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Biomedical subjects

Kiki Maoate

Publications and source records attributed to Kiki Maoate.

6 recordsLinked to original sources

Comparison of suture ligation and clip application for the treatment of patent ductus arteriosus in preterm neonates.

OBJECTIVE: We reviewed the experience of 2 centers performing surgical ligation of patent ductus arteriosus in preterm neonates to identify whether the choice of surgical technique--suture ligation or clip application--affected outcome. METHODS: Between 2000 and 2005, 67 newborn infants had open surgical closure of patent ductus arteriosus: 33 by suture ligation and 34 by clip application. The groups were similar in age and sex. RESULTS: The average length of the procedure was 55.8 +/- 13.7 minutes for suture ligation and 30.8 +/- 8.7 minutes for clip application (P < .05). Six neonates had intraoperative bleeding in the suture ligation group. Four patients had significant postoperative complications in the suture ligation group, compared with 2 in the clip application group. CONCLUSIONS: This study demonstrates that clip application results in a significant reduction in the operative time and, possibly, in less morbidity.

Cardiac Surgical Procedures↗

Appendicostomy stomas and antegrade colonic irrigation after laparoscopic antegrade continence enema.

BACKGROUND: Children with spina bifida, high anorectal anomalies, or neuronal intestinal dysplasia who are treated with a laparoscopic antegrade continence enema to achieve a socially acceptable level of fecal continence sometimes have problems with the stoma and its catheterization. The goal of this study was to determine the nature and incidence of these problems, and their relationship to the underlying condition. MATERIALS AND METHODS: A retrospective review of the hospital case notes of 74 consecutive patients who had a laparoscopic antegrade continence enema was undertaken. RESULTS: The laparoscopic antegrade continence enema procedure is well tolerated but is associated with a variety of usually minor complications including stomal stenosis, leakage, peristomal infection, granulation tissue overgrowth, mucosal prolapse, abdominal discomfort during irrigation, appendiceal false passage, and ineffective irrigation. Surgical revision of the stoma was required in 19% of the cases in this study, usually because of stenosis and skin overgrowth. Ongoing problems achieving colonic emptying were most likely to occur in patients with an anorectal malformation. CONCLUSION: Overall, the laparoscopic antegrade continence enema provides an effective method of facilitating emptying of the bowel. However, it has a high incidence of minor troublesome problems, with stenosis and skin overgrowth of the stoma being the most common. Younger children tend to have more complications and difficulty performing effective irrigation. Children with anorectal malformations were more likely to require surgical revision of the stoma, and often needed ongoing manual evacuation and bowel washouts despite the laparoscopic antegrade continence enema.

Adolescent↗

Hereditary thyroglossal duct cysts.

Thyroglossal duct cysts are one of the most commonly encountered benign neck lumps found in the paediatric population. Despite their relative frequency, reports of familial inheritance are rare. A total of 21 patients with hereditary thyroglossal duct cysts from seven families worldwide have been reported. The most common inheritance pattern is dominant, with a minority possibly representing a recessive aetiology. We describe a further instance of dominantly inherited thyroglossal duct cysts in two generations.

Child, Preschool↗

A simple technique of laparoscopic full-thickness anterior abdominal wall repair of retrosternal (Morgagni) hernias.

BACKGROUND/PURPOSE: Previous reports of laparoscopic repair of Morgagni hernias in children have involved relatively complex laparoscopic techniques. This report describes a simpler method of repair that we have applied to 4 children. METHODS: Four children with retrosternal (Morgagni) hernias underwent primary laparoscopic repair by placement of interrupted synthetic nonabsorbable sutures through the full-thickness of the anterior abdominal wall, incorporating the posterior rim of the defect and returning back out through the anterior abdominal wall, with the sutures tied in the subcutaneous tissue. RESULTS: The children, ranging in age from 11 to 36 months, underwent laparoscopic repair of their Morgagni hernias and had an uneventful postoperative recovery, apart from a port site hernia in one. CONCLUSIONS: This technique for primary laparoscopic repair of Morgagni hernia is easy to perform, well tolerated by the patient, and gives excellent cosmetic results. Laparoscopic closure of the defect by suturing the posterior rim of the hernia to the full thickness of the anterior abdominal wall would appear to provide a safe and effective means of repairing this type of hernia.

Abdominal Wall↗

Attitudes of Pacific parents to circumcision of boys.

BACKGROUND: Circumcision for cultural reasons is routine in Pacific Island countries. In New Zealand routine circumcision for which there is no medical indication is uncommon and no longer publicly funded within the public hospital system. This has caused difficulties for the Pacific people of New Zealand. AIM: This study documents the differences in the attitudes of Pacific parents and their male children to cultural circumcision, and assesses the strength of their beliefs. METHODOLOGY: Pacific boys between the ages of 8-18 and their parents resident in Christchurch were given a questionnaire to complete and then were interviewed. The participants were obtained mainly through church organisations and after broadcast on Pacifica radio. RESULTS: One hundred and sixteen of the 123 participants felt that they had strong ties to the Pacific community. The majority (89%) of the Pacific people felt that circumcision should be performed mainly for reasons of culture and hygiene. Only a small number were aware of the possible complications that might occur with circumcision. The average age that most Pacific people were circumcised and would want their children to be circumcised is between 6 and 10 years of age. Boys were less sure than their fathers that they would get their own sons circumcised. CONCLUSION: This study has shown that circumcision is expected and surprisingly well accepted by the boys of Pacific families despite the discomfort they know the procedure causes. There is a strong cultural demand from parents for circumcision. Guidance from church leaders or sexual health lessons at schools or elsewhere may alter the cultural importance of circumcision for Pacific Island people. However, the preference for circumcision is so well entrenched into their cultural beliefs and may take years to influence.

Adolescent↗