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S Shehata

Publications and source records attributed to S Shehata.

5 recordsLinked to original sources
PubMed2004

Transanal one-stage endorectal pull-through for Hirschsprung's disease: a multicenter study.

BACKGROUND/PURPOSE: Transanal endorectal pull-through (TEPT) is the latest development in treatment of Hirschsprung's disease (HD). This prospective study was designed to evaluate the safety and efficacy of 1 stage TEPT technique in the management of patients with HD. METHODS: One hundred forty-nine children (116 boys and 33 girls) aged 8 days to 14 years underwent 1 stage TEPT procedure over an 18-month period at 5 Egyptian academic pediatric surgical centers and affiliated hospitals. Median follow-up was 12 months (range, 3 to 21 months). These patients were evaluated with regard to age, sex, length of the aganglionic segment, intraoperative details, and postoperative functional results or complications. An electromyogram (EMG), endorectal ultrasound scan, and lower gastrointestinal (GI) motility studies were reserved for patients with postoperative problems with bowel control. RESULTS: Mean operating time was 120.2 +/- 27.8 minutes (range, 60 to 210 minutes). The average length of resected bowel was 26.8 +/- 12.4 cm (range, 15 to 45 cm). Thirteen patients required laparotomy because of extension of aganglionic segment beyond the sigmoid colon in 9, tear in the mesenteric vessels in 2, and difficulties in getting to the submucosal plane in 2. Three deaths (2%) occurred 3 days, 4 days, and 4 weeks postoperatively, respectively. Postoperative complications included transient perianal excoriation in 48 patients (30 were <3 months of age), enterocolitis (n = 26), anastomotic stricture (n = 7), recurrent constipation (n = 6), hypoganglionosis at distal end of pulled through segment (n = 2), cuff abscess (n = 3), anastomotic leak (n = 1), adhesive bowel obstruction (n = 1), and rectal prolapse (n = 1). Complete anorectal continence was noted in 35 of 42 (83.3%) children older than 3 years, whereas soiling and frequent accidents still occur in 7, who showed a steady improvement in their continence status. CONCLUSIONS: One-stage TEPT technique is both feasible and safe technique in properly selected children with rectosigmoid HD in all ages. The technique is easily learned and is associated with excellent clinical results.

Adolescent↗
PubMed2000

Hydrostatic reduction of intussusception: barium, air, or saline?

While there is agreement that hydrostatic reduction (HR) is the ideal first-line treatment for childhood intussusception, there is controversy about which technique is best, namely, barium, air, or saline. We present our experience in the Pediatric Surgical Center, University of Alexandria, in HR of intussusception under ultrasound (US) guidance. The study was divided into two phases: between 1983 and 1990 and between 1991 and 1998. HR was started gradually in phase I, and became routine in phase II. Diagnosis and reduction were done by the pediatric surgical staff. The success rate was 71.7% in phase I and 85.5% in phase II. Most unreduced cases were the ileo-ileocolic type: 58.6% in phase I and 69.3% in phase II. HR under US guidance is equal or superior to other techniques of reduction, while having the obvious advantage of avoiding radiation exposure.

Air↗
PubMedDate not supplied

Autotransfusion in vascular surgery.

A randomized prospective study of 202 patients undergoing peripheral vascular surgery, with the use of autotransfusion, is presented. Hematologic and hemostatic studies were performed on 50 samples of reclaimed and bank blood. The study showed a lower hemoglobin content in autotransfused blood. At the same time it showed a higher platelet count and higher concentration of labile clotting factors. When the patient's blood was tested 24 hours post-transfusion there was no significant residual hematologic or hemostatic defect. There were 15 complications related to blood transfusion including two deaths. The author concludes that autotransfusion significantly reduces the need for bank blood and post-transfusion complications and that it is safe and easy to use.

Aged↗