401 research outputs found
Congenital lung malformations
No full textCongenital lung malformations (CLMs) are rare developmental anomalies of the lung, including congenital pulmonary airway malformations (CPAM), bronchopulmonary sequestration, congenital lobar overinflation, bronchogenic cyst and isolated congenital bronchial atresia. CLMs occur in 4 out of 10,000 live births. Postnatal presentation ranges from an asymptomatic infant to respiratory failure. CLMs are typically diagnosed with antenatal ultrasonography and confirmed by chest CT angiography in the first few months of life. Although surgical treatment is the gold standard for symptomatic CLMs, a consensus on asymptomatic cases has not been reached. Resection, either thoracoscopically or through thoracotomy, minimizes the risk of local morbidity, including recurrent infections and pneumothorax, and avoids the risk of malignancies that have been associated with CPAM, bronchopulmonary sequestration and bronchogenic cyst. However, some surgeons suggest expectant management as the incidence of adverse outcomes, including malignancy, remains unknown. In either case, a planned follow-up and a proper transition to adult care are needed. The biological mechanisms through which some CLMs may trigger malignant transformation are under investigation. KRAS has already been confirmed to be somatically mutated in CPAM and other genetic susceptibilities linked to tumour development have been explored. By summarizing current progress in CLM diagnosis, management and molecular understanding we hope to highlight open questions that require urgent attention.<br/
Atresia dell'esofago. Diagnosi e terapia
No full textL'atresia dell'esofago è per il chirurgo pediatra la "patologia" per antonomasia. La tecnica chirurgica non ha subito significative modificazioni dal 1941, anno in cui fu riportato in letteratura il primo successo chirurgico, sino al maggio 1999 quando Steven Rothenberg e Tom Lobe eseguirono, in una atresia esofagea, la prima anastomosi termino-terminale per via toracoscopica. Gli autori trattano in maniera sintetica ma completa le problematiche relative alla diagnosi e le novità, nel campo della terapia chirurgica, affinché il pediatra ed il giovane chirurgo possano affrontare con sicurezza questa patologia malformativa che oggi consente, ai piccoli pazienti, una qualità di vita ottimale
Faculty Photo 2006-2007
No full textFirst Row (L to R): Helen Norton, Lisa Fairfax, Michael Van Alstine, Karen Rothenberg, Diane Hoffmann, Larry Gibson, Jana Singer
Second Row (L to R): Peter Quint, Patricia Campbell, Ellen Weber, Maxwell Chibundu, Brenda Bratton Blom, Robert Percival, Renee Hutchins, Michael Greenberger
Third Row (L to R): Daniel Goldberg, Roger Wolf, Andrew King, Deborah Hellman, Susan Hankin, Barbara Bezdek, Helen Norton, Sharon Reece, Lawrence Sung, Fernando Nunez, Robert Keller
Fourth Row (L to R): Peter Danchin, Steven Schwinn, Michael Pinard, Richard Boldt, Gordon Young, Richard Booth, Kathleen Hoke, Donald Gifford, Russell McClain, Jerome Deise, Mark Graberhttps://digitalcommons.law.umaryland.edu/photos/1006/thumbnail.jp
Атрезия пищевода — современное состояние проблемы (обзор литературы по базе PUBMED)
No full textEsophageal atresia is fundamentally important in pediatric surgery, as its treatment results create an accurate portrait of the standards of surgical care, which is provided by any medical institution. Cameron Haight performed the first successful reconstruction of the esophagus malformation relatively recently just over 70 years ago. Advances in neonatal surgery, technology and advances in neonatal intensive care have dramatically improved treatment outcomes for this disease. Current mortality from this developmental abnormality has become minimal, despite its frequent association with other malformations. A revolutionary approach to the treatment of esophageal atresia was developed by Steven Rothenberg in 1999, the pioneer and legend of pediatric minimally invasive surgery. In 1999, he revolutionized esophageal anastomosis by thoracoscopy. The innovative concept of the minimally invasive approach ensured minimal trauma to patients, thereby providing the possibility of rapid postoperative recovery of patients and reducing the length of their surgical hospital stay. This literature review raises the main controversy in the surgical treatment of esophageal atresia in the 21st century. Emphasis is placed on the study of the role of minimally invasive surgery and the treatment of concomitant abnormalities associated with gastroesophageal reflux and tracheomalacia. As part of the study, a description of all the latest technologies, advances in technical and scientific terms, solutions, exceptional experience, and competence in developing and implementing minimally invasive operations in young children. These developments changed the direction of pediatric surgery and improved the quality of surgical care for children with congenital malformation of the esophagus and how they were performed.Атрезия пищевода принципиально важная и фундаментальная позиция в детской хирургии, так как результаты ее лечения создают точный портрет стандартов хирургической помощи, который оказывает любое отдельное лечебное учреждение. Первая успешная реконструкция аномалии развития пищевода была выполнена Кэмероном Хайтом относительно недавно чуть более семидесяти лет назад. Прогресс технологий в хирургии новорожденных, а также успехи в неонатальной интенсивной терапии позволили радикально улучшить результаты лечения этого заболевания, так что текущая смертность от этой аномалии развития стала минимальной, несмотря на частую ассоциацию с другими мальформациями. Революционный подход в лечении атрезии пищевода, предпринятый впервые автором этой научной работы Стивеном Ротенбергом в 1999 г., пионером и легендой детской минимально инвазивной хирургии, произвел технологический переворот, который позволил выполнять пищеводный анастомоз при помощи торакоскопии. Инновационная концепция минимально инвазивного подхода обеспечила минимальную травму пациентов, предоставив тем самым возможность быстрого послеоперационного восстановления больных и сокращения сроков их пребывания в хирургическом госпитале. В настоящем обзоре литературы описаны основные споры, которые существуют в хирургическом сообществе при лечении пациентов с атрезией пищевода в XXI в. Особый акцент сделан на изучении роли минимально инвазивной хирургии и лечении сопутствующих аномалий, связанных с гастроэзофагеальным рефлюксом и трахеомаляцией. В рамках исследования рассмотрены все новейшие технологии, передовые в техническом и научном плане решения, исключительный опыт и компетенции в разработке и внедрении малоинвазивных операций у маленьких детей, которые изменили направление развития детской хирургии и повысили качество хирургической помощи детям с врожденной аномалией развития пищевода
Thoracoscopic Repair of Esophageal Atresia and Tracheo-Esophageal Fistula in Neonates: Evolution of a Technique
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