Preoperative computer tomography (CT) guidance localization utilizing a percutaneous guidewire before thoracoscopic resection is safe and beneficial in children with pulmonary nodules less than 1 cm in size or located deep in the pleural surface. This paper describes a successful thoracoscopic resection of a little subpleural pulmonary metastasis of a Wilm's tumor in a 5-year-old child utilizing preoperative CT-guided wire localization of the lesion. The thoracoscopic procedure was performed with the use of two ports, the nodule was easily localized,and the pulmonary wedge resection was made by the use of an endo-GIA linear stapling device after guidewire removal. The operating time was 45 minutes and the chest tube was removed after 48 hours. The postoperative course was uneventful, and the child was discharged on postoperative day 5. This technique allows the surgeon to resect little pulmonary nodules, avoiding the need of more invasive procedures as standard thoracotomy without adjunctive morbidity and with good cosmetic results.
Preoperative computer tomography (CT) guidance localization utilizing a percutaneous guidewire before thoracoscopic resection is safe and beneficial in children with pulmonary nodules less than 1 cm in size or located deep in the pleural surface. This paper describes a successful thoracoscopic resection of a little subpleural pulmonary metastasis of a Wilm's tumor in a 5-year-old child utilizing preoperative CT-guided wire localization of the lesion. The thoracoscopic procedure was performed with the use of two ports, the nodule was easily localized,and the pulmonary wedge resection was made by the use of an endo-GIA linear stapling device after guidewire removal. The operating time was 45 minutes and the chest tube was removed after 48 hours. The postoperative course was uneventful, and the child was discharged on postoperative day 5. This technique allows the surgeon to resect little pulmonary nodules, avoiding the need of more invasive procedures as standard thoracotomy without adjunctive morbidity and with good cosmetic results.
Neonatal mastitis with possible abscess complication is relatively rare. The most common causal agent is Staphylococcus aureus. The paper describes the case of a newborn of 8 days of life, with fever and bilateral mastitis. The newborn was treated with antibiotic therapy with vancomicin and gentamicin and required the right breast surgical drainage for abscess complication. Culture of the pus yielded a pure growth of methicillin-resistant Staphylococcus aureus. The mother of the newborn presented with mastitis that developed a few days earlier. Complications of neonatal mastitis are rare nonetheless cellulitis, fasciitis, osteomyelitis, meningitis, brain abscess and sepsis have been reported. It is therefore essential to treat the mastitis of the newborn promptly and take into consideration the possible resistance of Staphylococcus that is the main etiological agent. Therefore, possible abscess complications need to be treated surgically.
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