The ins and outs of pyloromyotomy: what we have learned in 35 years.

Purpose/background: The aim of the study is to evaluate a large series of infantile hypertrophic pyloric stenosis (IHPS) patients treated by one pediatric surgeon focusing on their diagnostic difficulties and complications.

Methods: From July 1969 to December 2003 (inclusive), the charts of 791 infants with IHPS were retrospectively reviewed.

Results: There were 647 (82%) males and 144 (18%) females; mean age was 38 days, median 51 (range 7 days-10 months).

Testicular atrophy after attempted pediatric orchidopexy for true undescended testis.

Background/purpose: A normal testis in the scrotum is the most important outcome of the attempted pediatric orchidopexy for a true undescended testis. The reports of post-orchidopexy testicular atrophy in the literature have ranged from non-existent to unclear. Our purpose in this study was to estimate the incidence of and associated risk factors for post-orchidopexy testicular atrophy.

Open appendectomy for pediatric ruptured appendicitis: a historical clinical review of the prophylaxis of wound infection and postoperative intra-abdominal abscess.

Background: We conducted a 3-decade clinical review of prophylaxis for wound infection and postoperative intra-abdominal abscess after open appendectomy for pediatric ruptured appendicitis.

Methods: We reviewed the charts of patients with ruptured appendicitis who underwent open appendectomy performed by the same pediatric surgeon at the Hospital for Sick Children, Toronto, Canada, between 1969 and 2003, inclusive. We evaluated 3 types of prophylaxis: subcutaneous (SC) antibiotic powder, peritoneal wound drain and intravenous (IV) antibiotics.

Predictors of metachronous inguinal hernias in children.

Purpose: Surgical management of the contralateral groin in unilateral inguinal hernia remains controversial. Our aim was to determine predictors of metachronous inguinal hernias in children using multivariable analysis.

Methods: A retrospective cohort study of 6,302 patients presenting with inguinal hernia to a single surgeon's practice over 35 years was undertaken.

Six thousand three hundred sixty-one pediatric inguinal hernias: a 35-year review.

Purpose: This study, by its mere size and uniformity (1 pediatric surgeon), aims to corroborate or refute the teachings and myths of the pediatric inguinal hernia.

Methods: From July 1969 to January 2004, 6361 infants and children with inguinal hernias were seen, operated on, and followed by the senior author. A retrospective survey of their charts was carried out to evaluate the demographics and clinical aspects of these patients.