Journal of Indian Association of Pediatric Surgeons最新文献

{"title":"Chylous Leak after Cystic Hygroma Excision in an Infant: A Rare Postoperative Complication.","authors":"Amar Shah, Aryan S Momin, Ria Sharma, Anirudh Shah","doi":"10.4103/jiaps.jiaps_126_24","DOIUrl":"10.4103/jiaps.jiaps_126_24","url":null,"abstract":"<p><p>Postoperative chylous leak is a rare but serious complication of any head-and-neck surgery. It can lead to metabolic imbalance, prolonged wound healing, wound dehiscence, and hospitalization. We present the case of a 9-month-old girl operated for a left cervical cystic hygroma who had a chylous leak requiring surgical management. This is probably one of the first reported cases of chylous leak following the excision of cystic hygroma in an infant.</p>","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"29 6","pages":"648-650"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11649057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846887","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":"Evaluating the Impact of Elective Endotracheal Tube Replacement on Postoperative Outcomes in Esophageal Atresia: A STROBE-guided Study.","authors":"Ruchira Nandan, Ram Badan Singh, Arvind Bhalekar, Bhanumurthy Kaushik Marripati, Ajay Narayan Gangopadhyay, Vaibhav Pandey","doi":"10.4103/jiaps.jiaps_78_24","DOIUrl":"10.4103/jiaps.jiaps_78_24","url":null,"abstract":"<p><strong>Background: </strong>Elective ventilation and paralysis have been shown to decrease the anastomosis-related complications following primary repair of esophageal atresia (EA). Repeated endotracheal tube (ETT) block and replacement can increase these complications. We evaluated the results of our strategy of electively changing the ETT just before shifting the patient to the postoperative ward for elective ventilation.</p><p><strong>Materials and methods: </strong>A retrospective study was conducted using the case records of patients from July 2015 to February 2024 including all the patients of EA with tracheoesophageal fistula who underwent primary repair with end-to-end esophageal anastomosis. The patients were divided into two groups Group A: ETT was changed and Group B: ETT was not changed immediately before shifting. The groups were compared for anastomotic leak and ETT tube block in the first 48 h.</p><p><strong>Results: </strong>Ninety-one patients were included in the study, 36 in Group A and 55 in Group B. Elective replacement of ETT decreased the tube block rates in the first 48 h following surgery (<i>P</i> = 0.032). Tension in the anastomosis was associated with a higher leak rate. The leak was present in 58.3% and 3.6% in cases with and without tension in the anastomosis (<i>P</i> = 0.001). Overall, the anastomotic leak was similar in both groups. In the subgroup of patients with anastomosis under tension, the rate of anastomotic leak was higher in patients with ETT block (<i>P</i> = 0.028).</p><p><strong>Conclusion: </strong>Elective replacement of EET decreases the tube block rates and anastomotic leak rates in cases with anastomosis under tension.</p>","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"29 6","pages":"596-599"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11649051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846892","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":"Ovarian Masses in Children: Surgical Experience and Outcomes.","authors":"Rohit Kapoor, Ankur Mandelia, Basant Kumar, Vijai Datta Upadhyaya, Anju Verma, Pujana Kanneganti, Tarun Kumar, Nishant Agarwal, Rahul Goel, Pooja Prajapati","doi":"10.4103/jiaps.jiaps_151_24","DOIUrl":"10.4103/jiaps.jiaps_151_24","url":null,"abstract":"<p><strong>Aims: </strong>This study aims to review our experience of treating ovarian masses in children with an emphasis on clinical presentation, diagnosis, treatment, and outcome.</p><p><strong>Methods: </strong>We retrospectively reviewed the electronic medical records of all patients below 18 years of age who underwent surgical treatment for ovarian masses at our institute between 2009 and 2023. Study variables included demography, clinical presentation, physical findings, tumor markers, radiologic features, operative details, histopathology, follow-up status, and overall survival.</p><p><strong>Results: </strong>During the study period, 30 patients with a mean age of 10.07 years (range: 15 days-18 years) underwent surgical treatment for ovarian masses. Nonneoplastic ovarian masses were seen in 5 (16.7%) patients, whereas 25 (83.3%) patients had benign (10 [33.3%], borderline 3 [10%], or malignant 12 [40%]) ovarian neoplasms. The most common clinical presentation in the benign group was abdominal pain (<i>n</i> = 6), whereas painless abdominal mass (<i>n</i> = 6) was the predominant complaint in children with malignant tumors. A functional ovarian mass presenting with precocious puberty or virilization was seen in 5 (16.7%) patients. On imaging, nonneoplastic and benign lesions had a mean size of 4.33 (range: 3.1-6) cm and 12.63 (range: 2.8-28) cm, respectively, whereas borderline and malignant masses had a mean tumor size of 22.5 (range: 6.5-32) cm and 12.55 (range: 3.5-18.7) cm, respectively (<i>P</i> < 0.05). The cystic component was identified in all nonneoplastic and benign tumors, whereas the solid component was present in all borderline and malignant lesions (<i>P</i> < 0.05). Tumor markers such as serum alpha-fetoprotein and beta-human chorionic gonadotropin were raised in 8 (66.67%) of malignant tumors, whereas markers were normal in all benign lesions and borderline malignant lesions and 4 (33.33%) of malignant tumors. Lactate dehydrogenase (LDH) was also raised in all malignant masses (<i>n</i> = 12), whereas it was normal in all benign and borderline malignant masses (<i>n</i> = 18). In 6 (20%) patients with nonneoplastic and benign masses with maximum tumor size <6 cm, the laparoscopic approach was adopted, whereas open surgery was preferred in the rest of the patients. At a mean follow-up of 53.5 (range: 4-117) months, all patients are alive and disease free.</p><p><strong>Conclusions: </strong>Preoperative imaging characteristics (tumor size and solid component) and raised tumor markers may help us to differentiate between benign and malignant ovarian pathologies. The overall prognosis of pediatric ovarian tumors seems to be favorable.</p>","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"29 6","pages":"617-622"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11649052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846867","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":"Double Trouble: A Rare Case of Dual Esophageal Stenosis in a 4-month-old.","authors":"Amar Shah, Ria Sharma, Anirudh Shah","doi":"10.4103/jiaps.jiaps_145_24","DOIUrl":"10.4103/jiaps.jiaps_145_24","url":null,"abstract":"<p><p>Esophageal stenosis is an uncommon clinical condition defined as a fixed narrowing of the esophagus. It can be congenital or acquired. The incidence of congenital esophageal stenosis (CES) is 1 in 25,000-50,000 live births. Most of these patients present in early infancy and many of them require surgical intervention. We report a very interesting case of a 4-month-old child with esophageal stenosis involving two different segments of the esophagus who was successfully treated surgically. This is one of the rarest variants of CES which involves two different segments of the esophagus.</p>","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"29 6","pages":"654-656"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11649056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846888","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":"Spontaneous Intrathoracic Rupture of Abdominal Neuroblastoma in a 2-year-old Child: A Rare Case Report.","authors":"Simmi K Ratan, Md Fahim Ahmad, Nitin Jain, Narendra Kumar, Sujoy Neogi, Shramana Mandal","doi":"10.4103/jiaps.jiaps_61_24","DOIUrl":"10.4103/jiaps.jiaps_61_24","url":null,"abstract":"<p><p>Neuroblastoma (NB) tumor rupture, typically intra-abdominal, is a rare and life-threatening condition with a poor prognosis, often associated with large aggressive tumors. Intrathoracic ruptures, rarely reported, may result from thoracic NB or malignant invasion. We present the first case of spontaneous intrathoracic rupture in a 2-year-old boy with abdominal NB.</p>","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"29 6","pages":"623-626"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11649053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846909","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":"Successful Endoscopic Management of Complete Tracheal Occlusion in a Child.","authors":"Bhavya Balaji, Aureen Ruby Dcunha, B Sandeep Rai, B H Giridhar, Swathi Sunil Rao","doi":"10.4103/jiaps.jiaps_125_24","DOIUrl":"10.4103/jiaps.jiaps_125_24","url":null,"abstract":"<p><p>Prolonged mechanical ventilation following cardiopulmonary and neurological events oftentimes necessitates a tracheostomy and tracheal granulation is one of its most common late complications. The literature recommends that large granulation be managed through surgical excision or endoluminal techniques. A 6-year-old boy presented with high-grade tracheal stenosis secondary to endotracheal cuff-related injury and prolonged tracheostomy. We present an unconventional yet successful method of management that included multiple sittings of endoscopic rigid bronchoscopic dilation and endoluminal cryotherapy.</p>","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"29 6","pages":"634-636"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11649058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846911","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":"Lateral-based Onlay Flap for Redo Hypospadias Repair (LABO-R).","authors":"V V S Chandrasekharam, Khyati Kiran Janapareddy","doi":"10.4103/jiaps.jiaps_128_24","DOIUrl":"10.4103/jiaps.jiaps_128_24","url":null,"abstract":"","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"29 6","pages":"657-658"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11649045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846907","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":"Primitive Myxoid Mesenchymal Tumor of Infancy: A Lost Battle.","authors":"Nitin James Peters, V Manasa Reddy, Amanjit Bal, Arihant Jain, Anjali Gupta, Renu Madan, Jai Kumar Mahajan","doi":"10.4103/jiaps.jiaps_103_24","DOIUrl":"10.4103/jiaps.jiaps_103_24","url":null,"abstract":"<p><p>Primitive myxoid mesenchymal tumor of infancy (PMMTI) is a low to intermediate-grade, poorly differentiated myofibroblastic tumor and is characterized by its tendency to recur locally. It commonly occurs in the 1^st year of life and is predominantly seen in the axial skeleton and rarely in the retroperitoneum. We report one such case of PMMTI, which is the second case reported in English literature.</p>","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"29 6","pages":"637-639"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11649055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846872","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":"Vasoactive Intestinal Polypeptide Secreting MS Neuroblastoma.","authors":"Josy Thomas, Nitin James Peters, Aravind Sekar, Deepak Bansal, Jitender Singh, Ravi P Kanojia, J K Mahajan","doi":"10.4103/jiaps.jiaps_104_24","DOIUrl":"10.4103/jiaps.jiaps_104_24","url":null,"abstract":"<p><p>We present a rare case of a 17-month-old child diagnosed with MS-stage neuroblastoma and associated chronic diarrhea due to elevated vasoactive intestinal peptide (VIP) levels. The unusual occurrence of a VIP-secreting tumor in a patient with MS neuroblastoma is a rare combination, not previously reported in the literature. The patient underwent exploratory laparotomy and excision of the tumor, leading to a significant decline in VIP levels and resolution of symptoms.</p>","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"29 6","pages":"627-629"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11649041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845954","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":"The State of Pediatric Kidney Transplantation in India: A Survey-based Analysis of Practices, Challenges, and Educational Needs.","authors":"Arka Banerjee, Adwait S Bendre, Gayatri Munghate, Minnie Bodhanwala","doi":"10.4103/jiaps.jiaps_102_24","DOIUrl":"10.4103/jiaps.jiaps_102_24","url":null,"abstract":"<p><strong>Background: </strong>Technical and immunological advancements have improved patient and graft survival rates in pediatric kidney transplantation (PKT). However, the landscape of PKT in India remains underexplored. We conducted a questionnaire-based survey among Indian pediatric surgeons to delineate contemporary trends in PKT.</p><p><strong>Methods: </strong>The online survey comprised 10 questions assessing pediatric surgeons' involvement in PKT, existing challenges, and educational needs.</p><p><strong>Results: </strong>Of 610 surveyed pediatric surgeons, 120 responded (19.67% response rate). Majority of the respondents were affiliated with teaching programs, either in the public sector (61.18%) or in corporate setups (25.21%). While 65.83% of respondents managed pediatric patients with chronic kidney disease, only 10% had PKT programs at their institutes. Most of the respondents (67.5%) believed that pediatric surgeons should perform PKTs. Despite this, only 15.83% were part of the renal transplantation team at their institute and only 2.5% routinely performed PKTs. Most of the respondents (63.33%) advocated for mandatory KT exposure during postdoctoral training.</p><p><strong>Conclusion: </strong>Despite enthusiasm among pediatric surgeons, actual involvement remains low. Dedicated PKT programs are necessary to address these challenges along with improved training by integrating transplantation sciences into the pediatric surgical curriculum. The study underscores the need for pediatric surgeons to specialize in transplantation and advocates for policy changes to address the prevailing challenges.</p>","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"29 6","pages":"608-611"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11649050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846915","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}