Journal of pediatric surgery最新文献

{"title":"Frequency-Dependent Effects of Transcutaneous Electrical Nerve Stimulation in Children with Refractory Functional Constipation: A Prospective Comparative Study.","authors":"Ali İhsan Anadolulu, Tansu Birinci Olgun, Berfin Özgenur Aydın, Gökçe Akyol, Çiğdem Ulukaya Durakbaşa","doi":"10.1016/j.jpedsurg.2026.163542","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2026.163542","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163542"},"PeriodicalIF":2.3,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216126","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":"Declining Rates of Cervical Spine Injury and Operative Intervention in Pediatric Trauma: A National TQIP Analysis.","authors":"Marshall W Wallace, Sommer Glasgow, Hsuan-Yu Wan, Anastasia M Kahan, Vijay M Ravindra, Robert A Swendiman, Katie W Russell","doi":"10.1016/j.jpedsurg.2026.163549","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2026.163549","url":null,"abstract":"<p><strong>Introduction: </strong>Pediatric cervical spine injuries (CSI) are present in 1-2% of all pediatric traumatic injuries and can be devastating. Contemporary injury prevention measures may decrease CSI incidence, however, their impact on pediatric CSI incidence are unknown. We aimed to evaluate contemporary epidemiological data of pediatric CSI in the United States.</p><p><strong>Methods: </strong>We evaluated the incidence of pediatric CSI using the Trauma Quality Improvement Program (TQIP) database from 2017-2024. Amongst children (age 0-17) with blunt trauma, CSI cases and CSI-related operative interventions were identified using ICD-10-CM and ICD-10-PCS codes, respectively. Trends in the incidence of overall and operative CSI were assessed for the total cohort and across age groups. P<0.05 was defined as statistically significant.</p><p><strong>Results: </strong>Among 805,466 pediatric patients with blunt trauma the overall incidence of CSI was 1.9% (<1 years: 0.5%, 1-4 years: 1.0%, 5-9 years: 0.9%, 10-14 years: 1.7%, 15-17 years: 4.4%). Increasing age and motor vehicle accident mechanism were independently associated with CSI. There was a significant decrease in overall- (2017: 2.08 %, 2024: 1.8%) and operative- (2017: 15.3%, 2024: 12.5%) CSI incidence across the study period, not explained by changes in overall trauma volume.</p><p><strong>Conclusions: </strong>Among traumatically injured children presenting to trauma centers in the United States, the incidence of CSI is decreasing over time. These findings suggest that public health measures such as improving vehicle safety standards, restraint- and helmet-laws may have a measurable impact on this potentially devastating pediatric injury pattern.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163549"},"PeriodicalIF":2.3,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207041","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":"Cumulative Incidence and Risk Factors for Pediatric Firearm Reinjury: A Two-Center Cohort Study.","authors":"Marissa Ray, Rory Edwards, Colton Brown, Olivia Hopper, Emily Rheaume, Richard A Falcone, Amy Makley, Meera Kotagal","doi":"10.1016/j.jpedsurg.2026.163547","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2026.163547","url":null,"abstract":"<p><strong>Background: </strong>Pediatric patients who experience firearm injury may be at risk for subsequent reinjury, yet the timing and predictors of recurrence remain poorly defined. Characterizing reinjury patterns at both individual and system levels is essential for informing targeted prevention strategies.</p><p><strong>Methods: </strong>We performed a retrospective review (2010-2024) of patients aged 0-18 years presenting with non-self-inflicted firearm injuries to two Level I pediatric and adult trauma centers. Cross-institutional database linkage was used to identify reinjury events. Cumulative incidence functions estimated reinjury risk over time, accounting for death as a competing risk. Univariate and multivariate Cox proportional hazards models evaluated independent predictors of reinjury.</p><p><strong>Results: </strong>Among 834 patients (84.9% male, 79% Black; median age 17 years [IQR 15-18]), 67 died from their index injury and 75 sustained a subsequent firearm injury at a median of 22 months (IQR 12-61). No reinjury events occurred among children younger than 11 years. Cumulative reinjury incidence at one, three, and five years was 2.5% (1.4-3.6), 5.9% (4.2-7.5), and 7.8% (5.8-9.7), respectively. Assault-related index injury (aHR 2.18, 95% CI 1.10-4.35), lower injury severity (aHR 0.59, 95% CI 0.36-0.97), and treatment at an adult trauma center (aHR 3.43, 95% CI 1.46-8.06) were independently associated with increased reinjury risk.</p><p><strong>Conclusions: </strong>Firearm reinjury among pediatric patients is concentrated in adolescence and often occurs years after the initial event. Reinjured youth were more likely to have been assaulted, uninsured, and initially treated for relatively minor injuries-factors that may limit engagement with supportive services. These findings underscore the need for developmentally tailored violence-prevention and resource-linkage interventions initiated at the time of first injury.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163547"},"PeriodicalIF":2.3,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207082","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":"Bilateral Wilms Tumor: Multi-institutional Analysis of Nephron-Sparing Surgery at Centers with Focused Wilms Tumor Expertise.","authors":"Andrew J Murphy, N Valeska Halstead, Brett Wiesen, Jordan A Coggins, Mary Houston, Andrew Nicklawsky, Gemma Beltran, Jennifer Pyrzanowski, Taylor Perry, Jonathan Roach, Kristine Corkum, Joshua Short, Amy Hou Chen, Barrett Cromeens, Sindhu Mannava, Brent R Weil, Elizabeth Mullen, Robert C Shamberger, Megan M Durham, Goeto Dantes, Peter F Ehrlich, Andrew M Davidoff, Nicholas G Cost","doi":"10.1016/j.jpedsurg.2026.163553","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2026.163553","url":null,"abstract":"<p><strong>Purpose: </strong>The proportion of children who undergo bilateral nephron-sparing surgery (BNSS) for bilateral Wilms tumor (BWT) is variably reported. We evaluated the frequency of BNSS versus unilateral radical nephrectomy with contralateral nephron-sparing surgery (NSS) at institutions with focused Wilms tumor expertise during the Children's Oncology Group (COG) AREN0534 era. We hypothesized that BNSS would be performed more frequently than the 35% frequency reported on AREN0534.</p><p><strong>Methods: </strong>We identified the top 10 enrolling institutions (all renal tumors) on the COG Renal Tumor Banking Study (AREN03B2) during the AREN0534 enrollment period and before publication of AREN0534 results. Six institutions participated in this multi-institutional retrospective cross-sectional study of children presenting with BWT from 2009 to 2017. Data on the index surgical procedure for each kidney were collected.</p><p><strong>Results: </strong>Sixty-four children with BWT were included. BNSS was performed in 45/64 (70.3%; 95% CI, 58-81%), while 19/64 (29.7%) underwent unilateral radical nephrectomy with contralateral NSS; no child underwent bilateral radical nephrectomy as their index surgical procedure. BNSS frequency varied by institution, chemotherapy exposure, and local stage. On multivariable analysis, increasing age at surgery was independently associated with lower odds of BNSS (OR 0.62/year, 95% CI 0.39-0.94). At a median follow-up of 111 months, recurrence-free and overall survival did not differ between groups.</p><p><strong>Conclusion: </strong>Institutions with focused Wilms tumor expertise achieved BNSS in 70% of children with BWT during the AREN0534 era, substantially exceeding the frequency reported on AREN0534 and supporting efforts to maximize nephron preservation when oncologically appropriate.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163553"},"PeriodicalIF":2.3,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207115","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":"Withdrawal of Life-Sustaining Treatment and the Severity-Matched Mortality Difference Between Abusive and Unintentional Pediatric Traumatic Brain Injury: A Propensity-Matched Cohort Study of the ACS TQIP.","authors":"Alexander S Mina, Keely Wolf, Jeffrey W Chen, Alexandra M Buda, Adam M Vogel, Howard I Pryor","doi":"10.1016/j.jpedsurg.2026.163551","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2026.163551","url":null,"abstract":"<p><strong>Purpose: </strong>Abusive head trauma carries higher mortality than unintentional traumatic brain injury (TBI), but whether this persists at comparable presenting severity, and how much reflects withdrawal of life-sustaining treatment (WLST), is unclear. We compared severity-matched in-hospital mortality between abusive and unintentional severe pediatric TBI and quantified the contribution of WLST.</p><p><strong>Methods: </strong>Retrospective cohort study of the American College of Surgeons Trauma Quality Improvement Program registry (2019-2024) including children with severe TBI (Glasgow Coma Scale ≤8) from abusive or unintentional blunt mechanisms. Abusive cases were matched 1:1 to unintentional controls on 43 indicators of demographics, presenting severity, and hospital factors. Mortality was analyzed with conditional logistic regression; WLST's contribution was assessed by restriction to patients without WLST, counterfactual decomposition, and multiple imputation retaining all abusive cases.</p><p><strong>Results: </strong>Crude mortality was 40.5% (abusive) vs 17.2% (unintentional). In 395 matched pairs, abusive injury was associated with higher mortality (odds ratio [OR] 1.39, 95% CI 1.01-1.90) and more frequent WLST (19.0% vs 14.2%). The association was attenuated among patients without WLST (OR 1.11, 0.71-1.71), but this underpowered finding was not reproduced after multiple imputation (1,009 pairs: mortality OR 1.58, 1.21-2.07; without WLST 1.55, 1.03-2.34). WLST mediated one-third of the excess mortality (33%, 7-60%) and preceded half of the excess deaths; the excess was confined to deaths after hospital day 1 (OR 1.65, 1.22-2.23).</p><p><strong>Conclusion: </strong>At comparable presenting severity, abusive TBI carries a modest excess mortality emerging after the first hospital day; roughly one-third runs through more frequent WLST and the remainder persists among children who continue treatment.</p><p><strong>Level of evidence: </strong>III - retrospective comparative study (propensity-matched cohort).</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163551"},"PeriodicalIF":2.3,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207058","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":"VIRTUAL REALITY-ENHANCED FOR PREOPERATIVE ANATOMICAL ASSESSMENT OF ABDOMINAL NEUROBLASTOMA: A COMPARATIVE STUDY WITH CONVENTIONAL CT IMAGING.","authors":"Laura Privitera, Rachel Wan, Alexander Dudko, Jana Jradi, Endrit Pajaziti, Jonathan J Neville, Tom Watson, Silvia Schievano, Stefano Giuliani","doi":"10.1016/j.jpedsurg.2026.163511","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2026.163511","url":null,"abstract":"<p><strong>Aim: </strong>Accurate assessment of tumour anatomy is critical for neuroblastoma surgical planning. This study evaluated whether patient-specific virtual reality (VR) models improve the accuracy of pre-operative anatomical assessment compared with conventional computed tomography (CT) imaging.</p><p><strong>Methods: </strong>CT scans from nine patients with abdominal neuroblastoma were segmented to create patient-specific VR models, which were then imported into an in-house VR application. Eleven paediatric surgeons (n=5 consultants; n=6 registrars) independently evaluated conventional CT images and VR reconstructions to assess vascular and organ involvement, image-defined risk factors (IDRFs), and operative strategies. Anatomical accuracy was quantified against intraoperative findings recorded in the International Neuroblastoma Surgical Report Form. Subjective ratings were collected using Likert scales. Mixed-effects models and non-parametric statistical analyses were conducted (p<0.05).</p><p><strong>Results: </strong>VR significantly improved overall anatomical accuracy, with a mean increase of 12.4 percentage points (95% CI 8.5-16.3; p<0.0001). Improvements were observed for vascular involvement (+12.5%, p<0.001), organ involvement (+9.6%, p<0.01), and IDRF identification (+13.7%, p<0.0001). Improvements in anatomical accuracy with VR were similar between consultants and registrars. VR did not significantly alter operative planning decisions or predicted tumour resectability. Surgeons reported greater confidence in anatomical understanding and surgical planning with VR than CT (p<0.001). The VR platform received high ratings for usability, integration into the preoperative planning workflow, and perceived clinical value.</p><p><strong>Conclusion: </strong>VR improved surgeons' anatomical assessment accuracy and confidence compared with traditional CT scans, highlighting VR's potential as a useful supplement to conventional imaging for preoperative evaluation in complex abdominal neuroblastoma.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163511"},"PeriodicalIF":2.3,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193887","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":"Why Kids Crash: Risk Factors for Pediatric E-Bike Injuries in California.","authors":"Alyssa Joachim, John Schomberg, Romeo C Ignacio, Amy Lawrence, Laura F Goodman","doi":"10.1016/j.jpedsurg.2026.163552","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2026.163552","url":null,"abstract":"<p><strong>Background: </strong>Electric bikes (e-bikes) are increasingly popular, particularly among pediatric riders, and pose a greater risk of serious injury than traditional bicycles due to their higher speeds. However, limited data exist regarding traffic and environmental conditions associated with pediatric e-bike crashes. This study aims to characterize the circumstances surrounding these collisions to better understand risk factors contributing to e-bike crashes.</p><p><strong>Methods: </strong>A retrospective analysis was conducted of police-reported e-bike collisions involving riders ≤18 years recorded in the Statewide Integrated Traffic Records System (SWITRS) between 2021-2025. Demographic characteristics, roadway conditions, and collision data were analyzed and stratified by injury severity.</p><p><strong>Results: </strong>878 pediatric e-bike crashes were identified. Median rider age was 14 years (IQR 13-15) and most were male (79.4%). 69 crashes (7.8%) resulted in serious injury, 491 (55.9%) in minor injury, 177 (20.1%) in possible injury, and 141 (16.0%) had an unknown injury status. Riders sustaining serious injuries were less likely to be helmeted and more likely to be involved in collisions in low-light conditions (p <0.0001 for both). Cyclists were reported at fault for 62.1% of accidents, with 12.1% involving e-bikers practicing unsafe riding practices. Hit-and-run accidents accounted for 8.8% of crashes.</p><p><strong>Conclusion: </strong>Pediatric e-bike crashes are frequently attributable to rider behavior. Crashes occurring in low-light conditions or involving riders without helmets are associated with greater injury severity. These findings highlight opportunities for targeted education and policy intervention for riders and drivers to reduce the number and severity of pediatric e-bike collisions.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163552"},"PeriodicalIF":2.3,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194264","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":"Upfront Distal Pancreatectomy vs. Upfront Non-Operative Management in Pediatric Grade III Pancreatic Trauma: a single institution review.","authors":"Marshall W Wallace, Sommer Glasgow, Anastasia M Kahan, Hsuan-Yu Wan, Trevor J Laborda, Kacey Barnes, Julia Smith, Zachary J Kastenberg, Katie W Russell, Robert A Swendiman","doi":"10.1016/j.jpedsurg.2026.163550","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2026.163550","url":null,"abstract":"<p><strong>Introduction: </strong>Management of grade III blunt pancreatic injury has shifted towards non-operative management (NOM) in pediatric trauma. In adults, the standard of care remains distal pancreatectomy (DP). We hypothesized that upfront DP in pediatric grade III pancreatic injury would be associated with faster post-injury recovery, compared to upfront NOM.</p><p><strong>Methods: </strong>We retrospectively reviewed minors presenting to a level 1 pediatric trauma center with AAST grade III blunt pancreatic injury from 2015-2025. Bivariate analyses compared baseline characteristics, management strategies and outcomes between upfront DP (<72 hours from injury) and upfront NOM (no DP within 72 hours of injury) strategies. Regression analyses evaluated independent predictors of time to full oral diet intake.</p><p><strong>Results: </strong>31 patients met inclusion criteria (n=12 DP, n=19 NOM). The baseline characteristics of each cohort were similar. There were non-significant trends towards lower readmissions (NOM: 0 [0-1], DP: 0 [0-0]), total hospital length of stay (days, NOM: 10 [7-29], DP: 9 [6-16]), time to full oral diet intake (days, NOM: 28 [4-37], DP: 8 [4-13]) and discharge on home supplemental nutrition (NOM: 47%, DP:17%) in the DP group. There were no differences in rates of post-traumatic diabetes mellitus or exocrine pancreatic insufficiency between groups, with limited follow up (NOM: 37d [18-90], DP: 41d [20-257]). Upfront distal pancreatectomy was independently associated with earlier time to full oral diet on regression analysis.</p><p><strong>Conclusions: </strong>Our hypothesis-generating findings suggest that in pediatric grade III blunt pancreatic injuries, upfront distal pancreatectomy may be associated with faster post-injury recovery, though statistical significance was not reached.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163550"},"PeriodicalIF":2.3,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194881","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":"Is Total Urogenital Mobilization Safe and Continent-Preserving Across a Wide Age Range in Congenital Adrenal Hyperplasia? A Single-Center Experience of 73 Patients.","authors":"Toghrul Omarov, Taryel Omarov","doi":"10.1016/j.jpedsurg.2026.163554","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2026.163554","url":null,"abstract":"<p><strong>Background: </strong>Despite widespread adoption of total urogenital mobilization (TUM) for feminizing genitoplasty in congenital adrenal hyperplasia (CAH), quantitative intraoperative benchmarks remain unreported in the literature, and urinary continence outcomes in CAH remain incompletely established.</p><p><strong>Purpose: </strong>To document urinary continence, complication rate and other operative parameters of TUM performed exclusively for CAH in a consecutive single-center cohort.</p><p><strong>Methods: </strong>73 consecutive 46,XX CAH patients (Prader III, n=45; Prader IV, n=28), aged 2 to 168 months, underwent TUM at a single institution between January 2014 and March 2025. Operative time, estimated blood loss, complications, and urinary continence, assessed clinically and urodynamically, were analyzed. Spearman correlation assessed the relationship between common channel length and intraoperative parameters.</p><p><strong>Results: </strong>Urinary continence, supported by clinical and urodynamic findings, was preserved in all 52 toilet-trained patients (100%). No complication attributable to the surgical technique occurred over 4 years median follow-up; 11 patients (15.1%) developed catheter-related Grade I urinary tract infection, all resolving fully. Median operative time was 145 minutes (IQR 120-178) and median estimated blood loss was 16 mL (IQR 12-19); no patient required perioperative transfusion. Common channel length correlated strongly with operative time (r=0.83, p<0.001) but not with estimated blood loss (r=0.23, p=0.09). Four patients with common channel length exceeding 6.5 cm required distal urethral plate augmentation without bladder neck involvement.</p><p><strong>Conclusions: </strong>TUM demonstrates a favorable perioperative and postoperative safety profile in CAH, with hemostatic stability independent of anatomical complexity. TUM safely preserves continence even in older children and anatomically complex cases with appropriate technical modification.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163554"},"PeriodicalIF":2.3,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194798","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":"Near-Infrared Autofluorescence for Parathyroid Identification in Pediatric Thyroid and Parathyroid Surgery.","authors":"Miriam Abellán Lucas, Beatriz Febrero, Francisco Javier López Hernández, Juan José Ruiz-Manzanera, María Teresa Soriano Palao, Jose Manuel Rodriguez Gonzalez","doi":"10.1016/j.jpedsurg.2026.163537","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2026.163537","url":null,"abstract":"<p><strong>Introduction: </strong>Identification and preservation of parathyroid glands (PGs) in children is particularly challenging due to their small size and frequent ectopic location. Near-infrared autofluorescence (NIRAF) enables real-time intraoperative recognition of PGs; however, its application in pediatric patients remains poorly documented. Accurate PG identification is essential to reduce postoperative hypoparathyroidism.</p><p><strong>Methods: </strong>We conducted a prospective observational case series including patients <18 years undergoing thyroidectomy or parathyroidectomy with the assistance of a NIRAF probe. Detection ratios, concordance with surgeon identification, false-positive or false-negative events, and postoperative calcium and parathyroid hormone (PTH) levels were recorded.</p><p><strong>Results: </strong>Eleven patients were enrolled, eight underwent thyroid procedures and three underwent parathyroid procedures. All PGs were identified in thyroid cases; 80% were first detected by NIRAF with 100% surgeon-probe concordance. Two false positives (thymic tissue) occurred, one in each group; two patients presented transient hypoparathyroidism.</p><p><strong>Conclusions: </strong>NIRAF appears to be feasible and safe for intraoperative PG identification in pediatric endocrine surgery.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163537"},"PeriodicalIF":2.3,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182676","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}