RBC transfusions in children requiring intensive care admission after traumatic injury*.

Objective: To describe packed RBC utilization patterns in trauma patients admitted to a PICU and study associated outcomes while controlling for severity.

Design: Retrospective cohort study.

Setting: The PICU of a tertiary care children's hospital.

UREKA: umbilical ring easy kannula access.

Background And Objectives: Standard techniques of laparoscopic access involve creating an abdominal wall defect and can result in complications. We describe the umbilical ring easy kannula access (UREKA) technique, evaluating safety and a decrease in complications related to port placement.

Methods: UREKA is performed via a supra- or infraumbilical incision followed by circumferential dissection of the umbilical stalk.

Pediatric bronchogenic cyst complicated by atypical mycobacterium infection: a case report.

Introduction: Bronchogenic cysts are lesions of congenital origin derived from the primitive foregut and are the most common primary cysts of the mediastinum. They are most frequently unilocular and contain clear fluid. Respiratory distress is the most common presentation in pediatric patients, manifested by recurring episodes of cough, stridor, wheezing and retractions.

Primary thoracoscopic gross total resection of neuroblastoma.

Background: Thoracic neuroblastomas are generally less aggressive and have a better prognosis than those arising below the diaphragm. Our purpose was to study the safety and efficacy of thoracoscopic resection and to evaluate tumor data and patient outcomes.

Patients And Methods: We reviewed the records of patients who underwent primary thoracoscopic resection of neuroblastoma (NB) between 1998 and 2002.

Diagnostic laparoscopy with planned appendectomy: an integral step in the evaluation of unexplained right lower quadrant pain.

Recurrent right lower quadrant (RLQ) abdominal pain is often difficult to diagnose and treat. We reviewed our experience with diagnostic laparoscopy with planned appendectomy for children with unexplained RLQ pain. This procedure was performed when the cause of atypical RLQ pain could not be diagnosed by comprehensive medical and radiological evaluation.

Snowmobile injuries and fatalities in children.

Background/purpose: Snowmobiling is a popular form of wintertime recreation but can be associated with significant morbidity and mortality. To better understand snowmobile trauma in children, medical records were reviewed, evaluating the relationships between demographic data, mechanisms, and resultant injuries. In addition, because prior studies of childhood snowmobile fatalities have reviewed only national databases, state and national data were combined to evaluate possible underreporting.

Sigmoid irrigation tube for the management of chronic evacuation disorders.

Background/purpose: Antegrade colonic irrigation, in which the right colon is accessed via appendicostomy or cecostomy, now is an important adjunct in the management of children with chronic evacuation disorders. However, in most children, the major area of dysfunction is the left rather than the right colon. The authors developed a simple, percutaneous endoscopic, laparoscopically controlled sigmoid irrigation tube placement and evaluated the results in 4 children.

Virtual reality modeling and computer-aided design in pediatric surgery: applications in laparoscopic pyloromyotomy.

As a test of the applicability of modern bioengineering tools to pediatric surgery, we developed by computer-aided design (CAD) methods and evaluated a virtual reality (VR) model of laparoscopic pyloromyotomy (LP) and created a set of retractable hook instruments, called Pylorohooks. Our VR model of LP incorporated the infant's body wall, stomach, and hypertrophied pylorus as well as laparoscopic cannulas and two Pylorohooks. CAD software was used to design the 3-mm-diameter, retractable, double-pronged, minimally-traumatic hook instrument.