Objective: The aim of this study is using the autologous reverse inlay jugular vein graft as a substitute for defective urethral plate and the incorporation of the graft to the urethral plate. Cripple hypospadias are the patients who have a history of previous multiple unsuccessful hypospadias surgery and still having anatomical and functional complications. Insufficient local or support tissue for the repair of defective urethral plate is always a problem. Material and Methods: In the study fourteen male 8-10 months old which is weighting four kg, New Zealand type rabbit are divided into two equal groups. Juguler vein graft (1st group) and buccal mucosal graft (2nd group) harvested and transferred to defective area in the urethral plate as a free flap. Results: In the histopatologic examination, epithelization, fibrosis and inflammation degrees were evaluated between the groups and in-groups. In the histopatological examination of the 1st group, uroepithelization is complete or nearly complete, fibrotic activity is (+) and the inflammation was found minimal. In the second group after 21st day, the uroepithelization on the graft is nearly thirty percent, fibrotic activity is (++) and the inflammation is also found minimal. Conclusion: From the results of the study, in the treatment of defective urethra in cripple hypospadias cases, reverse free juguler vein graft can be used as an alternative for buccal mucosa graft as a substitution material which has been used for a long time.
Objective: While robot-assisted laparoscopic surgery (RALS) is spreading rapidly all over the world, In pediatric surgery, this spread is slower than in adult surgery for many reasons. In this study, we discuss our initial experiences with pediatric robotic surgical cases. Material and Methods: Robotic-assisted endoscopic surgery between November 2017 and April 2022 was retrospectively reviewed. The medical records of the patients were reviewed retrospectively for some demographical features, surgical details, and follow-up time. Results: Of the 48 children, 27 were male and 21 were female. The youngest of the cases was 10 months old, while the oldest was 17 years old (mean 7.72±5.6, median 7). The shortest follow-up period after surgery was 5 months, while the longest follow-up was 60 months. A total of 63 surgical procedures were performed on 48 pediatric patients. 17 pyeloplasty (left 10, right 7), 9 Lich Gregoir operations (right 6, left 3), 4 ureteral reimplantation and tapering procedures due to left ureterovesical junction obstruction (UJO), 3 Hemi nephrectomy, one appendicovesicostomy, One right ureteral reimplantation, 11 Nissen fundoplication, 10 gastrostomy and one gastrojejunostomy, two ovarian sparing surgeries for ovarian cyst were performed. One urachal remnant excision, one adrenal mass excision, and one thoracic outlet mass excision were performed. Conclusion: This is the first study that includes a wide range of pediatric robotic surgical procedures in our country. Robotic-assisted laparoscopic procedures in pediatric surgery can be safely performed for many surgical pathologies. We think at the beginning some simple surgical procedures and then turning to the more complex procedures after at least 15 cases will be more appropriate.
Foreign body ingestion (FBI) is one of the common causes of emergency admissions in infancy and childhood. Although the large majority of children who present with the FBI have no psychiatric diagnosis, present studies demonstrate that attention deficit hyperactivity disorder (ADHD) and related psychiatric problems might be a risk factor for FBI. This study aimed to compare the demographic variables and attention deficit hyperactivity disorder levels and sluggish cognitive tempo symptoms (ADHD-SCT) in children who ingested foreign bodies with healthy children. Also, we aimed to address the relationship between ADHD-SCT symptoms and the age of FBI. The FBI group comprised 44 children (age 2-8, median age: 5, 68.2% boys) admitted to the emergency, pediatric surgery, and pediatric gastroenterology department after FBI, and the healthy control group comprised 30 children (age 3-8, median age: 6, 56.7% boys). We administered the sociodemographic information form, SNAP-IV ADHD rating scale, and Barkley’s child SCT ratings scale to both groups of parents. Our results demonstrated that maternal education level was significantly lower in the FBI group, although other demographic characteristics of the samples were similar (p=0.023). In addition, ADHD-hyperactivity/impulsivity scores were significantly higher in the FBI group (p=0.01). Still, there were no significant differences in ADHD-inattention, SCT-daydreaming, and SCT-sluggishness scores (for all, p>0.05). We found positive-moderate relationships between SCT-daydreaming and sluggishness symptoms and FBI age (r=0.314, r=0.348, respectively). This means that higher SCT scores are related to an older FBI age. In conclusion, for the first time, we evaluated the ADHD and SCT symptoms in young children against FBI and found that ADHD-hyperactivity, but not ADHD-inattention symptoms, were significantly higher in the FBI group, and SCT symptoms increase the risk of FBI at an older age. In addition, we found that a lower maternal education level could be an additional risk factor for FBI. Despite the high hyperactivity in the FBI group, the low rate of child psychiatry evaluation should be considered when evaluating a child.
Pilonidal sinus disease (PSD) is a common infectious and chronic inflammatory problem in the pediatric age group with no precise incidence data. PSD is more common in the pediatric age group between the ages of 15-17 due to rush routine educational activities in this age group, such as university entrance examinations. It is essential to early back to the daily routine, which the patient and parent highly desire, after treatment in PSD. This study was performed between December 2016 and March 2020. The files of 152 pediatric patients treated for PSD were analyzed retrospectively. The study group included 96 boys (63.2%) and 56 girls (36.8%). Eighty-five patients (55.9%) underwent phenol application, 41 (27.0%) underwent surgery, and 26 (17.1%) children underwent multiple procedures. The mean age of the patients was 16.2±1.39 years. The mean follow-up time was 21.6±12.2 months, and the mean body mass index (BMI) was 25.2±4.4 kg/m2. In the phenol group, the mean age was 16.3±1.2 years, the mean follow-up time was 17.3±9.55 months, and the mean BMI was 24.6±4.31 kg/m2. In the surgical group, the mean age was 16.0±1.74 years, the follow-up time was 35.6±3.82 months, and the mean BMI was 25.6±4.66 kg/m2. The patients' demographic data were gathered age, gender, BMI, type of procedure, number of applications, follow-up, complications, recurrence rate, and postoperative complication. Phenol application has essential advantages over surgical procedures in treating PSD, such as simple application, short hospitalization, cost-effectiveness, and low complication rates. To sum up, the phenol procedure is a straightforward treatment method that reduces complication rates and provides an early return to ordinary life.
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