No abstract available.
Cystadenocarcinoma, Mucinous* ; Female* ; Humans ; Mucins*

Inflammatory myofibroblastic tumor (IMT) is a rare reactive lesion characterized by the feature of myofibroblasts and a mixed inflammatory infiltrate that rarely undergoes malignant transformation. Extrapulmonary IMTs in children have been described involving the mesentery, omentum, retroperitoneum, abdominal soft tissues, liver, bladder, mediastinum, head and neck, extremity, appendix, and kidney. Medical records of children treated with abdominal IMT between 1985 and 2005 were reviewed retrospectively. Seven children were treated for IMT with the mean age of 3y 2m (range, 1y 1m to 14y). Tumors were located in transverse mesocolon (n=2), omentum (n=1), porta hepatis (n=2), complex site (antrum, duodenum, common bile duct, porta hepatis) (n=2). The symptoms included abdominal mass, fever, jaundice, abdominal pain and anemia. The masses were excised totally in transverse mesocolon, omentum IMT and there is no evidence of recurrence (follow-up periods: 6y 8m, 8y 9m, 4y 10m). In porta hepatis IMT, liver transplantations were performed and there is no evidence of recurrence (follow period: 6y 8m, 8y 7m). In one case of complex site IMT, partial excision of mass was performed and he still survived with no change of the residual tumor during follow-up period. The other one of complex site IMT denied further treatment after the biopsy. In conclusion, complete surgical excision including liver transplantation and close follow-up are mandatory for the abdominal IMT in child.
Abdominal Pain ; Anemia ; Appendix ; Biopsy ; Child ; Common Bile Duct ; Duodenum ; Extremities ; Fever ; Follow-Up Studies ; Head ; Humans ; Jaundice ; Kidney ; Liver ; Liver Transplantation ; Mediastinum ; Medical Records ; Mesentery ; Mesocolon ; Myofibroblasts ; Neck ; Neoplasm, Residual ; Omentum ; Recurrence ; Retrospective Studies ; Urinary Bladder

The survival rate for rhabdomyosarcoma (RMS) has significantly improved after the introduction of combined multimodality treatment. We report the 20-year treatment outcome of pediatric rhabdomyosarcoma in a single institution. The medical records of 16 patients treated for rhabdomyosarcoma between December 1986 and August 2007 at the Department of Pediatric Surgery, Seoul National University Children's Hospital, were retrospectively reviewed. Mean age at diagnosis was 7.1 years (range: 1.3 -14.2 years). Retroperitoneum was the most common primary site (n=7, 43.8%), and embryonal type was predominant (n=11, 6%). Before the treatment, most patients were in advanced TNM stage (stage III 50%, IV; 25%). The patient distribution according to the Intergroup Rhabdomyosarcoma Study Clinical Grouping System (IRS-CGS) was as follows; Group I 31.3%, Group II 12.5%, Group III 31.3% and Group IV 25%. Patients were classified into three groups according to the extent of resection of the primary tumor; complete resection (CR, n=5; 31.3%), gross total resection (GTR, n=7; 43.8%) and incomplete resection (IR, n=4; 25%). Recurrence was observed in 9 patients (56.3%) while there was no recurrence in CR patients. All patients with recurrence were identified as moderate or high-risk according to the IRS-V Risk Group. Pre-treatment TNM stage of RMS in our institution was advanced with aggressive clinical feature, however post- surgical conditions according to IRS-CGS were similar to the previous reports by IRS. This suggests that down-staging of IRS-CGS was achieved with multimodality treatment with CR or GTR. It also suggests that complete resection is the most important prognostic factor in the treatment of RMS in children. Patients classified as moderate or high-risk need close follow-up due to high recurrence rate. In case of localized recurrence, better outcome may be achieved with multimodality treatment including limited surgery.
Child ; Follow-Up Studies ; Humans ; Medical Records ; Prognosis ; Recurrence ; Retrospective Studies ; Rhabdomyosarcoma ; Survival Rate ; Treatment Outcome

PURPOSE: The purpose of this study was to determine if timing of enterostomy repair described in terms of postmenstrual age (PMA) could influence postoperative course, complications, and growth. METHODS: Under the Institutional Review Board approval, records of preterm infants who underwent enterostomy and subsequent repair from 2007 to 2013 at Seoul national university children's hospital were reviewed. Records of infants with congenital anomalies were excluded. Data collected included baseline characteristics, PMA, weight at enterostomy and enterostomy repair, postoperative course, enterostomy repair-related complications, and follow-up growth after repair. For analysis, patients were divided into 2 groups: group 1 with enterostomy repaired before PMA 40 weeks; and group 2 with enterostomy repaired since PMA 40 weeks. RESULTS: There were 54 infants: 16 in group 1 and 38 in group 2. The median weight at the time of enterostomy repair was greater in group 2 compared to those of group 1. Group 1 infants had more complications and had to be ventilated longer after enterostomy repair. They required longer periods of total parenteral nutrition and took longer to reach full enteral feeding. Group 1 infants also needed longer hospital stay after enterostomy repair. No statistical difference was observed in growth after discharge. CONCLUSION: The timing of enterostomy repair influences postoperative course and complications significantly. Therefore, it is recommended that enterostomy repair should be withheld until PMA 40 weeks. For predicting long term prognosis, more studies will be required.
Enteral Nutrition ; Enterostomy* ; Ethics Committees, Research ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Length of Stay ; Parenteral Nutrition, Total ; Prognosis ; Seoul

Primary lung lymphoma is an uncommon tumor, which constitutes 0.5% of primary lung cancer, and 3% of extranodal lymphoma. The most frequent radiologic presentation of pulmonary parenchymal lymphoma is single mass or nodule. But we have experienced a case which was radiologically presented as patchy lung infiltration at first, and then progressive multiple reticulonodular infiltrations in lung. A 48-year-old woman was admitted to the hospital because of fever and cough. Chest PA obtained on admission revealed multiple patchy infiltration. Eventually, open lung biopsy was performed and the specimen disclosed extranodal NK/T cell lymphoma, and in bone marrow aspiration, hemophagocytosis was present. We report a case of primary extranodal NK/T cell lung lymphoma presented as patchy lung infiltrations, which was treated with chemotherapy.
Biopsy ; Bone Marrow ; Cough ; Drug Therapy ; Female ; Fever ; Humans ; Lung Neoplasms ; Lung* ; Lymphoma* ; Middle Aged ; Thorax

PURPOSE: Laparoscopic continuous ambulatory peritoneal dialysis (CAPD) catheter insertion is used instead of open CAPD insertion because additional measures to prevent complications can be made without a conventional laparotomy. This study compared the early experience of laparoscopic CAPD catheter insertion with open CAPD insertion in children. METHODS: Between January 2006 and May 2011, 52, 16 and 36 patients who underwent CAPD insertion, laparoscopic CAPD insertion and open CAPD insertion, respectively, for end stage renal disease at Seoul National University Children's Hospital were enrolled in this study. The clinicopathological factors, operative factors and outcomes were analyzed by a retrospective medical record review. RESULTS: The mean operative time of the laparoscopic group was longer than that of the open groups (78 minutes vs 60 minutesm, p value=0.079). In the laparoscopic group, 3 patients underwent closure of the processus vaginalis and the occurrence of an inguinal hernia was prevented, whereas 3 patients in the open group underwent herniorrhaphy for an inguinal hernia. The mean period of catheter use in the laparoscopic and open group was 201 and 984 days, respectively. Complications occurred more frequently in the open group than in the laparoscopic group (14 patients (38.9%) vs. 2 patients (12.5%), p value=0.059). Peritonitis (19.4%) was the most common complication, which occurred only in the open group, followed by catheter obstruction due to omental wrapping. Catheter migration occurred more frequently in the open group (20%) than the laparoscopic group (12.5%). CONCLUSION: These results suggest that laparoscopic CAPD catheter insertion can be a suitable method for CAPD catheter insertion in children.
Catheter Obstruction ; Catheters ; Child ; Hernia, Inguinal ; Herniorrhaphy ; Humans ; Kidney Failure, Chronic ; Laparoscopy ; Laparotomy ; Medical Records ; Operative Time ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; Retrospective Studies

BACKGROUND/AIMS: There are a limited number of studies concerning the outcomes of diverticulitis in the Oriental population. We sought to evaluate the clinical features and the long-term outcomes of diverticulitis in Korean patients. METHODS: We retrospectively reviewed the clinical courses of 104 patients (59 men, 45 women; median age 48.5 years [range: 24-83 years]) hospitalized for their first episode of diverticulitis between 1989 and 2005. RESULTS: Right-sided diverticulitis was more common (71/104, 68%). However, the proportion of left-sided diverticulitis increased as age increased. Thirty-two patients underwent operations: 30 because of complications and 2 because of presumed appendicitis. Left-sided diverticulitis was an independent risk factor for complications (OR=7.6, p<0.001), and it required surgical treatment more often than right-sided diverticulitis did (61% vs. 17%, p<0.001). Eighty-five patients were followed for a median of 36 months. Four of the 62 medically treated patients developed recurrence of diverticulitis, with a 3-year cumulative recurrence rate of 4.8%. None of the 4 recurrences showed complications, and all were successfully managed using conservative treatment. No predictive factors for the recurrence of diverticulitis could be determined. CONCLUSIONS: The recurrence rate and risk of complications associated with recurrence are low in patients treated conservatively for the first episode of diverticulitis. Therefore, elective surgery to prevent recurrence and complications should be utilized sparingly in patients with diverticulitis.
Appendicitis ; Diverticulitis ; Diverticulitis, Colonic ; Diverticulosis, Colonic ; Humans ; Male ; Recurrence ; Retrospective Studies ; Risk Factors

PURPOSE: A transport of a critically ill infant, especially preterm infant, to an operating room (OR) from a neonatal intensive care unit (NICU) has special dangers like incidental removal of an intravenous line or a chest tube, extubation, stopping of vital sign monitoring, hypothermia and postanesthetic apnea, which could be fatal to the infant. An operation in a NICU, however, has high risk of sepsis and shortage of specialized staffs and equipments. Thus, it is generally favored so far to perform a surgery in an OR. We assessed the safety of surgery in a NICU. METHODS: 66 infants underwent operation in the NICU of Seoul National University Children's Hospital from January of 1995 to April of 2001. There were 30 cases of cryotherapy or laser photocoagulation for retinopathy of prematurity (ROP), 17 of peritoneal drainage catheter insertion, 10 of patent ductus arteriosus (PDA) ligation, 8 of extraventricular drainage, and 1 of laparotomy and peritoneal lavage. This study was conducted focusing on ROP and PDA patients. 28 cases of photocoagulation and 10 cases of PDA ligation conducted in the NICU were compared each other with 10 cases of photocoagulation and 10 cases of PDA ligation in the OR about surgical outcome and complications using retrospective medical record inspection. RESULTS: Regarding ROP, there was no big difference between the two groups in light of the clinical factors and the status of an infant before and after an operation except that inspiratory fraction of oxygen (FiO2) before an operation in the NICU group was higher than that of the other group. A total operation time was longer and there were more variations of weight, body temperature and blood pressure in the OR group. A higher rise of the mean airway pressure (MAP) and higher frequency of intraoperative hypothermia were found in the OR group and there was 1 case of extubation during an operation. The postoperative retinal detachment and the postanesthetic apnea were more frequent in the OR group. Regarding PDA, no big difference was found between the two groups in light of the clinical factors and the status of an infant except that the gestational age at birth was smaller and cardiac failure was more frequent in the NICU group. The total operation time was longer and the rises of FiO2 and MAP were higher in the OR group. There was no significant difference in operation results and postoperative complications. CONCLUSION: In light of the safety, the results, and the complications of an operation, no significant difference was found between the two groups. Accordingly, in case of ROP and PDA of a premature baby, We came to a conclusion that a NICU could be used as safe an operation place as an OR.
Apnea ; Blood Pressure ; Body Weight ; Catheters ; Chest Tubes ; Critical Illness ; Cryotherapy ; Drainage ; Ductus Arteriosus, Patent ; Gestational Age ; Heart Failure ; Humans ; Hypothermia ; Infant ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal* ; Laparotomy ; Ligation ; Light Coagulation ; Medical Records ; Operating Rooms* ; Oxygen ; Parturition ; Peritoneal Lavage ; Postoperative Complications ; Retinal Detachment ; Retinopathy of Prematurity ; Retrospective Studies ; Seoul ; Sepsis ; Vital Signs

PURPOSE: A transport of a critically ill infant, especially preterm infant, to an operating room (OR) from a neonatal intensive care unit (NICU) has special dangers like incidental removal of an intravenous line or a chest tube, extubation, stopping of vital sign monitoring, hypothermia and postanesthetic apnea, which could be fatal to the infant. An operation in a NICU, however, has high risk of sepsis and shortage of specialized staffs and equipments. Thus, it is generally favored so far to perform a surgery in an OR. We assessed the safety of surgery in a NICU. METHODS: 66 infants underwent operation in the NICU of Seoul National University Children's Hospital from January of 1995 to April of 2001. There were 30 cases of cryotherapy or laser photocoagulation for retinopathy of prematurity (ROP), 17 of peritoneal drainage catheter insertion, 10 of patent ductus arteriosus (PDA) ligation, 8 of extraventricular drainage, and 1 of laparotomy and peritoneal lavage. This study was conducted focusing on ROP and PDA patients. 28 cases of photocoagulation and 10 cases of PDA ligation conducted in the NICU were compared each other with 10 cases of photocoagulation and 10 cases of PDA ligation in the OR about surgical outcome and complications using retrospective medical record inspection. RESULTS: Regarding ROP, there was no big difference between the two groups in light of the clinical factors and the status of an infant before and after an operation except that inspiratory fraction of oxygen (FiO2) before an operation in the NICU group was higher than that of the other group. A total operation time was longer and there were more variations of weight, body temperature and blood pressure in the OR group. A higher rise of the mean airway pressure (MAP) and higher frequency of intraoperative hypothermia were found in the OR group and there was 1 case of extubation during an operation. The postoperative retinal detachment and the postanesthetic apnea were more frequent in the OR group. Regarding PDA, no big difference was found between the two groups in light of the clinical factors and the status of an infant except that the gestational age at birth was smaller and cardiac failure was more frequent in the NICU group. The total operation time was longer and the rises of FiO2 and MAP were higher in the OR group. There was no significant difference in operation results and postoperative complications. CONCLUSION: In light of the safety, the results, and the complications of an operation, no significant difference was found between the two groups. Accordingly, in case of ROP and PDA of a premature baby, We came to a conclusion that a NICU could be used as safe an operation place as an OR.
Apnea ; Blood Pressure ; Body Weight ; Catheters ; Chest Tubes ; Critical Illness ; Cryotherapy ; Drainage ; Ductus Arteriosus, Patent ; Gestational Age ; Heart Failure ; Humans ; Hypothermia ; Infant ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal* ; Laparotomy ; Ligation ; Light Coagulation ; Medical Records ; Operating Rooms* ; Oxygen ; Parturition ; Peritoneal Lavage ; Postoperative Complications ; Retinal Detachment ; Retinopathy of Prematurity ; Retrospective Studies ; Seoul ; Sepsis ; Vital Signs

OBJECTIVE: The purpose of the study was to investigate the time from the injection of muscle relaxants to the first spontaneous respiration between sugammadex and conventional reversal for patients undergoing laparoscopic cholecystectomy. METHODS: This study was retrospectively conducted on patients who were diagnosed with gallbladder stone (N802) between January 2014 and April 2017. The data were collected from the electronic medical records of a total of 186 patients (84 patients in the neostigmine group and 102 patients in the sugammadex group). RESULTS: The time required for the first spontaneous respiration in the sugammadex group was shorter than that in the neostigmine group (3.6 min vs 4.9 min; p < 0.05). After the injection of intermediate muscle relaxants, the comparison of heart rate and mean arterial pressure in the sugammadex and neostigmine groups revealed that the heart rate in the neostigmine group was higher than in the sugammadex group after 5 min (p < 0.05). The mean arterial pressure in the neostigmine group was higher than in the sugammadex group after 10 min (p < 0.05). A significant adverse effect of tachycardia was observed in the neostigmine group (p < 0.05), but the frequency of rescue antiemetic in the sugammadex group was significantly higher than in the neostigmine group (p < 0.05). CONCLUSION: In this study, the unwanted effect of neostigmine group was tachycardia; therefore, in the case of patients with hemodynamic instability, sugammadex is recommended. At 12 hours after the injection of sugammadex to patients, more antiemetics were required than in the neostigmine group; therefore, more research should be conducted on postoperative nausea and vomiting.
Antiemetics ; Arterial Pressure ; Cholecystectomy, Laparoscopic* ; Electronic Health Records ; Gallbladder ; Heart Rate ; Hemodynamics ; Humans ; Neostigmine* ; Postoperative Nausea and Vomiting ; Respiration* ; Retrospective Studies ; Tachycardia