Surgical Treatment Of Congenital Anomalies Research Articles

Diagnosis and surgical treatment of congenital anomalies of the development of the female genital organs

In the departments of pediatric surgery in clinics in Ryazan and Zaporizhia, 5 girls aged 12–16 years with malformations of the urinary and genital system were observed: duplication of the vagina and uterus, aplasia of the duplicated vagina in combination with aplasia of the kidney on the side of the malformation. In 3 children, the combined defect was right-sided, in 2 — left-sided, and accompanied by hematocolpos and hematometra. In the diagnosis of malformations of the urinary and genital system in girls, anamnesis, examination of the abdominal cavity and bimanual examination, ultrasound examination, excretory urography, vaginoscopy, and computed tomography were used. Currently, surgical excision of the underdeveloped vaginal wall is performed to empty it from menstrual discharge. The imposition of a wide window in the septum between the aplastic and healthy vagina is the preferred operation. Further observations are carried out by gynecologists.

Surgical treatment of congenital anomalies of the aortic arch : Long-term results

Congenital anomalies of the aortic arch gather a wide spectrum of malformations concerning the aortic arch or some of its branches and the pulmonary artery. These malformations are rare (1 in 1000 live births) and sometimes responsible of complete (vascular ring) or partial (vascular sling) encirclement of the oesophagus, trachea or bronchi. In cases of symptomatic airways obstruction or oesophagus compression the surgical treatment is mandatory and curative. In this paper we describe the experience of Children's Hospital of Toulouse on the surgical treatment of congenital anomalies of aortic arch.

Principles and experience of surgical treatment of spina bifida in adults

The study objective was to summarize our own experience of surgical treatment of spina bifida in adults. The mean age of patients was 33 years. The time elapsed since the onset of clinical presentations till surgery varied from 11 to 14 years. Among all elective, surgically significant pathologies of the spinal cord (tumors, syringomyelia, arachnoid cysts, spontaneous epidural hematoma, epidural abscess, abscess), spina bifida in adults amounted to 5.9%. The level of social adaptation of patients at the time of diagnosis was quite acceptable (patients had a normal index of intellectual development and the ability to move). The amount of surgery was large and included implementation of several important surgical manipulations. The operative time was 5.5 h, on average. As a result, the spinal cord and its roots were released from compression and retaining structures that, to some extent, allowed for avoiding dissection of the terminal ligament. Minimally invasive technologies can not still ensure implementation of all surgical manipulations for correction of the vertebral-medullary anomaly. Surgical treatment of congenital anomalies of the spinal cord in adults proved to be reasonable and effective.

Surgical management of congenital coronary arterial anomalies in adults

Congenital anomalies of the coronary arteries are an uncommon, but important, cause of pain in the chest, myocardial ischaemia and even sudden cardiac death, especially in young individuals. This paper focuses on the surgical treatment of congenital anomalies of the coronary arteries in adults; indications for surgery and the different surgical options will be reviewed.

Tissue engineering from human mesenchymal amniocytes: a prelude to clinical trials

Purpose The surgical treatment of congenital anomalies using tissues engineered from amniotic fluid-derived mesenchymal cells has been validated experimentally. As a prerequisite for testing the clinical feasibility of this therapeutic concept, this study was aimed to expand human mesenchymal amniocytes in the absence of animal products. Methods Human mesenchymal cells were isolated from amniotic fluid samples (n = 12) obtained at 20 to 37 weeks' gestation. Their phenotypic profiles and cell proliferation rates were compared during expansion under 2 different media, containing either fetal bovine serum or allogeneic human AB serum. Statistical analyses were by the 2-sided Wilcoxon signed rank test and linear regression ( P < .05). Results Mesenchymal cells could be isolated and expanded at any gestational age. There was a greater than 9-fold logarithmic expansion of mesenchymal cells, with no significant differences in the overall proliferation rates based on serum type ( P = .94), or gestational age ( P = .14). At any passage, cells expanded for up to 50 days remained positive for markers consistent with a multipotent mesenchymal progenitor lineage, regardless of the medium used. Conclusions Human mesenchymal amniocytes retain their progenitor phenotype and can be dependably expanded ex vivo in the absence of animal serum. Clinical trials of amniotic fluid-based tissue engineering are feasible within preferred regulatory guidelines.

CORRECTION AND STABILIZATION OF THE SPINE WITH NEW GENERATION IMPLANTS FOR VERTEBRAL CONGENITAL MALFORMATIONS IN CHILDREN AGED ONE TO FIVE YEARS

Objectives. To analyze the results of correction and stabilization of the spine with new generation implants for congenital malformation of the vertebrae in children of 1 to 5 years old. Material and Methods. A metal construction for surgical treatment of congenital anomalies of the spine in children of 1 to 5 years old was developed, consisting of transpedicular and laminar support elements. This construction was used in 38 patients with congenital thoracic and lumbar spine deformities associated with malformations of the vertebral bodies. Six patients had an isolated lateral or posterior-lateral hemivertebra in the thoracic spine and 11 – in the thoracolumbar junction, 3 patients had wedge-shaped vertebra in the thoracolumbar spine, and 18 – multiple or combined developmental anomalies of the spine. Initial angulation of scoliotic deformity was 24° to 50° and kyphotic deformity – 20° to 46°. Surgical treatment consisted of one-moment three-staged operation according to developed technique. Results. Correction of deformity within 92–100 % was achieved in patients with isolated hemivertebra in the thoracic and lumbar spine, and posterior wedge-shaped vertebrae in the thoracolumbar junction. In patients with multiple and combined developmental anomalies of the spine the correction of scoliotic deformity was 52–76 % and of kyphotic one – 58–80 %. Conclusion. The suggested metal construction provides the possibility to perform surgery at early stages even for developmental anomalies of the spine posterior support column in patients of 1 to 5 years old with congenital spine deformities.

Use of a plastic hemoderivative bag in the treatment of gastroschisis.

The authors report their experience with the use of a polyvinyl chloride (PVC) bag for blood-derivative transfer as a prosthesis for the creation of a silo for surgical treatment of gastroschisis (GS) in seven newborn infants. The bag is sterile, impermeable to micro-organisms, transparent, flexible, resistant, internally smooth, does not adhere to the bowel loops, readily available, and inexpensive, properties that make it an excellent alternative as a prosthesis for staged surgical treatment of congenital anomalies of the abdominal wall such as GS and omphalocele. The importance of a multidisciplinary team for the care of newborns with GS is also emphasized for a good postoperative outcome.

The contribution of microsurgical reconstruction to craniofacial surgery.

Craniofacial surgery has revolutionized the surgical treatment of congenital anomalies affecting the facial and cranial skeleton. Similar techniques have since been used in the reconstruction of patients with extensive craniofacial injuries and following craniofacial resection of tumors involving the midface. The application of microsurgical free flaps to some of these craniofacial problems is another significant advance. Microsurgical transfer of deepithelialized skin flaps or omentum will allow the augmentation of soft tissue contour defects of the face in patients with hemifacial microsomia and Romberg's progressive facial hemiatrophy. Following craniofacial resection of extensive tumors of the midface, microsurgical free flaps and vascularized bone grafts will provide soft tissue coverage and, occasionally, both bone and soft tissue composite reconstruction of the resultant defect. Finally, intracranial infection, following craniofacial surgery and neurosurgical excision of tumors involving the skull base, may be effectively prevented by separation of the dura from the nasopharynx by microsurgical transfer of free muscle flaps and omentum.

Lesions incompatible with life but surgically correctable in infancy and early childhood.

This presentation deals primarily with the diagnosis and surgical treatment of congenital anomalies that usually require correction in the immediate postnatal period. Abnormalities which are not surgical emergencies in the first few days of life but may be surgically correctable in early childhood, such as anomalies of the aortic arch and congenital heart disease, are discussed briefly.

Surgical Treatment of Congenital Anomalies of the Coronal and Metopic Sutures

Surgical Treatment of Congenital Anomalies of the Coronal and Metopic Sutures