Comparison of Surgical Outcomes of Laparoscopic Glue and Laparoscopic Suture Hernioplasty in Pediatric Female Inguinal Hernia

This study aimed to report the surgical outcomes of laparoscopic glue hernioplasty (LGH) compared with conventional laparoscopic suture hernioplasty (LSH) in pediatric female inguinal hernia repair. We retrospectively analyzed 465 female pediatric patients who underwent laparoscopic inguinal hernia repair between January 2013 and December 2020. LGH and LSH were performed in 95 and 370 cases, respectively. Surgical outcomes (length of hospital stay, operative time, complications, and recurrences) were compared between the LGH and LSH groups. We found that the operation times for bilateral hernia repair were shorter in the LGH group (LGH: 35.5 ± 8.2 min, LSH: 45.2 ± 11.6 min; p < 0.001). No significant differences in complications or recurrences were observed between the two groups during the follow-up period. Our findings suggest that LGH is a feasible and easily applied surgical technique for the treatment of pediatric female inguinal hernia.ope

Nissen Fundoplication for the Treatment of Gastroesophageal Reflux After Repair of Esophageal Atresia

Purpose Gastroesophageal reflux disease (GERD) frequently affects patients with esophageal atresia (EA). GERD is often resistant to medical therapy, and anti-reflux surgery in the form of fundoplication is required. However, there are no generally accepted indications for fundoplication in EA patients with significant gastroesophageal reflux (GER). This study aimed to report the outcomes and review the clinical characteristics and treatment of GERD with Nissen fundoplication among EA patients. Methods The medical records of patients with EA repair who underwent Nissen fundoplication for GERD treatment from January 2005 to December 2018 were retrospectively reviewed. Twenty patients were included in this study. Results In total, 166 patients with EA underwent treatment during the study period. Among these, 20 (12%) patients underwent Nissen fundoplication. The median age at the time of fundoplication was 5.3 (range, 1.6–49.4) months, and the mean body weight was 6.3±2.4 kg. The indications for Nissen fundoplication were hiatal hernia in 18 (90%) patients, feeding intolerance in 17 (85%), recurrent aspiration pneumonia in 13 (65%), GER-related refractory anastomosis stenosis in seven (35%), and reflux-related acute life-threatening events in five (25%). The median follow-up duration after Nissen fundoplication was 5.7 (range, 2.4–10.7) years; two (10%) patients experienced surgery-related complications, 11 (55%) had recurrent hiatal hernia, and three (15%) required re-operation. Feeding intolerance improved (p<0.001), and the number of esophageal dilatations decreased following Nissen fundoplication (p=0.038). There was no mortality during the follow-up period. Conclusion Nissen fundoplication was required in patients with more complicated EA and was performed at a young age. Nissen fundoplication was relatively effective in controlling EA-associated GERD. However, Nissen fundoplication in patients with EA may be associated with a high rate of recurrent hiatal hernia. A careful follow-up is necessary because poor long-term outcomes are common for such patients.ope

Spontaneous knotting of an antegrade continent enema catheter

Malone antegrade continent enema (ACE) is a procedure in which an appendicostomy is performed to effectively control intractable fecal incontinence. In this procedure, spontaneous knotting of the enema catheter inside the cecum may occur, albeit rarely. In such a situation, the knot of the ACE catheter in the cecum could not be removed easily. Here, we aimed to report two cases of spontaneous knotting of the ACE catheter during routine ACE. Moreover, we aimed to discuss the mechanism of spontaneous knotting of the catheter during ACE, preventive methods, and methods to remove the knotted catheters.restrictio

Successful multi-stage surgery for a giant lymphatic malformation encircling the leg in an infant

Treatment methods for lymphatic malformations vary and are selected according to the location and extent of the disease. A giant lymphatic malformation surrounding the leg in an infant is a rare and challenging condition. Only few cases of surgery of such giant lymphatic malformation have been reported in the literature. The objective of this clinical case report is to describe a successful multi-stage surgery for a giant lymphatic malformation encircling the leg in an infant.restrictio

Changes in outcomes and operative trends with pediatric robot-assisted resection of choledochal cyst

Background: This study aimed to report our experience with a robot-assisted resection of choledochal cysts (CCs) in pediatric patients, especially focusing on changes in outcomes and operative trends. Methods: We retrospectively reviewed medical records of all 158 patients under 18 years of age who underwent robot-assisted resection of CC in a single tertiary center between July 2008 and January 2021. Patients were divided into the first period (P1, July 2008-March 2016; N = 79) and second period (P2, April 2016-January 2021; N = 79) with equal number of participants. The patients of P2 were compared with those of P1 to assess clinical outcomes with operative details. Operative characteristics and postoperative prognosis were compared for each group. Results: The mean operative time was 383.6 min for the P2 group and 462.6 min for the P1 group (p < 0.001). The mean estimated blood loss was 28 mL in the P2 group and 63 mL in the P1 group (p = 0.025). The rate of emergency department visit after the operation was lower in the P2 group (3.8% vs. 13.9%, respectively, p = 0.047). The two groups showed no significant differences in the rate of late postoperative complications and reoperations. Conclusion: With the increase in the center's experience, robot-assisted resection of CC can be safely adopted and feasible, especially for pediatric patients. Levels of evidence: Treatment Study, Level III.restrictio