Pediatria Medica e Chirurgica最新文献

{"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}

{"title":"Guidelines of the Italian Society of Videosurgery in Infancy for the minimally invasive treatment of the ureteropelvic-junction obstruction.","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 Facetti,&nbsp;Pietro Bagolan,&nbsp;Claudio Vella,&nbsp;Maria Luisa Conighi,&nbsp;Daniela Codric,&nbsp;Simona Nappo,&nbsp;Paolo Caione","doi":"10.4081/pmc.2019.232","DOIUrl":"https://doi.org/10.4081/pmc.2019.232","url":null,"abstract":"<p><p>The hydronephrosis, characterized by the dilation of the renal pelvicalyceal system with possible functional damage to the renal parenchyma, is the most common congenital abnormality of the urinary system detected in utero through the prenatal ultrasound screening. (...).</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.2019.232","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37861913","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":"A rare cause of acute scrotum in a child: torsion of an epididymal cyst. Case report and review of the literature.","authors":"Mario Messina,&nbsp;Giulia Fusi,&nbsp;Francesco Ferrara,&nbsp;Edoardo Bindi,&nbsp;Chiara Pellegrino,&nbsp;Francesco Molinaro,&nbsp;Rossella Angotti","doi":"10.4081/pmc.2019.210","DOIUrl":"https://doi.org/10.4081/pmc.2019.210","url":null,"abstract":"<p><p>Torsion of an epididymal cyst is an extremely rare cause of acute scrotum in children and in young boys. Its reported incidence is 5-20%. The treatment is usually conservative. Many cases (up to 60%) regress spontaneously, especially if below 3 cm. Few cases have been reported in Literature (7 cases/2018). We add our patient as eighth case. He was a 13-year-old boy who was admitted for acute scrotum. Ultrasound excluded torsion of the testis and he was managed for 5 day conservatively. Based on clinical history and physical exam, we decided to perform a prompt surgery that revealed a torsion of epididymal cyst that was confirmed by histological exam.</p>","PeriodicalId":35535,"journal":{"name":"Pediatria Medica e Chirurgica","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/pmc.2019.210","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37362336","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":"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,&nbsp;Anna Maria Colombari,&nbsp;Emanuela Battisti,&nbsp;Pierpaolo Marchetti,&nbsp;Giorgio Piacentini","doi":"10.4081/pmc.2019.207","DOIUrl":"https://doi.org/10.4081/pmc.2019.207","url":null,"abstract":"<p><p>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.</p>","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}

{"title":"The APpendicitis PEdiatric (APPE) score: a new diagnostic tool in suspected pediatric acute appendicitis.","authors":"Mario Lima,&nbsp;Dora Persichetti-Proietti,&nbsp;Neil Di Salvo,&nbsp;Claudio Antonellini,&nbsp;Michele Libri,&nbsp;Beatrice Randi,&nbsp;Michela Maffi,&nbsp;Tommaso Gargano,&nbsp;Giovanni Ruggeri,&nbsp;Vincenzo Davide Catania","doi":"10.4081/pmc.2019.209","DOIUrl":"https://doi.org/10.4081/pmc.2019.209","url":null,"abstract":"<p><p>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.</p>","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}