Publications by authors named "Seiichi Hirobe"
Purpose: This study aimed to investigate the current practices in the diagnosis and surgical management of anorectal malformations (ARMs) in female patients in Japan, specifically focusing on anovestibular fistula (AVF), rectovaginal fistula (RVF), and persistent cloaca (PC).
Methods: An anonymous online survey was conducted with 61 institutional members of the Japanese Study Group for Anorectal Anomalies.
Results: Sixty-one institutions (100%) completed the survey.
Background Umbilical mucosal polyps are common, but physicians' unfamiliarity with them can prolong the patient's illness. Furthermore, the details of surgery for umbilical mucosal polyp removal are not well documented. Methods Patients with an umbilical mucosal polyp diagnosed on the basis of the lesion's characteristic appearance were prospectively enrolled.
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- This study examines the diagnosis and treatment practices for rectourethral fistulas (RUF) in male patients with anorectal malformations (ARMs) in Japan, using a comprehensive questionnaire survey among medical institutions.
- Results show that laparoscopic-assisted anorectoplasty (LAARP) is favored for high-type ARMs, while posterior sagittal anorectoplasty (PSARP) is preferred for intermediate-type ARMs, highlighting differences in surgical techniques and tools used.
- The findings indicate distinct management strategies for RUF in PSARP and LAARP procedures, suggesting the need for more research on postoperative outcomes related to these varied approaches.
Purpose: Long-gap esophageal atresia (LGEA) is still a challenge for pediatric surgery. No consensus exists as to what constitutes a long gap, and few studies have investigated the maximum gap length safely repairable by primary anastomosis. Based on surgical outcomes at a single institution, we aimed to determine the gap length in LGEA with a high risk of complications.
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- The study investigates treatment experiences and outcomes for patients with Currarino syndrome (CS) who also suffer from anorectal stenosis.
- It reviews seven cases treated in a single hospital over 23 years, detailing various surgical interventions for associated conditions like teratomas and meningoceles.
- The findings suggest that improving clinical outcomes for CS requires a comprehensive treatment approach and a better understanding of the disease’s complex pathology.*
Article Synopsis
- The study aims to use the iBALF score, a marker of liver fibrosis from blood tests, to identify patients with biliary atresia (BA) who are likely to have poor outcomes after bile drainage surgery.
- An analysis of 380 BA patients showed that those with an iBALF score above 5.27 had significantly lower chances of surviving with their native liver after one year, with only 4.7% of these patients achieving native liver survival.
- The findings suggest that patients with a preoperative iBALF score over 5.27 may not benefit from bile drainage surgery and should be considered for primary liver transplantation instead.
Article Synopsis
- The study compares the cosmetic outcomes of two types of transumbilical surgical incisions (vertical vs. periumbilical) in children under one year old after minimally invasive surgery.
- Forty patients were surveyed on satisfaction and evaluated for scar appearance, with results showing better satisfaction and shorter scar lengths in the vertical incision group.
- The findings suggest that vertical incisions may lead to more favorable cosmetic results, with a higher number of patients achieving better umbilical shape and scar visibility.*
Article Synopsis
- - The study examined 46 pediatric patients who underwent laparotomy for congenital biliary dilatation (CBD), analyzing how disease classification and preoperative conditions affect surgical difficulty and time.
- - Patients were split into two groups based on operative time: short (≤ 360 min) and long (> 360 min), with findings showing that certain preoperative factors like AST/ALT levels and bile duct size were significantly associated with longer surgeries.
- - Key predictors of surgical difficulty identified were maximum cyst diameter, preoperative AST levels, and bile duct anastomosis diameter, suggesting these factors could help anticipate surgery length and complexity in pediatric patients.
Purpose: The slide tracheoplasty (STP) is the standard treatment for severe congenital tracheal stenosis (CTS). Understanding the features of the tracheal stenosis in each case and choosing an appropriate incision design are very important for successfully executing the procedure. The present study aimed to evaluate the advantages of three-dimensional (3D) printed models of the trachea for improving CTS.
View Article and Find Full Text PDFPurpose: Radical surgery for congenital tracheal stenosis (CTS) is technically demanding. CTS combined with tracheal bronchus (TB) and pulmonary artery (PA) sling is a particularly challenging condition. We herein report our successfully modified surgical techniques for CTS combined with TB and PA sling.
View Article and Find Full Text PDFPurpose: The application of slide tracheoplasty (STP) in the treatment of congenital tracheal stenosis (CTS) has improved patient outcomes over the past few decades. We reviewed our experiences with the procedure, elucidated risk factors, and discussed important aspects of perioperative management to improve outcomes.
Method: Patients with CTS undergoing STP between July 1998 and December 2020 were enrolled.
Article Synopsis
- Pediatric pancreatic trauma management is still debated, and the effectiveness of using stents with endoscopic retrograde pancreatography (ERP) is not well understood.
- A study examined ten male children aged 4-14 with various grades of pancreatic injuries, where ERP showed that out of six patients, four had pancreatic duct injuries (PDI).
- The findings suggest that ERP can be beneficial, especially for managing PDI, as only one patient required surgery when the stent was placed directly across the injury, indicating that early ERP may be a viable treatment option.
Background: Minimally invasive surgery (MIS) is appropriate for the treatment of some neuroblastomas (NBs); however, the indications and technical issues are unclear. This study aimed to clarify the current status of MIS for mediastinal NB in Japan.
Methods: Preliminary questionnaires requesting the numbers of neuroblastoma cases in which MIS was performed from 2004 to 2016 were sent to 159 Japanese institutes of pediatric surgery.
Article Synopsis
- Patients with severe motor and intellectual disabilities often face tracheal stenosis due to chest deformities, which can lead to serious complications, including potentially life-threatening events.* -
- Two patients undergoing a novel thoracoplastic procedure with brachiocephalic artery transection experienced significant improvement in airflow and respiratory symptoms post-surgery, as confirmed by CT scans.* -
- The patients remain in stable condition one year after the procedure, with improved airway health and no further complications related to chest fragility or limb movement disorders.*
Background: Our group previously proved that the human enteric nervous system can be visualized with confocal laser endomicroscopy after topical application of cresyl violet using surgically resected intestine specimens. The present report documents the first in vivo visualization of the human enteric nervous system with confocal laser endomicroscopy using local cresyl violet staining. The aim of this study was to evaluate the technical feasibility and clinical efficiency of confocal laser endomicroscopy in patients with Hirschsprung's disease and allied disorders in vivo.
View Article and Find Full Text PDFThe necessity of nighttime appendectomies: Is appendicitis an emergency?
Afr J Paediatr Surg
March 2021
Background: In our institution, we avoid emergency nighttime appendectomies, instead performing the surgery during daylight hours the following day. We examined whether emergency or early appendectomies affect the outcome of patient morbidity.
Materials And Methods: Medical records of children treated for appendicitis between 2010 and 2012 were retrospectively reviewed.
Article Synopsis
- Congenital tracheal stenosis (CTS) is a rare and serious condition in children, particularly when complicated by a pulmonary artery sling (PA sling), and this study aims to identify when surgery is necessary for these cases.
- Researchers evaluated 42 patients treated at their hospital from 2005 to 2018, determining surgical indications based on various factors, including the ratio of tracheal diameter to stenotic length (DLR).
- The study found that a DLR value below 5.9 could be a useful indicator for deciding on surgical intervention in children with CTS complicated by PA sling, showing promising sensitivity and specificity.
Background: Hirschsprung's disease is a congenital abnormality of the enteric nervous system (ENS) presenting severe constipation soon after birth due to the lack of ganglion cells in the distal gut. Surgery for Hirschsprung's disease requires an intraoperative histopathological diagnosis to assess the extent of aganglionosis. Confocal laser endomicroscopy (CLE) is a novel endoscopic technique allowing real-time, in vivo analysis of cellular details during ongoing endoscopy.
View Article and Find Full Text PDFObjectives: To identify the imaging features peculiar to congenital tracheal stenosis (CTS) complicated with left pulmonary artery sling (LPAS) with the aim of presenting a hypothesis of tracheal stenosis embryology in LPAS.
Methods: We retrospectively reviewed CTS patients (with complete cartilaginous rings) admitted between April 2010 and July 2018. All the patients were classified into the LPAS or non-LPAS group, and their clinical characteristics and qualitative variables on computed tomography (CT) imaging were compared.
Purpose: Lingual thyroglossal duct cysts (L-TGDCs) are rare and sometimes lethal owing to their association with asphyxia. We aimed to analyze our single institutional experience with L-TGDCs.
Methods: Twelve L-TGDC cases treated at our institution between January 2010 and December 2017 were investigated.
Article Synopsis
- The study assessed the use of cresyl violet (CV) dye to visualize the myenteric plexus (MP) using probe-based confocal laser endomicroscopy (pCLE) from the serosal side.
- The dye showed strong affinity for MP in both transgenic mouse models and human surgical specimens, achieving successful visualization in 85.7% of human samples.
- Results indicated high sensitivity (92.3%) and specificity (100%) for MP detection, highlighting CV-assisted pCLE as a promising technique for real-time visualization of the MP.
Perinatal features of congenital cystic lung diseases: results of a nationwide multicentric study in Japan.
Pediatr Surg Int
September 2016
Purpose: The current study aimed to assess the perinatal risk and clinical features of congenital cystic lung diseases (CCLD).
Materials And Methods: Of the 874 CCLD patients identified in a nationwide survey, 428 patients born between 1992 and 2012 and treated at 10 high-volume centers, were retrospectively reviewed.
Results: Fetal hydrops was visualized using MRI in 9.