Journal of pediatric surgery最新文献

{"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}

{"title":"Pancreatic resection operations in pediatric patients: A NSQIP-Pediatric analysis of outcomes and factors associated with adverse events","authors":"Muhammed Ali Colak ,&nbsp;Shruthi Srinivas ,&nbsp;Yueran Zhang ,&nbsp;Lindsey Asti ,&nbsp;A. Jay Freeman ,&nbsp;Sara K. Rasmussen ,&nbsp;Kyle J. Van Arendonk ,&nbsp;Jaimie D. Nathan","doi":"10.1016/j.jpedsurg.2025.162473","DOIUrl":"10.1016/j.jpedsurg.2025.162473","url":null,"abstract":"<div><h3>Purpose</h3><div>We aim to utilize a large national database to assess postoperative outcomes of pancreatic resection operations in children and the factors associated with early postoperative adverse events.</div></div><div><h3>Methods</h3><div>Children (age ≤18 years) undergoing pancreatectomy between 2012 and 2021 were identified using the National Surgical Quality Improvement Program-Pediatric database. Demographics, comorbidities, and outcomes were reported across operation types. Multivariable logistic regression was used to identify factors associated with postoperative adverse events within 30 days.</div></div><div><h3>Results</h3><div>Of 336 patients identified, 260 (77.4 %) underwent distal pancreatectomy, 54 (16.1 %) underwent enucleation, 12 (3.6 %) underwent total pancreatectomy with islet autotransplantation, 5 (1.5 %) underwent pancreatoduodenectomy, 3 (0.9 %) underwent total pancreatectomy, and 2 (0.6 %) underwent debridement. Indications for operation included pancreatic neoplasms/cysts (n = 134, 39.9 %), hypoglycemia (n = 95, 28.3 %), other pancreatic diagnoses (n = 59, 17.6 %), pancreatitis/pseudocysts (n = 36, 10.7 %), and trauma (n = 12, 3.6 %). Median length of stay was 7 days (IQR: 5–15). In the 30-day postoperative period, 27 (8 %) patients were readmitted, 20 (6 %) patients underwent reoperation, 85 (25.3 %) patients had complications, and there was one (0.3 %) mortality. Overall, 106 (31.5 %) patients had postoperative adverse events. Odds of any adverse event were independently higher in those with preoperative comorbidities (adjusted odds ratio (aOR): 2.51, 95 % confidence interval (CI): 1.39–4.57) and need for preoperative nutritional support (aOR: 3.94, 95 % CI: 1.88–8.54).</div></div><div><h3>Conclusion</h3><div>In pediatric patients undergoing pancreatectomy operations, preoperative comorbidities and need for nutritional support are independently associated with higher odds of adverse events. Multidisciplinary preoperative optimization should be considered in these high-risk groups.</div></div><div><h3>Type of study</h3><div>Retrospective cohort study.</div></div><div><h3>Level of evidence</h3><div>III.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 10","pages":"Article 162473"},"PeriodicalIF":2.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667875","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":"Critical insights on: Mental health, psychosocial functioning and quality of life in adolescents with anorectal malformation.","authors":"Hassan Iqbal, Sunbal Sardar, Manal Sharif, Noaman Khan","doi":"10.1016/j.jpedsurg.2025.162474","DOIUrl":"10.1016/j.jpedsurg.2025.162474","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162474"},"PeriodicalIF":2.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667872","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":"Management of Anorectal Avulsion in Children: A Retrospective Cohort Study.","authors":"Jiayu Yan, Wenbo Pang, Dan Zhang, Kai Wang, Yangqing Cao, Yanan Zhang, Yajun Chen","doi":"10.1016/j.jpedsurg.2025.162471","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2025.162471","url":null,"abstract":"<p><strong>Aim: </strong>To introduce our experience in the management of anorectal avulsion in children and propose feasible treatment procedures for anorectal avulsion.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 20 patients (13 males, 7 females) with anorectal trauma at Beijing Children's Hospital from 2020 to 2024. Patients with anorectal avulsion were selected for a detailed review, including management process and prognosis, and were compared with patients with anorectal laceration.</p><p><strong>Results: </strong>Of the patients, 7 (7/20, 35.0%) were identified with anorectal laceration, 13 (13/20, 65.0%) had anorectal avulsion, and the mean age was 7.4 ± 3.5 years. Traffic accidents (11/20, 55.0%) were the major cause. Compared with patients with anorectal laceration, patients with anorectal avulsion had a higher average ISS ([26.0 (16.0-36.0) vs 4.0 (0.0-21.0)], p < 0.001) with unstable vital signs ([11/13, 84.6%] vs [0/7, 0.0%], p < 0.001). These patients were more likely to require diversion ostomy during primary management ([9/13, 69.2%] vs [1/7, 14.3%], p = 0.029) but had a higher probability of postoperative complications ([12/13, 92.3%] vs [0/7, 0.0%], p < 0.001). Twelve patients with anorectal avulsion (12/13, 92.3%) underwent anorectal manometry before anorectal reconstruction, except for 1 patient who had anal closure after primary repair. All patients underwent anal sphincter identification by muscle stimulator, and 10 (10/13, 76.9%) underwent sphincter repair and anoplasty again. Anorectal manometry before stoma closure showed that the maximum anal squeeze pressure of patients with anorectal avulsion were higher than those before anorectal reconstruction, and the duration of squeeze was also prolonged. At follow-up, patients with anorectal avulsion had undergone an average of 5.0 (2.0-14.0) operations, much more than patients with anorectal laceration ([1.0 (1.0-4.0)], p < 0.001), and 3 patients had not closed the stoma. The median bowel function score was significantly lower in patients with anorectal avulsion than in patients with anorectal laceration ([16.0 (10.0-20.0) vs All: 20], p = 0.008).</p><p><strong>Conclusion: </strong>Patients with anorectal avulsion require multiple evaluations and repairs to achieve a reasonable bowel function. It is recommended that further experience is accumulated to improve the management process.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162471"},"PeriodicalIF":2.4,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667874","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 gender gap in pediatric surgery: Barriers, disparities, and the way forward","authors":"Hannah Lea Luz ,&nbsp;Julia Haehl ,&nbsp;Clara Franziska Luz ,&nbsp;Sabine Zundel","doi":"10.1016/j.jpedsurg.2025.162481","DOIUrl":"10.1016/j.jpedsurg.2025.162481","url":null,"abstract":"<div><h3>Background</h3><div>Social media movements such as #ILookLikeASurgeon and the #NYerORCoverChallenge have highlighted the lack of visibility of women in the formerly male-dominated field of surgery. This issue, known as the gender career gap, is especially evident in pediatric surgery, where women remain underrepresented in leadership roles. The “glass ceiling” and “leaky pipeline” metaphors summarize these challenges. Addressing the “leaky pipeline” is crucial, not just for individual satisfaction but to retain qualified staff in light of a looming shortage of surgeons. With this study we aim to analyze the current situation and determine possible solutions.</div></div><div><h3>Materials and methods</h3><div>A web-based survey was distributed globally through pediatric surgery associations and LinkedIn, gathering 185 responses. The data were analyzed using Microsoft Excel, Stata, and NVivo.</div></div><div><h3>Results</h3><div>Seventy-four percent of female participants believed that gender impacts career opportunities, compared to only 32 % of male respondents. Additionally, 93 % of women reported experiencing sexual discrimination, and 42 % experienced sexual harassment. Regarding parenthood and career progression, 71 % of men did not reduce their work for childcare, whereas 29 % of women did, taking significantly longer periods off for caregiving. Proposed solutions included improving parental leave, offering part-time work options, and implementing mentorship programs to support women in the field.</div></div><div><h3>Conclusion</h3><div>Gender inequality in pediatric surgery is multifaceted, involving disparities in career advancement, discrimination, and parenthood impacts. Addressing these issues is vital to close the gender gap and ensure a high-qualified future workforce.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 10","pages":"Article 162481"},"PeriodicalIF":2.4,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667879","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":"Storage of Placental Blood - A Feasibility Study for Development of a Fetal Blood Bank.","authors":"Keyonna M Williams, Caitlin Clifford, Danielle Dougherty, Connor Plagens, Scott La Dell, Alissa R Carver, Shih-Hon Li, Erin E Perrone","doi":"10.1016/j.jpedsurg.2025.162459","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2025.162459","url":null,"abstract":"<p><strong>Objective: </strong>Neonates transfused with adult donor blood (rich in HbA) have a precipitous drop in fetal hemoglobin (HbF) levels. This study evaluates the feasibility of collection and storage of placental cord blood.</p><p><strong>Methods: </strong>Prospective study patients with uncomplicated term pregnancies undergoing scheduled cesarean section were recruited from July 2022 - December 2023. Cord blood was collected after delivery for processing and storage in our institutional blood bank. Samples were analyzed at 0, 7, 14, and 21 days.</p><p><strong>Results: </strong>Thirty patients were recruited (55% Caucasian with median maternal age 34 years, gestational age 39 weeks, birth weight 3.48 kg). Median collection volume was 83 mL; 8 collections were excluded due to inadequate volume. The median hemolysis was 0.10% on Day 0 and 0.23% on Day 21 with median loss 2.5%. Median biochemical storage lesion at 21 days was within expectations (24.5 mmol/L potassium, 71.2 mg/dL free hemoglobin, pH 6.38, LDH 191 IU/L). All day 21 blood cultures were negative. Hemoglobin fractions remained unchanged between 0 and 21 days (16.2-17.8% HbA and 83.8-82.2% HbF).</p><p><strong>Conclusion: </strong>Placental cord blood can be safely collected, processed, and stored for 21 days as a potential autologous blood product for neonates.</p><p><strong>Type of study: </strong>Level II, Prospective Cohort; Keywords: Blood bank, fetal hemoglobin, neonatal transfusion.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162459"},"PeriodicalIF":2.4,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667877","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}