[Comparing the complications of Gomco and classic methods of circumcision]

There are different surgical procedures for circumcision. Although the classic method is the most common one, it takes more time and causes more pain and complications compared to other methods. The purpose of this study was to compare the complications and the time taken for performing the surgery for Gomco and classic methods of circumcision. This case-control study was performed on 80 neonates referred to the outpatient operating room in Shahid Beheshti hospital for circumcision in 2011 and were divided into two equal groups: one group underwent the classic method and another, the Gomco method. The complications were assessed in two phases: during the surgery by counting bloody gauze pads and one week thereafter using the objective methods, then they were analyzed statistically. The mean age of neonates was 24.8 +/- 12.37 days and no significant difference was seen between two groups. The mean operation duration in the classic method [24.3 +/- 2.5 min] was approximately two times greater than that of the Gomco method [13.3 +/- 2.3 min]. Moreover, the amount of bleeding in the classic method [4.1 +/- 0.6 cc] was over three times greater than that of the Gomco one [1.3 +/- 0.7 cc]. No cases of infection were seen in both groups. Results show that the Gomco method takes less time and causes less pain and fewer complications compared to the classic method and may also be a suitable alternative to the classic method

[ case report on tubular duplication of cervical esophagus]

Foregut duplication is commonly found in the posterior mediastinum. About 10-20% of these anomalies are associated with esophageal duplication. It can occur in all parts of esophagus. Although the duplication of cervical esophagus has been previously reported, a majority of it was found in the thoracic oesophagus. Infant esophageal duplication is usually associated to respiratory distress or asymptomatic thoracic mass, casually detected in x-ray. Case Report: In this report the case was a 7 months old infant [7.5 kg] with the chief compliant of respiratory distress, fever and nutritional intolerance. Physical examination of the case showed dehydration, stridor, tachypnea, intercostal retraction and neck stiffness. Plain chest radiogram showed a dual cystic mass in the distal neck region. Neck and chest CT-scan showed cervical cystic lesion disseminated to the posterior mediastinum, probably propagated to the respiratory system. For treatment, cystic lesion attached to the esophagus was partially resected, esophagus was repaired and the remaining mucosa of the cyst was removed, then gastrostomy tube was inserted. Although the cervical esophageal duplication of cysts are rare in infant respiratory distress, they must be considered as one of differential diagnoses of the cervical masses