Successful laparoscopic removal of mesenteric and omental cysts in toddlers: 3 cases with a literature review

Mesenteric and omental cysts are rare benign intraabdominal anomalies with uncertain etiologies. Surgical removal is the preferred treatment owing to complications related to cyst enlargement. A 1-year-old boy with an intrauterine diagnosis of a cystic mass adjacent to his stomach and liver, a 3-year-old girl, and a 3-year-old boywith an incidental diagnosis of intraabdominal cystswere scheduled for laparoscopic surgery. Themass of the 1-year-old boywas amultiloculated cyst originating from the lesser omentum, the incidental mass in the girlwas amultiseptated cyst located in the jejunoilealmesentery, and the incidentalmass of the 3- year-old boy was a uniloculated cyst originating from the ileal mesentery. All the cysts were excised either laparoscopically or in a laparoscopy-assisted manner. The laparoscopic or laparoscopy-assisted excision of the mesenteric and omental cysts seems to be a feasible, safe, and cost-effective surgical procedure with shorter operative times, even in toddlers

Synchronous Occurrence of Papillary Carcinoma in the Thyroid Gland and Thyroglossal Duct in an Adolescent with Congenital Hypothyroidism

Thyroid carcinoma (TC) combined with congenital hypothyroidism is rare. The synchronous occurrence of these two conditions is even rarer. We describe a patient with congenital hypothyroidism in whom hyperthyroglobulinemia and nodules developed despite adequate replacement therapy. Papillary TC was detected at age 19 years. Postoperative diagnostic scintigraphy showed increased uptake in the thyroglossal duct region. Repetitive imaging of the thyroid gland can be useful in the early detection of TC in patients with congenital hypothyroidism. Moreover, this rare situation can be complicated by a synchronous thyroglossal duct carcinoma. Thyroglossal duct carcinoma can be detected if diagnostic scintigraphy is performed after total thyroidectomy

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

Thoracoscopic diaphragmatic hernia repair in late onset congenital diaphragmatic hernia: Report of case

Konjenital diyafram hernisi yenidoğanda solunum sıkıntısı ve yüksek mortalitenin önemli nedenlerinden biri olup nadiren ileri yaşlarda bulgu verebilir. Geç başvurulu diyafram hernileri yenidoğanda görülen hernilerden klinik özellikler ve sonuçları açısından farklılık göstermekte ve klasik diyafram hernilerinin bir varyantı olarak kabul görmektedir. Aralıklı ortaya çıkan gastrointestinal sisteme ait yakınmalar ile başvuran ve geç bulgu veren konjenital diyafram hernisi tanısı konulan dokuz yaşında kız olgu, geç tanılı diyafram hernilerinin klinik özellikleri ve minimal invaziv tedavi yöntemlerinin kullanılabilirliğini tartışmak amacıyla sunulmuştur.Congenital diaphragmatic hernia is an important cause of respiratory distress and high mortality in neonates and rarely presents in older ages. Clinical features and results of late onset diaphragmatic hernia is different from hernias that encountered in newborns and considered as a variant of classical diaphragmatic hernia. A nine year old girl was who admitted with intermittent gastrointestinal symptoms and diagnosed as late onset congenital diaphragmatic hernia is presented to discuss the clinical features and the use of minimal invasive treatment modalities in late onset diaphragmatic hernia

Hipospadiyas Cerrahisinde Askı Dikişine Bağlı Gelişen Komplikasyon

Proksimal ve distal hipospadiyas onarımlarında cerrahın deneyimi ve kullanılan tekniklerdeki gelişmeye karşın komplikasyon oranı hala %1-90 arasında değişmektedir. Literatüre bakıldığında; glans penis ile ilgili meatal darlık, prolapsus ve retraksiyonu içeren az sayıda komplikasyondan söz edilmiştir. Yapılan taramada; hipospadiyas cerrahisi sonrasında tanımlanmış glansın dorsal kısmı ile ilgili herhangi bir yayına rastlanmadı. Glansda askı, stentin tesbitlenmesi ya da her ikisinin kullanımı nedeni ile glansdan geçilen rekraksiyon dikişine bağlı gelişen ameliyat sonrası skar bu komplikasyonlara eklebilir. Bu çalışmanın amacı; hipospadiyas cerrahisi sırasında kullanılan askı dikişine bağlı glansda skar gelişen dört hastanın sunulmasıdır.The complication rates are still 1-90% both in proximal and distal hypospadias regardless of the surgeon’s experience and the usage of most developed techniques. The literature survey revealed few complications of glans penis including meatal stenosis, prolapsus and retraction. Despite our literature survey, we could not find any article concerning the permanent scar tissue at the dorsal part of glans following hypospadias surgeries. A new complication can be added to these, concerning glans which is the formation of postoperative scar tissue as a reaction to suture material used in traction, stent anchoring or both. The aim of this paper is to demonstrate four cases which had glanular scar due to traction suture following the surgical proce- dures for hypospadias repair

Megameatus intact prepuce and associated anomalies

Objective: Megameatus intact prepuce is described as subset of megalourethra or distal hypospadias by several authors. Despite suggested different operative techniques, some authors prefer not to operate this variant of penile anomaly. We aimed to evaluate 31 patients operated due to megameatus intact prepuce and associated anomalies . Material and methods: Thirtyone patients operated between 2008-2018 for MIP were evaluated retrospectively. All data were collected from hospital records. Patient age, application reasons, raphe anomalies, associated genitourinary and extragenitourinary pathologies, operative techniques, and postoperative complications were analyzed. Results: Mean age was 50 months (8-128 months). Ten of the patients had raphe anomalies. Genital raphe hyperpigmentation was seen in 1 patient, raphe deviation and bifurcated raphe was seen in6 and 3 patients respectively. Genitourinary anomalies were detected in 7 patients, bilateral undescended testes in 1 patient, penile chordee in 2 patients, ureteropelvic junction obstruction in 2 patients, penoscrotal web in 1 patient, nocturnal enuresis in one patient. Tubularized incised plate urethroplasty (TIPU) (n=5), tubularized urethral plate urethroplasty (TUPU)(n=16) and meatoplasty (n=10) were the operative techniques. Conclusion: . Co-occuring raphe anomalies should arise awareness of MIP among the clinicians who are engaged with the children’s medical conditions and also the possible anomalies especially in the societies which circumcision is not traditionally required. Further studies with large number series needed for better understanding of this pathology

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