Post-operative Dressing for Paediatric Hypospadias Repair

The optimal dressing is still unclear, despite hypospadias being one of the most prevalent surgical operations. Children’s dressing for hypospadias surgery was searched on PubMed as “dressing for hypospadias,” “postoperative dressing for pediatric hypospadias,” and “dressing AND hypospadias.” Experimental studies, animal studies, reviews, letters, and repetitive publications were excluded from the study. By evaluating these reviewed publications, factors affecting hypospadias dressing, such as surgeon, country, dressing type, characteristics, and why it is preferred, will be revealed. As a result, 17 articles were examined, and the advantages of each were established by examining the results. The type of hypospadias, the surgeon’s choice, and its ease of removal stand out as the crucial factors in treating hypospadias in children, along with the degree of development of the nation

An interesting and rare cause of post-operative intussusception: Roux limb intussusception

Intussusception is a common disease in children. Most intussusception is idiopathic and approximately 1% develops postoperatively. We present a case of a 6-year-old male patient who underwent surgery for a type 1 common bile duct cyst. In his post-operative 2nd month, the patient presented with a complaint of abdominal pain after eating, but his pain was not accompanied by nausea or vomiting. No pathological findings were evident in the examination or an abdominal X-ray of the patient. Intussusception was detected by ultrasonography and computed tomography. We wanted to introduce this interesting intussusception that originated from the Roux limb that was not seen before

Ovarian masses in infant-juvenile age.

The appropraite surgical treatment to pediatric patients with ovarian lesions are heterogeneous and ovarian preservation is desirable in children. The aim of this study is to the discuss findings related to a set of patients who were operated on for ovarian lesions

For Better Orchiopexy, Processus Vaginalis Should Be Dissected and a High Ligation Should Be Performed

Objective Data on the prevalence of patent processus vaginalis (PPV) and hernia in patients with cryptorchidism are controversial. While some pediatric surgeons do not dissect the processus vaginalis (PV), most prefer to do so to prevent hernia formation and to achieve an effective orchiopexy outcome. This study was performed to evaluate the importance of dissection and high ligation of the PV during treatment of undescended testis (UT). Methods The clinical findings and surgical procedures of 55 patients with UT were retrospectively investigated. Results The mean patient age was 2.5 (range 1.0–12.0) years. Non-palpable testis (NPT) was located on the right and left side in 39 and 16 patients, respectively. Ultrasonography revealed no testis in 10 patients and an atrophic testis in 7 patients. Seven patients had a parent with an inguinal hernia, and the silk sign or a PPV was detected during inguinoscrotal examination in 22 patients. Undescended testis repair was performed by an inguinal approach in all patients. The inguinal canal was opened in all patients; 42 patients had a wider-than-normal internal ring (>2.5 cm), and the posterior wall of the inguinal canal was consequently weakened. Two-stage orchiopexy was performed in 2 patients, and 15 underwent the Prentiss maneuver. In the remaining patients, the dissection was easily done, and the orchiopexy was performed without any difficulty. Scrotal edema and wound infection occurred in five and two patients, respectively. One patient presented with an atrophic testis, and three had recurrent UT. Inguinal hernia was not observed in any of the patients during the study period, and all procedures were performed on an outpatient basis. Conclusion High ligation of the PV is an effective method for successful orchiopexy and prevention of inguinal hernia in patients with NPT and UT

Our experience in two cases of type IV laryngotracheoesophageal cleft (LTEC) with a diagnosis of antenatal esophageal atresia.

Laryngotracheoesophageal clefts (LTECs) are rare congenital defects that are often accompanied by additional anomalies. The major issues in the treatment of these patients are intraoperative exposure insufficiency, technical difficulty of the operation, and anesthesia problems originating from the respiratory tract. Problems originating from mechanical ventilation and respiratory tract, eating disorders and relapse of fistula are among the problems encountered following surgery. Most of the time, concomitant additional anomalies also worsen the clinical picture. It was our aim with these case reports to report our experience in two cases with Type IV LTEC ranging from the inoperable type IV LTEC due to additional anomalies mounted up to severe respiratory distress to the carina that we operated on with a single stage anterior cervicothoracic approach on its fifth day on life

Our Cases and Literature Review for Presence of Bladder Hernias in the Inguinal Region in Children

Background: The rate of bladder injury during inguinal hernia repair in children is not well known. However, it is known that bladder injury during childhood inguinal hernia repair places a serious morbidity burden on children. We sought to determine an algorithm to avoid accidental bladder injuries. Methods: Reports that included pediatric patients with inguinal hernias containing the bladder were searched. Keywords and mesh term searches were conducted in the MEDLINE, Scopus, and Web of Science databases. We reviewed our clinical records and found that two patients had inguinal hernias containing the bladder. Results: Nineteen articles reporting on 26 patients diagnosed with the presence of the bladder within the inguinal canal from 1962 to 2021 were included in this article. Our two patients were added to this group. Diagnoses were made incidentally during genitourinary radiological examinations (n = 3), intraoperatively during hernia repair (n = 7), or due to clinical symptoms and findings (n = 18) after standard hernia repair. Bladder augmentation was required for three patients. Conclusions: During the operation, if there is any suspicion regarding the presence of the bladder in the inguinal region, we suggest performing a preoperative cystogram to confirm the position of the bladder and its injury. We recommend that the sac should be opened and the contents inspected before performing transfixion during high ligation of the hernia sac

Effects of Sildenafil Citrate on Ipsilateral Testis Damage Following Experimental Testicular Torsion in Rats

Objective: Testicular torsion results in damage of the gonad and represents surgical emergency. Testicular torsion induces sterility as a result of ischemia. The aim of this study was to determine the effects of a vasodilator agent sildenafil on the testicular damage following testicular torsion. Methods: Forty-two Wistar-albino male albino rats were divided into seven groups, each containing six rats. C: Control, S: Sham (operative procedure without torsion), T: Torsion (detorsion was performed 2 hours after 720 degrees left testis torsion and orchiectomy was done at the 4th hour.), Sildenafil (Viagra; Pfizer) was given without torsion to V1 group and V2 group (respectively 1 mg/kg and 2 mg/kg). Sildenafil was given to V1T group and V2T group respectively 1mg/kg and 2mg/kg at the first hour following torsion then detorsion was performed 2 hours after torsion and orchiectomy was done at the 4th hour. At the end of the study blood and testes tissue samples were obtained for malonyldialdehyde (MDA), nitric oxide (NO), Johnsen tubuler biopsy score (JTBS) and diameter of seminiferous tubule (STD) analysis. Results: JTBS and STD levels were highest in the C group and the lowest T Group and torsion reduced spermatogenesis significantly compared to the C and S groups (p < 0.05). Sildenafil administration without torsion (V1 and V2) did not change JTBS scores. JTBS levels of the V2T group were increased significantly when compared to V1T (p < 0,05). C compared to study groups showed statistically different changes in terms of STD (p < 0,05). Torsion reduced STD significantly compared to the C and S group (p < 0,05). Tissue and plazma MDA levels were the highest in the V2T group and the lowest C Group. Tissue NO levels were the highest in the V1T group and lowest in C Group. Sildenafil administration (1 mg/kg and 2 mg/kg) without torsion group compared to torsion groups in terms of plasma and testis tissue MDA and NO levels showed significantly statistically different changes. Conclusion: Sildenafil showed a protective effect against tubular damage histologicaly after unilateral torsion and detorsion.Scientific Research Foundation of Gazi University [01/2002-119]This study was sponsored by the Scientific Research Foundation of Gazi University (01/2002-119)

The Effect of Carbon Dioxide Insufflation Applied at Different Pressures and Periods on Thrombotic Factors.

The aim of this experimantal study which is applied on rats, is to determine the differences on the clotting factors over the application of low and high intraabdominal pressure (IAP) values in different periods of time in carbon dioxide (CO2) pneumoperitoneum. Thirty rats were randomized into five groups (n = 6): a control group (Group K) and 1 h and 6 mm Hg IAP (Group A), 2 h and 6 mm Hg IAP (Group B), 1 h and 12 mm Hg IAP (Group C) and 2 h and 12 mm Hg IAP were created with CO2 pneumoperitoneum (Group D). At the end of the experiment, plasma samples taken from subjects and fibrinogen, FII (prothrombin), FV, FVII, FVIII, FIX, FX, FXI, FXII, von willebrand's factor (vWF), ristocetin cofactor, protein C, protein S, antithrombin III (AT III) levels are studied. There were statistically significant differences in the mean levels of FII, FV, FVII, FVIII, FIX, FX, FXI, FXII, and protein S between the groups. A hypercoagulable state occurred with the following: increase in the coagulation parameters compared to the control group; increase in FVII in the group only Group C; decrease in AT III in all groups compared to the control group; decrease in protein C in the group only XII Group D compared to control group; decrease in protein S in all groups except group D compared to control group. CO2 insufflation predisposes to thromboembolic events both by inducing coagulation factors and by suppressing the fibrinolytic system contrary to the controversies in the literature

A very feasible alternative in patients with feeding difficulties from gastrostomy: Jejunal tube advanced through the gastrostomy.

Our aim is to share our experiences regarding patients who cannot be fed effectively through the gastrostomy tube, but were inserted feeding jejunostomy through the gastrostomy orifice using scopic fluoroscopic techniques utilised by the interventional radiology