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1.
Little DC Shah SR St Peter SD Calkins CM Morrow SE Murphy JP Sharp RJ Andrews WS Holcomb GW Ostlie DJ Snyder CL 《Journal of pediatric surgery》2006,41(5):914-918
Background
Children with esophageal foreign bodies are frequently seen by pediatric surgeons. Choking and dysphagia are common presentations; however, esophageal perforation has been reported. Historically, rigid esophagoscopy with extraction of the foreign body has been the recommended treatment. Alternatively, Foley balloon extraction is a safe and effective approach.Methods
Over a 16-year period, 555 children presented with an esophageal foreign body. Retrospective analysis of the medical record was undertaken. Statistics were by univariate analysis.Results
Two hundred ninety-eight boys and 257 girls presented with a mean age of 3.24 years. Dysphagia (37%) and drooling (31%) were the most common symptoms. Foreign bodies were lodged in the superior esophagus in 73%, and 88% of the objects were coins. Balloon extraction with fluoroscopy was performed in 468 children. Eighty percent of the objects were successfully removed with a mean fluoroscopy time of 2.2 min, and 8% were advanced into the stomach. The overall success rate was 88%, with failures necessitating rigid esophagoscopy under general anesthesia. Children younger than 1 year were the most likely to fail (25% failure rate). Airway aspiration never occurred. Significant savings in patient charges were observed with this approach.Conclusions
Balloon extraction of pediatric esophageal foreign bodies is a safe and cost-effective procedure. This technique is applicable for infants, children, and adolescents. Experienced practitioners should be able to achieve greater than 80% success rate. 相似文献2.
Kanamori Y Sugiyama M Hashizume K Yuki N Morotomi M Tanaka R 《Journal of pediatric surgery》2004,39(11):1686-1692
Background/Purpose
Probiotic and prebiotic therapies are potent new strategies to treat various intestinal diseases, including inflammatory bowel disease and viral and bacterial infections. Synbiotics is defined as the combined use of probiotics and prebiotics and is expected to have a stronger effect on intestinal diseases than probiotics or prebiotics alone, but there has been no report of its clinical application. The authors designed a protocol for synbiotic therapy composed of Bifidobacterium breve, Lactobacillus casei, and galactooligosaccharides and preliminarily ascertained its clinical effects in humans.Methods
This protocol of synbiotic therapy was applied for more than 1 year to 7 malnourished patients with short bowels who suffered from refractory enterocolitis.Results
The therapeutic protocol improved the intestinal bacterial flora (inducing the domination by anaerobic bacteria and suppressing the residence of pathogenic bacteria) and increased short chain fatty acids in the feces (from 27.8 to 65.09 μmol/g wet feces). All patients but 1 accelerated their body weight gain, and 5 patients showed increased serum rapid turnover proteins.Conclusions
This protocol for synbiotic therapy might be a potent modulator of intestinal flora and a promising strategy to treat short bowel patients with refractory enterocolitis. 相似文献3.
Robert J. Tibesar Andrew R. Scott Christopher McNamara Timothy A. Lander James D. Sidman 《Otolaryngology--head and neck surgery》2010,143(1):90-96
Objective
To determine the long-term results of distraction osteogenesis of the mandible for upper airway obstruction in children with micrognathia.Study Design
Case series with chart review.Setting
Tertiary care children's hospital.Subjects and Methods
The records of a pediatric otolaryngology practice and tertiary children's hospital were searched for patients treated with bilateral mandibular distraction osteogenesis for upper airway obstruction. Patients were selected if greater than three years of follow-up data were available. Data were analyzed for airway and feeding outcomes, and long-term surgical complications were identified.Results
Thirty-two patients met study criteria. Of the 11 patients who had tracheotomy prior to distraction, seven were decannulated after the procedure. Seventeen patients needed perioperative gastrostomy. Seven are now able to feed orally. Fifteen patients treated with mandibular distraction were able to avoid gastrostomy tube placement altogether. The complication of open bite deformity was experienced by nine patients (28%). Five of 32 patients (16%) had tooth malformation, tooth loss, or dentigerous cyst formation while an additional three patients (9%) had long-term facial nerve injury. Nineteen patients (59%) were under three months old at the time of their distraction. Only one of these patients (5.2%) required an additional distraction procedure.Conclusion
Long-term follow-up data on patients treated with mandibular distraction for upper airway obstruction show sustained airway improvement. Additionally, micrognathic children treated with distraction have improved outcomes in oral feeding with a relatively low rate of long-term complications. It remains important to follow these patients to monitor the need for secondary reconstructive procedures. 相似文献4.
Introduction
Most patients with recurrent painless rectal bleeding warrant endoscopic examination of the lower gastrointestinal tract. This is often limited to rectum or distal colon. The purpose of this study was to compare the diagnostic yield of limited colorectal endoscopy with total colonoscopy in children with recurrent painless rectal bleeding.Methods
Retrospective review of 314 patients aged 1 to 15 years who underwent colorectal endoscopy for recurrent rectal bleeding. Two hundred six underwent total colonoscopy, whereas 108 patients had endoscopy limited to the rectum in 22, sigmoid colon in 34, descending colon in 43, and transverse colon in 9. Diagnoses were recorded according to the endoscopic and histological findings.Results
After total colonoscopy, a diagnosis was established in 70% of children compared with 35% of those undergoing limited endoscopy (P < .001). This difference was most noticeable in children with inflammatory bowel disease. Juvenile polyps were diagnosed with similar frequency in both groups, reflecting the rectosigmoid distribution of most polyps.Conclusions
For children presenting with painless rectal bleeding, a diagnosis can be established in the majority if total colonoscopy is performed. This is particularly true for inflammatory bowel disease. Unless a rectal polyp is suspected, full colonoscopy should be planned. 相似文献5.
Even L Lea E Heno N Nawaf H Talmon Y Yoav T Samet E Elvin S Zonis Z Ze'ev Z Kugelman A Amir K 《Journal of pediatric surgery》2005,40(7):1122-1127
Aim
The aim of this study was to evaluate the yield of clinical symptoms, signs, and radiological studies in the diagnosis of foreign body aspiration (FBA) in children.Methods
During the 2-year study, we performed on all children admitted to the pediatric department for suspected FBA a protocol that included the following: thorough medical history, physical examination, radiological studies (chest x-ray and fluoroscopy), and rigid bronchoscopy by a senior otolaryngologist. The yield of these measures for the diagnosis of FBA was evaluated.Results
Foreign bodies were found in 56 (57%) of the 98 children with suspected FBA. Thirty-three (59%) children were boys and 23 (41%) girls (P < .05), with a mean age of 24 months (range, 8-84 months). Main symptoms in the children with FBA were the following: choking (76.8%), prolonged cough (14.3%), dyspnea (3.6%), and nonresolving pneumonia (1.8%). Physical examination, chest x-ray, and fluoroscopy findings were abnormal in 80.4%, 67.9%, and 46.9% of the children with FBA, respectively. The diagnostic yield of physical examination and radiological studies increased 24 hours after the event of FBA. In 45.2% of the children with positive history but with normal findings from physical examination and radiological studies, foreign bodies were found. Of the children with “doubtful” history, physical examination, chest x-ray, and fluoroscopy findings were abnormal in 58%, 38%, and 12.5%, respectively. Foreign bodies were found in 9.5% of these children.Conclusion
Medical history is the key for the diagnosis of FBA. Choking followed by an acute episode of coughing is the most common presentation of FBA. The yield of physical examination and radiological studies in the diagnosis of FBA is relatively low but is increased when the presentation is delayed and when history is doubtful. If FBA is suspected, bronchoscopy should be performed. 相似文献6.
Otsuji E Kuriu Y Ichikawa D Okamoto K Hagiwara A Yamagishi H 《American journal of surgery》2005,189(1):116-119
Background
We sought to define differences between multifocal and solitary gastric carcinoma to decrease the risk of missing a cancer while resecting another more evident carcinoma.Methods
We retrospectively examined clinicopathologic characteristics of multifocal gastric carcinoma including anatomic distribution and postoperative survival.Results
Multifocal gastric carcinoma was seen more frequently when patients were older and when the largest tumor was small and at an early stage. More than half of accessory lesions were located near the main tumor. No significant difference in postoperative survival was seen between patients with multifocal and solitary carcinoma, whether early or advanced.Conclusions
The entire stomach should be examined carefully before and during resection, especially when local or endoscopic surgery is performed. 相似文献7.
Purpose
Biliary microlithiasis is an uncommon but recognized cause of upper abdominal pain, cholecystitis, cholangitis, and pancreatitis in adults. Gallstones smaller than 3 mm may not be seen on transabdominal ultrasound and may only be seen on endoscopic ultrasound. This condition is poorly described in children. The aim of this study is to review the results of laparoscopic cholecystectomy to treat biliary microlithiasis in a pediatric case series.Methods
We performed a retrospective case review of children with biliary microlithiasis who were treated with laparoscopic cholecystectomy.Results
Three children were diagnosed with biliary microlithiasis. Two patients had recurrent right upper quadrant pain and nausea. A third patient had midepigastric pain and idiopathic pancreatitis. All 3 had a normal gallbladder on transabdominal ultrasound. Additional imaging with hepatobiliary scan, computed tomography, and magnetic resonance cholangiopancreatography revealed no biliary source for symptoms. Endoscopic ultrasound was performed on all 3 children, demonstrating microlithiasis of the gallbladder. Each child had a laparoscopic cholecystectomy with intraoperative cholangiogram. No abnormalities were seen on intraoperative cholangiogram. All 3 children had alleviation of pain and improvement of symptoms in postoperative follow-up.Conclusion
Children with biliary microlithiasis and associated clinical symptoms can be successfully treated with laparoscopic cholecystectomy. Endoscopic ultrasound should be considered in the evaluation of the child with clinical biliary symptoms and a negative transabdominal ultrasound result. 相似文献8.
Jones VS Soundappan SV Cohen RC Pitkin J La Hei ER Martin HC Cass DT 《Journal of pediatric surgery》2007,42(8):1386-1388
Background
The diagnosis of intestinal injuries in children after blunt abdominal trauma can be difficult and delayed. Most children who suffer blunt abdominal trauma are managed nonoperatively, making the diagnosis of intestinal injuries more difficult. We sought to gain information about children who develop intestinal obstruction after blunt abdominal trauma by reviewing our experience.Methods
Review of records from a pediatric tertiary care center over an 11.5-year period revealed 5 patients who developed small bowel obstruction after blunt trauma to the abdomen. The details of these patients were studied.Results
All patients were previously managed nonoperatively for blunt abdominal trauma. Intestinal obstruction developed 2 weeks to 1 year (median, 21 days) after the trauma. Abdominal x-ray, computerized tomography scan, or barium meal studies were used to establish the diagnosis. The pathology was either a stricture, an old perforation, or adhesions causing the intestinal obstruction. Laparotomy with resection and anastomosis was curative.Conclusions
Posttraumatic small bowel obstruction is a clinical entity that needs to be watched for in all patients managed nonoperatively for blunt abdominal trauma. 相似文献9.
Hui H Na L Zhijun C Zhijun CJ Fugao Z Fugao ZG Yan S Niankai Z Niankai ZK Jingjing C Jingjing CJ 《Journal of pediatric surgery》2008,43(4):718-721
Purpose
Tracheobronchial foreign body (TFB) aspiration is a life-threatening emergency for children. Knowing how to reduce the incidence of complications and mortality during the management of TFB is critically important.Methods and Patients
Pediatric patients with TFB, who were treated in the Department of Otorhinolaryngology-Head and Neck Surgery, The Affiliated Hospital of Medical College Qingdao University, Qingdao, Shandong Province, China, were included in this analysis during 1985 to 2007. One thousand four hundred twenty-eight patient records with TFB were retrospectively reviewed. This study mainly reported location and type of foreign body, complications, anesthesia methods, and outcome.Results
Among the 1428 patients, 1424 (99.72%) underwent successful removal of a foreign body by bronchoscopy. First-attempt removal was successful in 1347 whose bronchoscopy was done under general anesthesia combined with topical anesthesia and in 65 cases with inhaled anesthesia by ether combined with topical anesthesia, respectively. Second-attempt removal was successful in 12 patients whose bronchoscopy was done under inhaled anesthesia by ether combined with topical anesthesia. Foreign bodies were located in the trachea in 75 cases (5.25%), right bronchial tree in 780 patients (54.62%), left bronchial tree in 567 cases (39.71%), and bilateral bronchial tree in 6 cases (0.42%). Types of foreign body included peanuts (1244 cases, 87.12%), beans (93 cases, 6.51%), and others (91 cases, 6.37%). Tracheotomy was performed in 4 patients. Three patients (0.21%) died in this study. Four patients developed toxicity from tetracaine during topical anesthesia.Conclusions
Bronchoscopy under general anesthesia augmented with topical anesthesia is a very safe and effective procedure for patient with TFB. Surgeons and anesthetists must be aware of the risk of tetracaine toxicity and other complications. 相似文献10.
Purpose
Helicobacter pylori infection is common in Asia and is associated with dyspepsia, peptic ulcer, and gastric cancer. Eradication of the organism remains an important goal. Here, we looked at the trends in the prevalence of H pylori in symptomatic children over an 8-year period to assess the impact of an aggressive eradication program.Method
A retrospective review was carried out between 1997 and 2004. All children with a history of dyspepsia or acute gastrointestinal bleeding were included and underwent gastroscopy. Three antral biopsies were taken during endoscopy and sent for histological analysis. Positivity of H pylori was treated aggressively with quadruple therapy under protocol. The demographic data, the histological findings, and the H pylori status were recorded.Results
There were a total of 159 patients (71 males, 88 females) who underwent gastroscopy in this period. One hundred nineteen patients showed histological evidence of gastritis, and the positive rate of H pylori was 25.6%. The overall prevalence has not decreased (33.3% in 1997, 27.7% in 2004). Increasing age, however, was associated significantly with the higher risk of H pylori infection.Conclusion
H pylori has a high prevalence in Chinese children with increasing age. Eradication efforts seem to be unsuccessful in the reduction of prevalence. We hypothesize that this may be owing to cross-infection at meal times from sharing chopsticks. 相似文献11.
Purpose
Children with intestinal failure (IF) often have gastrointestinal (GI) symptoms, including bleeding, increased stool output, and feeding intolerance. The use of endoscopic assessment of these symptoms has not been previously reported. This report evaluates the diagnostic yield of GI endoscopy in the setting of IF.Methods
After institutional review board approval, we reviewed the medical records (including endoscopy, pathology and microbiology data) of patients with IF who underwent GI endoscopies between September 1999 and March 2007.Results
Twenty-seven patients underwent 61 GI endoscopies: 34 esophagogastroduodenoscopies, 17 colonoscopies, 7 flexible sigmoidoscopies, and 3 ileoscopies. Indications for endoscopy, which were not mutually exclusive, included chronic diarrhea (39%, n = 24), GI bleeding (36%, n = 22), suspected bacterial overgrowth (36%, n = 22), and suspected peptic disease (15%, n = 9). Based on gross endoscopic appearance, histopathology, or microbiology, 43 (70%) procedures yielded abnormalities. These included infectious (20%, n = 12), anatomical (18%, n = 11), peptic (15%, n = 9), allergic (15%, n = 9), and other (2%, n = 1) findings. Eleven (73%) of 15 duodenal cultures grew a spectrum of 17 bacterial species. Overall, 24 (89%) of 27 patients had gross endoscopic, histopathologic, or microbiologic abnormalities.Conclusions
In pediatric patients with IF, diagnostic upper and lower GI endoscopies yield high rates of abnormalities and can help guide clinical management. 相似文献12.
Background/Purpose
The authors had noted a number of children who had sustained burn injuries from the exhaust systems of recreational vehicles and wished to document the incidence of pediatric burn injury sustained from the exhaust systems of a wide scope of motorized vehicles.Methods
The authors conducted a 10-year retrospective chart review including all children admitted to our institution with burn injuries from contact with vehicular exhaust systems.Results
Twenty-three children were included. There were 18 boys, with a median patient age of 7 years. Most children (7 of 23) were injured from the exhaust systems of all-terrain vehicles. The average burn size (5%) was small, but almost two thirds of the burn injuries were full thickness. Of the 23 children, 21 required operative intervention for their burns, with 2 children requiring multiple surgical interventions. The average length of hospital stay was 11 days, and all children, except one who went to a rehabilitation facility, were discharged to home.Conclusions
Pediatric health care providers should be aware that exhaust system contact burns in children are not rare events and they do tend to be significant. Surgical consultation should be requested early in the management of these particular burn injuries in children. 相似文献13.
Wiersma R 《Journal of pediatric surgery》2008,43(8):1520-1523
Introduction
Bladder exstrophy is an uncommon condition, and the ramifications for patients living in a Third World environment are extensive.Patients and Methods
This was a retrospective study of 57 patients, managed between 1983 and 2006. The review looked at the home environment, clinical findings, treatment provided, and short-term outcome.Results
Of the 57 patients, 19 were born in metropolitan and 38 in rural hospitals. Twenty-four patients (42%) were referred on the first day of life, 21 (37%) within the first week, and 12 patients (21%) were older than 1 week of life. Associated congenital anomalies were seen in 18 patients (32%). Twelve patients died in hospital, the remaining 45 were discharged. Thirty three patients returned for review; their ages ranged from 2 to 17 years (median, 3 years). The overall mortality was 42%. On follow-up, urinary incontinence was the main complaint, which greatly affected the child's schooling and social life.Conclusion
Bladder exstrophy is an uncommon condition. The associated congenital abnormalities together with the impoverished environment result in a poor prognosis. Antenatal screening, early referral, and establishing urinary continence are factors that will improve the outcome in children with this condition in a Third World environment. 相似文献14.
15.
Miyano G Yamataka A Kato Y Tei E Lane GJ Kobayashi H Sueyoshi N Miyano T 《Journal of pediatric surgery》2004,39(12):1867-1870
Purpose
Is laparoscopic injection of 2-octyl-cyanoacrylate tissue adhesive (Dermabond: Db) into the inguinal hernia sac (IHS) effective for inguinal hernia repair?Methods
Thirty male 4-week-old Lewis rats were used as subjects for this study. In the right Db (R-Db) group (n = 10), a fine catheter was passed through an 18-guage indwelling intravenous cannula inserted in the right lower quadrant, and 0.2 mL Db was injected into the right IHS under laparoscopic control. The left side was not treated. Both IHSs were treated in the bilateral Db (B-Db) group (n = 10). In the no Db (N-Db or control) group (n = 10), only laparoscope insertion was performed. Herniography was performed before death. B-Db and N-Db rats were mated 50 days after treatment. Half of all rats were killed 2 months after treatment and the remaining half 12 months after treatment.Results
All rats survived until killing. Macroscopic findings postdeath confirmed herniography results; treated IHS were closed, and untreated IHS were patent. There were minor adhesions in 3 of 20 treated rats. Sperm were identified in the vaginas of all mated rats.Conclusions
These results suggest that our new technique is simple, safe, and reliable as an alternative to standard operative repair for inguinal hernia. 相似文献16.
Romeo E Foschia F de Angelis P Caldaro T Federici di Abriola G Gambitta R Buoni S Torroni F Pardi V Dall'oglio L 《Journal of pediatric surgery》2011,46(5):838-841
Background/Purpose
Congenital esophageal stenosis (CES) is a rare malformation. Endoscopic dilations represent a therapeutic option. This study retrospectively evaluated the efficacy and safety of a conservative treatment of CES.Patients and Methods
Patients diagnosed with CES since 1980 by a barium study or endoscopy were reviewed. Endoscopic ultrasonography (Olympus UM-3R-20-MHz radial miniprobe, Olympus Corporation, Tokyo, Japan), available from 2001, allowed for the differential diagnosis of tracheobronchial remnants (TBR) and fibromuscular hypertrophy (FMH) CES. All children underwent conservative treatment by endoscopic dilations (hydrostatic and Savary).Results
Forty-seven patients (20 men) had CES. Fifteen were associated with esophageal atresia; and 8, with Down syndrome. Mean age at the diagnosis was 28.3 months (range, 1 day to 146 months). Symptoms were solid food refusal, regurgitation, vomiting, and dysphagia. Congenital esophageal stenosis was located in the distal esophagus. Endoscopic ultrasonography demonstrated TBR and FMH in 6 patients. One hundred forty-eight dilations in 47 patients were performed. The stenosis healed in 45 (95.7%). Complications were 5 (10.6%) esophageal perforations, hydrostatic (3/32, or 9.3%), and Savary (2/116, or 1.7%). At follow-up, 1 patient with FMH CES and 1 patient with TBR CES required operation for persistent dysphagia.Conclusions
The conservative treatment yielded positive outcomes in CES. Endoscopic ultrasonography allows for a correct diagnosis of TBR/FMH CES. A surgical approach should be reserved for CES not responsive to dilations. 相似文献17.
Background/purpose
The natural history and management of pediatric duodenal injuries are incompletely described. This study sought to review injury mechanism, surgical management, and outcomes from a collected series of pediatric duodenal injuries.Methods
A retrospective chart review was conducted for a 10-year period of all children less than 18 years old treated for duodenal injuries at 2 pediatric trauma centers.Results
Forty-two children were treated for duodenal injuries. There were 33 blunt and 9 penetrating injuries. Injuries were classified using the Organ Injury Scale for the Duodenum. Twenty-four patients underwent operative management by primary repair (18), duodenal resection and gastrojejunostomy (4), or pyloric exclusion (2). Duodenal hematomas were treated nonoperatively in 94% of cases. The average ISS for operative versus nonoperative cases was 23 and 10, respectively. Delay in diagnosis or operative intervention (>24 hours) was associated with increased complication rate (43% v 29%) and hospitalization (32 v 20 days). Nine children requiring surgery experienced delays and were most highly associated with foreign body, child abuse, and bicycle injuries. There were no deaths caused by duodenal injuries.Conclusions
Duodenal injuries in children were predominantly blunt and had a low mortality rate. When surgery was required, primary repair was usually feasible. 相似文献18.
Background
Chronic pancreatitis requiring surgery is rare in children. We review our experience in treating pediatric chronic pancreatitis with longitudinal pancreaticojejunostomy (LPJ).Methods
Records of children with chronic pancreatitis treated with LPJ between 1997 and 2003 were reviewed. Demographic data, associated conditions, endoscopic interventions, operative procedures, postoperative complications, length and costs of hospitalization, and long-term outcome were recorded.Results
Four patients (one girl), 3 to 16 years old, underwent LPJ. Associated conditions included bile duct obstruction (2), single (1) or multiple (1) pancreatic duct strictures, recurrent familial pancreatitis (1), pseudocyst (1), Down's syndrome (1), and duodenal web (1). Preoperative endoscopic stenting was performed in two patients. All were on restricted diets, one on parenteral nutrition. Pre-LPJ, each child had 3 to 6 admissions for pancreatitis with mean total cost of $39,000, excluding diet charges. At surgery, two patients required biliary diversion for persistent biliary obstruction in addition to LPJ. Postoperatively, no patient developed fistulas or anastomotic leaks. There were no deaths. The median length of hospitalization post-LPJ was 8 days with mean cost of US$37,000. All patients resumed a normal diet post-LPJ. There were no recurrences of pancreatitis with follow-ups between 2 and 6 years.Conclusion
Longitudinal pancreaticojejunostomy is safe and cost-effective for treating pediatric chronic pancreatitis. It has minimal complications and frees patients from pancreatitis-related hospitalizations. 相似文献19.
Background
Lung nodules that develop in children with cancer may represent metastatic disease or other conditions potentially requiring aggressive treatment. Thoracoscopic methods have been used for nodule resection; however, lesions deep in the lung parenchyma can be difficult to visualize. Fluoroscopic-guided thoracoscopic surgical resection after computed tomography (CT)-guided localization using microcoils has been described in the adult literature and has the potential to assist in the resection of deep pulmonary nodules in children.Methods
Six patients (ages 6-15 years) with an undiagnosed pulmonary nodule were treated using a combined CT-guided microcoil localization/fluoroscopic video-assisted thoracoscopic surgical technique. Preoperatively, a platinum-fibered microcoil was deployed with the deep end of the coil placed either through or in the vicinity of the pulmonary nodule and the superficial end coiled on the pleural surface. The nodule and coil were then resected with endoscopic staplers guided by fluoroscopy and video-assisted thoracoscopic surgical.Results
Computed tomography-guided microcoil localization and fluoroscopic-guided thoracoscopic resection were successful and critically influenced the management of all patients. Three patients were diagnosed with malignancy (2 metastatic diseases and 1 Hodgkin disease). A diagnosis of nonmalignant disease was made in 3 patients (granuloma, eosinophilic granuloma, and aspergilloma).Conclusion
In the pediatric population, we have successfully applied a previously described adult technique using CT-localized microcoils to direct fluoroscopic-guided thoracoscopic surgical resection of pulmonary nodules. 相似文献20.
Gutiérrez San Román C Barrios JE Lluna J Ibañez V Hernández E Ayuso L Valdes E Roca A Marco A García-Sala C 《Journal of pediatric surgery》2006,41(11):1870-1873