Rancho Santa Margherita, CA) autostatic wound retractor.
文摘Genital dissatisfaction is well known in female and adults.Less is known about male adolescents and their genital satisfaction.The aim of this study was to investigate and report the role of surgery in male adolescents to improve the evaluation of their genitalia.We considered all patients treated for external genital pathology in the period of adolescence.Inclusion and exclusion criteria were created.Patients underwent an evaluation test before and after surgery.During the study period,137 patients were treated,and at the end of the study,98 cases were considered for analysis.The most frequent pathologies were webbed penis and penile curvature.A postoperative score improvement was noted and patients with concealed penis and webbed penis showed a better postoperative outcome.Overweight was considered an important factor associated with a worse preoperative score.Evaluation of the external genitalia is important in adolescents,and it is an understudied problem.Overweight may be associated with a worse evaluation of one’s genital and should be clinically considered to avoid related social problems in adulthood.Therefore,cosmetic genital surgery should be considered even in male adolescents.
文摘We read with pleasure the article written by Dang et al.^(1)and the authors should be noted for the large case series reported.Testicular torsion is one of the causes of acute scrotum,in all age groups.Even in adults,testicular torsion is dificult to diagnose,so it is necessary to perform a surgical exploration.Some diseases such as testicular cancer must be considered when treating a patient with testicular torsion.Radiological investigations sometimes help us in the diagnosis,but surgery is always necessary to exclude testicular damage.A long-term follow-up is always necessary to evaluate testicular function and viability.
