Journal of pediatric surgery最新文献

{"title":"Endoscopic Retrograde Cholangiopancreatography (ERCP) Findings in Pediatric Patients with Choledocholithiasis Justify a Surgery-First Approach: A Multi-Center Study.","authors":"Alison Lehane, Jessica L Rauh, Goeto Dantes, Hanna Alemayehu, Marshall Wallace, Irving J Zamora, Kylie Callier, Bethany J Slater, Derek Krinock, Robert Vandewalle, Amanda Witte, Katherine Flynn-O-Brien, Utsav M Patwardhan, Romeo Ignacio, Lucas Neff","doi":"10.1016/j.jpedsurg.2025.162388","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2025.162388","url":null,"abstract":"<p><strong>Background: </strong>Pediatric choledocholithiasis is traditionally managed with an endoscopy-first approach, where Endoscopic Retrograde Cholangiopancreatography (ERCP) is performed before laparoscopic cholecystectomy (LC). However, ERCP carries risks such as pancreatitis, bleeding, infection, and perforation, and may even be an unnecessary procedure should stones pass spontaneously. An alternative surgery-first approach, utilizing intraoperative cholangiogram (IOC), laparoscopic common bile duct exploration (LCBDE), power flushing, and glucagon, may offer a more efficient treatment pathway. This study aims to evaluate ERCP findings in pediatric patients undergoing an endoscopy-first pathway to characterize the nature and burden of stone disease in the common bile duct. Our ultimate goal is to determine the proportion of cases that could have been successfully managed with a surgery-first approach.</p><p><strong>Methods: </strong>This retrospective, multi-center study analyzed 127 pediatric patients (≤18 years) who underwent ERCP prior to LC for suspected choledocholithiasis. Data from seven children's hospitals were reviewed, including imaging studies, ERCP findings, and stone characteristics. ERCP findings were categorized as sludge, small (<4 mm), medium (5-7 mm), large (>8 mm), or absent stones. Cases with sludge, small/medium stones, or negative ERCP findings were considered amenable to a surgery-first approach as they are known to be manageable with intraoperative techniques.</p><p><strong>Results: </strong>69% of patients had ERCP findings that were amenable to transcystic surgical maneuvers without preoperative ERCP. Among those, 19% had only sludge, 46% had only stones, 24% had sludge and stones, and 11% had no evidence of obstruction. Large stones (>8 mm) were found in only 8% of cases.</p><p><strong>Conclusion: </strong>The findings support a surgery-first has potential for a paradigm shift as standard of care for pediatric choledocholithiasis, with ERCP reserved for select cases where surgical clearance fails or cholangitis is present. Adoption of this approach could reduce hospital stays, procedural risks, and healthcare costs while maintaining high efficacy in duct clearance. Prospective studies are warranted to refine clinical guidelines.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162388"},"PeriodicalIF":2.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180412","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":"Long-term aerodigestive morbidities after esophageal atresia/tracheoesophageal fistula repair.","authors":"Dave Ebbott, Yaniv Maddahi, Fari Fall, Devon Pace, Vanessa Reese, Loren Berman, Matthew Boelig","doi":"10.1016/j.jpedsurg.2025.162384","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2025.162384","url":null,"abstract":"<p><strong>Purpose: </strong>Short-term complications, such as gastroesophageal reflux disease (GERD) and anastomotic stricture, are well documented in esophageal atresia/tracheoesophageal fistula (EA/TEF) survivors; however, long-term aerodigestive morbidities remain poorly understood. This study evaluated the long-term aerodigestive morbidities of EA/TEF survivors through propensity-matched analysis using a large international electronic health record (EHR) database.</p><p><strong>Methods: </strong>EA/TEF cases from 2004-2024 were identified in the TriNetX EHR database, which encompasses over 100 million patients from 86 international healthcare organizations. Cases were identified using the International Classification of Disease (ICD) 9/10 codes and compared with a matched control group based on age, race, ethnicity, and sex. Outcomes were analyzed using the chi-square test and Kaplan-Meier morbidity curves, and subgroup analysis was used to assess differences in patients with and without congenital heart disease (CHD).</p><p><strong>Results: </strong>Among the 5,368 identified patients with EA/TEF, 5,052 were included in the analysis (median age, 13 years; interquartile range: 8-18 years). EA/TEF survivors had significantly higher rates of asthma (28% vs. 9%, p<0.0001), tracheomalacia (29% vs. 0%, p<0.001), pneumonia (31% vs. 11%, p<0.001), obstructive sleep apnea (OSA) (13% vs. 2%, p<0.001), GERD (50% vs. 5%, p<0.001), esophageal dyskinesia (8% vs. 0%, p<0.001), esophageal stricture (32% vs. 0%, p<0.001), and esophageal dilations (15% vs. 0%, p<0.001) than controls did. Moreover, there was increasing divergence (p < 0.001) of combined aerodigestive morbidity rates between the EA/TEF and control groups over long-term follow up. CHD emerged as an independent risk factor for increased esophageal and respiratory morbidity (p<0.001).</p><p><strong>Conclusion: </strong>These findings underscore the significant long-term aerodigestive morbidities in EA/TEF survivors, particularly those with CHD, highlighting the need for lifelong surveillance and targeted management to improve outcomes in this high-risk population.</p><p><strong>Type of study: </strong>Retrospective Comparative Study LEVEL OF EVIDENCE: Level III.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162384"},"PeriodicalIF":2.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182346","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":"The hormonal effect of fibroblast growth factor 19 on the intestinal adaptation in pediatric short bowel syndrome: an in vitro study using patients-derived enteroids.","authors":"Yiming Gong, Yang Wang, Yuling Zhao, Junkai Yan, Tian Zhang","doi":"10.1016/j.jpedsurg.2025.162387","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2025.162387","url":null,"abstract":"<p><strong>Background: </strong>Promoting intestinal adaptation is of paramount importance for restoring normal gastrointestinal function in pediatric patients with short bowel syndrome (SBS). However, the hormonal effect of fibroblast growth factor 19 (FGF19) on the intestinal adaptation of SBS patients remains unknown.</p><p><strong>Methods: </strong>Integrated analyses using transcriptomic profiles were performed across two datasets. In vivo datasets were obtained from a group of pediatric SBS patients without intact ileocecal valve (ICV) exhibiting immature gut function and reduced FGF19 levels (n=5), compared to their counterparts with ICV (n=4). In vitro datasets were obtained from SBS patients-derived enteroids (SBS-PDEs) treated with recombinant human FGF19 (rhFGF19).</p><p><strong>Results: </strong>As a result, 2680 differentially expressed genes (DEGs) were identified in vivo, most of which could be clustered into \"metabolic pathway\" and \"cell adhesion\"; 410 DEGs were identified in vitro, most of which could be clustered into \"extracellular matrix organization\" and \"cell adhesion\". In SBS-PDEs, treatment with rhFGF19 significantly enhanced the integrity of epithelial barrier function, and substantially improved the mitochondrial respiration function. Notably, there were 56 overlapped DEGs identified both in vitro and in vivo, most of which could be clustered into \"cell adhesion\".</p><p><strong>Conclusions: </strong>Beyond metabolic regulation, the hormonal effect of FGF19 on the maturation of intestinal epithelium may also include enhancing epithelial barrier function, improving mitochondrial respiration function, and regulating cell adhesion.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162387"},"PeriodicalIF":2.4,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173866","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":"Bulbospongiosus Muscle Reconstruction in Proximal Hypospadias: Post pubertal Function and Patient Satisfaction.","authors":"Supul Hennayake, Mahmoud Marei Marei, Amila De Silva, Arianna Mariotto, Adrian Bianchi","doi":"10.1016/j.jpedsurg.2025.162385","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2025.162385","url":null,"abstract":"<p><strong>Introduction: </strong>Ejaculatory disturbances are prevalent in pubertal studies following childhood proximal hypospadias repair. Bulbospongiosus muscle (BSM) is described as vital for evacuation of the last drop, erections and ejectile ejaculations. Our intention was to assess adolescent outcomes following reconstruction of split BSM observed in proximal hypospadias.</p><p><strong>Method: </strong>Hypospadias was defined as proximal when the bifurcation of the spongiosum was proximal to the anterior end of the pubic bones, and severe when ventral curvature (VC) was >30° after degloving. In these, between January 2003 and December 2009, the bulbospongiosus muscle was apposed in the midline around the bulbar urethra and the urethral plate was transected and grafted for 2-stage surgery. Annual post pubertal assessments, from 12-years of age, included the Hypospadias Objective Scoring Evaluation (HOSE) by the clinician, and Penile Perception Score (PPS) and urination and ejaculation descriptions provided solely by the patient.</p><p><strong>Results: </strong>22 fulfilled the inclusion criteria of having pubertal assessments. The mean age at last consultation was 17.2 years (SD 1.3 years). The meatus at follow-up was glanular in 15, coronal in 5 and distal shaft in 2. 95.4% described strong urinary streams and no dribbling, and 94.4% described ejectile ejaculations. Median HOSE score was 14p (12p-16p) and PPS 16p (14p-18p).</p><p><strong>Conclusion: </strong>Data offered by patients with proximal hypospadias following bulbospongiosus muscle reconstruction around the bulbar urethra, indicates a non-dribbling urinary steam, erections and ejectile ejaculations that meet with strong patient perception of satisfactory function and genital aesthetics. A suboptimal meatal site was not of major relevance.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162385"},"PeriodicalIF":2.4,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150830","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":"Trends in Mortality of Congenital Circulatory Malformations in the Pediatric Population: CDC Data Analysis (1999-2020).","authors":"Hafsa Shahid, Ali Tanvir, Fatima Sial, Rabia Shahid, Syed Shah","doi":"10.1016/j.jpedsurg.2025.162386","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2025.162386","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162386"},"PeriodicalIF":2.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142154","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":"Advancing Inclusive Excellence in Pediatric Surgery: A National Longitudinal Mentorship Program.","authors":"Grace Mallampalli, Amelia E Gavulic, Insiyah Campwala, Yousef Ibrahim, Sydney Castellanos, Anthony Stallion, Sabina Siddiqui, Marjorie J Arca, Marquise Singleterry, Benedict C Nwomeh, Natalie Moreno, Loren Berman, KuoJen Tsao, Cynthia Downard, Erika A Newman, Samir K Gadepalli","doi":"10.1016/j.jpedsurg.2025.162383","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2025.162383","url":null,"abstract":"<p><strong>Purpose: </strong>The Alliance of Pediatric Surgeons Growing and Advancing Representation (APGAR) was created to systematically expand mentorship and sponsorship for learners historically underrepresented in pediatric surgery. We implemented a structured, multi-tiered mentorship model that includes participants from high school through attending pediatric surgeons. We report the conceptual framework, development, and implementation of APGAR's pilot programming, participants' perspectives, and short-term impact.</p><p><strong>Methods: </strong>Longitudinal mentorship groups (\"pods\") were established with representatives across training levels from high school students to pediatric surgery attendings. Pods met independently at least every 3 months, supplemented by APGAR-wide virtual programming on key topics,. To evaluate program impact, a survey was administered before pod formation (Apr/May 2022) and at the one-year follow-up (Apr/May 2023). Descriptive statistics were used to characterize participant demographics. Two-sample t-tests and chi-squared tests were used to compare survey variables.</p><p><strong>Results: </strong>Within 17 pods, 104 trainees and 26 faculty pediatric surgeons participated, representing 54 institutions. Ninety-five participants completed the pre-survey and 31 completed post-surveys (22 completed both). Survey participants (70% students) were primarily women (80%), 39% White, 26% Asian, 18% Black, 10% multiracial, and 6% Hispanic. After one year, APGAR significantly impacted respondents' appreciation of the intellectual challenge offered by a career in pediatric surgery (78% vs. 94%, p = 0.031). Most reported an interest in pursuing pediatric surgery (56%) and value the mentorship provided (77%).</p><p><strong>Conclusion: </strong>APGAR programming successfully engaged learners in pediatric surgery through structured virtual programming, fostering early interest and exploration. Participants frequently cited the value of mentorship in shaping their perspectives.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162383"},"PeriodicalIF":2.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142916","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":"When Childhood Meets Cancer: Tracking Two Decades of Mortality in Pediatric Brain and Blood Malignancies.","authors":"Hafsa Shahid, Ali Tanvir, Nafeesa Gill, Fatima Sial, Rabia Shahid","doi":"10.1016/j.jpedsurg.2025.162382","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2025.162382","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162382"},"PeriodicalIF":2.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142461","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":"Role of Urinary Biomarkers in the Postoperative Follow-Up of Ureteropelvic Junction Obstruction: A Preliminary Report","authors":"Geminiganesan Sangeetha ,&nbsp;S. Kumaravel ,&nbsp;C.D. Mohana Priya ,&nbsp;Ramesh Babu","doi":"10.1016/j.jpedsurg.2025.162371","DOIUrl":"10.1016/j.jpedsurg.2025.162371","url":null,"abstract":"<div><h3>Background</h3><div>While the role of urinary biomarkers in differentiating non-obstructive dilatation (NOD) from ureteropelvic junction obstruction (UPJO) has been documented, there are limited reports on their utility in post-operative follow-up. This study aimed to document the values of urinary biomarkers: carbohydrate antigen (CA 19-9), neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule (KIM-1) following pyeloplasty.</div></div><div><h3>Methods</h3><div>In this prospective study, children with UPJO (those who worsened on ultrasound, or on renogram, or became symptomatic underwent dismembered pyeloplasty). Urinary biomarkers NGAL, KIM-1, and CA19-9 were measured before pyeloplasty, at 6-weeks and 6-months after stent removal. Surgical outcomes were assessed by reduction in antero-posterior diameter (APD) on ultrasound and improvement in differential renal function (DRF)/washout pattern on renogram.</div></div><div><h3>Results</h3><div>All patients in this study (n = 34) showed improvement after pyeloplasty. Urinary CA 19-9 levels (U/ml) showed a significant fall following pyeloplasty (p = 0.001) from 193 (147–308) before surgery to 34 (23–55) (6 weeks post-op) and 12 (10–13) (6 months post-op). Urinary NGAL (pg/ml) showed a significant decline following pyeloplasty (p = 0.001) from 38 (25–62) before surgery to 22 (14–29) (6 weeks post-op) and 13 (9–18) (6 months post-op). Urinary KIM-1 (pg/ml) values also showed a significant reduction following pyeloplasty (p = 0.001) from 799 (503–847) (before surgery) to 187 (167–236) (6 weeks post-op) and 121 (106–173) (6 months post-op). Biomarker levels had strong positive correlation with pelvis size (R: 0.85, 0.77 and 0.65 for CA 19-9, NGAL and KIM 1 respectively with p &lt; 0.001) and negative correlation (R: −0.72, −0.68 and −0.52 for CA 19-9, NGAL and KIM 1 respectively with p &lt; 0.001) with renal function.</div></div><div><h3>Conclusion</h3><div>A decline in postoperative urinary biomarker levels was associated with prompt resolution of hydronephrosis after pyeloplasty. We did not have any failures in this preliminary study and further larger studies are warranted.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 8","pages":"Article 162371"},"PeriodicalIF":2.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120045","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":"Small Change, BIG Impact: Proposal of the Brain Injury Guidelines for Kids (kBIG).","authors":"Annika B Kay, Sommer L Glasgow, Anastasia M Kahan, Robert A Swendiman, Zachary J Kastenberg, Christopher M Roach, Hsuan-Yu Wan, Robert J Bollo, Rajiv R Iyer, Vijay M Ravindra, David S Morris, Brian K Yorkgitis, Bellal Joseph, Katie W Russell","doi":"10.1016/j.jpedsurg.2025.162372","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2025.162372","url":null,"abstract":"<p><strong>Background: </strong>The adult Brain Injury Guidelines (BIG) stratify patients with traumatic intracranial hemorrhage into one of three risk categories and supports management of lower risk traumatic brain injury (TBI) with minimal resources. While the BIG have been widely adopted by adult trauma centers, application to pediatric populations remains unvalidated. The objective of this study was to determine the efficacy of BIG in a pediatric trauma population and develop adapted criteria based on injury patterns that may be unique to children with TBI.</p><p><strong>Methods: </strong>BIG was applied to a retrospective cohort of pediatric TBI patients, defined as <18 years old with skull fracture or intracranial hemorrhage on CT scan, from January 2018 to April 2024. Misclassification of BIG was defined as patients categorized as low- or moderate-risk who required neurosurgical intervention. Based on the performance of BIG, modifications were made to derive a pediatric-specific guideline, BIG for Kids (kBIG).</p><p><strong>Results: </strong>1,894 patients were analyzed. The misclassification rate of BIG 1 and 2 was 0% and 1.4%, respectively. We derived kBIG, with modifications to the categorization of minor skull fracture, epidural hematoma, neurologic exam and injury mechanism, which improved the misclassification rate of kBIG 2 to 0.8% and maintained a rate of 0% for all low-risk patients.</p><p><strong>Conclusions: </strong>We propose BIG for Kids, a modified version of the adult BIG for the management of TBI in pediatric patients. The kBIG was conservatively designed to ensure safety and to reduce unnecessary radiation exposure and resource utilization.</p><p><strong>Level of evidence: </strong>Cohort study / IV.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162372"},"PeriodicalIF":2.4,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102276","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":"Congenital Bronchial Atresia: To Surgically Treat or Conservatively Manage? A Systematic Review","authors":"Noemi Pasqua ,&nbsp;Ilia Bresesti ,&nbsp;Salvatore Zirpoli ,&nbsp;Michele Ghezzi ,&nbsp;Valerio Gentilino ,&nbsp;Federica Pederiva","doi":"10.1016/j.jpedsurg.2025.162368","DOIUrl":"10.1016/j.jpedsurg.2025.162368","url":null,"abstract":"<div><h3>Background</h3><div>No standardized guidelines exist for the management of isolated congenital bronchial atresia (CBA), particularly in asymptomatic cases. This systematic review analyzes both pediatric and adult cases to inform future treatment recommendations.</div></div><div><h3>Methods</h3><div>A systematic review was conducted following PRISMA guidelines, including studies of pediatric (&lt;15 years) and adult (≥15 years) patients with CBA.</div></div><div><h3>Results</h3><div>Out of 3686 screened studies, 85 met the inclusion criteria, encompassing 275 patients (169 children, 106 adults). Surgical intervention was reported in 69.8 % of cases, including 31.2 % of asymptomatic patients, with a particularly high rate of lobectomy in children (83.8 %).</div></div><div><h3>Conclusions</h3><div>Management of CBA remains contentious. While symptomatic are generally treated surgically, a notable proportion of asymptomatic patients also underwent surgery, with a particularly high rate of lobectomy in children. No evidence supports an increased risk of complications in untreated cases, suggesting a potential role for conservative management.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 8","pages":"Article 162368"},"PeriodicalIF":2.4,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094098","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}