Outcomes of Re-Intervention for Laparoscopic Transperitoneal Pyeloplasty in Children

postprin

Pneumovesical Ureteric Reimplantation in Pediatric Patients: An Intermediate Term Result

Introduction: Pneumovesical ureteric reimplantation has gained increasing popularity for the treatment of vesicoureteric reflux (VUR) and vesicoureteric junction obstruction (VUJO) in pediatric patients. In this study we reviewed our experience at an intermediate term basis. Methods: A retrospective review of all patients with pneumovesical ureteric reimplantation performed in a tertiary referral center between 2005 and 2015 was carried out. Patients' demographics, operative measures, and postoperative outcomes were recorded. Results: Thirty-one patients were identified during the study period. Twenty-three patients had VUR and 8 patients had VUJO. A total of 42 ureteric reimplantation procedures were carried out. The mean age at operation was 6.1 years old. The mean operative time was 221 minutes. On average the length of hospital stay was 7.4 days. Four patients required conversion to open approach. Four patients had low-grade residual VUR after the operation and all of them were treated conservatively. There was no major complication or mortality. Conclusion: Pneumovesical ureteric reimplantation is safe and effective for pediatric patients. Intermediate term result confirmed its reliability and low recurrence rate. It has good potential to become the preferred approach of choice in the future.postprin

Investigating Cell Surface Markers and Differentiation Potential of Compact Bone-Derived Mesenchymal Stem Cells

Background: The differentiation potential of mesenchymal stem cells (MSCs) derived from the bone-tissue to multiple lineages is not clear. Objective: This study was conducted to investigate the surface antigen expression and multilineage stem cell potential of the cells derived from culture of collagenase digested marrow-free compact bones of C57BL/6 mouse. Materials & Methods: Long bones of C57BL/6 mouse (n=6) were collected aseptically and bone marrow was flushed out. Collagenase-digested bone fragments were washed and cultured in plastic flasks. The plastic-adherent fibroblast-like spindle-shaped cells were cultured sequentially in multiple passages in low-glucose DMEM (Dulbecco’s Modified Eagle’s Medium) supplemented with 15% FBS (Foetal Bovine Serum) and antibiotics in a 37°C incubator with 5% CO2. Immunophenotyping for cell surface markers was done using flow cytometry. The cells were differentiated into the osteoblastic, adipogenic and chondrogenic lineages. Results: The culture of the adherent cells exhibited active proliferation and multiplication in consequent passages. The cultured cells revealed evidence of adipogenic and osteogenic differentiation confirmed by staining with oil red O and von Kossa stains. Under flow cytometry observation, a significant proportion of cultured cells expressed CD29 and stem cell antigen (Sca-1). Only 9.8% cells showed expression of CD105. These MSCs exhibited low ability in chondrogenic differentiation, which can potentially be attributed to their lack of CD105 expression. Lack of expression of CD45 showed evidence of absence of hematopoietic stem cells. Conclusion: This study showed that murine compact bone-chip culture can yield MSCs with significant proliferation capacity. The cells displayed the ability to differentiate into osteoblast and adipocyte lineages

Da Vinci Robotic System for Pediatric Surgery: Report of First 20 Cases

目的達芬奇機器人手術系統具有獨特的優勢,是當前微創外科手術的前沿領域。本文通過回顧分析和總結我中心在機器人輔助下完成小兒外科手術資料,為今后深入開展機器人小兒外科手術提供經驗和參考。方法 2007～2012年,我中心累積采用機器人輔助完成小兒外科手術20例(男女各10例;平均年齡10.7歲)。手術包括9例胃底折疊術、5例腎盂成形術、2例膽總管囊腫切除術、2例食管部分切除術、1例輸尿管膀胱再植術和1例可控性尿流改道術。結果 9例胃底折疊平均手術時間為220.1 min,5例腎盂成形平均手術時間為204.2 min。1例膽總管囊腫術中因組織分離困難而中轉開腹。1例先天性食管狹窄伴食管氣管瘺行食管部分切除術后2周復發,經二次手術治愈。結論機器人手術是小兒微創外科治療的有效手段。仍需對患兒長期隨訪,以進一步評估機器人手術的遠期效果。OBJECTIVE The Da Vinci robotic surgery system offers particular advantages and is currently a frontier study in the field of minimally invasive surgery. In this study, we retrospectively reviewed our experience in robotic surgical system in pediatric surgery as a tertiary referral center. We hope this pilot study can offer some recommendation for future development. METHODS Since 2007 to 2012, a total of 20 robotic-assisted operations(F: 10;M: 10) have been performed. The average age of the patient was 10.7 y(ranged from 3 to 18 y). The operations included 9 cases of fundoplication (one of them also underwent robotic assisted Heller’s operation for achalasia at the same time), 5 cases of pyeloplasty, 2 cases of excision of choledochal cyst, 2 cases of partial esophagectomy, 1 case of ureteric reimplantation, and 1 case of Mitrofanoff procedure. RESULTS The mean operation time of fundoplication and pyeloplasty were respectively 220.1 and 204.2 minutes. 0ne patient who underwent choledochal cyst excision was converted to open surgery due to difficult dissection. Disease recurrence was noted in one patient with partial esophagectomy for congenital esophageal stenosis due to tracheo-esophageal remnant. CONCLUSION The Da Vinci robotic sugical system is a reliable and effective approach for pediatric surgery. Long-term follow-up study is needed for further evaluation of its efficacy

Endoscopic injection for primary vesicoureteric reflux: predictors of resolution and long term efficacy

Free pape

Investigating Cell Surface Markers and Differentiation Potential of Compact Bone-Derived Mesenchymal Stem Cells

Background: The differentiation potential of mesenchymal stem cells (MSCs) derived from the bone-tissue to multiple lineages is not clear. Objective: This study was conducted to investigate the surface antigen expression and multilineage stem cell potential of the cells derived from culture of collagenase digested marrow-free compact bones of C57BL/6 mouse. Materials & Methods: Long bones of C57BL/6 mouse (n=6) were collected aseptically and bone marrow was flushed out. Collagenase-digested bone fragments were washed and cultured in plastic flasks. The plastic-adherent fibroblast-like spindle-shaped cells were cultured sequentially in multiple passages in low-glucose DMEM (Dulbecco’s Modified Eagle’s Medium) supplemented with 15% FBS (Foetal Bovine Serum) and antibiotics in a 37°C incubator with 5% CO2 . Immunophenotyping for cell surface markers was done using flow cytometry. The cells were differentiated into the osteoblastic, adipogenic and chondrogenic lineages. Results: The culture of the adherent cells exhibited active proliferation and multiplication in consequent passages. The cultured cells revealed evidence of adipogenic and osteogenic differentiation confirmed by staining with oil red O and von Kossa stains. Under flow cytometry observation, a significant proportion of cultured cells expressed CD29 and stem cell antigen (Sca-1). Only 9.8% cells showed expression of CD105. These MSCs exhibited low ability in chondrogenic differentiation, which can potentially be attributed to their lack of CD105 expression. Lack of expression of CD45 showed evidence of absence of hematopoietic stem cells. Conclusion: This study showed that murine compact bone-chip culture can yield MSCs with significant proliferation capacity. The cells displayed the ability to differentiate into osteoblast and adipocyte lineages