Journal of pediatric surgery最新文献

{"title":"Implementing Universal Firearm Injury Prevention Interventions across Pediatric Trauma Centers: A type II hybrid effectiveness-implementation study protocol.","authors":"Katherine Hoops, Natasha Houshmand, Anna DuVal, Julie R Bromberg, Andrew Kiragu, Charles Pruitt, Isam Nasr, Michelle Patch, Cassandra Crifasi, Michael J Mello","doi":"10.1016/j.jpedsurg.2026.163191","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2026.163191","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163191"},"PeriodicalIF":2.5,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839425","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 effectiveness of transversus abdominis single muscle flap repair for large congenital diaphragmatic hernia.","authors":"Camille Duchesne, Emmanuelle Verdier, Loriane Aquilina, Teophile Gaillot, Gwenaelle Le Bouar, Alain Beuchee, Olivier Azzis, Benjamin Fremond, Edouard Habonimana, Alexis P Arnaud","doi":"10.1016/j.jpedsurg.2026.163173","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2026.163173","url":null,"abstract":"<p><strong>Aim: </strong>Surgical repair of large congenital diaphragmatic hernia (CDH) remains a challenge. Although many different procedures are described, none has become a 'gold standard'. This study aimed to evaluate long-term results of the single muscle flap repair to avoid using a prosthetic patch.</p><p><strong>Materials and methods: </strong>After institutional review board approval (#15.92), we conducted a retrospective study including all neonates who underwent single transversus abdominis muscle flap repair as first-line treatment for large CDH between 1995 and 2023 in our institution. Survivors were assessed clinically for growth, hernia recurrence, surgical complications, abdominal deformities, chest wall deformities and scoliosis. Data are reported as medians with ranges.</p><p><strong>Results: </strong>Twenty-seven patients underwent surgical repair at a median age of 29 hours of life (4-96). All had an antenatal diagnosis, and 25 (92.6%) were left-sided defects. Twenty-two patients survived to hospital discharge and were available for long-term follow-up. At a median follow-up of 8.9 years (0.5-19.1), no diaphragmatic hernia recurrence was observed. Minor donor-site abdominal wall bulging occurred in 5 patients (23.8%), and 1 patient (4.5%) developed an abdominal wall hernia. Adhesive bowel obstruction requiring surgery occurred in 5 patients (22.7%). Pectus deformities were observed in 7 patients (33.3%). Thoracogenic scoliosis occurred in 7 patients (33.3%), with surgical treatment required in one case.</p><p><strong>Conclusion: </strong>Single transversus abdominis muscle flap repair provides durable closure of large congenital diaphragmatic hernia defects with no recurrence at long-term follow-up and acceptable morbidity. This technique represents a reliable alternative to prosthetic patch repair for large diaphragmatic defects.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163173"},"PeriodicalIF":2.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839403","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":"Repeat Pelvic Osteotomy Improves the Management of Failed Bladder Closure in Cloacal Exstrophy.","authors":"Chad B Crigger, Erin Mayeux, Jason Yang, Marjorie M Johnson, David Heap, Isam Nasr, Heather DiCarlo, Paul D Sponseller, John P Gearhart","doi":"10.1016/j.jpedsurg.2026.163174","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2026.163174","url":null,"abstract":"<p><strong>Purpose: </strong>The authors evaluated the operative benefits of repeat pelvic osteotomy in patients with cloacal exstrophy (CE) undergoing secondary or tertiary bladder closures.</p><p><strong>Methods: </strong>CE patients undergoing secondary or tertiary closures between 1975-2025 were identified. Primary pelvic osteotomy was defined as a patient's first osteotomy. Repeat osteotomy refers to the patient's subsequent osteotomy performed at the time of reclosure. Patient demographics, surgical factors, and outcomes were collected.</p><p><strong>Results: </strong>Among 35 secondary closures, 19 succeeded while 16 failed. A longer interval between primary and secondary closures (1.72 years vs. 0.64 years, p=0.0031) as well as primary and repeat osteotomies (4.23 years vs. 0.86 years, p = 0.037) was associated with higher success of secondary closures compared to failure. Primary and repeat osteotomies were significantly associated with secondary closure success while secondary closures without osteotomies had higher failure rates (p=0.02). For secondary closures, 8 patients did not receive an osteotomy. Regarding the type of osteotomy, combined vertical and transverse anterior innominate osteotomies were associated with higher successes in secondary closures (n=16, 61.11% vs. n=1, 11.11%), whereas posterior iliac only osteotomies were more likely to result in failure (n=5, 27.78% vs. n=7, 77.78%, p=0.02). Regarding immobilization techniques, the use of Buck's traction with external fixation for secondary bladder closure resulted in higher success rates, while the use of Spica casting, resulted in higher failure rates. (n=16, 63.16% vs. n=13, 25%, p=0.02). Secondary closure success was significantly higher at the authors' institution compared to outside hospitals with (n=13, 68.42% vs. n=6, 31.58%, p=0.0016).</p><p><strong>Conclusion: </strong>Repeat pelvic osteotomy enhanced secondary closure success in CE patients. Osteotomy techniques using combined vertical and transverse anterior innominate osteotomies, as well as the use of Buck's traction with external fixation, were particularly beneficial. These findings suggest that repeat osteotomy along with appropriate immobilization can enhance surgical outcomes in complex CE management of secondary bladder closures.</p><p><strong>Type of study: </strong>Treatment Study LEVEL OF EVIDENCE: Level III.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163174"},"PeriodicalIF":2.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839406","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":"Surgical approach to the management of biliary atresia in the United States.","authors":"Alyssa Stetson, Anne M Sescleifer, Anastasia M Kahan, Shaun M Kunisaki, Samuel M Alaish, Benjamin Padilla, Dave R Lal, Greg Tiao, Natasha Corbitt, Mark B Slidell","doi":"10.1016/j.jpedsurg.2026.163179","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2026.163179","url":null,"abstract":"<p><strong>Background: </strong>The Kasai portoenterostomy (KPE) is the only option to achieve native liver survival for patients with biliary atresia and yet technical variations exist. We surveyed members of three American pediatric surgery research consortia regarding their approach to the KPE.</p><p><strong>Methods: </strong>Members from the Eastern Pediatric Surgery Network (EPSN), Midwestern Pediatric Surgery Consortium (MWPSC), and Western Pediatric Surgery Research Consortium (WPSRC) developed the survey which was distributed via REDCap to consortia member institutions.</p><p><strong>Results: </strong>The survey was completed by 44/45 institutions. KPE is performed by pediatric surgeons at 41 sites (93%), a transplant surgeon at one (2%), and both at two (5%). Twenty-six sites (59%) transected into the liver capsule, 10 (23%) into the liver, two (5%) into the fibrous cord, and 6 (14%) reported variance. One site (2%) reported use of cautery in addition to sharp dissection for porta hepatis transection. The most common length for the Roux limb was 25-35 cm (16, 36%), with 14 sites (32%) creating a Roux limb < 25 cm, eight sites (18%) > 35 cm, and 6 sites (14%) responding that length varies between surgeons. Surgical diagnosis with intraoperative cholangiogram (IOC) was always performed at 33 sites (75%), and twenty-eight sites (64%) obtain both preoperative percutaneous and intraoperative biopsies. Two sites (5%) offer partially laparoscopic KPE.</p><p><strong>Conclusion: </strong>In the first survey of American surgical practices for KPE, we found consensus regarding some technical aspects of the operation. However, the responses to most questions demonstrated variability. Future studies will analyze how technical variations impact national KPE outcomes.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163179"},"PeriodicalIF":2.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839440","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":"Should We Continue to Follow the Swallow? Limited Value of Routine Preoperative Upper Gastrointestinal (UGI) Series in Pediatric and Adolescent Metabolic and Bariatric Surgery Patients.","authors":"Jiyun Lim, Aimee G Kim, Alaina P Vidmar, My H Vu, Kamran Samakar, Matthew J Martin, Stuart A Abel, Gisell Figueroa Belteton, Harry J Wong","doi":"10.1016/j.jpedsurg.2026.163177","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2026.163177","url":null,"abstract":"<p><strong>Background: </strong>Hiatal hernia is frequently encountered intraoperatively during metabolic and bariatric surgery (MBS) in adults with relatively poor diagnostic accuracy on preoperative imaging. However, data on pediatric MBS populations is limited. We aimed to determine the prevalence of hiatal hernias in a pediatric bariatric cohort and evaluate the utility of preoperative upper gastrointestinal (UGI) series.</p><p><strong>Methods: </strong>We conducted a retrospective review of 94 patients who underwent preoperative UGI series and sleeve gastrectomy from November 2023 to July 2025. Primary outcomes were the prevalence of hiatal hernias on UGI, concordance between UGI and intraoperative findings, and associations with reflux symptoms.</p><p><strong>Results: </strong>Hiatal hernia was identified in one patient (1.1%) on preoperative UGI series, which was consistent with intraoperative findings of a hiatal hernia in the same patient who underwent repair. Gastroesophageal reflux was identified on UGI in 19/90 patients (21%). Of 7 patients (7.4%) who had reflux symptoms preoperatively, only 3 had reflux on UGI. Three months postoperatively, 4/90 patients (4.4%) reported reflux symptoms, 2 of whom had preoperative symptoms and reflux on UGI.</p><p><strong>Conclusions: </strong>The prevalence of hiatal hernias in the pediatric MBS population is exceedingly low, and preoperative UGI findings failed to demonstrate meaningful findings. This suggests that UGI is not a useful predictive tool in this setting and routine preoperative evaluation for hiatal hernias may not be warranted.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163177"},"PeriodicalIF":2.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839435","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":"Assessing the Value of Postnatal Echocardiograms Prior to Congenital Duodenal Obstruction Repair.","authors":"Jessica G Wright, Sophia G Hameedi, Karen Texter, Meghan E Hovell, Carly G Schafer, Andrew J Inamdar, Ahmed Kamr, Lourenço Sbragia, Oluseyi Ogunleye, Oluyinka O Olutoye","doi":"10.1016/j.jpedsurg.2026.163176","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2026.163176","url":null,"abstract":"<p><strong>Background: </strong>Congenital duodenal obstruction (CDO) is surgically repaired in the immediate postnatal period; however, its association with congenital heart disease warrants preoperative evaluation of cardiac physiology. Given the availability and accuracy of prenatal echocardiography, we sought to determine the value of an additional postnatal preoperative echocardiogram.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted via chart review on patients diagnosed with CDO at a tertiary children's hospital from January 2013 to December 2023. Echocardiogram findings were reviewed, and defects were divided based on primary physiology.</p><p><strong>Results: </strong>Of the 90 patients with CDO, 31 (34%) patients had an associated cardiac anomaly--20 (65%) shunting lesions, 7 (23%) conotruncal anomalies, and 1 (2%) each had: single ventricle physiology, partial anomalous pulmonary venous return (PAPVR), and a vascular ring. Forty (44%) patients had an associated syndrome or chromosomal abnormality. Prenatal echocardiogram had a positive predictive value of 100% [80-100%], negative predictive value of 78% [58-100%], sensitivity of 75% [53-89%], and specificity of 100% [82-100%] for finding the described anomalies (p<0.0001). Of the 38 patients who had both prenatal and postnatal echocardiograms, 5 (13%) had a ventricular septal defect identified postnatally that was not seen prenatally. There were no false positive findings prenatally.</p><p><strong>Conclusion: </strong>In the presence of a prenatal echocardiogram, a postnatal echocardiogram is unlikely to identify a clinically significant additional cardiac anomaly that may impact CDO repair. Our data suggests that surgical repair of CDO need not be delayed for a postnatal echocardiogram if a prenatal echocardiogram was performed.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163176"},"PeriodicalIF":2.5,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839393","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":"Parental satisfaction with telemedicine follow-up after pediatric surgery: A cross-sectional study","authors":"Ahmed Abdelmohsen","doi":"10.1016/j.jpedsurg.2026.162976","DOIUrl":"10.1016/j.jpedsurg.2026.162976","url":null,"abstract":"<div><h3>Background</h3><div>Telemedicine has transitioned from emergency pandemic response to routine postoperative pediatric surgical care, yet evidence regarding parental satisfaction with sustained implementation remains limited, particularly using validated instruments across different modalities.</div></div><div><h3>Objective</h3><div>To evaluate parental satisfaction with telemedicine follow-up after pediatric surgery and identify key factors associated with satisfaction during the post-COVID-19 adoption period.</div></div><div><h3>Methods</h3><div>Cross-sectional survey of 327 parents whose children received telemedicine follow-up (video or phone) between January 2021 and December 2024. Satisfaction was measured using an adapted Telehealth Usability Questionnaire (TUQ). Multivariable logistic regression identified independent predictors of high satisfaction.</div></div><div><h3>Results</h3><div>Mean satisfaction score was 4.28/5 (SD 0.51), with 82.0 % reporting high satisfaction (TUQ ≥4.0). Video consultations (adjusted OR 1.78, 95 % CI 1.10–2.89, p = 0.018) and absence of technical problems (adjusted OR 3.14, 95 % CI 1.63–6.05, p = 0.001) independently predicted satisfaction. Safety outcomes were reassuring: 7.0 % required unscheduled in-person visits and 4.6 % presented to emergency departments within 14 days, with no significant differences between modalities. Nearly 72 % of parents preferred telemedicine for future follow-up appointments.</div></div><div><h3>Conclusions</h3><div>Telemedicine demonstrates high parental satisfaction with acceptable safety outcomes in routine postoperative pediatric surgical care. Video capability and technical reliability are critical satisfaction drivers. These findings support integration of telemedicine into standard care pathways with attention to infrastructure quality and family-centered flexibility.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"61 5","pages":"Article 162976"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125456","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":"A multicenter retrospective analysis by the Korean association of pediatric surgeons comparing laparoscopic and open surgical repair of congenital duodenal obstruction","authors":"Jinyoung Park ,&nbsp;Dayoung Ko ,&nbsp;Eun-jung Koo ,&nbsp;Hyunhee Kwon ,&nbsp;Ki Hoon Kim ,&nbsp;Dae Yeon Kim ,&nbsp;Seong Chul Kim ,&nbsp;Soo-Hong Kim ,&nbsp;Wontae Kim ,&nbsp;Hae-Young Kim ,&nbsp;Hyun-Young Kim ,&nbsp;So Hyun Nam ,&nbsp;Jung-Man Namgoong ,&nbsp;Junbeom Park ,&nbsp;Taejin Park ,&nbsp;Min-Jung Bang ,&nbsp;Jeong-Meen Seo ,&nbsp;Ji-Young Sul ,&nbsp;Joonhyuk Son ,&nbsp;Joohyun Sim ,&nbsp;Jeong Hong","doi":"10.1016/j.jpedsurg.2026.162948","DOIUrl":"10.1016/j.jpedsurg.2026.162948","url":null,"abstract":"<div><h3>Background</h3><div>This multicenter retrospective study aimed to compare key perioperative outcomes such as operative time, time to full enteral feeding, hospital stay duration, postoperative complications, and mortality, between laparoscopic and open surgical repair of congenital duodenal obstruction (CDO) performed by members of the Korean Association of Pediatric Surgeons (KAPS).</div></div><div><h3>Methods</h3><div>A national survey conducted between 2021 and 2023 provided data from 75 patients. Demographic characteristics, associated anomalies, anatomical types, surgical approach, and postoperative outcomes were compared between the laparoscopic (n = 36) and open (n = 39) groups.</div></div><div><h3>Results</h3><div>Among the 75 patients (30 males, 45 females; male-to-female ratio 1:1.5), no significant differences were observed between groups in sex, birth weight, or gestational age. Surgical procedures included 66 duodenoduodenostomies, four duodenojejunostomies, two gastrojejunostomies, two web excisions with duodenoplasty, and one segmental duodenal resection. Laparoscopic repair was associated with longer operative times (<em>p</em> = 0.005). Time to full enteral feeding was comparable in both groups (<em>p</em> = 0.117). Hospital stay was significantly shorter in the laparoscopic group (<em>p</em> = 0.012). Postoperative complications and mortality did not differ between groups; no deaths occurred.</div></div><div><h3>Conclusion</h3><div>Laparoscopic repair can be considered a safe and effective alternative to open surgery for selected patients with CDO, assuming adequate surgical expertise.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"61 5","pages":"Article 162948"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046822","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 use of the acellular dermal matrix in microtia reconstruction to decrease donor site morbidity after temporo-parietal fascia harvest","authors":"Maria Ida Rizzo ,&nbsp;Jacopo Maria Frattaroli ,&nbsp;Francesca Nascimben ,&nbsp;Marco Cirillo ,&nbsp;Marta Umbaca ,&nbsp;Marta Cajozzo ,&nbsp;Gaetano Paolo Dicorato ,&nbsp;Francesca Grussu ,&nbsp;Rossella Angotti ,&nbsp;Simone Faustino Marino ,&nbsp;Francesco Molinaro ,&nbsp;Giorgio Spuntarelli ,&nbsp;Urbano Urbani ,&nbsp;Mario Zama","doi":"10.1016/j.jpedsurg.2025.162753","DOIUrl":"10.1016/j.jpedsurg.2025.162753","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine whether and how the use of an acellular dermal matrix (ADM) underneath a scalp flap after temporal fascia harvest reduces postoperative donor-site complications in microtia surgery.</div></div><div><h3>Methods</h3><div>This case‒control study included patients with congenital microtia who underwent primary ear reconstruction with porous polyethylene implants between 2018 and 2021. Group No-ADM patients (2018–2019), Group ADM patients (2020–2021). The skin quality outcomes of the scalp flap after temporal fascia harvest were analysed through pinch tests and ultrasound imaging. Aesthetical and psychosocial outcomes were tested with standardized questionnaires that were administered to the patients and their parents.</div></div><div><h3>Results</h3><div>20 patients (60 % male), 8 (40 %) in the No-ADM group and 12 (60 %) in the ADM group. Re-do surgery rate was higher in the No-ADM group than in the ADM group (17.5 % vs 5 %; p &lt; 0.05). The pinch test was used to assess the recovery of tissue elasticity in the 100 % ADM group, and it was negative in the 75 % No-ADM group (p &lt; 0.05). The median US thickness was 4.87 mm in the No-ADM group and 4.48 mm in the ADM group (p = 0.37). Aesthetic analysis revealed higher satisfaction levels among patients in the ADM group than in those in the non-ADM group. There was no significant difference in terms of quality of life between the two groups.</div></div><div><h3>Conclusions</h3><div>ADM use decreases local morbidity after facial harvest in the temporoparietal region. The greater thickness of the skin in the No-ADM group despite the absence of the ADM was probably due to greater fibrogenesis, which was limited by the ADM in the ADM group. In conclusion, ADM reduces the risk of postoperative subcutaneous scar adhesions.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"61 5","pages":"Article 162753"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145422016","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":"Thoracoscopic near-infrared localization and division of H-type tracheoesophageal fistulas in newborns: A case series","authors":"Xun Guo ,&nbsp;Yao Liu ,&nbsp;Qiang Yu ,&nbsp;Qianlong Liu ,&nbsp;Xiang Ji ,&nbsp;Chunlin Miao ,&nbsp;Peng Li","doi":"10.1016/j.jpedsurg.2026.162949","DOIUrl":"10.1016/j.jpedsurg.2026.162949","url":null,"abstract":"<div><h3>Purpose</h3><div>Congenital H-type tracheoesophageal fistula (H-TEF) is a rare congenital esophageal malformation. Treatment involves minimally invasive surgery; however, accurate fistula localization remains challenging. Real-time imaging via near-infrared (NIR) thoracoscopy facilitates the distinction between different tissue structures. Therefore, we aimed to evaluate the clinical efficacy of the NIR-thoracoscopic simple clip method for treating congenital H-TEFs in neonates.</div></div><div><h3>Methods</h3><div>Neonates with H-TEFs underwent thoracoscopic NIR localization using indocyanine green (ICG) injection, followed by clipping and division. The inclusion criteria were: (1) H-TEF confirmed by esophagography and/or bronchoscopy, (2) fistula below T2 level, (3) birth weight ≥2.0 kg, and (4) parental consent. The exclusion criteria were: (1) severe cardiopulmonary malformations/coagulopathy, (2) prior TEF repair, and (3) surgical contraindications. After successful general anesthesia, the patient was placed in the supine position, and ICG (0.1 mg/mL) was injected into the fistula lumen under bronchoscopic guidance. The patient was then moved to the right supine position for the thoracoscopic surgery.</div></div><div><h3>Results</h3><div>Six neonates (male: 4, female: 2; median operative age: 7 days, range: 3–15 days; birth weight: 2.8 kg, range: 2.1–3.5 kg). They presented with dyspnea (6/6), cyanosis during feeding (6/6), and persistent pulmonary infection (4/6). The median operative time was 65 min (range: 53–77 min), and blood loss was &lt;5 mL. Transient hoarseness occurred in one patient (resolved in 7 days). No recurrences or strictures were observed during follow-up (median, 18 months).</div></div><div><h3>Conclusion</h3><div>Preoperative bronchoscopic ICG injection facilitates NIR thoracoscopic localization and dissection of intrathoracic H-TEFs in newborns.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"61 5","pages":"Article 162949"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093332","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}