Thoracoscopy versus thoracotomy for congenital lung malformations treatment: A single center experience

Introduction: Our aim is to compare thoracoscopy to thoracotomy in the treatment of congenital lung malformations (CLM) in children. Materials and Methods: We report a retrospective monocentric cohort study. Patients treated at our Center for CLM (1991\u20132020) were divided in two groups: patients treated with video-assisted thoracoscopic surgery (VATS) and open thoracotomy (OT). Characteristics of the two groups were compared through statistical analysis (GraphPad Prism7). A p value less than.05 was considered statistically significant. Results: One hundred six patients were included: 58 in VATS group, 48 in OT group. Prenatal diagnosis was possible in 73.6%. The most frequent surgical procedures were lobectomy (43.4%) and sequestrectomy (22.6%). All VATS patients underwent lung exclusion, mostly by endobronchial blocker (69%). Mean operative time was 146.1 min (\ub152.04 SD) in VATS and 159.2 (\ub146.53 SD) in OT (p =.1973). Conversion to OT was necessary in 20.6% of VATS patients, but decreased in the last 5 years (6.2%). There were not any intraoperative complication. Respectively in VATS and OT group, length of stay (LOS) was 4.5 days \ub1 3.6 SD versus 7.7 \ub1 3.4 SD (p <.0001), chest tube duration 2.8 days \ub1 3.4 SD versus 3.7 \ub1 2.4 SD (p <.0001), antibiotic treatment duration 3.7 days \ub1 4.7 SD versus 5 \ub1 2.6 SD (p =.1196). Postoperative complications were described in 22.6%. The commonest histological diagnosis (40.6%) was congenital pulmonary airway malformation. Conclusion: VATS resulted a feasible, effective and safe technique. Operative time and postoperative complications were similar in VATS and OT groups. VATS conversion rate decreased in time. VATS had a statistically significant shorter LOS and chest tube duration

Extraperitoneal kidney transplantation: a comparison between children weighting ≤15 kg and >15 kg. Experience of a single institution

Extraperitoneal approach is sometimes recommended for kidney transplantation (KT) in children weighting 15 kg (Normal-weight (NW) group). All the 108 KTs were performed through an extraperitoneal approach. The LW group included 31 patients (mean age 3.5 ± 1.4 years), whose mean weight was 11.1 ± 2.0 kg. In the LW group,—a primary graft nonfunction (PNGF) occurred in one patient (3.2%), surgical complications occurred in nine (29%), with four venous thrombosis. In the NW group, PNGF occurred in one case (1.3%), delayed graft function (DGF) in eight (10%), surgical complications in 11 (14%) with only one case of venous thrombosis. In both groups, no need for patch during wound closure and no wound dehiscence were reported. The extraperitoneal approach can be effectively used in LW children. No differences were observed in the overall complication rate (P = 0.10), except for the occurrence of venous thrombosis (P = 0.02). This might be related to patients’ characteristics of the LW group

Il tempo nel diritto, il diritto nel tempo

Il volume raccoglie alcune delle relazioni presentate al convegno ravennate del marzo 2019, dal titolo "Il tempo nel diritto, il diritto nel tempo", affrontando da prospettive diversi il tema del fattore temporale nella creazione, nello sviluppo e nella interpretazione del diritt