Aim: Laparoscopy has replaced laparotomy in a variety of surgical abdominal conditions. In pediatric patients the vast majority of adnexal lesions are benign. The aim of this study was to assess the safety and feasibility of laparoscopy in adnexal pathology in children.
Materials And Methods: The case notes of girls with confirmed adnexal disorders treated in a single center between 1998 and 2008 were reviewed retrospectively. Demographic data, clinical and imaging features, surgical findings and procedures, pathologic features, complications, and outcomes were recorded.
Results: Over a 10-year-period 21 patients underwent laparoscopic surgery. Median age at operation was 14 years (range: 2 d to 16 y). Laparoscopy was diagnostic in 1 patient whereas it was therapeutic in 14; 2 patients underwent a laparoscopy-assisted minilaparotomy. The procedure was converted to open in 4 patients due to technical difficulties. The most commonly performed procedures laparoscopically were cyst aspiration (n=6), cystectomy (n=4), unilateral oophorectomy (n=2), and cyst aspiration with deroofing (n=2). No operative or postoperative complications occurred. The overall mean postoperative length of stay was 2.3 days (range: 1 to 6 d); it was 1.8 days (range: 1 to 3 d) for patients who had laparoscopic procedures. Pathology revealed benign lesions in all cases.
Conclusions: In children with benign adnexal pathology, minimally invasive surgery is a feasible and safe approach. Additional benefits of shorter hospital stay, superior cosmetic result, and lesser risk of infertility, make laparoscopy a method of choice for managing pediatric patients.
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http://dx.doi.org/10.1097/SLE.0b013e3181c3132e | DOI Listing |
J Rheumatol
January 2025
P.F. Weiss, MD, MSCE, Department of Pediatrics, Division of Rheumatology and Clinical Futures, Children's Hospital of Philadelphia and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Pennsylvania, USA.
Objective: To evaluate the influence of pelvic magnetic resonance imaging (MRI) findings on axial disease assessment in juvenile spondyloarthritis (JSpA).
Methods: This was a cross-sectional study of patients with JSpA with suspected axial disease. Three experts reviewed each case and rated their confidence (-3 to +3) in the presence of axial disease, first with clinical data and second with clinical and MRI data.
Clin Microbiol Rev
January 2025
Centro de Investigación en Salud Pública, Facultad de Medicina Humana, Universidad de San Martín de Porres, Lima, Peru.
SUMMARYSporotrichosis is a subacute-to-chronic infection endemic to tropical and subtropical regions. It usually involves subcutaneous tissue but can occasionally cause extracutaneous infections, especially in hyperendemic areas. Extracutaneous infections are classified based on the anatomic location of the lesion and the route of infection (primary or multifocal).
View Article and Find Full Text PDFInsights Imaging
January 2025
Medical Research Department, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, P. R. China.
Objective: To develop an automatic segmentation model to delineate the adnexal masses and construct a machine learning model to differentiate between low malignant risk and intermediate-high malignant risk of adnexal masses based on ovarian-adnexal reporting and data system (O-RADS).
Methods: A total of 663 ultrasound images of adnexal mass were collected and divided into two sets according to experienced radiologists: a low malignant risk set (n = 446) and an intermediate-high malignant risk set (n = 217). Deep learning segmentation models were trained and selected to automatically segment adnexal masses.
Hand (N Y)
January 2025
Institute for Plastic Surgery, Southern Illinois University School of Medicine, Springfield, USA.
Background: Aggressive digital papillary adenocarcinoma (ADPA) is a rare skin adnexal tumor with a predilection for the hand. The presentation, treatment, and outcomes of ADPA remain poorly defined due to the scarcity of reports and low-level evidence of published findings.
Methods: We performed a meta-analysis following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines with the intent to provide hand surgeons a better understanding of the diagnosis and treatment of the disease.
Insights Imaging
January 2025
Department of Radiology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.
Objectives: To evaluate the value of contrast-enhanced CT in diagnosing ultrasonography-unspecified adnexal torsion (AT).
Methods: Surgically confirmed patients with painful pelvic masses (n = 165) were retrospectively collected from two institutes. Two senior radiologists independently reviewed the CT images and determined the Hounsfield unit difference between non-contrast vs portal venous phases (ΔHU) in both derivation and validation samples.
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