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Purpose: Undescended testis is one of the most common pathologies encountered by pediatric surgeons. In traditional orchidopexy operation, PPV is dissected from testicular vessels and spermatic cord. In this study, it was aimed to compare the results of undescended testis patients with and without PPV closure in terms of recurrence and atrophy Methods: After the approval of the local ethics committee, patients who were operated for undescended testis between January 2007 and December 2022 were evaluated. Patients were determined in two groups. first group was with PPV ligation (n=171), second group was without PPV ligation (n=1637). Results: Inguinal hernia was not observed after operation in 15 years of follow-up. There were 23 recurrences (%13,4) in group 1 and 48 recurrences (%2,9) in group 2. According to the preoperative evaluation; A decrease in testicular size was detected in 5 patients (2.9%) in Group 1 and 8 patients (0.4%) in Group 2 in the postoperative follow-up. Conclusion: There is no need to ligate the PPV with additional dissection and open the external oblique fascia if it is predicted that the spermatic cord and testicular vessels may come to scrotum without tension in patients who underwent orchiopexy surgery. Key Words: undescended testis, orchidopexy, processus vajinalis

Objective: Appendicitis is a common surgical emergency among children. The coronavirus pandemic affected the system of hospitals more than any other field, and great amount of people were concerned about visiting the hospitals for any reason. In this study, it was aimed to evaluate the profile of appendicitis by emphasizing perforated and acute appendicitis in the pandemic period and to compare the rates with previous three years. Material and Methods: Charts of the children who underwent laparoscopic appendectomy due to appendicitis between March 11-September 30 between 2017-2020 were retrospectively analyzed in terms of demographic data, duration of symptoms, duration between hospital admission and surgery, radiologic imaging and perioperative outcomes. Results: This study includes 467 children who underwent laparoscopic appendectomy. There were 97 procedures in 2020, 111 in 2019, 146 in 2018 and 113 in 2017. Multiple comparison tests revealed that age did not show difference; but onset of symptoms in admission (p= 0.004), hospitalization time before surgery (p< 0.001), total hospitalization time (< 0.001) showed statistically significant difference between years. Pairwise comparisons showed that these parameters were increased in 2020 compared to other years. Perforated appendicitis rate was significantly increased in 2020 when compared to previous years. Conclusion: Although there is no direct relation between appendicitis and COVID-19 infection in the current knowledge, perforated appendicitis was found to be increased in children during the COVID pandemic. Reason of the higher rate of perforated appendicitis may be multifactorial; however, the pandemic appears to have a role in increased morbidity in children with appendicitis indirectly due to delay of hospital admissions.

Aim:Laparoscopic-assisted transanal pull-through (LATP) is a procedure that has gained increasing popularity in the management of Hirschsprung’s disease. The purpose of this study was to compare outcomes of patients treated with LATP and transanal pull-through (TPT).Methods:Records of 45 patients with Hirschsprung’s disease who underwent surgery between 2006 and 2017 were retrospectively evaluated.Results:LATP was performed in 16 patients [13 male (81%), three female (19%)]. The median age of the patients was four months (7 days-84 months). Twenty nine patients [21 male (72.4%), eight female (27.6%)] underwent TPT. The median age of the patients was 11 months (10 days-90 months). The mean time to start feeding in LATP and TPT groups was two days (one-three days) and 2.6 days, respectively (p=0.074). The mean operative time was 2.6 hours in the LATP group (two-four hours) and 2.7 hours in the TPT group (p=0.971). The mean length of hospital stay in for LATP and TPT groups was 4.8 days (two-nine days) and six days (3-14 days), respectively (p=0.305).Conclusion:The advantages of LATP include multiple sample collection from several segments of the colonn at the same time as well as shorter time to frozen section diagnosis. In addition, the possibility of intraabdominal dissection allows transanal surgery to be faster and more effective.

Aim: Echinococcosis is still an important health problem throughout the world, particularly in the Mediterranean area. In humans, the lungs are the second most commonly affected sites. The disease may affect children and its treatment may be challenging. In children, small hydatid cysts of the lungs respond favorably to the medical treatment. Surgery is the standard option for the treatment of large and complicated cysts. In current practice, thoracotomy and parenchyme-saving procedures such as cystostomy and capitonnage remain the standard surgical approach for pulmonary hydatid cysts in children. However, surgical experience with thoracoscopy is limited. The aim is to present the experience in thoracoscopic management of pulmonary hydatid cysts in children. Patients and Methods: Medical records of children who underwent thoracoscopic cystostomy of pulmonary hydatid cysts between 2008- 2016 were reviewed. Surgical treatment was recommended for patients who remained symptomatic on medical treatment and when the cyst size was larger than 6 cm in diameter. Parenchyme-saving surgery was preferred which included cystostomy, removal of germinative membrane and control of air leaks. Capitonnage was not preferred because of the risk of deterioration in lung capacity. Results: Fifteen patients underwent 16 thoracoscopy procedures for pulmonary hydatid cysts. One of the patients had bilateral complicated pulmonary hydatid cysts. There were conversions to mini-thoracotomy in 3 (20%) procedures because the air leaks could not be controlled safely. The procedure was completed thoracoscopically in 12 patients. In thoracoscopically completed cases, prolonged air leak (over a week) occurred in 3 (25%) patients and one of them underwent thoracotomy to control bronchopulmonary fistula. One of the patients underwent laparoscopic cystostomy and capitonnage for associated liver hydatid cyst. There were no recurrences during 60 months of mean follow-up time and no problem was observed during the follow-up period. Conclusion: Thoracoscopic management is recommended in children with uncomplicated hydatid cyst. In complicated hydatid cysts, however, thoracoscopic wedge resection is recommended. If there is difficulty in controlling bronchial openings, mini-thoracotomy could be considered.

Amaç: Çalışmanın amacı pediatrik yaş gruplarında cerrahi torasik patolojilerde minimal invaziv cerrahi seçenekleri göstermektir.Gereç ve Yöntemler: Tek cerrah tarafından torakoskopik ameliyat edilen 45 hasta retrospektif incelendi. Altta yatan cerrahi patolojiler, cerrahi yaklaşım ve anestezi bakış açıları ve postoperatif sonuçlar analiz edildi.Bulgular: On yıllık periyotta 45 çocuğa torakoskopik cerrahi yöntem uygulandı. Torakoskopik cerrahi yaklaşım, Konjenital Diyafragma Hernisi (KDH), Özofagus Atrezisi (ÖA), Konjenital Malformasyonlar, Pulmoner ve Mediastinal Kitleler, Ampiyem, Spontan Pnomotoraks ve İntertisyal Akciğer Hastalık tanısı olan hastalara uygulandı. Hastaların 21’I kız, 24’ü erkek cinsiyetteydi. KDH ve ÖA dışındaki çocukların ortalama yaşı 4,5 yaş’tır (n=33, 2ay-17yaş). KDH ve ÖA’li çocukların ortalama yaşı 5,5 gün’dür (n=12, 1gün- 8ay). Toplam 6 hastada açığa dönüldü.Ortalama göğüs tüpü çıkarılma süresi 6 gündür (1-24 gün). Hastanede yatma süresi ortalama 9 gündür (3-34 gün).Sonuç: Torakoskopi, çocuk yaş grubunda deneyimli ellerde uygulanabilir ve güvenli bir yaklaşımdır. Komplikasyonları önlemek için her çocuk ayrı ayrı değerlendirilmelidir., Objective: The purpose of this study was to discuss minimal invasive surgical options for surgical thoracic pathologies in the pediatric age group.Material and Methods: A retrospective analysis was performed for 45 patients who had undergone thoracoscopic surgery by a single surgeon. The underlying pathologies, surgical procedures and anesthetic aspects and postoperative outcomes were analyzed. Results: Forty-five children underwent thoracoscopic surgery in a ten-year period. The conditions requiring thoracoscopic surgery were congenital diaphragmatic hernia (CDH), esophageal atresia (EA), congenital malformations, pulmonary and mediastinal masses, empyema, spontaneous pneumothorax, and interstitial lung diseases. There were 21 girls and 24 boys. The mean age of the children except the CDH and EA cases was 4.5 years (n=33, 2 months to 17 years). The mean age of the children with CDH and EA was 5.5 days (n=12, 1 day to 8 months). There were 6 conversions in total. The mean chest tube removal time was 6 days (1-24 days). The mean hospital stay was 9 days (3-34 days).Conclusion: Thoracoscopy in the pediatric age group is safe and feasible in experienced hands. Each child and condition should be evaluated individually to avoid complications

Fanconi anemia is a genetic defective hematopoesis condition characetrised by multipl congenital anomalies. Concomitance of genitourinary anomalies are 20%. There is lack of literature about concomitance of Fanconi anemia and transverse vaginal septum as genitourinary anomalie. İn this article, a 13-year old Fanconi aplastic anemia patient with vaginal septum and our approach aimed to be reported.

Cantrell’s Pentalogy (CP) is a rare congenital syndrome characterized by defects of lower sternum, anterior diaphragm and pericardium with complete or partial ectopia cordis, an omphalocele and congenital intracardiac defects. Few cases manifesting all the defects have been reported, howe-ver, only a small number have survived as the outcome mainly depends on the cardiac malforma-tion. Herein, we report a case of most severe form of CP manifesting all defects and associated with complete thoracoabdominal ectopia cordis to discuss the challenges in management of this uncommon entity.

Cantrell pentalojisi, komplet veya parsiyel ektopia kordis ile birlikte alt sternum, anterior diyafragma ve perikard defektleri, omfalosel ve konjenital intrakardiyak defektlerle karakterize olan ve seyrek gorulen bir konjenital sendromdur. Tum bu defektlerin birlikte goruldugu cok az sayida vaka rapor edilmistir. Bununla birlikte sonuclar ana olarak kardiyak malformasyona bagli oldugundan cok az sayida hasta sag kalabilmistir. Burada, sozugecen tum defektlerin ve eslik eden komplet torakoabdominal ektopia kordisin tespit edildigi Cantrell pentolojisinin en agir formu ve bu nadir gorulen durumun tedavisindeki fikir ayriliklari rapor edilmektedir

Faktor 13 eksikligi olan 15 yasinda erkek cocuk, iki gundurdevam eden karin, sol omuz agrisi ve kusma sikayetleriile basvurdu.Herhangi bir travma oykusu yoktu. Kanbasinci 65/25 mmHg, kalp tepe atimi:140/dk idi. Karindabelirgin distansiyon ve hassasiyet vardi. Hemoglobin:6.3g/dL, hematokrit:%21.8 idi. Hastanin Ultrasonografisindedalakta 4x2 cm boyutlarinda subkapsuler hematom ve karinicinde yaygin serbest sivi bulundu. Hastaya 15 mL/ Kgeritrosit suspansiyonu, 20 mL/ Kg taze donmus plazma tedavisibaslandi.Yasamsal bulgular, idrar cikisi ve hematokritstabil oldugunda yapilan abdominal tomografide dalakta7x6 cm boyutlarinda hematom tespit edildi.Hastanintakibinde sorunla karsilasilmadi.Solid organ yaralanmasi saptanan ve akut karin bulgulariylagelen hastalarda nadir gorulen bir kanama diyateziolan Faktor XIII eksikliginin de daima akilda tutulmasi gerekliliginedeniyle olgunun sunulmasi uygun bulunmustur.

Amaç: Çocukluk çağında laparoskopik apendektomi halen tartışmalıdır. Laparoskopik ve açık apendektomi yapılmış olan çocukların dosyaları geriye dönük olarak incelenip sonuçlar karşılaştırıldı. Hastalar ve Yöntem: Apendisit tanısıyla 36 aylık sürede apendektomi yapılmış olan 337 çocuk çalışmaya dahil edildi. Ameliyat sonrası kesi yeri enfeksiyonu, karın içi abse gelişimi ve brid ileus çalışmanın birincil sonuç kriterleri olarak belirlendi. Çalışmanın ikincil sonuç kriterleri ameliyat süresi, oral besleme zamanı, ağrı kesici ihtiyacı ve hastanede kalış süresi olarak saptandı. Bulgular: Çocukların 126’sına (%39.8) laparoskopik apendektomi (LA), 188’ine (%59) açık apendektomi (AA) yapıldı. Laparoskopik gruptaki üç hastada (%1) açık apendektomiye geçildi. Ameliyat süreleri LA (52±1.34 dk) ve AA’de (54±1.27 dk) benzerdi (p>0.05). Oral besleme zamanı (AA: 24 ±1.1saat, LA:14±0.5 saat), ağrı kesici ihtiyacı (AA:48±5 saat, LA:24±5 saat) ve hastanede kalış süresi (AA:3.9±0.1 gün, LA:2.8±0.1 gün) açısından gruplar karşılaştırıldığında LA grubunda daha kısa olduğu görüldü (p

Sakrokoksigeal teratom germ hucreli bir tumordur. Maternal riskler, hidramnios ve fetal hidropstan kaynaklanmaktad r. ntrapartum komplikasyonlar; tumor buyuklugune bagli distosi, t m ral kanlanmadan kaynaklanan hemoraji ve t m r r pt r d r. Bu yaz da prenatal tan konmu sakro- koksigeal teratomlu bir olgu sunulmu , do um ekline iliskin yaklasimlar tartisilmistir.