Biomedical subjects

Keith Georgeson

Publications and source records attributed to Keith Georgeson.

5 recordsLinked to original sources

PubMed2005

Preliminary report on the International Conference for the Development of Standards for the Treatment of Anorectal Malformations.

BACKGROUND: Anorectal malformations (ARM) are common congenital anomalies seen throughout the world. Comparison of outcome data has been hindered because of confusion related to classification and assessment systems. METHODS: The goals of the Krinkenbeck Conference on ARM was to develop standards for an International Classification of ARM based on a modification of fistula type and adding rare and regional variants, and design a system for comparable follow up studies. RESULTS: Lesions were classified into major clinical groups based on the fistula location (perineal, recto-urethral, recto-vesical, vestibular), cloacal lesions, those with no fistula and anal stenosis. Rare and regional variants included pouch colon, rectal atresia or stenosis, rectovaginal fistula, H-fistula and others. Groups would be analyzed according to the type of procedure performed stratified for confounding associated conditions such as sacral anomalies and tethered cord. A standard method for postoperative assessment of continence was determined. CONCLUSIONS: A new International diagnostic classification system, operative groupings and a method of postoperative assessment of continence was developed by consensus of a large contingent of participants experienced in the management of patients with ARM. These methods should allow for a common standardization of diagnosis and comparing postoperative results.

Anal Canal↗

PubMed2003

Minimally invasive surgery in neonates.

Minimally invasive surgery (MIS) has been one of the most important developments in surgery in the last century. By reducing the incision to small puncture wounds, morbidity, pain, adhesions and scarring are reduced. Due to their small size, neonates have not benefited from the advances in endoscopic surgery as rapidly as their adult counterparts. In the last 5 years, miniaturization of instruments and the development of sophisticated new techniques have enabled paediatric surgeons to apply endoscopic surgery to neonates. MIS is now being performed in both the neonatal chest and abdomen. This article reviews these new developments and discusses the potential for even further improvements in neonatal surgery in the future.

Humans↗

PubMed2003

Ectopic brain tissue in a neonate.

We report a 2-week-old male with a large cystic mass in the left cervical and face region. No connection to the brain or spinal cord was discernable either at operation or on imaging. Histological study of this mass revealed central nervous tissue including neuroglia, ependymal cells, non-neuroblastic neurons, pigmented retinal epithelium, and choroid plexus. This case represents the rare ectopic 'brain'. We review this case as well as the literature concerning these unusual masses.

Brain↗

PubMed2002

Treatment of lymphangiomas with OK-432 (Picibanil) sclerotherapy: a prospective multi-institutional trial.

OBJECTIVE: To describe and to determine the robustness of our study evaluating the efficacy of OK-432 (Picibanil) as a therapeutic modality for lymphangiomas. DESIGN AND SETTING: Prospective, randomized trial and parallel-case series at 13 US tertiary care referral centers. SUBJECTS: Thirty patients diagnosed as having lymphangioma. Ages in 25 ranged from 6 months to 18 years. Twenty-nine had lesions located in the head-and-neck area. INTERVENTION: Every patient received a 4-dose injection series of OK-432 scheduled 6 to 8 weeks apart unless a contraindication existed or a complete response was observed before completion of all injections. A control group was observed for 6 months. OUTCOME MEASURES: Successful outcome of therapy was defined as a complete or a substantial (>60%) reduction in lymphangioma size as determined by calculated lesion volumes on computed tomographic or magnetic resonance imaging scans. RESULTS: Overall, 19 (86%) of the 22 patients with predominantly macrocystic lymphangiomas had a successful outcome. CONCLUSIONS: OK-432 should be efficacious in the treatment of lymphangiomas. Our study design is well structured to clearly define the role of this treatment agent.

Adolescent↗

PubMed2002

Results of laparoscopic antireflux procedures in neurologically normal infants and children.

Most children treated for gastroesophageal reflux have been neurologically impaired. With the recent growth of laparoscopic surgery, neurologically normal children are being referred for fundoplication. We review the presentation diagnostic workup and surgical therapy for children with gastroesophageal reflux unresponsive to medical management. Although many techniques are available for surgical correction of gastroesophageal reflux in children, the laparoscopic Nissen fundoplication remains the standard for correction of gastroesophageal reflux. The technique is performed through five trocars, and emphasis is placed on obtaining at least 3 cm of intra-abdominal esophagus and holding the esophagus in this position with sutures between the crura and the esophagus. The fundoplication should be loose and no longer than 2 cm in length. Long-term follow-up has shown recurrence to be low in children who are neurologically normal as long as they do not gag and retch recurrently.

Child↗