Background: Gastric perforation is a rare, life-threatening condition in neonates. To avoid deterioration, prompt surgical treatment is mandatory. Patients: We report on 2 neonates (1 and 8 days old) with feeding tube...Background: Gastric perforation is a rare, life-threatening condition in neonates. To avoid deterioration, prompt surgical treatment is mandatory. Patients: We report on 2 neonates (1 and 8 days old) with feeding tube associated gastric perforation managed laparoscopically by single layer suture repair. Both children suffered from severe peritonitis. Operative time was 60 minutes in both cases. Oral feeding was started on postoperative day 3 and 7, respectively. No complications regarding the gastric perforation were encountered on follow-up (11 and 8 months, respectively) in both cases. Conclusions: We recommend laparoscopic suture repair as a safe and feasible method for surgical treatment of gastric perforation in neonates. These appear to be the first reported cases using this procedure for treatment of neonatal gastric perforation.展开更多
Introduction: Transient oliguria during laparoscopic surgery is a known phenomenon. Currently, no data on the impact of pneumoperitoneum on renal function in children are available. Patients and Methods: Thirty childr...Introduction: Transient oliguria during laparoscopic surgery is a known phenomenon. Currently, no data on the impact of pneumoperitoneum on renal function in children are available. Patients and Methods: Thirty children with normal kidney function, who underwent laparoscopic surgery, were included in a prospective study. A transure-thral catheter was placed to measure urine output during and 6 hours after operation. Renal blood flow (resistive index) was evaluated by Doppler ultrasound of a segmental renal artery before surgery, every 15 minutes during laparoscopy, and after 24 hours. Blood and urine samples were studied before and 24 hours after surgery. Hemodynamic parameters were monitored continuously during stan-dardized anesthesia, including a standardized intravenous infusion regimen. Results: Urine output decreased within 45 minutes of pneumoperitoneum in all patients. Of 8 children younger than 1 year, 7 (88% ) developed anuria vs 3 of 22 (14% ) children aged 1 to 15 years (P < .001). Nine children 1 year and older (32% ) developed oliguria. There was a significant recovering in the mean urine output until 5 to 6 hours after pneumoperitoneum in both age groups. No significant alterations of the renal blood flow (resistive index) and the serum and urine levels of cystatin C, creatinine, and urea nitrogen were evident until 24 hours postoperatively. The volume of infusion during pneumoperitoneum did not correlate with urine output. Conclusion: Pneumoperitoneum leads to anuria in most children younger than 1 year and to oliguria in about one third of older children. This is a completely reversible phenomenon. Urine output should not be taken into consideration for calculating intravenous fluid administration during pneumoperitoneum in children.展开更多
The etiology of gastroschisis is still unclear. To the authors’ knowledge, there are only 14 cases of familial gastroschisis in the literature. The authors add the second case of motherand-son occurrence and a case o...The etiology of gastroschisis is still unclear. To the authors’ knowledge, there are only 14 cases of familial gastroschisis in the literature. The authors add the second case of motherand-son occurrence and a case of siblings occurrence, thereby updating the current literature for family gastroschisis.展开更多
文摘Background: Gastric perforation is a rare, life-threatening condition in neonates. To avoid deterioration, prompt surgical treatment is mandatory. Patients: We report on 2 neonates (1 and 8 days old) with feeding tube associated gastric perforation managed laparoscopically by single layer suture repair. Both children suffered from severe peritonitis. Operative time was 60 minutes in both cases. Oral feeding was started on postoperative day 3 and 7, respectively. No complications regarding the gastric perforation were encountered on follow-up (11 and 8 months, respectively) in both cases. Conclusions: We recommend laparoscopic suture repair as a safe and feasible method for surgical treatment of gastric perforation in neonates. These appear to be the first reported cases using this procedure for treatment of neonatal gastric perforation.
文摘Introduction: Transient oliguria during laparoscopic surgery is a known phenomenon. Currently, no data on the impact of pneumoperitoneum on renal function in children are available. Patients and Methods: Thirty children with normal kidney function, who underwent laparoscopic surgery, were included in a prospective study. A transure-thral catheter was placed to measure urine output during and 6 hours after operation. Renal blood flow (resistive index) was evaluated by Doppler ultrasound of a segmental renal artery before surgery, every 15 minutes during laparoscopy, and after 24 hours. Blood and urine samples were studied before and 24 hours after surgery. Hemodynamic parameters were monitored continuously during stan-dardized anesthesia, including a standardized intravenous infusion regimen. Results: Urine output decreased within 45 minutes of pneumoperitoneum in all patients. Of 8 children younger than 1 year, 7 (88% ) developed anuria vs 3 of 22 (14% ) children aged 1 to 15 years (P < .001). Nine children 1 year and older (32% ) developed oliguria. There was a significant recovering in the mean urine output until 5 to 6 hours after pneumoperitoneum in both age groups. No significant alterations of the renal blood flow (resistive index) and the serum and urine levels of cystatin C, creatinine, and urea nitrogen were evident until 24 hours postoperatively. The volume of infusion during pneumoperitoneum did not correlate with urine output. Conclusion: Pneumoperitoneum leads to anuria in most children younger than 1 year and to oliguria in about one third of older children. This is a completely reversible phenomenon. Urine output should not be taken into consideration for calculating intravenous fluid administration during pneumoperitoneum in children.
文摘The etiology of gastroschisis is still unclear. To the authors’ knowledge, there are only 14 cases of familial gastroschisis in the literature. The authors add the second case of motherand-son occurrence and a case of siblings occurrence, thereby updating the current literature for family gastroschisis.
