Objective: Thyroid carcinomas are rare in childhood and adolescence. This study was conducted to ... more Objective: Thyroid carcinomas are rare in childhood and adolescence. This study was conducted to evaluate the clinical features and outcomes in children and adolescents with thyroid carcinoma at our center. Material and Methods: Twelve children and adolescents treated for thyroid carcinoma in our departments from 2004 to 2014 were included in the study. Results: Papillary carcinoma was found in 9 patients and follicular carcinoma in 3 patients. Neck swelling was the most common chief complaint. At the time of surgery, one patient (8%) had cervical lymph node metastasis, and one (8%) had angioinvasion. No patients had lung metastasis. Total thyroidectomy was performed in 4 patients, ipsilateral total and contralateral subtotal thyroidectomy in 5 patients, partial thyroidectomy in 2 patients and thyroglossal duct cyst excision in one patient. Eight patients (66%) required 131I ablation for residual or metastatic disease after thyroidectomy. At the time of this report, all patients were alive without recurrence. Conclusion: According to our data, children and adolescents with thyroid carcinoma have a good prognosis and benefit from total or near-total thyroidectomy followed by radioiodine therapy. Future prospective studies are required to clarify the short- and long-term side effects of treatment approaches.
Objective: To compare miniaturized percutaneous nephrolithotomy (mini-PNL) and retrograde intrare... more Objective: To compare miniaturized percutaneous nephrolithotomy (mini-PNL) and retrograde intrarenal surgery (RIRS) in children with 10-20 mm renal stones. MATERIALS AND METHODS: Between 2015 and 2019, 63 pediatric patients aged under 16 years who under went mini-PNL and RIRS for the treatment of kidney stones sized 10-20 mm were analyzed retrospectively. The mini-PNL group (n=30) was defined as group 1 and the RIRS group (n=33) was defined as group 2. Peri-operative data including stone-free rate, operative time, fluoroscopy time, hospitalization time, number of anesthesia sessions, complication rates, and cost-effectiveness were analyzed. Results: The mean age was 8.09±5.49 years in group 1 and 5.75±4.56 years in group 2. The stone free rate was not different at the first (80.0% vs. 57.6%) and third month (93.3% vs. 90.9%) follow-up in group 1 and group 2. The mean hospitalization, operative, and fluoroscopy times were statistically significantly longer in group 1. The mean number of anesthesia sessions for patients was 1.20±0.40 in group 1 and 2.15±0.44 in group 2 (p=0.00). Minor complication rates were not different and no major complications were observed in either group. The cost per patient was calculated as 365.97 Euros in group 1 and 698.64 Euros in group 2 (p=0.001). CONCLUSIONS: This study suggested that RIRS was an effective alternative treatment method for 10-20 mm kidney stones in children, with comparable stone-free and complication rates. RIRS has a shorter operative time, fluoroscopy time, hospital stay than mini-PNL, with a similar stone-free rate for 10-20 mm kidney stones in children. However, mini-PNL is cheaper and allowed a lower need for anesthesia sessions.
Purpose: The aim of the study was to examine the prevalence of redo-ureteroneocystostomy (redo-UN... more Purpose: The aim of the study was to examine the prevalence of redo-ureteroneocystostomy (redo-UNC) in pediatric vesicouretheral reflux (VUR) patients following open UNC and factors associated with redo-UNC. Material and methods: Data on 122 patients who underwent open UNC for VUR were analyzed in this retrospective case-control study. The patients were divided into a successful initial UNC group (UNC group, control) and an unsuccessful initial UNC group (redo-UNC group, case). The following variables were analyzed: sex, age, dysfunctional voiding, laterality of VUR (unilateral or bilateral), VUR grade, etiology of VUR (primary or secondary), relative renal function on renal scintigraphy, and surgical technique. The use of the following procedures in the initial UNC was recorded: an endoscopic subureteric injection(ESI) and ureteral tapering. Results: In our clinic, 122 patients (177 ureters), with an average age of 55.7 ± 41.2 months (range, 1-18 years) underwent open UNC for VUR between November 2005 and June 2014. Of these,67 (55%) had unilateral VUR, and 55 (45%) had bilateral VUR. There were 127 (71.8%) cases of grade 4-5 reflux. Postoperatively, hydronephrosis was noted in 19 (15.6%) patents. Ten (8.2%) patients underwent redo-UNC. In eight cases (6.5%), redo-UNC was performed because of ureterovesical (UV) junction obstruction.In the other two cases (1.7%), redo-UNC was dueto high-grade reflux. There were no statistically significant differences between the redo-UNC and UNC groups in any of the variables studied. Conclusion: Redo-UNC was required in 10 (8.2%) of cases after UNC. Age, sex, laterality of VUR, VUR grade,existence of primary or secondary VUR, relative renal function on renal scintigraphy, UNC technique, ESI procedure,and ureteral tapering were not risk factors for redo-UNC in our series.
Cystic partially differentiated nephroblastoma is a rare cystic renal neoplasm of infancy. It sho... more Cystic partially differentiated nephroblastoma is a rare cystic renal neoplasm of infancy. It should be distinguished from solid Wilms’ tumor with cystic change. Nephrectomy with a careful follow-up is the only adequate therapy for grade 1 tumor.
Background: Hydatid disease (HD) is a parasitic infection caused by Echinococcus granulosus. The ... more Background: Hydatid disease (HD) is a parasitic infection caused by Echinococcus granulosus. The liver is involved in 50-70 % of the cases. Cystobiliary communication is the most common complication of hepatic hydatid cysts. Low frequency of the complications of liver hydatid disease is noted in children when compared to adult series with high mortality and morbidity. We present our experience of complications in childhood liver hydatid cyst disease and compare the results with adult series. Methods: Seventy four cases of HD have been evaluated retrospectively. The diagnosis of HD was made on the basis of radiologic imaging methods. The median follow-up period was 30 months. Results: There were 44 females and 30 males, age ranging from 2 to 15 years (mean 9.5 years). Overall 94 liver hydatid cysts in 74 patients were treated. Obstructive jaundice and signs of cholangitis were not noted preoperatively in our series. Recurrence of cyst was seen in three patients (4%). Prolonged bilier drainage was seen in one patient (1.3%). Four patients (5.4 %) of our series had biliary opening up tosize of 5 mm . Anaphlactic reaction was seen in one patient intraoperatively. There were no mortalities. Conclusion: Unlike adult series we did not encountered complicated cyst hydatid disease in childhood. Predictors of morbidity for liver hydatid cyst in adults like age, size of the cyst, location of the cyst are not valid predictors in children. Therefore surgeons must be avoid of surgical procedure in children especially at biliary system.
Objective: Thyroid carcinomas are rare in childhood and adolescence. This study was conducted to ... more Objective: Thyroid carcinomas are rare in childhood and adolescence. This study was conducted to evaluate the clinical features and outcomes in children and adolescents with thyroid carcinoma at our center. Material and Methods: Twelve children and adolescents treated for thyroid carcinoma in our departments from 2004 to 2014 were included in the study. Results: Papillary carcinoma was found in 9 patients and follicular carcinoma in 3 patients. Neck swelling was the most common chief complaint. At the time of surgery, one patient (8%) had cervical lymph node metastasis, and one (8%) had angioinvasion. No patients had lung metastasis. Total thyroidectomy was performed in 4 patients, ipsilateral total and contralateral subtotal thyroidectomy in 5 patients, partial thyroidectomy in 2 patients and thyroglossal duct cyst excision in one patient. Eight patients (66%) required 131I ablation for residual or metastatic disease after thyroidectomy. At the time of this report, all patients were alive without recurrence. Conclusion: According to our data, children and adolescents with thyroid carcinoma have a good prognosis and benefit from total or near-total thyroidectomy followed by radioiodine therapy. Future prospective studies are required to clarify the short- and long-term side effects of treatment approaches.
Objective: To compare miniaturized percutaneous nephrolithotomy (mini-PNL) and retrograde intrare... more Objective: To compare miniaturized percutaneous nephrolithotomy (mini-PNL) and retrograde intrarenal surgery (RIRS) in children with 10-20 mm renal stones. MATERIALS AND METHODS: Between 2015 and 2019, 63 pediatric patients aged under 16 years who under went mini-PNL and RIRS for the treatment of kidney stones sized 10-20 mm were analyzed retrospectively. The mini-PNL group (n=30) was defined as group 1 and the RIRS group (n=33) was defined as group 2. Peri-operative data including stone-free rate, operative time, fluoroscopy time, hospitalization time, number of anesthesia sessions, complication rates, and cost-effectiveness were analyzed. Results: The mean age was 8.09±5.49 years in group 1 and 5.75±4.56 years in group 2. The stone free rate was not different at the first (80.0% vs. 57.6%) and third month (93.3% vs. 90.9%) follow-up in group 1 and group 2. The mean hospitalization, operative, and fluoroscopy times were statistically significantly longer in group 1. The mean number of anesthesia sessions for patients was 1.20±0.40 in group 1 and 2.15±0.44 in group 2 (p=0.00). Minor complication rates were not different and no major complications were observed in either group. The cost per patient was calculated as 365.97 Euros in group 1 and 698.64 Euros in group 2 (p=0.001). CONCLUSIONS: This study suggested that RIRS was an effective alternative treatment method for 10-20 mm kidney stones in children, with comparable stone-free and complication rates. RIRS has a shorter operative time, fluoroscopy time, hospital stay than mini-PNL, with a similar stone-free rate for 10-20 mm kidney stones in children. However, mini-PNL is cheaper and allowed a lower need for anesthesia sessions.
Purpose: The aim of the study was to examine the prevalence of redo-ureteroneocystostomy (redo-UN... more Purpose: The aim of the study was to examine the prevalence of redo-ureteroneocystostomy (redo-UNC) in pediatric vesicouretheral reflux (VUR) patients following open UNC and factors associated with redo-UNC. Material and methods: Data on 122 patients who underwent open UNC for VUR were analyzed in this retrospective case-control study. The patients were divided into a successful initial UNC group (UNC group, control) and an unsuccessful initial UNC group (redo-UNC group, case). The following variables were analyzed: sex, age, dysfunctional voiding, laterality of VUR (unilateral or bilateral), VUR grade, etiology of VUR (primary or secondary), relative renal function on renal scintigraphy, and surgical technique. The use of the following procedures in the initial UNC was recorded: an endoscopic subureteric injection(ESI) and ureteral tapering. Results: In our clinic, 122 patients (177 ureters), with an average age of 55.7 ± 41.2 months (range, 1-18 years) underwent open UNC for VUR between November 2005 and June 2014. Of these,67 (55%) had unilateral VUR, and 55 (45%) had bilateral VUR. There were 127 (71.8%) cases of grade 4-5 reflux. Postoperatively, hydronephrosis was noted in 19 (15.6%) patents. Ten (8.2%) patients underwent redo-UNC. In eight cases (6.5%), redo-UNC was performed because of ureterovesical (UV) junction obstruction.In the other two cases (1.7%), redo-UNC was dueto high-grade reflux. There were no statistically significant differences between the redo-UNC and UNC groups in any of the variables studied. Conclusion: Redo-UNC was required in 10 (8.2%) of cases after UNC. Age, sex, laterality of VUR, VUR grade,existence of primary or secondary VUR, relative renal function on renal scintigraphy, UNC technique, ESI procedure,and ureteral tapering were not risk factors for redo-UNC in our series.
Cystic partially differentiated nephroblastoma is a rare cystic renal neoplasm of infancy. It sho... more Cystic partially differentiated nephroblastoma is a rare cystic renal neoplasm of infancy. It should be distinguished from solid Wilms’ tumor with cystic change. Nephrectomy with a careful follow-up is the only adequate therapy for grade 1 tumor.
Background: Hydatid disease (HD) is a parasitic infection caused by Echinococcus granulosus. The ... more Background: Hydatid disease (HD) is a parasitic infection caused by Echinococcus granulosus. The liver is involved in 50-70 % of the cases. Cystobiliary communication is the most common complication of hepatic hydatid cysts. Low frequency of the complications of liver hydatid disease is noted in children when compared to adult series with high mortality and morbidity. We present our experience of complications in childhood liver hydatid cyst disease and compare the results with adult series. Methods: Seventy four cases of HD have been evaluated retrospectively. The diagnosis of HD was made on the basis of radiologic imaging methods. The median follow-up period was 30 months. Results: There were 44 females and 30 males, age ranging from 2 to 15 years (mean 9.5 years). Overall 94 liver hydatid cysts in 74 patients were treated. Obstructive jaundice and signs of cholangitis were not noted preoperatively in our series. Recurrence of cyst was seen in three patients (4%). Prolonged bilier drainage was seen in one patient (1.3%). Four patients (5.4 %) of our series had biliary opening up tosize of 5 mm . Anaphlactic reaction was seen in one patient intraoperatively. There were no mortalities. Conclusion: Unlike adult series we did not encountered complicated cyst hydatid disease in childhood. Predictors of morbidity for liver hydatid cyst in adults like age, size of the cyst, location of the cyst are not valid predictors in children. Therefore surgeons must be avoid of surgical procedure in children especially at biliary system.
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