Nissen fundoplication in the management of gastroesophageal reflux occurring after repair of esophageal atresia.

Background/purpose: Gastroesophageal reflux is a major cause of complications after esophageal atresia repair. The suitability of the Nissen fundoplication in these patients is still disputed. Therefore, the authors evaluated the results of their prospective treatment protocol in those patients who underwent a Nissen fundoplication.

Gastroesophageal reflux and Barrett's esophagus in adults born with esophageal atresia.

Objective: Postoperative morbidity after correction of esophageal atresia is partly determined by gastroesophageal reflux disease, which has been proven to affect from one-half to two-thirds of patients during childhood. We conducted a follow-up study to test our hypothesis that, if former patients still show gastroesophageal reflux at adult age, they are at high risk for developing Barrett's esophagus, which is considered to be premalignant.

Methods: Of 69 patients born between 1971 and 1978, all having undergone a primary anastomosis, 24 had died, five of them because of aspiration.

Normal ranges of 24-hour pH-metry established in corrected esophageal atresia.

Background: This study was undertaken to determine baseline values of 24-hour pH-metry in children who had undergone correction for esophageal atresia.

Methods: A 24-hour pH-metry without medication was conducted in 13 patients with an uncomplicated postoperative course after correction of esophageal atresia. The pH-metry was performed in the hospital with a flexible glass electrode.

Prospective medical and surgical treatment of gastroesophageal reflux in esophageal atresia.

Background: Gastroesophageal reflux is a major cause of anastomotic complications after repair of esophageal atresia. For this reason, we evaluated a prospective, postoperative treatment protocol with the emphasis on comparing medical and operative treatment.

Study Design: From 1994 to 1995, 26 consecutive patients underwent correction of esophageal atresia in the Sophia Children's Hospital.

Function of pediatric Nissen-Rossetti fundoplication followed up into adolescence and adulthood.

Background: We analyzed the very long-term results of the Nissen-Rossetti fundoplication performed in young children. Little has been reported about follow-up longer than 5 years in homogeneous populations. This study concerns a homogeneous group with a minimum follow-up of 10 years; these former patients, therefore, are now adolescents or adults.

[Favorable results of percutaneous endoscopic gastrostomy in children in need of long-term tube feeding].

Objective: Analysis of indications, weight and peroperative and postoperative complications in 32 consecutive children who underwent percutaneous endoscopic gastrostomy (PEG).

Design: Retrospective.

Setting: Sophia Children's Hospital, Rotterdam, The Netherlands.

Neonatal transport by helicopter in The Netherlands: a 7-year overview.

In the Netherlands, neonatal intensive care is provided in 10 neonatal intensive care centres. Although antenatal transport is preferred, each year more than 1000 newborns are transported to the centres, in the majority of cases by ambulance. Transport by helicopter became available in 1987.

Lyophylized dura patch repair of congenital diaphragmatic hernia: occurrence of relapses.

During an 8-year period, 71 neonates with congenital diaphragmatic hernia were admitted to the Sophia Children's Hospital. Seventeen patients died before surgery. The other 54 patients underwent either direct suture (18) or patch closure with lyophylized dura (36), depending on the size of the defect.

Incidence and management of gastroesophageal reflux after repair of congenital diaphragmatic hernia.

During a period of 6 years, 31 of 54 infants with congenital diaphragmatic hernia survived and were evaluated to study incidence and management of gastroesophageal reflux. At 6 months' follow-up 16 patients had gastroesophageal reflux proven by upper gastrointestinal series; at 12 months' follow-up 11 patients. Three patients having gastroesophageal reflux did not respond to medical treatment and underwent Nissen fundoplication.

Long-term survival of a patient with congenital short bowel and malrotation.

Since 1969, reports of 16 patients presenting with the congenital short bowel and malrotation syndrome have been published. The prognosis of this malformation is poor; only two patients survived. We present the history of a third patient, successfully treated with long-term survival.

Stenting of the ureterovesical anastomosis in pediatric renal transplantation.

From January 1985 to July 1989, 36 children received a renal transplant at our hospital. Their ages ranged from 2 to 18 years. All patients had a standard neoureterocystostomy according to Lich-Grégoir.

Total parenteral nutrition associated cholestasis: a predisposing factor for sepsis in surgical neonates?

Of 496 neonates and infants less than 1 year of age admitted to the paediatric surgical intensive care unit (PSICU) over a 5 year period (1983-1987), 94 required total parenteral nutrition (TPN) for more than 14 consecutive days, generally due to congenital anomalies of the digestive tract. Cholestasis occurred in 15 of them and 12 of these patients developed sepsis. In contrast, of the 79 patients on TPN that remained free from cholestasis, only 23 developed sepsis.

Total colectomy and ileorectal anastomosis in the treatment of total colonic aganglionosis: a long-term follow-up study of six patients.

Six patients with total colonic aganglionosis (TCA) with ileal involvement were treated with a total colectomy and ileorectal anastomosis according to Rehbein. Follow-up lasted from 1 to 7 years and showed no mortality. Postoperative management consisted of total parenteral nutrition initially, followed by gradual introduction of oral feeding beginning with a low-osmolarity low-residue diet, the use of loperamide, an adequate oral intake of salt, and regular bowel deflation.

Congenital diaphragmatic hernia: impact of preoperative stabilization. A prospective pilot study in 13 patients.

In case of congenital diaphragmatic hernia (CDH), survival generally depends not on prenatal diagnosis, planned delivery, and immediate postnatal operation, but on the gravity of pulmonary hypoplasia and persistent hypertension (PPH). Many vasoactive drugs have become available for lowering PPH, but the mortality rate for CDH still amounts to 40% to 70%. Preoperative stabilization might prevent or at least reduce the risk of PPH.

Double-sided psoas abscess in a young infant: sonographic and radiographic findings.

Psoas abscess is rare in children and is exceptional in the neonatal period. A sonographically and radiographically well-documented case of double-sided primary psoas abscess in a few-week-old infant is presented. To our knowledge this is the first description of a case of double-sided psoas abscess in a neonate.