Circumcision With Plastic Clamb in Newborn Infants

Various devices were used to carry circumcision operation out. It noted that these devices, especially the Plastic Clamp method, significantly decrease complications as long as basic surgical rules, are followed. This study aims to examine the application of Plastic Clamp circumcision in infants. Children whose physical examinations revealed circumcision contradictions excluded from the study. During the study period, a total of 485 children was circumcised using the plastic clamp method under sedated anesthesia and by a single pediatric surgeon. Measurements take before operations and plastic clamps with diameters ranging from 1.2 to 1.6 cm used. The duration of the surgical procedure, early and late period post-operative complications, the separation duration of the plastic clamp, and problems evaluated. Study Results, the average length of the surgical operation was determined to be 5.5 minutes. The average hospital stay duration of the patients was 2 hours. During the follow-ups, edemas were observed in mucosal areas of 24 (4.9%) patients, 48 hours after the clamp placed and edema and swelling recovered seven days after the circumcision at the latest. On average, it observed that plastic clamp separated on its own in 7.1 days. It noted that in 4 (0.8%) patients, the plastic clamp separated prematurely during 6 hours following the operation due to pulling. Conclusion study plastic Clamp (Alisklamp) is starting to gain popularity because it falls off on its own and that it can be applied quickly under local anesthesi

What should be the criteria of renal pelvic dilatation in fetal anomaly screening?

Background: Different classification systems are used for diagnosing the renal pelvic dilatation in the fetus using imaging techniques in the antenatal period. The most commonly used parameter for the diagnosis of renal pelvic dilatation is the anteroposterior diameter (APD) of the renal pelvis in the transverse plane. Objectives: The objectives of this study are to compare the measurements of the renal pelvic dilatation in fetuses with the measurements reported in the literature together with their short-term follow-up resultsin the postnatal period. Materials and Methods: The infants were included in the study if they were consulted with the pediatric surgery clinic due to the diagnosis of renal pelvic dilatation detected by measuring the APD of the renal pelvis in the transverse plane during an ultrasound examination when their mothers were screened for detecting fetal anomalies between July 2017 and February 2018 at the perinatology clinic. Results: The postnatal ultrasound examination, conducted for monitoring purposes, revealed that 82.7% (n=57) of the infants diagnosed with a dilatation of the renal pelvis had regression or resolution of the renal pelvic dilatation;however, it was observed that it persisted in the postnatal period in 17.3% (n=12) of the patients. The classification of the renal pelvic dilatation in 47 fetuses diagnosed during the screening for fetal anomalies in the second trimester of pregnancy showed that 41 (87.2%) of them were classified as mild, 5 (7.2%) of them were classified as moderate, and 1 (1.4%) of them was classified as severe. Conclusion: Based on the findings of measurements performed in the pregnant women screened at our hospital, this study reported the measurements of the renal pelvic dilatation in fetuses and compared the results reported in the literature together with their short-term follow-up results in the postnatal period.&nbsp

Hidden hazard in appendix in children: Carcinoid tumors

Introduction: Carcinoid tumors (CT) are the most common tumors of the appendix. The incidence of CT of the appendix is generally 1–2 in every 1000 appendectomy material. Objectives: The objectives of the study were to discuss the follow-up and treatment of CT of the appendix in the specimen of patients who underwent an appendectomy. Materials and Methods: This retrospective study enrolled the patients who were diagnosed with CT of the appendix as a result of an examination of the appendix specimen after the patients underwent an appendectomy. All the patients, who underwent appendectomy in the pediatric surgery clinic of our hospital between November 2015 and November 2018, were included in the study. Patients’ demographic characteristics, clinical findings, pre-operative laboratory and imaging results, location, diameter and size of the tumor, mesoappendix invasion status, mitotic index and Ki-67 elevation, hospital stay duration, surgical types and complications, and results of laboratory and imaging tests were evaluated. Findings: Eight of the 621 patients (1.2%) who underwent an appendectomy were diagnosed with CT of the appendix. The median age of the patients was 13 years (range, 11–16 years). Of the eight patients, five (62.5%) were female and three (37.5%) were male. All patients presented to our clinic with abdominal pain. No surgical complications were observed during the operation and in the early post-operative period. The mean hospital stay was 2.7 days (2–5 days). In all the patients, the tumor size was <2 cm, the surgical margins were clean, the mitotic index was <2%, the Ki-67 index was below 1%, and the tumor had not spread to the mesoappendix. Only in one of the patients, the CT was located in the appendix radix; in the other seven patients, the tumor was in the middle and end of the appendix. Conclusion: CT of the appendix are clinically similar to acute appendicitis but may be found incidentally during other surgical procedures other than an appendectomy. Diagnosis is made after the pathological specimen diagnosed with CT is histopathologically evaluated. The size, diameter, and depth of the tumor, mesoappendix invasion, mitotic index, and Ki-67 elevation are used in the evaluation and treatment of the tumor

Pierre Robin sequence in association with tracheoesophageal fistula and esophageal atresia

The first symptom of esophageal atresia and tracheoesophageal fistula is the inability to eat and respiratory distress after feeding. The coexistence of Pierre Robin Sequence (PRS) with esophageal atresia and tracheoesophageal fistula is a rare clinical condition. In infants with PRS, evaluation of respiratory and nutritional problems is important. The coexistence of esophageal atresia and tracheoesophageal fistula leads to increased nutritional and respiratory problems. Problems that may occur in the airways may occur late. In this case report, we aimed to present a case of neonatal infant with rare esophageal atresia, tracheoesophageal fistula, and PRS

Problems related to voiding pattern in patients with hypospadias repair: i̇s the problem related to only operation?

Background: Problems related to the urine flow are rather common in hypospadias patients. As these problems are detected during follow-up of urine flow in the post-operative period, it is difficult to determine whether it is a problem emerging secondary to the surgery or it is a congenital condition. Objective: The objective of this study was to evaluate the lower urinary tract functions in hypospadias patients with pre-operative and post-operative uroflowmetric examinations and to determine whether it is a complication of the surgery or a congenital condition. Materials and Methods: A total of 63 patients who underwent hypospadias surgery and were monitored postoperatively between January 2012 and January 2013 were enrolled in the study. Data about the pre- and post-operative uroflowmetry parameters were collected and compared. Results: Of total 83 patients, only 63 (76.8%) patients, whose parent’s provided the written consent, were studied. The mean age was 6.9±2.4 years (3–14 years). The mean bladder volume estimated according to the age of the patients was 266.5±71.7 ml. The mean bladder volume before and after the surgery was 179±56 ml and 189±53 ml, respectively, and the bladder volumes were 67% and 71% of the estimated bladder volume, respectively. There was no significant difference between the bladder volumes measured before and after the surgery (p=0.159). Furthermore, no significant change in the measurements regarding the maximum flow rate, time to maximum flow rate, total time of the urine flow, mean flow rate, voided volume, voiding time, and post-void residual volume was observed. Conclusion: The uroflowmetry is an easy-to-use, non-invasive, and objective method, which can be used for the early diagnosis of the urethral stricture following the hypospadias surgery and the evaluation of the obstructions in the lower urinary trac

Z Plasty Single Center Results in The Treatment of Pilonidal Sinus Disease in Children: Z Plasty Results in the Treatment of Pilonidal Sinus Disease

Pilonidal sinus is a common chronic disease of the sacrococcygeal region. Treatment varies according to the clinical presentation of the disease. Although many surgical methods have proposed, the ideal approach is still lacking due to high recurrence rates. This study aimed to evaluate the role of Z-plasty in achieving primary recovery in pilonidal disease and morbidity and recurrence. Twenty-four patients (15 males and nine females) who underwent sinus excision and Z-plasty closure for the sacrococcygeal pilonidal sinus included in this study. Follow-up ranged from 6 to 12 months. There were 15 males and nine females with a median age of 16 years. The mean hospital stay was two days. There was no recurrence, and all patients were satisfied with the cosmetics. Two patients (5%) had numbness on the flap. No flap necrosis observed in any patient. Only three patients had a wound infection (7.5%). Wound seroma developed in five patients (12.5%). Although some technical expertise is required, excision of sinus and Z-plasty provides superior results in terms of recurrence and hospitalization of pilonidal sinus patients during hospitalization

Investigation of Biliary Canal Variations as a Cause of Stone Formation in the Choledochal Canal

The present study aimed to investigate if there is an association between the diameter of the choledochal duct and choledochal duct stone formation. The present study consisted of 79 patients who had endoscopic interventions and MRCP procedure with surgery history. Some followed due to disorders of the liver, gall bladder, and biliary tract and some of whom presented hepatobiliary complaints between 2017 and 2019. The choledochal duct diameter measured from MRCP images and choledochal duct stone had examined; the type classified according to Huang classification. Among the cases classified, 29 patients, was Huang Type A1, 27 patients were Huang Type A2, 16 patients were Huang Type A3, and seven patients were Huang Type A4. There was not any statistically significant association in terms of choledochal diameter regarding the types. Choledochal duct diameter was statistically higher in female patients than male patients (p<0.05). According to the age group, a statistically significant difference detected for choledochal duct stone formation; individuals over 45 years of age present an increase for choledochal duct stone (p<0.05). The choledochal duct diameter was found higher in female patients compared with male patients; stone formation has found increased in both gender over 45 years of age. It should consider before surgical procedures and radiological tests