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Copyright of Jinekoloji-Obstetrik & Neonatoloji Tip Dergisi is the property of T.C. Saglik Bakanligi Ankara Sehir Hastanesi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Studies on preserving the Azygos vein (AV) in primary esophageal atresia (EA) repair and its effects on complications such as stenosis, anastomotic leakage, and fistula are gradually increasing. We aimed to evaluate cases with preserved AV during primary repair of EA with thoracotomy. Material and Methods: The demographic data, operation notes, and postoperative outcomes of primary EA repair cases with preserved AVs operated between 2016 and 2021 were evaluated from hospital records, retrospectively. Results: In 5 years, the AVs of 9 neonates with esophageal atresia + distal fistula were preserved in 6 males and 3 females. The mean birth weight was 2374 g. Four cases were preterm. Echocardiography revealed an Interatrial Septal Aneurysm in 1, Fallot's Tetralogy in 1, and a right aortic arch in 1 patient. The mean age at surgery was 4 days (1-8 days); all patients were operated through a right thoracodorsal incision by the same surgeon. Extra-pleural thoracotomies were completed as intrapleural in four patients. The oblique-oblique anastomosis was tension-free in all cases. Enteral feeding began on the 4th day by nasogastric tube. The median duration of intubation was 6.6 days (1-11 days). Chest tubes were removed on the 10th day (8-14th day). No patient had anastomotic leakage, detachment, or fistula recurrence. The median hospitalization duration was 23.2 days (10-32 days). Four patients underwent esophageal dilation. Conclusion: Postoperative anastomotic leakage, fistula, and stenosis increase mortality and morbidity in children undergoing EA repair. During primary repair, the preservation of AV, which significantly contributes to esophageal drainage, should be preferred unless it increases intraoperative risk. [ABSTRACT FROM AUTHOR]

The term infravesical obstruction is used for functional or anatomical disorders that are located distal to the bladder neck and cause disruption or interruption of urinary flow. Among these pathologies, the most common cause of urinary system obstruction in male newborns is the posterior urethral valve. In this study, it was aimed to review the diseases that may cause infravesical obstruction in children. [ABSTRACT FROM AUTHOR]

The diagnosis of congenital diaphragmatic hernia (CDH) is usually straightforward. However, cases with right-sided CDH can be challenging. We report a case of a neonate with right-sided diaphragmatic hernia presenting with hydrothorax. [ABSTRACT FROM AUTHOR]

Objective: We aimed to determine the behavioral attitudes and diagnostic/interventional characteristics of the patients relatives who applied to our polyclinic during the closure period of COVID-19 pandemic. Material and Methods: This prospective study was conducted between June and July 2020. All results were statistically analyzed. Results: Hundred and five (61.8%) male, 65 (38.2%) female patients who applied to our outpatient clinic. The median age was 2 years. A total of children came with their parents, and 99.4% were wearing masks. Although 93.5% of the parents were wearing their masks correctly. At least one of the additional protective outfits was used by 7.1% of parents. Forty (23.5%) parents adapted at least one of the health protective behaviors. About 52.4% of patients were not wearing masks; and 92.6% of masked people were wearing them correctly. Surgery was performed in 10.5% of the patients under general anesthesia. Conclusion: The use of masks in children of working mothers and elderly fathers was increased; and correct use of masks in children was affected by the father's professions. The use of additional health protective methods in patients in those who come by their own vehicle was decreased. In the rate of mask use as the child's age gets older, they were found to be statistically significant parameters. [ABSTRACT FROM AUTHOR]

Aim: Testicular tumors are rare in children and have a bimodal distribution. The first peak is at two years of age in boys and comprises mainly non-GCNIS derived tumors (pre-pubertal teratoma and yolk sac lesions). Here, the clinical features and treatment of testicular tumors in prepubertal children in our center are presented. Materials and Methods: The clinical records of those patients treated for testicular tumors younger than 18 years in our institution from January, 2006 to June, 2022 were reviewed retrospectively. Results: A total of 12 patients were included in this study. All of the patients were younger than 3 years, except for one patient, who was 8 years old. The median age at primary diagnosis was 17 months (1-107 months). The most common clinical presentation was testicular swelling (n=9). Three patients were diagnosed incidentally. Serum α-fetoprotein (AFP) was increased in 3 patients with yolk sac tumors (>1,000 ng/dL) and in one patient with mature cystic teratoma (1 month-old infant with an AFP concentration of 629 ng/dL). Preoperative β-hCG levels were normal in all patients (<1.2 mIU/mL). Of the 11 patients whose preoperative scrotal ultrasound could be obtained, 5 solid-cystic lesions, 3 cystic lesions, and 2 solid lesions were reported. Calcification was detected in 4 patients. All 4 patients with malignant tumors and 3 patients with benign tumors underwent radical inguinal orchiectomy. Of the 5 tumors removed by testis preserving surgery, 2 were mature teratomas, 2 were epidermoid cyst and 1 was a benign multi-cystic lesion. There was a patient with yolk sac tumor who died in the fifth month postoperatively while receiving chemotherapy. The remaining patients had no metastatic or local primary testicular tumor recurrence during a mean follow-up of 92 months (2-198 months). Conclusion: Most pre-pubertal tumors are benign and testicular sparing surgery can be performed in patients with negative serum tumor markers. Inguinal radical orchiectomy is sufficient in the treatment of yolk sac tumor. [ABSTRACT FROM AUTHOR]

Background. Meconium peritonitis occurs when meconium leaks into the peritoneal cavity as a result of intrauterine gastrointestinal perforation. In this study, we aimed to evaluate the results of newborn patients who were followed and treated due to intrauterine gastrointestinal perforation in the pediatric surgery clinic. Methods. All newborn patients who were followed up and treated for intrauterine gastrointestinal perforation in our clinic between December 2009-2021 were analyzed retrospectively. Newborns who had no congenital gastrointestinal perforation were not included in our study. The data were analyzed using NCSS (Number Cruncher Statistical System) 2020 Statistical Software. Results. Within twelve years, intrauterine gastrointestinal perforation was detected in 41 newborns, including 26 (63.4%) males, and 15 (36.6%) patients who were operated on in our pediatric surgery clinic. Surgical findings of 41 patients diagnosed with intrauterine gastrointestinal perforation revealed the presence of volvulus (n=21), meconium pseudocyst (n=18), jejunoileal atresia (n=17), malrotation-malfixation anomaly (n=6), volvulus due to internal hernia (n=6), Meckel's diverticulum (n=2), gastroschisis (n=2), perforated appendicitis (n=1), anal atresia (n=1), and gastric perforation (n=1). Eleven patients (26.8%) died. Total intubation time was significantly higher in deceased cases. Postoperatively, deceased cases passed their first stool significantly earlier than surviving newborns. Besides, ileal perforation was seen significantly more frequently in deceased cases. However, the frequency of jejunoileal atresia was significantly lower in the deceased patients. Conclusions. Although sepsis has been held primarily responsible for the deaths in these infants from past to present, insufficiency in lung capacity necessitating intubation negatively affects their survival. Early passage of stool is not always an indicator of good prognosis after the operation, and patients may die due to malnutrition and dehydration, even after they are discharged after feeding, defecating and having weight gain. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Behcet Uz Children's Hospital is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The most important indication for tracheotomy in children is long-term intubation due to cardiopulmonary and neurological diseases. Pediatric tracheostomy is associated with varying complication (10–58%) and mortality (0–3.6%) rates. Herein, we aimed to present the results of our 12 years of pediatric tracheostomy experience. Methods: This was a retrospective study of medical records of pediatric patients who underwent tracheostomy in our pediatric surgery department from 2009 to 2021. Results: During 12 years, 37 tracheostomies were performed in 17 (45.9%) males and 20 (54.1%) female children, and the median age was 5 months (min: 2 months–14 years). Emergency tracheostomy was performed in 8 (21.6%), while planned tracheostomy in 29 (78.4%). During the operation and early postoperative days, any medical problem was detected in 34 (91.9%) patients, while 2 (5.4%) neonates with tracheal atresia were lost in the first and second postoperative days. One patient was desaturated (2.7%) due to decannulation during the tracheostomy dressing; however, tracheostomy cannula was safely inserted again after intratracheal intubation. Two cannulas were removed; granulation tissue was formed in 1 case, and occlusion of the cannula was observed in 2 cases (one on the post-operative 2nd day, and the second one on the post-operative 10th day) as complications of tracheostomy. Twenty-three patients (62.2%) survived, and 14 (37.8%) patients died. Among the surviving patients, two tracheostomies were closed in a boy (with congenital diaphragmatic hernia), and in a girl (with esophageal atresia, distal tracheoesophageal fistula, severe tracheomalacia, and Fallot tetralogy), 3 years postoperatively. Conclusion: Pediatric tracheotomy can be successfully performed with minimal complication rates through appropriate surgical technique and adequate postoperative care. [ABSTRACT FROM AUTHOR]

Hydrometrocolpos is a pelvic cystic mass representing the distension of the vagina and uterus due to a lower genital tract obstruction causing accumulation of utero‐cervical‐vaginal secretions or urine in the vagina and endometrial cavity. Prenatal diagnosis is uncommon and differential diagnosis of the underlying etiologies is quite challenging in the prenatal period. We present three cases of female fetuses with hydrometrocolpos and discuss the prenatal differential diagnoses in the light of ultrasound findings along with postnatal diagnoses and outcomes. [ABSTRACT FROM AUTHOR]

Massive hemobilia, an acute life-threatening condition, remains a diagnostic challenge in pediatric patients due to its rarity. In this study, the difficulties encountered in the diagnosis and treatment of acute massive hemobilia and acute obstructive jaundice in a 3-year-old boy are discussed in the light of the literature. [ABSTRACT FROM AUTHOR]

Objective: Since acute appendicitis is a clinical condition that develops after inflammation of the appendix, changes in the markers related to infection are expected in the laboratory tests of these cases. In this study, it was aimed to determine the changes in C-reactive protein (CRP) and hemogram examinations taken before and after surgery in children with perforated appendicitis and even to determine the markers that could indicate appendix perforation. Material and Methods: This study was conducted in children with perforated appendicitis who were operated on in our pediatric surgery department in 2019. Only patients whose pre-operative and post-operative laboratory tests were performed in our hospital were included in the study. The demographic characteristics, pre-operative and post-operative (CRP, White blood cell [WBC], neutrophil, lymphocyte, mean platelet volume [MPV], and platelets [PLT]) values were analyzed retrospectively. Results: Only 69 of 141 children with perforated appendicitis who were operated on in 2019 had pre- and post-operative tests performed in our hospital. Of the 69 cases included in our study, 29 were female (40.1%) and 40 were male (59.9%). The median pre-operative values of CRP, WBC, neutrophil, lymphocyte, MPV, and PLT were 4.4 (0.2-21.66) mg/dL, 14.46 (5.27-32.6) 103/mm3, 10.03 (2.6-20.25) 103/mm3, 1.76 (0.17-8.69) 103/mm3, 8.7 (6.99-134) fL, and 280 (134-497) 103/mm3, respectively. The median values of CRP, WBC, Nötrofil, Lenfosit, MPV, and PLT on the 5th post-operative day were 3.8 (0.2-17.7) mg/dL, 11.39 (4.4-36.8) 103/mm3, 8.63 (2.12-22.02) 103/mm3, 1.75 (0.41-6.17) 103/mm3, 8.7(6.5-146) fL, and 286 (146-721) 103/mm3, respectively. The difference of CRP and WBC between pre- and post-operative values was found to be significant based on Wilcoxon Signed Rank Test (Non-parametric) (<0.05). Conclusion: Moderately high CRP and WBC values are important as an infection marker in the diagnosis of acute appendicitis. Similar to the literature, it has been shown that the CRP level, which was high before the operation, gradually decreased after the operation, but still did not return to normal at discharge. The decrease in CRP and WBC values after surgery is an indication that inflammation has regressed after appendectomy, but it takes time to completely return to normal. [ABSTRACT FROM AUTHOR]

Cupping therapy, in its traditional name in the Middle East as al-hijamah, is a traditional and complementary treatment method that generally uses containers placed on the skin to create negative pressure through suction, and has been used all over the world from past to present. Infantile hypertrophic pyloric stenosis is a disease in which the outlet of the stomach undergoes almost complete obstruction due to the hypertrophy of the pyloric canal. It is seen in infants in the 1 months after birth and it’s the most effective treatment is surgery. This study discusses a patient with infantile hypertrophic pyloric stenosis, in whom the traditional alternative medicine method was performed due to severe jaundice, and then treated surgically. [ABSTRACT FROM AUTHOR]

Objective: This study is a preliminary report in the efficacy of lateral T-stoma (LTS), which we developed as a solution for anastomosis dysfunction and/or short bowel syndrome in the jejunoileal atresia (JIA). Method: The primary pathologies and results of all cases who underwent lateral t-stoma between July 2017-2020 were evaluated retrospectively. Results: Case 1 with meconium pseudocysts secondary to intrauterine volvulus had Type-3A JIA at 50 cm from the Treitz, and end-oblique anastomosis was performed. The LTS was created proximal to the first anastomosis. on Day 15 due to abdominal distension with 5/1 diameter ratio. The patient was discharged 13 days later. The LTS was closed in the 10th month. In Case 2 with Type-2 JIA at 60 cm from the Treitz, primary LTS was created proximal to the anastomosis with 5/1 diameter ratio. Patient was discharged 15 days later. The LTS was closed in the 10th month. End-to-side anastomosis was performed in Case 3 with Type-2 JIA located 70 cm from Treitz. Anastomotic leakage occurred on Day 36, and the LTS was created with 6/1 diameter ratio. The LTS was closed in the 5th month. Prenatally diagnosed Case 4 was postnatally intubated due to pulmonary hypertension, and surfactant was applied. Intrauterine volvulus, meconium pseudocyst and intestinal perforation were detected at 50 cm from the Treitz, and jejunoileal anastomosis together with primary LTS was performed with 5/1 diameter ratio. Nasogastric feeding started on the 10th day, but patient was lost on Day 44 without extubation. Primary repair and end-stoma were performed in Case 5 with gastroschisis/intestinal atresia with perforation. Due to high-flow stomal discharge/weight loss, the ileo-colic anastomosis and LTS were performed proximal to anastomosis with 3/1 diameter ratio at 60 cm from Treitz on Day 68. Patient was discharged on Day 90. In Case 6 with prenatal diagnosis as meconium cyst with Type-2 JIA (at 65 cm from Treitz), primary LTS was created proximal to the anastomosis with 4/1 diameter ratio. The LTS was closed in the 14th month due to high-flow stomal discharge. Conclusion: Creation of lateral T-stoma proximal to the anastomosis in JIAs with large differences in diameters may shorten hospitalization time and relieve functional obstruction/short bowel syndrome. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to scintigraphically investigate the preoperative and postoperative renal functions of patients operated due to ureteropelvic junction obstruction, discuss the factors affecting the indication of surgery and emphasize the important points to consider during scintigraphic examination. Method: We retrospectively analyzed pediatric cases who underwent pyeloplasty due to ureteropelvic junction obstruction. Patients operated for primary ureteropelvic junction obstruction whose preoperative and postoperative dynamic scintigraphy results could be obtained were included in the study. The patients were divided into two groups as those with <50% and =50% ipsilateral differentiated renal function. The difference between the groups was considered statistically significant when p<0.05. Results: The median ages of 36 cases in <50% DRF group and 24 cases in =50% DRF group were 7.7 months and 8.5 months, respectively. The mean ipsilateral differentiated renal function values of the main groups were significantly different from each other both in the preoperative and postoperative periods. The changes within the two main groups were also analyzed, yielding significant differences. Ipsilateral differentiated renal function changes on a general, group and subgroup basis, and preoperative ultrasound findings of the ipsilateral kidney in subgroups were revealed. Conclusion: Increased hydronephrosis degree and renal pelvis anterior-posterior diameter are closely related to overestimated ipsilateral kidney function. For deciding on surgery in patients with ureteral obstruction, scintigraphic examinations make sense with the help of US and the clinical condition of the patient. [ABSTRACT FROM AUTHOR]

Background: Many physicians in Turkey are both clinicians and researchers, and publishing their research contributes to better patient care as well as to career advancement. Objective: To identify the barriers faced by Turkish physicians to writing research papers and getting them published. Methods: Respondents were asked, through eight multiple-choice questions, about the difficulties they faced in writing research papers and in getting them published in journals. We also searched published literature for accounts of similar difficulties and answers to the question 'What is your purpose in writing scientific publications?' Results: A total of 18% (155 of 871) of physicians completed the questionnaire. About the difficulties faced in writing, 82 out of the 155 participants, or 57%, reported problems in finding financial support; 58 (40%), in obtaining required permissions and clearances; 65 (45%), in acquiring relevant skills, especially those related to data analysis or statistics; and 42 (29%), in languagerelated skills. About the difficulties in getting their papers published in journals, 85 (60%) said that they tried to overcome the difficulties by searching for appropriate solutions on the internet; 66 (47%) sought help from experienced colleagues; and 47 (33%) needed professional help in English translation and editing. Need for financial support was reported by a significantly (p = 0.04) larger proportion of associate professors or full professors (69%) than that of residents (47%) and fellows (45%). Conclusion: The main problems that Turkish physicians face in preparing scientific manuscripts were lack of financial support, inadequate knowledge of data analysis and statistics, and the paperwork involved in obtaining required approvals and permissions--problems that were common to the departments of internal medicine and of surgery. The primary motivation for writing and publishing was career advancement, especially through promotion to a higher academic rank. [ABSTRACT FROM AUTHOR]