European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift für Kinderchirurgie
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Review Meta Analysis Comparative Study
Thoracoscopy versus thoracotomy for esophageal atresia and tracheoesophageal fistula repair: review of the literature and meta-analysis.
The thoracoscopic approach to esophageal atresia (EA) with tracheoesophageal fistula (TOF) represents a challenging procedure whose real benefits remains unclear. Our purpose is to identify, through a meta-analysis, clinical evidence of the reliability of the thoracoscopic repair (TR) for EA/TOF compared with the open repair. ⋯ The effectiveness of the endoscopic technique for EA/TOF repair is indicated with outcomes not different from open surgery. A randomized controlled trial is needed in this field to indicate which procedure is superior, open or TR.
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Acute kidney injury (AKI) is a serious postoperative complication in children undergoing surgery for congenital heart disease. The incidence of this complication and its consequences may have changed due to advances in surgical technique, but comparisons between studies are compromised by differences in study design, diagnostic criteria, and patient selection. ⋯ However, the pathophysiology behind AKI remains unsolved and ambiguous, which limits the usefulness of both traditional and new diagnostic tools. Furthermore, this gap in the understanding of AKI may be responsible for the lack of a specific preventive intervention or treatment.
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The use of extracorporeal membrane oxygenation (ECMO) has increased since its inception. As this modality gained wider acceptance, its application in a variety of disease states has increased. ⋯ Various reports in the literature have compared VV ECMO and VA ECMO. We present a review of the literature with regard to both physiology and clinical application.
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Review Meta Analysis
Extracorporeal membrane oxygenation in infants with congenital diaphragmatic hernia: a systematic review of the evidence.
The aim of this study was to evaluate the evidence supporting the use of extracorporeal membrane oxygenation (ECMO) in infants with congenital diaphragmatic hernia (CDH) and severe respiratory failure. ⋯ Non randomised studies suggest a reduction in mortality with ECMO. However, differences in the indications for ECMO and improvements in other treatment modalities may contribute to this reduction. The meta-analysis of RCTs indicates a reduction in early mortality with ECMO but no long-term benefit. A large RCT in infants with CDH and severe respiratory failure is warranted.