Background The creation of a joint between two bowel ends in newborns and infants is one of the core surgical procedures in pediatric surgery. For a proper and perfect gastrointestinal (GI) anastomosis, the factors to be considered are intraoperative duration, restoration of normal GI function, effective hemostasis, reduction of tissue damage, and prevention of postoperative mortality and morbidity. The safety and efficacy of stapled GI tract anastomosis in adults have been extensively documented; however, available literature on the same is limited for infants. Materials and methods Fifty-six patients were divided into two groups—stapled group and hand-sewn group. Patients operated on both emergency and elective basis were included in the study. Hand-sewn anastomosis was done by either end-to-end single-layer or double-layer anastomosis. Suture material used for the anastomosis was Vicryl 3-0 or Vicryl 4-0. Stapled anastomosis was done by 55 mm linear cutting GI stapler with side-to-side anastomosis. Results The present study included a total of 56 patients; there were 28 neonates and 28 infants; 37 of them were males. The most common clinical presentations were vomiting, abdominal distention, refusal to feed, and lethargy. The intraoperative duration in stapled GI anastomosis was less when compared to hand-sewn anastomosis, so was the return of bowel activity and consequently early initiation of feeds and shorter hospital stay. Conclusion The present study favors stapled over hand-sewn GI anastomosis in infancy in view of decreased intraoperative duration, reduced blood loss, early return of peristalsis, early initiation of feeds, and shorter duration of hospital stay. However, a small number of patients and lack of matching are the shortcomings of this study. How to cite this article Mitra AS, Chandak U, Kulkarni KK, et al. Stapled vs Conventional Hand-sewn Gastrointestinal Anastomosis during Infancy: A Prospective Comparative Study from Central India. Euroasian J Hepato-Gastroenterol 2020;10(1):11–15.
Sacrococcygeal teratoma is considered the most common tumor in the neonatal period with a female-to-male ratio of 3–4:1. They are believed to arise early in gestation from the totipotential cells of Hensen’s node and the derived ectoderm, mesoderm, and endoderm. A 2.25 kg cesarean-delivered male, term neonate presented with large nonpulsatile, globular erythematous mass with lobulated surface and variable consistency. Magnetic resonance imaging of the lumbosacral spine showed multilocular cystic and solid lesion with foci of calcification and subtle communication with spinal canal. Histopathological examination showed mature endodermal, ectodermal, and mesenchymal elements such as cartilage, glial tissues, keratin cyst, and glandular elements with focus of primary neuroepithelial and pancreatic elements. Entire tumor was excised. The baby expired secondary to wound infection. Early diagnosis by improving antenatal care with timely surgical intervention and good nursing care improves the outcome.
Accidental impaction of objects in the respiratory passage is a life-threatening condition. A 9-month-old male infant was admitted with fever, cough and respiratory distress without history of choking. He was treated as wheezy bronchitis with appropriate therapy but, did not show response. HRCT showed an impacted foreign body in the trachea which caused a partial luminal compromise. Two attempts to remove foreign body by rigid bronchoscope failed, and tracheostomy was performed due to fall in oxygen saturation. After stabilization, again saturation was falling and air entry was absent on right hemithorax. Considering the possibility of movement of foreign body in right bronchus, bronchoscope was reintroduced and foreign body was removed in piecemeal. This process was complicated with cardiorespiratory arrest, twice from which the patient was revived. Postoperative period was uneventful. So, high index of suspicion is required to diagnose such a foreign body of the tracheobronchial tree to prevent morbidity and mortality.
Solid pseudopapillary tumour (SPN), also known as Frantz tumour is a peculiar tumour of unknown origin. It accounts for 2.5 % of resected pancreatic neoplasms. It is a low-grade malignant potential tumour. In completely resected tumours, it has good survival rate. We report a case series of 4 cases of solid-pseudopapillary tumour of the pancreas. In all 4 cases, the tumour was completely resected with enucleation done in one patient and histopathology showed solid pseudopapillary tumour. Patients are in follow-up with no metastasis and in good health. Due to the rarity of the tumour and good survival with complete resection, studies are required for its deeper understanding.
INTRODUCTION We reported congenital mature cystic teratoma of parotid that presented as a swelling in the left parotid gland region since birth, increasing in size gradually. Teratoma is common neoplasm, but is very rarely found in parotid gland. Thus teratoma should be kept in mind while evaluating a case of a soft tissue mass of parotid area and malignancy should be ruled out.
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