Journal of Pediatric Surgery Open最新文献

{"title":"Intestinal microecology in pediatric surgery-related gastrointestinal diseases: Current insights and future perspectives","authors":"Yuqing Wu,&nbsp;Suolin Li,&nbsp;Lin Liu,&nbsp;Xiaoyi Zhang,&nbsp;Jiaxun Lv,&nbsp;Qinqin Li,&nbsp;Yingchao Li","doi":"10.1016/j.yjpso.2024.100134","DOIUrl":"https://doi.org/10.1016/j.yjpso.2024.100134","url":null,"abstract":"<div><p>Intestinal microecology is established from birth and is constantly changing until homeostasis is reached. Intestinal microbiota is involved in the immune inflammatory response of the intestine and regulates the intestinal barrier function. The imbalance of intestinal microecology is closely related to the occurrence and development of digestive system diseases. In some gastrointestinal diseases related to pediatric surgery, intestinal microbiota and its metabolites undergo a series of changes, which can provide a certain basis for the diagnosis of diseases. The continuous development of microecological agents and fecal microbiota transplantation technology has provided a new means for its clinical treatment. We review the relationship between pathogenesis, diagnosis and treatment of pediatric surgery-related gastrointestinal diseases and intestinal microecology, in order to provide new ideas and methods for clinical diagnosis, treatment and research.</p></div><div><h3>Level of evidence</h3><p>: This is a review study, hence not applicable.</p></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"6 ","pages":"Article 100134"},"PeriodicalIF":0.0,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949711624000194/pdfft?md5=024a7ac91dc024fec7b7fd3165210eda&pid=1-s2.0-S2949711624000194-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140163638","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 impact of video gaming and playing a musical instrument on robotic surgical simulator performance - the Robotic Surgical Simulator Study (RS3)","authors":"Julia E. Hollmann ,&nbsp;Julia Scholsching ,&nbsp;Dennis Muensterer ,&nbsp;Oliver J. Muensterer","doi":"10.1016/j.yjpso.2024.100137","DOIUrl":"https://doi.org/10.1016/j.yjpso.2024.100137","url":null,"abstract":"<div><h3>Background</h3><p>A personal history of video gaming has been associated with improved laparoscopic skills acquisition in some but not all studies. The impact of playing a musical instrument on laparoscopic or robotic proficiency is less investigated.</p></div><div><h3>Methods</h3><p>This study evaluates the impact of video gaming, playing a musical instrument, and other demographic parameters on robotic simulator proficiency in a cohort of 27 participants. Candidates performed 3 standardized exercises on a virtual reality robotic training platform, resulting in a proficiency score. After completing a detailed survey, participants repeated the standardized exercises to obtain a basic learning curve. Gaming history, playing a musical instrument, surgical experience, and demographic parameters were correlated with overall robotic proficiency and improvement during the experimental session.</p></div><div><h3>Results</h3><p>Participants with previous gaming history had 33 % higher overall robotic performance scores (<em>p</em> = 0.02). There was no difference in performance between surgical trainees and attending physicians with high volume laparoscopic surgery experience (average of 77 laparoscopic procedures). In this small cohort, playing an instrument had no influence overall (<em>p</em> = 0.2), but we found a trend towards increased proficiency in those playing the piano, yielding 30 % higher scores (<em>p</em> = 0.14). Participants performed up to 22 % better in the second run of the \"Suture Sponge\" exercises (<em>p</em> = 0.08), indicating a steep learning curve of simulated robotic surgery.</p></div><div><h3>Conclusions</h3><p>A history of video gaming and playing the piano is associated with improved performance on a virtual-reality robotic surgical simulator. The steep learning curve underlines the benefit of virtual robotic surgical training before performing robotic procedures on patients.</p></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"6 ","pages":"Article 100137"},"PeriodicalIF":0.0,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949711624000224/pdfft?md5=8b299246f59a0e3c088f322b3cdadc1e&pid=1-s2.0-S2949711624000224-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140121946","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":"Outcomes of paediatric fundoplication stratified by subtype of neurological impairment","authors":"Emily Decker ,&nbsp;David J. Wilkinson ,&nbsp;Robert T. Peters ,&nbsp;Dipak Ram ,&nbsp;Nick Lansdale","doi":"10.1016/j.yjpso.2024.100136","DOIUrl":"10.1016/j.yjpso.2024.100136","url":null,"abstract":"<div><h3>Aims</h3><p>Jejunal feeding is increasingly seen as an alternative to fundoplication in neurologically impaired children. However, fundoplication may offer important advantages. This study aimed to determine: (i) contemporary outcomes of fundoplication from a sub-specialised service; and (ii) whether outcomes were influenced by neurological characteristics.</p></div><div><h3>Methods</h3><p>Single-centre retrospective review of consecutive children undergoing fundoplication by three surgeons over five years (2017–2022) using a standardised technique. Children were stratified as neurologically unimpaired, static brain injury, neuromuscular condition or neurodegenerative impairment. Failure was defined as a requirement for subsequent jejunal feeding or further surgery. Data are presented as median (IQR) unless stated. Comparisons used Fisher's test.</p></div><div><h3>Results</h3><p>144 children underwent fundoplication at 1.9 years (1–5 years): 97/144 (67 %) had neurological impairment. Surgery was completed laparoscopically 128/144 (89 %) and converted in 9/137 (7 %). 84/144 (60 %) underwent concomitant gastrostomy formation. At 35 months (22–47), absolute failure was 16 % (23/144). Failure was higher in those with neurodegenerative conditions (not significant). Persistence of symptoms was noted in 23/144 (16 %). Two (1.4 %) required reoperation (&lt;30 days). Nine (6.4 %) required admission to critical care. One death within 30 days was unrelated.</p></div><div><h3>Conclusions</h3><p>Given fundoplication may provide significant benefits (avoiding pump feeds, frequent tube failure/changes and risk of jejunal perforation), success rates are high and morbidity low, fundoplication should be offered to families as an alternative to jejunal feeding as part of comprehensive counselling. There was no significant difference in outcome between neurological impairment subtypes in this sample size.</p></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"6 ","pages":"Article 100136"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949711624000212/pdfft?md5=6ac4d326244457fd8769725272f928df&pid=1-s2.0-S2949711624000212-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140086914","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 value of serum MMP-7 and SOX9 levels in the diagnosis and prognosis of biliary atresia","authors":"Xiaodan Xu ,&nbsp;Jayinaxi Musha ,&nbsp;Xueting Wang ,&nbsp;Yilin Zhao ,&nbsp;Zhiru Wang ,&nbsp;Rongjuan Sun ,&nbsp;Haojie Wang ,&nbsp;Hui Ma ,&nbsp;Li Zhao ,&nbsp;Jianghua Zhan","doi":"10.1016/j.yjpso.2024.100135","DOIUrl":"10.1016/j.yjpso.2024.100135","url":null,"abstract":"<div><h3>Introduction</h3><p>To investigate the diagnostic value of serum MMP-7 and SOX9 levels in patients with biliary atresia (BA) and to further analyze their relationship with the liver fibrosis and prognosis.</p></div><div><h3>Methods</h3><p>Sixty-eight patients hospitalized for jaundice and underwent surgical treatment from March 2019 to February 2022 were retrospectively analyzed, including 44 patients with BA and 24 patients with other cholestatic liver diseases as disease controls (DC). Serum levels of MMP-7 and SOX9 were detected using enzyme-linked immunosorbent assay (ELISA). The diagnostic value of MMP-7 and SOX9 for BA was evaluated using the receiver operating characteristic (ROC) curve.</p></div><div><h3>Results</h3><p>Serum levels of MMP-7 and SOX9 were higher in the BA group compared to the DC group (<em>P</em> = 0.0002, <em>P</em> = 0.0006). The AUC for the combined diagnosis of serum MMP-7, SOX9 and GGT was 0.888 (95 % CI:0.788–0.952, <em>P</em> &lt; 0.0001), which was significantly different from the diagnosis of MMP-7 or SOX9 alone (<em>P</em> = 0.034, <em>P</em> = 0.030). Serum levels of MMP-7 and SOX9 were significantly positively correlated with the liver fibrosis score (r_s = 0.41, <em>P</em> = 0.006; r_s = 0.58, <em>P</em> &lt; 0.0001). BA patients who maintained native liver survival had lower preoperative serum levels of MMP-7 and SOX9 (<em>P</em> = 0.008, <em>P</em> = 0.0008).</p></div><div><h3>Conclusions</h3><p>The combined diagnosis of BA by MMP-7, SOX9 and GGT has better accuracy than MMP-7 or SOX9 alone. Serum SOX9 levels can assess the severity of BA liver fibrosis and correlate with BA native liver survival, but more sample data are needed to further investigate its predictive value.</p></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"6 ","pages":"Article 100135"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949711624000200/pdfft?md5=383c35c9499190785bdb0eb4153db025&pid=1-s2.0-S2949711624000200-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140090936","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":"Morphological changes and hub genes screening in rats with anorectal malformations during hindgut development","authors":"Si Ying Li ,&nbsp;Chen Yi Wang ,&nbsp;Mu Yu Li ,&nbsp;Xiao Bing Tang ,&nbsp;Zheng Wei Yuan ,&nbsp;Yu Zuo Bai","doi":"10.1016/j.yjpso.2024.100133","DOIUrl":"https://doi.org/10.1016/j.yjpso.2024.100133","url":null,"abstract":"<div><h3>Background</h3><p>Anorectal malformations (ARMs) are among the most common congenital digestive tract malformations worldwide. Although there have been extensive efforts for elucidating their pathogenesis, the specific molecular mechanisms underlying ARMs remain unclear.</p></div><div><h3>Methods</h3><p>We generated ARM Wistar rat models using ethylenethiourea. Nine pregnant rats were allocated to the ARM and control groups, respectively. Hindgut tissue was isolated from embryos collected on gestational days 14, 15, and 16, representing the key timepoints of anorectal development. High-throughput sequencing was used to identify differentially expressed genes. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed on the obtained genes. Module analysis was performed via Search Tool for the Retrieval of Interacting Genes (STRING), and a protein-protein interaction (PPI) network was constructed using Cytoscape software. Gene Set Enrichment Analysis (GSEA) was conducted to verify the enrichment of development/apoptosis/epithelium/morphogenesis/Wnt pathway-related core gene sets and identify ARM hub genes. Reverse transcription-quantitative polymerase chain reaction assay was employed to verify mRNA levels of hub genes.</p></div><div><h3>Results</h3><p>313 GSEA core genes form ten core gene sets were selected. Based on the 281 differentially expressed circRNAs (|Fc| &gt; 2, FDR &lt; 0.05), 42 PPI core genes were obtained. According to the integration of GSEA analysis and PPI network, three hub genes (Cul1, Gli3, and Osr2) highly associated with ETU-induced ARMs were identified. The qRT-PCR validation data were consistent with the sequencing results.</p></div><div><h3>Conclusions</h3><p>These results provide a theoretical basis for the further identification of potential diagnostic and therapeutic targets in ARMs.</p></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"6 ","pages":"Article 100133"},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949711624000182/pdfft?md5=03fe0adccea1531b21b1125b762eb201&pid=1-s2.0-S2949711624000182-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140014288","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":"Starting on the road to pediatric enhanced recovery after surgery: strategies and themes","authors":"Sherif Emil ,&nbsp;Julia Ferreira ,&nbsp;Chantal Frigon ,&nbsp;Elena Guadagno ,&nbsp;Marcy Horge ,&nbsp;Justine Laurie","doi":"10.1016/j.yjpso.2024.100128","DOIUrl":"https://doi.org/10.1016/j.yjpso.2024.100128","url":null,"abstract":"<div><p>Like many innovations in surgery, implementing enhanced recovery after surgery (ERAS) programs in pediatric surgery has lagged behind its adult counterpart. Our institutions have recently made a concerted effort to introduce and implement ERAS widely throughout the Department of Pediatric Surgery, which includes 10 surgical specialties. Our strategy revolved around the early inclusion of all stakeholders, significant educational efforts, and creating a roadmap for development and implementation of ERAS programs. It culminated in the first Canadian pediatric ERAS conference, which was held in Montreal on April 28, 2023, and served as a launching pad for instituting an ERAS culture in our hospital. Throughout the process, we identified specific themes that helped emphasize the rationale for pediatric ERAS programs and kept stakeholders engaged in the efforts. In this paper, we share these strategies and themes, believing they can aid other pediatric institutions seeking to initiate an ERAS culture.</p><p>Level of evidence: V</p></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"6 ","pages":"Article 100128"},"PeriodicalIF":0.0,"publicationDate":"2024-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949711624000133/pdfft?md5=5c983c1bce185d5383bc793ec4bc142b&pid=1-s2.0-S2949711624000133-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139985899","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":"Differences between male and female patients with pilonidal disease","authors":"Bill Chiu ,&nbsp;Claire Abrajano ,&nbsp;Hiroyuki Shimada ,&nbsp;Razie Yousefi ,&nbsp;Kyla Dalusag ,&nbsp;Madeline Adams ,&nbsp;Wendy Su ,&nbsp;Thomas Hui ,&nbsp;Claudia Mueller ,&nbsp;Julie Fuchs ,&nbsp;James Dunn","doi":"10.1016/j.yjpso.2024.100132","DOIUrl":"https://doi.org/10.1016/j.yjpso.2024.100132","url":null,"abstract":"<div><h3>Background</h3><p>Pilonidal disease begins in puberty when males and females have different sex hormone expression. We hypothesize that sex differences can lead to clinical differences in pilonidal disease.</p></div><div><h3>Methods</h3><p>Patient demographics, Fitzpatrick skin type, hair characteristic, presentation, pain score, recurrence were recorded 2019–2022. All patients underwent regular epilation+/-pit excision. Excised pits were stained for estrogen receptor, progesterone receptor, and androgen receptor.</p></div><div><h3>Results</h3><p>237 patients (110F, 127 M) were followed 351±327days. Females present younger than males (17.5 ± 3.9 vs.18.4 ± 3.6years). While no sex-related differences noted in recurrence rate (4.5% vs.7.9 %) or skin type, there were significant sex-related differences in hair amount, thickness, density, and color. More males had granuloma than females (34% vs.12 %): 63 % granuloma were located left of midline, 30 % right, 7 % center. More males than females presented with drainage (67% vs.35 %). Significant differences were noted in patient-reported pain: Females’ mean initial pain score was higher than that of males’ (5.6 ± 2.5 vs.4.7 ± 2.2). 35 % females had menstruation-related gluteal cleft pain (MRGCP), not associated with recurrence or pads/tampons use. Females on contraceptives (15.5 %females) had lower pain score than those who were not (3.9 ± 2.7 vs.5.8 ± 2.4) and none of these females reported MRGCP. Patients with drainage had lower pain score than those without (4.5 ± 2.4 vs.5.8 ± 2.2). Excised pits from females with MRGCP had higher proportion of fibroblasts stain positive for estrogen receptor and androgen receptor compared to those without MRGCP (28.4 %±9.0 %vs.14.4 %±6.5 %, 18.0 %±11.7 %vs.6.9 %±9.0 %, respectively).</p></div><div><h3>Conclusions</h3><p>Male and female pilonidal patients differ in pain intensity, drainage, and granuloma formation. More fibroblasts with estrogen receptor and androgen receptor expression is a potential mechanism for MRGCP that is ameliorated by contraceptive use.</p></div>","PeriodicalId":100821,"journal":{"name":"Journal of Pediatric Surgery Open","volume":"6 ","pages":"Article 100132"},"PeriodicalIF":0.0,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949711624000170/pdfft?md5=f1557f8535f775419165c41910b99383&pid=1-s2.0-S2949711624000170-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139985370","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":"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}