Detubularized isolated ureterosigmoidostomy in a complicated common cloaca: A case report

Urinary incontinence in a child secondary to a severe congenital anatomical disorder or due to complication of a previous surgery can be difficult to manage. Decisions can be especially hard when a redo procedure is being considered. We present one such case where a 6 year old girl previously operated for cloaca was brought with incontinence and after much consideration of options available, underwent a modified ureterosigmoidostomy to aid in her continence. The modification used was detubularized isolated ureterosigmoidostomy, described by Atta et al in 1996

Sacrococcygeal teratoma associated with hindgut duplication: A case report & review of literature

The index case report describes a previously unreported coexistence of sacrococcygeal teratoma and a tubular duplication of the rectum. The child presented with a large sacrococcygeal mass. He was treated with pre-operative chemotherapy to reduce the bulk of the tumor and subsequently underwent surgical resection. Exploration surprisingly revealed an additional long tubular duplication of the rectum, which did not share any lumen with the parent gut. The duplication cyst and the residual tumor were excised. The histopathology report confirmed residual mature teratoma and the duplication cyst. Relevant literature is reviewed

Video-Assisted thoracoscopic surgery for pediatric empyema by two-port technique: A single-center experience with 167 consecutive cases

Background/Purpose: The aim of our study is to determine efficacy, safety, and feasibility of video-assisted thoracoscopic surgery (VATS) in childhood empyema with a technique of only two ports and open instruments at a tertiary care center in India. Methods: This is a retrospective study of patients below 18 years, with empyema presenting to the Department of Pediatric Surgery of a Tertiary Care Referral Hospital in India, over a period of 9 years who underwent VATS decortication. Only two ports with open surgical instruments were used. The patients were assessed on the basis of mean duration of preoperative symptoms, duration of surgery, average blood loss, postoperative pain relief, complications, and need for redo surgery. Results: A total of 97 patients underwent primary VATS decortications without inserting an intercostal drainage (ICD) tube and 70 patients as a secondary procedure after ICD tube was inserted. Mean duration of symptoms was 11 days. The average blood loss during surgery was estimated to be 170 cc. The mean duration of surgery was 90 min. The most common postoperative complication was air leak seen in 19.16% of patients. Minor leaks usually settled by 24 h. In eight patients, a negative suction had to be applied to the ICD tube for persistent air leak. The average length of postoperative stay was 4 days. Two patients required a repeat open decortication procedure due to nonresolution of symptoms and poor lung expansion after VATS. Patients had minimal pain and excellent cosmetic outcome after VATS. Conclusion: Two-port VATS decortication procedure is as feasible and effective as three-port procedure for decortication with better cosmetic result and pain relief