https://journal.chestnet.org/article/S0012-3692(15)31113-2/pdf

Tracheomalacia and tracheobronchomalacia in children and adults: an in-depth review.

Objective To evaluate the causes, clinical presentation, diagnosis, operative management, postoperative care, and outcome in infants with intestinal atresia. Design Retrospective case series. Setting Pediatric tertiary care teaching hospital. Patients A population-based sample of 277 neonates with intestinal atresia and stenosis treated from July 1, 1972, through April 30, 1997. The level of obstruction was duodenal in 138 infants, jejunoileal in 128, and colonic in 21. Of the 277 neonates, 10 had obstruction in more than 1 site. Duodenal atresia was associated with prematurity (46%), maternal polyhydramnios (33%), Down syndrome (24%), annular pancreas (33%), and malrotation (28%). Jejunoileal atresia was associated with intrauterine volvulus, (27%), gastroschisis (16%), and meconium ileus (11.7%). Interventions Patients with duodenal obstruction were treated by duodenoduodenostomy in 119 (86%), of 138 patients duodenotomy with web excision in 9 (7%), and duodenojejunostomy in 7 (5%) A duodenostomy tube was placed in 3 critically ill neonates. Patients with jejunoileal atresia were treated with resection in 97 (76%) of 128 patients (anastomosis, 45 [46]; tapering enteroplasty, 23 [24]; or temporary ostomy, 29 [30]), ostomy alone in 25 (20%), web excision in 5 (4%), and the Bianchi procedure in 1(0.8%). Patients with colon atresia were managed with initial ostomy and delayed anastomosis in 18 (86%) of 21 patients and resection with primary anastomosis in 3 (14%). Short-bowel syndrome was noted in 32 neonates. Main Outcome Measures Morbidity and early and late mortality. Results Operative mortality for neonates with duodenal atresia was 4%, with jejunoileal atresia, 0.8%, and with colonic atresia, 0%. The long-term survival rate for children with duodenal atresia was 86%; with jejunoileal atresia, 84%; and with colon atresia, 100%. The Bianchi procedure (1 patient, 0.8%) and growth hormone, glutamine, and modified diet (4 patients, 1%) reduced total parenteral nutrition dependence. Conclusions Cardiac anomalies (with duodenal atresia) and ultrashort-bowel syndrome (

https://jamanetwork.com/journals/jamasurgery/articlepdf/211600/sws7004.pdf

Intestinal Atresia and Stenosis: A 25-Year Experience With 277 Cases

https://www.annalsthoracicsurgery.org/article/S0003-4975(02)03564-6/pdf

Tracheal replacement: a critical review

Purpose To determine if tumor-specific loss of heterozygosity (LOH) for chromosomes 1p or 16q is associated with a poorer prognosis for children with favorable-histology (FH) Wilms tumor entered on the fifth National Wilms Tumor Study (NWTS-5). Patients and Methods Between August 1995 and June 2002, 2,021 previously untreated children with FH or anaplastic Wilms tumor, clear-cell sarcoma of the kidney (CCSK) or malignant rhabdoid tumor of the kidney (RTK), were treated with stage- and histology-specific therapy. Their tumors were assayed for LOH for polymorphic DNA markers on chromosomes 1p and 16q. Results LOH for 1p or 16q was rarely observed in CCSK (n = 90) or RTK (n = 22). The relative risk (RR) of relapse for patients with FH stage I to IV tumors with LOH, stratified by stage, was 1.56 for LOH 1p (P = .01) and 1.49 for LOH 16q (P = .01), whereas the RR of death was 1.84 (P = .03) and 1.44 (P = .15), respectively. When the effects of LOH for both regions were considered jointly among patients with st...

Loss of Heterozygosity for Chromosomes 1p and 16q Is an Adverse Prognostic Factor in Favorable-Histology Wilms Tumor: A Report From the National Wilms Tumor Study Group

Serial transverse enteroplasty (STEP): a novel bowel lengthening procedure.

Tracheoplasty for congenital stenosis of the entire trachea.

A new surgical approach to extensive aganglionosis

Multistaged extrathoracic esophageal elongation procedure for long gap esophageal atresia: Experience with 12 patients.

Congenital stenosis involving a long segment of the trachea: Further experience in reconstructive surgery

A retrocolic side-to-side duodenojejunostomy has been a generally accepted standard operative procedure for the correction of congenital duodenal atresia and stenosis. However, this operation has the complication of delayed anastomotic function that often requires a use of transanastomotic feeding tube or intravenous hyperalimentation. A diamond-shaped side-to-side duodenoduodenal anastomosis has been performed in nine consecutive cases of congenital duodenal obstruction, with satisfactory results. A transverse incision is made in the dilated proximal duodenum, and a longitudinal incision in the duodenum distal to the obstruction. The stoma is fashioned by approximating the end of each incision to the appropriate midportion of the other incision. Transanastomotic feeding tubes were not used and oral feedings were easily tolerated. This technique offers the theoretical advantage of providing a more physiological gastrointestinal pathway.

Diamond-Shaped Anastomosis for Congenital Duodenal Obstruction

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