Jacob Charles Langer

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BACKGROUND Perforated necrotizing enterocolitis is a major cause of morbidity and mortality in premature infants, and the optimal treatment is uncertain. We designed this multicenter randomized trial to compare outcomes of primary peritoneal drainage with laparotomy and bowel resection in preterm infants with perforated necrotizing enterocolitis. METHODS(More)
BACKGROUND The surgical management of Hirschsprung's disease (HD) has evolved from the original 3-stage approach to the recent introduction of minimal-access single-stage techniques. We reviewed the early results of the transanal Soave pullthrough from 6 of the original centers to use it. METHODS The clinical course of all children with HD undergoing a(More)
BACKGROUND Management of asymptomatic congenital cystic adenomatoid malformation (CCAM) is controversial. The natural history of untreated asymptomatic CCAM is unknown, although most surgeons recommend resection of these lesions to prevent future infection. The aim of this study was to determine the relative surgical risk of resection compared with the risk(More)
Cystic adenomatoid malformation (CCAM) is a rare lesion that often is diagnosed by prenatal ultrasonography. Outcome varies from hydrops and fetal death to resolution before birth. The authors reviewed their 7-year experience with 17 fetuses diagnosed with CCAM by prenatal ultrasonography to determine the natural history of the lesion and to identify(More)
BACKGROUND/PURPOSE The anticipated level of aganglionosis can influence the surgical approach to Hirschsprung's disease. The aim of this study was to determine the accuracy of the contrast enema in predicting this level. METHODS Over a 6-year period (1995 through 2000), 88 patients with Hirschsprung's disease underwent surgical correction. Preoperative(More)
Our objective was to study long-term respiratory outcomes of congenital diaphragmatic hernia (CDH) treated in the perinatal period. This was a cohort study with 26 adolescent survivors and age- and gender-matched controls. Medical histories were retrieved from hospital charts and questionnaires. Pulmonary function testing included measurement of maximum(More)
PURPOSE Many centers perform a one-stage pull-through procedure for Hirschsprung's disease (HD) diagnosed in infancy. The authors have developed a one-stage pullthrough procedure using a transanal approach that eliminates the need for intraabdominal dissection. METHODS Nine children aged 3 weeks to 18 months with biopsy-proven HD underwent a transanal(More)
Hypertrophic pyloric stenosis (HPS) is a common condition affecting infants that presents with progressive projectile nonbilious vomiting. The pyloric portion of the stomach becomes abnormally thickened and manifests as gastric outlet obstruction. The cause is unknown. Pyloromyotomy remains the standard of treatment and outcome is excellent. This article(More)
Apart from serving as an important landmark for description and staging of pathologic conditions, the diaphragm is also affected by various types of pathologic conditions in children. Congenital abnormalities affecting the diaphragm include aplasia or hypoplasia, accessory diaphragm, eventration, and hernias. Congenital diaphragmatic hernias (CDHs) include(More)
Ninety patients with adenocarcinoma of the extrahepatic bile ducts were treated between 1969 and 1984. Fifty-four tumors involved the upper third, 15 the middle third, and 21 the lower third of the common duct. Twenty-two patients had gallstones and five had inflammatory bowel disease. Forty-three patients had operations before definitive treatment; the(More)