Pediatria Medica e Chirurgica最新文献

{"title":"Secondary hydrosalpinx in adolescents: a challenging decision-making process for surgical choice and future fertility preservation.","authors":"Angela Riccio,&nbsp;Gabriele Lisi,&nbsp;Maria Enrica Miscia,&nbsp;Gilda Di Paolo,&nbsp;Giuseppe Lauriti,&nbsp;Pierluigi Lelli Chiesa","doi":"10.4081/pmc.2020.233","DOIUrl":"https://doi.org/10.4081/pmc.2020.233","url":null,"abstract":"<p><p>Hydrosalpinx in pre-pubertal children and non-sexually active adolescents is a rare finding with several etiology and negative impact on future female fertility. The therapeutic approach in these specific populations is debated and it must consider its etiology and adult guidelines focused on fertility issues, which suggest laparoscopic salpingectomy. We described two adolescent cases (15 years asymptomatic and 13 years with abdominal pain) presenting a monolateral hydrosalpinx secondary to surgery for Hirschsprung's disease and complicated appendicitis, respectively. Both patients underwent to uncomplicated robotic-assisted salpingectomy, with uneventful follow-up and preserved ovarian function. Robotic-assisted salpingectomy for hydrosalpinx secondary to previous surgical conditions is a safe and careful approach for adolescents in order to preserve ovarian vascularization, function and future fertility.</p>","PeriodicalId":35535,"journal":{"name":"Pediatria Medica e Chirurgica","volume":"42 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25381184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoracoscopic treatment of a rare bilateral extralobar lung sequestration in a 3-years old girl.","authors":"Cosimo Bleve,&nbsp;Maria Luisa Conighi,&nbsp;Diego Biondini,&nbsp;Pier Luca Ceccarelli,&nbsp;Leonardo Giarraputo,&nbsp;Sergio Savastano,&nbsp;Salvatore Fabio Chiarenza","doi":"10.4081/pmc.2020.237","DOIUrl":"https://doi.org/10.4081/pmc.2020.237","url":null,"abstract":"<p><p>Majority of sequestrations fall into two categories: Intra-Lobar (ILS) and Extra-Lobar (ELS). Rarely the abnormal lung could be attached to the gastrointestinal tract, Bronchopulmonary Foregut Malformation (BPFM). We described a case of a girl of 3-years-old with antenatal diagnosis of left intrathoracic mass of the inferior lobe. Postnatal Computed-Tomography (CT) revealed a bilateral ELS with an isthmic bridge crossing the vertebral spine. She follows a MRI follow-up at 18months/30months confirming the lesion. Before surgery, a three-dimensional-CT-angiography was performed to study the mass, its blood supply and to plan surgery. She underwent to thoracoscopic resection. Two aberrant blood vessels were dissected from the thoracic aorta and ligated. The postoperative course was uneventful. She was discharged after 3 days. The rarity of our case is due to the bilateral extension. An appropriate preoperatory imaging study is necessary for the success of surgery while thoracoscopy is particularly appropriate in surgical treatment.</p>","PeriodicalId":35535,"journal":{"name":"Pediatria Medica e Chirurgica","volume":"42 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25343318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic Fowler-Stephens orchidopexy for intra-abdominal cryptorchid testis: a single institution experience.","authors":"Alfonso Papparella,&nbsp;Laura De Rosa,&nbsp;Carmine Noviello","doi":"10.4081/pmc.2020.224","DOIUrl":"https://doi.org/10.4081/pmc.2020.224","url":null,"abstract":"<p><p>Fowler-Stephens Laparoscopic Orchiopexy (FSLO) permits the mobilization of Intra-Abdominal Testis (IAT) to the scrotal position after spermatic vessel ligation. We reported our experience of FSLO for IAT. The charts of all boys who underwent a FSLO were retrospectively reviewed. Data were analysed for demographic data, procedure, complications and follow-up results. From January 2008 to June 2016, 160 laparoscopies for Non Palpable Testis (NPT) were performed at a mean age of 3,2 years. 61% of patients had a right NPT, while 6% were bilateral. In 64 cases, an IAT was found: 20 were managed by FSLO with a two-stage procedure in 11 patients. There were no differences in hospitalisations; one patient had a prolonged ileus. Follow-up ranged from 1 to 8 years. Of the 20 patients who underwent FSLO, testicular atrophy developed in three; the remaining testes were in the scrotal position, with normal consistency. FSLO was applied in 31% of IAT. The overall success rate of the technique was 85 %. The percentage of atrophy associated after spermatic vessels interruption appears to provide a good chance of testicular survival.</p>","PeriodicalId":35535,"journal":{"name":"Pediatria Medica e Chirurgica","volume":"42 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25317706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guidelines of the Italian Society of Videosurgery (SIVI) in Infancy for the minimally invasive treatment of Hypertrophic Pyloric Stenosis in neonates and infants.","authors":"Salvatore Fabio Chiarenza,&nbsp;Cosimo Bleve,&nbsp;Maria Escolino,&nbsp;Ciro Esposito,&nbsp;Fabio Beretta,&nbsp;Maurizio Cheli,&nbsp;Maria Grazia Scuderi,&nbsp;Vincenzo Di Benedetto,&nbsp;Giovanni Casadio,&nbsp;Maurizio Marzaro,&nbsp;Marco Gambino,&nbsp;Andrea Conforti,&nbsp;Alessio Pini Prato,&nbsp;Francesco Molinaro,&nbsp;Simona Gerocarni Nappo,&nbsp;Paolo Caione,&nbsp;Maria Mendoza-Sagaon","doi":"10.4081/pmc.2020.243","DOIUrl":"https://doi.org/10.4081/pmc.2020.243","url":null,"abstract":"<p><p>The most appropriate treatment for the infantile Hypertrophic Pyloric Stenosis (HPS) is still debated. The non-surgical conservative treatment with oral or intravenous administration of atropine does not enjoy a widespread appreciation for several factors (...).</p>","PeriodicalId":35535,"journal":{"name":"Pediatria Medica e Chirurgica","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/pmc.2020.243","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38664043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guidelines of the Italian Society of Videosurgery in Infancy (SIVI) for the minimally invasive treatment of fetal and neonatal ovarian cysts.","authors":"Salvatore Fabio Chiarenza,&nbsp;Maria Luisa Conighi,&nbsp;Andrea Conforti,&nbsp;Cosimo Bleve,&nbsp;Ciro Esposito,&nbsp;Maria Escolino,&nbsp;Fabio Beretta,&nbsp;Maurizio Cheli,&nbsp;Vincenzo Di Benedetto,&nbsp;Maria Grazia Scuderi,&nbsp;Giovanni Casadio,&nbsp;Maurizio Marzaro,&nbsp;Marco Gambino,&nbsp;Alessio Pini Prato,&nbsp;Francesco Molinaro,&nbsp;Simona Gerocarni Nappo,&nbsp;Paolo Caione","doi":"10.4081/pmc.2020.242","DOIUrl":"https://doi.org/10.4081/pmc.2020.242","url":null,"abstract":"<p><p>In the last three decades, fetal ovarian cysts were diagnosed more frequently, due to technological improvement and the increasing use of prenatal screening ultrasound. Nonetheless, treatment uncertainties are still present, either prenatally or postnatally. Recently, significant innovations on diagnosis and treatment have been proposed and a more conservative, minimally invasive approach may be offered to the Pediatrician or the Surgeon who face with this condition during prenatal or neonatal age. (...).</p>","PeriodicalId":35535,"journal":{"name":"Pediatria Medica e Chirurgica","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38664042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peritoneal dialysis catheters in pediatric patients: 10 years of experience in a single centre.","authors":"Mario Lima,&nbsp;Niel Di Salvo,&nbsp;Giovanni Marchi,&nbsp;Vincenzo Davide Catania,&nbsp;Michele Libri,&nbsp;Tommaso Gargano","doi":"10.4081/pmc.2020.221","DOIUrl":"https://doi.org/10.4081/pmc.2020.221","url":null,"abstract":"<p><p>Peritoneal Dialysis (PD) is one of the numerous options for chronic dialysis and in many cases when access for acute dialysis is required early in a hospital course, at any age. PD catheter can be inserted with an open or laparoscopic approach. The complication rate after catheter insertion is still high, as reported in published literature. We present the experience matured at our Centre in the last 10 years on implantation of peritoneal dialysis catheters in children, emphasising surgical complications. We conducted a retrospective study on patients who underwent PD at our Centre in a range period of 10 years. We analysed patients 'demographic data, past and present medical, perioperative and post-operative data, permanence of the catheter, duration of dialysis, the gap between placement and use, outcomes and complications. We compared the data, dividing patients in 2 groups: patients operated with a traditional open technique and patients operated laparoscopically. We retrospectively reviewed 29 children with an average age of 3years and 6 months. Mean age was 42 months (1 month; 8 years) for the VLS group, 18 months (11 days, 4 years) for the OT group. Mean operative time was 106 min for the VLS group; 44 min for the OT group. The Catheter permanence period was 17 days (12h-64 days). Duration of dialysis was between 48 hours and 23 days (average 8 days). In the total population, we registered 8 complications (5 minor, 3 major), the overall complication rate being 33 % (minor complication rate 21%, major complication rate 12,5 %). 6 complications occurred in patients operated laparoscopically (6/14 = 36 %); 2 complications in the OT group (2/10 = 20 %). The complication rate after PD catheter insertion is still high. Advantages and disadvantages of the open and laparoscopic approach must be known. Both minor and major complications, such as bowel perforations and occlusions, must be understood and differentiated.</p>","PeriodicalId":35535,"journal":{"name":"Pediatria Medica e Chirurgica","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/pmc.2020.221","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38528360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-pressure balloon dilatation in children: our results in 30 patients with POM and the implications of the cystoscopic evaluation.","authors":"Francesca Destro,&nbsp;Giorgio Selvaggio,&nbsp;Federica Marinoni,&nbsp;Andrea Pansini,&nbsp;Giovanna Riccipetitoni","doi":"10.4081/pmc.2020.214","DOIUrl":"https://doi.org/10.4081/pmc.2020.214","url":null,"abstract":"<p><p>Primary Obstructive Megaureter (POM) is a common cause of hydronephrosis in children with spontaneous resolution in most cases. High-Pressure Balloon Dilatation (HPBD) has been proposed as a minimally invasive procedure for POM correction in selected patients. The aim of the paper is to review our experience with HPBD in patients with POM. We performed a retrospective study in a single Centre collecting data on patients' demographics, diagnostic modalities, surgical details, results and follow-up. In particular, the endoscopic aspect of the orifice permitted the identification of 3 patterns: adynamic ureteral segment, stenotic ureteric ring and pseudoureterocelic orifice. We performed HPBD in 30 patients over 6 years. We had 23 patients with adynamic distal ureteral segment (type 1), 4 with stenotic ring (type 2) and 3 with ureterocelic orifice (type 3). In 3 patients (10%) the guidewire did not easily pass into the ureter requiring ureteral stenting or papillotomy. Post-operative course was uneventful. Five patients (3 pseudoureterocelic) required open surgery during follow-up. HPBD for the treatment of POM is a safe and feasible procedure and it can be a definitive treatment of POM. Complications are mainly due to double J stent and none of our patients had symptoms related to vescico-ureteral reflux. The aspect of the orifice, identified during cystoscopy, seems to correlate with the efficacy of the dilatation: type 1 and 2 are associated with good and excellent results respectively; type 3 do not permit dilatation in almost all cases requiring papillotomy. HPBD can be performed in selected patients of all paediatric ages as first therapeutic line. The presence of a pseudoureterocelic orifice or long stenosis might interfere with the ureteral stenting and seems associated with worse outcomes.</p>","PeriodicalId":35535,"journal":{"name":"Pediatria Medica e Chirurgica","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/pmc.2020.214","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38562207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic balloon dilatation of primary obstructive megaureter: method standardization and predictive prognostic factors.","authors":"Salvatore Fabio Chiarenza,&nbsp;Cosimo Bleve,&nbsp;Elisa Zolpi,&nbsp;Francesco Battaglino,&nbsp;Lorella Fasoli,&nbsp;Valeria Bucci","doi":"10.4081/pmc.2019.219","DOIUrl":"https://doi.org/10.4081/pmc.2019.219","url":null,"abstract":"<p><p>The management of congenital primary obstructive megaureter (POM) is usually conservative, especially during the first year of life. Endoscopic high-pressure balloon dilatation (EHPBD) is indicated when symptoms, increasing dilatation and progressive renal damage are recorded, particularly in children younger than one year of age. We identified and described endoscopic prognostic factors predicting the success or failure of endoscopic dilatation. Thirty-eight patients (33 M;5 F) with POM from 2005-2018 were included. Diagnosis was based on US distal ureter dilatation (>7 mm), obstructive MAG-3 diuretic renogram and absence of vesicoureteral reflux (cystography). 24 patients were under 1 year of age. All patients underwent cystoscopy and high-pressure balloon dilatation with 3,5 Fr dilating balloon, after ascending pyelography. Median follow-up was of 6.5 years. We identified characteristics with poor prognosis: stenotic punctiform ureteral ostium and/or ostium located in a bladder diverticulum (9 pts) and stenotic tract longer than 1 cm (5 pts). The patients with a stenotic tract shorter than 1 cm (18 pts) were divided into two groups: <5 mm (5 pts) and between 5 and 10 mm (13 pts) showed a good response to dilatation. Endoscopic evaluation of ureteral ostium with pneumatic dilatation when possible is a useful diagnostic and therapeutic solution for POM treatment, especially under one year of age. EHPBD is effective in short stenotic tracts (<5 mm). It may also be repeated with good results in intermediate stenotic sections (5 mm-1 cm). According to our preliminary results, the procedure is more effective if performed earlier (3-7 months of life). Greater cohort and longer follow-up are needed to verify the stability of these results.</p>","PeriodicalId":35535,"journal":{"name":"Pediatria Medica e Chirurgica","volume":"41 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/pmc.2019.219","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37483847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guidelines of the Italian Society of Videosurgery in Infancy for the minimally invasive treatment of the esophageal atresia.","authors":"Salvatore Fabio Chiarenza,&nbsp;Maria Luisa Conighi,&nbsp;Ciro Esposito,&nbsp;Maria Escolino,&nbsp;Fabio Beretta,&nbsp;Maurizio Cheli,&nbsp;Vincenzo Di Benedetto,&nbsp;Maria Grazia Scuderi,&nbsp;Giovanni Casadio,&nbsp;Maurizio Marzaro,&nbsp;Leon Francesco Fascetti,&nbsp;Andrea Conforti,&nbsp;Pietro Bagolan,&nbsp;Claudio Vella,&nbsp;Cosimo Bleve,&nbsp;Daniela Codric,&nbsp;Paolo Caione","doi":"10.4081/pmc.2019.230","DOIUrl":"https://doi.org/10.4081/pmc.2019.230","url":null,"abstract":"<p><p>Esophageal Atresia (EA) is defined as an interruption in esophageal continuity that results in a proximal tract that ends in a blind pouch in 98% of cases, and a distal tract that in 87% of cases arises via a Fistula from the Trachea (TEF). (...).</p>","PeriodicalId":35535,"journal":{"name":"Pediatria Medica e Chirurgica","volume":"41 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/pmc.2019.230","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37861911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guidelines of the Italian Society of Videosurgery in Infancy for the minimally invasive treatment of pediatric nephrectomy and partial nephrectomy.","authors":"Salvatore Fabio Chiarenza,&nbsp;Cosimo Bleve,&nbsp;Ciro Esposito,&nbsp;Maria Escolino,&nbsp;Fabio Beretta,&nbsp;Maurizio Cheli,&nbsp;Vincenzo Di Benedetto,&nbsp;Maria Grazia Scuderi,&nbsp;Giovanni Casadio,&nbsp;Maurizio Marzaro,&nbsp;Leon Francesco Fascetti,&nbsp;Pietro Bagolan,&nbsp;Caludio Vella,&nbsp;Maria Luisa Conighi,&nbsp;Daniela Codric,&nbsp;Simona Nappo,&nbsp;Paolo Caione","doi":"10.4081/pmc.2019.231","DOIUrl":"https://doi.org/10.4081/pmc.2019.231","url":null,"abstract":"<p><p>Throughout history, the pediatric laparoscopic nephrectomy was first described at the beginning of the Nineties by Erlich and colleagues in a child and by Koyle and colleagues in an unweaned patient. (...).</p>","PeriodicalId":35535,"journal":{"name":"Pediatria Medica e Chirurgica","volume":"41 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/pmc.2019.231","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37861912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}