Day-case laparoscopic cholecystectomy in childhood: outcomes from a clinical care pathway.

Aim: The aim of this study was to report clinical outcomes following the use of a pediatric day-case laparoscopic cholecystectomy (DCLC) clinical care pathway. The pathway was modified in September 2009 and we compare the clinical outcomes before and after this modification.

Methods: A care pathway for DCLC was introduced in 2008 with emphasis on the day of admission, timing of surgery, choice of anesthetic agents, analgesia, postoperative feeding, mobilization, and pain scoring.

Gastrostomy insertion in the 21st century: PEG or laparoscopic? Report from a large single-centre series.

Purpose: To determine whether laparoscopic-assisted gastrostomy (LAG) has superseded percutaneous endoscopic gastrostomy (PEG) based on the clinical outcomes.

Methods: A retrospective study was undertaken for the period January 06-December 09. Demographic and clinical outcomes were recorded and the two groups were compared.

Management of gastroesophageal reflux associated with malrotation in children.

Aim: Children being investigated for gastroesophageal reflux (GOR) have a high incidence of malrotation. Current literature suggests these patients should be managed with a combined antireflux and Ladd's procedure. We review our experience, the largest series to date, of performing an elective Ladd's procedure as the first-line intervention.

A rare pitfall in the diagnosis of oesophageal atresia.

The diagnosis of oesophageal atresia (OA) is usually made soon after birth. Two diagnostic criteria are failure to pass a nasogastric (NG) tube and a chest radiograph demonstrating a curled NG tube in the upper oesophageal pouch. A 6-day-old neonate was referred to our institution with persistence of symptoms following exclusion of the diagnosis of OA on the basis of an NG tube radiologically confirmed to reach the stomach.

Laparoscopic retrieval of disconnected shunt catheters from the peritoneal cavity as a day-case procedure in children--early feasibility report.

Purpose: The aim of this study was to report our experience with laparoscopic retrieval of disconnected shunt catheters in children.

Methods: Demographic data, indications for shunt insertion, time to disconnection, symptomatology, time to retrieval, operative details, length of stay and complications were recorded retrospectively. Laparoscopy was performed using two 5-mm ports and 10-12-mmHg CO(2) pneumoperitoneum.

Efficacy of video-assisted thoracoscopic surgery in managing childhood empyema: a large single-centre study.

Background/purpose: A randomised controlled trial evaluating the role of video-assisted thoracoscopic surgery (VATS) in childhood empyema reported a failure rate of 16.6%. Our aim is to determine the outcome of VATS in a large series of children managed by 3 paediatric surgeons experienced in endoscopic surgery.

Small bowel evisceration through the rectum in childhood.

Small bowel evisceration through the rectum is extremely rare in childhood and has previously been reported in association with swimming pool suction injuries. We report a case of ileal evisceration resulting from a self-inflicted injury in a teenaged boy. Such a mechanism of injury leading to evisceration of the small bowel is previously unreported in children or adults.

Antenatal rectal perforation presenting in the neonate.

Perforation of the rectum in the antenatal period is extremely rare. Three cases have been reported worldwide. Its aetiology and pathophysiology are poorly understood.