Advances and Updates in Fetal and Neonatal Surgery, an Issue of Clinics in Perinatology: Volume 49-4

The undertaking of the treatment of an infant born with bladder exstrophy is one of the most weighty responsibilities that can fall upon the shoulders of the reconstructive sur- geon. The modern treatment of a child born with bladder exstrophy began in the mid- 1970's with the widespread application of staged reconstruction. This approach has consistently yielded very good results in several series. However, as in all serious congeni- tal birth defects, there is certainly room for advancement. Issues such as the routine use of osteotomy, timing and type of epispadias repair, combining bladder closure with epispadias repair, the approach to the small bladder, and the management of a failed exstrophy still remain. This National Institute of Health/Na- tional Kidney Foundation/Johns Hopkins-sponsored seminar was an attempt to bring ex- perts in the field of pediatric orthopedic surgery, pediatric urology, pediatric surgery, adult urology, and basic science together to share their experiences in an attempt to foster new clinical and basic science research communications between the participants. If these col- laborations result, then this first international meeting will have been successful. The editors would like to thank all of the contributors for their timely and complete submissions. John P. Gearhart, M.D. Ranjiv Mathews, M.D. vii CONTENTS 1. The Embryology and Epidemiology of Bladder Exstrophy ................. .

Mittal, R L

Levitt, Marc A

<p>Paediatric surgeons who practice in areas where medical resources are stretched over wide geographical areas face a number of challenges. This resource provides an easy and useful guide to help readers understand the essentials of paediatric surgery. Using the authors' own experiences, the text illustrates the different management practices required when dealing with paediatric patients in rural and remote settings.</p> <p>The most frequently encountered fetal, infant and paediatric conditions are reviewed, together with coverage of trauma, burns, urology, thoracic surgery, emergency abdominal surgery, minimally invasive paediatric surgery and problems with external genitalia.</p> <p>This book is intended to be a practical guide for clinicians to the common and important problems seen in paediatric surgery, enabling them to make clinical management plans and ensure effective communication with local teams.</p>

Steven A. Rosenberg, MD In the past two decades significant progress has quality of life. The use of local radiation therapy has occurred, in the management of patients with mus- had a profound impact on the ability to achieve local loskeletal cancers, that has improved both the survival control. Cooperation between surgeons and radiation and the quality of life of afflicted patients. Changes in therapists often results in the tailoring of surgical p- the management of these patients have mirrored cedures to maximize the combined application of these trends in the entire field of oncology. two effective treatment modalities. Although impact on The most significant change has been improvement overall survival has not been demonstrated due to the in the surgical techniques for the resection of musculo- addition of radiation therapy, important advances in skeletal cancers based on a detailed understanding of improving the quality of life of patients receiving this the anatomic features of each particular tumor site, as combined-modality treatment have been evident. well as an appreciation of the natural biology that affects A third change impacting on the survival of patients the local spread of these tumors. The current volume of with musculoskeletal cancers has been the aggressive Musculoskeletal Cancer Surgery: Treatment of Sarcomas and resection of metastatic deposits.

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