Mean Hospital-stay Research Articles

Outcome of very-low-birth-weight infants in a developing country: a prospective study from the western region of Turkey

Objective: To illustrate neonatal outcomes, including morbidity, birth weight and gestational age-specific mortality, and care practices for very-low-birth-weight infants admitted to our tertiaryneonatal intensive care unit in Turkey and compare these with the corresponding data from recent reports from developed countries.Methods: Perinatal data were collected prospectively from January1996 to December 2000. Perinatal events and the neonatal course to 120 days of life, discharge, or death were evaluated.Results: Of 173 infants, 82% survived until discharge to home or to 120days of life. Survival was 13% for infants of 501-750 g at birth, 74% for those of 751-1000 g, 92% for those of 1001-1250 g and 87% for those of 1251-1500 g. Mortality rates were greater for male than forfemale infants (25% vs. 12%). The mean birth weight was 1218 (450-1500) g and the mean gestational age was 29.8 (23-36) weeks. The birth weight and gestational age distributions showed that the majorityof infants (48%) weighed 1251-1500 g and were between 28 and 31 weeks' gestation (57%). Antenatal steroids were administered to only 19% of mothers. The overall Cesarean section rate was 77%. Respiratorydistress syndrome was diagnosed in 36% and surfactant was administered to 98% of these infants. The rate of ventilator support was 54% for a mean duration of 9 days. Air leak syndromes were diagnosed inonly nine infants (5%). Severe intracranial hemorrhage (grade > II) and periventricular leukomalacia developed in 9% of infants. Four infants had evidence of chronic lung disease. Retinopathy of prematurity(stage > II) was noted in only one infant, and proven necrotizing enterocolitis (Bell's classification stage > 2) was not observed. The rate of survival without major morbidity was 91%. The mean hospitalstay was 40 days for survivors and 19 days for infants who died.Conclusion: Despite marked differences in socioeconomic conditions and tertiary care facilities, the mortality (except in thesmallest babies) and morbidity rates were comparable with those of recent studies from developed countries.

Laparoscopic adrenalectomy in children

The aim of this study was to describe the indications and results of laparoscopic adrenalectomy in children. This retrospective multicenter study included six children (four boys, two girls) aged 2-16 years (mean, 9.5). Three children had hypertension. In three cases, the adrenal mass was discovered incidentally. The tumors were bilateral in two children, right-sided in two cases, and left-sided in two cases. The mean tumor size was 4 cm (range, 1-7). Each child underwent MIBG scintigraphy and MRI before the operation. Four right and two left adrenal glands were resected by laparoscopy (transperitoneal), and two left glands were resected by retroperitoneoscopy. Two conversions were necessary for two left adrenal glands (one retroperitoneoscopy, one laparoscopy). Two partial resections and six adrenalectomies were performed. Histological examination of the tumors revealed two ganglioneuromas, one neuroblastoma, and five pheochromocytomas (two bilateral). One child had an involved node (pheochromocytoma). Both bilateral pheochromocytomas had von Hippel-Lindau disease. There was no morbidity. Mean hospitalstay was 6 days. Postoperative evaluation at 1 month was normal in all children. The indications for laparoscopic adrenalectomy in children are benign tumors and pheochromocytomas. In these cases, laparoscopic adrenalectomy is feasible and safe, even in cases of pheochromocytoma.