Main Subjects : Pediatric Surgery
Annals of the College of Medicine, Mosul,
2020, Volume 42, Issue 2, Pages 184-189
Background: Proximal hypospadias repair carries high complications rates. single
stage is the standard practice for management but sometimes it is not easy to perform
single stage for posterior hypospadias and here appears the need for staged surgery
in this study we assess the out coms and complications of the most commonly used
techniques in Mosul pediatric surgery center at alkhansaa teaching hospital
Objective: To assess the results of management of posterior hypospadias by
Tubularized incised plate as single stage and staged repair and to knew the most
important complications associated with these two procedures.
Methods: this is prospective study for forty patients who were admitted to Mosul
pediatric surgery center at alkhansaa teaching hospital from October 2011 till
October 2013, their age ranged from 9 month to 15 years, five of them were operated
before with complete failure, 31 patient operated by single stage Tubularized Incised
Plate technique and the other 9 by two stage technique and they were followed for
Results: The total complications rate was (52%) as follow: (7) cases (17.5%)
develop meatal stenosis, (4) patients (10%) develop retrusive meatus, No one
develops stricture, (10) cases (25%) develop fistula and none of them develop
the total complication rate for Single stage TIP technique was (48.3%) the total
complication rate of complications for staged surgery was (66.6%).
Conclusion: proximal hypospadias repair is very challenging with high
complication rate which need a good experience to deal with it. Single stage or
multistage procedure can be utilized to repair this type of hypospadias. Most of the
published papers has low number of cases in comparison to the anterior type which
represent 70_80% of all cases and for that reason may be the great difference in
between different centers in the incidence of complications rate.
Annals of the College of Medicine, Mosul,
2020, Volume 42, Issue 1, Pages 62-67
Context: Congenital hydrocephalus is one of the common neurological problems in infants, characterized by excessive accumulation of cerebrospinal fluid (CSF) in the central nervous system. Numerous babies delivered every day with this anomaly all over the world most of them in the developing countries. There are several forms of treatment; the commonest one is ventriculo-peritoneal shunt that transfers the CSF to the peritoneal cavity. It is associated with relatively low morbidity and mortality rates. Aim: This study aimed to evaluate the ventriculo-peritoneal shunt therapy outcomes for congenital hydrocephalus and find its complications.
Patients and methods: In this research, an observational case series study design had been adopted in Ibn-Sina teaching hospital applied on a convenient sample of 52 infants of both sexes with congenital hydrocephalus over a period of three years. Ethical consents were obtained from their parents. Then, clinical evaluation was done through head circumference and fontanel examinations followed by CT-scan and ultrasonic testing to confirm the diagnosis. All patients were subjected to the ventriculo-peritoneal shunt (VP) surgery with full coverage of appropriate antibiotics, and then they were followed for 6 months to assess the effectiveness of VP shunt in the treatment of hydrocephalus and to identify any complication associated with this surgery.
Results: Most cases (79%) were below 3 months of age and 55.5% of them were males. Only 13.5% of cases developed complications including upper and lower shunt obstruction, shunt infection (28.6% for each), and skin laceration in 14.2% of those 13.5% complicated cases. Most of these complications happened to infants older than 3 months of age.
Conclusion and recommendation: The study concluded that Ventriculo-peritoneal shunt was associated with low complication rate especially among young infants. Thus, it is recommended to adopt this procedure for the treatment of infantile hydrocephalus particularly among infants below 3 months of age.
Key words: Congenital, Hydrocephalus, Ventriculo-peritoneal, Shunt.