scholarly journals Early and long-term complications following transanal pull through Soave technique in infants with Hirschsprung's diseaseric infants with Hirschsprung's disease

2019 ◽  
Author(s):  
Manoochehr Ghorbanpour ◽  
Mohammad Ali Seyfrabie ◽  
Babak Yousefi
Keyword(s):  
Intestinal Obstruction ◽  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Statistical Tests ◽  
Case Series ◽  
P Value ◽  
Short Term ◽  
Case Series Study ◽  
The Mean

Objective. Patients undergoing Soave surgery for Hirschsprung's disease are at risk for some complications. The aim of this study was to investigate such short-term and long-term complications and evaluate the outcome of the operation in these patients. Methods. A case series study was carried out during the last 12 years, during 2007 to 2018 in Besat hospital of Hamadan. Data collection conducted using a checklist includes questions about demographic information, clinical features, and short-term and long-term complications, and consequences of post-operative surgery. The findings of the study were analyzed using SPSS software version 20 and appropriate statistical tests. P-value less than 0.05 was considered statistically significant. Results. A total of 55 children underwent Soave surgery during the last 12 years in Besat Hospital Hamadan, Iran. The mean age of the patients was 38±10 days during surgery, of which 56.4% were female. The mean hospital stay was 7.3 days. Also, the mean weight of children at birth was 2970±447 gr. Most of the patients were born as NVD (52.7%) and term (74.5%). The most common comorbidity was congenital heart disease. The most common short-term complication was intestinal obstruction in 14 patients (25.5%) and the most frequent long-term complication was intestinal obstruction and constipation (27.3% each cases). The mortality rate of patients in this study was 14.5% in total. Conclusions. One stage surgical procedure in Hirschsprung's disease is a safe and effective method, but care should be taken in choosing patients and patients should be monitored for possible complications, so that they can be considered and implemented for proper treatment.

Outcome of Short-Term and Long Term Antibiotic Prophylaxis in Colostomy Closure

2016 ◽  
Vol 4 (2) ◽  
pp. 43-48
Author(s):  
Md Jamal Saleh Uddin ◽  
Sukumar Chakrabarti ◽  
Md Shahidul Islam
Keyword(s):  
Antibiotic Prophylaxis ◽  
Wound Infection ◽  
Anorectal Malformation ◽  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Colostomy Closure ◽  
Term Therapy ◽  
Short Term ◽  
Sigmoid Colostomy

Background and Objectives: Antibiotic prophylaxis is a common practice in children undergoing colostomy closure for anorectal malformation, Hirschsprung's disease. Traditionally, antibiotics are given for unnecessarily longer period of time, which consumes scarce health resources having alternate efficient use. The present study was undertaken to compare the outcome between short-term and long-term antibiotic prophylaxis in colostomy closure. Materials & Methods: This randomized clinical trial was conducted in Dhaka Shishu Hospital, Dhaka over a period of 15 months from April 2001 to June 2002. Children admitted with anorectal malformation, Hirschsprung's disease for colostomy closures were the study population. However, immuno-compromised children or children already getting antibiotics were excluded from the study. A total of 46 such children were consecutively included and were randomly allocated to long-term group (n = 21) and short-term group (n = 25). The long-term group received antibiotic up to 5th postoperative day, while the short-term group received the same antibiotic up to 2nd postoperative day. Transverse colostomy was the main procedure employed in colostomy closure; however, a few patients required sigmoid colostomy. The outcome measures were incidence of wound infection, hospital stay and cost of treatment. Result: Majority of the children were between 1 - 5 years of age (75% in short-term and 50% in long-term group) followed by under 1 year (10% in short-term and 40% in long-term group) and > 5 years (15% in short-term and 10% in long-term group). The overall male to female ratio was 3:1. Majority (85%) of the patients in both long­term and short-term groups belonged to lower income group. Over half (52.2%) of the children had anorectal malformations (ARM) and the rest (47.8%) had Hirschsprung's disease (HD). Children were generally malnourished according to Gomez classification. Majority (91%) was operated on by transverse colostomy and few (9%) by sigmoid colostomy. Three patients in each group developed postoperative wound infection. Blood culture of none of these patients yielded growth of any organism, though wound swab culture did so in 5 cases out of 6 infected patients. In 2 cases, the organism was E.coli, in 2 cases, it was Pseudomonas and in one case Staph. aureus. Total cost of antibiotics in short-term therapy was less than 50% of that required in long-term therapy. The outcome in terms of recovery, complications and postoperative hospital stay was no different between groups. Conclusion: The study concluded that short-term antibiotic prophylaxis is as efficacious as long-term in preventing wound infection in patients with colostomy closure for anorectal malformation and Hirschsprung's disease. Short-term antibiotic prophylaxis is cost-effective Ibrahim Cardiac Med J 2014; 4(2): 43-48

scholarly journals HIRSCHSPRUNG’S DISEASE

2010 ◽  
Vol 17 (02) ◽  
pp. 223-231
Author(s):  
MUHAMMAD ZAFAR IQBAL ◽  
Hammad Azam ◽  
MUHAMMAD JAHANGIR ◽  
Muhammad Tahir ◽  
MUHAMMAD ANWAR ◽  
...  
Keyword(s):  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Case Series ◽  
Abdominal Distension ◽  
Functional Results ◽  
International Studies ◽  
Stool Incontinence ◽  
Case Series Study ◽  
Duhamel Procedure ◽  
One Year

Introduction: Hirschsprung’s Disease is one of the most common congenital anomalies that Pediatric Surgeons manage. In spite of the various modifications of pull through procedures available, the long term functional results are less than ideal. However, Modified Duhamel Procedure is one which has relatively good functional results and that is the reason we have selected this procedure for Hirschsprung’s disease in Sheikh Zayed Hospital, Rahim Yar Khan. Objectives: To evaluate the outcome of patients after Modified Duhamel Procedure for Hirschsprung’s Disease. Design: This is case series study. Settings: Department of Pediatric Surgery Sheikh Zayed Medical College/ Hospital Rahim Yar Khan. Period: Seventeen cases were studied over a period of two year i.e. from November 2006 to December, 2008. Material and Method: Seventeen (17) cases from both sexes were operated for Hirschsprung’s Disease over a period of one year and Modified Duhamel Procedure was adopted for all these cases. All patients were diagnosed cases of rectosigmoidal aganglionosis and follow up was done over a period of one year according to a comprehensive Proforma. Four parameters like normal stool evacuation, abdominal distension, soiling and stool incontinence were followed and then the results were compared with other national and international studies. Results: Fever 19.4% (n=04), wound infection 19.4% (n=04), vomiting 9.52% (n=02), abdominal distension 4.76% (n=01), and bleeding per rectum 4.76% (n=01), were the immediate post operative complications. Fourteen patients (82.35%), used to pass stool once daily. Abdominal distension was observed occasionally in six patients (28.57%). Soiling was seen in five patients (29.41%). Out of Seventeen, stool incontinence was seen in only three patients (17.64%). Conclusion: Modified Duhamel Procedure with the help of linear cutter stapler device is quite safe, easy and less time consuming. Infact Modified Duhamel is a procedure of choice for Hirschsprung’s Disease. 

scholarly journals Clinical profile of SUNCT/SUNA in Japan: A clinic-based study

2019 ◽  
Vol 2 ◽  
pp. 251581631982990 ◽  
Author(s):  
Shoji Kikui ◽  
Junichi Miyahara ◽  
Hanako Sugiyama ◽  
Kentaro Yamakawa ◽  
Yoshihiro Kashiwaya ◽  
...  
Keyword(s):  
Case Series ◽  
Japanese Patients ◽  
Preventive Therapy ◽  
Short Term ◽  
Case Series Study ◽  
Clinical Profiles ◽  
The Mean ◽  
Series Study ◽  
Headache Center

Objectives: This study aimed to report the clinical profiles of patients with short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT)/short-lasting unilateral neuralgiform headache attacks with cranial autonomic (SUNA) in a Japanese population by surveying those enrolled at a regional headache center in Japan. Methods: In this consecutive case series study, the clinical characteristics of patients with SUNCT (eight men, three women; mean age: 59.5 ± 20.5 years) and SUNA (five men, four women; mean age: 51.3 ± 18.4 years) who visited Tominaga Hospital from February 2011 to January 2017 were examined. Headaches were diagnosed according to the International Classification of Headache Disorders, Third edition (ICHD-3) guidelines. Results: Brief clusters of separate attacks were reported by all patients. The mean duration of attacks was 91.9 ± 87.9 s. Ipsilateral rhinorrhea was observed in 9 of 20 (45.0%) cases and facial sweating was observed in 1 of 20 (5.0%) cases. An eminent response to lamotrigine was observed in 9 of 9 (100%) patients; however, adverse events were only reported in 2 of 9 (22.2%) cases. An intravenous infusion of lidocaine was demonstrated to be completely successful for short-term prevention in 5 of 6 (83.3%) SUNCT cases. Conclusions: Lamotrigine can successfully treat most patients, and intravenous lidocaine is useful for the short-term preventive therapy of severe recalcitrant attacks in Japanese patients with SUNCT/SUNA.

Functional and Radiographic Outcomes of Minimally Invasive Intramedullary Nail Device (MIIND) for Moderate to Severe Hallux Valgus

2020 ◽  
pp. 107110072096967
Author(s):  
Carlo Biz ◽  
Alberto Crimì ◽  
Ilaria Fantoni ◽  
Jacopo Tagliapietra ◽  
Pietro Ruggieri
Keyword(s):  
Hallux Valgus ◽  
Case Series ◽  
Radiographic Outcomes ◽  
Case Series Study ◽  
Significant Correction ◽  
The Mean ◽  
Series Study ◽  
Severe Hallux Valgus

Background: This study was aimed at assessing clinical and radiographic outcomes of the Minimally Invasive Intramedullary Nail Device (MIIND) to correct moderate to severe hallux valgus (HV) and the long-term persistence of its effects. Methods: This case series study involved 100 patients, 84 women and 16 men (mean age, 59 years), who underwent the MIIND procedure with a mean follow-up of 97 months. Assessment was performed preoperatively, postoperatively, at 6 and 12 months, and at last follow-up. Clinical outcomes were evaluated with American Orthopaedic Foot & Ankle Society (AOFAS) scores, visual analog scale (VAS), and patient satisfaction. Intermetatarsal angle (IMA), metatarsophalangeal hallux valgus angle (HVA), distal metatarsal articular angle (DMAA), and tibial sesamoid position were assessed. Statistical analysis was performed. Results: The mean AOFAS score improved from 57.9 to 90.5 points, VAS scale was 1.5 ± 2.0, and patients’ satisfaction was 8.7 ± 1.4. The mean correction of the HVA and IMA showed a significant correction; however, the effect of time was not statistically significant on DMAA. Sex ( P = .047), severity ( P = .050), associated procedures ( P = .000), and preoperative angle ( P = .000) showed significant association with HVA correction and its persistence over time. Age was not statistically significant. Complications were 9 cases of superficial wound infection and 6 recurrences. Conclusions: The MIIND technique proved a viable procedure to correct moderate to severe HV with a low rate of complications and recurrence, producing significant correction of most radiographic parameters assessed and their persistence, even at long term. Level of Evidence: Level IV, case series study.

scholarly journals ISOLATED ILEOCECAL FORM OF AGANGLIONOSIS IN A NEWBORN

2019 ◽  
Vol 23 (1) ◽  
pp. 52-53
Author(s):  
Gennady I. Chepurnoy ◽  
A. V. Leiga ◽  
V. B. Katsupeyev ◽  
M. G. Chepurnoy ◽  
N. A. Mikhanoshina ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Postoperative Period ◽  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Clinical Observation ◽  
Functional Results ◽  
Distal Colon ◽  
Acute Intestinal Obstruction ◽  
Rare Form

There is presented a clinical observation of such rare form of Hirschsprung’s disease in a newborn -as terminal aganglionosis of the ileum and hypo-ganglionosis of the cecum, manifested by acute intestinal obstruction. Resection of the ileocecal angle and leaving the distal colon in the child’s body with good functional results in the long-term postoperative period made it possible to affirm the existence of high isolated segmental forms of Hirshprung’s disease.

Force Plate Analysis of Dogs with Bilateral Hip Dysplasia Treated with a Unilateral Triple Pelvic Osteotomy: A Long-term Review of Cases

1998 ◽  
Vol 11 (02) ◽  
pp. 85-93 ◽  
Author(s):  
Joanne R. Cockshutt ◽  
H. Dobson ◽  
C. W. Miller ◽  
D. L. Holmberg ◽  
Connie L. Taves ◽  
...  
Keyword(s):  
Gait Analysis ◽  
Hip Dysplasia ◽  
Weight Bearing ◽  
Force Plate ◽  
Case Series ◽  
Pelvic Osteotomy ◽  
Vertical Force ◽  
Long Term Outcome ◽  
Case Series Study

SummaryA retrospective case series study was done to determine the long-term outcome of operations upon dogs treated for canine hip dysplasia by means of a triple pelvic osteotomy (TPO). Twentyfour dogs with bilateral hip dysplasia, that received a unilateral TPO between January 1988 and June 1995, were re-examined at the Ontario Veterinary College. The assessment included physical, orthopedic and lameness examinations, standard blood work, pelvic radiographs and force plate gait analysis. They were compared to bilaterally dysplastic dogs that had not been treated, and also to normal dogs. Force plate data analysis demonstrated a significant increase in peak vertical force (PVF) and mean vertical force over stance (MVF) in the limb that underwent surgical correction by means of a TPO, when compared to the unoperated hip. It was determined that performing a unilateral TPO on a young dysplastic dog resulted in greater forces and weight bearing being projected through the TPO corrected limb when compared to the unoperated limb.Dogs with bilateral hip dysplasia treated with a unilateral triple pelvic osteotomy (TPO) were assessed by force plate gait analysis, radiographs and orthopedic examination. There was a significant increase in hip Norberg angles over time, although degenerative changes did progress. Limbs that had been operated upon had significantly greater peak and mean ground reaction forces than limbs that had not received an operation.

Long-term outcomes of lumbar microdiscectomy in the pediatric population: a large single-institution case series

2019 ◽  
Vol 24 (5) ◽  
pp. 549-557
Author(s):  
Malia McAvoy ◽  
Heather J. McCrea ◽  
Vamsidhar Chavakula ◽  
Hoon Choi ◽  
Wenya Linda Bi ◽  
...  
Keyword(s):  
Conservative Management ◽  
Functional Outcomes ◽  
Pediatric Patients ◽  
Clinical Presentation ◽  
Case Series ◽  
Csf Leak ◽  
Single Institution ◽  
The Mean

OBJECTIVEFew studies describe long-term functional outcomes of pediatric patients who have undergone lumbar microdiscectomy (LMD) because of the rarity of pediatric disc herniation and the short follow-up periods. The authors analyzed risk factors, clinical presentation, complications, and functional outcomes of a single-institution series of LMD patients over a 19-year period.METHODSA retrospective case series was conducted of pediatric LMD patients at a large pediatric academic hospital from 1998 to 2017. The authors examined premorbid risk factors, clinical presentation, physical examination findings, type and duration of conservative management, indications for surgical intervention, complications, and postoperative outcomes.RESULTSOver the 19-year study period, 199 patients underwent LMD at the authors’ institution. The mean age at presentation was 16.0 years (range 12–18 years), and 55.8% were female. Of these patients, 70.9% participated in competitive sports, and among those who did not play sports, 65.0% had a body mass index greater than 25 kg/m2. Prior to surgery, conservative management had failed in 98.0% of the patients. Only 3 patients (1.5%) presented with cauda equina syndrome requiring emergent microdiscectomy. Complications included 4 cases of postoperative CSF leak (2.0%), 1 case of a noted intraoperative CSF leak, and 3 cases of wound infection (1.5%). At the first postoperative follow-up appointment, minimal or no pain was reported by 93.3% of patients. The mean time to return to sports was 9.8 weeks. During a mean follow-up duration of 8.2 years, 72.9% of patients did not present again after routine postoperative appointments. The total risk of reoperation was a rate of 7.5% (3.5% of patients underwent reoperation for the same level; 4.5% underwent adjacent-level decompression, and one patient [0.5%] ultimately underwent a fusion).CONCLUSIONSMicrodiscectomy is a safe and effective treatment for long-term relief of pain and return to daily activities among pediatric patients with symptomatic lumbar disc disease in whom conservative management has failed.

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