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Objective:To study the safety and feasibility of laparoscopic surgery for treatment of hepaticojejunostomy strictures after cholangiectasis surgery in children.Methods:The clinical data of 12 children was retrospectively analysed. There were 5 males and 7 females, aged 4 (range 0.45 to 9.00) years old, who developed hepaticojejunostomy strictures after cholangiectasis surgery and underwent reoperative treatment at Anhui Provincial Children's Hospital from January 2013 to January 2021. These patients were divided into the laparoscopic surgery group ( n=5) and the open surgery group ( n=7) based on the mode of reoperation. The children were followed-up by outpatient review and the relevant clinical data of the children in the 2 groups was analyzed. Results:The reoperations were completed successfully in the 2 groups. The maximum preoperative dilated common hepatic duct diameter was significantly larger in the laparoscopic group (1.26±0.23) cm than the open group (0.64±0.19) cm ( P<0.05). The alkaline phosphatase and glutamyltransferase levels in the laparoscopic surgery group were significantly lower before the operation (all P<0.05), and the total bilirubin, direct bilirubin, alkaline phosphatase, and glutamyltransferase levels were significantly lower in the laparotomy group than before the operations (all P<0.05). In the laparoscopic group, the time of the reoperations, postoperative hospital stay, and blood loss were 268(117, 340) min, (9.0±2.9) d and (14.0±5.5) ml, respectively, while those in the open group were 180(150, 205) min, (9.7±3.4) d and (13.3±2.6) ml, respectively. There were no significant differences between the two groups (all P>0.05). On follow-up, all children were well except for one child who showed mild elevation levels of alanine aminotransferase and aspartate aminotransferase. Conclusion:Laparoscopic surgery for hepaticojejunostomy strictures after cholangiectasis surgery in children was safe and feasible. Its curative effect was no less than that of open surgery.
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Objective To summarize our experiences of applying totally implantable venous access ports ( TIVAP) in chemotherapy for young children with malignant tumors.Methods Between December 2011 and May 2015, 50 young children with malignant tumors were implanted with TIVAP in Anhui Provincial Children's Hospital for chemotherapy.A retrospective review was conducted with their clinical records, focusing on success rate, clinical effect, and complications of TIVAP.Results The technical success rate was 100%with no intrao-perative complication such as puncture-related injury.In one case the device had to be adjusted through reopera-tion due to malposition of catheter tip.The port was removed in one case after 1 year due to infection.15 patients had the ports removed after the completion of chemotherapy.5 patients died due to the relapse and metastasis of tumor.29 patients are still using the port with no complications.Conclusion TIVAP is a safe device in young children, ensuring reliable vascular access for chemotherapy and improving patients'quality of life.