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Volume 25(2); December 2019

Original Articles

[English]
Sacrococcygeal Teratoma: A Survey by the Korean Association of Pediatric Surgeons in 2018
Jung-Tak Oh, Hye Kyung Chang, Min Jeong Cho, Yong Hoon Cho, Soo Jin Na Choi, Yoon Mi Choi, Jae Hee Chung, Sang Young Chung, Jeong Hong, Seok Joo Han, Yeon Jun Jeong, Eunyoung Jung, Kyuhwan Jung, Dae Youn Kim, Hae-Young Kim, Hyun-Young Kim, Ki Hoon Kim, Sang Youn Kim, Seong Chul Kim, Seong Min Kim, Soo-Hong Kim, Jong-In Lee, Myung-Duk Lee, Nam-Hyuk Lee, Suk-Koo Lee, So Hyun Nam, Jin Young Park, Kwi-Won Park, Tae-Jin Park, Jeong-Meen Seo, Jae Ho Shin, Jiyoung Sul
Adv Pediatr Surg 2019;25(2):35-43.   Published online December 18, 2019
DOI: https://doi.org/10.13029/aps.2019.25.2.35
Purpose

The Korean Association of Pediatric Surgeons (KAPS) performed a nationwide survey on sacrococcygeal teratoma in 2018.

Methods

The authors reviewed and analyzed the clinical data of patients who had been treated for sacrococcygeal teratoma by KAPS members from 2008 to 2017.

Results

A total of 189 patients from 18 institutes were registered for the study, which was the first national survey of this disease dealing with a large number of patients in Korea. The results were discussed at the 34th annual meeting of KAPS, which was held in Jeonju on June 21–22, 2018.

Conclusions

We believe that this study could be utilized as a guideline for the treatment of sacrococcygeal teratoma to diminish pediatric surgeons' difficulties in treating this disease and thus lead to better outcomes.

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[English]
Early Experience of Doxycycline Sclerotherapy for Lymphatic Malformations
Ju Yeon Lee, Jung-Man Namgoong, Seong Chul Kim, Dae Yeon Kim
Adv Pediatr Surg 2019;25(2):44-50.   Published online October 11, 2019
DOI: https://doi.org/10.13029/aps.2019.25.2.44
Purpose

Lymphatic malformations (LMs) are congenital malformations of the lymphatic system which can be effectively treated by sclerotherapy. This study aims to evaluate the efficacy of doxycycline in the treatment of LMs.

Methods

We retrospectively reviewed the medical records of all patients who were diagnosed as LMs and underwent doxycycline sclerotherapy in Asan Medical Center between March 2013 and February 2014. Thirty-five sclerotherapy procedures were performed on 21 patients. The procedures were performed under general anesthesia. After each treatment, the clinical and radiographic response was characterized as complete (≥80% decrease in lesion size), partial (<80% decrease of size), or no response (no decrease of size).

Results

There were 11 male patients and 10 female patients. The median age of sclerotherapy was 21 months (range, 2–180 months). The most common location was cervicofacial (52.3%), followed by extremity (28.6%) and truncal (19.0%). The most common lesion type was macrocystic (71.4%), followed by microcystic (28.5%). There was one (2.8%) skin necrosis which was recovered by wound management. Thirty-eight percent of patients had a complete response, 47.6% of patients had a partial response and 14.3% of patients had no response. Median frequency of treatment was one (range, 1–5). No response group consisted of all microcystic type.

Conclusion

Sclerotherapy with Doxycycline is safe and effective for macrocystic LMs.

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[English]
Comparison of the Surgical Outcomes between Open Fundoplication and Laparoscopic Fundoplication in Children with Gastroesophageal Reflux Disease
Su young Hong, Hee-Beom Yang, Sao Thi Han, Hyun-Young Kim, Sung Eun Jung
Adv Pediatr Surg 2019;25(2):51-59.   Published online December 17, 2019
DOI: https://doi.org/10.13029/aps.2019.25.2.51
Purpose

This study aimed to compare the outcomes of open fundoplication (OF) and laparoscopic fundoplication (LF) in children with gastroesophageal reflux disease (GERD).

Methods

We retrospectively reviewed the electronic medical charts of pediatric patients who underwent fundoplication for GERD between January 2005 and May 2018 at the Korean tertiary hospital. Patient characteristics, operation type, associated diagnosis, operation history, neurologic impairment, postoperative complication, recurrence, and operation outcomes were investigated. The Mann-Whitney U test or Student's t-test was used to evaluate continuous data as appropriate. The χ2 test was used to analyze categorical data.

Results

A total of 92 patients were included in this study; 50 were male and 42 were female. Forty-eight patients underwent OF and 44 patients underwent LF. Patient characteristics, such as sex ratio, gestational age, symptoms, neurological impairment, and history of the previous operation were not different between the two groups. A longer operative time (113.0±56.0 vs. 135.1±49.1 minutes, p=0.048) was noted for LF. There was no significant difference in operation time when the diagnosis was limited to only GERD, excluding patients with other combined diseases. Other surgical outcomes, such as intraoperative blood loss, transfusion rate, hospital stay, and recurrence rate were not significantly different between the 2 groups. The complication rate was slightly higher in the OF group than in the LF group; however, the difference was not significant (20.8% vs. 11.4%, p=0.344).

Conclusion

LF is as safe, feasible, and effective as OF for the surgical treatment of GERD in children.

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Case Report

[English]
Recurrent Congenital Milium of the Nipple
Hyun Beak Shin, Yeon-Jun Jeong
Adv Pediatr Surg 2019;25(2):60-62.   Published online December 12, 2019
DOI: https://doi.org/10.13029/aps.2019.25.2.60

Congenital milia of the nipple are extremely rare, and standard treatment has not yet been established because nipple preserving excision is problematic due to the location. Although most reports show excisional biopsy resulting in good outcomes without recurrence, there is a lack of consensus about treatment modality, with several studies suggesting that incisional evacuation by needle, or a ‘wait and see’ approach represent sufficient treatment. This case report is about a recurrent case after incisional evacuation for congenital milium of the nipple. We recommend nipple preserving excision with exfoliation of the milial capsule as being the most appropriate treatment modality for congenital milium of the nipple.

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