Journal of Pediatric Surgery Open最新文献

{"title":"Laparoscopic colostomy for colorectal problems in children","authors":"A. Domínguez-Muñoz,&nbsp;A. Costa-Roig,&nbsp;E. Fernández-Portilla,&nbsp;J. Nieto-Zermeño,&nbsp;E. Bracho-Blanchet,&nbsp;I. Lizárraga-Rodríguez,&nbsp;J. Salazar-Rivera,&nbsp;R. Dávila-Pérez","doi":"10.1016/j.yjpso.2025.100209","DOIUrl":"10.1016/j.yjpso.2025.100209","url":null,"abstract":"<div><h3>Purpose</h3><div>To describe our experience in laparoscopic colostomy with separated stomas for colorectal issues in pediatric patients.</div></div><div><h3>Methods</h3><div>This prospective cohort, single-institution study included patients aged 0–18 years who exhibited colorectal problems requiring a colostomy and who were managed at a tertiary-level care hospital between October 2023 and September 2024.</div></div><div><h3>Results</h3><div>Fourteen patients were analyzed. Eleven (78 %) patients with anorectal malformation (ARM), 2 (14 %) with acquired rectal fistula, and 1 (7 %) with recurrent rectal fistula due to suspected inflammatory bowel disease. In total, 7 (63 %) of 11 patients with ARM underwent diversion during the neonatal period. Further, 4 (36 %) patients had diverted due to megarectum later in life. All patients underwent laparoscopic colostomy with separated stomas. The mean surgical duration was 114 (78–141) minutes. Enteral feeding was started at a mean of 1.7 [1–3] days postoperatively. The median length of hospital stay was 10.4 ([1]-51) days. There were no cases of stoma prolapse, wound infection, or skin excoriation. One (7 %) patient with a recto-vestibular fistula developed mucosal fistula stenosis at 90 days after colostomy.</div></div><div><h3>Conclusions</h3><div>Laparoscopic colostomy with separate stomas in children with colorectal problems is a safe, reproducible technique, with a lower risk of complications and with greater advantages compared with the open technique.</div></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"10 ","pages":"Article 100209"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820947","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":"Testicular atrophy and growth post orchidopexy in pediatric patients: A systematic review","authors":"Faisal F. Aljadani ,&nbsp;Badr M. Rafi ,&nbsp;Leen M. Alghamdi ,&nbsp;Mohammed M. Bukhari ,&nbsp;Lena M. Afif ,&nbsp;Baraa B. Milibari ,&nbsp;Jehad H. Habeeballah ,&nbsp;Ali A. Almehmadi ,&nbsp;Abdullah Mesawa","doi":"10.1016/j.yjpso.2025.100205","DOIUrl":"10.1016/j.yjpso.2025.100205","url":null,"abstract":"<div><h3>Background</h3><div>Undescended testis, also known as cryptorchidism, is a common congenital anomaly in male infants. It is defined as unilateral or bilateral absence of testes in the scrotum. Testicular volume changes, testicular atrophy, or growth are well known established outcomes of surgical orchidopexy. Testicular growth is the end-result wanted for the management of undescended testis. Contrastingly, testicular atrophy is an unwanted complication of orchidopexy. This systematic review is conducted with the aim of getting a clearer picture of whether there is a correlation between the timing, surgery type, or technique of the orchidopexy and the testicular volume changes.</div></div><div><h3>Methods</h3><div>This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). A thorough search was done on several databases with the aim of finding relevant randomized controlled trials. The screening process was conducted using the Rayyan tool. Five randomized controlled trials were included for the data extraction process in our systematic review.</div></div><div><h3>Results</h3><div>The main findings of our systematic review revealed that earlier surgical management results in better testicular growth. Whereas delaying the surgical management did not show good catch-up growth. Both the types of surgeries and types of fixations had no effect on the size of the testis. Regarding laparoscopic techniques, staged laparoscopic traction orchidopexy showed more favorable results.</div></div><div><h3>Conclusions</h3><div>Early surgical fixation is the critical factor in determining testicular volume changes post-surgery. Neither surgery type or technique play a role in yielding positive or negative results.</div></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"10 ","pages":"Article 100205"},"PeriodicalIF":0.0,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143643172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Down-regulation of FGF10 in hypospadias prepuce associated with severity","authors":"Susumu Yamada ,&nbsp;Katsumi Miyahara ,&nbsp;Naho Fujiwara ,&nbsp;Kazuto Suda ,&nbsp;Hiroyuki Koga ,&nbsp;Geoffrey J. Lane ,&nbsp;Atsuyuki Yamataka ,&nbsp;Go Miyano ,&nbsp;Manabu Okawada","doi":"10.1016/j.yjpso.2025.100206","DOIUrl":"10.1016/j.yjpso.2025.100206","url":null,"abstract":"<div><h3>Background</h3><div>Fibroblast growth factors (FGF) expressed in the genital tubercle, especially FGF8 and FGF10, may be implicated in the morphogenesis of external genitalia. We investigated the expression of FGF8 and FGF10 in hypospadias prepuce to confirm any correlation.</div></div><div><h3>Methods</h3><div>Hypospadias was classified according to the location of the external meatus as coronal/subcoronal (mild; <em>n</em> = 7), midshaft (moderate; <em>n</em> = 6), or penoscrotal (severe; <em>n</em> = 3). Prepuce tissue specimens obtained intraoperatively from hypospadias patients (H; <em>n</em> = 16) and phimosis patients (P; <em>n</em> = 8) between 2010 and 2016 were examined immunohistochemically by calculating the mean intensity of FGF positive cells from the papillary dermis in each of 5 randomly chosen 100 μm x 100 μm areas. Quantification of immunostaining was performed using ImageJ®. FGF10 was quantified by Western blotting.</div></div><div><h3>Results</h3><div>Median ages at surgery were 4.1 and 3.4 years for H and P, respectibely. Both FGF8 and FGF10 were expressed in the upper dermis, especially the papillary layer. FGF8 was similar; P versus mild H (<em>p</em> = 0.98), moderate H (<em>p</em> = 0.97), severe H (<em>p</em> = 0.77), mild H versus moderate H (<em>p</em> = 0.85), severe H (<em>p</em> = 0.91), moderate H versus severe H (<em>p</em> = 0.59), but FGF10 was down-regulated in H in proportion to severity (P: 13.08 % versus mild H: 7.28 %, moderate H: 5.01 %, and severe H: 1.38 %) (<em>p</em> &lt; 0.05, respectively). Western blot analysis was expressed as the ratio of FGF10 protein amount per β-actin (P: 0.91 versus mild H: 0.99, moderate H: 0.65, severe H: 0.48).</div></div><div><h3>Conclusion</h3><div>The down-regulation of FGF10 identified may contribute to further understanding the etiology of hypospadias and may have some possible application for treating hypospadias.</div></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"10 ","pages":"Article 100206"},"PeriodicalIF":0.0,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143592315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technique for laparoscopic gastrostomy button placement for type A esophageal atresia with immediate gap analysis","authors":"John M. Woodward ,&nbsp;Joseph C. L'Huillier ,&nbsp;Brie Mucci-Jackson ,&nbsp;Ruchi Amin ,&nbsp;Phillip Benson Ham 3rd","doi":"10.1016/j.yjpso.2025.100204","DOIUrl":"10.1016/j.yjpso.2025.100204","url":null,"abstract":"<div><h3>Purpose</h3><div>Patients with pure esophageal atresia (Type A) are typically managed with staged surgical intervention, however timing of surgical correction and outcome vary with gap length. We propose a modified technique and order of operation to initially establish enteral access and assess gap length though a minimally invasive approach in this patient population that commonly has microgastria.</div></div><div><h3>Operative Technique</h3><div>We propose a modified operative approach for pure EA and demonstrate its success in a patient. In our approach, a laparoscopic gastrostomy tube is placed and immediate gap analysis performed at the index operation. Our patient is a 1-day-old 2.6 kg male born at 35 weeks with pure esophageal atresia. In the operation, the abdomen was entered laparoscopically. After lowering insufflation pressure, the stomach was exteriorized and secured to the fascia in four quadrants. The stomach was entered using an introducer needle and fluoroscopic dye was subsequently administered to confirm safe entry in the absence of gastric insufflation. A balloon gastrostomy was passed into the stomach using the Seldinger technique. A grasper was used to compress the pylorus while flushing additional contrast through the gastrostomy tube to assess gap length. The grasper was then relaxed to show contrast passing into the duodenum and ruling out a gastric outlet obstruction from the balloon.</div></div><div><h3>Conclusion</h3><div>This technique allows for laparoscopic gastrostomy button placement with immediate gap analysis in a patient with pure esophageal atresia.</div></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"10 ","pages":"Article 100204"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally invasive management of Müllerian anomalies in pediatric patients: A retrospective case series and literature review","authors":"Mario Riquelme ,&nbsp;Juan Pelayo ,&nbsp;Irving Cardenas-Medina ,&nbsp;Ana Cantu-Zendejas ,&nbsp;Alejandro Cendejas-Higuera ,&nbsp;Eduardo Olazabal ,&nbsp;Mario Palafox","doi":"10.1016/j.yjpso.2025.100203","DOIUrl":"10.1016/j.yjpso.2025.100203","url":null,"abstract":"<div><div>Müllerian anomalies (MA) are structural defects that arise due to alterations in the development of the paramesonephric or Müllerian ducts during the first 16 weeks of gestation. Few cases have been reported on laparoscopic management as a diagnostic and therapeutic method in Müllerian anomalies. This study presents a retrospective case series of 9 patients diagnosed with Müllerian anomalies. A diagnostic approach was performed on 9 patients with suspected Müllerian anomalies, including 3 patients with OHVIRA Syndrome. Of all patients, 8 of them were treated with minimally invasive procedures, and one delayed the treatment. Our findings highlight the importance of employing advanced imaging techniques, such as MRI and UroCT, in complex cases to ensure accurate diagnosis and optimal surgical planning. Our case series demonstrates that most patients can have their condition successfully managed through a minimally invasive approach, as highlighted in the reported cases. Future studies should focus on expanding the clinical evidence base, focusing on long-term follow-up to assess fertility outcomes, quality of life and durability of these surgical interventions.</div></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"10 ","pages":"Article 100203"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143563177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic total proctocolectomy and ileal pouch-anal anastomosis in one or more stages in Familial Adenomatous Polyposis: A single center's experience","authors":"Paula Lorena Roumieu,&nbsp;Juan Siffredi,&nbsp;Victor Di Benedetto,&nbsp;María Marcela Bailez","doi":"10.1016/j.yjpso.2025.100202","DOIUrl":"10.1016/j.yjpso.2025.100202","url":null,"abstract":"<div><h3>Introduction</h3><div>Laparoscopic total proctocolectomy (LTPC) and ileal pouch-anal anastomosis (IPAA) is our first choice for the treatment of Familial Adenomatous Polyposis (FAP). The surgeries were planned in one or multiple stage procedures depending on the clinical condition and intraoperative evaluation of the patient. We present our experience in the last 9 years comparing single and staged procedures.</div></div><div><h3>Methods</h3><div>The medical records of patients with FAP treated between 2014 and 2023 were analyzed. The surgical indication was agreed upon by an interdisciplinary committee according to the clinical management guidelines for FAP. The surgical technique used had been previously presented. Patients were divided into 3 groups (G) according to the number of surgical stages and compared operative time, initiation of oral feeding, hospital stay, perioperative morbidity and long-term functional outcomes.</div></div><div><h3>Results</h3><div>19 patients with a mean age of 12.7 years were included: Eight were treated in one stage (G1), 5 in two (G2) and 6 in three or more (G3). Operative time in G1, G2 and G3 was 386.3, 384.6 and 270.5 mins respectively. Initiation of oral feeding was 5.5 days in G1, 5.0 in G2 and 5.5 in G3. The median hospital stay in the first stage was 15.5 days in G1, 8 days in G2 and 22 days in G3. Early complications included anastomotic dehiscence, operative site infection, and intra-abdominal collection, and late complications included intestinal occlusion and anastomotic stricture. The average follow-up was 26 months. All patients are continent. Ten are on a hypofermentative diet and 4 of them use loperamide.</div></div><div><h3>Discussion</h3><div>LTPC / IPAA is a proven method for the treatment of FAP in the pediatric age, safe and reproducible. Non-significant difference between group 1 and 2 concluded that procedure without protective ileostomy is not associated with greater morbidity. A multidisciplinary team is required as well as advanced laparoscopic training.</div></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"10 ","pages":"Article 100202"},"PeriodicalIF":0.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effectiveness of per-oral carbohydrate and electrolyte solution for enhanced recovery after surgery (ERAS) in pediatric surgery: A randomized clinical trial","authors":"Andi Ade Wijaya Ramlan ,&nbsp;Christopher Kapuangan ,&nbsp;Raihanita Zahra ,&nbsp;Rahendra Rahendra ,&nbsp;Komang Ayu Ferdiana ,&nbsp;Titis Prawitasari ,&nbsp;Willy Yant Kartolo ,&nbsp;Ivana Firman ,&nbsp;Andana Haris ,&nbsp;Nathasha Brigitta Selene","doi":"10.1016/j.yjpso.2025.100200","DOIUrl":"10.1016/j.yjpso.2025.100200","url":null,"abstract":"<div><h3>Introduction</h3><div>Preoperative fasting in children is necessary to prevent aspiration pneumonia, but prolonged fasting can lead to hypoglycemia, dehydration, electrolyte imbalance, and postoperative nausea and vomiting (PONV). Preoperative carbohydrate loading, part of Enhanced Recovery After Surgery (ERAS), may alleviate discomfort and improve recovery.</div></div><div><h3>Methods</h3><div>This controlled trial randomized 137 children aged 1 to 12 years undergoing elective surgery lasting &lt;6 h into two groups: Carbohydrate-Electrolyte (CE) fluid (<em>n</em> = 67) and clear water (CW) (<em>n</em> = 70). Participants received 50 mL/kg of the assigned fluid following the standard 6–4–1 fasting regimen (solid food, breast milk, clear fluids). Primary outcomes included comparisons of blood glucose and electrolyte levels before and after induction. Secondary outcomes assessed preoperative anxiety, thirst, hunger, PONV, emergence delirium (ED), and pain scores.</div></div><div><h3>Results</h3><div>Blood glucose levels remained within normal limits with no significant differences between groups (<em>p</em> &gt; 0.05), with the CW group exhibiting lower mean glucose levels. Electrolyte levels were similar across groups. Preoperative anxiety, hunger, and postoperative pain showed no significant differences, while preoperative thirst was higher in the CW group (<em>P</em> = 0.040). ED occurred in 5.9 % of patients, with significantly lower scores in the CE group (<em>P</em> = 0.010). Postoperative nausea was more prevalent in the CW group (19.1 %) compared to the CE group (6 %) (<em>P</em> = 0.036).</div></div><div><h3>Conclusion</h3><div>Preoperative CE fluid administration stabilizes blood glucose and electrolyte levels while reducing preoperative thirst, postoperative nausea, and potentially ED compared to CW. These indicate that CE fluids may improve perioperative comfort and outcomes in pediatric patients.</div></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"10 ","pages":"Article 100200"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143454650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified iris system: initial experience with a new technology for safety in hiatal surgery in pediatric patients","authors":"Joel Cazares ,&nbsp;Eduardo De la Rosa-Bustamante ,&nbsp;Jorge Colín-Garnica ,&nbsp;Arturo Guillen-Cárdenas ,&nbsp;Marbella Sepulveda-Valenzuela ,&nbsp;Miguel Torres-Salas ,&nbsp;Jorge Alberto Cantú-Reyes","doi":"10.1016/j.yjpso.2025.100201","DOIUrl":"10.1016/j.yjpso.2025.100201","url":null,"abstract":"<div><h3>Purpose</h3><div>We present our initial experience with a modified IRIS U-kit system (MIUS) (Stryker, USA) for real-time esophageal visualization during Nissen fundoplication (NF) surgery in pediatric patients, aiming to enhance safety and reduce complications, especially in cases involving esophageal dysmotility and neurological impairments.</div></div><div><h3>Methods</h3><div>A retrospective, experimental study from April to June 2023 including patients with Gastroesophageal Reflux Disease (GERD). The IRIS U-kit, originally designed for urology, was adapted to aid esophageal visualization. This system utilized an illuminated ureteral stent with optical fibers inserted into a feeding tube (bougie).</div></div><div><h3>Results</h3><div>Five pediatric patients with an average age of 6.2 years successfully underwent laparoscopic NF. Three patients had neurological impairments, one had trisomy 21, and one had no neurological issues. Using MIUS enabled real-time esophageal visualization throughout the surgery, even in challenging areas affected by periesophagitis. No complications were reported. All NF procedures, with or without additional interventions like gastrostomy and pyloroplasty, were completed safely.</div></div><div><h3>Discussion</h3><div>NF surgery in pediatric patients, especially those with neurological impairments, poses risks of complications including perforations. Real-time esophageal visualization using the MIUS proved valuable in enhancing surgical safety, preventing complications and as an educational tool for resident training.</div></div><div><h3>Conclusions</h3><div>The MIUS demonstrated feasibility and safety in NF surgery for pediatric patients, even in cases with esophageal dysmotility and neurological impairments without using endoscopy. This innovative approach has the potential to be applied in reoperations, Heller myotomies, and esophageal atresias. To our knowledge, this is the first successful use of the IRIS system in non-urological patients.</div></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"10 ","pages":"Article 100201"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143350377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variations in pediatric intussusception management and outcomes across Aotearoa New Zealand: A national multicenter retrospective study","authors":"Brodie M. Elliott ,&nbsp;Georges K. Tinawi ,&nbsp;Jonathan M. Wells ,&nbsp;Shona Naera ,&nbsp;Andrew Weston ,&nbsp;Jacqueline Copland ,&nbsp;Shirin Gosavi ,&nbsp;Kristine Jung ,&nbsp;Udaya Samarakkody ,&nbsp;Samuel Haysom ,&nbsp;Rieke L. Meister ,&nbsp;Christopher I. Cassady ,&nbsp;Stephen Evans","doi":"10.1016/j.yjpso.2025.100198","DOIUrl":"10.1016/j.yjpso.2025.100198","url":null,"abstract":"<div><h3>Introduction</h3><div>Intussusception is a relatively common pediatric surgical pathology, but no standardized management guideline exists in Aotearoa New Zealand (AoNZ). We therefore aimed to conduct a national audit of intussusception management across AoNZ and describe any practice variations.</div></div><div><h3>Methods</h3><div>We performed a national 15-year retrospective, multicenter cohort study of all children treated for intussusception between 01 Jan 2007 and 01 Jan 2022 across AoNZ. We analyzed clinical and radiological data to determine inter-center variation, including treatment intent, subsequent management, and success rates.</div></div><div><h3>Results</h3><div>Six hospitals managed 529 children with intussusception. The median age at presentation was ten months (1m – 14.9y). Primary enema reduction was attempted in 88.5 % of cases, varying from 80 – 100 %. After post hoc exclusion of cases requiring resection, there was significant variation in enema reduction success (58.8 % – 100 %; <em>p</em> &lt; 0.001). The overall general anesthesia rate was 36 % (8 – 46 %), mostly from secondary operative management after failed enema reduction (8 – 38 %). Delay to enema reduction &gt;48 h was associated with a lower success rate (60.5 % vs 79.7 %; <em>p</em> &lt; 0.001) and with all four perforations (0.9 %). Enema success was more dependent on the prehospital duration of symptoms (25.8 h vs. 46.8 h; <em>p</em> &lt; 0.001) and prehospital transfer (68.7 % vs. 78.4 %; <em>p</em> = 0.012) than in-hospital delay to reduction (3.4 h vs. 3.6 h; <em>p</em> = 0.79).</div></div><div><h3>Conclusions</h3><div>We demonstrated a wide range of enema reduction success rates and subsequent operative management requirements across AoNZ. Prehospital delay in treatment was associated with the failure of enema reduction. Investigation into enema reduction practices and subsequent national care standardization is urgently recommended.</div></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"10 ","pages":"Article 100198"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143132148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating intranasal sufentanil-ketamine for preoperative sedation in children: A case-control study","authors":"Abbas Ostadalipour ,&nbsp;Saghar Samimi ,&nbsp;Bita MalekianZadeh ,&nbsp;Nima Nazari ,&nbsp;Ebrahim Espahbodi ,&nbsp;Maziar Maghsoudloo ,&nbsp;Vina Goudarzi ,&nbsp;Parisa Kianpour ,&nbsp;Shahram Samadi ,&nbsp;Farhad Etezadi","doi":"10.1016/j.yjpso.2024.100190","DOIUrl":"10.1016/j.yjpso.2024.100190","url":null,"abstract":"<div><h3>Background</h3><div>Hospitalization and surgical procedures can cause significant emotional distress in children aged 3 to 7. This study aimed to assess the efficacy and safety of intranasal (IN) sufentanil-ketamine (SK) for preoperative sedation and evaluate parental satisfaction scores in children undergoing strabismus surgery under general anesthesia.</div></div><div><h3>Method</h3><div>This observational case study included sixty children aged 3 to 7 years with ASA physical status I/II at Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. Participants were divided into two groups: those receiving IN SK group and those not receiving pre-anesthetic sedation (C group). The SK group received 0.5 µg/kg sufentanil and 0.5 mg/kg ketamine intranasally 20 min before anesthesia. Heart rate (HR), systolic blood pressure (SBP), and oxygen saturation (SpO2) were recorded at baseline and 15 min post-intervention. Sedation levels were assessed using the University of Michigan Sedation Scale (UMSS), and parental separation anxiety was evaluated using the Parental Separation Anxiety Scale (PSAS).</div></div><div><h3>Results</h3><div>There were no significant differences in demographics or baseline HR, SBP, and SpO2 between groups. However, the SK group had significantly higher sedation levels (<em>P</em> &lt; 0.001), with 83.4 % achieving satisfactory sedation compared to none in the C group. The SK group also had significantly more favorable parental separation scores (<em>P</em> = 0.001). Side effects were minimal, with nausea and vomiting in only one patient (3.3 %) in the SK group.</div></div><div><h3>Conclusion</h3><div>IN SK is effective and safe for preoperative sedation in children undergoing strabismus surgery. It provides satisfactory sedation and facilitates easier separation from parents with minimal side effects, making it a viable alternative for pediatric pre-anesthetic sedation.</div></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"10 ","pages":"Article 100190"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143132082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}