Weekend Admissions Associated with Increased Length of Stay for Children Undergoing Cholecystectomy.

Background And Objectives: Prior research shows an association between increased length of stay (LOS) and weekend surgical admissions, but none have looked at this relationship in children undergoing nonelective cholecystectomy for benign noncongenital biliary disease. We investigated whether weekend admissions lead to a longer LOS in this patient population.

Methods: The Statewide Planning and Research Cooperative System database was queried for children ≤ 17 years undergoing cholecystectomy in New York State between January 1, 2009 and December 31, 2012.

Nonoperative management of periappendiceal abscess in children: A comparison of antibiotics alone versus antibiotics plus percutaneous drainage.

Purpose: To determine the optimal nonoperative management of periappendiceal abscess in a pediatric population, we compared the therapeutic efficacy and cost-effectiveness of antibiotics alone versus antibiotics plus percutaneous drainage (PD).

Methods: We conducted a 10-year retrospective chart review of pediatric patients less than 18 years of age who had acute perforated appendicitis complicated by periappendiceal abscess. Group 1 consisted of patients (N = 35) who received nonoperative management with antibiotics only.

Foregut Duplication Cysts in Children.

Background And Objectives: Duplications of the alimentary tract are rare anomalies. We report our experience with foregut duplication cysts including their clinical presentation, diagnostic modalities, and surgical management.

Methods: We report a 20-year retrospective review of all foregut duplication cysts managed at our institution.

Minimally Invasive Surgery in Pediatric Trauma: One Institution's 20-Year Experience.

Background: Minimally invasive surgery (MIS) for trauma in pediatric cases remains controversial. Recent studies have shown the validity of using minimally invasive techniques to decrease the rate of negative and nontherapeutic laparotomy and thoracotomy. The purpose of this study was to evaluate the diagnostic accuracy and therapeutic options of MIS in pediatric trauma at a level I pediatric trauma center.

"Big Operations Using Mini Instruments": The Evolution of Mini Laparoscopy in the Surgical Realm.

Laparoscopy using miniature (2-3.5 mm) instruments was introduced in the late 1980s and early 1990s. Though mini laparoscopy (Mini) created new opportunities for surgical diagnosis and therapy, the limitations of early instruments inhibited widespread adoption.

Laparoscopic Surgery for Acute Appendicitis in Children With Cancer.

Introduction: Abdominal pain during cancer chemotherapy may be caused by medical or surgical conditions. A retrospective review of 5 children with cancer who had appendicitis while receiving chemotherapy was performed.

Case Descriptions: Three had acute lymphoblastic leukemia,and 1 each had T-cell lymphoblastic lymphoma and rhabdomyosarcoma.

Laparoscopic-assisted management of traumatic abdominal wall hernias in children: case series and a review of the literature.

Background: Traumatic abdominal wall hernia (TAWH) is defined as herniation through a disrupted portion of musculature/fascia without skin penetration or history of prior hernia. In children, TAWH is a rare injury.

Objective: The objectives of this study were to report our experience with different management strategies of TAWH in children and to determine the utility of laparoscopy.

Laparoscopy and complicated meckel diverticulum in children.

Background And Objectives: Meckel diverticulum can present with a variety of complications but is often found incidentally during other surgical procedures. The role of laparoscopy in the management of Meckel diverticulum is established. We reviewed our experience with complicated cases of Meckel diverticulum in children managed with laparoscopy.

Extraperitoneal closure of persistent gastrocutaneous fistula in children.

Background And Objectives: Gastrostomy feeding in children is well established for nutritional support. Gastrostomy tubes may be permanent or temporary. After removal, spontaneous closure may occur, but persistence of the tract requires surgical repair.

Vinyl glove ingestion in children: a word of caution.

Background: Vinyl gloves when ingested will harden and develop sharp edges producing gastric bezoars; bowel obstruction; and, ultimately, perforation. We report 4 children with complications secondary to vinyl glove ingestion who required surgical intervention.

Methods: A 3-year-old boy, a 13-year-old adolescent girl with Down syndrome, a 14-year-old adolescent girl, and a 15-year-old adolescent boy presented with bowel obstruction secondary to a bezoar caused by a vinyl glove.

Bedside lung mechanics predict survival in hypoplastic lung disease.

Newer bedside pulmonary mechanics using conventional ventilators allow for CONTINUOUS serial determinations of tidal volume (V(T)). We sought to determine whether the degree of pulmonary hypoplasia could be measured using bedside pulmonary graphics and whether survival could be predicted in potential extracorporeal membrane oxygenation (ECMO) candidates. Data on all neonates considered for or treated with ECMO at our center between April 2000 and March 2005 were collected.

Laparoscopic intragastric removal of giant trichobezoar.

Background And Objectives: Gastric bezoars are a rare clinical entity, most commonly observed in patients with mental or emotional illness. Large bezoars can be difficult to remove laparoscopically without extending a port incision.

Methods: We report the case of a large symptomatic trichobezoar with Rapunzel syndrome that occurred in a 17-year-old girl who had trichotillomania.

Correlation of complex ascites with intestinal gangrene and perforation in neonates with necrotizing enterocolitis.

Background/purpose: The purpose of this study was to determine whether a correlation exists between the finding of complex ascites on ultrasound (US) and the presence of intestinal perforation or gangrene in neonates with complicated necrotizing enterocolitis (NEC).

Methods: Charts of neonates with NEC (n = 76) whose care involved consultations with the pediatric surgery service between 2005 and 2008 were reviewed. Twenty-three babies with NEC without free air had a bedside abdominal US.

Repair of long gap esophageal atresia without anastomosis.

Background/purpose: Repair of long gap esophageal atresia represents a challenge. Several different techniques may be used. We describe 5 cases of long gap esophageal atresia managed successfully with suture approximation without anastomosis.

Primary omental infarct: conservative vs operative management in the era of ultrasound, computerized tomography, and laparoscopy.

Purpose: Primary omental infarct is a rare condition in children. The preoperative diagnosis can be accurately accomplished using ultrasound (US) and computerized tomography (CT). This study aimed to elucidate the efficacy of conservative vs operative management.

Laparoscopic placement of peritoneal dialysis catheters in children.

Background: Peritoneal dialysis (PD) is preferred over hemodialysis. The aim of this study was to evaluate our experience with laparoscopic PD catheter placement and omentectomy in children.

Methods: We reviewed all children (N = 21) who underwent laparoscopic placement of PD catheters and omentectomy.

Use of decubitus radiographs in the diagnosis of foreign body aspiration in young children.

Background: Lateral decubitus radiographs are often obtained in young children with suspected foreign body aspiration. Their usefulness has not been well studied.

Objectives: To assess the value of decubitus radiographs in detecting foreign body aspiration in young children and compare their value to history and physical examination.

The safety of central line placement prior to treatment of pediatric acute lymphoblastic leukemia.

Background: Central venous lines are placed in children with acute lymphoblastic leukemia at diagnosis, despite significant cytopenias, to facilitate the administration of chemotherapy and blood sampling. The present study aimed to determine the safety of central line placement in these patients.

Methods: We reviewed the charts of 115 consecutive patients treated during a 10-year period.

Laparoscopy in the management of pediatric intraabdominal tumors.

Background And Objectives: Unresectable intraabdominal tumors pose a challenge to the pediatric oncology team. Tumor tissue is needed for diagnostic and prognostic analyses. Laparotomy is quite invasive and computerized tomography-guided needle biopsies, though less invasive, may not procure enough tissue for a complete analysis.

Thoracoscopic pericardial window creation and thoracic duct ligation in neonates.

Objective: We describe 2 newborn infants with persistent pericardial effusion treated with thoracoscopic pericardial window and thoracic duct ligation.

Methods: Patient 1 was a premature female newborn who presented with severe cardiac anomalies, including dextrocardia. She was treated with pulmonary artery handing and pacemaker placement for complete cardiac block.

Cholelithiasis and choledocholithiasis after sequential cytarabine and asparaginase.

We report 2 children with acute leukemia who developed symptomatic cholelithiasis and choledocholithiasis shortly after receiving sequential high-dose cytarabine and asparaginase. Known risk factors for gallstone formation were not present in our patients. These children did not experience any unusual therapy-related hepatic toxicity after laparoscopic cholecystectomy.

Perioperative management in children with sickle cell disease undergoing laparoscopic surgery.

Objective: The aim of this study was to evaluate our experience with laparoscopic surgery in children with sickle cell disease.

Methods: A retrospective chart review was performed to analyze the indication for surgery, perioperative management, surgical technique, complications, duration of hospitalization, and outcome. One pediatric surgeon performed all procedures.