Laparoscopic approach to small intestinal obstruction in children: a preliminary experience

The objective of the present study was to evaluate the feasibility and outcome of laparoscopic management of small intestinal obstruction. A retrospective review of 30 children admitted for an attempt of laparoscopic treatment of acute intestinal obstruction was performed, their mean age was 6.7 +/- 1.73 years. Of the 30 laparoscopic attempts, 20 could have been performed successfully, while 10 patients needed a conversion to laparotomy due to inadequate laparoscopic visualization in 6 cases, gangrenous bowel in 2 cases and inability to relieve the obstruction laparoscopically in 2 cases. There were no intra- or postoperative complications in the laparoscopic group

Endoscopic and histological study of mucosal changes in oesophageal substitutes in children

Thirty children with different esophageal substitutes following corrosive esophageal stricture were subjected to endoscopic and histological study. The patients with retrosternal colon bypass were eight cases, eleven cases with retrosternal gastric tube bypass and eleven cases with transhiatal esophagectomy with gastric pull up. They were eighteen males and twelve females with ages ranged from four to fifteen years with a mean age of 5.5 years. Endoscopic mucosal biopsies were taken from the cervical esophageal stump and the esophageal substitutes. All cases showed different degrees of endoscopic changes in both cervical esophageal stump mucosa and the mucosa of different types of esophageal substitutes. It was concluded that both colon and stomach showed different degrees and types of mucosal changes in their mucosa and esophageal stump mucosa. Their incidence and severity were less in colon than stomach, but difference was not marked. Antireflux surgery is needed in cases of post- corrosive replacement of the esophagus to prevent dysplasia and metaplasia in esophageal substitute and cervical esophageal stump