Objective To explore the safety and feasibility of transumbilical single-site laparoscopic partial splenectomy for pediatric splenic cysts.Methods A retrospective analysis was conducted on 5 cases of splenic cysts from January 2021 to April 2024,with cyst diameters ranging from 6 cm to 11 cm.A vertical incision approximately 2 cm in length was made at the umbilicus,and three 5 mm trocars were inserted in a"triangle"shape,one for observation and two for operation.Splenectomy of the upper pole(4 cases)or lower pole(1 case)was performed.Results The operations were successfully completed in all the 5 cases without conversion to open surgery.One case required intraoperative transfusion of suspended red blood cells.The operation time was 100-250 min(mean,162 min),the intraoperative blood loss was 30-200 ml(mean,72 ml),the postoperative drainage time was 2-3 d,and the postoperative hospital stay was 4-8 d(mean,6.4 d).No complications were observed.One case had mild thrombocytosis(434×109/L)at one week postoperatively,which returned to normal upon re-examination two weeks later.Postoperative pathological examination confirmed splenic cysts.Follow-ups ranged for6-44 months,with an average of 28.4 months.No complications such as thrombocytosis,cyst recurrence,residual splenic necrosis,venous thrombosis,or incisional hernia were reported.Conclusion Transumbilical single-site laparoscopic partial splenectomy is safe and feasible for treating pediatric splenic cysts.

Objective:To summarize the surgical management strategy for pediatric pancreatic tumors.Methods:Clinical data of 17 children with pancreatic tumors who underwent surgical treatment in Children's Hospital Affiliated to Shandong University from January 2018 to April 2024 were retrospectively analyzed, including 6 males and 11 females, ranging in age from 1 month to 13 years, with a median age of 10 years and 2 months. The data of tumor length and diameter, tumor location, surgical method and postope-rative pathology were analyzed. The prognostic data of all children were followed up by regular telephone and outpatient follow-up.Results:In 17 cases, the tumor diameter was (7.3±2.2) cm, 10 cases were located in the head of the pancreas, 7 cases were located in the tail of the pancreatic body, 1 case was accompanied by liver metastasis, and 1 case was accompanied by left adrenal invasion. Among these cases, 10 cases had pancreatic head tumor, 6 cases had simple pancreatic tumor resection, 1 case had laparoscopic pancreatic tumor resection, and 3 cases had pancreatic head resection plus pancreato-jejunal Roux-en-Y anastomosis. Among the 7 cases of pancreatic body and tail tumors, 3 cases underwent pancreatic body and tail resection, 1 case underwent laparoscopic pancreatic body and tail resection, 1 case underwent tumor resection, 1 case underwent pancreatic body and tail resection plus splenectomy plus hepatic metastasis resection, 1 case underwent pancreatic body and tail resection plus left adrenal resection plus splenectomy. Postoperative pathology showed that there were 13 cases of solid pseudopapilloma, 3 cases of pancreatic blastoma, and 1 case of pancreatic cyst. The median follow-up time was 36 months (2-71 months). All patients survived well.Conclusion:Solid pseudopapillary of the pancreas is the most common type of pancreatic tumor in children, with surgical resection being the first choice of of treatment, offering a favorable prognosis postope-ratively.

Objective To explore the feasibility of video-assisted thoracoscopic surgery(VATS)in the treatment of congenital pulmonary airway malformation(CPAM)or pulmonary isolation complicated with ipsilateral mediastinal bronchogenic cyst in children.Methods From July 2019 to July 2024,VATS was carried out to treat CPAM or pulmonary isolation with ipsilateral mediastinal bronchogenic cyst in 7 children.A three-hole thoracoscopic surgery via lateral thoracic approach was performed.The patients were placed in a healthy lateral position.The observation hole was located at the intersection of the subscapular line and the 5th intercostal space,and the operating hole was established according to the surgical requirements in combination with the lumboscopic diamond rule.A 5 mm trocar was used for all three holes.The pressure of CO2 pneumothorax was 4 mm Hg and the flow rate was 2 L/min,which was adjusted at any time according to the intraoperative conditions of the children.The operation was mainly designed for lung operation.The pulmonary operation was conducted firstly,and then the bronchogenic cyst was treated.If necessary,block resection was applied to avoid serious complications of trachea.Results All the operations were performed under thoracoscopy without conversion to open surgery.The operation time was 37-191 min(median,101 min).The intraoperative bleeding volume was 1-15 ml(median,5 ml).One case was not given a closed chest drainage tube placed,and the other 6 cases were placed a closed chest drainage for 1-5 d(median,3d).Postoperative pathology showed 5 cases of CPAM combined with bronchogenic cysts,including 4 cases of type 2(bronchiole type)and 1 case of type 3(bronchiole/alveolar type),and 2 cases of extralobular pulmonary isolation combined with bronchogenic cysts.All the 7 cases were followed up for 6-57 months(median,27 months),and chest CT showed no recurrence of lesions.Conclusions CPAM or pulmonary isolation may be accompanied by bronchogenic cysts.Preoperative imaging examination should correspond to surgical observation,and careful exploration should be conducted to avoid missed diagnosis.VATS is safe and feasible for treating CPAM or pulmonary isolation with ipsilateral mediastinal bronchogenic cysts.

Objective:To summarized the clinical characteristics and surgical management of anterior cervical enterogenic in pediatric patients. Methods:Clinical data were retrospectively analyzed for 9 children with pathologically confirmed anterior cervical enterogenic cysts（including bronchogenic and esophagogenic subtypes） treated at the Children's Hospital of Shandong University（Jinan Children's Hospital） between January 1, 2020, and November 30, 2023. Results:Nine patients（6 males and 3 females） were involved in this study, aged 14 days to 10 years old. There were 4 cases on the left side, 4 on the right side, and 1 in the middle of the neck. All patients presented with neck masses. The patients were followed up from 3 months to 35 months after surgery and recovered well, with no recurrence or complications observed. Conclusion:①Anterior intestinal cysts in children are rare and easy to be misdiagnosed. ②Concurrent branchial cleft fistulas or associated anomalies may coexist, necessitating comprehensive evaluation. ③Preoperative diagnosis is not easy and mainly depends on pathological diagnosis. ④The treatment of anterior cervical enterogenic cysts in children is surgical resection of the lesion.
Humans ; Male ; Female ; Child ; Retrospective Studies ; Child, Preschool ; Infant ; Neck ; Cysts/surgery*

Objective To explore the feasibility of video-assisted thoracoscopic surgery(VATS)in the treatment of congenital pulmonary airway malformation(CPAM)or pulmonary isolation complicated with ipsilateral mediastinal bronchogenic cyst in children.Methods From July 2019 to July 2024,VATS was carried out to treat CPAM or pulmonary isolation with ipsilateral mediastinal bronchogenic cyst in 7 children.A three-hole thoracoscopic surgery via lateral thoracic approach was performed.The patients were placed in a healthy lateral position.The observation hole was located at the intersection of the subscapular line and the 5th intercostal space,and the operating hole was established according to the surgical requirements in combination with the lumboscopic diamond rule.A 5 mm trocar was used for all three holes.The pressure of CO2 pneumothorax was 4 mm Hg and the flow rate was 2 L/min,which was adjusted at any time according to the intraoperative conditions of the children.The operation was mainly designed for lung operation.The pulmonary operation was conducted firstly,and then the bronchogenic cyst was treated.If necessary,block resection was applied to avoid serious complications of trachea.Results All the operations were performed under thoracoscopy without conversion to open surgery.The operation time was 37-191 min(median,101 min).The intraoperative bleeding volume was 1-15 ml(median,5 ml).One case was not given a closed chest drainage tube placed,and the other 6 cases were placed a closed chest drainage for 1-5 d(median,3d).Postoperative pathology showed 5 cases of CPAM combined with bronchogenic cysts,including 4 cases of type 2(bronchiole type)and 1 case of type 3(bronchiole/alveolar type),and 2 cases of extralobular pulmonary isolation combined with bronchogenic cysts.All the 7 cases were followed up for 6-57 months(median,27 months),and chest CT showed no recurrence of lesions.Conclusions CPAM or pulmonary isolation may be accompanied by bronchogenic cysts.Preoperative imaging examination should correspond to surgical observation,and careful exploration should be conducted to avoid missed diagnosis.VATS is safe and feasible for treating CPAM or pulmonary isolation with ipsilateral mediastinal bronchogenic cysts.

Objective To explore the safety and feasibility of transumbilical single-site laparoscopic partial splenectomy for pediatric splenic cysts.Methods A retrospective analysis was conducted on 5 cases of splenic cysts from January 2021 to April 2024,with cyst diameters ranging from 6 cm to 11 cm.A vertical incision approximately 2 cm in length was made at the umbilicus,and three 5 mm trocars were inserted in a"triangle"shape,one for observation and two for operation.Splenectomy of the upper pole(4 cases)or lower pole(1 case)was performed.Results The operations were successfully completed in all the 5 cases without conversion to open surgery.One case required intraoperative transfusion of suspended red blood cells.The operation time was 100-250 min(mean,162 min),the intraoperative blood loss was 30-200 ml(mean,72 ml),the postoperative drainage time was 2-3 d,and the postoperative hospital stay was 4-8 d(mean,6.4 d).No complications were observed.One case had mild thrombocytosis(434×109/L)at one week postoperatively,which returned to normal upon re-examination two weeks later.Postoperative pathological examination confirmed splenic cysts.Follow-ups ranged for6-44 months,with an average of 28.4 months.No complications such as thrombocytosis,cyst recurrence,residual splenic necrosis,venous thrombosis,or incisional hernia were reported.Conclusion Transumbilical single-site laparoscopic partial splenectomy is safe and feasible for treating pediatric splenic cysts.

Objective:To summarize the surgical management strategy for pediatric pancreatic tumors.Methods:Clinical data of 17 children with pancreatic tumors who underwent surgical treatment in Children's Hospital Affiliated to Shandong University from January 2018 to April 2024 were retrospectively analyzed, including 6 males and 11 females, ranging in age from 1 month to 13 years, with a median age of 10 years and 2 months. The data of tumor length and diameter, tumor location, surgical method and postope-rative pathology were analyzed. The prognostic data of all children were followed up by regular telephone and outpatient follow-up.Results:In 17 cases, the tumor diameter was (7.3±2.2) cm, 10 cases were located in the head of the pancreas, 7 cases were located in the tail of the pancreatic body, 1 case was accompanied by liver metastasis, and 1 case was accompanied by left adrenal invasion. Among these cases, 10 cases had pancreatic head tumor, 6 cases had simple pancreatic tumor resection, 1 case had laparoscopic pancreatic tumor resection, and 3 cases had pancreatic head resection plus pancreato-jejunal Roux-en-Y anastomosis. Among the 7 cases of pancreatic body and tail tumors, 3 cases underwent pancreatic body and tail resection, 1 case underwent laparoscopic pancreatic body and tail resection, 1 case underwent tumor resection, 1 case underwent pancreatic body and tail resection plus splenectomy plus hepatic metastasis resection, 1 case underwent pancreatic body and tail resection plus left adrenal resection plus splenectomy. Postoperative pathology showed that there were 13 cases of solid pseudopapilloma, 3 cases of pancreatic blastoma, and 1 case of pancreatic cyst. The median follow-up time was 36 months (2-71 months). All patients survived well.Conclusion:Solid pseudopapillary of the pancreas is the most common type of pancreatic tumor in children, with surgical resection being the first choice of of treatment, offering a favorable prognosis postope-ratively.

Objective To investigate the feasibility of retroperitoneoscopy in the treatment of adrenal masses in infants under 6 months old.Methods From January 2020 to November 2023,retroperitoneoscopic surgery was performed in 5 infants under 6 months old with adrenal tumors.Their age was from 1 month and 18 days to 4 months and 27 days,and their body weight was 5-8 kg.The lesion was found by prenatal ultrasonography in 1 case and by abdominal ultrasonography for other reasons after birth in 4 cases.Ultrasound and CT indicated a diameter of 1.7-5.5 cm for the adrenal masses.Results The operations of adrenalectomy and tumor resection were completed under retroperitoneoscopy.The operative time was 65-135 min(median,94 min).The intraoperative blood loss was less than 10 ml.The postoperative drainage tube retention time was 3-6 d(median,5 d).Pathological diagnosis showed 4 cases of adrenal neuroblastoma and 1 case of adrenal hyperplasia.Follow-ups for 1-36 months(median,3 months)with abdominal ultrasound and CT scanning showed no recurrence or metastasis.Conclusion Retroperitoneoscopy is relatively safe for the treatment of adrenal tumors in infants under 6 months old(tumors with acceptable boundaries).

Objective To summarize the clinical experience of thoracoscopic treatment of anterior mediastinal enterogenous cysts.Methods From July 2019 to July 2023,27 children diagnosed as having anterior mediastinal enterogenous cysts were treated with total thoracoscopic surgery through the lateral thoracic approach(three port method)in our department.The patients were placed in a healthy lateral position.The observation hole was located in the 5th intercostal space under the scapula,and the other 2 operating holes were established based on the location of the lesion and the endoscopic diamond-shaped method,both of which were 5 mm trocars.The CO2 pneumothorax was established at a pressure of 6 mm Hg.The visceral pleura of the cyst was opened with an electric hook,the cyst was fixed and pulled by intestinal forceps,and the cyst was completely removed by forceps and electric hook separation alternately.Results No conversion to thoracotomy was required.Complete resection was performed in 26 cases,and residual cyst wall existed in 1 case.Esophageal muscular layer was opened in 9 cases.During the operation,cysts obstructed the surgical field of view in 5 cases,which was not conducive to observation.The cyst puncture and fluid extraction were performed.The operation time was 45-120 min(median,70 min).The amount of blood loss was 3-10 ml(median,5 ml).Postoperative hospitalization lasted for 2-5 d(median,3d).The 27 cases were followed up for 1-43 months(median,22 months),and there was no recurrence.The compressed trachea in 2 cases was all recovered,with emphysema fully recovered.Conclusions Thoracoscopic treatment of anterior mediastinal enterogenous cysts in children is safe and feasible.When the surrounding structure of the lesion is complex,it can be combined with bronchoscopic or gastroscopic surgery if necessary.

Objective To investigate the safety and feasibility of transumbilical single-site laparoscopic treatment of Meckel's diverticulum in children.Methods A total of 122 patients with Meckel's diverticulum were treated with transumbilical single-site laparoscopic treatment in our department from January 2019 to June 2023.A longitudinal incision was made through the umbilical cord,and 5 mm trocars were inserted into the left and right sides of the incision.The laparoscope and non-invasive intestinal forceps were inserted via the observation and operation holes to probe the abdominal cavity and locate the diverticulum.After the umbilical cord incision was expanded,the diverticulum was pulled out from the abdominal cavity for external resection and anastomosis.Results All the 122 children were diagnosed by laparoscopy.There were 4 cases who were diagnosed as having acute gangrenous appendicitis preoperatively,but were confirmed as having Meckel's diverticulum with perforation under laparoscope intraoperatively.There were 38 cases of lower digestive tract bleeding,48 cases of inflammatory reaction,12 cases of intussusception,8 cases of intestinal obstruction caused by cord and band compression,and 12 cases of peritonitis caused by perforation.All the operations were successfully completed,and the operation time was 58-125 min,with an average of 78 min.Pathological examination after surgery showed Meckel's diverticulum in all the cases.Two cases of incision infection were cured after dressing change treatment.The patients were given a liquid diet 2-4 d after surgery and discharged 5-9 d later.A total of 119 patients were followed up for 3-18 months after surgery,and the surgical results were satisfactory.There were no serious complications such as rectal bleeding,anastomotic stenosis,adhesive intestinal obstruction,or incisional hernia after surgery.Conclusions Transumbilical single-site laparoscopic treatment of Meckel's diverticulum in children is safe and feasible.Meckel's diverticulum combined with perforation or intestinal obstruction is not a contraindication of transumbilical single-site laparoscopic surgery.