Journal of Pediatric Surgery Open最新文献

{"title":"Impact of sorafenib on postoperative complications in thoracic surgery: A single-institution retrospective review","authors":"Yuma Yagi ,&nbsp;Tomoko Yokosuka ,&nbsp;Hidehito Usui ,&nbsp;Masakatsu Yanagimachi ,&nbsp;Mio Tanaka ,&nbsp;Kumiko Nozawa ,&nbsp;Hiroaki Goto ,&nbsp;Norihiko Kitagawa","doi":"10.1016/j.yjpso.2026.100280","DOIUrl":"10.1016/j.yjpso.2026.100280","url":null,"abstract":"<div><h3>Background</h3><div>Sorafenib (SFN) is known to cause postoperative complications, such as delayed wound healing, particularly in abdominal surgeries. However, its effects on thoracic surgeries remain unclear. This study examines the impact of SFN on postoperative outcomes in thoracic surgery.</div></div><div><h3>Methods</h3><div>A retrospective comparative study was conducted at Kanagawa Children’s Medical Center from January 2013 to July 2021. The study included patients who underwent thoracic surgery for thoracic or mediastinal metastases of hepatoblastoma. Patients were divided into SFN and non-SFN groups based on whether they received SFN. Repeated surgeries on the same patient were analyzed as separate procedures.</div></div><div><h3>Results</h3><div>A total of 18 patients (83 surgeries) were included: 11 patients (35 surgeries) in the SFN group and 16 patients (48 surgeries) in the non-SFN group. Five patients in the SFN group exhibited six postoperative complications, including pneumothorax (<em>n</em> = 3), wound dehiscence (<em>n</em> = 2), and postoperative bleeding (<em>n</em> = 1). In contrast, complications occurred in two patients in the non-SFN group: pneumothorax (<em>n</em> = 1) and wound infection (<em>n</em> = 1). The pneumothorax case in the non-SFN group was attributed to positive-pressure ventilation during contralateral surgery. In the SFN group, one case had the same cause, while two cases developed as late-onset pneumothorax after hospital discharge.</div></div><div><h3>Conclusion</h3><div>Patients receiving SFN may develop late-onset pneumothorax. These findings highlight the need for careful postoperative management in patients undergoing thoracic surgery while on SFN therapy.</div></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"14 ","pages":"Article 100280"},"PeriodicalIF":0.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147600049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of three-dimensional models for surgical planning in pediatric neuroblastoma: a multi-institutional case series","authors":"Sara A. Mansfield ,&nbsp;Melissa K. Suh ,&nbsp;William J. Weadock ,&nbsp;Daniel J. Robertson ,&nbsp;Stephanie F. Polites ,&nbsp;Jonathan M. Morris ,&nbsp;Patrick B. Thomas ,&nbsp;Osama Raslan ,&nbsp;Jayanthi Parthasarathy ,&nbsp;Erika A. Newman ,&nbsp;Andrew M. Davidoff ,&nbsp;Zachary Abramson ,&nbsp;Erin G. Brown","doi":"10.1016/j.yjpso.2026.100281","DOIUrl":"10.1016/j.yjpso.2026.100281","url":null,"abstract":"<div><h3>Background</h3><div>Neuroblastoma resections are complex operations due to the propensity to involve critical adjacent structures. Pre-operative planning is critical to understand relevant anatomy and accurately assess image-defined risk factors. The aim of this case series is to describe the utility of 3D imaging for neuroblastoma.</div></div><div><h3>Methods</h3><div>This was a multi-institution case series of patients with neuroblastomas highlighting a variety of anatomic locations and image-defined risk factors. Pre-operative 2D cross-sectional imaging was obtained per institutional routine. 3D segmentation was then completed, and 3D images were created and delivered through a variety of technologies. Surgical teams reported on the usefulness of these 3D renderings.</div></div><div><h3>Results</h3><div>Nine patients from six institutions were included. Representative 3D images are included for each case with descriptions of the perceived utility in pre-operative planning and intraoperative considerations.</div></div><div><h3>Conclusion</h3><div>This case series highlights the possible advantages of 3D imaging for neuroblastoma surgery. The ability to use this technology across a variety of institutions indicates this may be feasible on a wider scale. Studying the exact benefits of 3D imaging for these operations should be the emphasis of future research.</div></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"14 ","pages":"Article 100281"},"PeriodicalIF":0.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147600033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of hospital, surgeon, and geography-related factors associated with timely surgical care for undescended testes in a universal health care system","authors":"Hyunwoong Harry Chae ,&nbsp;Elaine J Redmond ,&nbsp;Alex Zheng ,&nbsp;Andrew MacNeily ,&nbsp;Kourosh Afshar ,&nbsp;Erik Skarsgard ,&nbsp;Jason M. Sutherland ,&nbsp;Soojin Kim","doi":"10.1016/j.yjpso.2025.100258","DOIUrl":"10.1016/j.yjpso.2025.100258","url":null,"abstract":"<div><h3>Introduction</h3><div>Canada’s healthcare system aims to provide equitable access to care. Guidelines recommend surgery for undescended testes (UDT) before 18 months of age. We evaluated time-appropriate access to surgery for UDT patients in Canada.</div></div><div><h3>Methods</h3><div>We conducted a secondary analysis of UDT patients who received surgery between 2010–2018. Multivariable logistic models identified factors associated with surgery within 18 months.</div></div><div><h3>Results</h3><div>Among 19,209 UDT cases, 5186 (27.0%) had surgery within 18 months- 5051/17,947 (28.1%) orchidopexies and 135/1262 (10.7%) orchiectomies. Higher odds of timely orchidopexy were observed at teaching children’s (OR 1.52, CI 1.29–1.79, <em>p</em> &lt; 0.001) and teaching non-children’s hospitals (OR 2.21, CI 1.87–2.61, <em>p</em> &lt; 0.001) versus community hospitals. Hospitals with higher UDT volume (2nd–4th quartiles versus 1st quartile hospitals; &gt;46 cases/year) were more likely to perform surgery within 18 months for both procedures (all OR&gt;1, <em>p</em> &lt; 0.05). Pediatric (OR 1.67, CI 1.53–1.84, <em>p</em> &lt; 0.001) and general surgeons (OR 1.89, CI 1.58–2.26, <em>p</em> &lt; 0.001) were more likely than pediatric urologists to operate within 18 months for orchidopexy, while only pediatric surgeons were more likely for to do so for orchiectomy (OR 1.95, CI 1.00–3.79, <em>p</em> = 0.05). Odds of surgery within 18 months declined over time for orchidopexies (OR 0.99, CI 0.97–1.00, <em>p</em> = 0.039) and orchiectomies (OR 0.88, CI 0.81–0.95, <em>p</em> = 0.001).</div></div><div><h3>Conclusion</h3><div>Fewer than 30% of UDT surgeries in Canada occurred within 18 months. High-volume and teaching hospitals, and pediatric/general surgeons, were more likely to operate within 18 months. Odds of operation within 18 months declined in recent years. Systemic factors may delay care for UDT patients in Canada.</div></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"14 ","pages":"Article 100258"},"PeriodicalIF":0.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145986720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “A single-center retrospective study of the surgery outcome of Megarectosigmoid (MRS) after anorectal malformation (ARM) repair” [Journal of Pediatric Surgery Open 14 (2026) 100266]","authors":"Le Zheng ,&nbsp;Yifeng Shao ,&nbsp;Anxiao Ming ,&nbsp;Jianfeng Luo ,&nbsp;Mei Diao ,&nbsp;Long Li","doi":"10.1016/j.yjpso.2026.100270","DOIUrl":"10.1016/j.yjpso.2026.100270","url":null,"abstract":"","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"14 ","pages":"Article 100270"},"PeriodicalIF":0.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147749146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender gap in pediatric surgery and pediatric urology meetings across Latin America: Fair enough?","authors":"Francisca Yankovic ,&nbsp;Alejandra Rios Rubio ,&nbsp;Gabriela Sorrentino ,&nbsp;Ahmet Ali Sancaktutar ,&nbsp;Juan Manuel Moldes ,&nbsp;Pedro-Jose Lopez","doi":"10.1016/j.yjpso.2025.100242","DOIUrl":"10.1016/j.yjpso.2025.100242","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Previous studies have highlighted growing awareness of female involvement in scientific meetings, consistently reporting lower participation rates for women physicians overall. However, few reports have specifically addressed gender participation in pediatric surgery and urology conferences. This study aimed to evaluate women’s participation in major Latin American congresses of pediatric surgery and pediatric urology. As a secondary objective, it assessed women’s representation in scientific societies and the proportion of female trainees in pediatric surgery across Latin American countries</div></div><div><h3>Methods</h3><div>A retrospective review of publicly available pediatric surgery meeting programs (2018–2023) was conducted to assess participation by gender and role. Participation roles were categorized as clinical lecturer, participant in clinical round table, or moderator. Female participation was compared against an expected parity value of 0.5 using proportion and Chi-square tests. Participation in organizational committees, sponsored symposia, or pre-conference courses was excluded. Data on the number and gender of members in pediatric surgical societies from five Latin American countries were collected, along with the number and gender of residents currently in pediatric surgery training in the same countries.</div></div><div><h3>Results</h3><div>Twelve scientific programs comprising 968 participations in pediatric surgery/urology meetings were analyzed. Men accounted for 68% of all participations. In keynote lectures, the gender gap widened, with 82% of participations by men. Across all participation types, statistically significant differences were observed: lecturers (<em>p</em> &lt; 0.001), panel participants (<em>p</em> &lt; 0.001), and moderators (<em>p</em> &lt; 0.001). Women were significantly less represented as lecturers compared with moderators (<em>p</em> &lt; 0.001). Female representation in pediatric surgery scientific societies across Latin America was approximately 45%, and nearly 60% of current trainees in pediatric surgery were women.</div></div><div><h3>Conclusions</h3><div>Despite increased awareness of the gender gap, women remain markedly underrepresented in pediatric surgery and pediatric urology meetings—especially in keynote lectures, where participation by women was only 18%. These findings contrast with the relatively high proportion of women in professional societies and among surgical trainees.</div></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"14 ","pages":"Article 100242"},"PeriodicalIF":0.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Verrucous venous malformations in children: A case for surgical excision","authors":"Halah Hassan ,&nbsp;Hannah Triscott ,&nbsp;Professor Roy Kimble","doi":"10.1016/j.yjpso.2026.100265","DOIUrl":"10.1016/j.yjpso.2026.100265","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Verrucous venous malformations (VVMs) are rare congenital vascular anomalies characterized by ectatic venous channels in the dermis and subcutis, with overlying verrucous epidermal changes. Typically presenting in early childhood, they may cause pain, bleeding, infection, and psychosocial distress. Diagnosis and management are often difficult due to clinical and histopathologic overlap with other vascular lesions. Non-surgical therapies have been trialled with limited success, and surgical excision remains the primary treatment. However, the efficacy of surgery, particularly when combined with reconstructive techniques, has not been systematically compared to alternative modalities.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Methods&lt;/h3&gt;&lt;div&gt;Twenty-three paediatric patients (aged one month to 17 years) with congenital or early-onset vascular lesions suspected to be VVMs were evaluated at a tertiary vascular anomalies clinic between 2019 and 2025. Clinical presentation, imaging, histopathology, IHC, and NGS results of a 32-gene vascular anomaly panel were reviewed. All patients underwent biopsy or excision. Data were collected retrospectively from operative reports, pathology results, and follow-up documentation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Twenty-three patients (12 male, 11 female; mean age 6.6 years) were included in this series. Lesions were present at birth in all 23 children. Pain and ulceration were the most common symptoms reported, and most lesions demonstrated progressive enlargement. All were solitary and located on the limbs (&lt;em&gt;n&lt;/em&gt; = 19) or trunk (&lt;em&gt;n&lt;/em&gt; = 4), with a predilection for the lower limb. Imaging suggested low-flow vascular malformation in 14 patients. Twenty children underwent surgical excision. Excision techniques included elliptical excision, rhomboid flap reconstruction, and, in extensive lesions, staged excision with dermal regeneration templates, negative pressure wound therapy (NPWT) and split-thickness skin grafts (STSG). Adjunctive therapies were trialled in seven patients, including laser treatments such as Pulsed Dye Laser (PDL), Fractional Carbon Dioxide Laser (CO₂) and Neodymium-Doped Yttrium Aluminum Garnet Laser (Nd:YAG), microneedling, sclerotherapy, and topical sirolimus. Histopathology confirmed VVM in 19/21 children; immunohistochemistry showed GLUT1 positivity in 18/19 and D2–40 in 8/19. MAP3K3 mutations were identified in 8/20 patients and a KRIT1 variant in one. Postoperative recovery was uncomplicated in most lesions. No major complications or functional impairments were observed, and most patients achieved satisfactory aesthetic and functional outcomes. Quality-of-life assessment using the BBSIP demonstrated consistent functional and psychosocial benefit.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;VVMs present diagnostic and therapeutic challenges due to their overlap with other vascular anomalies and variable histopathologic and molecular features. Surgical excision","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"14 ","pages":"Article 100265"},"PeriodicalIF":0.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A single-center retrospective study of the surgery outcome of Megarectosigmoid (MRS) after anorectal malformation (ARM) repair","authors":"Zheng Le ,&nbsp;Shao Yifeng ,&nbsp;Ming Anxiao ,&nbsp;Luo Jianfeng ,&nbsp;Diao Mei ,&nbsp;Li Long","doi":"10.1016/j.yjpso.2026.100266","DOIUrl":"10.1016/j.yjpso.2026.100266","url":null,"abstract":"<div><h3>Background</h3><div>The Megarectosigmoid (MRS) after anorectal malformation (ARM) repair can have a negative impact on the pediatric quality of life. However, current treatments lack consensus due to variable efficacy.</div></div><div><h3>Objective</h3><div>To evaluate the long-term outcome of laparoscopic-assisted MRS resection (resection of the dilated sigmoid colon and rectum) with anal reconstruction (LAMR-AR) and provide the indications to surgical treatment for MRS.</div></div><div><h3>Methods</h3><div>A retrospective cohort analyzed 49 pediatric MRS patients, who all had underwent ARM repair before LAMR-AR. Clinical data included imaging and surgical parameters. Patients were stratified by anal morphology: normal anus group (NAG) vs abnormal anus group (AAG) (stenosis/ectopic anus). Functional outcomes were assessed via Rintala scores (R-score) and Krickenbeck criteria for soiling/constipation.</div></div><div><h3>Results</h3><div>This study enrolled a cohort of 49 pediatric patients (28 males, 21 females) with a median age of 2.75 years (interquartile range [IQR]: 1.42–3 years). Postoperatively, in normal anus group, constipation decreased from 92.9%(26/28 grade3:26) to 7.1%(2/28 grade2:1 grade3:1)(<em>p</em>&lt;0.01), while soiling increased from 3.6%(1/28 grade3:1) to 57.1%(16/28 grade1:9 grade2:7)(<em>p</em>&lt;0.01). As for the abnormal anus group, constipation decreased from 85.7%(18/21 grade3:18) to 23.8%(5/21 grade2:4 grade3:1)(<em>p</em>&lt;0.01) and soiling increased from 4.8%(1/21 grade3:1) to 71.4%(15/21 grade1:2 grade2:9 grade3:4)(<em>p</em>&lt;0.01).Cases in abnormal anus group showed higher complications after ARM repair rates (32.1% vs 14.3%, <em>p</em> <em>=</em> 0.04 abnormal anus group: wound infection/abscess (5), mucosal prolapse (6), recurrent urethral fistula (1), vaginal fistula (1), vestibular fistula (1), wound dehiscence (1) vs normal anus group: cutaneous fistula (1), urethral fistula (1), perianal abscess (1), mucosal prolapse (1)) and worse outcome in lower R-scores(NAG:17(15–19);AAG:14(11–16) <em>p</em> = 0.012).</div></div><div><h3>Conclusion</h3><div>LAMR-AR is more recommended for patients without anal abnormalities.</div></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"14 ","pages":"Article 100266"},"PeriodicalIF":0.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145986721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in surgical technique, functional outcomes, and postoperative care for pectus conditions","authors":"Madison C. Betcher,&nbsp;Daniel A. DeUgarte,&nbsp;Veronica F. Sullins,&nbsp;Howard C. Jen,&nbsp;Christine E. Dichter,&nbsp;Justin P. Wagner","doi":"10.1016/j.yjpso.2026.100261","DOIUrl":"10.1016/j.yjpso.2026.100261","url":null,"abstract":"<div><h3>Objective</h3><div>To summarize advances in the last decade of care for pectus deformities—primarily pectus excavatum (PE) and pectus carinatum (PC)—with attention to surgical technique, perioperative outcomes, functional and psychosocial effects, and emerging gaps in standardization.</div></div><div><h3>Methods</h3><div>Review of recent clinical studies, consensus statements, and large cohort analyses addressing indications, operative and non-operative management, outcomes, and postoperative protocols.</div></div><div><h3>Results</h3><div>Technique refinements to minimally invasive repair (e.g., multi-bar configurations, bridge fixation, shorter bars, and routine thoracoscopy) have reduced bar displacement and major complications while enabling more complete anterior chest wall remodeling. The modified Ravitch procedure remains an option for adults, complex anatomy, or recurrence, with comparable long-term satisfaction. Non-operative therapies—vacuum bell for selected children and orthotic bracing for PC—achieve good results when initiated early and used consistently. Cardiopulmonary diagnostics increasingly demonstrate postoperative improvements in cardiac output, indices of ventricular performance, and exercise capacity, with pulmonary function changes small or inconsistent. The psychosocial burden of disease is substantial, even in mild deformity, and improves after correction. Enhanced Recovery After Surgery pathways and intercostal nerve cryoablation shorten length of stay, lower opioid exposure, and support same-day discharge in selected programs. Despite progress, indications and preauthorization practices vary widely; reliance on “physiologic” criteria and extensive testing contributes to disparities in access.</div></div><div><h3>Conclusions</h3><div>Contemporary PE/PC care is safer, more effective, and more patient-centered, but remains heterogeneous. Field-wide, consensus-driven guidance that integrates anatomic severity, symptoms, psychosocial distress, and progression would improve equity of access, align payer policy with evidence, and standardize outcomes-oriented care.</div></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"14 ","pages":"Article 100261"},"PeriodicalIF":0.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Board Page","authors":"","doi":"10.1016/S2949-7116(26)00024-9","DOIUrl":"10.1016/S2949-7116(26)00024-9","url":null,"abstract":"","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"14 ","pages":"Article 100284"},"PeriodicalIF":0.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147749158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of obstructive peristomal complications in pediatric tracheostomy patients. A case series – Surgical decannulation","authors":"R. Sancho ,&nbsp;M. Díaz ,&nbsp;L. Solorio ,&nbsp;R. Quimbert ,&nbsp;N.N. Mata ,&nbsp;A.R. Barraza","doi":"10.1016/j.yjpso.2025.100259","DOIUrl":"10.1016/j.yjpso.2025.100259","url":null,"abstract":"<div><h3>Background</h3><div>Tracheal stenosis and suprastomal granuloma with collapse of the anterior tracheal wall are obstructive complications in pediatric tracheostomy patients. The objective of this study is to determine the safety and prognosis of surgical decannulation with simultaneous resection of the obstructive granuloma and tracheoplasty</div></div><div><h3>Methods</h3><div>A descriptive study between 2015 and 2024, seven children with obstructive complications associated with tracheostomy were included for surgical treatment with resection of suprastomal granuloma, stomoplasty and tracheoplasty simultaneously in surgical decannulation after failure of endoscopic treatment, surgical, endoscopic and prognostic characteristics are analyzed</div></div><div><h3>Results</h3><div>Seven, with bronchopulmonary dysplasia (n = 4) and prolonged intubation <em>n</em> = 3), all with obstructive suprastomal granulomas &gt; 95% of the airway with failure of endoscopic resection, all with dynamic peristomal obstruction &gt;75% and in 2 of them infrastomal tracheal stenosis Cotton III and IV, 5 were treated with granuloma resection, stomoplasty and anterior tracheoplasty achieving immediate extubation in 4 and one remained intubated for 24 h due to supraglottic edema, and in 2 granuloma resection, anterior malacia and infrastomal stenosis with end-to-end tracheal anastomosis were performed, all with successful decannulation</div></div><div><h3>Conclusions</h3><div>Surgical decannulation in the treatment of obstructive peristomal complications in children with tracheostomy is a safe option, with low morbidity and no recurrence with zero mortality when endoscopic treatment has failed</div></div><div><h3>Level of evidence</h3><div>IV</div></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"14 ","pages":"Article 100259"},"PeriodicalIF":0.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}