Biomedical subjects

D Shinhar

Publications and source records attributed to D Shinhar.

6 recordsLinked to original sources

PubMed1998

The use of collagen-coated vicryl mesh for reconstruction of the canine cervical esophagus.

Collagen-coated vicryl mesh (CCVM) was used experimentally to patch partial and total segmental defects in the canine cervical esophagus. The esophageal healing process over a 6-month period with successful incorporation of the CCVM and esophageal wall regeneration are described. Twenty-two (91.7%) of 24 dogs survived the procedure without any evidence of esophageal stricture or dysphagia. CCVM has proved to be a suitable material for substitution of esophageal tissue in the canine model. Its clinical use in congenital and acquired esophageal lesions should be considered only pending further experimental laboratory work.

Animals↗

PubMed1998

Lymphangioma circumscriptum.

Two children with lymphangioma circumscriptum (LC), a rare cutaneous lymphangioma, are described. One was diagnosed antenatally as having a right axillary cystic hygroma; in addition, postnatally LC was noted on the right forearm. A few years later a mediastinal lymphangioma was diagnosed. This combination of LC associated with additional malformations of the lymphatic system has not been reported previously, and may point to a generalized developmental disorder of the lymphatic system. The pathophysiology of the lesion is discussed with a review of the pertinent literature. It appears that LC primarily affects the subcutaneous tissue in the form of cystic dilatation of lymphatic channels without systemic lymphatic communication. The skin lesions are probably secondary to the increased intraluminal pressure. The typical clinical appearance is manifested by multiple skin vesicles and lymphorrhea. The main treatment modality is surgical excision. Recurrences are not unusual and require re-excision.

Child, Preschool↗

PubMed1997

Laparoscopic and thoracoscopic surgery in children and adolescents: a 3-year experience.

Our initial experience over the last 3 years with laparoscopic and thoracoscopic surgery in children and adolescents is reported. Between September 1992 and August 1995, a total of 215 laparoscopic and thoracoscopic procedures were performed: 32 appendectomies for acute appendicitis, 10 cholecystectomies for symptomatic gallstones, 11 procedures for adnexal pathology, 6 laparoscopies in children with nonpalpable testes, 3 diagnostic laparoscopies, and 153 thoracoscopic sympathectomies in children suffering from primary palmar hyperhidrosis. The post-operative course was uneventful in all cases. In 2 children with acute appendicitis we converted to the open technique due to technical difficulties. We are encouraged by the results of our initial experience. There is no doubt that laparoscopic cholecystectomy, laparoscopic surgery of adnexal pathology, and thoracoscopic sympathectomy, because of their numerous benefits - shorter operative time, hospitalization, and convalescence as well as less postoperative pain and improved cosmetic results - are replacing the open techniques. We are not convinced as yet of the advantages of laparoscopic appendectomy in children; we are presently performing both laparoscopic and conventional techniques and studying the various parameters in order to reach a more definite conclusion. Various other endoscopic surgical procedures will be carefully considered in the near future.

Acute Disease↗

PubMed1996

[Psoas abscess: diagnostic dilemma in childhood].

A series of 16 children diagnosed as having a psoas abscess or deep iliac lymphadenitis seen over a 25-year period (1970-1994) is presented. 10 were treated conservatively while 5 were drained surgically and 1 percutaneously under imaging guidance. The presenting signs and symptoms may mimic the frequently seen entities, acute appendicitis and acute hip arthritis. Lower abdominal and inguinal pain, limp, fever and increased white count are common in all of these conditions. Accurate differential diagnosis is necessary to avoid unnecessary surgery due to a wrong diagnosis. Ultrasonography is preferred for diagnosis. Antibiotic therapy should be instituted immediately, aimed primarily at Staphylococcus aureus, the most common causative agent, although other organisms may be implicated. When a psoas abscess has been diagnosed, surgery and drainage are indicated. One of the preferred approaches is percutaneous drainage under imaging guidance. Convalescence is usually rapid and without late sequelae.

Anti-Bacterial Agents↗

PubMed1996

[Thoracoscopic upper thoracic sympathectomy for primary palmar hyperhidrosis].

We report our initial experience, over the past 3 years, with thoracoscopic sympathectomy for severe, primary, palmar hyperhidrosis in children and adolescents. From 1992-1995, 179 thoracoscopic sympathectomies were performed in 61 girls and 35 boys, 5.5 to 18 years old (mean 14.8). During the first 2 years the procedures were performed bilaterally but not simultaneously. During the past years, 65 underwent bilateral, simultaneous sympathectomy, using a single 10 mm subaxillary port of entry. 94 (98%) had immediate and permanent relief of palmar sweating. The immediate postoperative course was uneventful in all except 2 who had residual pneumothorax that required 24-hour intercostal drainage. These results compare favorably with the open method and are actually better in terms of less pain, early discharge, quicker return to normal activity and a smaller and less conspicuous scar. We emphasize the benefits of early surgery in children with severe, palmer hyperhidrosis, to avoid the many years of psychological, social and physical discomfort during adolescent growth and development.

Adolescent↗

PubMed1996

The laparoscopic approach to uterine adnexal torsion in childhood.

Seven girls with adnexal torsion (of varying degrees) were treated laparoscopically during a 6-month period. All had associated adnexal pathology. Six had simple follicular cysts (> 4 cm in diameter), and one had a 10-cm dermoid cyst. Detorsion with resection of the cyst and preservation of ovarian tissue was performed in all cases. No intraoperative or postoperative complications were encountered. Video-assisted minimally invasive surgery is suitable for the treatment of adnexal pathology in children; the hospitalization period is short, the cosmetic results are excellent, and the return to normal activity is rapid.

Adnexal Diseases↗