[Show abstract][Hide abstract] ABSTRACT: The umbilical hernia is common in the pediatric population. Most of the cases have a
spontaneous regression around the age of 3 years. Complications are very rare, and
thus surgery is not routinely indicated before the age of 3 years
We report an exceptional case of spontaneous rupture of an umbilical hernia in a
3-year-old girl with an emphasis on the management of this rare complication and a
literature review of similar cases
Journal of Pediatric Surgery Case Reports 10/2015; DOI:10.1016/j.epsc.2015.10.004
[Show abstract][Hide abstract] ABSTRACT: Introduction Minimally invasive surgery (MIS) has emerged as an alternative to open approach for cancer diagnosis in children ∼20 years ago, but only recently for tumor resection. The purpose of this review is to update the use of MIS in pediatric oncological surgery over the past five years. Methods The authors conducted a systematic review of papers published between 2009 and 2014 focusing on indications and results of the technique. Results New indications in Wilms tumor, pheochromocytoma, and lung nodules have emerged, thanks to the growing use of MIS in benign urological and thoracic surgery with satisfactory results. Case control studies comparing MIS to open approach have been published for the first time in more classical indications such as neurogenic tumors, while robot-assisted procedure has shown concern in results about its early experience in solid tumors. Conclusion MIS is a promising method for removal of thoracic and abdominal malignancies as long as oncological principles are strictly followed. Long-term follow-up is mandatory to further delineate objective indications.
Georg Thieme Verlag KG Stuttgart · New York.
European Journal of Pediatric Surgery 12/2014; 24(06). DOI:10.1055/s-0034-1396419 · 0.99 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This review presents the evidence of video-assisted surgery in the pediatric population and discusses future progress in this field. Videosurgery minimizes the cosmetic impact and the pain induced by open procedures and has been in constant development in adults and children. Earlier training of surgeons and residents combined with advances in anesthetics and technology have expanded the use of videosurgery for more complex interventions. Although most feasible surgical procedures have been performed by laparoscopy, the literature has not yet defined it as the gold standard for most interventions, especially because of the lack of evidence for many of them. However, laparoscopy for cholecystectomy is now the preferred approach with excellent postoperative outcomes and few complications. Although no evidence has been demonstrated in children, laparoscopy has been shown to be superior in adults for gastroesophageal reflux disease and splenectomy. Laparoscopic appendectomy remains controversial. Nevertheless, meta-analyses have concluded in moderate but significant advantages in terms of pain, cosmetic considerations, and recovery for the laparoscopic approach. Laparoscopy is now adopted for undescended testes and allows both localization and surgical treatment if necessary. For benign conditions, videosurgery can be an excellent tool for nephrectomy and adrenalectomy. However, laparoscopy remains controversial in pediatric surgical oncology.
Archives de Pédiatrie 04/2013; · 0.41 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Abnormalities of the male genitalia have increased in the last 2 decades in numerous developed countries and remain a frequent reason of consultation in pediatric surgery. The diagnostic spectrum is wide, and surgeons should pay particular attention to these abnormalities because of their potential psychological effect. Anatomically, these abnormalities can affect one of three parts of the penis. First, the foreskin may not be fully retracted. This is normal at birth and can be caused by prepuce adherents that can continue until adolescence. Today, true phimosis is treated with topical corticoids from the age of 3years. If medical treatment fails, a surgical procedure is required. Second, the urethra can be affected by hypospadia, which is the most frequent abnormality of the urethra. It is associated with ectopic urethral meatus, hypoplastic foreskin, and penis curvature. Its pathogenic background is not clearly understood. Surgery options differ according to the type of hypospadia and according to the surgeon's experience. It is sometimes hard to deal with, especially in a perineal form, where genetic and hormonal studies are recommended. These interventions can lead to complications ranging from stenosis to fistula. Therefore, parents have to be informed of the benefits and risks of the surgical procedures. Epispadias is rare but more serious because of the increasing risk of urinary incontinence. Finally, abnormalities of the corpora cavernosa - often associated with hypospadias - can include penis curvature and micropenis, for which an endocrinological analysis is essential.
Archives de Pédiatrie 10/2012; · 0.41 Impact Factor