ABSTRACT
The achalasia is an uncommon pathology in childhood but the disturbances in growth, development and the severity of pulmonary symptoms are more severe than adults. In a period of twenty five years we have diagnosed three children of sixteen months, 4,5 and twelve years of achalasia and treating them with a modified Heller procedure as primary therapy adding anti-reflux procedure in the youngest. Literature review indicates excellent results following modified Heller's operation in more than 85 per 100 of cases. When an anti-reflux procedure is not performed the incidence of gastro-oesophageal reflux in childhood is 20 per 100.
Subject(s)
Esophageal Achalasia/surgery , Age Factors , Cardia/surgery , Child, Preschool , Esophageal Achalasia/diagnostic imaging , Esophagus/surgery , Female , Humans , Infant , Male , RadiographySubject(s)
Cholelithiasis/diagnosis , Adult , Female , Fetal Diseases/diagnosis , Humans , Infant, Newborn , Pregnancy , Prenatal Diagnosis , UltrasonographyABSTRACT
From 1975 to 1987, we have operated 20 cases with lung metastases. They were 12 females and 8 males with ages between 1,6 and 12 years old (average of 5 years). The histology of the primary neoplasia was: 13 cases with Wilms' Tumors, 3 cases with Ewing's Sarcoma and 1 case with Neuroblastoma, Rhabdomiosarcoma, Hepatoblastoma and Neuroectodermic Tumor of Askin. We found 38 metastases and there were performed through a Thoracotomy 28 wedge resection, 7 pulmonary lobectomies and 3 biopsies. The operative mortality was 0%. The most frequent location of the lesion were on medium and lower lobule of the right lung. The survival was 70% (14 cases) after 4 years of average of the follow up. The survival for Wilms Tumors was 61% (8 cases) and all patients with Ewing's Sarcoma, Rhabdomiosarcoma, Neuroblastoma and Neuroectodermic Tumor of Askin were alive. The Thoracotomy is a useful method for therapy of tumors in children with lung metastases associated to chemotherapy and radiotherapy.
Subject(s)
Lung Neoplasms/secondary , Lung Neoplasms/surgery , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Infant , MaleSubject(s)
Adenocarcinoma , Carcinoma, Papillary , Thyroid Neoplasms , Adenocarcinoma/etiology , Adenocarcinoma/pathology , Adenocarcinoma/therapy , Adolescent , Adult , Carcinoma, Papillary/etiology , Carcinoma, Papillary/pathology , Carcinoma, Papillary/therapy , Child , Combined Modality Therapy , Female , Humans , Lymphatic Metastasis , Male , Neoplasms, Radiation-Induced , Thyroid Neoplasms/etiology , Thyroid Neoplasms/pathology , Thyroid Neoplasms/therapySubject(s)
Fecal Incontinence/surgery , Rectum/surgery , Adolescent , Anal Canal/abnormalities , Anal Canal/surgery , Child , Child, Preschool , Fecal Incontinence/etiology , Female , Humans , Male , Rectum/abnormalitiesABSTRACT
We report 30 patients with Hodgkin's disease treated at "La Paz" Children Hospital of Madrid, from 1965 to 1984, to determine the role of the laparotomy in modifying the presurgical clinic stage. Laparotomy changed this stage in 40% of patients, in whom stage advanced from I or II to III or IV. The only side effect of surgery was pneumococcal sepsis in two patients. All children were treated with polyvalent pneumococcal vaccine and penicillin or erythromycin, before laparotomy.
Subject(s)
Hodgkin Disease/pathology , Laparotomy , Adolescent , Child , Child, Preschool , Evaluation Studies as Topic , Female , Humans , Infant , Infant, Newborn , Laparotomy/adverse effects , Male , Neoplasm Staging , Pneumonia/prevention & controlABSTRACT
Two patients with Cricopharyngeal achalasia have been treated at the Clínica Infantil "La Paz" (Madrid) in the last 20 years. They were one and a half, and four and a half months old at the time of operation. The postoperative period and follow-up has been satisfactory. Clinical symptoms in both of them were cough, cyanosis, regurgitation and aspirative pneumonia. One of them came with the diagnosis of congenital esophageal stenosis, and the other one with the diagnosis of tracheoesophageal fistula. The diagnosis was confirmed by endoscopy and barium-X-ray. Section of the Cricopharyngeus muscle was curative and recovery of the normal function has been complete.
Subject(s)
Esophageal Achalasia/surgery , Child, Preschool , Deglutition Disorders/etiology , Esophageal Achalasia/complications , Esophageal Achalasia/diagnostic imaging , Female , Humans , Male , Pharyngeal Muscles/physiopathology , RadiographyABSTRACT
From 1970-1982, 70 newborns with different kinds of tumors were studied at "La Paz" Children's Hospital in Madrid. Our review was directed to study sex, site, kind and malignity. This type of neonatal work is uncommon in pediatric literature. We make special emphasis in the follow-up of malignant. tumors. 63% of these tumors were benign ant the remaining were malignant. The overall mortality was 28%.
Subject(s)
Neoplasms , Carcinoma, Hepatocellular/pathology , Dysgerminoma/pathology , Dysgerminoma/surgery , Female , Hemangioma/surgery , Humans , Infant, Newborn , Liver Neoplasms/pathology , Lymphangioma/surgery , Male , Neoplasms/diagnosis , Neoplasms/surgery , Neuroblastoma/classification , Neuroblastoma/surgery , Wilms Tumor/pathologyABSTRACT
Although chest wall osseous tumors are frequent in infancy, a few cases have been reported in the last years. Most of these cases had a benign course although in many of them a malignant histological diagnosis was formerly made. We report a case of chest wall tumor in a two months old boy. The histological pattern was similar to that described by McLeod and Dahlin as "chest wall hamartoma of the infancy". Seven months after the tumor resection the child lived well and without recurrence.
Subject(s)
Hamartoma/pathology , Ribs , Thoracic Neoplasms/pathology , Hamartoma/diagnostic imaging , Hamartoma/surgery , Humans , Infant , Male , Radiography , Thoracic Neoplasms/diagnostic imaging , Thoracic Neoplasms/surgeryABSTRACT
79 cases of Wilms' tumor with age at diagnosis between 0 and eight years, are reported. 76 of them are evaluable for therapeutic results. 54 (71%) are alive and disease-free, with a mean survival of 53 months. Group A (35 patients) received pre-surgical treatment with radiotherapy and the survival rate is 77%. Group B (32 patients) were not treated before surgery and the survival rate is 84%. Both groups received post-surgical treatment with radiotherapy and chemotherapy (vincristine and actinomycin D). Patients in group C, chronologically the oldest, did not receive chemotherapy and its survival rate was 20%. Prognostical significance of age, sex, site, clinical stage and histology are examined. Classical concepts on histological classifications are revised and present criteria are shown, along with its' therapeutic and prognostic implications.
Subject(s)
Kidney Neoplasms/therapy , Wilms Tumor/therapy , Child, Preschool , Humans , Infant , Infant, Newborn , Kidney Neoplasms/drug therapy , Kidney Neoplasms/radiotherapy , Nephrectomy , Wilms Tumor/drug therapy , Wilms Tumor/radiotherapyABSTRACT
17 cases of Hodgkin's disease are reported, seen in a ten year period. Age of patients oscillated between three and seven years. There was a predominance of mixed cellularity type in histologic pattern. Most of patients were diagnosed in advanced clinical stages. Primary sign of disease was presence of cervical adenopathies and there were few cases of thoracic disease. Treatment consisted in radiotherapy and chemotherapy, according to histological type and clinical stage. Survival in our serie is of 53.3% with periods of observation from six months to seven years.