[Medico-surgical consensus for management of children with gastroesophageal reflux Acapulco, Mexico 2002].

Unlabelled: Gastroesophageal reflux (GER) is a common disease in children less one year old. It is present around 10% of unselected infant population. 40-50% have abnormal 24 h pH monitoring.

Patterns of management of congenital tracheal stenosis.

Background/purpose: Stenosing airway disease, including congenital and acquired lesions, is rare in the pediatric age group. Until recently, the outlook for patients with congenital tracheal stenosis (CTS) was dismal because medical management was the only way of treatment. Surgical and endoscopical techniques developed in the last years have improved the prognosis.

[Surgery of lung metastasis].

Introduction: The 30-40% of the oncologic patients have pulmonary metastases. Lung can be the only organ affected. In selected patients, exeresis of the pulmonary nodules can mean their healing.

[Bronchoscopies in neonatal intensive care units: safety and efficiency].

The aim of our study is to asses the risks and complications in bronchoscopies at Neonatal Intensive Care Units (NICU). Between 1991 and 1999, we performed 142 bronchoscopies at the NICU. The mean age was 1.

Surgery of subglottic stenosis in neonates and children.

The excellent management of patients in the different Intensive Care Units has decreased mortality but, as a side effect, we have to treat an increasing number of patients with airway problems secondary to prolonged intubation. The clinical records of patients diagnosed of acquired or congenital subglottic stenosis (SE) between 1990 and 1995 were retrospectively reviewed. Types of treatment included conservative, endoscopic, and open surgery: anterior cricoid split (ACS), anterior laryngotracheoplasty (ALTP) and anteroposterior laryngotracheoplasty (APLTP).

Surgical approach to funnel-shaped congenital tracheal stenosis.

Purpose: The aim of this study was to evaluate the results obtained by 2 different techniques of tracheoplasty in the treatment of long-segment, funnel-shaped congenital tracheal stenosis (CTS) in 2 tertiary paediatric hospitals.

Methods: The clinical records of patients with long segment congenital tracheal stenosis during the period January 1990 to June 1999 were reviewed retrospectively. Age, gender, symptoms, imaging (x-ray, computed tomography, magnetic resonance imaging, or bronchography), endoscopic findings, associated anomalies, treatment, intubation time, postoperative treatment, intensive care unit stay, complications, hospital stay, evolution, and follow-up time were analyzed.

[Treatment of suprastomal tracheomalacia by anterior cricoid suspension].

Background: One of the reasons of failure to decannulate patients after airway surgery or long-term tracheostomy is suprastomal tracheomalacia.

Objectives: Evaluate the results obtained in the treatment of suprastomal tracheomalacia by anterior cricoid suspension.

Material And Methods: We present 8 patients with suprastomal tracheomalacia associated to long-term tracheostomy corrected by this technique.

Splenic littoral cell angioma in an infant.

A 1-year-old girl presented with fever, asthenia, and splenomegaly with hypersplenism. Abdominal ultrasound scan and magnetic resonance imaging showed multiple nodular cystic masses in an enlarged spleen. The histological examination of the resected spleen showed a novel type of vascular tumor called littoral cell angioma.

Bronchial mucoepidermoid tumor in a 3-year-old child.

A 3-year-old girl was evaluated for persistent middle lobe atelectasis. Fiberoptic bronchoscopy revealed a spherical mass occupying the middle-lobe bronchus. The biopsy specimen disclosed a low-grade mucoepidermoid carcinoma.

[The treatment of the tracheobronchomalacia in pediatric age].

Objective: Aortopexy is the more extended treatment for severe tracheomalacia, when it fails, reintervention and other procedures are necessary. We present our experience in the treatment of this pathology.

Material And Methods: Tracheomalacia, bronchomalacia and tracheobroncomalacia cases during a twelve year period (1983-1995) were reviewed (type, age, symptoms, surgical procedures and results were collected).

Primary neuroblastoma presenting as a paratesticular tumor.

A 3-month-old boy was operated on for an inguinal tumor. Histological diagnosis was neuroblastoma. This is the second known case of primary paratesticular neuroblastoma reported in the literature.

[Surgical treatment versus tracheostomy of the laryngeal stenosis in children].

Incidence of pediatric laryngeal stenosis has increased due to better Intensive Care Units. The medical records of the patients with laryngeal stenosis treated in the hospital between 1990 and 1995 were reviewed, analyzing the type of lesion, ethiologic factors, surgical technique employed and post-op result. The surgical technique was chosen conditioned by the age, weight of the patient, grade of the stenosis according to Cotton's classification and presence or absence of respiratory distress.

Synovial sarcoma of the esophagus.

A 14-year-old girl presented with dysphagia and weight loss. Barium swallow, computed tomography, and endoscopy showed a polypoid intraluminal mass in the cervical esophagus. The tumor was locally resected and postoperative chemotherapy and radiotherapy were administered.

Treatment of esophageal varices by endoscopic ligation in children.

Endoscopic variceal ligation (EVL) is an alternative technique to endoscopic variceal sclerotherapy (EVS) to treat esophageal varices. This method consists of mechanical ligature and thrombosis of varices using elastic rubber rings. During an 11-month period, nine pediatric patients with esophageal varices secondary to portal hypertension were treated by EVL.

[Ambulatory surgery. Experience at a pediatric surgery department].

In October 1987 we opened an Outpatient Surgical Unit, since January 1988 to December 1993 we have treated 8232 patients with an mean age (range of 2 weeks to 17 years). All the patients were given general anesthesia, loco-regional anesthetics or deep sedation. 33.

[Treatment of post-traumatic pancreatic pseudocyst by percutaneous Huisman's drainage].

Pancreatic pseudocysts is a complication of acute posttraumatic pancreatitis. They usually cause recurrent abdominal pain, nausea, vomiting and elevation of serum amylase levels. A history of epigastric blunt trauma, the before mentioned clinical signs and echographic or scanning studies may lead to a certain diagnosis.

[Surgical alternatives in congenital tracheal stenosis].

Congenital tracheal stenosis is a rare condition with a high mortality. In a 12-year period, 5 cases (ages 5 days to 4 years) with this anomaly were treated. 4 were corrected, the operative repair consisted of segmental resection and anastomosis in one patient, and rib-cartilage tracheoplasty in the other three.

[Surgery of the structural lesions of the respiratory tract].

22 clinical files of patients treated in our institution since 1983 for structural lesion of the airway are reviewed. 3 cases presented congenital tracheal stenosis, 15 congenital or acquired subglottic stenosis, 1 severe tracheomalacia, 1 subglottic membrane, 1 congenital subglottic cyst and 1 subglottic granuloma. A conservative or surgical approach (endoscopic, anterior cricoid split, Fearon's laryngotracheoplasty, modified Rethi's procedure, Kimura's tracheoplasty and aortopex) was used.

[Intestinal anastomosis by biodegradable rings].

During an 9-month period (March to November 1992), six children underwent an intestinal anastomosis by means of a biofragmentable ring (BAR). Patients ages ranged from 5 to 16 years old. There were no mayor complications at surgery.

[The indications, technics and results of the use of tissue expanders in pediatric surgery].

We review our experience in tissue expansion in twenty-four pediatric patients. The most frequent indications for the use of tissue expanders included congenital nevi and burn scars, they were also used with success in alopecia, congenital abdominal wall defects, mammary hypoplasia and microtia. Tissue expanders were always placed subcutaneously.

[Congenital esophageal stenosis associated with corneosclera].

One case of congenital esophageal stenosis due to tracheobronchial remnants and associated with microphthalmos and corneosclera is reported. Diagnostic and therapeutic methods employed are discussed.

[Results of the treatment of Hirschsprung's disease using Duhamel technique and mechanical sutures].

The original Duhamel procedure for the treatment of Hirschsprung's disease (HD) has undergone several important modifications over the years. The use of mechanical suture in recent years has added significant advantages to this surgical procedure. Sixteen patients with HD were operated on according to this surgical technique, from 1985 to 1990.

[Our experience with the treatment of congenital megacolon using mechanical sutures].

The DUHAMEL operation is widely used for the treatment of HIRSCHSPRUNG disease. Recently, technical modifications using stapled instruments have been introduced. The results of 12 patients treated between 1985 and 1989, performing the DUHAMEL procedure are reviewed.

[Surgery on the prepuce for correction of distal hypospadias without chordee].

Distal hypospadias are the most frequent form of all. Many surgical procedures have been described. We present a series of 84 patients treated using a modification of the technique described in 1967 by Saint Aubert, known as preputioplasty.