Journal of pediatric surgery最新文献

{"title":"Endovascular Stenting in Pediatric Trauma: A Critical Analysis of Long-Term Outcomes and Follow-Up Gaps.","authors":"Mifta Rizka, Rizky Andana Pohan, Santy Andrianie","doi":"10.1016/j.jpedsurg.2025.162735","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2025.162735","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162735"},"PeriodicalIF":2.5,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275042","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":"Response to \"Exercise-induced ectopy and its relationship to fitness, cardiac function, and markers of severity in youth with pectus excavatum\".","authors":"Yasmine Houas, Said Jlidi","doi":"10.1016/j.jpedsurg.2025.162725","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2025.162725","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162725"},"PeriodicalIF":2.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Congenital diaphragmatic hernia: exclusion criteria for repair or ECMO?","authors":"Michelle J Yang, Christian C Yost, Ryan J Carpenter, Anastasia M Kahn, Stephen J Fenton, Katie W Russell, Bradley A Yoder","doi":"10.1016/j.jpedsurg.2025.162721","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2025.162721","url":null,"abstract":"<p><strong>Background: </strong>Mortality in congenital diaphragmatic hernia (CDH) approximates 30%. Both severe lung hypoplasia and other anomalies contribute to demise regardless of repair and/or extracorporeal membrane oxygenation (ECMO). We report clinical and physiological parameters for CDH infants not offered repair or ECMO (NoR/ECMO).</p><p><strong>Methods: </strong>A single center retrospective analysis of 364 CDH infants managed from 01/2003 - 12/2024. We analyzed reasonings to not offer repair or ECMO in 49 infants (13%) across two time epochs. We compared the outcomes of infants that did or did not meet 3 possible lethal lung hypoplasia criteria based on maximum SpO₂ and minimum paCO₂ in the first 24 hours of life.</p><p><strong>Results: </strong>Concurrent anomalies (n=27, 55%), prematurity < 34 weeks gestation (n=17, 35%), and/or severe lung hypoplasia (n=15, 30%) were the most common reasons for NoR/ECMO; multiple reasons occurred in 19 (39%). There were no differences between epochs for NoR/ECMO. We assessed 3 combinations of highest SpO₂ and lowest paCO₂ in the first 24 hours of life on outcomes. Only 9/364 (2.5%) patients had both highest SpO₂ < 85% and lowest paCO₂ > 75 mmHg; none were offered ECMO or repair. Another 15 infants met one or the other criteria; 4 were offered ECMO and repair with no survivors.</p><p><strong>Conclusion: </strong>In our center, severe concurrent anomalies, prematurity, and severe lung hypoplasia accounted for 90% of all CDH infants not offered repair or ECMO. Failure to achieve either SpO₂ ≥ 85% and/or paCO₂ ≤ 75 mmHg within the first 24 hours of life despite optimal medical management was uncommon but consistent with lethal lung hypoplasia.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162721"},"PeriodicalIF":2.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258571","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":"Letter to the Editor: Odds Ratios versus Risk Ratios: Rejuvenating an Important Debate and an Opportunity to Learn.","authors":"Fabiola Cassaro, Stefania Mondello, Pietro Impellizzeri, Martina Maiorana, Carmelo Romeo, Salvatore Arena","doi":"10.1016/j.jpedsurg.2025.162724","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2025.162724","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162724"},"PeriodicalIF":2.5,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258533","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 Robotic Gynecologic Surgery: A Retrospective Institutional Experience and Systematic Review.","authors":"Giulia Fusi, Carlo Maria Ferlini, Veronica Vitali, Alessandro Raffaele, Luigi Avolio, Giovanna Riccipetitoni, Mirko Bertozzi","doi":"10.1016/j.jpedsurg.2025.162713","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2025.162713","url":null,"abstract":"<p><strong>Introduction: </strong>While robotic-assisted surgery has been shown to be safe and feasible for various pediatric conditions, its applicability in pediatric gynecologic surgery remains understudied in pediatric populations. This study contributes institutional data and a literature review to assess the feasibility, safety, and clinical role of robotic surgery in pediatric gynecology.</p><p><strong>Materials and methods: </strong>We conducted a retrospective analysis of medical records from our institution over the past decade, focusing on all girls undergoing robotic gynecological procedures. Parameters such as operative time, length of hospital stay (LOS), complication rate, conversion rate, and pathology were assessed.</p><p><strong>Results: </strong>Twenty-nine girls (median age 13.15 years, median weight 52 kg) underwent various robotic procedures including ovarian cystectomy (n=15), tubal/paratubal cyst excision (n=6), salpingo-oophorectomy for complex masses (n=2), gonadectomy for gonadal dysgenesis (n=2), robotic excision of uterine horn for bicornuate uterus (n=2) and removal of Müllerian remnants (n=2). Median operative time was 103 minutes, with no conversions. Median LOS was 2 days (range 1-5). One minor complication was recorded (Clavien Dindo I) (1/29, 3.4%).</p><p><strong>Conclusions: </strong>Our review of 29 pediatric patients highlights the safety and efficiency of a robot-assisted approach to pelvic and internal female genitalia procedures, with a zero-major complication rate across all cases. These findings support the feasibility of robotic surgery in managing complex gynecological conditions in children. However, definitive evidence comparing its outcomes to traditional laparoscopy is still lacking. Well-designed prospective, randomized studies are essential to establish the gold standard for these indications.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162713"},"PeriodicalIF":2.5,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251740","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":"Postnatal outcomes of in utero repair of simple gastroschisis in an ovine model.","authors":"Emily Byrd, Jamie E Anderson, Juan Maria Geronimo Lopez, Su Yeon Lee, Monalisa Hassan, Chris Pivetti, Michele Persiani, Sina Vatoofy, Zoe Saenz, Steven J McElroy, Geoanna M Bautista, Shinjiro Hirose","doi":"10.1016/j.jpedsurg.2025.162720","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2025.162720","url":null,"abstract":"<p><strong>Background: </strong>Gastroschisis is a congenital abdominal wall defect resulting in fetal bowel evisceration, causing significant postnatal morbidity, including prolonged bowel dysmotility and increased susceptibility to life-threatening infections. This study aimed to optimize an ovine model of gastroschisis by evaluating defect size to improve fetal survival and assess the impact of in utero repair (IUR) on postnatal outcomes.</p><p><strong>Methods: </strong>Ovine gastroschisis defect creation was achieved with a 2 or 3 cm abdominal wall defect at gestational age (GA) 76-82 days. Fetuses underwent repair either in utero at GA 101-107 or at birth via ex utero intrapartum treatment (EXIT) at GA 139-143. Postnatal outcomes included weight gain and bowel motility. Bowel histology, qRT-PCR of intestinal cytokines, and amniotic fluid cytokine analyses were performed.</p><p><strong>Results: </strong>Initial defect size increase (1.5 to 3 cm) resulted in high rates of ring dislodgement (71%) and associated complications, which significantly improved with a 2 cm defect. Six lambs survived to delivery (four IUR and two EXIT). IUR lambs demonstrated significantly higher weight gain compared to EXIT lambs (p = 0.007) and faster barium clearance (64-84 hours vs. 89- >168 hours). Histologic intestinal damage was reduced in IUR animals vs. EXIT. IL-6 and IL-17A expression were increased in IUR intestine, while IFN-γ was increased in EXIT bowel. Amniotic fluid cytokine analysis demonstrated variability.</p><p><strong>Conclusions: </strong>We describe an optimized model of ovine simple gastroschisis with in utero repair. Postnatal outcomes suggest IUR may enhance bowel motility, reduce intestinal damage, and modulate inflammatory responses more effectively than EXIT repair.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162720"},"PeriodicalIF":2.5,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238894","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 Surgery and Healthcare Quality: Historical Exemplars of Quality Improvement and the Seven Basic Tools of Quality.","authors":"Edward P Tagge, Steven L Raymond, Joyce McRae, Loren Berman, Monica Barry, Daniel G Tagge, Mehul V Raval, Faraz A Khan","doi":"10.1016/j.jpedsurg.2025.162718","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2025.162718","url":null,"abstract":"<p><strong>Level of evidence: </strong>V.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162718"},"PeriodicalIF":2.5,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232579","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":"Letter to the Editor \"Testicular pain in children: Near-infrared spectroscopy cannot differentially diagnose underlying\".","authors":"Asma Jabloun, Aida Daib, Youssef Hellal","doi":"10.1016/j.jpedsurg.2025.162714","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2025.162714","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162714"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225521","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":"Minimal Invasive Duodenal Atresia Repair - Does Surgical Technique of Anastomosis Matter? A Systematic Review and Meta-analysis.","authors":"Tobias Jhala, Jonathan Aichner, Lea Berger, Justus Lieber, Tobias Luithle, Philipp Szavay, Jörg Fuchs","doi":"10.1016/j.jpedsurg.2025.162493","DOIUrl":"10.1016/j.jpedsurg.2025.162493","url":null,"abstract":"<p><strong>Introduction: </strong>Minimally invasive repair of duodenal atresia has gained widespread popularity since its introduction in 2001. While the diamond-shaped (DS) anastomosis is considered the gold standard in open surgery and superior to the side-to-side (SS) anastomosis, the SS anastomosis has regained popularity in minimally invasive repairs of duodenal atresia. To date, no comprehensive review has assessed the impact of anastomotic technique on outcomes in minimally invasive duodenal atresia repair. This systematic review evaluates the impact of DS versus SS anastomosis on complications and outcomes in laparoscopic duodenal atresia repair.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted from January 2001 to December 2024 across PubMed, EMBASE, and Web of Science to identify studies reporting on minimally invasive duodenal atresia repair with hand-sewn anastomosis. Thirteen studies, including 288 patients (159 DS, 129 SS), were included. Primary outcomes analyzed included operative time, conversion rate, time to feeding, and length of hospital stay. Secondary outcomes focused on postoperative complications, including anastomotic leaks and strictures. Statistical analyses were performed using Mann-Whitney U tests and Fisher's exact tests.</p><p><strong>Results: </strong>No significant differences were found between DS and SS with regard to operative time, time to initial or full feeding, or hospital stay. The DS group had a higher conversion rate (11 % vs. 3 %, p = 0.01), but no significant difference was observed in overall complications, stricture rates, or time to feeding. Notably, the DS group had a significantly higher incidence of anastomotic leakage (p = 0.03), primarily driven by a single study. The leakage rate was lower in studies using a continuous running suture for the DS anastomosis.</p><p><strong>Conclusion: </strong>In laparoscopic duodenal atresia repair, the SS anastomosis is not inferior to the DS technique in terms of operative time, hospital stay, or feeding outcomes. The DS technique carries a higher risk of anastomotic leakage, which can be mitigated with the use of a continuous suture technique. Both techniques are equally safe for minimally invasive duodenal atresia repair, suggesting that SS offers a viable alternative to DS.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162493"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765019","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":"Outcomes of Vacuum-Assisted and Conventional Wound Management in Pediatric Abdominal Surgery: A Retrospective Study From a Resource-Limited Setting.","authors":"Vaibhav Pandey, Shashi Prakash Mishra, Marripati Bhanumurthy Kaushik, Manish Khobragade, Sunil Kumar Singh Gaur, Ruchira Nandan","doi":"10.1016/j.jpedsurg.2025.162495","DOIUrl":"10.1016/j.jpedsurg.2025.162495","url":null,"abstract":"<p><strong>Background: </strong>Complicated abdominal wounds following pediatric laparotomy, particularly in cases of enterocutaneous fistulae, trauma, or re-exploration, present significant management challenges, especially in resource-limited settings. Despite evidence supporting vacuum-assisted closure (VAC) therapy in adults, its use in pediatric populations remains limited.</p><p><strong>Aim: </strong>This study aimed to evaluate and compare the outcomes of vacuum-assisted and conventional wound management techniques in pediatric abdominal surgery within a resource-constrained environment.</p><p><strong>Methods: </strong>A retrospective observational study was conducted at a tertiary pediatric surgical centre in Northern India from January 2016 to December 2024. A total of 43 children (0-18 years) with complicated postoperative abdominal wounds were included. Patients were divided into two groups: Group 1 (n = 19) underwent traditional wound closure, while Group 2 (n = 24) received wound management using VAC therapy or simple wound manager systems. Primary outcomes were time to wound healing and incidence of wound-related complications. Secondary outcomes included hospital stay, re-exploration, and spontaneous fistula closure.</p><p><strong>Results: </strong>The wound manager group showed a slightly longer median healing time (15 vs. 12 days) but had zero re-explorations compared to three cases in the traditional group (p = 0.0011). VAC therapy led to earlier granulation (median 6 vs. 10 days), greater complete epithelialization (80 % vs. 40 %, p = 0.04), and spontaneous closure in 20 % of enterocutaneous fistulas. Four patients continued VAC therapy at home without complications.</p><p><strong>Conclusion: </strong>VAC and simple wound manager systems are effective in managing complex pediatric abdominal wounds, reducing the need for reoperation and enhancing healing outcomes. Their adoption in low-resource settings could significantly improve pediatric surgical care.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162495"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765020","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}