ABSTRACT
Background: Mesohepatectomy (MH) or central hepatectomy (CH) is a recognized surgical technique for centrally located pediatric liver tumors. This technique of liver resection avoids extended liver resections and thereby helps in the preservation of liver parenchyma. In this article, we aim to analyze our experience and outcome with this technique of liver resection. Methods: A retrospective analysis of patients who underwent MH from January 2015 to June 2023 at our institute was performed. The variables analyzed include demographics, preoperative treatment, perioperative management, and postoperative outcome. Results: A total of five patients underwent CH. Four patients had hepatoblastoma, and one patient had mesenchymal hamartoma. All four patients with hepatoblastoma received neoadjuvant chemotherapy. All five patients had negative surgical margins, and one of the five developed disease recurrences necessitating resurgery and ultimately died of metastasis. one patient sustained intraoperative major bile duct injuries, and one patient had postoperative Abnormal, well-circumscribed, extra-biliary collection of bile. Conclusion: MH with clear margins is feasible in the selected subset of pediatric liver tumors involving segments IV, V, and VIII with outcomes equivalent to extended hepatic resections.
ABSTRACT
Fetus in fetu (FIF) is a rare congenital anomaly. Anomalies of inferior vena cava (IVC) in the host are rare and not reported in the literature. In this case report, the surgical management and the findings of a rare vascular anomaly of IVC in a 10-month-old male child with FIF are discussed. This case highlights the importance of antenatal ultrasonogram in the detection of FIF and to diligently look for structural anomalies of IVC in the host in such cases.
ABSTRACT
Aims: The mediastinum is the second common site of origin of pediatric neuroblastic tumors. Primary thoracic neuroblastoma (NB) is considered to be a site with favorable outcome and is reported to have a better prognosis than the other sites of origin. This is an observational study on our experience in the management of children with primary thoracic neuroblastic tumors. Materials and Methods: A retrospective observational review of the medical records of all the children treated for primary thoracic neuroblastic tumors including NB, ganglioneuroblastoma, and ganglioneuroma over a period of 8 years from January 2011 to December 2018 at our Institute was performed. We analyzed the factors including age, stage, histology, symptoms at presentation, surgical management, adjuvant treatment, and the 2-year survival of patients. Results: A total of 23 cases of primary thoracic neuroblastic tumors were identified during the study period. Ten patients had Stage III disease (43%), six had Stage IV (26%), four had Stage II, and three patients had Stage I. A total of four children (17%) died during the study period. A total of 13 children underwent complete excision of the tumor. Conclusion: In this retrospective review, we have observed that the mediastinal site of origin alone did not uniformly confer an excellent prognosis for all the patients. While the patients with lower stage tumors, favorable biological profile, and infants had excellent prognosis, in another small subset of patients with undifferentiated histology, the prognosis was guarded with an increased risk of recurrence. The clinical presentation with pleural effusion and compression of the airway at the time of presentation was associated with poor outcome.
ABSTRACT
Inguinal hernia with appendix as content, classically called as Amyand's Hernia has been well documented in children. Undescended testis with an associated hernia is also not uncommon and is an indication for early orchidopexy. We report a case of undescended testis which presented as an irreducible right inguinal hernia, which on exploration was found to have an inflamed appendix.
