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33 Prophylactic Procedures inPediatric Surgery
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393
after prophylactic resections [28, 29]. In children,
it has been found that MD-related complications
are higher in children younger than 8years of age
than older children [30].
In conclusion, it has been recommended that
leaving an incidental MD in situ is mandatory,
which is identied on imaging studies.
Asymptomatic MD found during abdominal
exploration in early ages of life, one should resect
the MD.In young adults <50years of age, especially men, MD’s longer than 2cm, and with an
associated anomaly on palpation, resection must
be carried out. In elderly patients, no resection is
recommended in the appearance of a normalappearing MD.
33.4 Prophylactic Surgery
forIntestinal Malrotations
Intestinal malrotation is a rare congenital anomaly of intestinal position with an incidence of 3.9
per 10,000 live births according to the report of
the Centers for Disease Control, where other
reports an incidence of 0.2–1% in the pediatric
population [31, 32]. Malrotation is a result of an
error in intestinal rotation and xation of the
intestinal mesentery. The duodenojejunal junction lies at the right side of the midline close to
the ileocecal valve causing a relatively narrow
mesenteric stalk. This anatomical decit may
cause midgut volvulus, followed by ischemic
bowel, possible short gut syndrome, and death.
Most of the patients are symptomatic under
the age of 1, where 50% of patients are in the
newborn period [33]. The sudden onset of the
symptoms after volvulus is typical at this age
with bilious vomiting, abdominal distension,
abdominal tenderness, peritonitis indicating perforation, and rectal bleeding indicating bowel
ischemia at later phase. In later childhood, the
symptoms become more atypical like cyclic
vomiting (often non-bilious), recurrent abdominal pain, and failure to thrive [34].
The surgical procedure for malrotation was
described by Ladd in 1936 as detorsion of the
volvulus, division of the Ladd’s bands, widening
of the mesenteric root, and positioning the small
bowels to the right and the large bowels to the left
quadrants of the abdomen [35]. Some authors
added prophylactic appendectomy to this original
procedure to avoid misdiagnosis of a left lower
quadrant appendicitis, where others have discouraged this maneuver to avoid associated complications [36]. Although the laparoscopic repair
of volvulus in a neonate was described by van der
Zee etal. in 1995, this approach is still not performed routinely in infants and children as the
rst choice [37, 38].
The treatment of malrotation in symptomatic
children has been well established, but the treatment of malrotation in an asymptomatic child or
malrotation diagnosed incidentally remains controversial regarding the need and the timing of
the operation. Some clinical conditions may be
associated with malrotation or nonrotation like
congenital diaphragmatic hernia (CDH), omphalocele, gastroschisis, congenital heart disease
(CHD), and heterotaxy syndrome (HS), for which
prophylactic Ladd’s procedure remains a matter
of debate [39].
Surgical correction of malrotation with or
without symptoms is warranted for infants
because of the high risk of volvulus at this period
[40]. It is also not clear how much the risk of volvulus decreases within years of age because there
are also reported patients’ malrotation with volvulus in age 70s [34]. In the report of Prasil etal.
(2000), they have the charts of patients operated
on for malrotation in means of age (<2 or >2years
old). They have found that 17.2% of patients
older than 2 years have volvulus and recommended surgical attention in all patients regardless of age [41]. Malek etal. (2006) designed a
model of the probability of a Ladd’s procedure
and reported that most patients with malrotation
will undergo this operation in childhood. They
recommended careful observation of adults with
asymptomatic malrotation for unusual or
unexplained abdominal discomforts associated
with a partial or total volvulus [42]. In a recent
review of American Pediatric Surgical
Association on asymptomatic malrotation, they
have stated that upper gastrointestinal studies
remain the best imaging modality for malrotation, but even ultrasound cannot be used to rule
our malrotation or volvulus, and the narrowbased mesentery cannot be determined with
394
G. Köylüoğlu and M. O. Öztan
imaging studies as a predictor of volvulus in the
future. As a Grade C recommendation, they said
to operate on asymptomatic patients who are
“younger at age” without given a specic age
[43].
In conclusion, it is a fact that labeling of any
malrotation as “asymptomatic” is not reasonable
because many patients have been thought of as
asymptomatic-declared abdominal symptoms at
carefully taken history. To prevent the catastrophic results of midgut volvulus, prophylactic
surgery for malrotation is recommended in all
patients at low risk for postoperative morbidity or
mortality.
33.5 Prophylactic Fecal Diversion
Fecal diversion in children is used for several
aims; it is mainly used to divert the fecal stream
for decompression, for emergency salvage, and
before the reconstructive correction of the lower
colorectal anomalies.
After the initial management of the patient
with a traumatic wound, it is crucial to achieve a
proper infection control for the prevention of sepsis and establish a good wound healing. In
patients with severe full-thickness perineal and
gluteal burns, open pelvic traumas, or colorectal
traumas, fecal contamination may be prevented
with a temporary-diverting colostomy [44–46]. It
is also benecial for giving the child a favorable
long-term functional outcome by reducing the
depth of the wound, facilitating wound care, and
reducing the debridement frequency in the operation room.
A protective colostomy in anorectal malformation (ARM) is needed to avoid contamination
before the denitive operation [47, 48]. An infection and dehiscence is the most unwanted situation after ARM repair because there is a greater
risk of damaging the continence mechanism, and
secondary procedure is much complex than the
primary one [49]. In patients with at perineum,
meconium-stained urine, bowel gas above the
coccyx, and cloaca receive a diverting colostomy,
preferably located at the descending colon [50].
The distal part of the stoma may be created as a
mucous stula to avoid prolapse [47]. After the
denitive repair, the colostomy is closed after
reaching the appropriate size of the anus.
Another group of patients, who need a fecal
diversion, are the patients with inammatory
bowel disease and familial adenomatous polyposis coli [51]. After initial subtotal or total colectomy in patients with ulcerative colitis and
familial polyposis, it has been reported that a
temporary loop ileostomy prevents anastomotic
leak from the created ileal pouch and reduces
overall complication rate [52]. In Crohn’s disease
(CD) patients, the role of diversion is to allow
healing of perianal disease and induce remission
in refractory colonic and perianal CD [53, 54].
Although this approach has a high incidence of
disease remission, intestinal-continuity restoration rates differ between 10 and 39% in various
reports [53, 55].
33.6 Prophylactic Incidental
Appendectomy
In a patient without acute appendicitis ndings
but undergoing laparotomy for other reasons, the
appendectomy is called prophylactic incidental
appendectomy (IA) [56]. However, planned
appendectomy in absence of appendicitis or
another surgical procedure is called elective
appendectomy [57]. However, this surgical procedure is a controversial issue because of potential complications. An easy surgical procedure,
no additional anesthesia, lower morbidity rate,
and exclusion of difculties in diagnosing appendicitis in the future are the benets of the IA [58].
Prolonged operation time, increased morbidity,
and transformation of the process from clean to
clean-contaminated due to colonic ora are
undesirable features of IA [58]. Besides, the
appendix is increasingly being used in urological
and biliary reconstructive surgeries and for
colonic irrigation in bowel management [56].
Due to all these advantages and disadvantages,
the decision of whether to make IA or not has
been considered more (Table33.1) [56].
Considering the developments in the use of
appendix for reconstruction in recent years, the
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Table 33.1 Summary of recommendations
Condition Recommended Not recommended
Malrotation Yes, to prevent future
Congenital diaphragmatic hernia Yes, to prevent later atypical
Oncologic surgery Yes, neutropenia may hide the
Anorectal malformations and
exstrophy
Neurological diseases,
ventriculoperitoneal shunt,
hydrocephalus, etc.
Cystic brosis Maybe yes in the cystic brosis,
Hirschsprung’s disease and chronic
constipation
Incidentally discovered fecalith Yes, it may be, depending on
Biliary atresia and choledochal
cysts
misdiagnosis [
appendicitis [
symptoms of peritonitis [
56] Due to high rate of intestinal/bladder
Not [
Not [56] Due to high rate of intestinal/bladder
in order to irrigate meconium
66]
[
Not [56] For antegrade continence enema in bowel
the patient’s easy access to
healthcare[56]
67] Due to the possibility of its use in biliary
Not [
59]
62]
64]
It may require for bowel/bladder
incontinence and a long-term gastrostomy
60, 61]
[
When a patch is required for repair, due to
increased risk of contamination [63]
Appendectomy during Wilms’ tumor
surgery does not change the postoperative
complication rate [
incontinence [
incontinence [
Unclear in other circumstances [
management [56]
reconstruction [67]
56]
56]
395
65]
56]
comorbid conditions of the patient should be
considered before performing IA. Advances in
minimally invasive surgery make the decision
even more difcult. The long-life expectancy in
children, the additional medical history, and the
possibility of using appendix as a tubular channel
should be rigorously evaluated during the
decision- making process [56].
33.7 Prophylactic
Cholecystectomy
Prophylactic cholecystectomy (PC) is dened as
the removal of the non-diseased gallbladder when
laparotomy is being undertaken for other
reasons.
Choledochal cysts cause many complications,
such as ductal stricture, stone formation, cholangitis, rupture, and secondary biliary cirrhosis. In
addition, the risk of choriocarcinoma, pancreas,
and gallbladder cancer risk increase 20–30 times
compared to the normal population [68]. While the
incidence of malignancy in cysts is 0.4% under the
age of 18, it reaches 11% in all adults and 38%
over the age of 60. The presence of abnormal pancreaticobiliary junction (APBJ) in cysts increases
the risk of malignancy [
69]. APBJ alone increases
the risk of pancreatic and biliary malignancy, even
without cyst or ductal dilatation. Especially gallbladder cancers are common in APBJ patients
without cysts. Prophylactic cholecystectomy is
recommended in these patients [70].
The incidence of gallstones has increased in
patients with short bowel syndrome (SBS). In
one study, gallstones were detected in 4 of 24
patients who underwent ileal resection in the
neonatal period [
71]. This rate rises up to 44% in
adult ages [72]. Cholelithiasis causes more complications in patients with SBS compared to the
general population. Approximately, half of the
patients with SBS go to recurrent laparotomies.
Prophylactic cholecystectomy is a reasonable
procedure to be performed safely and without
causing any complications [73]. In general,
urgent intervention requirements may be required
because patients with SBS undergo multiple
operations. In such cases, cholecystectomy may
not be recommended. Also, the issue of whether
prophylactic cholecystectomy causes intestinal
396
G. Köylüoğlu and M. O. Öztan
dysfunctions and hepatic diseases in patients
with SBS has not yet been claried [73].
Splenectomy is recommended for the treatment of hereditary spherocytosis (HS) in children. During the same operation, cholecystectomy
should be performed if there are stones in the
gallbladder. If there is no stone, prophylactic cholecystectomy is not recommended. In a study,
stone formation was not observed in the follow up of patients without cholelithiasis during splenectomy [74].
33.8 Prophylactic Splenectomy
Prophylactic splenectomy can be dened as the
removal of the spleen, which is actually diseasefree, which exaggerates one or more of its normal
functions in order to contribute to the treatment
of some special hematological diseases in children. Splenectomy is indicated in patients with
(HS), auto hemolytic anemia, and thalassemia
because in any case, the spleen causes excessive
hemolysis [75].
HS is the most common cause of hemolytic
anemia, although it is rarely seen. It occurs due to
a defect in the red blood cell membrane.
Prophylactic splenectomy is effective in improving anemia in patients with severe hemolysis.
Partial splenectomy may be preferred in children
under the age of 6. Compared with total splenectomy, partial splenectomy also has a lower risk of
sepsis of encapsulated bacteria. If necessary, a
total splenectomy can be delayed until after the
age of 6 [76].
Acute splenic sequestration crisis observed in
sickle cell disease is a serious complication that
requires prophylactic splenectomy. In the past,
splenectomy was not recommended before
5 years of age because of fear of postsplenectomy sepsis. Recently, reports are indicating that
splenectomy can be done at an earlier age
with appropriate vaccination and prophylactic
antibiotics [77].
Also, prophylactic splenectomy is performed
since the spleen is responsible for platelet
destruction as in idiopathic thrombocytopenic
purpura. Splenectomy is usually a suitable option
for a small percentage of chronic ITP patients
with severe thrombocytopenia and hemorrhagic
symptoms and requiring repeated pharmacological interventions. Although splenectomy is effective in most patients, rates of splenectomy among
children with ITP have decreased signicantly
since the early 2000s, especially among children
under 5years of age [78]. While the cause of the
decline is not clear, it may be associated with an
increased availability of effective second-line
treatments.
33.9 Prophylactic Surgery
inPediatric Surgical
Oncology
Prophylactic surgery in children with certain cancer predisposition syndrome may decrease the
incidence of malignancy. It is superior due to low
complication rate and high cost-effectiveness
compared to conventional screening and routine
examinations [79].
33.9.1 Familial Adenomatous
Polyposis
Colorectal cancer is seen in 1/471 rate in familial
adenomatous polyposis (FAP) patients before
20 years of age [80]. The risk of developing
cancer during life is approximately 100%. In
general, three prophylactic surgical methods are
used: total proctocolectomy with ileal pouch-anal
anastomosis (IPAA), total abdominal colectomy
with ileorectal anastomosis (IRA), and proctocolectomy with ileostomy [81]. The timing and
age of prophylactic colectomy are uncertain
because the data are limited in terms of surgical
results in children. In classical FAP, the timing of
surgery is done between the ages of 15 and 25,
depending on age, compliance, presence of dysplasia/cancer, genotype, and the number of adenomas [81]. The most appropriate age should be
determined according to the psychological compliance of the young patient to aggressive surgery. IRA or IPAA options are determined
according to the number and/or size of polyps,
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397
postoperative follow-up compliance, and family’s common sense. Patients undergoing IRA
develop 30% rectal cancer until age 60. IPAA is
more advantageous in terms of optimal bowel
control. As can be seen, discussions on the timing, size (extend) of surgery, and the types of
reconstruction continue in pediatric FAP management [79].
33.9.2 Medullary Thyroid Cancer
In children, the thyroid gland is particularly sensitive to irradiation and carcinogenesis. Unlike
adults, thyroid cancers show regional lymph node
and distant organ metastasis at the time of diagnosis. Despite these characteristic features, thyroid cancers in childhood have a good prognosis.
Medullary thyroid carcinoma (MTC) in children
is detected either as a solitary nodule or due to the
presence of MTC in one of the family members
and typically as part of MEN2A or MEN2B.
Total thyroidectomy performed with central
neck dissection in children with RET gene mutation is the standard prophylactic surgical
approach. Early total thyroidectomy seems to be
effective in preventing the development of MTC
in the long term [82]. However, due to insufcient data, performing prophylactic surgery,
especially based on RET gene positivity, especially in the early (under 2 years) period may
cause unnecessary thyroidectomies [83].
Compared to adults, thyroidectomy complications are much higher in children, and especially
infants. In very young children, it is very difcult
to distinguish parathyroid glands from surrounding tissues during surgery. Although the complication rate of experienced surgeons is quite low,
postponing thyroidectomies under the age of 2
should be considered [79]. However, the
American thyroid association (ATA) has revised
the MTC guidelines on disease management
[84]. Today, the decision on the timing of prophylactic thyroidectomy is not based solely on DNA
analysis. In addition, clinical data and most
importantly, basal or stimulated serum calcitonin
level is used. The ATA revised guidelines identied the highest-risk, high-risk, and moderate-risk
groups for prophylactic thyroidectomy in children. In those at the highest-risk group, thyroidectomy should be performed in the rst year of
life, even in the rst months of life. Prophylactic
thyroidectomy should be performed at the age of
5 or earlier considering the serum calcitonin levels in the high-risk group. Timing in the mediumrisk group should be based on high serum
calcitonin levels. It can be extended for several
years or even 10years with 6-month or 1-year
evaluations [79].
33.10 Conclusion
As can be understood from the abovementioned
diseases, when performing a prophylactic surgical procedure, the benet-harm balance, the risks
that may develop later in life, the psychological
conditions of the patients and their parents, and
the age group to be applied should be carefully
evaluated.
References
1. Lau S, Lee Y, Caty M.Current management of hernias
and hydroceles. Semin Pediatr Surg. 2007;16:50–7.
2. Miltenburg DM, Nuchtern JG, Jaksic T, Kozinetiz C,
Brandt ML. Laparoscopic evaluation of the pediatric inguinal hernia: a meta-analysis. J Pediatr Surg.
1998;33:874–9.
3. Rowe MI, Clatworthy HW Jr. The other side of
the pediatric inguinal hernia. Surg Clin North Am.
1971;51:1371–6.
4. Rowe MI, Copelson LW, Clatworthy HW.The patent
processus vaginalis and the inguinal hernia. J Pediatr
Surg. 1969;4:102–7.
5. Alzahem A.Laparoscopic versus open inguinal herniotomy in infants and children: a meta-analysis.
Pediatr Surg Int. 2011;27:605–12.
6. Miltenburg DM, Nuchtern JG, Jaksic T, Kozinetz
CA, Brandt ML.Meta-analysis of the risk of metachronous hernia in infants and children. Am J Surg.
1997;174:741–4.
7. Ron O, Eaton S, Pierro A.Systematic review of the
risk of developing a metachronous contralateral inguinal hernia in children. Br J Surg. 2007;94:804–11.
8. Holcomb GW III, Brock JW III, Morgan WM
III.Laparoscopic evaluation for a contralateral patent
processus vaginalis. J Pediatr Surg. 1994;29:970–3.
9. Dreuning KMA, Ten Broeke CEM, Twisk JWR,
Robben SGF, van Rijn RR, Verbeke JIML, et al.
398
G. Köylüoğlu and M. O. Öztan
Diagnostic accuracy of preoperative ultrasonography
in predicting contralateral inguinal hernia in children:
a systematic review and meta-analysis. Eur Radiol.
2019;29:866–76.
10. Mollen KP, Kane TD.Inguinal hernia: what we have
learned from laparoscopic evaluation of the contralateral side. Curr Opin Pediatr. 2007;19:344–8.
11. Toki A, Watanabe Y, Sasaki K, Tani M, Ogura K,
Wang ZQ. Adopt a wait-and-see attitude for patent processus vaginalis in neonates. J Pediatr Surg.
2003;38:1371–3.
12. Ikeda H, Suzuki N, Takahashi A, Kuroiwa M, Sakai
M, Tsuchida Y.Risk of contralateral manifestation in
children with unilateral inguinal hernia: should hernia
in children be treated contralaterally? J Pediatr Surg.
2000;35:1746–8.
13. Chertin B, De Caluwé D, Gajaharan M, PiasecznaPiotrowska A, Puri P. Is contralateral exploration
necessary in girls with unilateral inguinal hernia? J
Pediatr Surg. 2003;38:756–7.
14. Grosfeld JL, Cooney DR, Smith J, Campbell RL.Intraabdominal complications following ventriculoperitoneal shunt procedures. Pediatrics. 1974;54:791–6.
15. Clarnette TD, Lam SK, Hutson JM. Ventriculoperitoneal shunts in children reveal the natural history
of closure of the processus vaginalis. J Pediatr Surg.
1998;33:413–6.
16. Tackett LD, Breuer CK, Luks FI, Caldamone AA,
Breuer JG, DeLuca FG, etal. Incidence of contralateral inguinal hernia: a prospective analysis. J Pediatr
Surg. 1999;34:684–7.
17. Palanivelu C, Rangarajan M, Senthilkumar R,
Madankumar MV, Kavalakat AJ.Laparoscopic management of symptomatic Meckel’s diverticula: a simple tangential stapler excision. JSLS. 2008;12:66–70.
18. Ueberrueck T, Meyer L, Koch A, Hinkel M, Kube R,
Gastinger I.The signicance of Meckel’s diverticulum in appendicitis—a retrospective analysis of 233
cases. World J Surg. 2005;29:455–8.
19. Caracappa D, Gullà N, Lombardo F, Burini G,
Castellani E, Boselli C, etal. Incidental nding of carcinoid tumor on Meckel’s diverticulum: case report
and literature review, should prophylactic resection be
recommended? World J Surg Oncol. 2014;12:144.
20. Zani A, Eaton S, Rees CM, Pierro A. Incidentally
detected Meckel diverticulum: to resect or not to
resect? Ann Surg. 2008;247:276–81.
21. Alemayehu H, Hall M, Desai AA, St Peter SD, Snyder
CL. Demographic disparities of children presenting
with symptomatic Meckel’s diverticulum in children’s
hospitals. Pediatr Surg Int. 2014;30:649–53.
22. Park JJ, Wolff BG, Tollefson MK, Walsh EE, Larson
DR. Meckel diverticulum: the Mayo Clinic experience with 1476 patients (1950–2002). Ann Surg.
2005;241:529–33.
23. Hansen CC, Søreide K. Systematic review of epidemiology, presentation, and management of
Meckel’s diverticulum in the 21st century. Medicine
(Baltimore). 2018;97:e12154.
24. Bani-Hani KE, Shatnawi NJ.Meckel’s diverticulum:
comparison of incidental and symptomatic cases.
World J Surg. 2004;28:917–20.
25. Karaman A, Karaman I, Cavusoaglu YH, Erdoağan
D, Aslan MK. Management of asymptomatic or
incidental Meckels diverticulum. Indian Pediatr.
2010;47:1055–7.
26. Slívová I, Vávrová Z, Tomášková H, Okantey O,
Penka I, Ihnát P.Meckel’s diverticulum in childrenparameters predicting the presence of gastric heterotopia. World J Surg. 2018;42:3779–84.
27. Cullen JJ, Kelly KA, Moir CR, Hodge DO, Zinsmeister
AR, Melton LJ III.Surgical management of Meckel’s
diverticulum. An epidemiologic, population- based
study. Ann Surg. 1994;220:564–8.
28. Gezer HÖ, Temiz A, İnce E, Ezer SS, Hasbay B,
Hiçsönmez A. Meckel diverticulum in children:
evaluation of macroscopic appearance for guidance in
subsequent surgery. J Pediatr Surg. 2016;51:1177–80.
29. Stone PA, Hofeldt MJ, Campbell JE, Vedula G, DeLuca
JA, Flaherty SK.Meckel diverticulum: ten-year experience in adults. South Med J. 2004;97:1038–41.
30. Onen A, Ciğdem MK, Oztürk H, Otcu S, Dokucu
AI.When to resect and when not to resect an asymptomatic Meckel’s diverticulum: an ongoing challenge.
Pediatr Surg Int. 2003;19:57–61.
31. Torres AM, Ziegler MM.Malrotation of the intestine.
World J Surg. 1993;17:326–31.
32. Isani MA, Schlieve C, Jackson J, Elizee M, Asuelime
G, Rosenberg D, etal. Is less more? Laparoscopic versus open Ladd’s procedure in children with malrotation. J Surg Res. 2018;229:351–6.
33. Gross E, Chen MK, Lobe TE. Laparoscopic evaluation and treatment of intestinal malrotation in infants.
Surg Endosc. 1996;10:936–7.
34. Yanez R, Spitz L. Intestinal malrotation presenting outside the neonatal period. Arch Dis Child.
1986;61:682–5.
35. Ladd WE.Surgical diseases of the alimentary tract in
infants. N Engl J Med. 1936;215:705–8.
36. Davidson JR, Eaton S, De Coppi P.Let sleeping dogs
lie: to leave the appendix at the time of a Ladd procedure. J Pediatr Surg. 2017;53(1):205–7. https://doi.
org/10.1016/j.jpedsurg.2017.09.003.
37. van der Zee DC, Bax NM. Laparoscopic repair of
acute volvulus in a neonate with malrotation. Surg
Endosc. 1995;9:1123–4.
38. Miyano G, Fukuzawa H, Morita K, Kaneshiro M,
Miyake H, Nouso H, et al. Laparoscopic repair of
malrotation: what are the indications in neonates
and children? J Laparoendosc Adv Surg Tech A.
2015;25:155–8.
39. Arnaud AP, Suply E, Eaton S, Blackburn SC, Giuliani
S, Curry JI, etal. Laparoscopic Ladd’s procedure for
malrotation in infants and children is still a controversial approach. J Pediatr Surg. 2019;54:1843–7.
40. Malek MM, Burd RS.Surgical treatment of malrotation after infancy: a population-based study. J Pediatr
Surg. 2005;40:285–9.
33 Prophylactic Procedures inPediatric Surgery
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
399
41. Prasil P, Flageole H, Shaw KS, Nguyen LT, Youssef
S, Laberge JM. Should malrotation in children be
treated differently according to age? J Pediatr Surg.
2000;35:756–8.
42. Malek MM, Burd RS.The optimal management of
malrotation diagnosed after infancy: a decision analysis. Am J Surg. 2006;191:45–51.
43. Graziano K, Islam S, Dasgupta R, Lopez ME, Austin
M, Chen LE, et al. Asymptomatic malrotation:
diagnosis and surgical management: An American
Pediatric Surgical Association outcomes and evidence
based practice committee systematic review. J Pediatr
Surg. 2015;50:1783–90.
44. Faringer PD, Mullins RJ, Feliciano PD, Duwelius PJ,
Trunkey DD. Selective fecal diversion in complex
open pelvic fractures from blunt trauma. Arch Surg.
1994;129:958–63.
45. Choi PM, Wallendorf M, Keller MS, Vogel
AM. Traumatic colorectal injuries in children: the
National Trauma Database experience. J Pediatr Surg.
2017;52:1625–7.
46. Quarmby CJ, Millar AJ, Rode H.The use of diverting colostomies in paediatric peri-anal burns. Burns.
1999;25:645–50.
47. Pena A, Migotto-Krieger M, Levitt MA.Colostomy
in anorectal malformations: a procedure with serious but preventable complications. J Pediatr Surg.
2006;41:748–56.
48. Chen CJ. The treatment of imperforate anus:
experience with 108 patients. J Pediatr Surg.
1999;34:1728–32.
49. Peña A. Management of anorectal malformations during the newborn period. World J Surg.
1993;17:385–92.
50. Bischoff A, Levitt MA, Peña A.Update on the management of anorectal malformations. Pediatr Surg Int.
2013;29:899–904.
51. Coran AG. A personal experience with 100 consecutive total colectomies and straight ileoanal
endorectal pull-throughs for benign disease of the
colon and rectum in children and adults. Ann Surg.
1990;212:242–7.
52. Chen YJ, Grant R, Lindholm E, Lipskar A, Dolgin
S, Khaitov S, etal. Is fecal diversion necessary during ileal pouch creation after initial subtotal colectomy in pediatric ulcerative colitis? Pediatr Surg Int.
2019;35:443–8.
53. Dharmaraj R, Nugent M, Simpson P, Arca M,
Gurram B, Werlin S.Outcomes after fecal diversion
for colonic and perianal Crohn disease in children. J
Pediatr Surg. 2018;53:472–6.
54. Sauk J, Nguyen D, Yajnik V, Khalili H, Konijeti G,
Hodin R, et al. Natural history of perianal Crohn’s
disease after fecal diversion. Inamm Bowel Dis.
2014;20:2260–5.
55. Yamamoto T, Allan RN, Keighley MR.Effect of fecal
diversion alone on perianal Crohn’s disease. World J
Surg. 2000;24:1258–62.
56. Healy JM, Olgun LF, Hittelman AB, Ozgediz D, Caty
MG.Pediatric incidental appendectomy: a systematic
review. Pediatr Surg Int. 2016;32:321–35.
57. Davis CR, Trevatt A, Dixit A, Datta V. Systematic
review of clinical outcomes after prophylactic surgery. Ann R Coll Surg Engl. 2016;98:353–7.
58. Silvert MA, Meares EM Jr. Rationale of incidental
appendectomy. Urology. 1976;7:129–34.
59. Ingoe R, Lange P.The Ladd’s procedure for correction of intestinal malrotation with volvulus in children. AORN. 2007;J85:300–8.
60. Stanll AB, Pearl RH, Kalvakuri K, Wallace LJ,
Vegunta RG. Laparoscopic Ladd’s procedure: treatment of choice for midgut malrotation in infants
and children. J Laparoendosc Adv Surg Tech A.
2010;20:369–72.
61. Mohta A. Plea against incidental appendicectomy.
Indian Pediatr. 2003;40:1015–6.
62. Kshirsagar AY, Bansal SS, Somnath SR, Prabhu
AN, Dhulkhed V, Nikumbh DB. Acute appendicitis presenting as chest pain. Int J Surg Case Rep.
2012;3:128–30.
63. Tsao K, Allison ND, Harting MT, Lally PA, Lally
KP. Congenital diaphragmatic hernia in the preterm
infant. Surgery. 2010;148:404–10.
64. Steinberg R, Freud E, Yaniv I, Katz J, Zer M.A plea
for incidental appendectomy in pediatric patients with
malignancy. Pediatr Hematol Oncol. 1999;16:431–5.
65. Ritchey M, Haase GM, Shochat SJ, Kelalis
PP.Incidental appendectomy during nephrectomy for
Wilms’ tumor. Surg Gynecol Obstet. 1993;176:423–6.
66. Fitzgerald R, Conlon K. Use of the appendix stump
in the treatment of meconium ileus. J Pediatr Surg.
1989;24:899–900.
67. Shah AA, Shah AV. Appendix as a biliary conduit
for choledochal cysts in children. Eur J Pediatr Surg.
2005;15:128–31.
68. Søreide K, Søreide JA. Bile duct cyst as precursor to biliary tract cancer. Ann Surg Oncol.
2007;14:1200–11.
69. Ragot E, Mabrut JY, Ouaïssi M, Sauvanet A, Dokmak
S, Nuzzo G, etal. Pancreaticobiliary maljunctions in
European patients with bile duct cysts: results of the
multicenter study of the French Surgical Association
(AFC). World J Surg. 2017;41:538–45.
70. Sugiyama M, Atomi Y. Anomalous pancreaticobiliary junction without congenital choledochal cyst. Br J
Surg. 1998;85:911–6.
71. Teitelbaum DH, Han-Markey T, Drongowski RA,
Coran AG, Bayar B, Geiger JD, etal. Use of cholecystokinin to prevent the development of parenteral
nutrition-associated cholestasis. JPEN J Parenter
Enteral Nutr. 1997;21:100–3.
72. Nightingale JM, Lennard-Jones JE, Gertner DJ, Wood
SR, Bartram CI.Colonic preservation reduces need for
parenteral therapy, increases incidence of renal stones,
but does not change high prevalence of gall stones in
patients with a short bowel. Gut. 1992;33:1493–7.
400
G. Köylüoğlu and M. O. Öztan
73. Thompson JS, Mercer DF, Vargas LM, Grant WJ,
Rochling FA, Langnas AN.Prophylactic cholecystectomy in short bowel syndrome: is it being utilized?
Am J Surg. 2018;216:73–7.
74. Sandler A, Winkel G, Kimura K, Soper R.The role of
prophylactic cholecystectomy during splenectomy in
children with hereditary spherocytosis. J Pediatr Surg.
1999;34:1077–8.
75. Machado NO, Grant CS, Alkindi S, Daar S, Al-Kindy
N, Al Lamki Z, etal. Splenectomy for haematological
disorders: a single center study in 150 patients from
Oman. Int J Surg. 2009;7:476–81.
76. Iolascon A, Andolfo I, Barcellini W, Corcione F,
Garçon L, De Franceschi L, etal. Recommendations
regarding splenectomy in hereditary hemolytic anemias. Haematologica. 2017;102:1304–13.
77. Gokarn N, Manwani D, Friedmann P, Borenstein SH,
Jan D, Renaud E.Outcomes after early splenectomy
for hematological disorders. J Laparoendosc Adv
Surg Tech A. 2014;24:897–900.
78. Bhatt NS, Bhatt P, Donda K, Dapaah-Siakwan F,
Chaudhari R, Linga VG, et al. Temporal trends
of splenectomy in pediatric hospitalizations with
immune thrombocytopenia. Pediatr Blood Cancer.
2018;65:e27072.
79. Sandoval JA, Fernandez-Pineda I, Malkan AD.Riskreduction surgery in pediatric surgical oncology: a
perspective. J Pediatr Surg. 2016;51:675–87.
80. Church JM, McGannon E, Burke C, Clark
B. Teenagers with familial adenomatous polyposis:
what is their risk for colorectal cancer? Dis Colon
Rectum. 2002;45:887–9.
81. Kennedy RD, Potter DD, Moir CR, El-Youssef
M.The natural history of familial adenomatous polyposis syndrome: a 24 year review of a single center
experience in screening, diagnosis, and outcomes. J
Pediatr Surg. 2014;49:82–6.
82. Skinner MA, Moley JA, Dilley WG, Owzar K,
Debenedetti MK, Wells SA Jr. Prophylactic thyroidectomy in multiple endocrine neoplasia type 2A. N
Engl J Med. 2005;353:1105–13.
83. Moore SW, Appfelstaedt J, Zaahl MG.Familial medullary carcinoma prevention, risk evaluation, and RET
in children of families with MEN2. J Pediatr Surg.
2007;42:326–32.
84. Wells SA Jr, Asa SL, Dralle H, Elisei R, Evans
DB, Gagel RF, et al. Revised American Thyroid
Association guidelines for the management of medullary thyroid carcinoma. Thyroid. 2015;25:567–610.
Prophylactic Surgery
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
forNeurosurgical Pathologies
NurullahYüceer
34
34.1 Introduction
Neurosurgical pathologies, in which the most
prophylactic surgery is performed, are brain
tumors, cerebrovascular diseases, craniospinal
injuries, congenital and degenerative diseases. As
a neuroradiological examination in patients suspected of intracranial pressure increase as a result
of clinical evaluations, the most commonly used
diagnostic methods today are magnetic resonance imaging, computed tomography (CT) and
angiography with direct radiographs. Timing of
prophylactic surgery differs among these pathologies. It is preferred that the timing of prophylactic surgery is limited to days in cerebral
aneurysms. The timing of prophylactic surgery in
brain and spinal tumors can be limited to weeks.
The prophylactic surgery timing in congenital
and degenerative patients can be within months.
Neurological examination is normal in the majority of patients scheduled for prophylactic surgery.
The results are very good in these patients who
underwent prophylactic surgery [1, 2].
N. Yüceer (*)
Department of Neurosurgery, School of Medicine,
İzmir Katip Çelebi University, İzmir, Turkey
e-mail: nurullah.yuceer@ikc.edu.tr
34.2 Increased Intracranial
Pressure andHydrocephaly
Increased intracranial pressure reects changes
in the brain, cerebrospinal uid (CSF) and blood
volume that make up the intracranial structures.
Intracranial pressure is 10–15 mmHg in adults
and older children, 3–7mmHg in young children,
1.5–6 mmHg in newborns. In patients with
increased intracranial pressure, headache, nausea
and vomiting and bilateral papillary edema are
typical. Hydrocephalus is an abnormal, usually
progressive accumulation of CSF within the ventricular system that distends the ventricles and
often raises. The main causes that can lead to
hydrocephalus are congenital causes, such as stenosis of the aqueduct of Sylvius or atresia of the
foramina of Magendie and Luschka, tumors,
intraventricular hemorrhages, infections, vascular pathologies, traumas. Prophylactic treatments
are applied to the causes of hydrocephalus to prevent possible complications [3–5].
In intracranial space-occupying lesions, changes
are observed in these intracranial structures. Not
only the growth of intracranial space- occupying
lesions, but also increases in intracranial blood volume/or cerebrospinal uid lead to increases in
intracranial pressure. Intracranial pressure increase
usually causes headache, nausea, vomiting and
bilateral papillary edema in patients. If patients
with increased intracranial pressure are not treated,
© The Author(s), under exclusive license to Springer Nature Switzerland AG 2021
O. N. Dilek et al. (eds.), Prophylactic Surgery, https://doi.org/10.1007/978-3-030-66853-2_34
401
402
cd
cd
ab
ab
N. Yüceer
Fig. 34.1 Top row: Third ventricular colloid cyst causing
acute hydrocephalus in a 36-year-old woman. The patient
was brought to the emergency room with a loss of consciousness. CT scan (a) and T1- and T2-weighted axial
MRIs with contrast demonstrate third ventricular colloid
cyst causing acute hydrocephalus. The patient was operated on urgently. Her postoperative neurological examination was normal. Control postoperative CT scan was
normal (d). Bottom row: Left frontal glioblastoma in a
55-year-old man. The patient presented with the com-
neurological decits, and various herniation syndromes, which lead to changes in consciousness,
develop [1, 2, 6] (Fig.34.1).
34.3 Brain Tumors
According to the classication made by the
World Health Organization, brain tumors are
divided into seven subgroups: neuroepithelial
tumors, tumors of the cranial-spinal nerves,
tumors of the meninges, lymphomahematopoietic tumors, stretching-cell tumors,
sellar tumors and metastatic tumors (Fig.34.2).
Approximately, 40% of brain tumors are glial
tumors. While 60% of brain tumors in adults
show supratentorial location, in children, the
same rate is seen in the posterior fossa.
plaints of headache and speech disorder that had been
present for a month. In his examination, dysphasia was
detected. CT scan (a), T1- and T2-weighted MRIs (b, c)
examinations revealed a tumor in the left frontal that
caused edema. Gross total tumor excision was performed.
Postoperative CT scan (d) was normal. The patient’s
speech improved after the operation. Pathology examination conrmed gliobastoma. Radiotherapy and chemotherapy were performed
Medulloblastoma is the most common malignant
tumor in the posterior fossa that does not have a
glial origin in children [7].
It is well known that low-grade glial tumors
rise to higher-grade tumors (Fig.34.2). Especially
in diffusion and spectroscopic examinations
using magnetic resonance imaging, preventive
surgical interventions can be recommended to
patients considering that there may be an increase
in high-grade tumors in patients with low-grade
glial tumors [8–10]. The same can be considered
in benign tumors, such as meningioma (Fig.34.3)
[11]. Hemangioblastomas are life-threatening
tumors that tend to bleed and grow [12].
Prophylactic surgeries are performed in
patients with acromegaly (Fig. 34.4), Cushing
disease and those who are not hormone secretaries, and who are at risk of vision loss with chiasm
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