The application of endoscopy in pediatric surgery began in 1970s,and it was used for diagnosis of disease at first.After that,laparoscopy and thoracoscopy were widely applied in pediatric general surgery,urology and thoracic surgery.Nowadays,most pediatric abdominal and thoracic diseases could be treated by endoscopic minimally invasive surgery,including pediatric congenital malformation,acute abdominal disease,tumor,and so on.Neonatal laparoscopy has developed rapidly in recent years,which could be performed in most neonatal surgeries.With the development of technology,the application of 3D laparoscopy and surgical robot bring laparoscopy into a new era.Predictably,with the updates of endoscopic devices and the technical improvement,endoscopy could be more popular and used for more difficult surgery and younger children.

Objective To evaluate spiral CT and three dimensional reconstruction in the diagnosis of severe renal trauma in children. Methods 4 children were taken spiral CT one month after injured in car accidents.Picker CT Twin is used to scan kidney and ureter,including plane scan and contrast enhancement nephrography. Pitch 1.0 and slice thickness 6.5 mm were selected.MPR,MIP and 3D reconstruction were used as postprocessing. Results Of the 4 cases,2 cases had laceration of right kidney and UPJ avulsion,1 case a completely amputated lower pole of left kidney and 1 case a UPJ avulsion in right ureter. Giant urine cysts could be found in all the 4.The CT findings were confirmed by operations. Conclusions Spiral CT and 3D images could accurately depict the condition and severity of injuries of kidney and ureter.The 3D images depict the injuries and surounding structures from various directions,so that the optimal kind of operation could be selected with the reference of images.

Objective To evaluate CTU in the diagnosis of renal duplication in children. Methods 18 children suspected of renal duplication were imaged by CTU.Of the 18 cases,11 have underwent IVU and 4 MRU. Results 18 cases of renal duplication were diagnosed by CTU,confirmed by operation.3 of 11 were detected on IVU,and 1 of 4 on MRU.The diagnosis rate of CTU in renal duplication has been 100%,higher than IVU and MRU. Conclusions CTU is a reliable and optimal technique for the diagnosis of renal duplication.

Objective To study the effect of CO_2 pneumoperitoneum on animals with intra-abdominal infection.Methods A total of 60 New Zealand white rabbits were used in this study.The animals were divided into two groups (30 in each),and injected with Escherichia coli or bacteroides fragilis into the abdominal cavity to establish models of intra-abdominal infection.In each group, the rabbits were subdivided into laparotomy,pneumoperitoneum,and control subgroups.Before the injection,the peripheral blood of the rabbits in each group was obtained to determine the WBC count and level of C-reactive protein (CRP,by ELISA).After the operation,the tests were repeated for 4 times at days 1,2,4,7 respectively.Afterwards,the animals were killed,and the viscera were harvested for aerobic and anaerobic culture.Results In each of the two groups,the WBC count in the laparotomy subgroup were significantly higher than that in the pneumoperitoneum subgroup at day 1 (P

Objective KG1This study is to evaluate defectography in postoperative defecation function of Hirschsprung′s disease (HD). KG2MethodsKG1 Between 1979 and 1993, 30 HD cases were treated operatively and followed-up by defectography. KG2ResultsKG1 Thirty cases were classified into 3 groups, according to the standard quantitative clinical scoring systems with the stooling score from 0 to 14. There were 4 cases (13%) graded as excellent (maximum score of 14) with normal bowel habit, 21 cases (70%) as good (score between 10～13) with minor continence problems, 5 cases (16 7%) as fair (score between 5～9) with marked limitations in social life. Anorectal manometry study showed that the anal resting pressure and voluntary sphincter force (maximal queeze pressure minus resting pressure) in fair group were significantly lower than that in control group( P