Minimally Invasive Surgery for Congenital Abdominal Cystic Lesions in Newborns and Infants

Abstract

Background/Aim: In the variety of congenital abdominal cystic lesions (CACL) of different origin, ovarian cyst is the most common intra-abdominal pathology in female neonates. The prognosis and timing of treatment varies depending on the nature of CACL. This study aimed to assess the results of diagnostics and treatment of CACL. Patients and Methods: A retrospective analysis was performed of 39 cases of CACL, with the spectrum including ovarian, enteric, mesenteric and pancreatic origin. Outcome of minimally invasive surgery, open surgery or conservative approach was analyzed. Results: Twenty-eight neonates underwent surgery, while 11 were treated conservatively. Twenty patients were treated with a laparoscopic technique and eight with laparotomy combined with laparoscopy. Final diagnosis included: Fifteen cases of ovarian pathology (ovarian torsion in 11 cases), 12 treated laparoscopically and three with laparotomy, six enteric duplications (four laparoscopic and two laparotomic), three mesenteric cysts (one laparoscopic and two laparotomic), two pancreatic cysts (both laparoscopic only), two duodenal stenoses, including duodenal septum (both laparotomies with Heineke-Mikulicz plasty). No blood transfusion apart from two cases requiring re-laparotomy and no early complications were observed in any case; no death occurred. Conclusion: With the strategy of management based on ultrasound and laboratory data, a laparoscopically assisted minimal access approach resulted in minimal risk of complications and complete recovery in all patients, leading to exclusion of oncological risk.

Giant Gastroduodenal Duplication Cyst with Juxta-Pancreatic Communication

“…Radiologic studies, including abdominal ultrasonography, magnetic resonance imaging or abdominal CT scan, are usually needed for antenatal or postnatal diagnosis. 12 An abdominal CT scan is recommended for postnatal diagnosis due to its ability to document the anatomical relationship with the surrounding structures. 2 As previously mentioned, the current patient had an antenatal diagnosis of duodenal atresia by ultrasound that was ruled-out postnatally.…”

Clinical Spectrum and Outcomes of Neonatal Necrotizing Enterocolitis

“…We previously showed that in case of congenital abdominal cystic lesions, a laparoscopically assisted minimal-access approach resulted in minimal risk of complications and complete recovery in all patients (17). On the other hand, a completely different approach was necessary for patients with Hirschsprung's disease (18).…”

High risk of invasive fungal disease in children undergoing hematopoietic cell transplantation or complex anticancer therapy: the adverse role of post-transplant CMV replication

“…Antifungal prophylaxis introduced in HCT patients and in patients with acute leukemias in 2014-2015, slowed down the increase in incidence of fungal infections from 2016 onwards, although it did not stop it. Looking into possible activities, other options to improve the outcome of IFD might be: wider use of invasive diagnostics, treatment with reference antifungals according to recommendations [9,17], use of minimally-invasive surgery in diagnostics and treatment [32,33], or successful prophylaxis and treatment of viral infections preceding development of IFD [4,34,35]. New diagnostic methods and antifungals may appear.…”