共查询到20条相似文献，搜索用时 31 毫秒
1.
James K. Wall Tiffany J. Sinclair William Kethman Christina Williams Craig Albanese Karl G. Sylvester Matias Bruzoni 《Journal of pediatric surgery》2018,53(3):503-507
Background
Minimal access surgery (MAS) has gained popularity in infants less than 5 kg, however, significant challenges still arise in very low weight infants.Study design
A retrospective chart review was performed to identify all infants weighing less than 3 kg who underwent an advanced MAS or equivalent open procedure from 2009 to 2016. Advanced case types included Nissen fundoplication, duodenal atresia repair, Ladd procedure, congenital diaphragmatic hernia repair, esophageal atresia/tracheoesophageal fistula repair, diaphragmatic plication, and pyloric atresia repair. A comparative analysis was performed between the MAS and open cohorts.Results
A total of 45 advanced MAS cases and 17 open cases met the inclusion criteria. Gestational age and age at operation were similar between the cohorts, while infants who underwent open procedures had significantly lower weight at operation (p = 0.003). There were no deaths within 30 days related to surgery in either group. Only 3 MAS cases required unintended conversion to open. There were 2 (4.4%) postoperative complications related to surgery in the MAS cohort and 2 (11.8%) in the open cohort.Conclusion
Advanced MAS may be performed in infants weighing less than 3 kg with low mortality, acceptable rates of conversion, and similar rates of complications as open procedures.Type of study
Prognosis study.Level of evidence
Level III. 相似文献2.
Etienne St-Louis Nadia Safa Elena Guadagno Robert Baird 《Journal of pediatric surgery》2018,53(5):946-958
Background
Gastrostomy tubes are a common adjunct to the care of vulnerable pediatric patients. This study systematically evaluates the epidemiology and risk-factors for gastrocutaneous fistulae (GCF) after gastrostomy removal in children and reviews treatment options focusing on nonoperative management (NOM).Methods
After protocol registration (CRD-42017059565), multiple databases were searched. Studies describing epidemiology in children and GCF treatment at any age were included. Critical appraisal was performed (MINORS risk-of-bias assessment tool). One-sided meta-analysis was executed to estimate efficacy of therapeutic adjuncts using a random-effects model.Results
Sixteen articles evaluating pediatric GCF were identified. 44% defined GCF as persistence > 1 month which occurred in 31 ± 7% of cases. Risk factors for pediatric GCF include age at gastrostomy, timing of removal, open technique, and fundoplication. Mean MINORS score was 0.60 ± 0.16. Seventeen additional studies were identified reporting 142 patients undergoing NOM (endoscopic, systemic, and local therapies), and one pediatric comparative study was identified. Overall aggregate proportion of GCF closure after any NOM is 77% (80% success rate in local/systemic therapies; 75% success rate in endoscopic approaches). No adverse events were reported.Conclusion
Persistent GCF complicates the management of gastrostomies in 1/3 of children with predictable risk factors. Several treatment options exist that obviate the need for general anesthesia. Their efficacy is unclear. Further prospective investigations are clearly warranted.Level of Evidence
III — Systematic Review and Meta-Analysis Based on Retrospective Case Control Studies. 相似文献3.
In Geol Ho Kyong Ihn Eun-Jung Koo Eun Young Chang Jung-Tak Oh 《Journal of pediatric surgery》2018,53(10):2008-2012
Purpose
This study aimed to evaluate the usefulness of laparoscopic repair of inguinal hernia (LR) in infants in comparison with open hernia repair (OR).Methods
We retrospectively analyzed the clinical data of 465 infants treated for inguinal hernia from January 2006 to December 2015. Among them, 124 underwent LR and 341 underwent OR.Results
In the OR group, 16.1% (55/341) primarily underwent bilateral inguinal hernia repair and 13.6% (42/308) subsequently developed metachronous contralateral inguinal hernia during follow-up. In the LR group, 75.8% (94/124) underwent primary bilateral inguinal hernia repair and only 1.6% (2/123) developed metachronous contralateral inguinal hernia. The mean operation times of unilateral inguinal hernia repair showed no statistical differences between LR and OR. However, the mean operation times of bilateral inguinal hernia repair were shorter in LR (39.8 ± 10.4 vs. 51.1 ± 14.4 min, p < 0.001). Postoperative recurrence and wound infection showed no statistical differences between the groups, but postoperative scrotal swelling was more common in OR (0.0% vs. 4.0%, p = 0.006).Conclusion
LR in infants showed a lower incidence of metachronous hernia, shorter operation times, and better postoperative course than OR. LR could be considered the primary operation method in infants with inguinal hernia.Levels of Evidence
Prognosis Study, Retrospective Study, Level III. 相似文献4.
Alisha R Fernandes Tessa Elliott Carter McInnis Bethany Easterbrook J Mark Walton 《Journal of pediatric surgery》2018,53(5):933-936
Purpose
Percutaneous endoscopic gastrostomy (PEG) enables enteral nutrition for patients with inadequate oral intake. Laparoscopic guidance of PEG insertion is used for high-risk populations, including in infants less than 5 kg at insertion. This study aimed to assess complication rates with traditional PEG tube insertion in infants less than 5 kg at a single tertiary care center.Methods
A retrospective review of patients less than 5 kg who underwent PEG insertion was conducted. PEG insertion-related complications, up to four years following insertion, were collected. Outcomes were reported as counts and percentages, or median with minimum and maximum values.Results
480 pediatric gastrostomy procedures between January 1, 2009 and February 1, 2017, were screened, with 129 included for analysis. Median weight at PEG insertion was 3800 g. Superficial surgical site infection (SSI) occurred in 6 (4.7%) patients, and 1 (0.8%) required readmission for intravenous antibiotics. One (0.8%) required endoscopic management for retained foreign body, 1 (0.8%) required operative management for gastrocolic fistula, and 1 (0.8%) for persistent gastrocutaneous fistula. No deep space SSI, procedure-related hemorrhage requiring readmission or transfusion, buried bumper syndrome, or procedure-related mortality occurred.Conclusion
Traditional PEG tube insertion in infants less than 5 kg results in complication rates comparable to pediatric literature standards.Level of Evidence
Level II, retrospective prognosis study. 相似文献5.
Scott S. Short Brian T. Bucher Douglas C. Barnhart Nadia Van Der Watt Sarah Zobell Ashley Allen Michael D. Rollins 《Journal of pediatric surgery》2018,53(11):2174-2177
Purpose
We sought to examine the short-term outcomes following single-stage repair of rectoperineal and rectovestibular fistulae in infants and identify risk factors for wound complication.Methods
Patients with a rectoperineal or rectovestibular fistula treated with a single-stage repair beyond the neonatal period (> 30 days of age) at a pediatric colorectal center (2011–2016) were reviewed.Results
36 patients with a rectoperineal and 7 patients with a rectovestibular fistula were repaired using the Posterior Sagittal Anorectoplasty (PSARP) approach. Median follow-up was 31 months. The median age and weight at the time of repair were 166 days and 6.5 kg. Four patients (11%) suffered a wound complication (3 rectoperineal, 1 rectovestibular). Two required a diverting colostomy to allow wound healing. Two patients suffered skin separation managed with local wound care. All 4 patients experienced satisfactory wound healing without anoplasty stricture. Two different patients developed a stricture of the neo-anus. Age and weight at time of repair, gender, and presence of a genitourinary anomaly were not associated with wound complications.Conclusion
Delayed single-stage repair of rectoperineal and rectovestibular fistulae can be performed safely in infants beyond the newborn period. With attentive treatment, satisfactory healing can be anticipated if a wound complication is encountered.Level of Evidence
Retrospective Comparative Study, Level III. 相似文献6.
Steven S. Rothenberg 《Journal of pediatric surgery》2018,53(1):121-125
Purpose
This study evaluates the results of thoracoscopic management of complex, non-type C, EA and TEF in infants.Methods
From March 2000 to February 2017, 23 patients were treated for Type A N = 13, Type B N = 4, and Type E N = 6. Patients diagnosed with EA had G-tube feeds for a period of 4–9 weeks. All procedures were performed thoracoscopically. EA gaps were between 4 and 7 1/2 vertebral bodies.Results
All surgeries were completed thoracoscopically. Average operative time was 95 min for Type A, 115 min for Type B, and 50 min for Type E. Two patients with long gaps had small leaks which resolved with conservative management. One patient with an H-type was re-intubated causing a partial disruption of the tracheal repair. This required thoracoscopic re-exploration with repair and placement of an intercostal muscle flap. No patient has any clinical evidence of fused ribs, chest wall asymmetry, shoulder girdle weakness, or winged scapula.Conclusion
Thoracoscopic repair of complex EA and TEF is safe and effective. The excellent visualization of the thoracic inlet allows for extensive mobilization creating sufficient length for long gaps and safely managing high fistulas. This may limit injury to adjacent structures and avoid a neck incision and chest wall deformity.Level of evidence
IV. 相似文献7.
Wegdan Mawlana Paul Zamiara Hilary Lane Margaret Marcon Eveline Lapidus-Krol Priscilla PL Chiu Aideen M Moore 《Journal of pediatric surgery》2018,53(9):1651-1654
Background
Esophageal atresia with or without tracheoesophageal fistula (EA/TEF) is a complex disorder, and most outcome data are confined to mortality and feeding-related morbidities. Our objective was to examine mortality, growth and neurodevelopmental outcomes in a large recent cohort of infants with EA/TEF.Methods
Single center study of EA/TEF infants referred from January 2000 to December 2015. Data collected included associated defects, neonatal morbidity and mortality and growth and neurodevelopmental outcomes at age 12–36 months. Multiple regression analysis was used to determine variables associated with adverse outcome.Results
Of the 253 infants identified, 102 infants (40%) were preterm. Overall mortality was 8.3%, the majority from major cardiac malformations (p < 0.001) Neurodevelopmental assessments (n = 182) showed that 76% were within normal, while some delay was seen in 24%, most often in expressive and receptive language. Nine infants had hearing impairment and 5 had visual impairment. Gastrostomy tubes were required in 47 patients and 15% continued to have weight growth velocities less than the 10th centile. A number of specialist interventions were required, Speech/Language being frequent.Conclusion
Mortality in EA/TEF is primarily related to concomitant anomalies, especially cardiac. Multidisciplinary follow up is important for early identification and intervention for growth failure and developmental delay.Type of study
Retrospective studyLevel of evidence
Level II 相似文献8.
Colin Muncie Michael Morris Barry Berch David Sawaya Christopher Blewett 《Journal of pediatric surgery》2018,53(1):126-129
Purpose
The safety and effectiveness of a stapled intestinal anastomosis in adults, children, and infants is well documented. However, in neonates it is not well validated. We hypothesized that premature infants who received a stapled bowel anastomosis utilizing endoscopic staplers had similar outcomes compared to patients with a handsewn anastomosis.Methods
A retrospective study was performed reviewing premature infants who underwent an intestinal anastomosis over a 4-year period. Patients greater than 36 weeks gestational age at birth or a weight greater than 5 kg at surgery were excluded. Patient demographics, type of intestinal anastomosis, and anastomotic related complications within 3 months were collected and analyzed.Results
Sixty-five patients underwent 71 operations involving an intestinal anastomosis: 33 cases were handsewn, and 38 cases were stapled. Groups were noted to have differences in age, weight, and diagnosis. Complications including leak and anastomotic stricture did not differ between groups. Reports of blood per rectum after surgery were more common in the stapled group (24% versus 6%, p = 0.0522), but this did not reach statistical significance.Conclusion
There were no significant differences in anastomotic complications when comparing the handsewn and stapled intestinal anastomosis techniques in premature infants weighting less than 5 kg.Type of study
Treatment Study.Level of evidence
III. 相似文献9.
10.
Jason O. Robertson Cory N. Criss Lily B. Hsieh Niki Matsuko Josh S. Gish Rodrigo A. Mon Kevin N. Johnson Ronald B. Hirschl George B. Mychaliska Samir K. Gadepalli 《Journal of pediatric surgery》2018,53(4):629-634
Purpose
For the last seven years, our institution has repaired infants with CDH that require ECMO early after cannulation. Prior to that, we attempted to decannulate before repair, but repaired on ECMO if we were unable to wean after two weeks. This study compares those strategies.Methods
From 2002 to 2016, 65 infants with CDH required ECMO. 67.7% were repaired on ECMO, and 27.7% were repaired after decannulation. Data were compared between patients repaired ≤ 5 days after cannulation (“early protocol”, n = 30) and > 5 days after cannulation or after de-cannulation (“late protocol”, n = 35). We used Cox regression to assess differences in outcomes between groups.Results
Survival for the early and late protocol groups was 43.3% and 68.8%, respectively (p = 0.0485). For patients that were successfully decannulated before repair, survival was 94.4%. Moreover, the early repair protocol was associated with prolongation of ECMO (16.8 ± 7.4 vs. 12.6 ± 6.8 days, p = 0.0216).After multivariate regression, the early repair protocol was an independent predictor of both mortality (HR = 3.48, 95% CI = 1.28–9.45, p = 0.015) and days on ECMO (IRR = 1.39, 95% CI = 1.07–1.79, p = 0.012). All bleeding occurred in patients repaired on ECMO (29.5%, 13/44).Conclusions
Our data suggest that protocolized CDH repair early after ECMO cannulation may be associated with increased mortality and prolongation of ECMO. However, early repair is not necessarily harmful for those patients who would otherwise be unable to wean from ECMO before repair. Further work is needed to better move towards individualized patient care.Type of study
Treatment Study.Level of evidence
Level III. 相似文献11.
Kibileri Williams Lauren Baumann Adil Shah Fizan Abdullah Emilie K. Johnson Tolulope A. Oyetunji 《Journal of pediatric surgery》2018,53(1):86-89
Purpose
Undescended testis (UDT) is the most common congenital anomaly of the male genitalia. The American Urological Association guidelines recommend orchiopexy by age 18 months to ameliorate the risk of subfertility. The study aim was to assess adherence to these guidelines on a national level.Methods
We retrospectively reviewed both the State Ambulatory Surgery Database (SASD) in 2012 and the Pediatric Health Information System (PHIS) for 2015. All patients aged 18 years or less with a diagnosis of UDT who underwent orchiopexy were included. Demographic data including age at repair as well as surgical subspecialty and payer status were extracted.Results
Analysis of the 2012 SASD for New Jersey, Florida, and Maryland yielded 1654 patients. The majority were white, 791 (48.3%), with a median age at repair of 4 years (IQR 1–8). Most patients, 1048 (64%), had orchiopexy later than age 2. A total of 844 males were identified from the PHIS database. Of these, 63% were white. The median age at repair was 5 years (IQR 1–9). There were 577 (68%) patients older than 2 years at orchiopexy.Conclusion
Almost 70% of boys with undescended testes in the United States are undergoing orchiopexy at least 6 months later than the recommended age.Type of study
Retrospective.Level of evidence
III. 相似文献12.
Charles R. Hong Brenna S. Fullerton Charles E. Mercier Kate A. Morrow Erika M. Edwards Karla R. Ferrelli Roger F. Soll Biren P. Modi Jeffrey D. Horbar Tom Jaksic 《Journal of pediatric surgery》2018,53(6):1197-1202
Purpose
The purpose of this study was to examine postnatal growth outcomes and predictors of growth failure at 18–24 months corrected age among extremely low birth weight (ELBW) survivors of necrotizing enterocolitis (NEC) compared to survivors without NEC.Methods
Data were collected prospectively on ELBW (22–27 weeks gestation or 401–1000 g birth weight) infants born 2000–2013 at 46 centers participating in the Vermont Oxford Network follow-up project. Severe growth failure was defined as < 3rd percentile weight-for-age.Results
There were 9171 evaluated infants without NEC, 416 with medical NEC, and 462 with surgical NEC. Rates of severe growth failure at discharge were higher among infants with medical NEC (56%) and surgical NEC (61%), compared to those without NEC (36%). At 18–24 months follow-up, rates of severe growth failure decreased and were similar between without NEC (24%), medical NEC (24%), and surgical NEC (28%). On multivariable analysis, small for gestational age, chronic lung disease, severe intraventricular hemorrhage or cystic periventricular leukomalacia, severe growth failure at discharge, and postdischarge tube feeding predicted < 3rd percentile weight-for-age at follow-up.Conclusions
ELBW survivors of NEC have higher rates of severe growth failure at discharge. While NEC is not associated with severe growth failure at follow-up, one quarter of ELBW infants have severe growth failure at 18–24 months.Type of study
Prognosis study.Level of evidence
II 相似文献13.
Tamer E. Helmy Wael Ghanem Hesham Orban Helmy Omar Mahmoud El-Kenawy Ashraf T. Hafez Mohammed Dawaba 《Journal of pediatric surgery》2018,53(8):1461-1463
Objective
To detect whether grafting the incised plate during Snodgrass repair would improve outcome.Materials and methods
Sixty patients with primary distal hypospadias were included. Patients were equally randomized using closed envelop method to either Snodgrass or grafted tubularized incised plate repair (GTIP). All operations were performed by a single surgeon. All intaroperative data were recorded. All patients were followed up for 1 year. Success was defined as slit shaped meatus at the tip of the glans with no stenosis, fistula or diverticulum.Results
All 60 patients were evaluated at 1 year of follow-up. Mean age at surgery was 40 ± 15 months. Both groups were comparable as regard to patients' age, meatus location, length and width and depth of urethral plate and glans width. Success was documented in 29/30 patients (96.7%) in the Snodgrass group. The only complication was meatal stenosis in one patient, whereas success was documented in 28/30 patients (93.3%) in the GTIP group. The two failures were secondary to partial glans dehiscence. Success rate was not statistically different. Flow rate data at 1 year showed insignificant difference between both groups as regards Q-max and voiding time. The only statistically significant difference between both groups was a longer operative time 106 ± 12 min in the GTIP group compared to only 77 ± 9 for the Snodgrass group (p = 0.005).Conclusions
Snodgrass and GTIP techniques for primary distal hypospadias repair have similar outcome. With a significantly shorter operative time, Snodgrass repair remains the first choice for primary distal hypospadias repair.Type of the study
Prospective randomized study.Level of evidence
Level I. 相似文献14.
Kathryn Taylor Kristin A. Sonderman Lindsey L. Wolf Wei Jiang Lindsey B. Armstrong Tracey P. Koehlmoos Brent R. Weil Robert L. Ricca Christopher B. Weldon Adil H. Haider Samuel E. Rice-Townsend 《Journal of pediatric surgery》2018,53(11):2214-2218
Purpose
We aimed to describe the incidence, timing, and predictors of recurrence following inguinal hernia repair (IHR) in children.Methods
We used the TRICARE claims database, a national cohort of > 3 million child dependents of members of the U.S. Armed Forces. We abstracted data on children < 12y who underwent IHR (2005–2014). Our primary outcome was recurrence (ICD9-CM diagnosis codes). We calculated incidence rates for the population and stratified by age, time from repair to recurrence, and multivariable logistic regression to determine predictors.Results
Nine thousand nine hundred ninety-three children met inclusion criteria. Age at time of IHR was ≤ 1y in 37%, 2-3y in 23%, 4–5y in 16%, and 5–12y in 24%. Median follow-up time was 3.5y (IQR:1.6–6.1). 137 patients recurred (1.4%), with an incidence of 3.46 per 1000 person-years. Over half occurred in children 0-1y at repair (60%). The majority occurred within a year following repair (median 209?days [IQR:79–486]). Children 0-1y had 2.53 times greater odds of recurrence (compared to > 5y). Children with multiple comorbidities had 5.45 times greater odds compared to those with no comorbidities.Conclusions
The incidence of recurrence following IHR is 3.46 per 1000 person-years. The majority occurred within a year of repair. Children ≤ 1y and those with multiple comorbidities were at increased risk.Level of Evidence
Prognosis Study, Level II. 相似文献15.
Dani O. Gonzalez Jennifer N. Cooper Shawn D. St. Peter Peter C. Minneci Katherine J. Deans 《Journal of pediatric surgery》2018,53(3):513-520
Background
In patients undergoing gastroschisis closure, the effects of timing of closure and patient and hospital-level characteristics on length of stay (LOS) and time to enteral autonomy are unknown.Study design
Using the Pediatric Health Information System, we compared neonates who underwent early (within 1 day of birth) versus delayed (> 1 day after birth) gastroschisis closure from 2005 to 2013. We evaluated the relationship between time to closure and both LOS and days on total parenteral nutrition (TPN).Results
Of 4459 neonates with gastroschisis, 43.9% underwent early closure and 56.1% underwent delayed closure. Delayed closure, complicated gastroschisis, government insurance, lower birth weight, older age at closure, and complex chronic conditions were associated with longer LOS and days on TPN (all p < 0.05). There was significant inter-hospital variability in both outcomes, after adjusting for patient- and hospital-level characteristics, including hospitals' gastroschisis and neonatal volumes, median age at closure, and percentages of complicated and delayed gastroschisis patients, (p < 0.01).Conclusion
Delayed gastroschisis closure is associated with longer LOS and duration of TPN, even after excluding complicated cases. Furthermore, after controlling for hospital volume, rate of complicated gastroschisis, and timing of closure, the persistent inter-hospital variability suggests that practice variability is partially responsible for these differences.Type of study
Retrospective study.Level of evidence
III 相似文献16.
Robert J. Obermeyer Nina S. Cohen Sheema Gaffar Robert E. Kelly M. Ann Kuhn Frazier W. Frantz Margaret M. McGuire James F. Paulson 《Journal of pediatric surgery》2018,53(6):1226-1229
Background/Purpose
Our previously published data suggested several risk factors for infection after the Nuss procedure. We aimed to further elucidate these findings.Methods
An IRB-approved (14–03-WC-0034), single institution, retrospective review was performed to evaluate the incidence of postoperative Nuss bar infections associated with seven variables. These were subjected to bivariate and multivariable analyses. A broad definition of infection was used including cellulitis, superficial infection with drainage, or deep infection occurring at any time postoperatively.Results
Over 7 years (4/1/2009–7/31/2016), 25 (3.2%) of 781 patients developed a postoperative infection after primary Nuss repair. Multivariable analyses demonstrated an increased risk of infection with perioperative clindamycin versus cefazolin for all infections (AOR 3.72, p = .017), and specifically deep infections (AOR 5.72, p = .004). The risk of a superficial infection was increased when antibiotic infusion completed > 60 min prior to incision (AOR 10.4, p = .044) and with the use of peri-incisional subcutaneous catheters (OR 8.98, p = .008).Conclusion
Following primary Nuss repair, the rate of deep bar infection increased with the use of perioperative clindamycin rather than cefazolin. The rate of superficial infection increased when perioperative antibiotic infusion was completed more than 60 min prior to incision and with the use of peri-incisional subcutaneous catheters. Further studies are needed to better understand these findings.Type of study
Retrospective chart review.Level of evidence
Level III treatment study. 相似文献17.
Yangyang R. Yu Annalyn S. DeMello Christopher S. Greeley Charles S. Cox Bindi J. Naik-Mathuria David E. Wesson 《Journal of pediatric surgery》2018,53(5):1028-1032
Purpose
This study examines non-accidental trauma (NAT) fatalities as a percentage of all injury fatalities and identifies injury patterns in NAT admissions to two level 1 pediatric trauma centers.Methods
We reviewed all children (< 5 years old) treated for NAT from 2011 to 2015. Patient demographics, injury sites, and survival were obtained from both institutional trauma registries.Results
Of 4623 trauma admissions, 557 (12%) were due to NAT. However, 43 (46%) of 93 overall trauma fatalities were due to NAT. Head injuries were the most common injuries sustained (60%) and led to the greatest increased risk of death (RR 5.1, 95% CI 2.0–12.7). Less common injuries that increased the risk of death were facial injuries (14%, RR 2.9, 95% CI 1.6–5.3), abdominal injuries (8%, RR 2.8, 95% CI 1.4–5.6), and spinal injuries (3%, RR 3.9, 95% CI 1.8–8.8). Although 76% of head injuries occurred in infants < 1 year, children ages 1–4 years old with head injuries had a significantly higher case fatality rate (27% vs. 6%, p < 0.001).Conclusion
Child abuse accounts for a large proportion of trauma fatalities in children under 5 years of age. Intracranial injuries are common in child abuse and increase the risk of death substantially. Preventing NAT in infants and young children should be a public health priority.Type of study
Retrospective Review.Level of evidence
II 相似文献18.
Mirjam Stahl Simon Y. Graeber Cornelia Joachim Sandra Barth Isabell Ricklefs Gesa Diekmann Matthias V. Kopp Lutz Naehrlich Marcus A. Mall 《Journal of cystic fibrosis》2018,17(2):249-255
Background
Lung clearance index (LCI) detects early ventilation inhomogeneity and has been suggested as sensitive endpoint in multicenter intervention trials in infants and preschoolers with cystic fibrosis (CF). However, the feasibility of multicenter LCI in this age group has not been determined. We, therefore, investigated the feasibility of LCI in infants and preschoolers with and without CF in a three-center setting.Methods
Following central training, standardized SF6-MBW measurements were performed in 73 sedated children (10 controls, 49 with CF and 14 with other lung diseases), mean age 2.3 ± 1.2 years across three centers, and data were analyzed centrally.Results
Overall success rate of LCI measurements was 91.8% ranging from 78.9% to 100% across study sites. LCI was increased in patients with CF (P < 0.05) and with other lung diseases (P < 0.05) compared to controls.Conclusion
Our results support feasibility of LCI as multicenter endpoint in clinical trials in infants and preschoolers with CF. 相似文献19.
Mark O. Wielpütz Oyunbileg von Stackelberg Mirjam Stahl Bertram J. Jobst Monika Eichinger Michael U. Puderbach Lutz Nährlich Sandra Barth Christian Schneider Matthias V. Kopp Isabell Ricklefs Michael Buchholz Burkhard Tümmler Christian Dopfer Jens Vogel-Claussen Hans-Ulrich Kauczor Marcus A. Mall 《Journal of cystic fibrosis》2018,17(4):518-527
Background
A recent single-centre study demonstrated that MRI is sensitive to detect early abnormalities in the lung and response to therapy in infants and preschool children with cystic fibrosis (CF) supporting MRI as an outcome measure of early CF lung disease. However, the feasibility of multicentre standardisation remains unknown.Objective
To determine the feasibility of multicentre standardisation of chest MRI in infants and preschool children with CF.Methods
A standardised chest 1.5 T MRI protocol was implemented across four specialised CF centres. Following training and initiation visits, 42 infants and preschool children (mean age 3.2 ± 1.5 years, range 0–6 years) with clinically stable CF underwent MRI and chest X-ray (CXR). Image quality and lung abnormalities were assessed using a standardised questionnaire and an established CF MRI and CXR score.Results
MRI was successfully performed with diagnostic quality in all patients (100%). Incomplete lung coverage was observed in 6% and artefacts also in 6% of sequence acquisitions, but these were compensated by remaining sequences in all patients. The range of the MRI score in CF patients was similar across centres with a mean global MRI score of 13.3 ± 5.8. Cross-validation of the MRI against the CXR score revealed a moderate correlation (r = 0.43–0.50, p < 0.01).Conclusion
Our results demonstrate that multicentre standardisation of chest MRI is feasible and support its use as radiation-free outcome measure of lung disease in infants and preschool children with CF. 相似文献20.
Are esophagocrural sutures needed during laparoscopic fundoplication: A prospective randomized trial
Shawn D. St. Peter Ashwini Poola Obinna Adibe David Juang Jason D. Fraser Pablo Aguayo G.W. Holcomb 《Journal of pediatric surgery》2018,53(1):25-29