Journal of Pediatric Surgery Open最新文献

{"title":"Combined surgical and interventional cardiology approach for central venous access salvage in children with intestinal failure: A case series","authors":"Emily Byrd ,&nbsp;M. Jake Petersen ,&nbsp;Minna M. Wieck ,&nbsp;Frank Ing ,&nbsp;Shinjiro Hirose","doi":"10.1016/j.yjpso.2024.100186","DOIUrl":"10.1016/j.yjpso.2024.100186","url":null,"abstract":"<div><h3>Background</h3><div>Pediatric patients with intestinal failure are critically dependent on central venous access for nutrition and fluids. Long-term central venous access can be complicated by recurrent infections, catheter malfunction, and venous stricture and thrombosis. Prior studies have discussed hybrid procedures to salvage suboptimal central venous access sites; however, data is very limited.</div></div><div><h3>Methods</h3><div>This is a retrospective review of six pediatric patients with intestinal failure (IF) and long-term total parenteral nutrition (TPN) dependence who underwent one or more hybrid procedures for achieving complex vascular access, vascular mapping, and/or salvage of vascular access sites.</div></div><div><h3>Results</h3><div>Median age at the time of intervention was 1.4 years (range 2.5 weeks – 2.6 years) with a median weight of 10 kg (range 3.3–13.8 kg). The median number of lifetime central lines was 4 (range 2–6). Indications for hybrid intervention included line fractures, occlusions, dislodgement, recurrent infections, and refractory central line infection. The most common procedures included vascular access, vein mapping, and balloon angioplasty of occluded central veins. The median procedure time was 4.6 h (range 1.3–5.9 h) with a median procedural radiation dose of 2.2 Gycm² (range 0.1–6.7 Gycm²). All patients who underwent hybrid procedures had successful exchange and/or rehabilitation of the at-risk access site.</div></div><div><h3>Conclusions</h3><div>These cases highlight the importance of vascular mapping for identifying potential access sites, as well as techniques for successful vascular rehabilitation for maintenance or salvage of existing central venous access. A multidisciplinary hybrid approach is a feasible and effective means of maintaining central venous access.</div></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"9 ","pages":"Article 100186"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143102546","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":"Early removal of indwelling urinary catheters in children undergoing abdominal tumor resection with epidural analgesia","authors":"Shachi Srivatsa ,&nbsp;Jennifer H. Aldrink ,&nbsp;Dana Schwartz ,&nbsp;Grant Heydinger ,&nbsp;Andrew Davidoff ,&nbsp;Andrew J. Murphy ,&nbsp;Kyle O. Rove ,&nbsp;Sara A. Mansfield","doi":"10.1016/j.yjpso.2024.100191","DOIUrl":"10.1016/j.yjpso.2024.100191","url":null,"abstract":"<div><h3>Purpose</h3><div>Epidural analgesia (EA) is commonly employed for postoperative pain management in children undergoing abdominal tumor resection. Indwelling urinary catheters (IUCs) often remain for the duration of EA administration due to concern for associated urinary retention. This study focuses on children undergoing abdominal tumor resection with appropriate EA coverage, to assess whether IUC can be removed early with minimal risk of reinsertion for urinary retention.</div></div><div><h3>Methods</h3><div>A retrospective review of children who underwent abdominal tumor resections with EA between 2015 and 2023 at two institutions was conducted. Data were summarized, and rates of postoperative urinary retention requiring catheter reinsertion and catheter-associated urinary tract infections (CAUTIs) were compared between patients with early and late IUC removal groups using Fisher's exact testing. “Early” was defined as IUC removal with EA in place and “late” as IUC removal after or concurrent with EA discontinuation.</div></div><div><h3>Results</h3><div>A total of 228 children underwent abdominal tumor resections with EA. Of these, 104 had early, and 124 had late IUC removal. The average postoperative day (POD) of IUC removal in the early group was 1.1±0.5 days and 2.9±1.1 days in the late group. EA was at T12 level or higher in 101 patients (97.1 %) in the early group, and 68 (54.8 %) in the late group (p&lt;0.001). EA contained opioids in 27 (26.0 %) in the early group and 54 (43.5 %) in the late group (p=0.005). There were 6 (5.8 %) children in the early group and 1 (0.8 %) in the late group requiring re-catheterization (p = 0.049). For those requiring re-catheterization, the EA level was T7-8 in 5 patients, T10-11 in 1 patient, and T4 in 1 patient (late). There was 1 (1.0 %) patient with a CAUTI in the early group, and 3 (2.4 %) patients in the late group (p = 0.63).</div></div><div><h3>Conclusions</h3><div>Early removal of indwelling urinary catheters in the setting of thoracic epidural analgesia is associated with a small risk of urinary retention necessitating catheter re-insertion. Balancing the need for IUCs with this possibility, patient comfort, and infectious risk should inform decision-making to best align with enhanced recovery efforts.</div></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"9 ","pages":"Article 100191"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143102543","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":"Functional outcomes following injury in pediatric patients without traumatic brain injury","authors":"Ryo Yamamoto ,&nbsp;Lillian Liao ,&nbsp;Keitaro Yajima ,&nbsp;Akira Endo ,&nbsp;Kazuma Yamakawa ,&nbsp;Junichi Sasaki","doi":"10.1016/j.yjpso.2024.100183","DOIUrl":"10.1016/j.yjpso.2024.100183","url":null,"abstract":"<div><h3>Background</h3><div>Pediatric trauma patients often have disability after successful resuscitation for hemorrhage. Clinical characteristics related to dependency on living following injury were elucidated among pediatric patients without traumatic brain injury.</div></div><div><h3>Methods</h3><div>This retrospective cohort study used the 2019–2021 Japan Trauma Data Bank and included pediatric patients aged ≤16 years without head injury (Abbreviated Injury Scale [AIS] ≥ 2). The unfavorable function was defined as dependency in daily life at discharge (Glasgow Outcome Scale ≤ 3), and predictors for unfavorable functional outcomes were examined using a generalized estimating equations (GEE) model, including age, sex, physical disability before injury, injury mechanism, transportation time, prehospital procedures, vital signs on arrival, surgery in each body region, transfusion, AIS in each region, and institutions. Furthermore, these factors were analyzed separately in toddler/preschool (≤5 years), school age (6–11 years), and adolescence (12–16 years).</div></div><div><h3>Results</h3><div>Among 1,412 patients eligible for the study, 137 had an unfavorable physical function at discharge. The GEE model revealed that female sex, physical disability before injury, prehospital transfusion, lower Glasgow Coma Score (GCS) score on arrival, neck surgery, and higher AIS in the neck and extremity/pelvis were independently associated with unfavorable function at discharge. In age-specific analyses, physical disability before injury strongly predicted worse functional outcomes in toddlers/preschoolers, whereas higher AIS in the chest and lower systolic blood pressure on arrival were additional predictors of dependent living among adolescents.</div></div><div><h3>Conclusions</h3><div>Severe neck/extremity/pelvis injury and lower GCS on arrival are associated with unfavorable functional outcomes in patients with pediatric trauma.</div></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"9 ","pages":"Article 100183"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143102596","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":"Corrigendum to “Mesenchymal Stem Cells Attenuates Hirschsprung diseases-Associated Enterocolitis by Reducing M1 Macrophages Infiltration via COX-2 Dependent Mechanism” [J Pediatr Surg 59 (2024) 1498–1514]","authors":"Xinyao Meng ,&nbsp;Jun Xiao ,&nbsp;Jing Wang ,&nbsp;Minxian Sun ,&nbsp;Xuyong Chen ,&nbsp;Luyao Wu ,&nbsp;Ke Chen ,&nbsp;Zejian Li ,&nbsp;ChenZhao Feng ,&nbsp;Didi Zhuansun ,&nbsp;Jixin Yang ,&nbsp;Xiaojuan Wu ,&nbsp;Donghai Yu ,&nbsp;Wei Li ,&nbsp;Yonghua Niu ,&nbsp;Ying He ,&nbsp;Mingfa Wei ,&nbsp;Feng Chen ,&nbsp;Bo Xiong ,&nbsp;Jiexiong Feng ,&nbsp;Tianqi Zhu","doi":"10.1016/j.yjpso.2024.100187","DOIUrl":"10.1016/j.yjpso.2024.100187","url":null,"abstract":"","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"9 ","pages":"Article 100187"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143102598","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":"Perceptions and decision making regarding circumcision amongst parents and medical personnel","authors":"Y. Doruk Bilgili ,&nbsp;Duygu Tatli Uçarci ,&nbsp;B. Haluk Güvenç","doi":"10.1016/j.yjpso.2024.100181","DOIUrl":"10.1016/j.yjpso.2024.100181","url":null,"abstract":"<div><h3>Aim of the study</h3><div>Despite the fact that male circumcision being one of the most common procedures, there is a lack of awareness amongst parents and doctors. In this study, a questionnaire was applied to find answers covering topics, which include best timing of operation and type of anaesthesia, indications, expected complications, and contraindications, as well as effect on sexual performance.</div></div><div><h3>Methods</h3><div>A total of 146 test subjects (48 parents, 48 local pediatricians, and 50 general practitioners (GP)) were requested to fill out a questionnaire concerning the mentioned topics.</div></div><div><h3>Main results</h3><div>GP mostly preferred (46 %) circumcision under age of two when compared to parents (18.8 %) (<em>p</em> = 0.001). However, 18.8 % of pediatricians and 30 % of GP preferred circumcision during phallic stage. Parents (47.9 % vs 16.7 %-10 %) believed that newborns did not require any type of anaesthesia (<em>p</em> &lt; 0.001). From a religious point of view, the act of circumcision is regarded mandatory according to 10.4 % of parents, 8.3 % pediatricians, and 4 % GP. Doctors regarded circumcision as compulsory (pediatricians 60 % - GP 68.8 %) in preventing venereal diseases compared to parents (37.5 %) (<em>p</em> &lt; 0.001). Need for circumcision in the presence of hydronephrosis was regarded unnecessary by parents (10.4 %) when compared to doctors (<em>p</em> &lt; 0.001). However, this point of view was interestingly shared by 35.4 % of the pediatricians and 40 % GP. According to 37.5 % of the parents, circumcision did not correlate with good reproductive ability (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Results showed that enhanced medical education and awareness are required amongst medical personnel with regards to a widely known subject as circumcision. Public information is also needed to achieve a better state of knowledge.</div></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"9 ","pages":"Article 100181"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143102547","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":"Factors associated with biloma formation in biliary atresia patients after Kasai operation and outcomes of percutaneous transhepatic biliary drainage","authors":"Niramol Tantemsapya,&nbsp;Rattakan Jutiyon,&nbsp;Mongkol Laohapensang","doi":"10.1016/j.yjpso.2024.100189","DOIUrl":"10.1016/j.yjpso.2024.100189","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to investigate factors associated with the development of biloma after Kasai operation, and to study the outcomes of treatment.</div></div><div><h3>Methods</h3><div>A retrospective chart review was conducted on biliary atresia patients who underwent Kasai operation at Siriraj Hospital from 2006 to 2021. The eligible 79 patients were divided into groups with biloma (n=13) and without biloma. Clinical and laboratory data at diagnosis and postoperation were compared. The treatment outcome of biloma was studied. Finally, the overall outcomes of portoenterostomy between both groups were analyzed.</div></div><div><h3>Results</h3><div>Patients with biloma demonstrated a longer time to jaundice clearance (p=0.004), more frequent episodes of postoperative cholangitis (p=0.006), and higher levels of alkaline phosphatase (ALP) at 5 months post-operation (p=0.037). There was a significant decrease in bilirubin levels (p=0.028) and gamma-glutamyltransferase (GGT) (p=0.021) after biloma treatment. However, there was no significant difference in the overall outcomes of Kasai operation between the two groups.</div></div><div><h3>Conclusion</h3><div>Biloma formation should be suspected in biliary atresia patients requiring longer duration to clear jaundice, having persistent ALP level and frequent episodes of cholangitis after the Kasai operation. Treatment of biloma improves liver function but it did not show a significant difference in the overall outcome of portoenterostomy.</div></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"9 ","pages":"Article 100189"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143102544","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":"Editorial Board Page","authors":"","doi":"10.1016/S2949-7116(25)00004-8","DOIUrl":"10.1016/S2949-7116(25)00004-8","url":null,"abstract":"","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"9 ","pages":"Article 100195"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143102597","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":"Efficacy and safety of retrograde laparoscopic appendectomy in pediatric complicated appendicitis: A 14- year retrospective analysis","authors":"Mario Riquelme ,&nbsp;Carlos Garcia-Hernandez ,&nbsp;Irving Alan Cardenas-Medina ,&nbsp;Ana Cantu-Zendejas ,&nbsp;Alejandro Cendejas-Higuera","doi":"10.1016/j.yjpso.2024.100188","DOIUrl":"10.1016/j.yjpso.2024.100188","url":null,"abstract":"<div><h3>Background</h3><div>Acute appendicitis is the leading cause of emergency abdominal surgery in children. Complicated cases, particularly those with perforation or gangrene, pose a surgical challenge due to significant inflammation and altered anatomy.</div></div><div><h3>Objective</h3><div>To evaluate the efficacy and safety of retrograde laparoscopic appendectomy (RLA) as an alternative technique in pediatric patients with complicated acute appendicitis, based on data collected over a 14-year period. This study also examines the surgical technique and potential complications associated with <strong>RLA.</strong></div></div><div><h3>Methods</h3><div>This retrospective, observational, and descriptive case series analyzed 30 cases of complicated acute appendicitis treated with RLA from a total of 415 laparoscopic appendectomies performed over 14 years. The patients' ages ranged from 4 to 18 years. Dissection began at the appendicular base, progressing retrogradely to the tip. Variables analyzed included operative time, hospital stay, postoperative complications, and conversion rates to open surgery.</div></div><div><h3>Results</h3><div>The study included 19 boys (63 %) and 11 girls (37 %). The average operative time was 75 minutes, and the mean hospital stay was 4 days. There were no conversions to open surgery. Postoperative complications were limited to abscess formation at the port sites in 10 % of cases. No intraoperative complications or residual intra-abdominal abscesses were reported.</div></div><div><h3>Conclusion</h3><div>Retrograde laparoscopic appendectomy (RLA) is a safe and effective technique for managing complicated acute appendicitis in pediatric patients. It is a reproducible procedure for surgeons with experience in laparoscopic techniques, offering a viable alternative in complex cases.</div></div><div><h3>Type of study</h3><div>Retrospective, observational, and descriptive case series.</div></div><div><h3>Level of evidence</h3><div>Level IV</div></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"10 ","pages":"Article 100188"},"PeriodicalIF":0.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143132151","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":"Management of pneumatosis intestinalis after stoma takedown in preterm infants","authors":"Shannon N. Acker ,&nbsp;S. Chris Derderian ,&nbsp;Diane Melara ,&nbsp;Theresa Grover ,&nbsp;Sai Krupa Rajaramsiva ,&nbsp;Ann M. Kulungowski ,&nbsp;Romeo C. Ignacio Jr.","doi":"10.1016/j.yjpso.2024.100184","DOIUrl":"10.1016/j.yjpso.2024.100184","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to compare pre-term infants with and without post stoma takedown pneumatosis intestinalis (PSTPI), describe outcomes of PSTPI, and discuss current management strategies.</div></div><div><h3>Study Design</h3><div>We reviewed infants born at &lt;34 weeks who underwent laparotomy with stoma formation and subsequent stoma takedown between 2010 and 2019 at two level IV NICUs. Comparisons were made between infants with PSTPI defined by the presence of PI on plain radiograph after stoma takedown (<em>n</em> = 13), and those without PSTPI (<em>n</em> = 102) with either Fisher's exact or Mann Whitney U test.</div></div><div><h3>Result</h3><div>No infants required urgent operation for PSTPI. All infants were treated with a period of NPO (median 8 days; range: 2–39) and antibiotic therapy (median 7 days; range:3–10). TPN at discharge was more common among the PSTPI group (31 % vs 10 %; <em>p</em> = 0.05).</div></div><div><h3>Conclusions</h3><div>Among this limited cohort, PSTPI among premature infants seems to follow a benign course and is often adequately treated with antibiotics and bowel rest.</div></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"10 ","pages":"Article 100184"},"PeriodicalIF":0.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143132142","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":"Validation study of synthetic models for esophageal atresia with tracheoesophageal fistula (EA/TEF): A simulation-based training in pediatric surgery","authors":"Zahradníková Petra ,&nbsp;Hnilicová Silvia ,&nbsp;Lindák Martin ,&nbsp;Pechanová Rebeka ,&nbsp;Števková Dominika ,&nbsp;Vitovič Pavol ,&nbsp;Laurovičová Miroslava ,&nbsp;Horn František ,&nbsp;Tvrdoň Tomáš ,&nbsp;Babala Jozef","doi":"10.1016/j.yjpso.2024.100180","DOIUrl":"10.1016/j.yjpso.2024.100180","url":null,"abstract":"<div><h3>Background</h3><div>Pediatric surgery is a highly specialised field, with minimally invasive surgery (MIS) posing greater technical challenges than conventional open surgery. Proficiency requires both in and out-of-operating-room training, with simulation playing a crucial role. The purpose of this study was to explore MIS perceptions, training experiences, and preferences regarding laparoscopic simulation training. Furthermore, we aimed to validate two synthetic EA/TEF models.</div></div><div><h3>Method</h3><div>A questionnaire focused on the degree of adoption of MIS among paediatric surgeons was proposed online to participants at the 68th Czech and Slovak Pediatric Surgery Congress in Slovakia in 2024. All participants also had scheduled sessions to practice advanced laparoscopic skills on two synthetic EA/TEF models. The purpose of this study was to analyse experiences with paediatric MIS, the implementation of simulation training, and personal stances on integrating simulation training into training curricula. EA/TEF models were validated with a 5-point Likert scale.</div></div><div><h3>Results</h3><div>Thirty-three paediatric surgeons from 14 centres in two countries completed the questionnaire. Six (18 %) were novices, 12 (36 %) intermediate trainees, and 15 (45 %) specialists with over 11 years of practice. Eight participants (18 %) declared weekly access to simulation training, while 49 % had none. Additionally, 15 individuals (45.5 %) strongly agree and 48.5 % agree that regular training on simulators enhances surgical skills in MIS procedures in the operating room. Twenty-six respondents (76 %) believe that simulator training should be part of the requirements for pediatric surgical trainees, with no significant difference according to the surgeons' experience (<em>p =</em> 0.290). Thirty surgeons validated the EA/TEF models. Highest ratings were for overall impression and tool usefulness in experienced surgeons' training (mean scores: 4.5 and 4.6). The working space received the lowest score (mean: 3.6 ± 0.8), with experienced surgeons rating it significantly lower (3.4) than the inexperienced group (4.1, <em>p =</em> 0.030). No significant differences were observed between models in Likert scale parameters.</div></div><div><h3>Conclusion</h3><div>Simulation training is essential for teaching MIS in paediatric surgery, improving skills, and should be part of specialisation preparation. Synthetic EA/TEF models received high ratings as effective training tools for thoracoscopic EA/TEF training. Further studies are needed to prove construct validity.</div></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"9 ","pages":"Article 100180"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142702644","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}