Pain control and analgesic requirements following laparoscopy-assisted transversus abdominus plane (TAP) block compared to port site infiltration post-paediatric laparoscopic appendicectomy. A Randomised controlled trial.

Background: Appendicectomy is a common procedure in children. Regional anaesthesia helps reduce requirements for opioids and hospital stay and enhances recovery. Laparoscopic-assisted Transversus Abdominus Plane block (L-TAP) was shown to be efficient and potentially superior to port site infiltration (PSI); however, this was not previously studied in paediatric appendicitis.

The Irish Experience with Sacrococcygeal Teratomas: Are Type IV Lesions More Common than We Think?

Introduction:  Sacrococcygeal teratomas (SCTs) are rare tumors occurring in approximately 1 in 35,000 to 40,000 live births. The Altman classification is used to describe SCTs. There are four types, with type 1 predominantly external through to type IV which is a presacral, completely internal mass.

Circumcision Rates after the Release of Preputial Adhesions.

Aim We aim to determine if the release of preputial adhesions (RPA) successfully managed symptoms related to physiological phimosis and prevented the need for circumcision. Methods We performed a retrospective review and analysed data on RPA procedures performed between January 2005 and December 2017. Results 534 RPA’s were performed.

Colectomies in children with inflammatory bowel disease: a national referral centre experience.

Objectives: Few studies have reported on the utility and efficacy of laparoscopic colectomy in the paediatric population. We aim to compare the characteristics and outcomes of children with inflammatory bowel disease (IBD) who underwent open vs laparoscopic treatment at our centre.

Methods: A 10-year retrospective review was performed.

Smartphones in clinical practice: doctors' experience at two Dublin paediatric teaching hospitals.

Introduction: We conducted a study at two main centres for paediatric surgery in the Republic of Ireland, Temple Street Children's University Hospital (TSCUH) and Our Lady's Children's Hospital Crumlin (OLCHC).

Aim: The aim of the study was to assess doctors' opinions, frequency and methods of smartphone use in clinical practice.

Methods: Doctors (n = 265) at the two hospitals were invited to complete a 12-item survey.

Incidence and outcome of retained Port-A-Cath fragments during removal.

Purpose: Port-A-Cath devices are frequently used for long-term venous access. We postulate that long-term use predisposes them to getting stuck and retained in a central vein at the time of removal. We aim to report the incidence and outcome of this complication.

Abdominal radiography is not necessary in children with intussusception.

Background: Children with intussusception require rapid and accurate diagnosis to enable timely intervention for satisfactory outcome. Ultrasonography is the recommended standard diagnostic modality; however, abdominal radiography (AR) is still used as an initial investigation. The aim of this study was to investigate the benefit of AR in intussusception by determining diagnostic accuracy and analysing correlation of AR findings with outcome.

Animal attack: an unusual case of multiple trauma in childhood.

A 2½ year old girl attended our facility following attack by a tapir at a city zoo. She sustained multiple injuries including a forearm laceration and multiple perforating wounds to her abdominal wall. She had several procedures, including bowel resection, performed under the care of the General Paediatric Surgery and Plastic Surgery teams and was treated with a course of IV antibiotics.

Oesophageal inflammatory paediatric chylothorax.

Paediatric chylothoraces are rare, particularly outside the operative setting. Cases of spontaneous chylothorax are often demanding diagnostically and frequently associated with patient morbidity. We present a challenging case of paediatric chylothorax associated with inflammatory oesophageal perforation likely related to foreign body ingestion.

The national incidence and outcomes of gastroschisis repairs.

The birth prevalence of gastroschisis worldwide has increased over the past decades. We aim to determine the Irish national incidence of gastroschisis repairs (NIGR) over a 5 year period (2007- 2011) and clinical outcomes by a retrospective cohort review of cases admitted to all Irish paediatric surgical units. Seventy patients were identified.

Patterns of internet use by parents of children attending a pediatric surgical service.

Purpose: The internet has revolutionised the way we search for information. We determined the level of internet use by parents of children attending general surgical services and identified trends in online information-seeking behaviour.

Methods: A questionnaire based on the work by Boston and Tassone was distributed to parents attending both the day surgical units and surgical outpatients department in a paediatric tertiary referral centre.

Publication patterns on neonatal surgery over 65 years.

Background/purpose: Staying abreast of the literature in a given speciality is difficult. The aim of this study is to analyze the publication patterns of the neonatal surgical literature over the last six decades.

Materials: A search strategy for the Web of Science database was designed using MeSH defined terms for 10 index neonatal surgical conditions, with output analyzed over two time-periods.

The top 100 cited articles in urology: An update.

Background: In this paper, we identify and analyze the top 100 cited articles in urology since 1965 and assess changes in the top 100 since 2007.

Methods: We selected highest impact journals in both urological and general medicine journals from the 2011 edition of Journal Citation Reports: Science edition. We identified and analyzed the 100 most cited articles using the Science Citation Index Expanded (1965-present).

Scrotal exploration for acute scrotal pain: a 10-year experience in two tertiary referral paediatric units.

Objective: Acute scrotal pain is a common presentation to the paediatric emergency department. Testicular torsion is one of the most common causes of acute scrotal pain. Testicular torsion is a surgical emergency requiring immediate surgical exploration to prevent permanent testicular damage or loss.

Epidermolysis bullosa: management of esophageal strictures and enteric access by gastrostomy.

Epidermolysis bullosa (EB) is a spectrum of rare, inherited, blistering skin disorders, primarily affecting the skin and pharyngoesophageal mucosa. EB affects approximately 2 to 4 per 100,000 children each year. Blistering and scarring occur in response to even the most minor trauma.

Esophageal atresia repair with thoracotomy: the Cincinnati contemporary experience.

Esophageal atresia/tracheoesophageal fistula (EA/TEF) repair using an open muscle-sparing thoracotomy has been the standard approach used in our institution. Whereas perioperative mortality is now very uncommon, short- and long-term morbidity is very common in these patients. However, the complexity of the esophageal anatomy and significant comorbidities appear to be important contributors to significant complications in these patients.

Transhepatic central venous catheter for long-term access in paediatric patients.

Vascular access in paediatric patients with chronic and/or life-threatening illness is crucial to survival. Access is frequently lost in this group because of thrombosis, infection, or displacement, and vascular options can quickly be exhausted. The last resort access procedure is generally a direct atrial catheter inserted via a thoracotomy.

Penile malignant peripheral nerve sheath tumour (schwannoma) in a three-year-old child without evidence of neurofibromatosis.

Malignant schwannoma (malignant peripheral nerve sheath tumour, MPNST) is a rare high-grade tumour arising from peripheral nerves. We report the case of a 3-year-old male who presented with a non-tender lesion on the dorsum of his penis. The lesion was excised and a formal circumcision performed.

The Adriamycin rat/mouse model and its importance to the paediatric surgeon.

The teratogenic effect of Adriamycin (doxorubicin) in the rat model, and more recently in the mouse, has provided paediatric surgeons with a reliable, easily reproducible method of studying the embryology and molecular biology for a range of complex congenital anomalies. Concomitantly these animal models have stimulated interest among embryologists for the effect on the notochord, shedding more light on the important organizational role of this structure in the developing embryo. Finally, as more is learnt of the pathogenesis of the various malformations induced by Adriamycin, future therapeutic interventions involving gene therapy, drugs or surgery may arise.

Alpha glutathione S-transferase: a potential marker of ischemia-reperfusion injury of the intestine after cardiac surgery?

Background: The aim of the study was to assess the utility of alpha glutathione S-transferase (alphaGST) as a potential marker of intestinal ischemia-reperfusion injury in children after cardiac surgery.

Methods: Twenty-six patients undergoing cardiac surgery were enrolled in this longitudinal experimental study. Blood samples were drawn for analysis at specified time points during surgery and analyzed for alphaGST levels.

Mucinous cystadenoma of the ovary in perimenarchal girls.

Ovarian masses in children are an uncommon occurrence. They represent less than 2% of all tumours in girls less than 16 years of age. Mucinous tumours of the ovary occur principally in middle adult life and are extremely rare prior to menarche.