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Riccipetitoni G, Pelizzo G, Ruffoli M, Cavaiuolo S, Vella C, La Pergola E, Pansini A, Del Re G, Vatta F, Avolio L, Romano PG, Raffaele A. Effectiveness of Articulating Linear Stapler for Total and Partial Laparoscopic Splenectomy in Children. J Laparoendosc Adv Surg Tech A 2021; 31:1331-1336. [PMID: 34424747 DOI: 10.1089/lap.2020.0812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: We performed a retrospective study to determine the effectiveness and feasibility of articulating linear stapler in laparoscopic total splenectomy (LTS) and laparoscopic partial splenectomy (LPS), focusing on technical laparoscopic skills that could help pediatric surgeons to avoid intra- and postoperative complications. Methods: Retrospective cohort study of children younger than 18 years who underwent laparoscopic spleen surgery between January 2008 and March 2020. Age, sex, indication for surgery, operative time (OT), intra- and postoperative complications, and postoperative length of hospital stay (LHS) were analyzed. Data from parenchymal resection and vessels sealing techniques were obtained. Results: Thirty patients, 19 LTS and 11 LPS, were included. The mean age of the patients was 10.9 years, and 16 patients were male and 14 were female. For hematologic diseases, LTS was the elective surgery, associated with cholecystectomy in 5 cases. LPS was the common procedure for splenic cysts. The stapler was used in LTS to close the hilum vessels and in LPS for parenchymal resection. No statistically significant differences in OT were observed comparing LTS and LPS. Two conversions occurred in LTS; none in LPS. The mean LHS was 6 days in both groups. No recurrence or major complications appeared in both groups at 1-12 years of follow-up. In particular for LPS, there are no relapse of cyst neither reduction in splenic function. Conclusions: This study shows the effectiveness, feasibility, and safety of mechanic stapler in splenic surgery both for hilum vessels sealing and for parenchymal resection. The use of this device can reduce risk of hemorrhagic recurrences or major surgical complications improving the safety of the operation.
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Affiliation(s)
- Giovanna Riccipetitoni
- Pediatric Surgery Unit, Department of Maternal and Child Health, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Gloria Pelizzo
- Department of Biomedical and Clinical Science "L.Sacco," University of Milano, Milano, Italy.,Pediatric Surgery Unit, V. Buzzi Children's Hospital, Milan, Italy
| | - Maria Ruffoli
- Pediatric Surgery Unit, Department of Maternal and Child Health, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Silvia Cavaiuolo
- Pediatric Surgery Unit, Department of Maternal and Child Health, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Claudio Vella
- Department of Pediatric Surgery, Sant'Anna University Hospital, Ferrara, Italy
| | - Enrico La Pergola
- Department of Biomedical and Clinical Science "L.Sacco," University of Milano, Milano, Italy
| | - Andrea Pansini
- Department of Biomedical and Clinical Science "L.Sacco," University of Milano, Milano, Italy
| | - Giulia Del Re
- Department of Biomedical and Clinical Science "L.Sacco," University of Milano, Milano, Italy
| | - Fabrizio Vatta
- Pediatric Surgery Unit, Department of Maternal and Child Health, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Luigi Avolio
- Pediatric Surgery Unit, Department of Maternal and Child Health, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Piero Giovanni Romano
- Pediatric Surgery Unit, Department of Maternal and Child Health, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Alessandro Raffaele
- Pediatric Surgery Unit, Department of Maternal and Child Health, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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Pelizzo G, Vestri E, Del Re G, Filisetti C, Osti M, Camporesi A, Rizzo D, De Angelis A, Zoia E, Tommasi P, Zuccotti G, Calcaterra V. Supporting the Regional Network for Children with Burn Injuries in a Pediatric Referral Hospital for COVID-19. Healthcare (Basel) 2021. [PMID: 34066726 DOI: 10.339/healthcare9050551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Considerable reorganization of the regional network for pediatric burn treatment during the pandemic was required to cope with severe burn injuries in small children. In support of the emergency network for burns during the COVID-19 pandemic, we referred to regional indications for centralization in our hospital for all children aged less than 5 years who presented with severe burns, >15% of total body surface area (TBSA), or who necessitated admittance to the pediatric intensive care unit (PICU). A new service with a dedicated management protocol was set up to treat pediatric burns in our SARS-CoV-2 pediatric hospital during the lockdown period. A multidisciplinary burn treatment team was set up to offer compassionate and comprehensive burn care. Patient's clinical data, burn features, treatment and follow up were recorded. A higher number of admissions was recorded from February to December 2020 compared with the same period in 2019 (52 vs. 32 admissions). Eighteen patients were admitted to the COVID-19 Service (10 M/8 F; 3.10 ± 2.6 yrs); ten children (55.5%) were hospitalized in the ward and eight in the ICU (44.5%). Fifty percent of the cases presented with lesions extending over >15% TBSA; in one case, TBSA was 35%. All patients suffered 2nd-degree burns; while five patients also had 3rd degree lesions covering more than 15% TBSA. All of the injuries occurred at home. No major secondary infections were recorded. Successful treatment was achieved in 94.4% of cases. The average length of stay was 15.2 ± 12.6 days. A proactive, carefully planned service, involving a multidisciplinary team, was created to ensure appropriate care in a pediatric hospital during the COVID-19 period, despite the effective pandemic associated challenges. Better health promotion in pediatric burn cases should also include dedicated TBSA assessment and a database of children's burn characteristics.
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Affiliation(s)
- Gloria Pelizzo
- Pediatric Surgery Department, "Vittore Buzzi" Children's Hospital, 20154 Milan, Italy.,Department of Biomedical and Clinical Science "L. Sacco", University of Milan, 20122 Milan, Italy
| | - Elettra Vestri
- Pediatric Surgery Department, "Vittore Buzzi" Children's Hospital, 20154 Milan, Italy
| | - Giulia Del Re
- Pediatric Surgery Department, "Vittore Buzzi" Children's Hospital, 20154 Milan, Italy
| | - Claudia Filisetti
- Pediatric Surgery Department, "Vittore Buzzi" Children's Hospital, 20154 Milan, Italy
| | - Monica Osti
- Pediatric Surgery Department, "Vittore Buzzi" Children's Hospital, 20154 Milan, Italy.,Department of Surgery, Policlinico San Donato, 20097 Milan, Italy
| | - Anna Camporesi
- Pediatric Intensive Care Unit, "Vittore Buzzi" Children's Hospital, 20154 Milan, Italy
| | - Dario Rizzo
- Outpatients Unit, "Vittore Buzzi" Children's Hospital, 20154 Milan, Italy
| | | | - Elena Zoia
- Pediatric Intensive Care Unit, "Vittore Buzzi" Children's Hospital, 20154 Milan, Italy
| | - Paola Tommasi
- Pediatric Department, "Vittore Buzzi" Children's Hospital, 20154 Milan, Italy
| | - Gianvincenzo Zuccotti
- Department of Biomedical and Clinical Science "L. Sacco", University of Milan, 20122 Milan, Italy.,Pediatric Department, "Vittore Buzzi" Children's Hospital, 20154 Milan, Italy
| | - Valeria Calcaterra
- Pediatric Department, "Vittore Buzzi" Children's Hospital, 20154 Milan, Italy.,Pediatrics and Adolescentology Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
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