Pediatria Medica e Chirurgica最新文献_第9页

High-pressure balloon dilatation in children: our results in 30 patients with POM and the implications of the cystoscopic evaluation. 儿童高压球囊扩张:30例POM患者的结果及膀胱镜评估的意义。

Pediatria Medica e Chirurgica Pub Date : 2020-10-08 DOI: 10.4081/pmc.2020.214

Francesca Destro, Giorgio Selvaggio, Federica Marinoni, Andrea Pansini, Giovanna Riccipetitoni

{"title":"High-pressure balloon dilatation in children: our results in 30 patients with POM and the implications of the cystoscopic evaluation.","authors":"Francesca Destro, Giorgio Selvaggio, Federica Marinoni, Andrea Pansini, Giovanna Riccipetitoni","doi":"10.4081/pmc.2020.214","DOIUrl":"https://doi.org/10.4081/pmc.2020.214","url":null,"abstract":"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.","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}

引用次数: 7

Endoscopic balloon dilatation of primary obstructive megaureter: method standardization and predictive prognostic factors. 内镜下原发性阻塞性血压计球囊扩张术:方法标准化及预测预后因素。

Pediatria Medica e Chirurgica Pub Date : 2019-12-23 DOI: 10.4081/pmc.2019.219

Salvatore Fabio Chiarenza, Cosimo Bleve, Elisa Zolpi, Francesco Battaglino, Lorella Fasoli, Valeria Bucci

{"title":"Endoscopic balloon dilatation of primary obstructive megaureter: method standardization and predictive prognostic factors.","authors":"Salvatore Fabio Chiarenza, Cosimo Bleve, Elisa Zolpi, Francesco Battaglino, Lorella Fasoli, Valeria Bucci","doi":"10.4081/pmc.2019.219","DOIUrl":"https://doi.org/10.4081/pmc.2019.219","url":null,"abstract":"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.","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}

引用次数: 6

Guidelines of the Italian Society of Videosurgery in Infancy for the minimally invasive treatment of the esophageal atresia. 意大利婴幼儿视频外科学会食管闭锁微创治疗指南。

Pediatria Medica e Chirurgica Pub Date : 2019-12-19 DOI: 10.4081/pmc.2019.230

Salvatore Fabio Chiarenza, Maria Luisa Conighi, Ciro Esposito, Maria Escolino, Fabio Beretta, Maurizio Cheli, Vincenzo Di Benedetto, Maria Grazia Scuderi, Giovanni Casadio, Maurizio Marzaro, Leon Francesco Fascetti, Andrea Conforti, Pietro Bagolan, Claudio Vella, Cosimo Bleve, Daniela Codric, Paolo Caione

引用次数: 0

Guidelines of the Italian Society of Videosurgery in Infancy for the minimally invasive treatment of pediatric nephrectomy and partial nephrectomy. 意大利婴幼儿电视外科学会微创治疗小儿肾切除术和部分肾切除术指南。

Pediatria Medica e Chirurgica Pub Date : 2019-12-19 DOI: 10.4081/pmc.2019.231

Salvatore Fabio Chiarenza, Cosimo Bleve, Ciro Esposito, Maria Escolino, Fabio Beretta, Maurizio Cheli, Vincenzo Di Benedetto, Maria Grazia Scuderi, Giovanni Casadio, Maurizio Marzaro, Leon Francesco Fascetti, Pietro Bagolan, Caludio Vella, Maria Luisa Conighi, Daniela Codric, Simona Nappo, Paolo Caione

引用次数: 0

Guidelines of the Italian Society of Videosurgery in Infancy for the minimally invasive treatment of the ureteropelvic-junction obstruction. 意大利婴幼儿电视外科学会微创治疗输尿管肾盂连接处梗阻的指南。

Pediatria Medica e Chirurgica Pub Date : 2019-12-19 DOI: 10.4081/pmc.2019.232

Salvatore Fabio Chiarenza, Cosimo Bleve, Ciro Esposito, Maria Escolino, Fabio Beretta, Maurizio Cheli, Vincenzo Di Benedetto, Maria Grazia Scuderi, Giovanni Casadio, Maurizio Marzaro, Leon Francesco Facetti, Pietro Bagolan, Claudio Vella, Maria Luisa Conighi, Daniela Codric, Simona Nappo, Paolo Caione

引用次数: 0

A rare cause of acute scrotum in a child: torsion of an epididymal cyst. Case report and review of the literature. 儿童急性阴囊的罕见病因:附睾囊肿扭转。病例报告及文献复习。

Pediatria Medica e Chirurgica Pub Date : 2019-06-21 DOI: 10.4081/pmc.2019.210

Mario Messina, Giulia Fusi, Francesco Ferrara, Edoardo Bindi, Chiara Pellegrino, Francesco Molinaro, Rossella Angotti

引用次数: 7

The influence of type of delivery, skin-to-skin contact and maternal nationality on breastfeeding rates at hospital discharge in a baby-friendly hospital in Italy. 意大利一家爱婴医院分娩类型、皮肤接触和母亲国籍对出院时母乳喂养率的影响

Pediatria Medica e Chirurgica Pub Date : 2019-05-22 DOI: 10.4081/pmc.2019.207

Mauro Cinquetti, Anna Maria Colombari, Emanuela Battisti, Pierpaolo Marchetti, Giorgio Piacentini

{"title":"The influence of type of delivery, skin-to-skin contact and maternal nationality on breastfeeding rates at hospital discharge in a baby-friendly hospital in Italy.","authors":"Mauro Cinquetti, Anna Maria Colombari, Emanuela Battisti, Pierpaolo Marchetti, Giorgio Piacentini","doi":"10.4081/pmc.2019.207","DOIUrl":"https://doi.org/10.4081/pmc.2019.207","url":null,"abstract":"The aim of this epidemiological study is to evaluate how type of delivery, skin-to-skin contact and maternal nationality influence breastfeeding practices of newborns at discharge in a large population of babies born in the Baby-Friendly Hospital of San Bonifacio, Verona, Italy. Data were collected for all healthy newborns consecutively born over a period of three years, regarding type of delivery, feeding at hospital discharge, skin-to-skin procedure, and for a smaller group maternal nationality was recorded as well. The rate of exclusive breastfeeding in a group of 6017 newborns was 82.1%, higher among babies born by vaginal delivery than in those born by cesarean section (84.9% vs 65%; P<0.001). It was higher in those who had skin-to-skin contact than in those who did not, in both vaginal delivery (85.3% vs 69.2%; P<0.001) and cesarean section (67.7% vs 55.1%; P=0.009). Also, it was found to be higher in babies born to immigrant mothers than in those born to Italian mothers (89.9% vs 79.5%). Vaginal delivery, skin-to-skin contact and maternal foreign nationality have a positive association with breastfeeding at hospital discharge.","PeriodicalId":35535,"journal":{"name":"Pediatria Medica e Chirurgica","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/pmc.2019.207","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36998779","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}

引用次数: 12

The APpendicitis PEdiatric (APPE) score: a new diagnostic tool in suspected pediatric acute appendicitis. 小儿阑尾炎(APPE)评分:疑似小儿急性阑尾炎的新诊断工具。

Pediatria Medica e Chirurgica Pub Date : 2019-04-02 DOI: 10.4081/pmc.2019.209

Mario Lima, Dora Persichetti-Proietti, Neil Di Salvo, Claudio Antonellini, Michele Libri, Beatrice Randi, Michela Maffi, Tommaso Gargano, Giovanni Ruggeri, Vincenzo Davide Catania

{"title":"The APpendicitis PEdiatric (APPE) score: a new diagnostic tool in suspected pediatric acute appendicitis.","authors":"Mario Lima, Dora Persichetti-Proietti, Neil Di Salvo, Claudio Antonellini, Michele Libri, Beatrice Randi, Michela Maffi, Tommaso Gargano, Giovanni Ruggeri, Vincenzo Davide Catania","doi":"10.4081/pmc.2019.209","DOIUrl":"https://doi.org/10.4081/pmc.2019.209","url":null,"abstract":"Our aim was to develop an APpendictis-PEdiatric score (APPE score) in quantifying risk of acute appendicitis based on combination of clinical and laboratory markers. 1025 patients were classified in: acute appendicitis (AA) and non-appendicitis. Demographic/clinical features, and laboratory were collected. They were compared for quantitative-variables and categorical-variables. Significant predictors (P=<0,05) were included in logistic regression model. Based on regression-coefficients, a diagnostic score was tested by calculating the area under the ROC curve. Two cut-offs were established to define classes of risk of AA. 9 variables were identified as potentially predictors for AA. Those underwent logistic regression and a score was assigned, for maximum 21-points. The score showed an area under the curve: 0.831 and a linear proportion with the state of appendicular inflammation (R20.85). Patients with a score ≤8 were at low risk of AA (sensitivity 94%); those with a score ≥15 were at high risk for AA (specificity 93%). Those between 8 and 15 were defined at intermediate risk class. APPE-score guides clinicians in classifying patients with suspected-AA according to clinical and laboratory findings in order to improve their management.","PeriodicalId":35535,"journal":{"name":"Pediatria Medica e Chirurgica","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/pmc.2019.209","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37131969","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}

引用次数: 6

Toward sutureless laparoscopic inguinal hernia repair in children? 儿童无缝线腹腔镜腹股沟疝修补术?

Pediatria Medica e Chirurgica Pub Date : 2019-03-19 DOI: 10.4081/pmc.2019.167

Antonio Marte, Laura De Rosa, Lucia Pintozzi, Vincenzo Esposito

{"title":"Toward sutureless laparoscopic inguinal hernia repair in children?","authors":"Antonio Marte, Laura De Rosa, Lucia Pintozzi, Vincenzo Esposito","doi":"10.4081/pmc.2019.167","DOIUrl":"https://doi.org/10.4081/pmc.2019.167","url":null,"abstract":"We report our experience with a sutureless technique for laparoscopic inguinal hernia repair in children. Twenty-eight children, 12 girls and 16 boys, aged 3 months to 7 years, underwent sutureless laparoscopic inguinal hernia repair. In girls, we utilized simple cauterization of the internal inguinal ring with a single trocar technique. In boys denudation of the peritoneum was obtained utilizing a three-trocar technique. The peritoneum around the internal inguinal ring was peeled off and detached from the vas and the vessels, and then wrapped around the grasper, resulting in a large area of denudation. No perioperative complications were observed. No recurrences nor testicular damage were noted after a mean follow-up of 18 months (range 6-35 months). The mean operative time was 12 min (range 7-20 min) for girls and 19 min (range 15-30 min) for boys. A 6-year-old girl exhibited a lymphocele. The sutureless technique appears to be easy, safe, and effective, provided that the patients are carefully selected. In boys, special attention needs to be paid to preservation of the vas and the testicular vessels.","PeriodicalId":35535,"journal":{"name":"Pediatria Medica e Chirurgica","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/pmc.2019.167","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37252783","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}

引用次数: 6

Paediatric surgery in the robotic era: early experience and comparative analysis. 机器人时代的儿科外科:早期经验与比较分析。

Pediatria Medica e Chirurgica Pub Date : 2019-01-18 DOI: 10.4081/pmc.2019.204

Mario Lima, Eduje Thomas, Neil Di Salvo, Tommaso Gargano, Giovanni Ruggeri

{"title":"Paediatric surgery in the robotic era: early experience and comparative analysis.","authors":"Mario Lima, Eduje Thomas, Neil Di Salvo, Tommaso Gargano, Giovanni Ruggeri","doi":"10.4081/pmc.2019.204","DOIUrl":"https://doi.org/10.4081/pmc.2019.204","url":null,"abstract":"The aim of this study is to present our preliminary experience in robotics and a comparative analysis with conventional Minimally- Invasive Surgery (MIS). Cases operated by da Vinci Xi® System from February 2016 to October 2017 are reviewed retrospectively through demographics, diagnosis-procedure and short-term outcome parameters. A comparison with a matching conventional MIS population was also conducted. 40 robotic procedures were carried out and 112 (out of 3705) non-robotic procedures met inclusion criteria for comparison. Among robotic patients we observed: an average age of 143.5 months, weight of 42.9 Kg, operative and anaesthesia induction time respectively of 116.8 and 34.8 minutes. Furthermore, we observed a 6.1-day length of stay, 2.5% conversion rate and no complications. From the comparison between the groups, no statistical difference emerged in the length of stay, in conversion rates or in complications. A statistical significance was observed in terms of operative time in favour of non-Robotic- System. Our experience has meant to introduce the System in our surgical environment, comparing to the conventional MIS (an already established approach routinely performed at our center). Results have shown comparable safety and feasibility.","PeriodicalId":35535,"journal":{"name":"Pediatria Medica e Chirurgica","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/pmc.2019.204","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36876115","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}

引用次数: 4