Feasibility of laparoscopic tumour nephrectomy in children.

Aims: The laparoscopic approach to tumour nephrectomy in children is controversial. We therefore reviewed our institution's cases of tumour nephrectomy (laparoscopic, open, and converted) to better understand which is suitable for this approach, what factors prevent it, and whether one can excise tumours greater than the CCLG recommendation of 300 ml.

Methods: All tumour nephrectomies performed between 2002 and 2016 were identified using our surgical database.

One hundred years of pyloric stenosis in the Royal Hospital for Sick Children Edinburgh.

Aim: Pyloric stenosis was first reported in 1717 and was treatable from the start of the 1900s. Our hospital opened in 1860. In this study we report the historical account of the management of pyloric stenosis in Edinburgh from 1910 to 2013.

Risk of incomplete pyloromyotomy and mucosal perforation in open and laparoscopic pyloromyotomy.

Background: Despite randomized controlled trials and meta-analyses, it remains unclear whether laparoscopic pyloromyotomy (LP) carries a higher risk of incomplete pyloromyotomy and mucosal perforation compared with open pyloromyotomy (OP).

Methods: Multicenter study of all pyloromyotomies (May 2007-December 2010) at nine high-volume institutions. The effect of laparoscopy on the procedure-related complications of incomplete pyloromyotomy and mucosal perforation was determined using binomial logistic regression adjusting for differences among centers.

Is it possible for "traditional" laparoscopic surgery to leave "invisible" scars?

Background: Improved cosmesis is widely recognized as the main benefit of single-port laparoscopy (SPL). Recently, some centers have started to perform SPL in infants and neonates. However, in our experience, the cosmetic result following traditional laparoscopic surgery in this age range is excellent.

The risks of minimal access surgery in children: an aid to consent.

Aim: The aim of this study was to determine the risk of complications and conversions for minimally invasive procedures in children, thus allowing properly informed consent.

Methods: Data were retrieved for all minimally invasive surgical procedures performed between 1995 and 2009.

Results: There were 2352 cases performed in 2288 (1428 were male) patients.

The central tendon defect: a rare problem, a novel technique.

The rarest form of congenital diaphragmatic hernia involves a central tendon defect, which is often associated with a massive pericardial effusion. Very few of these have been reported, and they present unique challenges to the pediatric surgeon. We present a case report of our recent experience of this condition in a term neonate and the difficulties in diagnosing the condition.

Mammary duct ectasia in children: report of a short series and review of the literature.

Background: Mammary duct ectasia is uncommon in children, and is usually considered to be an acquired disease in adults. However the occurrence in infants and children suggest it may be developmental.

Aims: To report a case series of mammary duct ectasia, and review the published literature to ascertain the common findings and histological findings in children.

Successful treatment of childhood high-risk hepatoblastoma with dose-intensive multiagent chemotherapy and surgery: final results of the SIOPEL-3HR study.

Purpose: The primary objective was to determine the efficacy of a newly designed preoperative chemotherapy regimen in an attempt to improve the cure rate of children with high-risk hepatoblastoma.

Patients And Methods: High risk was defined as follows: tumor in all liver sections (ie, Pretreatment Extension IV [PRETEXT-IV]), or vascular invasion (portal vein [P+], three hepatic veins [V+]), or intra-abdominal extrahepatic extension (E+), or metastatic disease, or alpha-fetoprotein less than 100 ng/mL at diagnosis. Patients were treated with alternating cycles of cisplatin and carboplatin plus doxorubicin (preoperatively, n = 7; postoperatively, n = 3) and delayed tumor resection.

Cisplatin versus cisplatin plus doxorubicin for standard-risk hepatoblastoma.

Background: Preoperative cisplatin alone may be as effective as cisplatin plus doxorubicin in standard-risk hepatoblastoma (a tumor involving three or fewer sectors of the liver that is associated with an alpha-fetoprotein level of >100 ng per milliliter).

Methods: Children with standard-risk hepatoblastoma who were younger than 16 years of age were eligible for inclusion in the study. After they received one cycle of cisplatin (80 mg per square meter of body-surface area per 24 hours), we randomly assigned patients to receive cisplatin (every 14 days) or cisplatin plus doxorubicin administered in three preoperative cycles and two postoperative cycles.

Intraoperative upper GI endoscopy ensures an adequate laparoscopic Heller's myotomy.

Introduction: In this article, we present our case series of laparoscopic Heller's myotomies. These were all performed with the aid of intraoperative upper gastrointestinal (GI) endoscopy.

Materials And Methods: During a 7-year period, 5 patients underwent a laparoscopic Heller's myotomy.

Esophageal atresia surgery in the 21st century.

The results of thoracoscopic repair of oesophageal atresia with or without tracheo-oesophageal fistula are presented. Twenty-six children had the repair performed thoracoscopically (22 in Edinburgh and 4 by Edinburgh surgeons in other institutions). Twenty infants had oesophageal atresia with tracheo-oesophageal fistula and 6 had isolated oesophageal atresia without fistula.

Neonatal laparoscopic Ladd's procedure can safely be performed even if the bowel shows signs of ischemia.

Unlabelled: In this we describe two cases of neonatal malrotation with volvulus treated laparoscopically in our institution.CASE 1: A term baby girl was presented on day 3 of life with malrotation and volvulus. On inspection laparoscopically,the cecum was lying in a subhepatic position to the left of the midline.

Is conversion a complication of laparoscopic surgery.

Introduction: In this paper, we review our laparoscopic and thoracoscopic experience and look specifically at the cases that resulted in conversion.

Methods: Data were retrieved on all minimally invasive surgical procedures performed in our institution.

Results: There were 1,759 cases performed between 1997 and 2007.

Endoluminal balloon dilatation for pelvi-ureteric junction obstruction in children: an effective alternative to open pyeloplasty.

Objective: Pelvi-ureteric junction obstruction (PUJO) is one of the commonest causes of paediatric urinary tract obstruction. Open pyeloplasty has always been the reference standard treatment with variable results. Recently, attention has turned to minimally invasive procedures.

Early experience of pediatric thoracoscopic lobectomy in the UK.

Purpose: The aim of this study was to report on the early experience of pediatric thoracoscopic lobectomy in two UK centers (Royal Hospital for Sick Children, Edinburgh, and Addenbrookes Hospital, Cambridge).

Methods: Twelve patients between February 2000 and November 2005 were treated with a lobectomy for pulmonary disease.

Results: Diagnoses included 7 congenital cystic adenomatous malformations, 4 patients with bronchiectasis, and 1 thoracic mature teratoma.

Effect of patient weight and anesthetic technique on CO2 excretion during thoracoscopy in children assessed by end-tidal CO2.

Aim: The aim of this study was to review the changes in CO(2) excretion and anesthetic management during thoracoscopy in children.

Methods: We analyzed end-tidal carbon dioxide concentration (EtCO(2); kPa) during CO(2) pneumothorax. EtCO(2) was measured on a continuous basis by using a positive sampling system and recorded every 10 minutes.

Giant anterior urethral diverticulum in a neonate.

Congenital anterior urethral diverticulum is an uncommon condition that tends to present in older children with signs of chronic urinary problems. A neonate presented following recurrent collapse, and cystography revealed a giant urethral diverticulum. The diverticulum was incised at cystoscopy, leading to a full recovery.

Choice of incision: the experience and evolution of surgical management of infantile hypertrophic pyloric stenosis.

Purpose: This study evaluated the impact of laparoscopic pyloromyotomy since it came into use at our institution in March 1999.

Materials And Methods: The recovery profiles and intraoperative and postoperative complications of 170 infants who underwent laparoscopic, semicircumumbilical incision, or right upper quadrant incision pyloromyotomies between March 1999 and April 2005 were analyzed.

Results: Eighty-one (48%) of operations were undertaken laparoscopically, 51 (30%) by traditional right upper quadrant incision, and 38 (22%) by semicircumumbilical incision.

Two-stage Fowler-Stephens orchidopexy preserving the gubernacular vessels and a purely laparoscopic second stage.

Purpose: We describe a modification of the two-stage laparoscopic Fowler-Stephens technique in which the gubernacular vessels are preserved and the testis is brought down the canal via the internal ring. A purely laparoscopic second stage is performed. We report our outcomes with this technique.

2005 PRETEXT: a revised staging system for primary malignant liver tumours of childhood developed by the SIOPEL group.

Over the last 15 years, various oncology groups throughout the world have used the PRETEXT system for staging malignant primary liver tumours of childhood. This paper, written by members of the radiology and surgery committees of the International Childhood Liver Tumor Strategy Group (SIOPEL), presents various clarifications and revisions to the original PRETEXT system.

Laparoscopy as an adjunct to peritoneal drainage in perforated necrotizing enterocolitis.

Intestinal perforation in very low birth weight infants with necrotizing enterocolitis has a high morbidity and mortality. We report the use of laparoscopy on day 30 of life in the treatment of a very low birth weight infant (900 g) with perforated necrotizing enterocolitis. The question of laparotomy versus peritoneal drain is ongoing.

Elevated amylase in childhood.

A 3-year-old boy was referred to a regional centre with an acute abdomen. On admission, his abdomen was clinically benign but an extremely high serum amylase titre noted. The patient was treated with simple observation and over the following period he was found to have an inflamed parotid gland.

Endoscopic nephrectomy in children: is retro the way forward?

Objective: To determine the benefits of nephrectomy in children performed via a retroperitoneoscopic approach compared to the laparoscopic route.

Materials And Methods: We reviewed all endoscopic nephrectomies performed at our institution from August 1998 to February 2003.

Results: A total of 32 endoscopic nephrectomies were undertaken: 22 laparoscopic nephrectomies with 5 conversions to open surgery, and 10 retroperitoneoscopic.