Journal of pediatric surgery最新文献

{"title":"Child Physical Abuse and Cervical Spine Injury: A Prospective Observational Study of over 1,200 Children in the Western Pediatric Cervical Spine Study.","authors":"Anastasia M Kahan, Tagrid Ruiz-Maldonado, Hsuan-Yu Wan, Vijay M Ravindra, Sean S Ciullo, Mauricio A Escobar, Katie W Russell","doi":"10.1016/j.jpedsurg.2026.163445","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2026.163445","url":null,"abstract":"<p><strong>Background: </strong>The incidence and patterns of cervical spine injury (CSI) have not been well described in children who present after suspected child physical abuse (CPA). The purpose of this study was to describe the pattern of CSI in patients evaluated for suspected CPA in a large, prospectively collected dataset.</p><p><strong>Methods: </strong>This is a secondary analysis of a prospectively collected, multicenter, pediatric CSI dataset which included 72 trauma centers across the United States. All children with suspected CPA were included, with concerns for CPA determined by each participating center. All children had cervical spine imaging within 24 hours of injury.</p><p><strong>Results: </strong>Among 19,995 pediatric blunt trauma patients, 1,251 children with suspected CPA were identified. Median age was 6 months (IQR 2-12), 42% female, 19% presented with a GCS less than 14, and 11% required intubation. Concomitant traumatic brain injury (TBI) was present in 61% of patients. Overall, 75 children (6%) were diagnosed with CSI. Ligamentous injury was most common (68%), followed by spinal cord injury (19%). No patient underwent operative cervical spine stabilization. Unstable ligamentous injury occurred in seven patients. Four were identified on CT, three were detected on MRI. One patient had a normal initial XR prior to MRI diagnosis with a presenting GCS of 10. On multivariable regression, GCS 3-13 (OR 3.29, 95% CI 1.61-6.47), and intubation (OR 3.07, 95% CI 1.57-6.27) were associated with CSI.</p><p><strong>Conclusion: </strong>In this large prospective multicenter cohort, CSI occurred in 6% of children evaluated for suspected CPA and consisted primarily of ligamentous injuries. Low GCS and intubation were strongly associated with CSI. Unstable injuries were rare, CT identified all injuries in which it was performed, and no missed unstable injuries were observed in neurologically intact children with normal screening radiographs. These findings suggest that CT may be a useful adjunct for CSI evaluation in obtunded patients with suspected CPA (GCS < 14) and support a low threshold for advanced imaging in this population. In children with suspected physical abuse who undergo CT imaging, our findings support that a normal CT may be sufficient to allow removal of cervical immobilization regardless of mental status.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163445"},"PeriodicalIF":2.3,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897436","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 Metabolic and Bariatric Surgery Among Adolescents, 2016-2025.","authors":"John B Rode, Thomas H Inge, Allan D Wu, Caren Mangarelli, Justin R Ryder","doi":"10.1016/j.jpedsurg.2026.163441","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2026.163441","url":null,"abstract":"<p><strong>Background: </strong>Guidelines endorse metabolic and bariatric surgery (MBS) for eligible adolescents with severe obesity. We described trends in MBS among eligible adolescents and characterized demographic and clinical features, postoperative healthcare utilization, and complications.</p><p><strong>Methods: </strong>Using Epic Cosmos, we conducted a retrospective, population-based study of US adolescents aged 12-19 years from 2016 through 2025. The primary outcome, annual MBS utilization among eligible adolescents, was modeled by negative binomial regression. Secondary outcomes (patient characteristics, healthcare utilization, complications) were assessed with t-tests, chi-square, weighted least-squares, and logistic regression.</p><p><strong>Results: </strong>Overall, 5,430 adolescents underwent MBS, with utilization rising 7.7-fold from 31 to 239 per 100,000 eligible (p<0.001); at peak, only 0.24% of those eligible underwent MBS. Sleeve gastrectomy (SG) predominated (89.1%). Utilization was steeply graded by obesity severity: by 2025, adolescents with a BMI ≥50 kg/m² underwent SG roughly nine times as often as those at the lowest eligible BMI class (605 vs 69 per 100,000). Mean length of stay declined from 2.0 to 1.6 days (p<0.001). Serious early complications were uncommon: within 30 days, surgical and infectious complications each affected ≤0.6% of patients, and cardiovascular and thromboembolic events ≤0.3%. The most common diagnoses were gastrointestinal and biliary: nausea and vomiting (12.5%) by one year and cholecystectomy (7.5%) by three years. Reoperation, conversion to gastric bypass, and death were rare (each <0.4%).</p><p><strong>Conclusions: </strong>Despite increasing use, only a small fraction of eligible adolescents undergo MBS. Given low complication rates, these data highlight a need to expand more equitable access and implementation within clinical workflows.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163441"},"PeriodicalIF":2.3,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891862","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":"Recto-Perineal Fistula - Do We Need to Fix It? Long-Term Outcomes of Non-Operative Management.","authors":"Ori Blich, Aner Keinan, Aviva Harrer, Ofra Carmel, Michael Koussa, Yaron Armon","doi":"10.1016/j.jpedsurg.2026.163443","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2026.163443","url":null,"abstract":"<p><strong>Background: </strong>Surgical reconstruction has traditionally been considered the standard of care for imperforate anus with recto-perineal fistula. However, increasing recognition of the role of functional anatomy raises the possibility that selected patients may be managed without surgery.</p><p><strong>Methods: </strong>We conducted a single-center retrospective cohort study of children with imperforate anus and perineal fistula managed either non-operatively or surgically. Patients were selected for non-operative management based on clinical assessment of fistula caliber, perineal body, and sphincter muscle coverage. Long-term bowel function was evaluated using a standardized ARM-Net-based questionnaire derived from the Rintala score. Clinical outcomes and need for delayed surgical intervention were recorded.</p><p><strong>Results: </strong>A total of 97 patients with recto-perineal fistula were included, of whom 62 (63.9%) were managed non-operatively. At a mean follow-up age of 7.0 ± 3.0 years, most non-operatively managed patients achieved normal bowel function (73.3%), with low rates of constipation and minimal need for bowel management. No patients required delayed surgical reconstruction. Compared to a contemporaneous surgical cohort (n = 35), non-operatively managed patients demonstrated superior functional outcomes; however, these findings reflected baseline differences in anatomical characteristics, including greater sphincter muscle coverage. On univariable analysis, favorable anatomical features and non-operative management were associated with normal bowel function.</p><p><strong>Conclusions: </strong>In carefully selected patients with imperforate anus and recto-perineal fistula, non-operative management is associated with excellent long-term bowel function and may obviate the need for surgical reconstruction. These findings support a more individualized, anatomy-based approach to management.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163443"},"PeriodicalIF":2.3,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887884","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":"Timing of Inguinal Hernia Repair Does Not Influence Recurrence in Premature Infants.","authors":"Stephanie F Brierley, Brielle Ochoa, Amir Alhajjat, Emily Byrd, Stephanie D Chao, Matthew S Clifton, Christopher E Clinker, Goeto Dantes, Jose Diaz-Miron, Elizabeth A Fialkowski, Lauren Gillory, Juan P Gurria, Yigit Guner, Zaid Haddadin, Alexandra Highet, Carlos T Huerta, Olivia A Keane, Pablo Laje, Hau D Le, Justin Lee, Aaron Lesher, Samir R Pandya, Saunders Lin, Steven T Papastefan, Raphael H Parrado, Eduardo A Perez, Lorraine I Kelley-Quon, Warren Rehrer, Katie W Russell, Leigh Selesner, Blynn L Shideler, Bethany J Slater, Michael A Stellon, Caroline Stephens, Krysta M Sutyak, KuoJen Tsao, Cristine S Velazco, Nell Webber, Minna M Wieck, Peter T Yu, Daniel J Ostlie, Benjamin E Padilla","doi":"10.1016/j.jpedsurg.2026.163442","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2026.163442","url":null,"abstract":"<p><strong>Introduction: </strong>The optimal timing of inguinal hernia repair (IHR) in premature infants remains unclear. Our study aims to compare recurrence rates between IHRs performed before and at/after 55 weeks postmenstrual age (PMA).</p><p><strong>Methods: </strong>A multicenter retrospective cohort study was conducted of premature infants who underwent IHR at ≤1 year of age between 1/2017-12/2019. The primary outcome was inguinal hernia recurrence, defined as recurrence requiring surgical re-repair. Demographic, clinical, perioperative and postoperative variables were analyzed. Multivariable logistic regression was performed to identify factors associated with recurrence.</p><p><strong>Results: </strong>A total of 2,412 premature infants underwent 3,808 IHRs: 3,292 (86.4%) hernias were repaired early (before 55 weeks PMA), and 516 (13.6%) were repaired late (after 55 weeks PMA). Incarceration rates were similar between the groups (9.4% vs. 8.2%, p=0.422), as were the proportion of repairs performed laparoscopically (30.0% vs. 31.2%, p=0.594). Patients undergoing early repair were more frequently admitted postoperatively (81.2% vs. 27.2%, p<0.001). There were no significant differences in hernia recurrence (1.2% vs. 0.8%, p=0.358) or time to recurrence (3 months [IQR 2.0, 9.0] vs. 9 months [IQR 4.3, 11.5], p=0.218) between early and late repair groups. On multivariable regression, laparoscopic repair (OR 1.910 [95% CI 1.018, 3.581], p=0.044) and concurrent procedure (OR 2.046 [95% CI 1.034, 4.047], p=0.040) were independently associated with a higher risk of recurrence, while late repair was not (OR 0.749 [95% CI 0.259, 2.165], p=0.593).</p><p><strong>Conclusion: </strong>Time of repair was not an independent predictor of hernia recurrence. Therefore, recurrence risk alone should not drive the decision for early repair; rather timing should be individualized based on patient physiology, anesthetic considerations, and reliability of follow-up.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163442"},"PeriodicalIF":2.3,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887962","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":"Health literacy profiles in parents of children with congenital colorectal disorders: A cluster analysis.","authors":"Signe Olsbø, Marie Hamilton Larsen, Åsmund Hermansen, Kristin Bjørnland","doi":"10.1016/j.jpedsurg.2026.163439","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2026.163439","url":null,"abstract":"<p><strong>Aim: </strong>To identify and describe health literacy (HL) profiles and possible associations with sociodemographic and clinical characteristics among parents of children with congenital colorectal conditions.</p><p><strong>Methods: </strong>Parents (n=269) of children with Hirschsprung disease (HD) or anorectal malformation (ARM) completed the Health Literacy Questionnaire-parent version (HLQ-p) and the General Self-Efficacy Scale. Demographic and clinical data were collected. Ward's hierarchical clustering was used to identify clusters across the nine HLQ-p domains. Ethical approval was obtained.</p><p><strong>Results: </strong>Four parental HL profiles were identified. Cluster 1 (n=75, 28%) showed consistently low HL across all domains, with particular difficulties in information appraisal and social support. This cluster had the lowest self-efficacy, lower educational attainment, nearly half were non-native speakers, and half were not living with the child's other parent. Cluster 2 (n=57, 21%) demonstrated moderate HL, but distinct challenges in information appraisal. Many had high education, cohabitated, and were native-speaking households. This group had the highest prevalence of child comorbidity. Cluster 3 (n=109, 41%) exhibited generally high HL and strong engagement with healthcare providers, but struggled with information appraisal. Self-efficacy was high, and most parents lived with the child's other parent. Cluster 4 (n=28, 10%) had the highest HL and self-efficacy, a high proportion of parents with high education and universal cohabitation.</p><p><strong>Conclusion: </strong>Nearly half of the parents exhibit low HL, including many with traditionally advantageous sociodemographic characteristics. Language diversity and child comorbidity amplified HL challenges, and difficulties in evaluating and applying health information were common across all parent groups.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163439"},"PeriodicalIF":2.3,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887932","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":"Triaging Infantile Cholestasis: Validation of Non-Invasive Diagnostic Modalities and a Composite Scoring System for Early Detection of Biliary Atresia.","authors":"Yang Yang Lee, Siddhant Chavan, Alba Bueno, Evelyn G P Ong, Khalid Sharif, Girish Gupte","doi":"10.1016/j.jpedsurg.2026.163437","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2026.163437","url":null,"abstract":"<p><strong>Background: </strong>Biliary atresia (BA) is the most common cause of infantile obstructive jaundice, with outcomes critically dependent on timely Kasai portoenterostomy. Differentiating BA from other causes of infantile cholestasis remains challenging. We aimed to evaluate the diagnostic performance of individual investigations and the composite predictive index (the Simple Biliary Atresia Score, SBAS) within a UK national tertiary paediatric liver unit.</p><p><strong>Methods: </strong>This retrospective observational cohort study included all infants referred with conjugated hyperbilirubinaemia at less than 100 days of life to the Liver Unit at Birmingham Children's Hospital between March 2022 and March 2025. . The primary endpoint was the diagnosis or exclusion of BA, confirmed by intra-operative cholangiography and histopathology. SBAS was calculated from gallbladder length, common bile duct diameter, periportal echogenicity, direct-to-total bilirubin ratio, and GGT, yielding a 0-7 composite score; a cutoff ≥3 defined high risk. Diagnostic performance was assessed using sensitivity, specificity, predictive values, and AUROC.</p><p><strong>Results: </strong>Of 143 included infants, 46 (32.2%) were diagnosed with biliary atresia. Direct bilirubin (median 102 vs 85 μmol/L, p=0.015) and GGT (333 vs 135 U/L, p<0.001) were higher in biliary atresia, and all sonographic markers differed significantly between groups. At SBAS ≥3 the score achieved sensitivity 97.7% (95% CI 87.9-99.6), specificity 68.5% (58.3-77.2), positive predictive value 60.0% (48.3-70.7) and negative predictive value 98.4% (91.4-99.7); the AUROC of the score as a continuous variable was 0.874 (0.817-0.930), exceeding that of every individual investigation. The single false negative was a cystic biliary atresia misinterpreted on ultrasound. Alagille syndrome was over-represented among false positives (17.9% vs 1.6% of true negatives). Liver biopsy was performed in 55 of 142 infants (38.7%), in 50 cases concurrently with operative cholangiography.</p><p><strong>Conclusion: </strong>SBAS is a robust, low-cost, bedside triage tool that retains excellent sensitivity and discriminative performance in a UK tertiary referral cohort, supporting its use as secondary triage to identify infants requiring urgent escalation to definitive management.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163437"},"PeriodicalIF":2.3,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880946","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 retirement runway: Smoothing the bumpy road.","authors":"David A Klima, Kevin P Moriarty, Evan R Kokoska, Richard G Weiss, Aodhnait S Fahy, Stephen S Kim, Marcene R McVay-Gillam","doi":"10.1016/j.jpedsurg.2026.163402","DOIUrl":"10.1016/j.jpedsurg.2026.163402","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163402"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794543","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":"Art and visual communication in surgery: bridging tradition and innovation.","authors":"Yifan Li","doi":"10.1016/j.jpedsurg.2026.163438","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2026.163438","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163438"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874481","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":"Pediatric Injury Survivorship and the Pediatric Trauma Quality of Life Clinic: A Year in Review.","authors":"Samantha P Kretschmann, Gani Ali, Hannah M Olson, Brooke M Cheaton, Terri A deRoon Cassini, Frances M Kaczor, Kelly Keyzer, Danielle Leranth, Patricia Marik, Madeline Wittman, Colleen Trevino, Katherine T Flynn-O'Brien","doi":"10.1016/j.jpedsurg.2026.163431","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2026.163431","url":null,"abstract":"<p><strong>Purpose: </strong>Survivorship, optimization of physical, mental, and emotional health, and quality of life after injury, is critical. We developed the first ever Pediatric Trauma Quality of Life (pTQOL) Clinic, focused on pediatric firearm injury. Our goal was to review the first-year experience of this clinic.</p><p><strong>Methods: </strong>Patient demographic and injury characteristics were captured for the first year of the clinic from the institutional trauma registry. Additional data were obtained from chart review about index hospitalizations and clinic visits. Reflections on pTQOL experiences were elicited from team members, patients, and families.</p><p><strong>Results: </strong>A total of 126 pTQOL encounters were scheduled for 86 patients. Among those, 57 were completed by 49 patients. The median age at injury was 16.39 years, ranging from 3.07 to 17.98 years. Most patients were male firearm injured youth. Services seen during clinic visits included General Surgery, Psychology, Physical Therapy, Social Work, Hospital-Based Violence Intervention Programs, and Orthopedic Surgery. pTQOL visits led to 56 new referrals for 29 patients in a variety of specialties with bullet excisions scheduled for 4 patients. pTQOL team members, patients, and families reported high levels of satisfaction with the clinic.</p><p><strong>Conclusion: </strong>The first ever pTQOL Clinic was successful in its first year. pTQOL provided an opportunity for patients to engage with multiple services in one appointment, including Social Work and Psychology, which are often limited in the post discharge setting, and led to numerous new referrals. Additional process improvements are underway in response to variable appointment completion rates and identified challenges.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163431"},"PeriodicalIF":2.3,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865513","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":"Perinatal Management of High-Risk Congenital Lung Malformations: A Multicenter Analysis.","authors":"Rakesh Reddy Gurrala, Marissa A Ray, Philip Stanic, Claire Wunker, Cecilia Gigena Heitsman, Deion Pena, Abby C Larson, Nicole J Bertaux, Kyra Halbert-Elliott, Latoya A Stewart, Tayana Jean-Pierre, Jooyoung Park, Cortnie R Vaughn, Terry L Buchmiller, Casey M Calkins, Benjamin D Carr, Darrell L Cass, Joseph T Church, S Christopher Derderian, Vincent P Duron, Stephen J Fenton, Anthony Raymond Ferrantella, Brian W Gray, Patricia S Greco, Aimee G Kim, Caroline Maloney, Jason O Robertson, Beth Rymeski, Christopher W Snyder, Raphael C Sun, Jesse D Vrecenak, Peter T Yu, Irving J Zamora, Shaun M Kunisaki, Inna N Lobeck","doi":"10.1016/j.jpedsurg.2026.163433","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2026.163433","url":null,"abstract":"<p><strong>Background: </strong>Congenital lung malformations (CLMs) are often diagnosed prenatally, with high-risk cases potentially benefiting from perinatal intervention. We report outcomes following perinatal intervention for CLMs across a national multicenter cohort.</p><p><strong>Methods: </strong>Retrospective analysis of prenatally diagnosed CLMs (2016-2024) from a 17-center consortium was performed. Prenatal characteristics, procedural details, and outcomes were analyzed for patients undergoing ex utero intrapartum treatment (EXIT), cesarean section-to-immediate resection (STR), or emergent resection within 24 hours of birth (ER).</p><p><strong>Results: </strong>Of 1756 CLM patients, 25 (1.4%) underwent perinatal intervention: 15 EXIT (0.9%), 4 STR (0.2%), and 6 ER (0.3%). Among EXIT cases, 11 (73%) underwent EXIT-to-resection and 4 (27%) EXIT-to-airway. Most lesions were large, with a median congenital pulmonary airway malformation volume ratio (CVR) at delivery of 2.3 (IQR 1.57-2.70). Mediastinal shift was universal (100%), while hydrops was present in 33%. Congenital pulmonary airway malformation (CPAM) was the most common pathology-based diagnosis among EXIT patients (87%). Procedural survival was 15/15 (100%) for EXIT, 4/4 (100%) for STR, and 5/6 (83%) for ER. Thirty-day survival was 13/15 (87%) for EXIT, 4/4 for STR, and 3/6 for ER. ECMO was used in 2/15 EXIT, 1/4 STR, and 1/6 ER neonates. Median NICU length of stay for survivors was 30 days (EXIT), 24 days (STR), and 25 days (ER).</p><p><strong>Conclusion: </strong>Perinatal intervention for CLM remains rare. These findings provide contemporary multicenter data on EXIT, STR, and ER and may help inform prenatal counseling and delivery planning. Further study is warranted to refine patient selection for perinatal intervention and delivery modification.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163433"},"PeriodicalIF":2.3,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865529","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}