Address for correspondence: Dr. Beuy Joob, Sanitation 1 Medical Academic Center, Bangkok, Thailand. E-mail: [email protected]

REFERENCES 1.

Obiora EU, Okwuchukwu ES, Ogundu II. Transanal protrusion of intussusceptions in children. Afr J Paediatr Surg 2014;11:229-32.

2.

3.

4.

Ameh EA, Mshelbwala PM. Transanal protrusion of intussusception in infants is associated with high morbidity and mortality. Ann Trop Paediatr 2008;28:287-92. Ray A, Mandal KC, Shukla RM, Roy D, Mukhopadhyay B, Bhattacharya M. Neglected intussusception presenting as transanal prolapse of small bowel. Indian J Pediatr 2012;79:1370-1. Tennant S, Halliday K. Intussusception mimicking rectal prolapse. Pediatr Radiol 2008;38:700-2.

Topical feracrylum citrate versus adrenaline as haemostatic agent in hypospadias surgery Access this article online Quick Response Code:

Website: www.afrjpaedsurg.org

seems to be safer than adrenaline in control of bleeding. However, there are many considerations.

DOI: 10.4103/0189-6725.143191

Sora Yasri, Viroj Wiwanitkit1 Primary Care Unit, KMT Primary Care Centre, Bangkok, Thailand, 1 Tropical Medicine Unit, Hainan Medical University, China

PMID: *****

Sir, Dear editor, a report on “topical feracrylum citrate versus adrenaline as haemostatic agent in hypospadias surgery” is interesting.[1] Laddha et al. noted “Feracrylum is more efficient and safer topical haemostatic agent than adrenaline.[1]” In fact, using of tropical agent

Address for correspondence: Dr. Sora Yasri, KMT Primary Care Centre, Bangkok, Thailand, E-mail: [email protected]

REFERENCE 1.

Laddha AK, Mulla M, Sharma SS, Lahoti BK, Mathur R. A prospective comparison of topical feracrylum citrate versus adrenaline as haemostatic agent in hypospadias surgery in children. Afr J Paediatr Surg 2014;11:215-8.

Single-incision laparoscopic surgery and conventional laparoscopic treatment of varicocele Access this article online Quick Response Code:

Website: www.afrjpaedsurg.org DOI: 10.4103/0189-6725.143192 PMID: *****

Sir, We would like to discuss on the publication on “single-incision laparoscopic surgery and conventional laparoscopic treatment of varicocele.” [1] As report by Marte et al., “the safety integrity level (SIL-V) procedure is safe and effective and allows fast and efficient isolation of the vascular bundle.”[1] In fact, SIL-V procedure might be a good alternative. However, African Journal of Paediatric Surgery

there are some concerns on SIL-V procedure. First, it should be noted that the case selection must be well-done. Sometimes, the failure of SIL-V procedure is possible, and this need the “conversion to conventional laparoscopic surgery.”[2,3] In addition, the postoperative undersigned outcomes can be seen in some cases. Sherif et al. reported that important sequalae were “persistent varicocele (10%) and hydrocele (10%).”[3] Sherif et al. concluded that “using specially designed ports and instruments in selected patients”[3] were required for success of the procedure.[3] Sim Sai Tin, Viroj Wiwantikit1 Medical Center, Shantou, Hainan Medical University, Hainan, China 1

Address for correspondence: Prof. Sim Sai Tin, Medical Center, Shantou, China. E-mail: [email protected] October-December 2014 / Vol 11 / Issue 4

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REFERENCES 1.

Marte A, Pintozzi L, Cavaiuolo S, Parmeggiani P. Single-incision laparoscopic surgery and conventional laparoscopic treatment of varicocele in adolescents: Comparison between two techniques. Afr J Paediatr Surg 2014;11:201-5.

2.

Tam YH, Lee KH, Sihoe JD, Chan KW, Cheung ST, Pang KK. Initial experience in children using conventional laparoscopic instruments in single-incision laparoscopic surgery. J Pediatr Surg 2010;45:2381-5.

3.

Sherif H, El-Tabey M, Abo-Taleb A, Abdelbaky A. Single-incision laparoscopic surgery in urology. Curr Urol 2012;6:8-14.

Manual versus hydrostatic reduction for intussusception Access this article online Quick Response Code:

Website: www.afrjpaedsurg.org

of the cases.[3] The good control of positioning during HR seems to be a critical point to be kept in mind for minimizing the perforation complication.[4]

DOI: 10.4103/0189-6725.143193

Sora Yasri, Viroj Wiwanitkit1,2,3

PMID: ****

Sir, The report on comparison manual versus hydrostatic reduction (HR) for intussusception is interesting.[1] Ocal et al. have reported that “HR together with ultrasonography is a safe technique in the treatment of intussusception, which also shortens the duration of hospitalisation and significantly reduces the treatment costs.”[1] In fact, there are some concerns on this report. First, there is no evidence from the present single-centre report on the cost; hence, it should not be able to make any conclusion that an alternative can reduce treatment cost. Focusing on reduction, sonographically guided HR is confirmed for its efficacy in many reports.[1,2] However, this does not mean that there is no complication of the procedure. According to the recent report by Okazaki et al., the bowel perforation due to HR could be observed in 1-2%

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October-December 2014 / Vol 11 / Issue 4

Primary Care Unit, KMT Center, Bangkok, Thailand, 1Hainan Medical University, China, 2Tropical Medicine Unit, Faculty of Medicine, University of Nis, Serbia, 3Joseph Ayobabalola University, Nigeria Address for correspondence: Dr. Sora Yasri, Primary Care Unit, KMT Center, Bangkok, Thailand. E-mail: [email protected]

REFERENCES 1.

2.

3.

4.

Ocal S, Cevik M, Boleken ME, Karakas E. A comparison of manual versus hydrostatic reduction in children with intussusception: Single-center experience. Afr J Paediatr Surg 2014;11:184-8. Peh WC, Khong PL, Chan KL, Lam C, Cheng W, Lam WW, et al. Sonographically guided hydrostatic reduction of childhood intussusception using Hartmann’s solution. AJR Am J Roentgenol 1996;167:1237-41. Okazaki T, Ogasawara Y, Nakazawa N, Kobayashi H, Kato Y, Lane GJ, et al. Reduction of intussusception in infants by a pediatric surgical team: Improvement in safety and outcome. Pediatr Surg Int 2006;22:897-900. Bramson RT, Blickman JG. Perforation during hydrostatic reduction of intussusception: Proposed mechanism and review of the literature. J Pediatr Surg 1992;27:589-91.

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