Journal of pediatric surgery最新文献

{"title":"Corrigendum to \"Child- and Proxy-reported Differences in Patient-reported Outcome and Experience Measures in Pediatric Surgery: Systematic Review and Meta-analysis\" [Journal of Pediatric Surgery 60 (2025) 162172].","authors":"Zanib Nafees, Siena O'Neill, Alexandra Dimmer, Elena Guadagno, Julia Ferreira, Nancy Mayo, Dan Poenaru","doi":"10.1016/j.jpedsurg.2025.162482","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2025.162482","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162482"},"PeriodicalIF":2.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Virtual Reality for Pediatric Trauma Education - A Preliminary Face and Content Validation Study\" [Journal of Pediatric Surgery 60 (2025) 161951].","authors":"Fabio Botelho, Said Ashkar, Shreenik Kundu, Tj Matthews, Elena Guadagno, Dan Poenaru","doi":"10.1016/j.jpedsurg.2025.162483","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2025.162483","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162483"},"PeriodicalIF":2.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding the ACS Children's Surgery Ecosystem: A Blueprint for the Children's Surgery Collaborative.","authors":"Anoosha Moturu, Catherine Grant, Stephanie Hall, Clifford Y Ko, Kevin P Lally, Mehul V Raval","doi":"10.1016/j.jpedsurg.2025.162480","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2025.162480","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162480"},"PeriodicalIF":2.4,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Neonatal Surgical Outcomes Using The Clavien-Dindo Classification: A Multicentre Study Of Complications And Risk Factors In A Middle-Income Country.","authors":"Alia Maisyah Ahmad Lela, Shireen Anne Nah, Wei Sheng Tan, Srihari Singaravel, Yew-Wei Tan, Anand Sanmugam","doi":"10.1016/j.jpedsurg.2025.162469","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2025.162469","url":null,"abstract":"<p><strong>Purpose: </strong>Neonatal surgery in low- and middle-income countries can be complicated by limited resources, delayed presentations, and variability in neonatal intensive care. This study applied the Clavien-Dindo (CD) classification to evaluate postoperative complications in neonates across three tertiary centres in Malaysia, aiming to (1) establish baseline complication rates and (2) identify risk factors for severe morbidity and mortality in a middle-income context.</p><p><strong>Method: </strong>A retrospective analysis was conducted on 278 neonates (≤28 days old or corrected age for preterms) who underwent surgery at three government hospitals between July 2020 and September 2021. Demographic data, surgical diagnoses, and 30-day postoperative complications were recorded. Complications were graded using the CD system, with Grades I-II considered minor and III-V considered major. Logistic regression identified predictors of major complications (CD ≥III), with p<0.05 as significant.</p><p><strong>Results: </strong>Among 278 neonates (mean 36 wk, range 25-42; 60 % term), 61 % underwent bowel surgery. Thirty-day morbidity was 20 % overall and 11 % major (CD ≥ III); CD IIIb re-operations were the commonest major event, and mortality was 4.3 %. Multivariable logistic regression identified intra-abdominal sepsis as the sole independent, modifiable predictor of major complications (adjusted OR 2.96, 95 % CI 1.09-7.84, p = 0.033). Extreme prematurity (< 30 wk) carried a three-fold but borderline risk (OR 3.32, 0.96-10.89, p = 0.057), while birth-weight, surgeon seniority and centre HRPZ II were non-significant. Surgery at the rural SWACH centre showed lower major morbidity (OR 0.13, 0.02-0.54, p = 0.003), likely reflecting referral patterns.</p><p><strong>Conclusion: </strong>The Clavien-Dindo classification proved practical for quantifying neonatal surgical complications and clarifying severity patterns in an LMIC setting. Prematurity emerged as the key determinant of adverse outcomes, underlining the importance of integrated neonatal care to mitigate perioperative risks. These findings provide benchmarks for quality improvement and resource allocation to enhance neonatal surgical care in resource-limited environments.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162469"},"PeriodicalIF":2.4,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on: The Definition of an Oesophageal Stricture.","authors":"Simon Eaton, Natalie Durkin, Paolo De Coppi","doi":"10.1016/j.jpedsurg.2025.162468","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2025.162468","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162468"},"PeriodicalIF":2.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discharge Opioid Prescriptions Following Pediatric Appendectomy: a NSQIP-P Study.","authors":"Amna Minhas, Humza Thobani, Arsalan Javid, Joyce McRae, Georgi Mladenov, Benjamin Farber, Andrei Radulescu, Faraz Khan, Steven L Raymond","doi":"10.1016/j.jpedsurg.2025.162475","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2025.162475","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate national trends in opioid prescriptions following discharge for appendectomy in children with appendicitis using the National Surgical Quality Improvement Program - Pediatric (NSQIP-P) database. Furthermore, we aimed to analyze the association between opioid prescriptions at discharge and emergency department (ED) visits and readmissions in this patient cohort.</p><p><strong>Methods: </strong>The NSQIP-P database was queried for all patients under 18 years of age who underwent laparoscopic appendectomy for simple or complicated appendicitis. Patients were stratified based on whether they received an opioid prescription at discharge. Demographics, clinical characteristics and postoperative outcomes were compared between patients receiving opioid prescriptions versus those who did not. Multivariable logistic regression was used to identify predictors of opioid prescribing and its association with ED visits and unplanned readmissions.</p><p><strong>Results: </strong>Among 22,148 pediatric appendectomy patients, 5.2% received opioids at discharge. In patients with simple appendicitis, older age (p<0.001), male sex (p=0.027), Black/African American race (p=0.012), computed tomography (CT) without ultrasound (p<0.001) and decreased length of stay (p=0.002) were independent predictors of opioid prescription. In cases of complicated appendicitis, independent predictors of opioid prescription included older age (p=0.001), CT use without ultrasound (p<0.001) and shorter hospital stay (p<0.001). Discharge opioids were associated with increased odds of ED visits (aOR 1.28, 95% CI: 1.00-1.60), but not unplanned readmissions (aOR 1.13, CI 95%: 0.75-1.64).</p><p><strong>Conclusion: </strong>Despite declining national rates, variation in opioid prescribing following appendectomy persists. Poor radiation stewardship and patient demographics appear to be associated with prescribing patterns. Efforts to optimize pain management and reduce unnecessary opioid exposure are warranted.</p><p><strong>Type of study: </strong>Retrospective Comparative Study.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162475"},"PeriodicalIF":2.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unconventional Alternative Shunts in Pediatric Extrahepatic Portal Vein Obstruction - Experience with satisfactory outcome.","authors":"Tarun Kumar Gupta, Basant Kumar, Pujana Kanneganti, Vijai D Upadhyaya, Nishant Agrawal, Tarun Kumar","doi":"10.1016/j.jpedsurg.2025.162462","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2025.162462","url":null,"abstract":"<p><strong>Background: </strong>Major variceal hemorrhages in children of the Indian subcontinent, are caused by extrahepatic portal vein obstruction (EHPVO). Portosystemic shunt surgery (PSS) is the recommended course of action for long-term care in refractory cases, even if endoscopic techniques constitute the initial line of treatment for acute variceal hemorrhage. The most usual surgery, particularly with splenomegaly, is the proximal splenorenal shunt (PSRS). However, in some cases, unusual or alternative nonconventional shunts are required for treatments due to anatomical variances and technical difficulties. We present our experience with pediatric patients underwent unconventional shunt procedures with satisfactory outcome.</p><p><strong>Methodology: </strong>Retrospectively between June 2019 and July 2024; all patients underwent unconventional or \"alternative shunts were included in the study. The patients' information was collected from hospital electronic and operative records, and all available data was analyzed.</p><p><strong>Result: </strong>Seven (7/112; 6.3%) patients were operated as unconventional shunt for various reasons in total of 112 patients during study period. Five were males and median age was 11 years (ranged 3-17 years). The most common symptoms were splenomegaly with hypersplenism (6/7; 85.7%) growth retardation (7/7; 100%) abdominal pain/discomfort (4/7; 57.2%), hematemesis (5/7; 71.4%) and melena (4/7; 57.2%) in the combination with each other. Various unconventional shunts, including spleno-adrenal, inferior mesenteric-vena caval, and collateral-based shunts, were performed. The median shunt diameter was 7 mm [7-8 mm (25th - 75th Percentile)] and post-surgery reduction in median omental vein pressure was significant (p=0.017). All patients showed improved hematological parameters and variceal regression. One patient experienced shunt thrombosis, successfully managed with interventional radiology. Follow-up ranging from 5 to 56 months showed good outcomes with improved appetite, weight gain.</p><p><strong>Conclusion: </strong>Unconventional shunts are a viable alternative in select cases where conventional shunt options are not feasible, providing a valuable surgical rescue plan when anatomical constraints are encountered.</p><p><strong>Type of study: </strong>Retrospective observational cohort study LEVEL OF EVIDENCE: 4.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162462"},"PeriodicalIF":2.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of Life and its Clinical Determinants After Slide Tracheoplasty for Congenital Tracheal Stenosis","authors":"Taichi Nakatani ,&nbsp;Keiichi Morita ,&nbsp;Yumiko Tachibanaki ,&nbsp;Akiko Yokoi ,&nbsp;Tadashi Hatakeyama","doi":"10.1016/j.jpedsurg.2025.162477","DOIUrl":"10.1016/j.jpedsurg.2025.162477","url":null,"abstract":"<div><h3>Objective</h3><div>Long-term outcomes following slide tracheoplasty in patients with congenital tracheal stenosis (CTS) have rarely been reported. Data on postoperative quality of life (QOL) and its contributing factors are limited. This study aimed to assess the long-term QOL in individuals who underwent slide tracheoplasty for CTS and to identify associated influencing factors.</div></div><div><h3>Methods</h3><div>The medical questionnaires, PedsQL4.0 and VHI-30, from 62 patients who underwent slide tracheoplasty for CTS at our institution from January 1998 to November 2021 were reviewed.</div></div><div><h3>Results</h3><div>Forty-six patients had no tracheostomy, and 35 reported no respiratory symptoms. Fourteen patients showed no abnormalities across all evaluated items. Total PedsQL 4.0 scores did not differ significantly from those of healthy children. When comparing the total PedsQL 4.0 scores of patients and parents across different background factors, variables significantly associated with differences included respiratory symptoms, growth retardation, and VHI-30 scores below 8 points. Multiple regression analysis showed that VHI-30 scores below 8 points were the most significant factor influencing both patient and parent scores. A comparison of the background factors revealed significant differences in VHI-30 for stenosis length, postoperative extubation, current tracheostomy, and respiratory symptoms. Logistic regression analysis showed that respiratory symptoms were the most important factor.</div></div><div><h3>Conclusion</h3><div>QOL in patients with CTS following slide tracheoplasty was generally favorable across all age groups. However, elevated VHI-30 scores were associated with a reduction in QOL. Patients with respiratory symptoms tended to have higher VHI-30 scores and voice-related impairment. Monitoring and addressing respiratory and voice symptoms may improve QOL.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 10","pages":"Article 162477"},"PeriodicalIF":2.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustained Outcomes After Enhanced Recovery Pathway Implementation in Pediatric Colorectal Surgery.","authors":"William Yu Luo, Chis Agala, Priya Vasan, Nicole Buddenbaum, Robin Koonce, Maria Concetta Lupa, Sean E McLean, Anthony G Charles, Adesola C Akinkuotu, Michael Ryan Phillips","doi":"10.1016/j.jpedsurg.2025.162476","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2025.162476","url":null,"abstract":"<p><strong>Introduction: </strong>Previous studies have demonstrated improvements in length of stay and opioid utilization after implementing Enhanced Recovery After Surgery Pathways (ERPs) for pediatric colorectal surgery. However, the long-term impact of ERPs on postoperative outcomes following the implementation of specific ERP components has not been examined.</p><p><strong>Methods: </strong>In this single-institution retrospective and longitudinal cohort review of pediatric patients undergoing colorectal surgery before (Pre-ERP - 4/2014-8/2015) and after an ERP implementation (ERP - 9/2015-1/2024). Poisson regression was performed to determine the role of pathway implementation on length of stay (LOS), opioid utilization total (OU) (morphine milliequivalents/kilogram), indwelling urinary catheter use, total intravenous fluid (IVF) use, and time to PO intake. Secondary analysis compared patients during implementation (9/2015-4/2020) and sustainment periods (5/2020-1/2024) to report long-term ERP impacts.</p><p><strong>Results: </strong>On multivariable regression, LOS for ERP patients was lower than for pre-ERP patients, and OU was almost half the pre-ERP OU (p≤0.01). The ERP cohort also had shorter indwelling urinary catheter duration, less IVF volume, and shorter time to PO intake. Secondary analysis found that these effects improved further in the post-ERP sustainment phase.</p><p><strong>Conclusion: </strong>To our knowledge, this represents the largest single-institution study to date of children ≤18 years old who underwent colorectal surgery before and after ERP implementation. There were significant improvements in LOS, OU, urinary catheter duration, time to PO intake, and IVF use. This is the first study to report the impact of ERPs after implementation during sustainment and emphasizes the importance of ERPs in optimizing pediatric surgical outcomes for children undergoing colorectal surgery.</p><p><strong>Type of study: </strong>Retrospective cohort study LEVEL OF EVIDENCE: Level III.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162476"},"PeriodicalIF":2.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of postoperative antibiotic protocols for pediatric complicated appendicitis: A Western Pediatric Surgery research consortium study.","authors":"Utsav M Patwardhan, Anastasia Kahan, R Scott Eldredge, Katie W Russell, Justin Lee, Scott S Short, Benjamin Padilla, Sarah B Cairo, Shannon N Acker, Aaron R Jensen, Lorraine I Kelley-Quon, David H Rothstein, Elizabeth A Fialkowski, Stephanie D Chao, Lauren Gillory, Samir Pandya, Jose Diaz-Miron, Romeo C Ignacio","doi":"10.1016/j.jpedsurg.2025.162461","DOIUrl":"10.1016/j.jpedsurg.2025.162461","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162461"},"PeriodicalIF":2.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}