Long-Term Outcomes of Hemispheric Disconnection in Pediatric Patients with Intractable Epilepsy

Abstract BACKGROUND Although ventriculoperitoneal shunts (VPS) remain the first-line option in most instances of pediatric hydrocephalus, the long-term efficacy of ventriculoatrial shunts (VAS) remains unknown. OBJECTIVE To characterize the long-term outcomes and adverse occurrences associated with both VPS and VAS at our institution. METHODS The authors retrospectively analyzed all cerebrospinal fluid (CSF) shunting procedures performed over a 13-yr period at a single institution. A total of 544 pediatric shunt patients were followed for at least 90 d (VPS: 5.9 yr; VAS: 5.3 yr). RESULTS A total of 54% of VPS and 60% of VAS required at least 1 revision. VPS demonstrated superior survival overall; however, if electively scheduled VAS lengthening procedures are not considered true “failures,” no statistical difference is noted in overall survival (P = .08). VPS demonstrated significantly greater survival in patients less than 7 yr of age (P = .001), but showed no difference in older children (P = .4). VAS had a significantly lower rate of infection (P < .05) and proximal failure (P < .001). CONCLUSION VAS can be a useful alternative to VPS when the abdomen is unsuitable, particularly in older children. Although VPS demonstrates superior overall survival, it should be understood that elective VAS lengthening procedures are often necessary, especially in younger patients. If elective lengthening procedures are not considered true failures, then the devices show similar survival.

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Pediatric inhalation injury

Burns & Trauma ◽

10.1186/s41038-017-0097-5 ◽

2017 ◽

Vol 5 ◽

Cited By ~ 3

Author(s):

Soman Sen

Keyword(s):

Pediatric Patients ◽

Inhalation Injury ◽

Smoke Inhalation ◽

Long Term Outcomes ◽

Management Options ◽

Smoke Inhalation Injury ◽

Early Management ◽

Pulmonary Physiology

Abstract Smoke inhalation injury can cause severe physiologic perturbations. In pediatric patients, these perturbations cause profound changes in cardiac and pulmonary physiology. In this review, we examine the pathology, early management options, ventilator strategy, and long-term outcomes in pediatric patients who have suffered a smoke inhalation injury.

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Similar Long-Term Outcomes in Children Presenting With Abscess vs Phlegmon at Diagnosis of Crohn Disease

Crohn's & Colitis 360 ◽

10.1093/crocol/otaa060 ◽

2020 ◽

Vol 2 (3) ◽

Author(s):

Andrew W Fondell ◽

Maua H Mosha ◽

Ross M Maltz ◽

Brendan M Boyle ◽

Barbara Joanna Niklinska-Schirtz ◽

...

Keyword(s):

Crohn Disease ◽

Chart Review ◽

Pediatric Patients ◽

Retrospective Chart Review ◽

Limited Data ◽

Long Term Outcomes ◽

Bowel Diseases ◽

Inflammatory Bowel ◽

Disease Present

Abstract Background Limited data are available for long-term outcomes of pediatric patients with abdominal abscess or phlegmon at diagnosis of Crohn disease. Methods We performed a retrospective chart review of such children over a recent 6-year period at 5 pediatric inflammatory bowel diseases. Results Fifty-two patients (mean age 15.9 ± 1.8 years) were reviewed. Thirty-six had an abscess and 27 (75%) required resectional therapy compared to 16 with phlegmon which 10 (63%) requiring surgery. Overall (37/52) 71% had surgery which was performed within 6 months in 32 (86%). Conclusions A similar high surgical rate exists whether pediatric patients with Crohn disease present with abscess or phlegmon.

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