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Haraux E. Response to "Challenges associated with the K-wire technique for external urinary drainage in pediatric laparoscopic pyeloplasty". J Pediatr Urol 2024; 20:151. [PMID: 37770340 DOI: 10.1016/j.jpurol.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 09/06/2023] [Indexed: 09/30/2023]
Affiliation(s)
- E Haraux
- Department of Pediatric Surgery, Amiens University Hospital, Amiens, France; PériTox Laboratory (UMR-I 01), University Health Research Center, Faculty of, Medicine, Jules Verne University of Picardy, Amiens, France.
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Ghestem T, Carolina D, Chappey B, Klein C, Haraux E. Evaluation of the K-wire technique for external urinary drainage in pediatric laparoscopic pyeloplasty. J Pediatr Urol 2023; 19:639.e1-639.e4. [PMID: 37419833 DOI: 10.1016/j.jpurol.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 05/19/2023] [Accepted: 06/05/2023] [Indexed: 07/09/2023]
Abstract
INTRODUCTION Urinary drainage is usually left in place after laparoscopic pyeloplasty to limit the risk of complications, such as urinary leakage. The procedure is sometimes laborious and complications may occur. PURPOSE Prospective evaluation of the Kirschner technique for urinary drainage during pediatric laparoscopic pyeloplasty. STUDY DESIGN This technique (Upasani et al., J Pediatr Urol 2018) involves introducing a nephrostomy tube (Blue Stent) with a Kirschner wire during laparoscopic transperitoneal pyeloplasty. We evaluated this technique by analyzing 14 consecutive pyeloplasties (53% on female patients, median age 10 years (6-16 years), on the right side in 40%) performed by a single operator between 2018 and 2021. The drain and urinary catheter were clamped and the perirenal drain removed on day 2. The stent was removed during consultation between days 7 and 15. RESULTS The median duration of surgery was 155 ± 7 min. Urinary drainage was installed within 5 min, without the need for radiological control and with no complications. All drains were correctly placed, with no drain migration or urinoma. Median hospital stay was 2 ± 1 days. One patient developed pyelonephritis (D8). The stent was removed without difficulty or complications. One patient presented an 8-mm lower calyx urinary stone at two months, revealed by macroscopic hematuria, necessitating extracorporeal shock wave lithotripsy. DISCUSSION The study design was based on a homogeneous series of patients, without comparison with another drainage technique or procedures performed by another operator. A comparison with other techniques might have been informative. Before this study, we tested various types of urinary drainage, to optimize performance. This technique was considered the simplest and least invasive. CONCLUSION External drain placement with this technique was rapid, safe, and reproducible in children. It also made it possible to test the tightness of the anastomosis and to avoid the need for anesthesia for drain removal.
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Affiliation(s)
- T Ghestem
- Department of Urology, Amiens University Hospital, F-80054 Amiens, France
| | - D Carolina
- Department of Pediatric Surgery, Amiens University Hospital, F-80054 Amiens, France
| | - B Chappey
- Department of Urology, Amiens University Hospital, F-80054 Amiens, France
| | - C Klein
- Department of Pediatric Surgery, Amiens University Hospital, F-80054 Amiens, France
| | - E Haraux
- Department of Pediatric Surgery, Amiens University Hospital, F-80054 Amiens, France; PeriTox - UMI 01, UFR de Médecine, Jules Verne University of Picardy, F-80054 Amiens, France.
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Priam A, Chabani N, Klein C, Haraux E. Scrotal orchidopexy for perineal ectopic testis. Arch Pediatr 2022; 29:404-406. [DOI: 10.1016/j.arcped.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 03/26/2022] [Indexed: 10/18/2022]
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Charvillat O, Plancq MC, Haraux E, Gouron R, Klein C. Epidemiological analysis of burn injuries in children during the first COVID-19 lockdown, and a comparison with the previous five years. ANN CHIR PLAST ESTH 2021; 66:285-290. [PMID: 34229909 PMCID: PMC8254538 DOI: 10.1016/j.anplas.2021.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/06/2021] [Accepted: 06/09/2021] [Indexed: 12/23/2022]
Abstract
Background Child burns rank among the most frequent domestic accidents in France. COVID-19 lockdown between March 16th and May 11th of 2020 increased time spent at home by children. Material This retrospective, observational study described the epidemiological impact of COVID-19 lockdown on child burns in a pediatric surgery department compared with previous five years. Child burns in the previous five years constituted the “before COVID-19 group” as the reference group. Child burns during the first lockdown formed the “COVID-19 group”. Demographics characteristics, the delay before first attendance at the surgery department, burns characteristics, the place of the incident, need of skin graft, and child reactions to trauma or isolation were recorded for these two groups. Results A total of thirty-seven children were included, 16 of them in the COVID-19 group. In the COVID-19 group, burned children were mainly boys, with a median age of 18 months. The median time before first attendance was four days. Main burns characteristics were to be deep partial thickness burns, involved lower limbs, caused by scalding. All burns occurred at home. Half parents reported child reactions to trauma or isolation among their children before burn injury. Conclusion The incidence of child burn injuries in the COVID-19 group was higher compared to the before COVID-19 group, but no increased delay to attendance recorded. Time spent at home and psychosocial impact of lockdown might partially explain this high incidence rate of child burns. Level of evidence IV.
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Affiliation(s)
- O Charvillat
- Department of Pediatric Orthopedics, Jules Verne University of Picardie and Amiens Picardie University Medical Center, Amiens, France
| | - M-C Plancq
- Department of Pediatric Orthopedics, Jules Verne University of Picardie and Amiens Picardie University Medical Center, Amiens, France
| | - E Haraux
- Department of Pediatric Orthopedics, Jules Verne University of Picardie and Amiens Picardie University Medical Center, Amiens, France
| | - R Gouron
- Department of Pediatric Orthopedics, Jules Verne University of Picardie and Amiens Picardie University Medical Center, Amiens, France
| | - C Klein
- Department of Pediatric Orthopedics, Jules Verne University of Picardie and Amiens Picardie University Medical Center, Amiens, France.
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Nadau E, Joseph C, Haraux E, Deroussen F, Gouron R, Klein C. Clinical features and outcomes in children with bone and joint infections of the ankle or foot. Arch Pediatr 2020; 27:464-468. [PMID: 33011034 DOI: 10.1016/j.arcped.2020.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 05/11/2020] [Accepted: 08/11/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND The foot and ankle are uncommon sites of bone and joint infections (BJIs) in children. The objectives of the present study were to determine the clinical and bacteriologic features of BJIs and to assess any associated complications and orthopedic sequelae. METHODS We performed a retrospective, single-center study of children treated for foot or ankle BJIs between 2008 and 2018 in a French university medical center. A total of 23 children were included. The median age at diagnosis was 9.1 years. Osteomyelitis was noted in 14 cases; it involved the calcaneus in seven cases, the distal fibula in four cases, the first metatarsal in two cases, and the distal tibia in one case. Arthritis affected the ankle in six cases and the cuneiform-cuboidal joint in one case. In two cases, osteoarthritis of the ankle was associated with distal osteomyelitis of the tibia. Clinical, radiological, and bacteriological parameters, surgical procedures, complications, and sequelae were recorded and analyzed. RESULTS The median (range) time to diagnosis was 3.18 days (0-10), and trauma was reported in four cases. Fever was present on admission in 18 cases, and the serum C-reactive protein level was elevated in 22 cases. Standard X-rays showed osteolysis in one case and bone sequestration in another. Staphylococcusaureus was identified in 10 cases. Surgery was performed in 17 cases. A subperiosteal abscess that required surgical drainage complicated 10 cases of osteomyelitis. No recurrence was observed. At the last follow-up, the median (range) age was 11.9 years (1.5-19). Sequelae (spontaneous tibia-talus fusion, first metatarsal epiphysis fusion, and varus deformity of the hindfoot) were observed in three cases, all of which were initially complicated by an abscess. CONCLUSION Physicians should be aware that pediatric BJIs of the lower limb may involve the foot and ankle. S. aureus is frequently involved. In cases of osteomyelitis, complications are closely associated with subperiosteal abscesses justifying an early diagnosis. These BJIs must be treated rapidly, and the risk of sequelae justifies long-term follow-up.
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Affiliation(s)
- E Nadau
- Department of pediatric orthopedics, Jules-Verne university of Picardie and Amiens Picardie university medical center, 80054 Amiens cedex 1, France
| | - C Joseph
- Department of infectious disease, Jules-Verne university of Picardie and Amiens Picardie university medical center, 80054 Amiens cedex 1, France; AGIR group, microbiology research unit, EA4294, Jules-Verne university of Picardie, 80054 Amiens cedex 1, France
| | - E Haraux
- Department of pediatric orthopedics, Jules-Verne university of Picardie and Amiens Picardie university medical center, 80054 Amiens cedex 1, France
| | - F Deroussen
- Department of pediatric orthopedics, Jules-Verne university of Picardie and Amiens Picardie university medical center, 80054 Amiens cedex 1, France
| | - R Gouron
- Department of pediatric orthopedics, Jules-Verne university of Picardie and Amiens Picardie university medical center, 80054 Amiens cedex 1, France
| | - C Klein
- Department of pediatric orthopedics, Jules-Verne university of Picardie and Amiens Picardie university medical center, 80054 Amiens cedex 1, France.
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Charvillat O, Plancq MC, Haraux E, Tourneux P, Gouron R, Klein C. Aplasia cutis congenita of both knees: A new therapeutic strategy. Arch Pediatr 2020; 27:277-280. [PMID: 32417075 DOI: 10.1016/j.arcped.2020.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 05/02/2020] [Indexed: 10/24/2022]
Abstract
Aplasia cutis congenita is defined as the absence of all layers of the skin. The condition involves mainly the scalp but it can affect any area of skin on the body. A clear therapeutic strategy is not available. Here, we describe the 6-year clinical outcome of a patient with aplasia cutis congenita of both knees following treatment with an artificial dermis and a thin skin graft.
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Affiliation(s)
- O Charvillat
- Department of Pediatric Orthopedic Surgery, Amiens University Medical Center and Jules Verne University of Picardie, 80054 Amiens cedex 1, France
| | - M-C Plancq
- Department of Pediatric Orthopedic Surgery, Amiens University Medical Center and Jules Verne University of Picardie, 80054 Amiens cedex 1, France
| | - E Haraux
- Department of Pediatric Orthopedic Surgery, Amiens University Medical Center and Jules Verne University of Picardie, 80054 Amiens cedex 1, France
| | - P Tourneux
- Médecine néonatale et réanimation pédiatrique, pôle femme-couple-enfant, groupe hospitalier Sud, 80054 Amiens cedex 1, France
| | - R Gouron
- Department of Pediatric Orthopedic Surgery, Amiens University Medical Center and Jules Verne University of Picardie, 80054 Amiens cedex 1, France
| | - C Klein
- Department of Pediatric Orthopedic Surgery, Amiens University Medical Center and Jules Verne University of Picardie, 80054 Amiens cedex 1, France.
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Surlemont J, Lecuelle D, Courbier G, Haraux E, Delforge X. Antibiotic therapy in pediatric acute appendicitis: Compliance with local protocol to reduce antibiotic overuse. Arch Pediatr 2020; 27:261-264. [PMID: 32409246 DOI: 10.1016/j.arcped.2020.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 11/06/2019] [Accepted: 04/07/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Acute appendicitis is one of the commonest surgical emergencies in pediatrics. Treatment usually consists of a combination of surgery and antibiotics. The present study was designed to assess compliance with our local antibiotic protocol and analyse the consequences of non-compliance. METHODS Children presenting with acute appendicitis between 2015 and 2017 were included in this study. The diagnosis of acute appendicitis was confirmed during surgery. Data concerning the antibiotic therapy received and infectious complications were reviewed. RESULTS A total of 142 children with acute appendicitis were included. Antibiotic therapy complied with the protocol in 27.4% of cases, while an excessive duration of antibiotic therapy was observed in 65% of cases. A total of 270 days of non-recommended antibiotic therapy was noted; 32% of patients received a non-recommended combination of antibiotics. The infectious complications rate was 12.8% in the group of patients receiving appropriate antibiotic therapy, and 11.6% in the group with non-compliance to the protocol. No statistically significant difference between the groups was found (P=0.85). CONCLUSION Poor compliance with the antibiotic guidelines for appendicitis resulted in antibiotic overuse with no benefit in terms of anti-infective efficacy. Better information for the medical team and repeated evaluation of our practices are essential.
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Affiliation(s)
- J Surlemont
- Department of Pediatric Surgery, CHU d'Amiens-Picardie, Site Sud, 80054 Amiens, France
| | - D Lecuelle
- Department of Pediatric Surgery, CHU d'Amiens-Picardie, Site Sud, 80054 Amiens, France
| | - G Courbier
- Department of Pediatric Surgery, CHU d'Amiens-Picardie, Site Sud, 80054 Amiens, France
| | - E Haraux
- Department of Pediatric Surgery, CHU d'Amiens-Picardie, Site Sud, 80054 Amiens, France
| | - X Delforge
- Department of Pediatric Surgery, CHU d'Amiens-Picardie, Site Sud, 80054 Amiens, France.
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Forzini T, Demouron M, Uhl M, Mesureur S, Renard C, Klein C, Haraux E. Computed tomograpy evaluation of ureteral length in children. J Pediatr Urol 2019; 15:555.e1-555.e5. [PMID: 31324475 DOI: 10.1016/j.jpurol.2019.06.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 06/15/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Although ureteral length (UL) is highly variable in children, reliable data on this topic are scarce. During urinary tract surgery, the use of an inappropriately dimensioned ureteral stent is associated with adverse effects. This study aimed to evaluate UL as a function of the child's age, using contrast-enhanced computed tomography (CT) of the abdomen and pelvis, and to calculate a new equation for predicting UL (and thus the optimal length of ureteral stents) in children. MATERIAL AND METHODS A retrospective, single-centre study of children (younger than 16 years) who are free of abdominal mass syndrome and severe scoliosis was conducted. After three-dimensional reconstruction of the CT data, the ureter was measured between the ureteropelvic junction and ureterovesical junction by two observers. The lengths of the right and left ureters were analyzed by age, with at least 10 CT measurements per age class. RESULTS The mean ULs on the right and left were, respectively, 9.7 and 9.91 cm before the age of 1 year, 20.10 and 21.08 cm at the age of 7 and 26.55 and 27.46 cm at the age of 16. The interobserver reproducibility of UL determination was high (intraclass correlation coefficient [95% confidence interval]: 0.97 [0.94-0.99]). On the basis of these results, the length of the double-J catheter should be equal to the child's age +12 cm (Table 1). CONCLUSION Computed tomography measurement of the UL in healthy children is reproducible and reliable and enabled the estimation of the UL by age group. This knowledge should facilitate the choice of the stent used in ureteral surgery. To confirm the study results, the stent size suggested here should be evaluated in routine practice.
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Affiliation(s)
- T Forzini
- Department of Urology and Transplantation, Amiens University Hospital, Amiens, France
| | - M Demouron
- Department of Visceral Surgery, Amiens University Hospital, Amiens, France
| | - M Uhl
- Department of Urology and Transplantation, Amiens University Hospital, Amiens, France
| | - S Mesureur
- Department of Pediatric Surgery, Amiens University Hospital, Amiens, France
| | - C Renard
- Department of Radiology, Amiens University Hospital, Amiens, France
| | - C Klein
- Department of Pediatric Surgery, Amiens University Hospital, Amiens, France
| | - E Haraux
- Department of Pediatric Surgery, Amiens University Hospital, Amiens, France; PeriTox - UMI 01, UFR de Médecine, Jules Verne University of Picardy, Amiens, France.
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Haraux E, Klein C. Commentary on 'External stent in laparoscopic pyeloplasty: The K-wire technique'. J Pediatr Urol 2019; 15:230-231. [PMID: 30833175 DOI: 10.1016/j.jpurol.2019.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 01/21/2019] [Indexed: 10/27/2022]
Affiliation(s)
- E Haraux
- Department of Pediatric Surgery, Amiens University Hospital, Amiens, France; PériTox Laboratory (UMR-I 01), University Health Research Center, Faculty of Medicine, Jules Verne University of Picardy, Amiens, France.
| | - C Klein
- Department of Pediatric Surgery, Amiens University Hospital, Amiens, France
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Delforge X, Kongolo G, Cauliez A, Braun K, Haraux E, Buisson P. Transient pseudohypoaldosteronism: a potentially severe condition affecting infants with urinary tract malformation. J Pediatr Urol 2019; 15:265.e1-265.e7. [PMID: 30962012 DOI: 10.1016/j.jpurol.2019.03.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 03/01/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND Secondary pseudohypoaldosteronism (S-PHA) is a life-threatening condition affecting young children with urinary tract malformation (UTM). OBJECTIVE The aim of the study was to highlight the diagnosis of S-PHA in children with UTM and propose appropriate management. STUDY DESIGN The authors retrospectively reviewed cases of S-PHA related to UTM observed at the institution and searched the PubMed® database to review the literature. RESULTS A total of 116 cases of S-PHA associated with UTM, including the four cases from the institution, were reviewed. One hundred six cases (92.2%) were younger than 6 months, and 95 cases (81.9%) occurred in boys. Urinary tract infection was associated in 105 cases (90.5%). All types of UTM were observed. In the absence of urinary tract infection, S-PHA was related to bilateral UTM or solitary kidney. In 89 cases (76.5%), S-PHA resolved with medical treatment only. In cases of UTM requiring immediate surgery, electrolyte imbalance related to S-PHA also resolved after surgery. Children with associated urinary tract infection and bilateral UTM are at higher risk of developing S-PHA. DISCUSSION The pathogenesis of S-PHA has not been fully elucidated. Renal tubular immaturity may be one of the factors involved, in view of the young age of the population being affected. A high rate of bilateral UTM (or UTM on solitary kidney) was observed (50.9%), suggesting an association with S-PHA. In the absence of urinary tract infection (UTI), S-PHA appeared to occur more frequently in the presence of bilateral UTM. Although the indication for early surgery remains unclear, it may have a role in the prevention of UTI and prevention of recurrence of S-PHA. Serum electrolytes should be checked in children with UTM before urological surgery, and/or presenting urinary tract infection, before the age of 6 months. The results of this study must be interpreted cautiously because of its retrospective nature and the fact that data were derived from various articles. Few articles on S-PHA related to UTM have been published in the literature. To the best of the authors' knowledge, the study constitutes the largest series published to date. CONCLUSIONS S-PHA results in potentially severe electrolyte imbalance and affects children younger than 6 months with UTI and/or UTM. Electrolyte abnormalities related to S-PHA often resolve after administration of appropriate intravenous electrolyte solution and treatment of UTI and/or surgery.
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Affiliation(s)
- X Delforge
- Department of Pediatric Urology, CHU Amiens, France.
| | - G Kongolo
- Department of Pediatric Intensive Care Unit, CHU Amiens, France
| | - A Cauliez
- Department of Pediatric Endocrinology, CHU Amiens, France
| | - K Braun
- Department of Pediatric Endocrinology, CHU Amiens, France
| | - E Haraux
- Department of Pediatric Urology, CHU Amiens, France
| | - P Buisson
- Department of Pediatric Urology, CHU Amiens, France
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Chevreau J, Naepels P, Buisson P, Razafimanantsoa L, Gondry J, Haraux E. [Giant mesocolic cystic lymphangioma: A treacherous prenatal presentation. Case report]. Arch Pediatr 2017; 24:552-556. [PMID: 28455093 DOI: 10.1016/j.arcped.2017.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 10/19/2016] [Accepted: 03/23/2017] [Indexed: 11/28/2022]
Abstract
Cystic lymphangiomas are usually located in the neck region. Less frequently, they can be found in the abdomen. In those cases, pre- and neonatal diagnosis is extremely difficult. We report on the case of a giant mesocolic cystic lymphangioma, diagnosed at birth, in a child who had been monitored during the prenatal period for what was believed to be a digestive dilatation. The progression was marked by excellent tolerance despite a complete lack of regression in the first 10 months of life. The authors discuss the prenatal signs that should suggest this diagnosis and an MRI, as well as management during the 1st year of life.
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Affiliation(s)
- J Chevreau
- Service de gynécologie-obstétrique, centre hospitalo-universitaire d'Amiens, avenue René-Laennec, 80054 Amiens cedex 1, France.
| | - P Naepels
- Service de gynécologie-obstétrique, centre hospitalo-universitaire d'Amiens, avenue René-Laennec, 80054 Amiens cedex 1, France
| | - P Buisson
- Service de chirurgie pédiatrique, centre hospitalo-universitaire d'Amiens, avenue René-Laennec, 80054 Amiens cedex 1, France
| | - L Razafimanantsoa
- Service de néonatalogie, centre hospitalo-universitaire d'Amiens, avenue René-Laennec, 80054 Amiens cedex 1, France
| | - J Gondry
- Service de gynécologie-obstétrique, centre hospitalo-universitaire d'Amiens, avenue René-Laennec, 80054 Amiens cedex 1, France
| | - E Haraux
- Service de chirurgie pédiatrique, centre hospitalo-universitaire d'Amiens, avenue René-Laennec, 80054 Amiens cedex 1, France
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Haraux E, Leroux F, Gouron R, Delforge X, Buisson P. [Congenital mesenteric band simulating a small-bowel volvulus in a mesenteric rotation anomaly]. Arch Pediatr 2017; 24:468-470. [PMID: 28347638 DOI: 10.1016/j.arcped.2017.02.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 10/12/2016] [Accepted: 02/21/2017] [Indexed: 11/19/2022]
Abstract
A congenital mesenteric band is a rare cause of intestinal obstruction. We describe a case of upper gastrointestinal obstruction on a jejunal congenital band in a 2-year-old child. The challenge is to make the diagnosis in a patient with no history of previous surgery.
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Affiliation(s)
- E Haraux
- Service de chirurgie de l'enfant, CHU Amiens-Picardie, rond-point Fernand-Léger, 80080 Amiens, France; Laboratoire PériTox-INERIS, université Picardie-Jules-Verne, rond-point Fernand-Léger, 80080 Amiens, France.
| | - F Leroux
- Service de chirurgie viscérale, CHU Amiens-Picardie, rond-point Fernand-Léger, 80080 Amiens, France
| | - R Gouron
- Service de chirurgie de l'enfant, CHU Amiens-Picardie, rond-point Fernand-Léger, 80080 Amiens, France
| | - X Delforge
- Service de chirurgie de l'enfant, CHU Amiens-Picardie, rond-point Fernand-Léger, 80080 Amiens, France
| | - P Buisson
- Service de chirurgie de l'enfant, CHU Amiens-Picardie, rond-point Fernand-Léger, 80080 Amiens, France
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Klein C, Haraux E, Leroux J, Gouron R. [Slipped capital femoral epiphysis]. Arch Pediatr 2017; 24:301-305. [PMID: 28161230 DOI: 10.1016/j.arcped.2016.12.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 10/13/2016] [Accepted: 12/07/2016] [Indexed: 11/30/2022]
Abstract
Slipped capital femoral epiphysis (SFCE) is a disorder of the hip, characterized by a displacement of the capital femoral epiphysis from the metaphysic through the femoral growth plate. The epiphysis slips posteriorly and inferiorly. SCFE occurs during puberty and metabolic and epidemiologic risk factors, such as obesity are frequently found. Most chronic slips are diagnosed late. Sagittal hip X-rays show epiphysis slip. In case of untreated SCFE, a slip progression arises with an acute slip risk. Treatment is indicated to prevent slip worsening. The clinical and radiological classification is useful to guide treatment and it is predictive of the prognosis. In situ fixation of stable and moderately displaced SCFE with cannulated screws gives excellent results. Major complications are chondrolysis and osteonecrosis and the major sequelae are femoroacetabular impingement and early arthritis.
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Affiliation(s)
- C Klein
- Service chirurgie de l'enfant, orthopédie et traumatologie, CHU d'Amiens-Picardie, 80054 Amiens cedex, France.
| | - E Haraux
- Service chirurgie de l'enfant, orthopédie et traumatologie, CHU d'Amiens-Picardie, 80054 Amiens cedex, France
| | - J Leroux
- Clinique chirurgicale infantile, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex 1, France
| | - R Gouron
- Service chirurgie de l'enfant, orthopédie et traumatologie, CHU d'Amiens-Picardie, 80054 Amiens cedex, France
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Haraux E, Ravasse P, Sharma D, Canarelli JP, Gouron R, Tillou X. [Evaluation of a teaching tool for learning the surgical technique of inguinal orchidopexy]. Prog Urol 2016; 26:507-16. [PMID: 27567743 DOI: 10.1016/j.purol.2016.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 06/10/2016] [Accepted: 07/22/2016] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Practical training of the surgery resident is based on the companionship currently hampered in particular by the increase of the number of residents in training. We created a teaching tool to promote learning and validation of a technique of classic urologic surgery, inguinal orchidopexy. The objective is to evaluate the applicability and the relevance of this tool. MATERIAL AND METHODS The tool is a technical evaluation sheet made from reference documentation. The trainers evaluated the residents at 3 times of the semester (hetero-evaluation at 0, 3 and 6 months). Residents evaluated themselves monthly on the same items. RESULTS Three trainers and 6 residents in surgery participated in the study between May and November 2013. The initial evaluation confirmed that the theoretical knowledge was acquired prior to the practical learning. The level of residents was very uneven at the beginning of the study but not at the end of the semester. The monthly evaluations gave a progressive and significant increase of notes. The notes of the intermediate and final hetero-evaluations rose gradually and they were always superior to those previous self-assessments (P<0.05). The tool was considered simple and useful for the participants. CONCLUSION This tool is applicable and relevant to the technical teaching of inguinal orchidopexy in this population. A larger study would be helpful to confirm it. This type of tool could be applied to the simple and common surgery techniques to enrich the educational tools used in the training. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- E Haraux
- Service de chirurgie de l'enfant, NCHU, 80054 Amiens, France; Laboratoire PériTox (EA4285 UMI 01 UPJV INERIS), 80054 Amiens, France.
| | - P Ravasse
- Service de chirurgie pédiatrique, CHU de Caen, 14033 Caen, France
| | - D Sharma
- Service de chirurgie pédiatrique, faculté de médecine Henri-Warembourg, université Lille 2, CHRU de Lille-Jeanne-de-Flandres, 59000 Lille, France
| | - J P Canarelli
- Service de chirurgie de l'enfant, NCHU, 80054 Amiens, France
| | - R Gouron
- Service de chirurgie de l'enfant, NCHU, 80054 Amiens, France
| | - X Tillou
- Service de chirurgie urologique, CHU de Caen, 14033 Caen, France
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Affiliation(s)
- F Le Roux
- Service de chirurgie digestive et métabolique, CHU d'Amiens, université Picardie Jules-Verne, 80000 Amiens, France.
| | - A Lipsker
- Service de chirurgie urologique et transplantation, CHU d'Amiens, université Picardie Jules-Verne, 80000 Amiens, France
| | - S Mesureur
- Service de chirurgie infantile, CHU d'Amiens, université Picardie Jules-Verne, 80000 Amiens, France
| | - E Haraux
- Service de chirurgie infantile, CHU d'Amiens, université Picardie Jules-Verne, 80000 Amiens, France
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Delforge X, Buisson P, Ricard J, Gourmel A, Mesureur S, Canarelli JP, Gouron R, Haraux E. [Penile shaft mass revealed by inguinal lymphadenopathies]. Arch Pediatr 2015; 22:1180-1, 1198-9. [PMID: 26387831 DOI: 10.1016/j.arcped.2015.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 08/03/2015] [Accepted: 08/19/2015] [Indexed: 10/23/2022]
Affiliation(s)
- X Delforge
- Service de chirurgie pédiatrique, CHU Amiens-Picardie, site Sud, 80054 Amiens cedex 1, France.
| | - P Buisson
- Service de chirurgie pédiatrique, CHU Amiens-Picardie, site Sud, 80054 Amiens cedex 1, France
| | - J Ricard
- Service de chirurgie pédiatrique, CHU Amiens-Picardie, site Sud, 80054 Amiens cedex 1, France
| | - A Gourmel
- Service d'oncologie pédiatrique, CHU Amiens-Picardie, site Sud, 80054 Amiens cedex 1, France
| | - S Mesureur
- Service de chirurgie pédiatrique, CHU Amiens-Picardie, site Sud, 80054 Amiens cedex 1, France
| | - J-P Canarelli
- Service de chirurgie pédiatrique, CHU Amiens-Picardie, site Sud, 80054 Amiens cedex 1, France
| | - R Gouron
- Service de chirurgie pédiatrique, CHU Amiens-Picardie, site Sud, 80054 Amiens cedex 1, France
| | - E Haraux
- Service de chirurgie pédiatrique, CHU Amiens-Picardie, site Sud, 80054 Amiens cedex 1, France
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Haraux E, Mercier A, Buisson P, Kongolo G, Ricard J, Canarelli JP, Leke A. P322: Type anatomique et prise en charge du laparoschisis. NUTR CLIN METAB 2014. [DOI: 10.1016/s0985-0562(14)70964-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Devauchelle C, Braun K, Tourneux P, Chardon K, Ricard J, Buisson P, Canarelli J, Boudailliez B, Bach V, Haraux E. SFCP CO-31 - Facteurs prédictifs d’hypospadias en Picardie. Résultats préliminaires. Arch Pediatr 2014. [DOI: 10.1016/s0929-693x(14)71669-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Viart L, Haraux E, Blanpain S, Cordonnier C, Ricard J, Canarelli JP, Buisson P. [Congenital mesoblastic nephroma: diagnosis and treatment of one case]. Prog Urol 2012; 22:189-91. [PMID: 22364631 DOI: 10.1016/j.purol.2011.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2010] [Revised: 09/06/2011] [Accepted: 09/09/2011] [Indexed: 10/16/2022]
Abstract
The congenital mesoblastic nephroma (CMN) described by Bolande et al. in 1967 is a renal tumor often discovered in neonatal period and early childhood. It's usually considered as a benign tumor with good prognostic for which nephrectomy is the reference treatment. But some cases of local recidives and metastatic sites had been described in the literature. For these reasons histologic analysis and quality of follow up are very important. In this observation we describe a neonatal kind of CMN and we discuss this pathology.
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Affiliation(s)
- L Viart
- Service d'urologie-transplantation, CHU Amiens, université Picardie Jules-Verne, 80000 Amiens, France.
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Buisson P, Haraux E, Hamzy M, Ricard J, Canarelli JP, Boudailliez B, Braun K. [Cystinuria in children: A report of 4 cases]. Arch Pediatr 2011; 18:553-7. [PMID: 21458974 DOI: 10.1016/j.arcped.2011.02.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2010] [Revised: 03/19/2010] [Accepted: 02/16/2011] [Indexed: 10/28/2022]
Abstract
Cystinuria is an inherited autosomal-recessive disorder of renal reabsorption of the dibasic amino acids. It is the cause of about 6% of all kidney stones observed in children. Cystine is relatively insoluble at the physiological pH of urine. Cystine stones are characteristic and frequent recurrences are observed. We report on 4 cases and describe the initial presentation (obstructive renal failure, urinary sepsis, familial screening) and the medical and surgical management. Medical management is mainly based on hyperhydration and urine alkalinization. Long-term therapy with sulfhydryl agents to prevent formation of renal stones seems to be effective but adverse side effects are frequent, requiring the withdrawal of treatment. Urological management has evolved from surgical stone removal to minimally invasive procedures (extracorporeal shock wave lithotripsy, ureteroscopy).
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Affiliation(s)
- P Buisson
- Service de chirurgie pédiatrique, hôpital Nord d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France
| | - E Haraux
- Service de chirurgie pédiatrique, hôpital Nord d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France
| | - M Hamzy
- Service de chirurgie pédiatrique, hôpital Nord d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France
| | - J Ricard
- Service de chirurgie pédiatrique, hôpital Nord d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France
| | - J-P Canarelli
- Service de chirurgie pédiatrique, hôpital Nord d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France; Service de pédiatrie, hôpital Nord d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France
| | - B Boudailliez
- Service de pédiatrie, hôpital Nord d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France
| | - K Braun
- Service de pédiatrie, hôpital Nord d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France
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Haraux E, Buisson P, Hamzy M, Ricard J, Gay-Quéheillard J, Bach V, Canarelli J. CL038 - Altérations motrices et histologiques secondaires à la dilatation intestinale chronique. Arch Pediatr 2010. [DOI: 10.1016/s0929-693x(10)70250-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Haraux E, Hamzy M, Mounard J, Djeddi D, Ricard J. SFCP-P50 – Chirurgie viscérale – Tumeur stromale de l’estomac, à propos d’un cas. Arch Pediatr 2008. [DOI: 10.1016/s0929-693x(08)72054-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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