Comparison of thoracotomy and thoracoscopy in patients with esophageal atresia - tracheoesophageal fistula

Objective: The aim of this study was to compare the patients who underwent EA-TEF repair with both classical and thoracoscopic methods, and thus to reveal the advantages and disadvantages of both techniques. Materials and methods: In this study, the files of 45 patients who underwent surgery for EA-TEF at the Erciyes University Faculty of Medicine (EUFM) Pediatric Surgery Clinic between August 2005 and July 2012 were retrospectively examined. Patients were divided into two groups based on the surgical method applied. Results: A total of 45 patients who presented with EA-TEF and underwent surgical procedures were evaluated. Thirty-one (70%) patients underwent thoracotomy (Group I), and 14 (30%) patients underwent surgery using the thoracoscopic method (Group II). The average gestational age was 37.5 weeks, and the birth weight was 2600 grams. Nineteen (42%) of the patients were female, and 26 (58%) were male. Group I was 39 weeks and 38 weeks in Group II. There was no significant difference in gestational age between the two groups (p>0.05). There was no significant difference between the groups regarding accompanying system anomalies (p>0.05). The time to surgery for patients in both groups was 2 days (p>0.05). The operation time in Group I (95 minutes) was shorter than in Group II (105 minutes) (p<0.05). The time to start gavage feeding after surgery in Group II was shorter compared to Group I (p<0.05). No difference was detected between the groups concerning the time to start oral feeding (p>0.05). No difference was detected between the groups concerning the length of hospital stay (p>0.05). There was no significant difference between the groups regarding the rate of complications (p>0.05). No patient died during surgery. Eleven (35%) of the 31 patients in Group I and 2 (14%) of the 14 patients in Group II died between postoperative days 1 and 25. There was no difference in mortality rates between the groups (p>0.05). Conclusions: Postoperative complications were detected at similar rates in both groups

Clinical Profile and Outcome of Esophageal Button Battery Ingestion in Children: An 8-Year Retrospective Case Series

Objective. To present the clinical profile and outcomes of esophageal button battery ingestion cases treated at our institution over an 8-year period. Methods. A total of 17 children who presented after ingesting a button battery and were treated at a tertiary care clinic over an 8-year period were included in this retrospective case series study. Data on patient demographics and esophageal location of the battery, time from ingestion to admission, symptoms, grade of mucosal injury, size of the battery, management, complications, and follow-up outcome were recorded. Results. Median age was 29 months (range, 2–99 months). Boys comprised (n=11, 64.7%) of the study population. The most common location was the proximal esophagus (n=10, 58.8%). The median time from ingestion to admission was 6 h (range, 3–24 h). Hypersalivation alone (n=6, 35.3%) or together with vomiting (n=5, 29.4%) was the most common symptom. Grade IIA mucosal injury was noted in six (n=6, 35.3%) patients. The diameter of the battery was a median of 18.0 mm (range, 14–22 mm). We did not observe any correlation between the size of the battery and the grade of the injury. Early postoperative complications were encountered in one patient (n=1, 5.8%) and late postoperative complications were noted in eight patients (n=8, 47.1%) which required further esophageal dilatations, and follow-up revealed normal findings in eight patients (n=8, 47.1%) and mortality occurred in one patient. Conclusion. The current case series study describing the clinical profiles and outcomes of 17 children who had ingested an esophageal button battery revealed male predominance, young patient age, and admission after a median of 6 h (3–24 h) of ingestion with nonspecific symptoms. Our findings confirm the success of rigid endoscopy to remove esophageal button batteries and indicate the likelihood of severe complications after removal

Comparison of the Electrothermal Bipolar Sealing System (LigaSure) Versus Endoloop in Pediatric Laparoscopic Appendectomy

Background: Laparoscopic appendectomy has long been in the process of replacing open appendectomy owing to a better wound healing, better cosmetic appearance, less pain, and less postoperative adhesion. Although there are many methods for ligating the appendix stump, studies on energy-based coagulation methods have attracted great interest in recent years. In our study, we aimed to compare the use of LigaSure™ appendiceal sealing and ligation of appendiceal stump by endoloop with regard to duration of surgery, length of hospital stay, and complications in laparoscopic appendectomies. Materials and Methods: A total of 174 consecutive patients under the age of 18 who underwent laparoscopic appendectomy in our clinic between September 2016 and February 2021 were retrospectively analyzed. Patients with perforated appendicitis were excluded from the study. The patients were divided into two groups as the appendix stump was ligated with endoloop (Group 1) and sealed with LigaSure (Group 2). Demographic characteristics of the patients, duration of surgery, length of hospital stay, and complications were recorded. Results: Of the 132 patients who were included in the study, Group 1 consisted of patients using endoloop (n = 39) and Group 2 comprised patients that LigaSure was employed (n = 93). There was no significant difference between Groups 1 and 2 in terms of age and length of hospital stay (P = .126 and P = .784, respectively); however, the operation time was found to be significantly shorter in Group 2 (P < .001). Conclusion: The use of LigaSure is a safe and fast method to seal the mesoappendix and appendix stump in pediatric laparoscopic appendectomy. We think that infection complications due to stump leakage and intra-abdominal spillage will less be encountered

Pulmonary Hydatid Cyst in Children: A Single-Institution Experience

Objective: Hydatid cysts can occur in any place such as the liver, lung, spleen, kidney, brain, and soft tissue. Pulmonary hydatid cysts are more prone to rupture than liver hydatid cysts. In this study, we aimed to present the demographic characteristics, clinical symptoms, radiological findings, surgical findings, type of surgery performed, and postoperative complications of patients with pulmonary hydatid cysts. Materials and method: The files of 94 patients who were operated on for pulmonary hydatid cysts in our clinic between January 2011 and October 2021 were retrospectively analyzed. The patients were divided into two groups: ruptured pulmonary hydatid cysts and non-ruptured pulmonary hydatid cysts. Results: A total of 120 pulmonary hydatid cysts were detected in 94 patients who were operated on for pulmonary hydatid cysts. Cyst rupture was detected in 63 (52.5%) patients. Rupture was found significantly higher in cysts with a diameter of <10 cm (p=0.005). Complaints of fever and hemoptysis were found significantly higher in the ruptured group. Pneumothorax was detected in six patients after the operation with an average of two months, one of which was the patient who underwent video-assisted thoracoscopy (VATS). Conclusion: Pulmonary hydatid cyst should be kept in mind in children presenting with lower respiratory tract symptoms in regions where echinococcosis is endemic. Parenchyma-sparing methods should be the first choice in the management of pulmonary hydatid cysts. Patients who develop early postoperative complications should also be followed closely for late impediments