Journal of pediatric surgery
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Randomized Controlled Trial Comparative Study
Use of fibrin glue in preventing urethrocutaneous fistula after hypospadias repair.
Urethrocutaneous fistula is one of the most common complications after hypospadias surgery. The incidence of fistula development has varied from 4% to 20% in larger series. We sought to investigate the role of fibrin glue (Tisseel manufactured by Baxter India Pvt Ltd, Chennai, India) to reduce the chances of fistula formation in cases in proximal penile hypospadias. ⋯ Fibrin glue in hypospadias repair does not eliminate fistula formation. However, it seems that it minimizes the incidence of fistula formation.
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Randomized Controlled Trial Comparative Study
Single daily dosing ceftriaxone and metronidazole vs standard triple antibiotic regimen for perforated appendicitis in children: a prospective randomized trial.
Appendicitis is the most common emergency condition in children. Historically, a 3-drug regimen consisting of ampicillin, gentamicin, and clindamycin (AGC) has been used postoperatively for perforated appendicitis. A retrospective review at our institution has found single day dosing of ceftriaxone and metronidazole (CM) to be a more simple and cost-effective antibiotic strategy. Therefore, we performed a prospective, randomized trial to compare efficacy and cost-effectiveness of these 2 regimens. ⋯ Once daily dosing with the 2-drug regimen (CM) offers a more efficient, cost-effective antibiotic management in children with perforated appendicitis without compromising infection control when compared to a traditional 3-drug regimen.
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Randomized Controlled Trial Multicenter Study
Kasai portoenterostomy: 12-year experience with a novel adjuvant therapy regimen.
The role of adjuvant therapy with corticosteroids and choleretics after Kasai portoenterostomy for biliary atresia (BA) remains uncertain. Experience with a novel postoperative adjuvant therapy regimen is reported. ⋯ In this series, adjuvant postoperative treatment with a short course of oral dexamethasone and longer-term ursodeoxycholic acid significantly improved the outcome after Kasai portoenterostomy.
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Randomized Controlled Trial Comparative Study
Laparoscopic pyloromyotomy for hypertrophic pyloric stenosis: a prospective, randomized controlled trial.
Several authors have reported on laparoscopic pyloromyotomy (LP) since the technique was originally described in 1990, but its benefits remain unproven. We performed a randomized controlled trial comparing LP to open circumumbilical pyloromyotomy (OP) for hypertrophic pyloric stenosis. ⋯ Laparoscopic pyloromyotomy does not decrease the incidence of postoperative vomiting, has a similar complication rate compared with the open umbilical approach, but may expose patients to a risk of inadequate pyloromyotomy.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effects of ropivacaine infiltration on cortisol and prolactin responses to postoperative pain after inguinal hernioraphy in children.
Painful interventions may have a serious adverse psychological impact, particularly in young patients. Inguinal hernia repair is the most common surgical outpatient procedure performed on infants and children. The aim of this study was to compare the effects of pre- and postincisional infiltration of the surgical area with ropivacaine on cortisol (C) and prolactin (PRL) release and postoperative pain in children undergoing inguinal hernia repair. ⋯ The findings of the current study suggest that wound infiltration with ropivacaine decreases the stress response to surgery and the postoperative pain.