Biomedical subjects

Yigal Efrati

Publications and source records attributed to Yigal Efrati.

7 recordsLinked to original sources

PubMed2005

An experimental study of the effect of two distinct surgical techniques of orchiopexy on spermatogenesis and testicular damage in cryptorchid testes.

OBJECTIVE: To compare the effect of two different techniques of testicular fixation on testicular function. DESIGN: Experimental study. SETTING: Surgical animal laboratory at an academic medical center. PATIENT(S): Sixteen mature golden hamsters underwent classic transfixation orchiopexy and true dartos pouch orchiopexy. INTERVENTION(S): Classic transfixation orchiopexy (CTO) involved transfixation of the testicular wall at two different points and fixation of the dartos fascia. True dartos pouch orchiopexy (TDPO) involved creating a window in the dartos fascia, passage of the testicle, and closure of the window from both sides of the testicle. MAIN OUTCOME MEASURE(S): Flow cytometric separation of testicular cells into haploid, diploid, and tetraploid fractions for histogram analysis. RESULT(S): A significant decrease in testicular weight was observed in 6 out of 16 animals undergoing CTO. Diploid cells comprised the main cell fraction, and almost no haploid or tetraploid cells were observed, while in the 16 animals undergoing TDPO no change from the control pattern was observed. CONCLUSION(S): This experimental work supports our clinical impression that TDPO should replace CTO as the method of choice for the treatment of an undescended testicle in children.

Animals↗

PubMed2004

Transinguinal laparoscopic examination: an end to the controversy on repair of inguinal hernia in children.

BACKGROUND: Contralateral exploration of the groin has been common practice among pediatric surgeons for nearly 50 years, based on the high incidence of patent processus vaginalis on the contralateral side with the potential for the subsequent development of a hernia. OBJECTIVES: To evaluate transinguinal laparoscopic examination of the contralateral side during repair of inguinal hernia in children in order to reach a decision regarding exploration of the contralateral side. METHODS: Over a 21 month period 124 children with unilateral inguinal hernia underwent laparoscopic evaluation of the contralateral groin. The operations were performed under general anesthesia as ambulatory procedures. RESULTS: Transinguinal contralateral laparoscopic exploration was positive (patent processus vaginalis) in 26 children (21%) and negative (closed processus vaginalis) in 88 (71%). Failure to introduce the telescope occurred in 10 patients (8%) due to a friable or narrow hernia sac. Twenty-five children below 2 years of age were spared exploration of the contralateral side as a result of the negative laparoscopic examination. On the other hand, 15 children aged 2-17 had their contralateral groin explored because of a positive finding at laparoscopy. CONCLUSIONS: Transinguinal laparoscopic examination of the contralateral side during repair of inguinal hernia in children is a simple, safe and quick method to avoid systematic bilateral explorations and should be part of every pediatric surgeon's experience.

Adolescent↗

PubMed2003

Neonatal periappendicular abscess--updated treatment.

The authors present a case of periappendicular abscess in a 5-day-old full-term neonate. Prompt diagnosis enabled us to deliver conservative treatment followed by interval laparoscopic appendectomy, instead of a risky urgent laparotomy. This is the first description of an advanced imaging-guided drainage procedure, followed by minimal invasive surgery, for the treatment of periappendicular abscess at such a young age.

Abdominal Abscess↗

PubMed2003

The best shot.

Explore the source record for details and available documents.

Child↗

PubMed2002

Double-ligature: a treatment for pedunculated umbilical granulomas in children.

Umbilical granulomas are common inflammatory reactions to the resolving umbilical stump. The double-ligature technique is simple to perform and provides good cosmetic and functional results with only minor complications. The granuloma becomes necrotic and drops off within seven to 14 days. The double-ligature is a preferable alternative to multiple topical applications of silver nitrate for the treatment of pedunculated umbilical granulomas in children.

Diagnosis, Differential↗

PubMed2002

Acute idiopathic scrotal edema in children--revisited.

BACKGROUND: Acute idiopathic scrotal edema (AISE), a self-limiting acute scrotal edema and erythema that resolves without sequela, was first reported by Qvist in 1956. METHODS: Thirty eight patients with AISE seen in the authors' department over the last 10 years were reviewed, comprising 44 episodes, most occurring in children under 10 years of age. The average age at presentation was 6.2 years. No past history of allergy was elicited. RESULTS: Unilateral involvement predominated (90.1%). None of the patients was found to have a primary source of scrotal, perineal, or perianal infection. Scrotal discomfort; scrotal, perineal, and inguinal swelling; and erythema were the most common findings. Laboratory and ancillary examination findings were normal, except for the occasional eosinophilia. Characteristic ultrasonographic findings, such as marked thickening of the scrotal wall, with heterogeneous and edematous appearance, increased peritesticular blood flow, mild reactive hydrocele, and enlarged inguinal lymph nodes were found. Treatment was conservative in 92.1% of the patients. Resolution of all episodes occurred within 1 to 4 days. Recurrent episodes were observed in 4 patients (10 episodes), which were clinically more severe than the original episode. CONCLUSION: Clinical experience, good judgment, and color Doppler ultrasound scan can reliably identify those children with an acute scrotum who require exploration and spare those with AISE, where surgery is not indicated.

Acute Disease↗

PubMed2002

[Non-palpable testicle--the role of laparoscopy].

We report our experience with 133 children treated laparoscopically for non-palpable testis during the last eight years. Diagnostic laparoscopy eventually combined with orchiectomy, for atrophic testicle, was performed in 59 patients. An apparently normal-sized intra-abdominal testicle was found in 74 patients, ten of whom were bilaterally affected. In 21 children, whose testicle were located in the vicinity of the internal ring, immediate laparoscopic-assisted orchidopexy was carried out. All other 53 children underwent two-stage Fowler-Stephens laparoscopic orchidopexy, only four of whom developed testicular atrophy. New insight concerning germ cell maturation dictates a revised protocol of hormonal therapy followed by early surgical intervention. Hopefully, this will further improve the superior outcome reported herein, similar to that in most of the recent series, which have established the laparoscopic management of non-palpable testicles as "state of the art".

Child↗