Rectal mucosal dissection during transanal pull-through for Hirschsprung disease: the anorectal or the dentate line?

Purpose: Both the dentate line (DL) and anorectal line (ARL) are anatomic landmarks for rectal mucosal dissection during transanal pull-through for Hirschsprung disease. We compared outcome after rectal mucosal dissection commencing above the DL (DL group; n = 8) with outcome after rectal mucosal dissection commencing on the ARL (ARL group; n = 6) with normal babies (Cont group; n = 10).

Methods: Rectal mucosal dissection commenced on the ARL in the ARL group and at various levels (0-10 mm) above the DL in the DL group.

Anterior transposition of the third part of the duodenum for the treatment of superior mesenteric artery syndrome.

A 14-year-old adolescent girl with superior mesenteric artery syndrome was referred to us after failure of conservative management. Anterior transposition of the duodenum was performed and appears to be safe for permanently circumventing the duodenal obstruction seen in superior mesenteric artery syndrome, even in a pediatric population.

Is intraoperative anal endosonography necessary during laparoscopy-assisted anorectoplasty for high/intermediate type imperforate anus?

Purpose: The aim of this study was to evaluate the relevance of anal endosonography (AES) during Georgeson laparoscopy-assisted anorectoplasty (GLA) for high/intermediate type imperforate anus (HIIA) using a continence evaluation questionnaire (CEQ) and postoperative AES (post-AES).

Methods: Fifteen HIIA patients who underwent GLA were enrolled in this prospective study. Six had intraoperative AES (op-AES) to confirm the accuracy of the positioning of the pull-through (PT) canal and 9 did not (no-AES).

Midterm postoperative clinicoradiologic analysis of surgery for high/intermediate-type imperforate anus: prospective comparative study between laparoscopy-assisted and posterior sagittal anorectoplasty.

Purpose: The objective of this study is to analyze the outcome of surgery for high/intermediate-type imperforate anus using anal endosonography (AES), magnetic resonance imaging (MRI), and a continence evaluation questionnaire (CEQ).

Methods: In this study, 24 cases of high/intermediate-type imperforate anus were studied. Fifteen of 24 had Georgeson's laparoscopy-assisted anorectoplasty (GLA), and 9 of 24 had Pena's posterior sagittal anorectoplasty (PPA).

A comparative study of laparoscopy-assisted pull-through and open pull-through for Hirschsprung's disease with special reference to postoperative fecal continence.

Aim: The objective of this study is to compare laparoscopy-assisted pull-through (LPT) and open pull-through (OPT) for Hirschsprung's disease with special reference to postoperative fecal continence.

Methods: Thirteen OPT patients (1991-1996) were reviewed retrospectively, and 22 LPT (1997-2002) were reviewed prospectively. A continence evaluation questionnaire (CEQ, max score = 10) assessing frequency of motions, severity of staining, severity of perianal erosions, anal shape, and requirement for medications was used.

Review of 86 patients with myelodysplasia and neurogenic bladder who underwent sigmoidocolocystoplasty and were followed more than 10 years.

Purpose: We reviewed the long-term outcome of sigmoidocolocystoplasty.

Materials And Methods: The records of 86 patients who underwent sigmoidocolocystoplasty with a followup of more than 10 years were reviewed, focusing on histopathology, renal function, vesicoureteral reflux, bladder stones and urinary continence. We developed a urinary continence evaluation score, calculated as the postoperative minus the preoperative urinary continence score, including 0-incontinence, 1-severe leakage, 2-moderate leakage, 3-mild leakage, 4-almost dry and 5-dry, for patient self-assessment of urinary continence.

Magnetic resonance urographic parameters for predicting the need for pyeloplasty in infants with prenatally diagnosed severe hydronephrosis.

Purpose: Treatment in infants with prenatally diagnosed, severe hydronephrosis remains controversial. We measured anatomical parameters using magnetic resonance urography to create a pelvic index ratio, which we correlated with outcome to assess its value.

Materials And Methods: We reviewed 35 cases of prenatally diagnosed severe hydronephrosis, including grade III in 19 and grade IV in 16.

Magnetic resonance imaging in lipoblastoma: can it be a diagnostic modality?

Magnetic resonance imaging (MRI) is generally an efficient tool for establishing the differential diagnosis of soft tissue tumours. We simultaneously encountered two patients with adipose tumours in the neck. Both had similar clinical features and MRI findings: lobular high intensity tumours on both T1-and T2-weighted images equivalent to subcutaneous fat with septal formation.

Mixed type I and II choledochal cyst: a new clinical subtype?

Traditionally, choledochal cyst (CC) is classified into five types according to Todani's classification. Of 356 cases of CC treated at our institute since 1965, we experienced four cases of mixed type I and II choledochal cyst (MTCC). The incidence of MTCC was 1.

Prospective analysis of primary modified Georgeson's laparoscopy-assisted endorectal pull-through for Hirschsprung's disease: short- to mid-term results.

The aim of this study was to analyze the short- to mid-term outcome of primary modified Georgeson's laparoscopy-assisted endorectal pull-through (PMGLEPT) for Hirschsprung's disease (HD). HD patients treated by PMGLEPT were evaluated prospectively by a single surgeon using a standard structured questionnaire to assess complications, incidence of enterocolitis, and evaluate continence (CE). CE involved scoring five parameters (frequency of motions, severity of staining/soiling, severity of perianal erosions, anal shape, and requirement for medications) on a 3-point scale (0, 1, and 2 for each parameter).

An extremely rare case of symptomatic right hepatic duct diverticulum located outside the liver.

Symptomatic hepatic duct diverticulum located outside the liver is extremely rare, with only one reported case. We encountered this anomaly and present our experience, focusing on surgical management. A 17-year-old-girl was referred to our institute because of recurrent right upper quadrant pain.

Giant, highly vascular sacrococcygeal teratoma: report of its excision using the ligasure vessel sealing system.

Reports about giant, highly vascular sacrococcygeal teratoma (GHV-SCT) are uncommon. A boy with a prenatally diagnosed GHV-SCT was born at 34 weeks' gestation weighing 3,716 g. At birth, the GHV-SCT was 20 x 17 x 14 cm.

Serum soluble vascular cell adhesion molecule-1 (VCAM-1) concentrations in children with reflux nephropathy.

Systemic inflammatory disorders causing renal tissue damage do so by the adherence of polymorphonuclear leukocytes to endothelium, a process that is mediated by cell surface adhesion molecules. We determined the circulating levels of serum vascular cell adhesion molecule-1 (VCAM-1) in vesicoureteric reflux (VUR) patients and investigated the relationship between serum VCAM-1, grade of VUR, and secondary renal scarring. Serum levels of VCAM-1 were measured in 53 children aged between 3 months and 15 years with VUR (13 had grade III, 29 had grade IV, and 11 had grade V) and 25 controls using ELISA.

Associated urologic anomalies in children with solitary kidney.

Purpose: The aim of this study was to investigate the incidence, nature, surgical treatment, and outcome of associated urologic anomalies (AUA) in children with anatomic or functional solitary kidney (SK).

Methods: In this study, SK was defined as the kidney that is present in cases of unilateral renal agenesis (RA), or the kidney that is contralateral to a kidney that is nonfunctional secondary to either noncystic dysplastic kidney disease (NCDK), or multicystic dysplastic kidney disease (MCDK). Fifty-seven consecutive patients with SK (17 owing to RA, 10 owing to NCDK, 30 owing to MCDK) were reviewed.