Journal of Pediatric Surgery Open最新文献

{"title":"Implementation of an ERAS protocol for pediatric metabolic and bariatric surgery: A single institutional perspective and lessons learned","authors":"Kristine L. Griffin,&nbsp;Wendy Jo Svetanoff,&nbsp;Karen Diefenbach,&nbsp;Jennifer H. Aldrink,&nbsp;Sara A. Mansfield,&nbsp;Dana Schwartz,&nbsp;Cindy McManaway,&nbsp;Marc P. Michalsky","doi":"10.1016/j.yjpso.2024.100131","DOIUrl":"https://doi.org/10.1016/j.yjpso.2024.100131","url":null,"abstract":"<div><h3>Background</h3><p>Enhanced recovery after surgery (ERAS) protocols have gained popularity in many surgical specialties. The overarching goals of ERAS include the use of comprehensive perioperative interventions to minimize postoperative nausea and vomiting (PONV), incorporate multimodal pain control, including reduced postoperative opioid utilization, encourage early postoperative mobilization and ambulation, and achieve prompt re-initiation of enteral nutrition. While many adult surgical programs have demonstrated successful implementation of ERAS protocols, there have been few descriptions in pediatric surgical literature focused on implementation of such strategies. In this review, we provide an overview of current pediatric-focused ERAS literature and highlight our institution's experience with implementing an ERAS protocol in our pediatric metabolic and bariatric surgery program.</p></div><div><h3>Methods</h3><p>A literature search was conducted to review ERAS experience in adult and pediatric surgery. Our institution's bariatric surgery program is described from the pre-ERAS period to the inception of our ERAS protocol, and the evolution into its current form. Over this time, we eliminated the routine use of nasogastric tubes and urinary catheters, expanded our pre-operative initiatives, limited intra-operative fluids, updated the intraoperative anesthetic regimen, broadened our multimodal pain and PONV management, and developed post-operative recovery-focused patient goals to improve fluid intake, increase early ambulation and pulmonary toilet resulting in a shortened hospital length of stay.</p></div><div><h3>Conclusion</h3><p>Pediatric surgical programs can benefit from utilization of ERAS strategies to decrease the time to enteral nutrition, provide comprehensive pain and PONV control, facilitate early ambulation, and reduction in hospital length of stay. Our a single-institutional experience deploying ERAS within the pediatric metabolic and bariatric surgery service has been successful and serves as a model for other surgical sub-specialty service lines within our organization.</p></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"6 ","pages":"Article 100131"},"PeriodicalIF":0.0,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949711624000169/pdfft?md5=59d3c2b8cf86c96c32bb2e4a849fb5dd&pid=1-s2.0-S2949711624000169-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139748432","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":"What is an enhanced recovery patient?","authors":"Ursula C. Adams,&nbsp;Laura N. Purcell,&nbsp;Anthony G. Charles,&nbsp;Michael R. Phillips","doi":"10.1016/j.yjpso.2024.100130","DOIUrl":"10.1016/j.yjpso.2024.100130","url":null,"abstract":"<div><p>The use of enhanced recovery protocols (ERP) in surgery delivers standardized, repeatable, and measurable care that improves clinical outcomes for patients. These pathways address the surgical care episode, from preoperative surgical readiness, during the surgical admission, until after discharge. Standardized pathways have been well-studied in adults, and emerging data in children show promise. However, data reporting has been targeted toward specific study populations and may be a barrier to broader pathway implementation. In this review, we discuss implementation of pediatric ERPs, examine outcome studies and published inclusion and exclusion criteria, and describe strategies for broader implementation of pediatric ERPs.</p></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"6 ","pages":"Article 100130"},"PeriodicalIF":0.0,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949711624000157/pdfft?md5=5b70f5ea53d2a2e7d222356adb07e4a5&pid=1-s2.0-S2949711624000157-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139823560","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":"Reconstruction of the abdominal wall with component separation technique in patients with giant omphalocele","authors":"C. Lagos Jefferson ,&nbsp;C. Torres ,&nbsp;F. Anich ,&nbsp;M. Obaíd ,&nbsp;A. Paulos ,&nbsp;V. Broussain ,&nbsp;S. Montedónico ,&nbsp;P. Quijada","doi":"10.1016/j.yjpso.2023.100115","DOIUrl":"10.1016/j.yjpso.2023.100115","url":null,"abstract":"<div><h3>Background</h3><p>Several techniques have been described to repair giant omphaloceles. Component Separation Technique (CST) is a surgical technique first reported in adults to repair large abdominal wall defects. The purpose of this study is to describe our experience using this technique in repairing large ventral hernias secondary to giant omphaloceles in children.</p></div><div><h3>Methods</h3><p>Nine patients with giant omphalocele were treated. The abdominal wall was reconstructed using CST, based on the enlargement of the abdominal wall by separate mobilization of the muscular layers. Patients were monitored for complications during admission, postoperative complications, and all patients were seen for follow-up.</p></div><div><h3>Results</h3><p>Component separation technique was performed at a median age of 7.2 years. The median diameter of the hernia was 109.8 cm2. There was no mortality. Minor complications were seen (infection, skin necrosis, and hematoma). There were no recurrences after an average follow-up of 3.3 years (2 - 4 years).</p></div><div><h3>Conclusions</h3><p>Component separation technique is a valuable method for repairing large ventral hernias as a consequence of giant omphaloceles in children. Our series supports the use of CST in children, in a wide age range, from newborns for primary closure to adolescence in cases of giant ventral hernias secondary to omphaloceles with multiple previous surgeries.</p></div><div><h3>Level of Evidence</h3><p>II</p></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"6 ","pages":"Article 100115"},"PeriodicalIF":0.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949711623001120/pdfft?md5=685fffc84b67b1e21f7aeaef4330f5f4&pid=1-s2.0-S2949711623001120-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139827631","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":"Individualized management of biliary tract injuries in pediatric patients: Lessons from a pediatric surgical center","authors":"Diana Lizbeth Escobedo Duarte ,&nbsp;Edgar Fernando Oliver García ,&nbsp;Oscar Ferrer Delgado Herrera ,&nbsp;Pierre Jean Aurelus ,&nbsp;Sofia Brenes Guzmán ,&nbsp;Juan Carlos Nuñez Enríquez ,&nbsp;Cesar Eduardo Vallín Orozco","doi":"10.1016/j.yjpso.2024.100126","DOIUrl":"10.1016/j.yjpso.2024.100126","url":null,"abstract":"<div><p>The biliary pathology, once uncommon in children has shown an increasing prevalence in this age group. This trend underscores the importance of having highly skilled surgeons with expertise in biliary tree management to avoid biliary duct injury (BDI).</p></div><div><h3>Methods</h3><p>A retrospective study analyzed 21 patients with biliary tract injuries from 2010 to 2022. It provides a descriptive analysis, raising concerns about its clinical value and emphasizing the need to understand biliary anatomy to prevent such injuries.</p></div><div><h3>Results</h3><p>Patients ranged from 0 to 17 years, with 57.1 % females and 42.9 % males. The most common primary diagnoses were hepatic tumors (33.3 %), chronic calculous cholecystitis, and choledochal cysts (23.8 % each). Surgical procedures included hepatectomy (33.2 %), choledochal cyst resection (23.8 %), and laparoscopic cholecystectomy (28.6 %). Conservative management was chosen in 28.1 % of cases, while surgery was performed in 71.4 %. Complications included bilioma (23.8 %), biliary fistula, and cholangitis (19 % each). Twelve patients underwent a second intervention, six requiring a third intervention, with hepaticojejunostomy being the most common (57.1 %). One patient received a liver transplant from a related living donor. The mortality rate was 9.5 %, with a median hospital stay of 35 days.</p></div><div><h3>Concussion</h3><p>BDI in pediatric patients poses challenges and is on the rise. Recognition of biliary anatomy is crucial to prevent injury. Clinical presentation includes fever, pain, jaundice, and cholestasis. Imaging studies aid early diagnosis. Specialized centers and precise classification are essential for optimal management. Less invasive options maybe suitable for mild cases, while hepaticojejunostomy remains standard for severe injuries. Further research is needed to refine management protocols and reduce morbidity and mortality in these complex cases.</p></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"6 ","pages":"Article 100126"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S294971162400011X/pdfft?md5=ff487f48403969e872ec81d094335267&pid=1-s2.0-S294971162400011X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139683888","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":"Success in the national care of pediatric trauma patients✰,✰✰","authors":"Kendall J Burdick ,&nbsp;Aixa Perez Coulter ,&nbsp;Michael Tirabassi","doi":"10.1016/j.yjpso.2024.100127","DOIUrl":"https://doi.org/10.1016/j.yjpso.2024.100127","url":null,"abstract":"<div><h3>Background</h3><p>Pediatric trauma patients should be treated at pediatric trauma centers, though not every patient can be transported to one. Our goal was to report outcomes for trauma patients at centers of varying levels of verification by the American College of Surgeons (ACS).</p></div><div><h3>Materials and Methods</h3><p>Retrospective review of the ACS Trauma Quality Improvement Program trauma registry data of patients (&lt;15 years old) receiving care at trauma centers in the United States. We compared level 1 and 2 pediatric trauma centers (PTC1 and PTC2) and level 1, 2 and 3 adult trauma centers (TC1, TC2, TC3). Main outcome measure was mortality. Secondary measures were injury severity score (ISS), length of stay (LOS), 30-day complications and race/ethnicity. We also stratified by trauma severity (non-severe vs severe ISS≥15), and age groups (0–3, 3–10, 10–15).</p></div><div><h3>Results</h3><p>41,399 patients met our inclusion criteria: 37,624 blunt, 3,775 penetrating. Of all patients, 66.7 % were treated at a PTC (69.9 % PTC1, 30.1 % PTC2), and 1.6 % of trauma resulted in mortality. Mortality rate (the percentage of cases treated that resulted in mortality) by trauma center varied more for penetrating trauma (range: 2.1–8.0) than for blunt trauma (range: 0.9–1.7). For blunt trauma, 46.6 % were treated at PTC1s and 1.3 % resulted in mortality. The highest mean ISS and length of stay were at TC1s. For penetrating trauma, 47.5 % were treated at PTC1s and 5.0 % resulted in mortality. Most traumas were non-severe and mortality rates for penetrating trauma were higher for the 10–15 age group, though still lower at pediatric trauma centers.</p></div><div><h3>Conclusion</h3><p>The majority of pediatric trauma patients were treated at a PTC with slightly better outcomes than TCs. Overall, treatment at PTCs resulted in slightly lower mortality rates, shorter LOS, and lower/equivalent 30-day complication rates.</p></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"6 ","pages":"Article 100127"},"PeriodicalIF":0.0,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949711624000121/pdfft?md5=f7437ba303644ec99332100763f956b1&pid=1-s2.0-S2949711624000121-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139674895","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":"Dynamic pathology in various disease-model mice using multiphoton laser scanning microscopy","authors":"Yuhki Koike ,&nbsp;Yuki Sato ,&nbsp;Koki Higashi ,&nbsp;Yuka Nagano ,&nbsp;Shimura Tadanobu ,&nbsp;Takahito Kitajima ,&nbsp;Kohei Matsushita ,&nbsp;Yoshinaga Okugawa ,&nbsp;Akira Mizoguchi ,&nbsp;Yuji Toiyama","doi":"10.1016/j.yjpso.2024.100125","DOIUrl":"10.1016/j.yjpso.2024.100125","url":null,"abstract":"<div><p>Live imaging of experimental animals is now possible thanks to recent technological advances that overcome the limitations of conventional histological analysis. In contrast to conventional histological microscopy techniques, this intravital approach can reveal previously unknown morphogenetic and functional processes in live tissues. In addition, this approach can capture real-time information on these processes, compared with conventional histological microscopy and other techniques that only provide snapshots in time. We used multi-photon laser-scanning microscopy (MPLSM) for in vivo real-time imaging of intra-abdominal organs, and investigated the intravital microscopic changes in various disease-model mice, referred to as ‘dynamic pathology’. For example, we used this technology to examine bacterial translocation in dextran sodium sulfate (DSS)-induced colitis, thrombus formation in laser-induced endothelial injury, neutrophil extracellular traps, the dynamics of circulating free DNA in a model of DSS-induced colitis, and to obtain a comprehensive understanding of the development and blood flow dynamics of the small intestinal microcirculation in a mouse model of necrotizing enterocolitis. This mini review summarizes the in vivo observation methods that we have developed to observe the dynamic pathology in various disease-model mice using MPLSM.</p></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"8 ","pages":"Article 100125"},"PeriodicalIF":0.0,"publicationDate":"2024-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949711624000108/pdfft?md5=93c640841a9f7f429b0a1daa8d237d51&pid=1-s2.0-S2949711624000108-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141963929","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":"Ileal lengthening through internal distraction: A novel procedure for ultrashort bowel syndrome","authors":"Aaron J Cunningham ,&nbsp;Taylor Anderson ,&nbsp;Claudia Mueller ,&nbsp;Matias Bruzoni ,&nbsp;James CY Dunn","doi":"10.1016/j.yjpso.2024.100124","DOIUrl":"10.1016/j.yjpso.2024.100124","url":null,"abstract":"<div><h3>Purpose</h3><p>Ultrashort bowel syndrome is a rare, but morbid surgical problem without effective treatment. Recent clinical analysis has demonstrated the critical influence of ileal length on ultimate enteral autonomy. Surgical techniques to increase ileal length in nondilated bowel do not exist. We describe a novel technique to lengthen ileum in children with ultrashort bowel syndrome.</p></div><div><h3>Methods</h3><p>Beginning in May 2021 prospective candidate children were identified. Candidacy for ileal tube lengthening included diagnosis of ultrashort bowel syndrome, intact ileocecal valve with remnant ileum, and proximal intestinal stoma or draining gastrostomy. Informed consent was obtained. Following laparoscopic lysis of adhesions, a balloon catheter was inserted through a left flank stab incision and into the lumen of the remnant ileum around a purse string suture. Cecopexy was performed in the right-lower quadrant. Clips were used to mark the cecum and the proximal extent of ileum. The catheter length was fixed externally at the completion of the procedure. Serial x-rays were used to measure distraction effect while increasing tension was applied to the catheter over the subsequent weeks. Ileal tube lengthening was performed until the end of the catheter was reached or the tube was dislodged. A contrast study was performed at the completion of lengthening. Intestinal length at time of restoration of continuity and clinical outcomes were recorded.</p></div><div><h3>Results</h3><p>Four infants were enrolled from May 2021-July 2023. Diagnoses leading to ultrashort bowel syndrome were mesenteric teratoma, necrotizing enterocolitis, and multiple intestinal atresia. At the time of restoration of intestinal continuity, a median of 1.75 cm (45 %) additional ileal length was achieved at a median of 25.5 days. There were no serious complications following ileal tube lengthening and no additional operative interventions were required.</p></div><div><h3>Conclusions</h3><p>Ileal lengthening through internal distraction is a feasible surgical intervention to salvage ileum for infants with ultrashort bowel syndrome. Ileal tube lengthening may result in distraction enterogenesis, providing a novel intervention to increase intestinal length.</p></div><div><h3>Level of evidence</h3><p>IV (Case series without comparison group).</p></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"6 ","pages":"Article 100124"},"PeriodicalIF":0.0,"publicationDate":"2024-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949711624000091/pdfft?md5=0a5afcbbc89ef8ca0b715ceed21aeae7&pid=1-s2.0-S2949711624000091-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139637696","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":"Is the restoration of bowel sounds a prerequisite for initiating enteral feeding following pediatric laparotomy? A randomized control trial","authors":"N.T. Abdulraheem ,&nbsp;A.A. Nasir ,&nbsp;L.O. AbdurRahman ,&nbsp;A.O. Oyinloye ,&nbsp;M.A. Alada ,&nbsp;M.O. Olanrewaju ,&nbsp;D.C. Nwosu ,&nbsp;J.O. Adeniran","doi":"10.1016/j.yjpso.2024.100120","DOIUrl":"10.1016/j.yjpso.2024.100120","url":null,"abstract":"<div><h3>Introduction</h3><p>Enteral nutrition is the mainstay of nutritional support in surgical patients. Ileus is the temporary inhibition of peristalsis. Primary post-operative ileus (PPI) occurs postoperatively; thence patients are traditionally kept on nil per oris (NPO) until PPI resolves, due to safety concerns. This study aims to determine the necessity or otherwise of this practice in paediatric surgical patients.</p></div><div><h3>Materials and methods</h3><p>A prospective, randomized control trial, in patients younger than 15 years. The early feeding group (EFG) commenced enteral feeding on the first post-operative day while controls commenced feeding after resolution of PPI. Data was analyzed using SPSS version 20.0, P <span><math><mo>≤</mo></math></span> 0.05 was regarded as significant. The primary outcome was tolerability of enteral feeds while secondary outcomes were complication rates, time to full enteral diet, and duration of hospital stay.</p></div><div><h3>Results</h3><p>There were 56 patients, 28 in each study group. Tolerability of oral feeds at initial commencement was similar in both groups (24 (85.7%) EFG versus 27 (96.4%) controls P = 0.16). Full enteral feeding was achieved faster in EFG than in controls (71.1 ± 28.7 hours versus 92.5 ± 31.4 hours, p=0.011). Post-operative hospital stay was shorter in EFG than controls (7.46 ± 3.8 days versus11.1 ± 5.2 days, p=0.009).</p></div><div><h3>Conclusions</h3><p>Early enteral feeding was well tolerated, brought about a faster return to a full enteral diet, and shorter post-operative hospital stay, it also did not cause a higher complication rate. Therefore, delaying feeding until the resolution of PPI after laparotomy appears unnecessary.</p></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"6 ","pages":"Article 100120"},"PeriodicalIF":0.0,"publicationDate":"2024-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949711624000054/pdfft?md5=39ef4bb02b93065829aa72ffbe55828e&pid=1-s2.0-S2949711624000054-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139537771","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 Australia New Zealand Congenital Colorectal Registry (ANZCCoRe): Driving innovation through collaboration","authors":"Isabel C. Hageman ,&nbsp;Misel Trajanovska ,&nbsp;Iris A.L.M. van Rooij ,&nbsp;Ivo de Blaauw ,&nbsp;Sebastian K. King","doi":"10.1016/j.yjpso.2024.100121","DOIUrl":"https://doi.org/10.1016/j.yjpso.2024.100121","url":null,"abstract":"<div><p>Colorectal paediatric surgeons, rare and complex colorectal patients, and data on this patient group are dispersed far and wide in Australia and New Zealand (ANZ). Online databases facilitate sharing and collating of data, and may help to connect physically separated clinicians and researchers. The Australia New Zealand Congenital Colorectal Registry (ANZCCoRe) is an international, multicentre patient registry that aims to improve clinical outcomes, standardise care, and enhance collaborations between centres with expertise in paediatric colorectal conditions across ANZ.</p><p>The ANZCCoRe will collect retrospective and prospective clinical data of patients with anorectal malformations (ARM) and/or Hirschsprung disease (HD) through an electronic data capturing platform. Collected data will include demographic characteristics, diagnostics, care pathways, associated anomalies, surgical details and complications, and functional outcomes. The datapoints will be categorised into required core data elements and requested additional data elements. Data will be deidentified and stored on secured servers, meeting ethical and legal requirements. Data quality procedures will exist and feasible application of the findability, accessibility, interoperability, and reusability (FAIR) principles will promote data sharing and reuse with other registries.</p><p>Besides gaining a better understanding of the patient and disease characteristics, monitoring care, and evaluating health-related outcomes, the ANZCCoRe provides a source for potential research participants. Lastly, the ANZCCoRe enhances advocacy for patients and families affected by colorectal conditions.</p><p>The ANZCCoRe is the first multicentre congenital colorectal patient registry in this geographical region. Its strengths lie in facilitating research, standardisation of care, patient advocacy, and collaboration with paediatric surgical centres across ANZ and beyond.</p><p>Level of Evidence: IV</p></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"6 ","pages":"Article 100121"},"PeriodicalIF":0.0,"publicationDate":"2024-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949711624000066/pdfft?md5=7bfcec84092151a05ea13d3be8240e29&pid=1-s2.0-S2949711624000066-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139505405","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 congenital blepharoptosis in pediatric patients","authors":"Angélica Paulos,&nbsp;Carolina Lagos,&nbsp;Valentina Broussain,&nbsp;Katherine Ellsworth,&nbsp;María José Hurtado,&nbsp;Andrea Hasbún","doi":"10.1016/j.yjpso.2024.100119","DOIUrl":"10.1016/j.yjpso.2024.100119","url":null,"abstract":"<div><h3>Introduction</h3><p>Palpebral ptosis corresponds to the lowered positioning of the upper eyelid margin (MRD1) in primary gaze. The objective of this work is to present the response to surgical treatment of palpebral ptosis operated in the last 3 years.</p></div><div><h3>Methods</h3><p>This was a retrospective study that included pediatric patients less than 15 years old operated for palpebral ptosis at the Pediatric Plastic Surgery Service from 2021 to 2023. We report 13 cases of operated blepharoptosis in 19 eyelids. The variables were MRD1 level in primary gaze pre and postoperative, levator muscle function, cause, associated syndrome, unilateral or bilateral, age, type of surgery (frontal sling vs. levator resection), and complications. Excellent response was defined when symmetric MRD1 was achieved, good response in 1 MRD asymmetry, and poor response in 2 or more MRD1 asymmetry.</p></div><div><h3>Results</h3><p>7 cases were myogenic, 2 mechanical, 1 neuropathic, and 3 blepharophimosis-ptosis-epicanthus inversus syndrome. The ages at surgery for severe ptosis were 3 months, 6 months and 2 years and the average age for moderate ptosis was 7 years (range 6 months to 15 years). Three patients were resolved with levator muscle advancement and resection and three with frontal sling. In the case of mechanical ptosis, plasty of the scar and resection of the mass was performed with resolution of the ptosis. Ten patients had an excellent response and 3 had good response. One lagophthalmos, hematoma, partial relapse and two entropions were presented as complications.</p></div><div><h3>Conclusion</h3><p>Blepharoptosis is a condition that must be managed in a multidisciplinary way to achieve symmetry in the gaze and reduce related complications. We have observed a good response with the levator muscle resection and frontal sling techniques.</p></div><div><h3>Leve of evidence</h3><p>4</p></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"7 ","pages":"Article 100119"},"PeriodicalIF":0.0,"publicationDate":"2024-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949711624000042/pdfft?md5=2f93f962c21699e96ffe55ded0dc528a&pid=1-s2.0-S2949711624000042-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139540478","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}