RESUMO
A technique was developed to adapt the Thal fundoplication to the laparoscopic approach. Modifications include tying an umbilical tape (as a loop) around the esophagus for retraction, interrupted fundoplication sutures, and extracorporeal gastrostomy through a trocar site. This technique was completed successfully in 10 pediatric patients.
Assuntos
Refluxo Gastroesofágico/cirurgia , Gastrostomia/métodos , Laparoscopia/métodos , Adolescente , Criança , Pré-Escolar , Gastrostomia/efeitos adversos , Gastrostomia/instrumentação , Humanos , Lactente , Laparoscópios , Laparoscopia/efeitos adversos , Período Pós-Operatório , Técnicas de SuturaRESUMO
Two infants with gastroschisis had most of the midgut avulsed during cesarean section. There was only 12 and 20 cm of small bowel remaining, with an intact ileocecal valve in each case. Cutaneous enterostomy followed by anastomosis was done in both patients. The first child is 4 years old and is now on total enteral feedings after prolonged intravenous support. The second infant is still on partial parenteral nutrition. The cases illustrate the vulnerability of the fetus with gastroschisis during extraction by cesarean section.
Assuntos
Músculos Abdominais/anormalidades , Cesárea , Hérnia Ventral/congênito , Intestino Delgado/lesões , Complicações Intraoperatórias , Feminino , Doenças Fetais , Hérnia Ventral/cirurgia , Humanos , Recém-Nascido , Intestino Delgado/cirurgia , MasculinoRESUMO
An unusual case of double atresia of the rectum, including an imperforate anus is reported. The author was unable to find a similar case published before.
Assuntos
Anus Imperfurado/complicações , Atresia Intestinal/complicações , Reto/anormalidades , Anus Imperfurado/diagnóstico , Anus Imperfurado/cirurgia , Humanos , Lactente , Atresia Intestinal/diagnóstico , Atresia Intestinal/cirurgia , Imageamento por Ressonância Magnética , Masculino , Reto/patologia , Reto/cirurgiaRESUMO
Three cases of long-gap esophageal atresia were repaired using a technique that included a right extrapleural thoracotomy, preservation of the entire esophagus available, both anastomoses in the mediastinum, use of a short segment of colon, and preservation of the ileocecal valve. This approach, not previously described, combines multiple features aimed at decreasing complications related to traditional techniques. Successful early results are promising.
Assuntos
Colo/transplante , Atresia Esofágica/cirurgia , Criança , Humanos , Lactente , Métodos , Complicações Pós-OperatóriasAssuntos
Atresia Intestinal/terapia , Intestino Delgado/anormalidades , Síndrome do Intestino Curto/terapia , Nutrição Enteral , Enterocolite Pseudomembranosa/cirurgia , Feminino , Seguimentos , Humanos , Recém-Nascido , Masculino , Nutrição Parenteral Total , Complicações Pós-Operatórias/terapia , Síndrome do Intestino Curto/etiologiaRESUMO
Bronchoscopic and conventional bronchographic examinations are reliable methods to evaluate the integrity of a sutured bronchial stump. However, sometimes the critical condition of the patient makes these diagnostic procedures impractical. We present here a simpler method to achieve this purpose. This requires minimal invasiveness, no disturbance to the therapeutic support, and no transportation of the patient.
Assuntos
Brônquios/cirurgia , Pneumonectomia , Deiscência da Ferida Operatória/diagnóstico por imagem , Broncografia , Pré-Escolar , Humanos , MasculinoRESUMO
Surgical treatment for pulmonary interstitial emphysema (PIE) has been reported with increasing frequency. We have done pulmonary lobectomies in 14 neonates with the localized form of PIE. This type of treatment was successful in 11 patients. Two patients expired in the hospital and one showed no improvement. Another six very compromised patients with diffuse PIE were treated during the same period with multiple visceral pleurotomies. Only one survived. Infants with diffuse PIE are usually poor surgical candidates, while those with acquired lobar emphysema (ALE) have been treated successfully with lobectomies.
Assuntos
Enfisema Pulmonar/cirurgia , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Pulmão/patologia , Masculino , Pneumonectomia , Prognóstico , Enfisema Pulmonar/patologiaRESUMO
Intestinal intussusception, perforation, and infarction constitute the major surgical complications in Henoch-Schönlein Purpura (HSP). This report reviews the surgical experience in 13 patients of the 58 treated for HSP at our institution in the past 10 years. In addition, the reported surgical cases of anaphylactoid purpura in the pediatric age are analyzed. Attention is focused on observations not previously emphasized in regard to the timing of the surgical event in relation to the cutaneous manifestation of HSP.
