Anah tar ke li me lerİnvajinasyon, ikiz, genetik, çevresel faktörler

Objective: Persistent Müllerian duct syndrome (PMDS) is a rare congenital disease characterized by the presence of rudimentary Müllerian structures within an intra-abdominal or hernial sac in a virilized male, often presenting as undescended testes. In this study, we aim to present a series of the PMDS patients who were managed by orchiopexy without removal of Müllerian remnants (MR). Material and methods:Between May 2010 and June 2017, we treated six cases diagnosed as PMDS in our department. Laparoscopy and gonadal biopsy were performed in all patients, and vessel ligation was done in four patients for the first session of Stephen-Fowler orchiopexy. After initial diagnosis, genetic analyses and endocrine investigations were performed. Demographic and clinical features of the patients, operative methods and follow-up data were analyzed retrospectively.Results: Mean age of the patients was 5.5 years. Three boys had undergone inguinal surgery due to hernia or undescended testis, while others were diagnosed during laparoscopic investigation of nonpalpable testis. As a definitive operation, testes and MR were completely removed in an adult patient, and the remaining patients were treated with laparoscopic or open orchiopexy with or without utero-cervical splitting and the MRs were left in situ. Two testes atrophied during follow-up period. Conclusion:The goal of the approach in PMDS patients is to preserve testes, as well as carry them to their natural location. Leaving the MR in place is a suitable option for blood circulation of the testes but the longterm results are still unknown.

Our method is a feasible approach for GT placement by the purse-string suturing and the fixation of the stomach to the abdominal wall without extending the port incision.

Omphalocele, exstrophy of cloaca, imperforate anus and spinal defect (OEIS Complex) is an extremely rare combination of serious defects, which was firstly described by Carey and colleagues. Surgical repair of cloacal exctrophy in patients with OEIS complex can be performed at one stage, but it can also be performed safely as staged to minimize the potential complications. In this case report, we aimed to present our early approach to the OEIS complex.

Objectives Postoperative ventilatory strategies in patients with esophageal atresia (EA) and tracheoesophageal fistula (TEF) may have an impact on early postoperative complications. Our national Esophageal Atresia Registry was evaluated to define a possible relationship between the type and duration of respiratory support on postoperative complications and outcome. Study Design Among the data registered by 31 centers between 2015 and 2021, patients with esophago‐esophageal anastomosis (EEA)/tracheoesophageal fistula (TEF) were divided into two groups; invasive ventilatory support (IV) and noninvasive ventilatory support and/or oxygen support (NIV‐OS). The demographic findings, gestational age, type of atresia, associated anomalies, and genetic malformations were evaluated. We compared the type of repair, gap length, chest tube insertion, follow‐up times, tensioned anastomosis, postoperative complications, esophageal dilatations, respiratory problems requiring treatment after the operation, and mortality rates. Results Among 650 registered patients, 502 patients with EEA/TEF repair included the study. Four hundred and seventy of patients require IV and 32 of them had NIV‐OS treatment. The IV group had lower mean birth weights and higher incidence of respiratory problems when compared to NIV‐OS group. Also, NIV‐OS group had significantly higher incidence of associated anomalies than IV groups. The rates of postoperative complications and mortality were not different between the IV and NIV‐OS groups. Conclusion We demonstrated that patients who required invasive ventilation had a higher incidence of low birth weight and respiratory morbidity. We found no relation between mode of postoperative ventilation and surgical complications. Randomized controlled trials and clinical guidelines are needed to define the best type of ventilation strategy in children with EA/TEF.

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One of the main issues in the penile surgery is wound dressing. There are several varied methods have been reported for circumcision or hypospadias dressing. We aim to report our experiment with Coban™ dressing in penile surgery.

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