SummaryBackgroundGastrointestinal tract duplication is a rare malformation associated with the presence of additional segment of the fetal gut. The aim of this study was to retrospectively review clinical features and imaging findings in intraoperatively confirmed cases of gastrointestinal tract duplication in children.Material/MethodsThe analysis included own material from the years 2002–2012. The analyzed group included 14 children, among them 8 boys and 6 girls. The youngest patient was diagnosed at the age of three weeks, and the oldest at 12 years of age.ResultsThe duplication cysts were identified in the esophagus (n=2), stomach (n=5), duodenum (n=1), terminal ileum (n=5), and rectum (n=1). In four cases, the duplication coexisted with other anomalies, such as patent urachus, Meckel’s diverticulum, mesenteric cyst, and accessory pancreas. Clinical manifestation of gastrointestinal duplication cysts was variable, and some of them were detected accidently. Thin- or thick-walled cystic structures adjacent to the wall of neighboring gastrointestinal segment were documented on diagnostic imaging.ConclusionsUltrasound and computed tomography are the methods of choice in the evaluation of gastrointestinal duplication cysts. Apart from the diagnosis of the duplication cyst, an important issue is the detection of concomitant developmental pathologies, including pancreatic heterotopy.

Background/Aim: The objective of the study was to propose clinical guidelines for the use of minimally invasive surgery (MIS) in pediatric oncology. Patients and Methods: Two groups of experts, including pediatric surgeons and pediatric oncologists were created in order to establish strategies of diagnostic and therapeutic surgical management in pediatric oncology. Results: On the basis of the analysis of the existing literature, we elaborated guidelines that were graded according to the simple practical clinical system: yes/no. This project was dedicated to the following topics: adrenal tumors including neuroblastoma, renal tumors including Wilms tumor (nephroblastoma), ovarian tumors and pulmonary nodules and metastases (osteosarcoma). Conclusion: Although existing data do not allow the recommendation of the use of MIS for all indications, this technique should currently be regarded as a standard of care in several areas of pediatric oncology. Minimally invasive surgery (MIS), in contrast to open surgery, is a technique that limits the size of incisions that allow access to peritoneal or thoracic cavities, followed by the use of laparoscope or thoracoscope for visualization and precise dissection. The same target operation should be performed via an open technique or a minimally invasive approach (1-3). The concept of MIS in children with cancer was used for the first time by Holocomb et al. (4), who showed laparoscopy and thoracoscopy to be highly accurate with minimal morbidity for the patient. Both modalities were useful for biopsies, assessment of resectability, staging, evaluation of metastatic or recurrent disease, assessing the potential benefit of second-look procedures, and for diagnosis of infectious complications. The development of this technology has been possible with improved visualization of anatomical structures (5). Subsequent studies and analyses confirmed that MIS procedures in pediatric oncology are safe and effective, resulting in earlier administration of adjuvant therapy. MIS is a developing concept, however in contrast to many areas in adults (6-8), there are no clear guidelines or recommendations in pediatric oncology, mainly due to heterogeneity of clinical diagnoses and small numbers of patients included in the studies. Thus, the aim of this study was to propose clinical guidelines for the use of MIS in pediatric oncology. Guideline Development Overview Two initial groups of experts, including pediatric surgeons and pediatric oncologists were created in order to establish strategies of diagnostic and therapeutic surgical management in pediatric oncology. According to our own experience the relevant issues of MIS utilization in pediatric oncology were defined as follow: adrenal tumors including neuroblastoma (NBL), renal tumors including Wilms tumor (WT), ovarian tumors, pulmonary nodules and metastases. The main desired outcome was evidence of a reduction in open surgery, and secondary outcomes included efficacy and safety, expressed as rate of complications. We performed Pub Med sea...

Introduction: Haemangioma, one of the most common benign neoplasms of early childhood, is a significant clinical problem due to cosmetic reasons but also because of possible health complications. Aim: Presentation of the method and results of treatment of infantile haemangiomas (IHs) using propranolol in a maximum dose of 3 mg/kg/day. Material and methods: In 2013 to 2018 there were 108 patients with IHs multidisciplinary diagnosed and treated. 77 of them were girls and 31 were boys; all were between the ages of 2 and 21 months (mean: 6.87 months). Lesions were most often located in the head region (n = 73). The main imaging study assessing the arteriovenous flow was USG, which was used to assess the size of haemangioma and its regression or progression. Also, coagulation parameters were analysed using laboratory tests. Results: Reduction of lesions occurred in 103 of 108 patients, which results in a percentage score above 95. In 19 patients, after completion of treatment, there were abnormalities of coagulation in laboratory tests whereas before the treatment, these abnormalities occurred in 82 patients. The average duration of treatment was longer than 12 months and the maximum dose of propranolol of 3 mg/kg/day was achieved after 3 to 5 months of treatment. Side effects occurred totally in 19 patients, with night anxiety and nightmares being the most common. Conclusions: After achieving the maximum dose of the drug later than recommended in the Recommendation of the Polish Haemangioma and Vascular Malformations Group criteria, there was no need for longer therapy, while the effectiveness of the treatment remained unchanged. Side effects that occurred were not life-threatening or detrimental to the health of patients.

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