Contrubition of Laparoscopic Level Determination on Hirschsprung Disease Diagnosis and Management

Aim:Laparoscopic-assisted transanal pull-through (LATP) is a procedure that has gained increasing popularity in the management of Hirschsprung’s disease. The purpose of this study was to compare outcomes of patients treated with LATP and transanal pull-through (TPT).Methods:Records of 45 patients with Hirschsprung’s disease who underwent surgery between 2006 and 2017 were retrospectively evaluated.Results:LATP was performed in 16 patients [13 male (81%), three female (19%)]. The median age of the patients was four months (7 days-84 months). Twenty nine patients [21 male (72.4%), eight female (27.6%)] underwent TPT. The median age of the patients was 11 months (10 days-90 months). The mean time to start feeding in LATP and TPT groups was two days (one-three days) and 2.6 days, respectively (p=0.074). The mean operative time was 2.6 hours in the LATP group (two-four hours) and 2.7 hours in the TPT group (p=0.971). The mean length of hospital stay in for LATP and TPT groups was 4.8 days (two-nine days) and six days (3-14 days), respectively (p=0.305).Conclusion:The advantages of LATP include multiple sample collection from several segments of the colonn at the same time as well as shorter time to frozen section diagnosis. In addition, the possibility of intraabdominal dissection allows transanal surgery to be faster and more effective

Laparoscopy is the Gold Standard in Ovarian Pathologies in Childhood: Clinical Evaluation and Literature Review

OBJECTIVE:Ovarian cysts and related torsions are the most common adnexial pathologies in childhood. Diagnostic laparoscopy is the gold standard approach for differential diagnosis. It is aimed to evaluate the data of patients who had surgery for ovarian pathology. STUDY DESIGN: Fifty-three girls of ten years are included the study. Demographic data, medical history, physical examination, laboratory and radiologic investigations, surgical procedure, histopathology, complications and follow up periods are recorded. RESULTS: The median age of children was 13. Excluding the patients who were diagnosed in intrauterine period (n=4), all of the patients had abdominal pain (92%). Laparoscopic cystectomy (56.7%), detorsion and cystectomy (16.9%) and oopherectomy (16.9%) were performed in patients with cysts. Diagnostic laparoscopy (3,8%) and laparoscopic detorsion (5.7%) were performed in patients without cyst. Dermoid cysts were found in three children and teratomas in two. Patients were discharged in postoperative second day. CONCLUSION: Diagnostic laparoscopy is the gold standard approach for differential diagnosis. Laparoscopic approach should be chosen because of shorter hospital stay, shorter healing period, and better cosmetic results. Besides, less pelvic adhesions compared to laparotomy in laparoscopy is important for further fertility