Neoplasms

Digestive System Diseases

Diseases and Abnormalities at or Before Birth

All Conditions

Symptoms and General Pathology

Rare Diseases

Choledochal Cyst

Cysts

Bile Duct Diseases

Biliary Tract Diseases

Gastrointestinal Diseases

Congenital Abnormalities

Digestive System Abnormalities

Bile Duct Cysts

To apply accelerated rehabilitation surgery to children with biliary dilatation during perioperative period

In this gruop,Children with cholangiectasia were given traditional perioperative treatment

Perioperative accelerated rehabilitation surgical measures

To provide traditional perioperative treatment for children with cholangiectasia

Traditional treatment

Xiaofeng Lv

Xiaofeng Lv, Master

Recently, with reference to the successful experience of accelerated rehabilitation surgery in the field of adult surgery, the investigators have conducted studies on ERAS in pediatric and even infant cholangiectasia surgery to discuss its feasibility and safety. The results showed that some items of ERAS could be safely applied in perioperative management of CBD, and could reduce traumatic stress and promote postoperative recovery. Therefore, the investigators assumed that the ERAS protocols could be safely applied in the treatment of CBD in children and even infants, reducing traumatic stress in children with CBD, promoting postoperative rehabilitation, reducing complications and hospitalization time, reducing hospitalization costs, and saving medical resources.

1. Optimize preoperative, intraoperative and postoperative perioperative management by learning from the successful experience of accelerated rehabilitation surgery model in other fields.

   For example: necessary and sufficient preoperative education of children and guardians; short fasting before surgery; oral carbohydrate at 2h before surgery; breast feeding at 4h before surgery (formula feeding at 6h before surgery); improved intestinal preparation; irregular placement of nasogastric tube; the use of general anesthesia plus epidural or sacral block anesthesia during surgery; attention to the whole process of heat preservation; strict control of infusion volume; and selection of minimally invasive hands Methods of operation; early postoperative activity, multi-mode analgesia, etc.
2. According to the pathophysiological characteristics of infants with cholangiectasia, several aspects were studied: minimally invasive surgery；promote gastrointestinal motor function recovery；develop principles and plans for early postoperative feeding；Rational placement of abdominal drainage tube; precise choice of anesthesia method, etc.

A RCT Study of ERAS in Infants With Choledochal Cyst

Application of Enhanced Recovery After Surgery During the Perioperative Period in Infants With Choledochal Cyst- a Multi-center Randomized Clinical Trial

To record the postoperative length of stay

To record the time of first exhaust and defecation and the time to return to full oral diet

To calculate the indwelling time of Gastrointestinal decompression tube after surgery

To calculate the indwelling time of Peritoneal drainage tube

To test the consentration of cortisol in blood

To test the consentration of IL-6 in blood

To test the consentration of IL-10 in blood

To test the consentration of CRP in blood

to observe postoperative pulmonary infection, infection of incision, baby, abdominal cavity infection and the occurrence of complications such as anastomotic fistula, cholangitis.

To investigate the "Parents satisfaction score scale" (minimum=0, maximun=100); the higher scores mean a better outcome.

To record the 30-day readmission rate after surgery

Nanjing Children's Hospital

professor

Musculoskeletal Diseases

Skin and Connective Tissue Diseases

Nervous System Diseases

Shock

Dupuytren Contracture

Fibroma

Contracture

Neoplasms, Fibrous Tissue

Neoplasms, Connective Tissue

Neoplasms, Connective and Soft Tissue

Neoplasms by Histologic Type

Muscular Diseases

Connective Tissue Diseases

patients will receive Extracorporeal Shock Wave Therapy and traditional treatment three times a week for six weeks

patients will receive traditional treatment three times a week for six weeks

The affected hand or fingers will be positioned comfortably to ensure optimal access to the fibromatosis lesion. Gel or oil will be applied to the skin to enhance the transmission of shock waves. Shock wave therapy will be administered using the selected energy level and frequency settings. Energy level and frequency will be customized based on individual patient requirements. (1000-1500 shock/session, frequency between 5-12HZ, compression power of 1.5- 2.5 bars).and will receive traditional treatment

Extracorporeal Shock Wave Therapy

the patients will receive traditional treatment in the form of laser (A low-level laser device with a wavelength of 830 nm and power output of 50 mW will be used as one Of the pain relief methods), ultrasound (An ultrasound device with a frequency of 1 MHz and an intensity of 1.5 W/cm² will be used), stretching and strengthening exercise and splinting.

traditional treatment

nabil abdel-aal, professor

mohamed soliman, spescialist

this study will be conducted to investigate the effect of extracorporeal shock wave therapy on ultrasonography chnges In patients with palmar fibromatosis

Palmar fibromatosis, also known as Dupuytren's contracture, is a condition that affects the hand and fingers. It is characterized by the thickening and tightening of the fascia, a layer of connective tissue beneath the skin of the palm. This thickening and tightening can lead to the formation of nodules or cords that restrict the movement of the affected fingers. The treatment options for palmar fibromatosis vary depending on the severity of the condition and its impact on hand function. Mild cases may not require immediate treatment but should be regularly monitored. However, if the symptoms worsen or hinder hand function, there are several treatment options available. Extracorporeal shock wave therapy (ESWT) is a non-invasive physical therapy procedure that uses high-energy sound waves to treat various musculoskeletal conditions. It is commonly used to manage pain and promote healing in conditions such as plantar fasciitis, tendinitis, calcific tendinitis, and other similar disorders The ESWT has shown promising results in reducing pain, improving function, and promoting healing in various musculoskeletal conditions. sixty patients with palmar fibromatosis will be assigned randomly to two groups; first one will receive extracorporeal shock wave with traditional therapy and the other one will receive traditional therapy only

extracorporeal shock wave therapy and traditional treatment

Effect Of Extracorporeal Shock Wave Therapy On Ultrasonography Changes In Patients With Palmar Fibromatosis: A Randomized Controlled Trial

Ultrasonography will be used to assess the thickness of lesion

The Arabic version of the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire will be administered to evaluate functional outcomes.The questionnaire consists of 11 items related to daily activities and symptoms. Each item is rated on a 5-point Likert scale, with higher scores indicating greater disability

algometer will be used to assess pressure pain threshold

Jamar hand held dynamometer will be used to assess hand grip strength

goniometer will be used to assess finger range of motion

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
A RCT Study of ERAS in Infants With Choledochal Cyst	NCT05770739	Enhanced Recove... Infant ALL Cholangiectasis	Perioperative a... Traditional tre...	1 Day - 12 Months	Nanjing Children's Hospital
A RCT Study of ERAS in Infants With Choledochal Cyst	NCT05770739	Enhanced Recove... Infant ALL Cholangiectasis	Perioperative a... Traditional tre...	1 Day - 12 Months	Nanjing Children's Hospital
Effect Of Extracorporeal Shock Wave Therapy On Ultrasonography Changes In Patients With Palmar Fibromatosis: A Randomized Controlled Trial	NCT06248866	Palmar Fibromat...	Extracorporeal ... traditional tre...	18 Years - 70 Years	Cairo University
A RCT Study of ERAS in Infants With Choledochal Cyst	NCT05770739	Enhanced Recove... Infant ALL Cholangiectasis	Perioperative a... Traditional tre...	1 Day - 12 Months	Nanjing Children's Hospital

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