10 Year Follow-Up of Randomized Trial of Laparoscopic Nissen Versus Thal Fundoplication in Children.

The aim of this study was to compare the long-term outcomes of laparoscopic complete (Nissen) fundoplication (LNF) with laparoscopic partial (Thal) fundoplication (LTF) in children. This is the only prospective, randomized study to follow patients up for more than 10 years. Interim results published in 2011 at median 2.

Slip-Knot-Loop Suture for Continuous Suturing in Laparoscopy.

Aims: One of the challenges of laparoscopic surgery is the time required to perform intracorporeal knots. This can result in considerably longer operating times when compared with the open approach. An example of this is pediatric laparoscopic pyeloplasty, where extensive laparoscopic suturing is required.

A simple scoring system to train surgeons in basic laparoscopic skills.

Aim: To develop and validate a scoring system for a training assessment tool using a box trainer which can objectively demonstrate progression in laparoscopic skills.

Method: 170 assessments were performed over a 5-year period by doctors working in a busy paediatric surgical department. Each participant was scored based on experience and then undertook six laparoscopic tasks in a box trainer in a dry skills lab.

Epidemiology of adhesions in infants and children following open surgery.

Adhesions following intra-abdominal surgery are a major cause of small bowel obstruction. The nature of surgical interventions in children (especially neonates) increases the risk of adhesion-related complications. Following laparotomy in neonates, the collective literature reveals an aggregate mean incidence of adhesive small bowel obstruction (ASBO) of 6.

Long-term catch-up weight gain following fundoplication in children.

Background: Laparoscopic fundoplication for severe gastroesophageal reflux (GOR) is well established in children. However, there are only a few reports on the long-term nutritional outcome following fundoplication. The aim of this study was to assess weight gain following fundoplication in children.

Laparoscopic fundoplication in children with ventriculo-peritoneal shunts.

Background: Children with ventriculo-peritoneal (V-P) shunts have a significant risk of morbidity and mortality from infections. Many of these patients have other co-morbidities and may require subsequent abdominal surgery, including fundoplication with or without gastrostomy placement. The aim of our study was to assess the outcomes of laparoscopic fundoplication in children with a V-P shunt in situ.

Surgical correction of tracheo-oesophageal fistula and oesophageal atresia in infants with VACTERL association: a retrospective case-control study.

Introduction: VACTERL is a rare, non-random association comprising at least three major component features defined by the acronym, and including Vertebral anomalies, Anorectal malformations, Cardiac defects, Tracheo-oEsophageal fistula with or without oesophageal atresia (TOF/OA), Renal abnormalities and Limb anomalies. The aim of this study was to compare the post-operative outcomes following surgical correction of TOF/OA in infants with VACTERL and isolated TOF/OA.

Methods: A retrospective case-control study comparing infants with VACTERL (case group) versus infants with isolated TOF/OA (control group) that underwent surgical correction of TOF/OA at our centre between January 2006 and December 2011.

Trilogy of gastrointestinal atresias: a case report and review of the literature.

This is a case report of a child with a rare combination of pyloric and colonic atresias, imperforate anus, hypoganglionosis of the rectum and sigmoid colon, unilateral multicystic dysplastic kidney, bilateral sensorineural deafness, spondyloepimetaphyseal dysplasia, subglottic stenosis, growth failure, and limb anomalies.

Long-term outcome of laparoscopic nissen fundoplication compared with laparoscopic thal fundoplication in children: a prospective, randomized study.

Background: Laparoscopic fundoplication is increasingly performed in pediatric surgery. Many types of fundoplication are performed, each has advantages and disadvantages. To date there has been no prospective randomized study to determine the optimal laparoscopic technique in children.

Gastrostomy feeding in cerebral palsy: enough and no more.

Aim: gastrostomy feeding children with spastic quadriplegic cerebral palsy (SQCP) improves weight gain but may cause excess deposition of body fat. This study was designed to investigate whether weight gain could be achieved without an adverse effect on body composition by using a low-energy feed in gastrostomy-fed children with SQCP.

Method: ourteen children (seven male; seven female; median age 2y; range 10mo-11y) with SQCP were studied, 13 of whom were classified as Gross Motor Function Classification Score (GMFCS) level V and one as GMFCS level IV.

Laparoscopic Nissen fundoplication versus Thal fundoplication in children: comparison of short-term outcomes.

Background: The aim of this study was to compare short-term outcomes, including intra- and perioperative complications following laparoscopic Nissen versus Thal fundoplication.

Patients And Methods: From July 1998 until April 2007, 175 patients were recruited. Patients were prospectively randomized to either a Nissen wrap or a Thal wrap.

Medicolegal costs of bile duct injuries incurred during laparoscopic cholecystectomy.

Background: When laparoscopic cholecystectomy (LC) is performed successfully, recovery is faster than after open cholecystectomy. However, LC results in higher incidences of biliary, bowel and vascular injury.

Methods: We performed a retrospective review of LC-related claims reported to the National Health Service Litigation Authority (NHSLA) during 2000-2005.

Long-term functional outcome of sacrococcygeal teratoma in a UK regional center (1993 to 2006).

Background: Sacrococcygeal teratoma (SCT) is the commonest neonatal neoplasm. Its long-term effects are important in prenatal counseling and the delivery of an appropriate postoperative plan.

Aim: To determine the long-term functional outcome after SCT excision in a UK regional center.

Adhesions after abdominal surgery in children.

Purpose: The objective of this study is to quantify the overall burden (operative and nonoperative) of small bowel obstruction caused by adhesions after laparotomy in children.

Methods: Data from the Scottish National Health Service Medical Record Linkage database were used to assess risk of an adhesion-related readmission in the 5 years after open abdominal surgery in children and adolescents younger than 16 years from April 1996 to March 1997.

Results: A total of 1581 children underwent abdominal surgery (ie, from duodenum downward).

Gastrostomy feeding in cerebral palsy: too much of a good thing?

Gastrostomy tube (GT) feeding in children with cerebral palsy (CP) is associated with significant increases in weight gain and, potentially, with overfeeding. This study aimed to measure energy balance and body composition in children with CP who were fed either orally or by GT. Forty children (27 males, 13 females; median age 8y 6mo; range 1y 4mo-18y 11mo) with spastic quadriplegic CP, of whom 22 were gastrostomy-fed and 18 orally-fed, underwent anthropometry, indirect calorimetry, and total energy expenditure determination (doubly-labelled water method).

Population-based analysis of the risk of adhesion-related readmissions after abdominal surgery in children.

Purpose: The aim of this study was to quantify the risk of adhesion-related readmissions after abdominal surgery in children.

Methods: This was a population-based study. One thousand five hundred eighty-one children younger than 16 years underwent laparotomy in 1996.

Small bowel obstruction due to adhesions following neonatal laparotomy.

The aim of this study was to assess the incidence of small bowel obstruction (SBO) due to adhesions following laparotomy in the neonatal period. This was a retrospective study of babies born between January 1998 and November 2003 who had a trans-abdominal procedure in the neonatal period in the John Radcliffe Hospital, Oxford, UK. Four hundred and fourteen patients had a trans-abdominal procedure during this period.

The incidence of complications following primary inguinal herniotomy in babies weighing 5 kg or less.

The aim of this study was to quantify the incidence of complications following inguinal herniotomy in small babies weighing 5 kg or less. This was a retrospective review of inguinal herniotomies performed in our unit between December 1997 and March 2002 on babies weighing 5 kg or less. A total of 154 patients underwent hernia repair, of which 125 patients (221 hernias) were available for review (81%).

Gastrostomy tube feeding in children with cerebral palsy: a prospective, longitudinal study.

We report a longitudinal, prospective, multicentre cohort study designed to measure the outcomes of gastrostomy tube feeding in children with cerebral palsy (CP). Fifty-seven children with CP (28 females, 29 males; median age 4y 4mo, range 5mo to 17y 3mo) were assessed before gastrostomy placement, and at 6 and 12 months afterwards. Three-quarters of the children enrolled (43 of 57) had spastic quadriplegia; other diagnoses included mixed CP (6 of 57), hemiplegia (3 of 57), undiagnosed severe neurological impairment (3 of 57), ataxia (1 of 57), and extrapyramidal disorder (1 of 57).

Impact of gastrostomy tube feeding on the quality of life of carers of children with cerebral palsy.

The aim of this prospective cohort study was to evaluate the impact of gastrostomy tube feeding on the quality of life of carers of children with cerebral palsy (CP). Short-Form 36 version II was used to measure quality of life in carers of 57 Caucasian children with CP (28 females, 29 males; median age 4y 4mo, range 5mo to 17y 3mo) six and 12 months after insertion of a gastrostomy tube. Responses were calibrated against a normative dataset (Oxford Healthy Life Survey III).

The value of anal endosonography compared with magnetic resonance imaging following the repair of anorectal malformations.

Background: Surgery for anorectal malformations (ARMs) attempts to position the neo-anus anatomically within the anal sphincter complex. Currently, MRI is the imaging modality of choice in determining the position of the neo-anus after reconstructive surgery.

Objective: The aim of this study was to compare the accuracy of anal endosonography (AES) with conventional MRI in demonstrating the anatomy of the neo-anus following repair of ARMs.