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Association of Paediatric Surgeons of Bangladesh
Journal of Paediatric Surgeons of Bangladesh
Original Articles · Vol. 11 No. 1-2 (2020)

Surgical Management and Outcome of Neural Tube Defects in Children

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JPSB
Journal of
Paediatric Surgeons of Bangladesh
Published : July 2020
CONTENTSVolume 11Number 1 & 2January - July 2020
Editorial
Pediatric Fluid Prescription, Close Monitoring and Raising Awareness
Mohammed Shadrul Alam
01
Original Articles
Cancer Status in Pediatric Population of Chittagong, Bangladesh
Tasmiah Tahera Aziz, Samira Hayee, Orindom Shing Pulock, Maliha Haider, Tahmina Banu
03
Snodgrass Procedure (TIP), game changing procedure: A single Surgeon’s Experience
Md Samidur Rahman, Md Shahin Reza, Zinat Tanjida, Elora Afroz Leema, Nazmul Haider Chowdhury Sonet, Md Ashekin Abir, Prosenjit Datta
11
Surgical Management and Outcome of Neural Tube Defects in Children
Anupam Das, Md Nurul Alam, Md Shamsur Rahman, Md Oyes Ahmed Chowdhury, Habib Ullah Khan, Md Sirajul Islam
17
Neonatal Surgical Situation in Bangladesh: Challenges and Way Forward
Md Sharif Imam, Tanvir Kabir Chowdhury, Md Mozammel Hoque, Tahmina Banu
24
Ultrasonographic guided Fine Needle Aspiration Cytology (FNAC) in the Diagnosis of Intra-abdominal Solid Mass in Children
Abdur Razzaque, Towhidul Islam, AKM Mizanur Rahman, Nazmun Naher Poly, Diponkar Kumar Saha
33
Evaluation of BATICH Score for the management of Paediatric Blunt Abdominal Trauma
Kamrul Ahasan Chowdhury, Rajib Khastagir, MA Mushfiqur Rahman, Rivu Raj Chakraborty, Tanvir Kabir Chowdhury
40
Understanding the Epidemiology of Labial Adhesion among Paediatric Age-groups in Bangladesh: A Single-center Cross-Sectional Study
Rifah Sanjeedah Tahsin, Sakibul Alam, Arpita Biswangree, Bijita Biswangree, Md Fahadul Islam, Debjyoti Barua, Md Sharif Imam
45
Case Reports
Tubercular ulcer on the dorsum of the penis in a toddler, a case report
Dipankar Kumar Saha, Khondoker Moynul Hasan, Sajal Kumar Majumdar, Mirza Kamrul Zahid, Abhi Kumar Chakraborty, Syed Mahmudur Rahman, AKM Maruf Reza, Soma Podder
52
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ASSOCIATION OF PAEDIATRIC SURGEONS OF BANGLADESH (APSB)
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Authors

  • Anupam DasAssistant Professor, Department of Paediatric Surgery, Sylhet Women’s Medical College Hospital, Sylhet, Bangladesh.
  • Md Nurul AlamEx. Professor and Head, Department of Paediatric Surgery, Sylhet MAG Osmani Medical College Hospital, Sylhet.
  • Md Shamsur RahmanAssociate Professor, Department of Paediatric Surgery, Sylhet MAG Osmani Medical College Hospital, Sylhet.
  • Md Oyes Ahmed ChowdhuryProfessor and Head, Department of Paediatric Surgery, Sylhet Women’s Medical College Hospital, Sylhet.
  • Habib Ullah KhanAssistant Professor, Department of Paediatric Surgery, Sylhet MAG Osmani Medical College Hospital, Sylhet.
  • Md Sirajul IslamAssistant Professor, Department of Paediatric Surgery, Sylhet MAG Osmani Medical College Hospital, Sylhet.

Keywords

surgical management of NTDs outcome of NTDs neural tube defects myelomeningocele encephalocele meningocele

Abstract

Introduction: Neural tube defects (NTDs) are common congenital malformations that affect the entire central nervous system. Proper surgical management of affected children may lead to a meaningful and productive life, and deficiently managed cases of NTDs can be a catastrophic condition not only for patient but also for the patient’s family. Methodology: This prospective observational study was conducted in the Department of Paediatric Surgery, Sylhet M.A.G. Osmani Medical College & Hospital during the period from March, 2018 to August, 2020. Thirty children with a neural tube defect during the study period were included. Associated with life threatening major congenital malformations were excluded. The surgical management protocol used for different sites of NTDs was studied. Results: The ages of the patients ranged from 1 day to 9 years with the median age of 3.5 days. There were 21 (70.0%) male and 9 (30.0%) female with a ratio of male to female was 2.33:1. Tendency to neural tube defect was more frequent in male than that of female (p=0.028). The types of NTDs were myelomeningocele (73.3%), encephalocele (10.0%), lipomeningocele (10.0%) and meningocele (6.7%). The sites of neural tube defects were lumbosacral (76.7%), occipital (10.0%), sacral (6.7%), lumber (3.3%) and cervical (3.3%). The nature of neural tube defects was ruptured in (60.0%) and not ruptured in (40.0%). Associated birth defects in this study were hydrocephalus in 56.7%, club foot in 16.7%, cervical prolapse in 6.7% and kyphosis in 6.7% cases. Associated neurological defects were lower limb paresis and paralysis in 83.3%, Urinary incontinence in 50.0% and faecal incontinence abnormality in 40.0% of cases. Postoperative complications were wound infection in 10.0%, wound dehiscence in 16.7%, CSF leakage in 23.3% and meningitis in 10.0% cases. The overall mortality rate was 6.7% of cases. Outcome of this study was recovery without complication in 66.7%, recovery with complications in 26.7% and death in 6.7% of cases. Recovery without complication was more frequent than recovery with complications and death. Conclusion: Lumbosacral myelomeningocele was the most common type of NTD. There was recovery without complication in most cases after operation. Early operation is associated with recovery without complication.

Journal of Paediatric Surgeons of Bangladesh (2020) Vol. 11 (1 & 2): 17–23

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