Lower Recurrence Rate After Surgical Treatment for Primary Spontaneous Pneumothorax Using a Digital Chest Drainage System.

Objective: This study assessed the impact of digital chest drainage systems for patients undergoing video-assisted thoracoscopic surgery (VATS) pleurodesis for primary spontaneous pneumothorax (PSP) as compared with conventional chest drainage.

Methods: A retrospective analysis of patients who underwent VATS pleurodesis for PSP was conducted. The primary outcome was pneumothorax recurrence, while secondary outcomes included time to mobilization, degree of lung expansion, drainage duration, and length of hospital stay.

Clinical characteristics and outcome of omphalocele and gastroschisis: a 20-year multicenter regional experience.

Omphalocele and gastroschisis are the most common types of abdominal wall defects. Comprehensive local experience helps parents to make decisions on the pregnancy and foresee the disease journey. A retrospective review of abdominal wall defect patients in all three pediatric surgical centers in Hong Kong between January 2003 and February 2023 was conducted.

Non-steroidal anti-inflammatory drugs reduce pleural adhesion in human: evidence from redo surgery.

Non-steroidal anti-inflammatory drugs (NSAIDs) reduced pleural adhesion in animal studies, but its effect on human had not been studied. A retrospective study was carried out for patients with solitary pulmonary nodules without a pre-operative tissue diagnosis positive for malignancy. The impact of the use of NSAIDs after stage one wedge resection was assessed by the degree of pleural adhesions encountered during second-stage, redo completion lobectomy.

Uniportal video-assisted thoracic surgery for major lung resection is associated with less immunochemokine disturbances than multiportal approach.

Multiportal video-assisted thoracic surgery (VATS) for major lung resection causes less immunochemokine production compared to thoracotomy. Whether uniportal VATS is similarly associated with lower early postoperative circulating levels of immunochemokines compared to multiportal VATS have not been studied. Selected patients who received uniportal or multiportal VATS major lung resection were recruited.

From Laparoscopic Pyeloplasty to Robot-Assisted Laparoscopic Pyeloplasty in Primary and Reoperative Repairs for Ureteropelvic Junction Obstruction in Children.

Purpose: Robot-assisted laparoscopic pyeloplasty (RALP) and laparoscopic pyeloplasty (LP) are both minimally invasive surgical options to correct ureteropelvic junction obstruction in children. There are limited data reporting surgeons' experience of switching from LP to RALP and comparing the outcomes of the two procedures.

Methods: We conducted a retrospective study on 63 consecutive children who underwent either LP or RALP by the same surgeon in a tertiary center from January 2008 to November 2016.

Early Reoperations after Primary Repair of Jejunoileal Atresia in Newborns.

To review nine-year experience in managing jejuno-ileal atresia (JIA) by primary resection and anastomosis and identify factors associated with reoperations. From April 2006 to May 2015, all consecutive neonates who underwent bowel resection and primary anastomosis for JIA were analyzed retrospectively. Patients with temporary enterostomy were excluded.

Improved outcomes after technical modifications in tubularized incised plate urethroplasty for mid-shaft and proximal hypospadias.

Purpose: To investigate and compare the outcomes after tubularized incised plate (TIP) urethroplasty in mid-shaft and proximal hypospadias using a standard and a modified technique.

Methods: We conducted a retrospective study in 104 consecutive children who underwent mid-shaft or proximal TIP repairs from Jan 2007 to Sept 2015. Patients in Cohort One had dorsal dartos (DD) neourethral coverage while patients in Cohort Two had either de-epithelialized split preputial (DESP) or tunica vaginalis (TV) flap coverage.

Tumor risk of children with 45,X/46,XY gonadal dysgenesis in relation to their clinical presentations: Further insights into the gonadal management.

Objective: To investigate the risk of gonadal germ cell neoplasms (GCN) in children with 45,X/46,XY gonadal dysgenesis and its relation to the clinical presentations.

Methods: We conducted a retrospective study reviewing the clinical and gonadal features of all consecutive children with 45,X/46,XY gonadal dysgenesis who received gonadal management in a tertiary center from 1985 to 2015. Study subjects were divided into Group I(significant genitalia anomaly), Group II(female phenotype) and Group III(male phenotype).

Can the colour of per-rectal bleeding estimate the risk of lower gastrointestinal bleeding caused by malignant lesion?

Purpose: To estimate the risk of lower gastrointestinal bleeding (LGIB) caused by malignant lesion in patients presenting with per-rectal bleeding (PRB), by using visual aid as an objective measurement of PRB colour.

Methods: This was a prospective observational study on patients presented with PRB to Family Medicine Specialty Clinic, who undergo flexible sigmoidoscopy (FS) or colonoscopy (CLN) from December 2012 to September 2013. Patients aged 40 years old or above, haemodynamically stable, with normal haemoglobin level were included.

Recurrent deep neck abscess and piriform sinus tract: a 15-year review on the diagnosis and management.

Background: Piriform sinus tract (PST) is a rare congenital condition. A delay in diagnosis is common leading to recurrent inflammation.

Method: A retrospective review was performed on all cases of PST treated at a tertiary referral centre between May 1997 and May 2012.

Single-incision laparoscopic surgery in diagnosis and treatment for gastrointestinal bleeding of obscure origin in children.

In this multimedia manuscript with video presentation, we reported our experience of performing single-incision laparoscopic surgery (SILS) on 3 children who presented with gastrointestinal bleeding from congenital small bowel lesions. Preoperative investigations including endoscopy and technetium scintigraphy were all negative in the 3 patients aged 4, 7, and 10 years, respectively. SILS was performed using reusable 3- and 5-mm ports and standard straight instruments.

Laparoendoscopic single-site nephrectomy and heminephroureterectomy in children using standard laparoscopic setup versus conventional laparoscopy.

Objective: To investigate the safety and effectiveness of laparoendoscopic single-site surgery (LESS) using standard laparoscopic setup in pediatric nephrectomy/heminephroureterectomy (HN) by comparing with conventional laparoscopy (CL).

Methods: Twelve consecutive children who underwent LESS (nephrectomy = 8, HN = 4) from 2009 to 2012 were compared with a matched cohort of 18 children who underwent CL (nephrectomy = 12, HN = 6) at the same institution. Data were reviewed retrospectively.

Simple maneuvers to reduce the incidence of false-negative findings for contralateral patent processus vaginalis during laparoscopic hernia repair in children: a comparative study between 2 cohorts.

Background: Transumbilical or transinguinal laparoscopic evaluation for contralateral patent processus vaginalis (CPPV) is commonly performed during laparoscopic or open hernia repair in children but may occasionally give false-negative findings.

Methods: A retrospective study was conducted to compare 2 cohorts of children who underwent laparoscopic repair for clinically demonstrated unilateral inguinal hernia and evaluation for CPPV by transumbilical laparoscopy during the study periods of 2004 to 2007 (cohort 1) and 2008 to 2011 (cohort 2). Cohort 1 was a known historical cohort with CPPV being evaluated by laparoscopic inspection alone, whereas additional maneuvers were adopted in cohort 2.

Unexpected metachronous hernia development in children following laparoscopic unilateral hernia repair with negative evaluation for contralateral patent processus vaginalis.

Background: Metachronous hernia has been reported to develop unexpectedly in children after negative evaluation for contralateral patent processus vaginalis (CPPV) by transinguinal laparoscopy. Scarce data exist regarding such phenomena following laparoscopic unilateral hernia repair and negative findings for CPPV in transumbilical laparoscopy.

Patients And Methods: A retrospective study was performed to investigate metachronous hernia development in a cohort of consecutive children who had undergone laparoscopic unilateral hernia repair with negative findings of CPPV by transumbilical laparoscopy 5 or more years ago.

Oophorectomy in children. Who and why: 13-year experience in a single centre.

Aim: Oophorectomy performed in children is extremely uncommon. We aimed to investigate the disease pattern and the association between the underlying pathology and the clinical presentation among those patients who had their ovaries removed in their childhood.

Methods: A retrospective study was performed on 41 consecutive children who underwent oophorectomy in a tertiary referral centre in the period between June 1995 and May 2008.

Impact of pediatric Rome III criteria of functional dyspepsia on the diagnostic yield of upper endoscopy and predictors for a positive endoscopic finding.

Objective: Pediatric Rome III criteria of functional dyspepsia (FD) has eliminated the mandatory use of upper endoscopy and recommended a symptom-based approach. In the absence of alarm symptoms, FD can be positively diagnosed in children having normal physical findings without exclusionary investigations. We aimed to investigate the effectiveness of Rome III guidelines to discriminate organic diseases from FD and to identify the predictors for positive endoscopic findings.

Initial experience in children using conventional laparoscopic instruments in single-incision laparoscopic surgery.

Background: Single-incision laparoscopic surgery (SILS) has been successfully performed in children using 5-mm reticulating instruments. There are, however, few reports investigating the use of conventional instruments in SILS in the pediatric population.

Methods: We conducted a retrospective review of all consecutive children who underwent SILS from October 2009 to January 2010, with the procedure being solely performed by conventional 3- and 5-mm instruments through a standard access technique.

Single-incision laparoscopic nephrectomy and heminephroureterectomy in young children using conventional instruments: first report of initial experience.

Objectives: To report the surgical technique and the early outcomes of nephrectomy and heminephroureterectomy by single-incision laparoscopic surgery (SILS) in children using conventional laparoscopic instruments only.

Methods: Three consecutive children (aged 3, 4 and 7 years) who underwent nephrectomy for multicystic dysplastic kidney (n = 2) and upper moiety heminephroureterectomy for duplex kidney (n = 1) by SILS were retrospectively reviewed. A standardized infraumbilical incision was used for the insertion of 3 reusable ports of 3 and 5 mm.

Technical report on the initial cases of single-incision laparoscopic combined cholecystectomy and splenectomy in children, using conventional instruments.

Aim: The authors report a technique to perform single-incision laparoscopic combined cholecystectomy and splenectomy in 3 children using conventional instruments.

Methods: Three ports, including 5-mm and 3-mm ports, were placed through an infraumbilical incision for the procedure. Splenectomy was completed in most parts by crossing the 2 straight instruments.

Genome-wide association study identifies a susceptibility locus for biliary atresia on 10q24.2.

Biliary atresia (BA) is characterized by the progressive fibrosclerosing obliteration of the extrahepatic biliary system during the first few weeks of life. Despite early diagnosis and prompt surgical intervention, the disease progresses to cirrhosis in many patients. The current theory for the pathogenesis of BA proposes that during the perinatal period, a still unknown exogenous factor meets the innate immune system of a genetically predisposed individual and induces an uncontrollable and potentially self-limiting immune response, which becomes manifest in liver fibrosis and atresia of the extrahepatic bile ducts.

Colonoscopy in Hong Kong Chinese children.

Aim: To investigate the safety and diagnostic yield of colonoscopy in Chinese children in whom the procedure is not often done.

Methods: We conducted a retrospective review of all colonoscopies in consecutive children who underwent their first diagnostic colonoscopy from Jan 2003 to 2008.

Results: Seventy-nine children (48 boys, 31 girls; mean age 9.

Triage decisions and outcomes for patients with Triage Priority 3 on the Society of Critical Care Medicine scale.

Objective: To identify factors associated with the triage decision for patients classified as Society of Critical Care Medicine (SCCM) Triage Priority 3, and their outcomes.

Design: Single-centre, prospective, observational cohort study.

Setting: General intensive care unit in a tertiary regional hospital, over the 9 months January to September 2007.

An 18-year experience in total colonic aganglionosis: from staged operations to primary laparoscopic endorectal pull-through.

Background: Traditionally, total colonic aganglionosis (TCA) was managed with enterostomy +/- pull-through. Since 1998, primary laparoscopic endorectal pull-through (PLEP) was offered to patients with TCA in our unit. A retrospective study was conducted and early results reviewed.

Laparoscopic hernia repair in children by the hook method: a single-center series of 433 consecutive patients.

Background: The relatively high recurrence rate reported in laparoscopic hernia repair in children using intracorporeal suturing technique remains a concern. We aimed to investigate the effectiveness of the hook method during hernia repair that allows extraperitoneal passage of suture to close the hernia sac without creating any tension or skip areas and does not require laparoscopic suturing skills.

Methods: A retrospective review was conducted on 433 consecutive children who underwent laparoscopic hernia repair using the hook method by 1 of 4 surgeons from July 2004 to June 2007.

Helicobacter pylori-positive versus Helicobacter pylori-negative idiopathic peptic ulcers in children with their long-term outcomes.

Objectives: The aim of this study is to investigate the differences in the characteristics between Helicobacter pylori-positive and H pylori-negative primary ulcers in Chinese children.

Patients And Methods: We conducted a retrospective review of children with primary peptic ulcers. Demographic data, clinical presentations, endoscopic features, histological findings, H pylori prevalence, and ulcer recurrences were studied.