Journal of Indian Association of Pediatric Surgeons最新文献

{"title":"Surgical Outcomes of Laparoscopic versus Open Inguinal Hernia Repair in Children: A 10-year Single-surgeon Study.","authors":"Amar Shah, Ria Sharma, Anirudh Shah","doi":"10.4103/jiaps.jiaps_272_24","DOIUrl":"10.4103/jiaps.jiaps_272_24","url":null,"abstract":"<p><strong>Aims: </strong>The aims of this study were to compare surgical outcomes of conventional open inguinal hernia repair (OR) with laparoscopic repair of inguinal hernia (LR) repair in Indian children operated by a single surgeon.</p><p><strong>Materials and methods: </strong>This is a retrospective (historical) nonrandomized cohort study of 1595 children with unilateral inguinal hernia for 10 years. All children who presented with unilateral inguinal hernia were included in this study. The study was divided into two phases of 5 years each, and patients were classified into Group 1 and Group 2. In the first 5 years (Group 1), all the children with unilateral inguinal hernia underwent conventional open repair. Over the next 5 years (Group 2), all the children with unilateral inguinal hernia underwent laparoscopic repair. All the operations were performed by the same surgeon who was well acquainted with laparoscopic surgery. Parameters studied included gender, side of the hernia, time of surgery, incidence of contralateral patent processus vaginalis (PPV), development of metachronous contralateral hernia, and complications.</p><p><strong>Results: </strong>A total of 1595 children with unilateral inguinal hernia were studied. Nine hundred and forty-five patients underwent OR (Group 1), and 650 patients underwent LR (Group 2). The male-to-female ratio in Group 1 was 2.5:1, and in Group 2 was 2.4:1. Right inguinal hernia was present in 59%, whereas 41% had a left inguinal hernia. In Group 1, 8% of children developed metachronous contralateral hernias. In Group 2, the contralateral processus vaginalis was found to be patent in 260 children. However, only 10% (26) of these children developed metachronous contralateral hernia on follow-up. In the present study, a significantly higher recurrence rate (2.5%) was observed in the LR group as compared to the OR group (0.3%). The overall operative time was lesser in the OR group (15 ± 8.4 min) versus LR group (25 ± 10 min).</p><p><strong>Conclusions: </strong>Only 10% of children with contralateral PPV in our study went on to develop a symptomatic hernia. Hence, we believe that upfront closure of the contralateral PPV with unilateral inguinal hernia may not be necessary. LR has a longer operating time and higher recurrence rates. The choice of technique depends on factors such as the availability of laparoscopic equipment and infrastructure, surgeon's preference, and expertise.</p>","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"30 3","pages":"382-386"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary Bladder/ Posterior Urethra Morphology in Posterior Urethral Valves Outcome.","authors":"Ramesh Babu","doi":"10.4103/jiaps.jiaps_292_24","DOIUrl":"10.4103/jiaps.jiaps_292_24","url":null,"abstract":"","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"30 3","pages":"424-425"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of Scientific Efforts to Define Cystometric Bladder Morphology in Neurogenic Bladder: A Narrated Review.","authors":"Arvind Sinha, Shrilakshmi Aithal","doi":"10.4103/jiaps.jiaps_247_24","DOIUrl":"10.4103/jiaps.jiaps_247_24","url":null,"abstract":"<p><p>Children with high-pressure bladders are at an increased risk of upper tract deterioration, potentially leading to chronic renal failure if not adequately managed. Regular bladder pressure monitoring is essential, especially in patients with neurogenic bladders, often resulting from spinal dysraphism. Urodynamic studies (UDSs) are the gold standard for assessing bladder pressure but are invasive, resource-intensive, and uncomfortable for patients. Over the last many decades, there have been regular attempts to characterize the morphology of the neurogenic bladder, including the classical subjective appearance of the \"Christmas Tree\" bladder, to objectively define the shape of the bladder via the use of height-to-width ratio. The study explores the evolution of scientific efforts to define bladder morphology in neurogenic bladder and to describe the current state of evidence regarding the correlation of the shape of the bladder with the detrusor pressures and upper tract changes in children with neurogenic bladder.</p>","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"30 3","pages":"265-270"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chromosomal Microarray Analysis in Spina Bifida: Genetic Heterogeneity and Its Clinical Implications.","authors":"Himani Pandey, Jyoti Sharma, Sourabh Kumar, Nakul Mohan, Vishesh Jain, Anjan Kumar Dhua, Devendra Kumar Yadav, Ashish Kumar Dubey, Prativa Choudhury, Prabudh Goel","doi":"10.4103/jiaps.jiaps_217_24","DOIUrl":"10.4103/jiaps.jiaps_217_24","url":null,"abstract":"<p><strong>Background: </strong>The etiology of spina bifida is multifactorial; the phenotype is the end result of both genetic and environmental influences. While whole exome sequencing has identified several pathogenic variants in Indian cohorts, the role of chromosomal imbalances and long contiguous stretches of homozygosity (LCSHs) remains largely unexplored in this population. Chromosomal microarray analysis (CMA) is an important tool that provides insights into such genetic aberrations, making it significant for evaluating patients with spina bifida.</p><p><strong>Objective: </strong>To identify LCSHs and chromosomal imbalances in three spina bifida patients through CMA analysis as a pilot investigation.</p><p><strong>Materials and methods: </strong>Genomic DNA was isolated from three spina bifida patients (P1: 10-year-old female, P2: 1-year-old male, and P3: 2.8-year-old male) and subjected to CMA using the Affymetrix 750K high-density array platform. The submicroscopic chromosomal imbalances and LCSHs were cross-referenced with public databases (Database of Genomic Variants, ClinVar, and OMIM) to evaluate their clinical significance. Functional annotations of the affected genes were performed to understand their role in neural tube development.</p><p><strong>Results: </strong>CMA revealed significant LCSH on chromosomes 2, 3, and 7 involving the genes <i>SOX11</i>, <i>WNT7A</i>, <i>FZD9</i>, <i>SEMA3A</i>, and <i>VHL</i>, all of which are involved in neural tube closure. Mosaic Klinefelter syndrome (25.9% mosaicism) was identified in the second patient while the third patient had a normal genetic profile. The detection of significant genetic variations in two of three cases underscores the potential utility of CMA in spina bifida patients.</p><p><strong>Conclusions: </strong>This study has generated valuable insights into the complex genetic landscape underlying the multifactorial etiopathogenesis of spina bifida. The findings not only underscore the importance of an integrated approach but also support the cause of a platform for large-scale investigations in the Indian population.</p>","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"30 3","pages":"290-295"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transperitoneal Laparoscopic Adrenalectomy in Children - Initial Experience in an Emerging Tertiary Center in Eastern India.","authors":"Avilash Sahu, Aditya Arvind Manekar, Subrat Kumar Sahoo, Bikasha Bihary Tripathy, Manoj Kumar Mohanty","doi":"10.4103/jiaps.jiaps_229_24","DOIUrl":"10.4103/jiaps.jiaps_229_24","url":null,"abstract":"<p><strong>Background: </strong>Adrenal tumors account for 0.2%-1% of all tumors in children. They can be benign or malignant, secretory or nonsecretory, and can arise either from the cortex or medulla. The common indication in children undergoing laparoscopic adrenalectomy (LA) is neuroblastic tumors (neuroblastoma, ganglioneuroma, and ganglioneuroblastoma).</p><p><strong>Methodology: </strong>This is a retrospective observational study conducted from October 2021 to February 2024 (28 months) in the pediatric surgery unit at our institute. All children under 18 years of age referred to us for surgery of adrenal mass were included in this study. Any children with image-defined risk factors (IDRFs + ve) were excluded from the study. Children were worked up and managed according to the protocol of the Institute Pediatric Tumor Board. The laparoscopic transperitoneal approach was used for all. All adrenal lesions with IDRF +ve were excluded from the study and resected via open approaches.</p><p><strong>Results: </strong>A total of six patients were included (three each in male and female groups). The mean age was 31 months (range 22 months-39 months). There were two cases of neuroblastoma, and one each of pheochromocytoma, adrenal adenoma, adrenocortical carcinoma, and paraganglioma. The median follow-up period was 24 months (range 7-32 months). On follow-up, there are no recurrences reported till date with zero mortality.</p><p><strong>Conclusion: </strong>LA is a safe and feasible operation in children without any IDRF. It should be preferred in children with small lesion with good plane between the tumor and normal tissues. For larger lesion and ACC, it should be used cautiously to prevent spillage. Thought difficult, laparoscopic resection is a safe approach for these adrenal tumors.</p>","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"30 3","pages":"317-321"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redo Pull-through in Hirschsprungs Disease - A Meta-Analysis of Outcomes Based on type of Pull-through.","authors":"M Srinivasa Rao, D Kalyan Ravi Prasad, J Bhaskar Reddy","doi":"10.4103/jiaps.jiaps_279_24","DOIUrl":"10.4103/jiaps.jiaps_279_24","url":null,"abstract":"<p><strong>Purpose: </strong>The meta-analysis investigates the effects of redo pull-through (PT) surgeries on bowel function outcomes in patients with rectosigmoid and long-segment Hirschsprung's disease (HD) who have already undergone an initial PT. By comparing different redo PT techniques, this study explores whether specific approaches yield better postoperative bowel function.</p><p><strong>Methodology: </strong>A literature search was conducted for articles on redo PT for HD; this included PubMed and ScienceDirect databases. The search terms or MeSH words \"Hirschsprung disease\" OR \"congenital megacolon\" AND \"re-do pull through\" OR \"re-do\" OR \"reoperation,\" connected by two Boolean operators \"OR\" and \"AND,\" were used to search the databases for relevant articles.</p><p><strong>Results: </strong>Fifteen articles of interest comprising 374 patients receiving redo PT were selected for analysis. The results suggest that selecting a redo PT method tailored to the patient's unique anatomical and surgical history may substantially improve functional outcomes, highlighting the potential for individualized strategies to enhance recovery and long-term quality of life for those requiring reoperation.</p><p><strong>Conclusion: </strong>The findings indicate that the Swenson redo PT approach yielded better bowel function outcomes compared to other techniques. While redo PT procedures were effective in reducing fecal incontinence, the incidence of enterocolitis remained consistent across the various approaches.</p>","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"30 3","pages":"330-342"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PostKasai Portoenterostomy Dissection of a Branch of the Right Hepatic Artery - A Rare Complication.","authors":"Charu Sharma, Nitinkumar Borkar, Revanth Kalla, C Ashwin, Nihar Kathrani","doi":"10.4103/jiaps.jiaps_286_24","DOIUrl":"10.4103/jiaps.jiaps_286_24","url":null,"abstract":"<p><p>Hepatic artery branch dissection is a lesser-known complication after biliary atresia surgery. The presentation is massive upper gastrointestinal bleeding and rapid drop in hemoglobin levels. We present a 6-week-old infant with biliary atresia who had dissection of a branch of the right hepatic artery which was managed by angioembolization.</p>","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"30 3","pages":"422-423"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Lipoblastoma: A Case Report in a 2-year-old Girl.","authors":"Amar Shah, Ria Sharma, Anirudh Shah","doi":"10.4103/jiaps.jiaps_239_24","DOIUrl":"10.4103/jiaps.jiaps_239_24","url":null,"abstract":"<p><p>Adipose tumors constitute only 6% of all soft-tissue neoplasms in the first two decades of life, with lipoblastomas accounting for one-third of these cases. Predominantly seen in children under 3 years old, preoperative diagnosis is challenging due to their heterogeneity and similarity to other lipomatous tumors. Surgical excision and histology remain essential for definitive diagnosis. We report the case of a 2-year-old girl with a right infraclavicular lipoblastoma.</p>","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"30 3","pages":"390-393"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Portal Vein Web: A Rare Cause of Extrahepatic Portal Vein Obstruction in a Child.","authors":"Benjamin Chacko, M M Zameer, Vinay Chandrashekar, Ashley L J D'Cruz, Sanjay Rao","doi":"10.4103/jiaps.jiaps_275_24","DOIUrl":"10.4103/jiaps.jiaps_275_24","url":null,"abstract":"<p><p>Portal vein thrombosis is the most common cause of portal hypertension in children. Congenital portal vein anomalies are rare. We report the case of a 3-year-old with extrahepatic portal vein obstruction secondary to portal vein web. The child was treated successfully by portal venoplasty.</p>","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"30 3","pages":"407-408"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreatitis in Association with Primary Hyperparathyroidism due to Ectopic Intrathymic Parathyroid Adenoma in a Pediatric Patient.","authors":"Soumya Kashiv, Himanshu Menghwani, Bijay Kumar Suman, Mahendra Kumar Jangid, Enono Yhoshu, Intezar Ahmed","doi":"10.4103/jiaps.jiaps_238_24","DOIUrl":"10.4103/jiaps.jiaps_238_24","url":null,"abstract":"<p><p>Primary hyperparathyroidism leads to increased serum parathyroid hormone levels resulting in hypercalcemia. Ectopic intrathymic parathyroid adenomas account for 6%-16% of all parathyroid adenomas and are rare in children but should be considered in cases with hypercalcemia. Early and timely diagnosis can preserve end-organ damage and bone and renal function.</p>","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"30 3","pages":"387-389"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}