Treatment of pilonidal disease with crystallized phenol has excellent cosmetic results with 80% success rate, but is it safe in pediatric patients?

2019 ◽  
Vol 54 (10) ◽  
pp. 2191
Author(s):  
Mehmet Eren Yuksel
2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Kalaskar ◽  
J Adamek

Abstract Introduction The accepted treatment of pilonidal disease still consists of surgical excision with primary wound closure. This treatment has complications such as excessive pain, delayed wound healing, and recurrence. We introduced this technique using a radial laser probe (SiLaCTM, Biolitec, Germany). Previous studies have shown encouraging results with respect to safety, patient satisfaction, and minimal recurrence rates. Method The pilot project was planned with the objectives to assess postoperative complications and reoperation rates. All operations were performed as day case procedures under general anaesthesia. We studied the data of our first 25patients operated with this technique between January 2019 and December 2019 using a prospective database and outpatient clinic follow up. Results The median follow up duration was 13 months. The initial success rate was 64%(16/25), reoperation was required in 32%(8/25) and one patient was lost to follow up. one patient returned with abscess formation in the postoperative period. Conclusions SiLaC is a safe and minimally invasive technique for the destruction of the pilonidal cyst and sinus. The success rate is modest, making this new therapy a minimally invasive option for the majority of the patients with pilonidal disease but it should be offered with caution.


2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Eva Brichtova ◽  
Martin Chlachula ◽  
Tomas Hrbac ◽  
Radim Lipina

Endoscopic third ventriculostomy (ETV) is a routine and safe procedure for therapy of obstructive hydrocephalus. The aim of our study is to evaluate ETV success rate in therapy of obstructive hydrocephalus in pediatric patients formerly treated by ventriculoperitoneal (V-P) shunt implantation. From 2001 till 2011, ETV was performed in 42 patients with former V-P drainage implantation. In all patients, the obstruction in aqueduct or outflow parts of the fourth ventricle was proved by MRI. During the surgery, V-P shunt was clipped and ETV was performed. In case of favourable clinical state and MRI functional stoma, the V-P shunt has been removed 3 months after ETV. These patients with V-P shunt possible removing were evaluated as successful. In our group of 42 patients we were successful in 29 patients (69%). There were two serious complications (4.7%)—one patient died 2.5 years and one patient died 1 year after surgery in consequence of delayed ETV failure. ETV is the method of choice in obstructive hydrocephalus even in patients with former V-P shunt implantation. In case of acute or scheduled V-P shunt surgical revision, MRI is feasible, and if ventricular system obstruction is diagnosed, the hydrocephalus may be solved endoscopically.


2021 ◽  
Vol 10 (17) ◽  
pp. 3936
Author(s):  
Kensuke Yokoyama ◽  
Tomonori Yano ◽  
Atsushi Kanno ◽  
Eriko Ikeda ◽  
Kozue Ando ◽  
...  

Balloon enteroscopy-assisted endoscopic retrograde cholangiography (BEA-ERC) is useful and feasible in adults with pancreatobiliary diseases, but its efficacy and safety have not been established in pediatric patients. We compared the success rate and safety of BEA-ERC between adults and pediatric patients. This single-center retrospective study reviewed 348 patients (pediatric: 57, adult: 291) with surgically altered gastrointestinal anatomies who underwent BEA-ERC for biliary disorders from January 2007 to December 2019. The success rate of reaching the anastomosis or duodenal papilla was significantly lower in pediatric patients than in adult patients (66.7% vs. 88.0%, p < 0.01). The clinical success rate was also significantly lower in pediatric patients (64.9% vs. 80.4%, p = 0.014). The rate of adverse events was significantly higher in pediatric patients than in adults (14.2% vs. 7.7%, p = 0.037). However, if the anastomotic sites were reached in pediatric patients, the treatment was highly successful (97.3%). The time of reaching target site was significantly longer in pediatric patients than in adult patients. This study shows that BEA-ERC in pediatric patients is more difficult than that in adult patients. However, in patients where the balloon enteroscope was advanced to the anastomosis, clinical outcomes comparable to those in adults can be achieved.


2010 ◽  
Vol 53 (6) ◽  
pp. 932-935 ◽  
Author(s):  
Erhan Aygen ◽  
Kemal Arslan ◽  
Osman Dogru ◽  
Murat Basbug ◽  
Cemalettin Camci

2015 ◽  
Vol 8 (1) ◽  
pp. 7-13
Author(s):  
Cristiane de Abreu T. Ricci ◽  
Laura Maria de Lima B. F. Lasmar ◽  
Paulo M. Pitrez ◽  
Raimundo F. Mascarenhas ◽  
Paulo A. M. Camargos

Background: In problematic severe asthma (PSA), inflammatory phenotypes can by identified by assessing cellularity in induced sputum (IS) samples. However, there have been few studies employing sputum induction (SI) in pediatric patients. Objectives: To assess the success rate, safety and tolerability of SI, as well as IS sample cellularity, in pediatric PSA patients. Methods: We conducted a cross-sectional study involving 44 pediatric PSA patients. We collected IS samples using inhalations of nebulized saline solution. On the basis of the post-bronchodilator forced expiratory volume in one second (FEV1, % of predicted), we administered nebulization with 4.5% hypertonic saline (for patients with an FEV1 ≥ 60%) or 0.9% isotonic saline (for those with an FEV1 < 60%). We classified IS samples as satisfactory if there was ≤ 20% squamous cell contamination and cell viability was > 50%. Results: The observed success rate was 75% (95% CI: 60-86). Most of the patients provided satisfactory samples, although multiple SI sessions were required in some cases (27%). In comparison with the IS samples containing > 20% squamous cells, those containing ≤ 20% showed significantly more neutrophils (P = 0.02) and eosinophils (P = 0.03). The most common adverse events were mild wheezing (in 14%) and salty taste (in 9%). In 8% of the sessions, there was a ≥ 20% decrease in FEV1. Conclusion: In our sample of pediatric patients with PSA, sputum induction was safe and generally well tolerated, suggesting that it could be useful in the assessment of inflammatory processes in such patients.


2020 ◽  
Author(s):  
Radosław Pietrzak ◽  
Magda Franke ◽  
Monika Gawałko ◽  
Piotr Lodziński ◽  
Paweł Balsam ◽  
...  

2020 ◽  
Vol 133 (1) ◽  
pp. 53-63
Author(s):  
Young-Eun Jang ◽  
Sang-Hwan Ji ◽  
Eun-Hee Kim ◽  
Ji-Hyun Lee ◽  
Hee-Soo Kim ◽  
...  

Background Pediatric radial artery cannulation is challenging because of the small vessel size. Nitroglycerin is a potent vasodilator and facilitates radial artery cannulation by increasing the internal diameter and preventing the vasospasm in adult patients. The authors hypothesize that subcutaneous nitroglycerin injection will improve the success rate of pediatric radial artery cannulation. Methods This double-blind, randomized, controlled, single-center study enrolled pediatric patients (n = 113, age less than 2 yr) requiring radial artery cannulation during general anesthesia. The participants were randomized into the nitroglycerin group (n = 57) or control group (n = 56). After inducing general anesthesia, nitroglycerin solution (5 μg/kg in 0.5 ml), or normal saline (0.5 ml) was subcutaneously injected above the chosen radial artery over 10 s with ultrasound guidance. Three minutes later, the ultrasound-guided radial artery cannulation was performed. Radial artery diameter was measured before and after the subcutaneous injection and after cannulation. The primary outcome was the first-attempt successful cannulation rate. The secondary outcomes included the diameter of the radial artery and the overall complication rate including hematoma and vasospasm. Results A total of 113 children were included in the analysis. The nitroglycerin group had a higher first-attempt success rate than the control group (91.2% [52 of 57] vs. 66.1% [37 of 56]; P = 0.002; odds ratio, 5.3; 95% CI, 1.83 to 15.6; absolute risk reduction, –25.2%; 95% CI, –39.6 to –10.7%). Subcutaneous nitroglycerin injection increased the diameter of the radial artery greater than normal saline (25.0 ± 19.5% vs. 1.9 ± 13.1%; 95% CI of mean difference, 16.9 to 29.3%; P &lt; 0.001). Overall complication rate was lower in the nitroglycerin group than in the control group (3.5% [2 of 57] vs. 31.2% [18 of 56]; P = 0.001; odds ratio, 0.077; 95% CI, 0.017 to 0.350; absolute risk reduction, 28.6%; 95% CI, 15.5 to 41.8%). Conclusions Subcutaneous nitroglycerin injection before radial artery cannulation improved the first-attempt success rate and reduced the overall complication rates in pediatric patients. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New


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