Abstracts List

Title
First Name
Last Name
Specialty
Institute
Country
Phone No
E-mail
Preference
Topics
Title of Presentation
Abstract
Prof.
Mohamed
El Debeiky
Pediatric Surgery Department
Ain Shams University
Egypt
+201001425659
mohamedeldebeiky@med.asu.edu.eg
oral
Neonatal Surgery
Neonatal MIS; influence on operative & postoperative care
Abstract: Introduction: With the increased application of MIS, started the worries about the operative & postoperative consequences in NICU with expected fears about increased operative & postoperative stresses. Materials & Methods: Neonates operated upon by MIS over 1 year time has been compared to those with conventional surgery. Results: MIS requires skills and experience. Relatively longer operative time with MIS compared to open surgery, yet with successful technique has less stress during anesthesia and postoperative convalescence in NICU. Conclusion: Despite the initial concerns about increased surgical stress, it seems that MIS has more controllable operative and postoperative influences.
Dr.
Sahar
elleuch
anesthesiology
Hedi chaker hospital
Tunisia
52911835
saharr.eleuchh@gmail.com
poster
Pediatric Genitourinary Surgery
Analgesic efficacy of caudal dexamethasone combined with bupivacaine in ilioinguinal pediatric surgery: prospective randomized controlled trial.
Authors:Elleuch.S1, Jarraya.A1, Zitouni.H2, Mhiri.R2, Kolsi.K1 1: Department of Anesthesiology, Hedi Chaker Hospital, Sfax, Tunisia 2: Department of pediatric surgery,Hedi Chaker Hospital, Sfax, Tunisia Introduction: The aim of the study was to assess the efficacy of caudal dexamethasone with bupivacaine 0.25% for postoperative pain relief in children undergoing sub-umbilical surgical procedures. Patient and Methods: In this prospective randomized double blind study, 56 children of ASA-I class aged from 1 to 5 years scheduled for sub-umbilical surgical procedures were randomly allocated to two groups: - group I received caudal block with : bupivacaine 0.25% (1 ml/kg) with placebo - group II received caudal block with : bupivacaine 0.25% (1 ml/kg) with dexamethasone 0.1 mg/ml. Postoperatively patients were assessed for analgesia and side effects. Results: Demographic parameters (age, weight, size, sex) and per operative heart rate and blood pressure were similar in both groups. Significantly high levels and prolonged duration of post-operative analgesia were observed from the 6th to the 24th post operative hours in group II (P<0.005) with no increased side effects. Conclusions: Caudal dexamethasone may safely improve and prolong post operative analgesia for sub-umblical surgical procedures in children.
Mrs.
Takwa
Mili
Pediatric Surgery
Bachir Hamza Hospital, Pediatric Surgery B, Tunis
Tunisia
+216 53 139 901
mili.takwa@hotmail.com
poster
Pediatric Gastrointestinal Surgery
Apple Peel Intestinal Atresia: Surgical Management and Postoperative Course MILI T., BEN AHMED Y., OUMAYA M., CHARIEG A., NOUIRA F., JOUINI R., JLIDI S.
BACKGROUND: Apple peel atresia is the least frequently encountered type of intestinal atresia. It represents approximately 10% of all atresia. In this study, we aimed to describe the surgical management and the direct postoperative outcome of apple peel atresia. METHODS: In a retrospective analysis of 40 patients with jejunal atresia treated at our department over a 10-year period (2009–2018), 10 were classified as having apple peel atresia (25%). RESULTS: Of the 10 neonates born with apple peel atresia, intestinal obstruction was suspected and diagnosed by antenatal ultrasonography in 6. There was no sex preponderance (5/5). Four neonates were born preterm (40%). The median birth weight was 2,750 g. The median time to surgery was 2 days. Operative management consisted of resection of the atresia with enteroplasty and primary anastomosis in all cases. Three patients ended up with a short bowel syndrom. Postoperative complications consisted of anastomotic leak in 3 patients (10%), 53% suffered from paralytic ileus, 35 % from cholestasis, and 40% were septic. Re-operation was performed in 3 patients. Four patients died (40%). CONCLUSION: Even though survival rates have improved significantly over the years, apple peel atresia remains a life-threatening malformation, which still causes substantial morbidity and mortality.
Mrs.
Takwa
Mili
Pediatric surgery
Bachir Hamza Hospital, Pediatric Surgery "B", Tunis
Tunisia
+216 53 139 901
mili.takwa@hotmail.com
oral
Pediatric Gastrointestinal Surgery
Proximal Jejunal Atresia: Early Postoperative Outcome BEN AHMED Y., MILI T., OUMAYA M., CHARIEG A., NOUIRA F., JOUINI R., JLIDI S.
OBJECTIVE: Atresia of the jejunum and ileum is one of the major causes of neonatal intestinal obstruction. Traditionally, jejunal and ileal atresia have been grouped together as jejunoileal atresia. In this study, we aimed to elucidate separately the early postoperative outcome of jejunal atresia. METHODS: A retrospective analysis of all patients diagnosed with jejunal atresia, who were treated at our department over a 10-year period, 2009–2018 inclusive, was carried out. RESULTS: 30 cases of jejunal atresia were confirmed. They were 15 girls and 15 boys. Fifteen of our patients (50%) was diagnosed prenatally. The mean birth weight was 2640 g and the main gestational age was 35,6 SA. . Associated congenital anomalies were seen in 7 cases (23%). The median age at diagnosis was 2 days (0-27 days) and the main time to surgery 48 hours. The type of atresia was: type 3 in 53%, type 4 in 23%, type 1 in 16% and type 2 in 8% of cases. Operative management consisted of resection and primary anastomosis with plasty in all patients. Postoperative complications consisted of anastomotic leak in 5 patients (16%), anastomotic stricture in 3 patients (10%), paralytic ileus in 4 patients (13%), cholestasis in 2 patients and short bowel in 6 patients (20%). Three patients (10%) presented with an adhesive intestinal obstruction during the early postoperative period. Eight patients (23%) required reoperation. The main time to full oral intake was 12 days. The average duration of hospital stay was 25 days. Nine neonates died, giving a mortality rate of 30 %. CONCLUSION: Prolonged ileus and anastomotic dysfunction requiring long-term parenteral nutrition were the major causes of complications leading to death with a poorer outcome in jejunal atresia by comparison with ileal atresia. We suggest that atresia of the jejunum and ileum be considered differently.
Dr.
sahar
elleuch
anesthesiology
Hedi Chaker hospital
Tunisia
52911835
saharr.eleuchh@gmail.com
poster
Pediatric Gastrointestinal Surgery
Postoperative analgesia in children when using clonidine in addition to fentanyl with bupivacaine given caudally
Authors:Elleuch.S1, Jarraya.A1, Zitouni.H2, Abid.A1, Mhiri.R2, Kolsi.K1 1: Department of Anesthesiology, Hedi Chaker Hospital, Sfax, Tunisia 2: Department of pediatric surgery,Hedi Chaker Hospital, Sfax, Tunisia Abstract The aim of the study was to evaluate the efficacy of clonidine in association with fentanyl as an additive to bupivacaine 0.25% given via single shot caudal epidural in pediatric patients for postoperative pain relief. In the present prospective randomized double blind study, 40 children of ASA-I-II aged 1-5 years scheduled for infraumblical surgical procedures were randomly allocated to two groups to receive either bupivacaine 0.25% (1 ml/kg) with fentanyl 1 μg/kg and clonidine 1μg/kg (group I) or bupivacaine 0.25% (1 ml/kg) with fentanyl 1 μg/kg (group II). Caudal block was performed after the induction of general anesthesia. Postoperatively patients were observed for analgesia, sedation, hemodynamic parameters, and side effects or complications.Both the groups were similar with respect to patient and various block characteristics. Heart rate and blood pressure were not different in 2 groups. Significantly prolonged duration of post-operative analgesia was observed in group I (P<0.05). Side effects such as respiratory depression, vomiting and bradycardia were similar in both groups. The adjunction of clonidine to fentanyl as additives to bupivacaine in single shot caudal epidural in children may provide better and longer analgesia after infraumblical surgical procedures.
Ms.
Yosra
Ben ahmed
Pediatric Surgery
Bachir Hamza Hospital, Pediatric Surgery "B", Tunis
Tunisia
+216 22866913
yosra_bahmed@yahoo.fr
oral
Pediatric Genitourinary Surgery
SINGLE SCROTAL INCISION APPROACH: CAN WE GO FURTHER? BEN AHMED Y., MILI T., BEN CHOUCHENE I., NOUIRA F., CHARIEG A., JOUINI R., JLIDI S.
Objective: Transscrotal orchidopexy is emerging as an alternative approach for palpable low-lying undescended testes. In this study, we aimed to evaluate the surgical outcomes of single scrotal incision orchidopexy in children with a palpable cryptorchid testis. Methods: We retrospectively reviewed all patients who underwent transscrotal orchidopexy during a 9-year period. Post-operative complications, testicular location, and testicular trophicity were reviewed at the follow-up evaluation. Results: A total of 113 orchidopexies (96 patients) were included, we thought accessible to do them by scrotal approach. The single incision technique was possible in 111 cases (98%). Two cases required an additional inguinal incision. Age ranged from 2 to 12 years. Average operating time was 20 minutes per testicular unit. A patent processus vaginalis was found in 62 cases (55%). The position of the testis assessed at surgery was at the external inguinal ring in 76% of cases and at the inguinal canal in 24% of cases. But testis drop in the scrotum in all cases, under anesthesia. In the early postoperative period, one patient developed wound dehiscence due to local infection. Six months post operatively; no testicular atrophy or inguinal hernia were noted. 12 patients (10%) presented a testicular ascension requiring a second surgical intervention. During follow-up (ranging from 2 to 24 months), all testes showed good cosmetic results. Conclusion: Single scrotal incision orchidopexy is a simple and safe technique that is associated with a short operation time and hospital stay with a good cosmetic result. Its comparable success and complication rates makes it an attractive alternative of the traditional inguinal approach.
Dr.
sahar
elleuch
anesthesiology
Hedi chaker hospital
Tunisia
52911835
saharr.eleuchh@gmail.com
poster
Pediatric Trauma
Multiple anesthetic drugs allergy in young infant: a case report
Authors:Elleuch.S1, Jarraya.A1, Zitouni.H2, Abdelmoula.M1, Mhiri.R2, Kolsi.K1 1: Department of Anesthesiology, Hedi Chaker Hospital, Sfax, Tunisia 2: Department of pediatric surgery,Hedi Chaker Hospital, Sfax, Tunisia Background: Allergic reaction during anesthesia is a serious, potentially fatal complication. Compared to the total number of per anesthetics allergies, multiple anesthetic drugs allergy remains a rare event, making the choice of anesthetic drugs even more delicate. Perioperative allergic reactions occurring during anesthesia are less common in children than adults because allergen sensitization increases with drug exposures. Case Report: We report the case of an eleven months old patient proposed to resume a cure of a trigger finger. Recurrent rhinitis and a trigger finger cure at the age of 9 months were mentioned by the parents. Two minutes after fentanyl injection, occurred a bradycardia, a cutaneous rash, and a severe bronchospasm. Further questioning to the parents revealed skin redness to areas that were in contact with the electrocardioscope electrodes during the first operation. At the allergoanaesthetic screening after the peri-anaesthetic incident, the skin tests were positive to multiple anesthetic drugs (propofol, thiopental, morphine, fentanyl, suxamethonium, alfentanil, cis-atracurium and vécuronium). Discussion: Twelve cases of adult intraoperative anaphylaxis due to multiple drugs have been reported [1]. In our case, the bronchospasm occurred in an infant immediately after the injection of fentanyl. Literature review shows that opioid analgesics are rarely incriminated in allergies. However, anaphylactic shocks were reported with morphine, fentanyl, and pethidine. References: [1] Levy JH, Rockoff MA. Anaphylaxis to meperidine. AnesthAnalg 1982;61:301–3.
Ms.
Yosra
Ben Ahmed
Pediatric Surgery
Bachir Hamza Hospital, Pediatric Surgery "B", Tunis
Tunisia
22866913
yosra_bahmed@yahoo.fr
oral
Pediatric Genitourinary Surgery
SINGLE SCROTAL INCISION APPROACH: CAN WE GO FURTHER?
Objective: Transscrotal orchidopexy is emerging as an alternative approach for palpable low-lying undescended testes. In this study, we aimed to evaluate the surgical outcomes of single scrotal incision orchidopexy in children with a palpable cryptorchid testis. Methods: We retrospectively reviewed all patients who underwent transscrotal orchidopexy during a 9-year period. Post-operative complications, testicular location, and testicular trophicity were reviewed at the follow-up evaluation. Results: A total of 113 orchidopexies (96 patients) were included, we thought accessible to do them by scrotal approach. The single incision technique was possible in 111 cases (98%). Two cases required an additional inguinal incision. Age ranged from 2 to 12 years. Average operating time was 20 minutes per testicular unit. A patent processus vaginalis was found in 62 cases (55%). The position of the testis assessed at surgery was at the external inguinal ring in 76% of cases and at the inguinal canal in 24% of cases. But testis drop in the scrotum in all cases, under anesthesia. In the early postoperative period, one patient developed wound dehiscence due to local infection. Six months post operatively; no testicular atrophy or inguinal hernia were noted. 12 patients (10%) presented a testicular ascension requiring a second surgical intervention. During follow-up (ranging from 2 to 24 months), all testes showed good cosmetic results. Conclusion: Single scrotal incision orchidopexy is a simple and safe technique that is associated with a short operation time and hospital stay with a good cosmetic result. Its comparable success and complication rates makes it an attractive alternative of the traditional inguinal approach.
Dr.
sonia
Annabi Bahri
Pediatric surgery
Regional hospital of Gabes
Tunisia
98488245
annabisonia@yahoo.fr
poster
Pediatric Genitourinary Surgery
An unusual localization of lymphangioma of the penis: about 2 cases
Cystic lymphangioma or cystic lymphatic malformations are rare benign dysembryoplasias of the lymphoganglionic system. We report 2 cases , 2 boys presented a cystic formation of the uretral meatus. Treatment consisted of complete resection in one and incomplete resection in the another boy. Histological examination concludes a cystic lymphangioma. The evolution is favorable . The cystic lymphangioma is a rare benign tumor whose localization most frequent is craniofacial. Localization of the penis hase been rarely reported . The diagnosis can be evoked clinically but it's the histological study that confirms. The management of cystic lymphangioma involves several therapies including surgery, percutaneous sclerotherapy and other depending on the type of lesion, its location, its extent and its evolutionary potentiel. It keeps a good prognosis.
Ms.
Meriem
Oumaya
Pediatric Surgery
Department of pediatric surgery B, CHILDREN HOSPITAL TUNIS
Tunisia
0021652374785
meriem.oumaya@gmail.com
poster
Minimally Invasive Pediatric Surgery
Meckel's diverticulum in children: A diagnostic challenge
Authors: Oumaya M, Ben Ahmed Y, Chibani I, Mili T, Charieg A, Nouira F, Jouini R, Jlidi S Objective : Meckel's diverticulum (MD) is one of the most common congenital gastrointestinal malformations in children. However, the nonspecific clinical presentations often cause a diagnostic as well as therapeutic challenge to pediatric surgeon. Material and methods: We retrospectively analyzed the clinical data of all patients diagnosed with MD admitted to our department of pediatric surgery of the Children's hospital of Tunis, during 20 years period between January 1999 and December 2018. Factors documented including demographic criteria, clinical manifestations, preoperative examinations, surgical methods, histopathological characteristics, and outcomes. Results: The patients included 49 males and 8 females, aged from 12 days to 14 years. The mean age of our patients was 5 years. All our patients were symptomatic and presented with various clinical features: The most common presentations were intestinal obstruction (49%) and intestinal bleeding (40%). The preoperative diagnostic rate of MD was only 42.1 % (24/57). Among the patients with bleeding per rectum, 19 underwent a Tc-99m scan that showed a positive tracer in 15 patients. All patients underwent resection of the diverticulum. A segmental ileal resection of the diverticulum with termino-terminal anastomosis was performed in 54 patients, under laparoscopy or laparotomy: Surgical approaches were selected according to the clinical presentations. Enterostomy was performed in the 3 other patients. Histology revealed ectopic gastric mucosa in 21 patients, almost constant in all cases of bleeding Meckel diverticulum. The postoperative courses were uneventful. Conclusion: Meckel's diverticulum remained a challenge, as it is still difficult to be diagnosed preoperatively. Integrative application of multiple approaches can help us to achieve a more accurate diagnosis. The key point of the treatment is to remove the heterotopic tissue completely as it is the cause of most complications. Laparoscopy should become the first choice of methods in diagnosis and treatment of MD.
Dr.
Sonia
Annabi Bahri
Pediatric surgery
Regional hospital of Gabes
Tunisia
98488245
annabisonia@yahoo.fr
poster
Pediatric Trauma
Pancreatic trauma:about 14 cases
Blunt trauma to the abdomen accounts for the majority of abdominal injury in children. Pancreatic injury,although uncommon,is the fourth most common solid organ injury. Unlike other solid organ injuries, pancreatic trauma may be subtle and difficult to diagnose. We reported 14 cases of pancreatic trauma, aged of 2 to 14 years. All trauma macanism are blunt trauma. All the patients undego computer tomography to detect injuries: trauma to adjacent organes is detect in 3 patients. In one patient the initial diagnosis is Frantz tumor. The mots frequent complications were: actue pancreatitis in 85%, pancreatic pseudcyst which one needed endoscopic drainage, rupture of the duodenum in one patient. Conservatif treatment is in indicated in 13 child, and surgical treatment in one who cas a rupture of duodenum. Pancreatic injury alththough uncommon can occur and warrants special attention due to its associated morbidities.
Dr.
Marwa
MESSAOUD
Pediatric surgery
Department of pediatric surgery, Fattouma Bourguiba University Hospital
Tunisia
+21252706035
marwa.mesaoud@gmail.com
poster
Neonatal Surgery
Fibroepithelial polyp of vagina in neonatal girls: Case report and literature review
Background: Congenital anomalies of the female genital tract are relatively common, while the fibroepithelial polyp of vagina in an infant girl is extremely rare. We report a case of a newborn with vaginal fibroepithelial polyp. Materials and Methods: A newborn girl was referred to our hospital because of a vaginal mass discovered during the systematic physical examination of newborn.