• 제목/요약/키워드: Pediatric surgery

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지난 10년간 소아외과 질환의 임상적 고찰 (A Clinical Review of Ten Years' Pediatric Surgical Experience)

  • 최수진나;정상영;김신곤
    • Advances in pediatric surgery
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    • 제4권2호
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    • pp.110-116
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    • 1998
  • This is a clinical review of 2,191 pediatric surgical patients under the age of 15 years, operated upon at the Division of Pediatric Surgery, Department of Surgery, Chonnam University Hospital from January 1988 to December 1997. The total number of operations in the pediatric age for all specialties were 13,144(13.2 %). The total operations including those performed on adults were 99,555. The most common age group operated upon was under 5 year of age(44.4 %). The number of operations in Division of General Pediatric Surgery were 2,191(16.7 %) out of total 13,144 operations in all pediatric specialties. The patients under 1 year of age in general pediatric surgery was 42.9 %(941/2,191). The most common diseases in neonates were anorectal malformation(20.6 %) and hypertrophic pyloric stenosis(20.3 %). Infants older than neonates most commonly were operated upon for inguinal hernia(32.4 %) and intussusception(19.6 %). The total mortality rate in the neonatal intensive care unit was 31.3 %. Gastroschisis had the highest mortality.

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소아에서 복강경을 이용한 메켈씨 게실 절제술 (Laparoscopic Meckel's Diverticulectomy in Children)

  • 한석주;김준영;허정욱;한애리;황의호
    • Advances in pediatric surgery
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    • 제7권2호
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    • pp.157-161
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    • 2001
  • Meckel's diverticulum is one of the common causes of gastrointestinal bleeding in the pediatric patient requiring laparotomy. Two children with Meckel's diverticulum have been successfully treated by laparoscopic excision. Both patients recovered without incident and were discharged at 3 and 5 days after surgery. The authors believe that laparoscopic diverticulectomy is a safe, effective. and minimal invasive treatment of Meckel's diverticulum in children.

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소아 대퇴탈장의 중요성 (The Importance of Femoral Hernia in Children)

  • 한석주;최봉수;한애리;오정탁;최승훈;황의호
    • Advances in pediatric surgery
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    • 제6권2호
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    • pp.124-127
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    • 2000
  • Femoral hernia is very rare in children and is easily misdiagnosed. During a period of three years, three children with femoral hernia were treated by one pediatric surgeon at Severance Hospital. Only one case was diagnosed correctly before surgery, and the others were thought to be either an indirect inguinal hernia or groin mass. Curative hernioplasty (McVay hernioplasty) could be done in only one case at the time of first operation. Diagnosis of femoral hernia in children is a challenge because of rarity and similarity of clinical presentation to indirect inguinal hernia. Co-incidental findings of indirect inguinal hernia sac or patent processus vaginalis during surgery can perpetuate the misdiagnosis. In case of absence of expected indirect inguinal hernia or apparent recurrence of indirect inguinal hernia, one should consider the possibility of femoral hernia.

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Optimal First-Line Antibiotic Treatment for Pediatric Complicated Appendicitis Based on Peritoneal Fluid Culture

  • Aiyoshi, Tsubasa;Masumoto, Kouji;Tanaka, Nao;Sasaki, Takato;Chiba, Fumiko;Ono, Kentaro;Jimbo, Takahiro;Urita, Yasuhisa;Shinkai, Toko;Takayasu, Hajime;Hitomi, Shigemi
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제24권6호
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    • pp.510-517
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    • 2021
  • Purpose: Consensus is lacking regarding the optimal antibiotic treatment for pediatric complicated appendicitis. This study determined the optimal first-line antibiotic treatment for pediatric patients with complicated appendicitis based on peritoneal fluid cultures. Methods: This retrospective study examined the cases of pediatric patients who underwent appendectomy for complicated appendicitis at our institution between 2013 and 2019. Peritoneal fluid specimens obtained during appendectomy were cultured for the presence of bacteria. Results: Eighty-six pediatric patients were diagnosed with complicated appendicitis. Of them, bacteria were identified in 54 peritoneal fluid samples. The major identified bacteria were Escherichia coli (n=36 [66.7%]), Bacteroides fragilis (n=28 [51.9%]), α-Streptococcus (n=25 [46.3%]), Pseudomonas aeruginosa (n=10 [18.5%]), Enterococcus avium (n=9 [16.7%]), γ-Streptococcus (n=9 [16.7%]), and Klebsiella oxytoca (n=6 [11.1%]). An antibiotic susceptibility analysis showed E. coli was inhibited by sulbactam/ampicillin in 43.8% of cases versus cefmetazole in 100% of cases. Tazobactam/piperacillin and meropenem inhibited the growth of 96.9-100% of the major identified bacteria. E. coli (100% vs. 84.6%) and P. aeruginosa (100% vs. 80.0%) were more susceptible to amikacin than gentamicin. Conclusion: Tazobactam/piperacillin or meropenem is a reasonable first-line antibiotic treatment for pediatric complicated appendicitis. In the case of aminoglycoside use, amikacin is recommended.

소아 환자의 위 주름술에 있어서 복강경과 개복술의 비교 (Comparison between Laparoscopic and Open Nissen Fundoplication in Pediatric Patients)

  • 곽홍기;정수민;이석구;서정민
    • Advances in pediatric surgery
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    • 제18권2호
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    • pp.59-67
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    • 2012
  • Fundoplication is a common surgical procedure for gastroesophageal reflux Disease (GERD). Recently the procedure has been performed with increased frequency laparoscopically. The aim of this study is to compare laparoscopic Nissen fundoplication (LNF) and open Nissen fundoplication (ONF) for GERD in children. We studied retrospectively the 88 pediatric patients who underwent the Nissen fundoplication for GERD as primary antireflux surgery from 1994 and 2009. ONF was performed in 34 cases and LNF was in 54 cases. 58 patients have neurologic impairment. Time to initial food intake after the surgery were reduced in the LNF group (p= 0.032). Recurrent GERD symptom occurred in one patient in LNF group and four patients in ONF group within 1 year after the surgery (p= 0.012). There were no statistically significant differences in post operative morbidity and mortality between both groups. In conclusion, our practice of Nissen fundoplication indicates that LNF takes priority in most pediatric patients.

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신장에서 발생한 신경모세포종 1예 (A Case of Intrarenal Neuroblastoma)

  • 한애리;한석주;오정탁;최승훈;황의호
    • Advances in pediatric surgery
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    • 제6권2호
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    • pp.156-159
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    • 2000
  • Neuroblastoma arises from the embryonic tissue of the adrenergic rest. It is commonly found in children and mostly in nonrenal tissue. We present a case of intrarenal neuroblastoma which was initially thought to be a Wilms' tumor. The patient was a 18 months-old girl treated with radical nephrectomy and adjuvant chemotherapy after operation. The neoplasm within the kidney in children cannot always indicate Wilms' tumor. Neuroblastoma of the adrenal gland or retroperitoneal tissue may often compress or invade the kidney directly or arise from the kidney. Clinical aspects that differentiate between neuroblastoma and Wilms' tumor are discussed with a review of the literatures.

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Chemoport 제거 중 발생한 카테터 색전증 (Catheter Embolism during Chemoport Removal)

  • 송기병;남소현;김대연;김성철;김영휘;김인구
    • Advances in pediatric surgery
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    • 제12권2호
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    • pp.238-243
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    • 2006
  • Chemoport is widely used in pediatric surgery field. But various complications can occur during the process of insertion or removal of chemoport. Surgeons must be familiar with the treatment of these complications. We had one catheter cuts off during chemoport removal, become a catheter embolism. Interventional radiologic removal was successful. Verifying the length of removed catheter and careful observation of the catheter tip during removal procedure is important to prevent the possibility of catheter embolus. Radiologic intervention was accessible to remove the retained catheter.

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이탈된 위루관에 대한 투시경하 변형 Seldinger씨 방법을 이용한 경피적 위루관 재삽입술 (Percutaneous Gastrostomy Tube Reinsertion after Accidental Dislodgement Using Modified Seldinger's Technique)

  • 김주희;김성민;오정탁;최승훈;황의호;한석주
    • Advances in pediatric surgery
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    • 제12권2호
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    • pp.251-256
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    • 2006
  • This case report describes a baby who received a laparoscopic gastrostomy tube insertion, which was dislodged accidentally at $16^{th}$ postoperative day. After the dislodgement, cutaneous tract rapidly closed, and reinsertion seemed to be impossible. However, gastrostomy tube was reinserted safely with fluoroscopy-guided Seldinger's technique under local anesthesia with sedation. This is the unique method of modified Seldinger's technique for reinsertion of gastrostomy tube under local anesthesia and sedation for accidentally dislodged gastrostomy tube. This method was thought to be safe, easy and useful technique for gastrostomy reinsertion after dislodgement of gastrostomy tube.

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Totally Implantable Venous Devices (TIVD)의 불완전 제거 2예 (Incomplete Removal of Totally Implantable Venous Devices : Report of 2 Cases)

  • 손상용;이한별;김수홍;박태진;정규환;김현영;김웅한;정성은
    • Advances in pediatric surgery
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    • 제18권1호
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    • pp.18-23
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    • 2012
  • Totally implantable venous devices (TIVD)는 장기간 항암 화학 요법이나 총 정맥 영양, 수액치료가 필요한 환자에서 많이 사용된다. TIVD는 매우 유용하고 안전한 장치이지만, 이와 관련된 다양한 합병증이 보고 되어 왔다. 저자들은 카테터의 혈관 내 유착에 의해 TIVD의 제거가 불완전하게 된 2예를 경험하였기에 보고하는 바이다.

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