Journal of pediatric surgery最新文献

{"title":"Predicted surgical risk does not establish benefit from preoperative drainage: Comment on yang et al.","authors":"Xin Wang","doi":"10.1016/j.jpedsurg.2026.163496","DOIUrl":"10.1016/j.jpedsurg.2026.163496","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163496"},"PeriodicalIF":2.3,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030935","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":"Invited commentary on: The bumpy road to retirement: Current practices, perspectives, and the need for formal transition pathways in pediatric surgery.","authors":"Mary L Brandt, Loren Berman","doi":"10.1016/j.jpedsurg.2026.163495","DOIUrl":"10.1016/j.jpedsurg.2026.163495","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163495"},"PeriodicalIF":2.3,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030949","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":"Protecting children through product safety: progress, peril and the role of pediatric surgeons.","authors":"Shanquell Dixon, Ashley Carducci, Nina Kosciuszek, Alexa Turpin, Joanne E Baerg","doi":"10.1016/j.jpedsurg.2026.163493","DOIUrl":"10.1016/j.jpedsurg.2026.163493","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163493"},"PeriodicalIF":2.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025164","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":"Report on the 35th annual meeting of the International Pediatric Endosurgery Group.","authors":"Pablo Laje","doi":"10.1016/j.jpedsurg.2026.163486","DOIUrl":"10.1016/j.jpedsurg.2026.163486","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163486"},"PeriodicalIF":2.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025086","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":"Recurrent small bowel obstruction following contrast challenge versus surgical intervention at index presentation:1-year follow-up of the adhesive bowel obstruction in children (ABC) study.","authors":"K Elizabeth Speck, Elizabeth A Gilliam, Kyle J Van Arendonk, Ronald B Hirschl, Seth D Goldstein, Charles M Leys, Troy A Markel, Beth Rymeski, Tiffany Wright, Shawn D St Peter, Dave R Lal, Grace Mak, Nikhil R Shah, Ihab F Halaweish, Katherine C Bergus, Cory N Criss, Samantha A Ayala, Suhail Zeineddin, Devashish S Joshi, Matthew P Landman, Sindhu Mannava, Stephen Trinidad, Stewart R Carter, Christina Georgeades, Andrew Yeh, Baddr Shakhsheer, Katherine T Flynn-O'Brien, Peter C Minneci","doi":"10.1016/j.jpedsurg.2026.163490","DOIUrl":"10.1016/j.jpedsurg.2026.163490","url":null,"abstract":"<p><strong>Aim: </strong>Long-term outcomes after contrast challenge (CC) in pediatric adhesive small bowel obstruction (ASBO) are unknown. This study assesses ASBO recurrence and need for surgical intervention within 1-year of ASBO admission.</p><p><strong>Methods: </strong>We performed a multi-institutional prospective implementation study of a standardized CC algorithm in children (≤18 years) admitted with ASBO (10/2021-09/2024). Patients requiring urgent/emergent surgery were excluded. Readmission for ASBO recurrence was monitored for 1 year after index admission. Nonparametric tests were performed to compare groups.</p><p><strong>Results: </strong>Of the 264 patients enrolled, 262 patients (99%) were alive for 1-year follow-up; neither death was related to ASBO or CC exposure. Within 1 year, 35 patients (13%) had a recurrent ASBO; 19 (54%) were ultimately managed surgically. Recurrence was not associated with prior contrast administration (14% CC vs 12% no CC; p = 0.70) or failure of non-operative management (NOM) (12% surgery vs 14% no surgery; p = 0.55) at 1 year. Similarly, failure of NOM for recurrent ASBO was not different based on CC (50% CC vs 67% no CC; p = 0.39) or prior failure of NOM (73% previous failed NOM vs 45% successful NOM; p = 0.14). There was no difference in recurrence based on NOM outcome in CC patients (15% successful NOM vs 11% failed NOM, p = 0.51).</p><p><strong>Conclusion: </strong>In the largest, prospective pediatric ASBO study, the 1-year ASBO recurrence rate was 13%, regardless of prior management strategy - neither contrast challenge nor surgery at index admission for ASBO affected ASBO recurrence or subsequent failure of NOM. Utilizing a CC for recurrent ASBO remains a valuable diagnostic tool to discern operative needs.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163490"},"PeriodicalIF":2.3,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017197","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 patch repair of large congenital diaphragmatic hernia defects is safe and associated with low recurrence rate.","authors":"Marta Gazzaneo, Athanasios Tyraskis, Laura Privitera, Stefano Giuliani, Dhanya Mullassery, Sonia Basson, Kate Cross, Simon Blackburn, Joseph Curry, Stavros P Loukogeorgakis, Simon Eaton, Paolo De Coppi","doi":"10.1016/j.jpedsurg.2026.163451","DOIUrl":"10.1016/j.jpedsurg.2026.163451","url":null,"abstract":"<p><strong>Background: </strong>Thoracoscopic patch repair of congenital diaphragmatic hernia (CDH) remains challenging for large defects, with no consensus on optimal patch fixation technique. This study evaluates outcomes of thoracoscopic patch repair stratified by defect size and suturing technique and compares them with primary thoracoscopic repair.</p><p><strong>Methods: </strong>A retrospective review was performed of CDH patients undergoing thoracoscopic repair at a single tertiary centre (2019-2025). Primary outcomes were operative time and recurrence, stratified by defect size and suturing technique (interrupted vs. running), with secondary comparison with primary thoracoscopic repair.</p><p><strong>Results: </strong>Of 63 patients undergoing thoracoscopic CDH repair, 46 (73%) had patch repair; 39 (61.9%) were completed thoracoscopically (conversion rate 11.1%). Among patients receiving a patch 69.2% (27/39) had type C or D defects. Mean operative time was 154.4 ± 33.5 min. Type D defects were associated with significantly longer operative times than type B (189 ± 25 vs. 142 ± 24 min; p = 0.03). Recurrence occurred in 3/39 (7.7%) patients at a mean follow-up of 17 months; no significant association with defect size was identified (p > 0.99). Suturing technique did not significantly influence operative time (interrupted vs. running: 164 ± 33 vs.153 ± 33 min; p = 0.39) or recurrence (1.4%vs.3.8% at quadrant-level analysis; p > 0.05). Recurrence rates were comparable between thoracoscopic patch and primary repair groups (7.7%vs.5.9%; p > 0.99).</p><p><strong>Conclusions: </strong>Thoracoscopic patch repair of large CDH defects is feasible. Operative times and recurrence rate were comparable between suturing techniques. Larger multicentre studies are needed to validate these findings.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163451"},"PeriodicalIF":2.3,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017243","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":"Multicenter long-term outcomes of laparoscopic versus open Ladd's procedure for intestinal malrotation.","authors":"Nathan Aminpour, Trevor Marshall, Akasha Baretto, Zimin Zhuang, Albert Chong, Roman Sydorak","doi":"10.1016/j.jpedsurg.2026.163482","DOIUrl":"10.1016/j.jpedsurg.2026.163482","url":null,"abstract":"<p><strong>Purpose: </strong>The Ladd's procedure is the surgical treatment for symptomatic intestinal malrotation in children. Although laparoscopic techniques have gained popularity, there is concern that it may lead to decreased adhesion formation and thus increased susceptibility to volvulus. This study examined long-term outcomes of laparoscopic versus open Ladd's procedure.</p><p><strong>Methods: </strong>Retrospective review was conducted of 281 patients who underwent Ladd's procedure at a large integrated healthcare system from 2010 to 2024. Choice of technique (laparoscopic or open) was based on surgeon preference. 109 patients met inclusion criteria for this study. Exclusion criteria included prior abdominal surgery or intra-abdominal pathology such as gastroschisis, omphalocele or duodenal atresia.</p><p><strong>Results: </strong>Among the 109 patients, 73 (67.0%) underwent open surgery and 36 (33.0%) underwent laparoscopic surgery. Patients who underwent open Ladd's procedure had a reoperation rate of 9.6% (7/73) compared to 5.6% (2/36) in the laparoscopic group (OR 1.75, 95% CI 0.34-8.90; P = 0.72). Fourteen cases were converted laparoscopic to open. Within the open cohort, one patient required reoperation for volvulus and six for small bowel obstruction (SBO). Within the laparoscopic cohort, two patients required reoperation for SBO. The mean time from index operation to future surgery was 1.8 years (6 days-10.1 years).</p><p><strong>Conclusions: </strong>There was no increased risk of volvulus and a trend towards decreased risk of SBO with laparoscopic Ladd's procedure. Although more technically challenging, these findings may support the safety and long-term benefits of laparoscopic Ladd's procedure and suggest it can be considered as the initial treatment when feasible.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163482"},"PeriodicalIF":2.3,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001699","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 guidelines compliance and outcomes in Canada.","authors":"Pramod Puligandla, Robert Baird, Marc Beltempo, Seungwoo Lee, Alexandra Dimmer, Gabriel Altit, Elena Guadagno, Erik Skarsgard","doi":"10.1016/j.jpedsurg.2026.163448","DOIUrl":"10.1016/j.jpedsurg.2026.163448","url":null,"abstract":"<p><strong>Background: </strong>Perinatal congenital diaphragmatic hernia (CDH) care in Canada has been supported by comprehensive management guidelines published in 2018, with variable implementation/uptake across sites. We evaluated institutional compliance across 8 Key Performance Indicators (KPIs) and assessed differences in clinical outcomes.</p><p><strong>Methodology: </strong>The prospective CAPSNet patient database was interrogated. Patients pre- (2013-17) and post-guideline (2019-2023) publication were compared with a 1-year intervening washout. Neonates admitted to sites reporting >10 cases over each study epoch were included (8/16). The 8 KPI's addressed (1) prenatal diagnosis and risk stratification; (2) prenatal echocardiography; (3) prenatal genetic testing; (4) preoperative echocardiography; (5) use of GORE-tex™ or muscle flaps for non-primary repair; (6) pre-discharge echocardiography; (7) diagnosis and management of pulmonary hypertension; and (8) structured, long-term interdisciplinary follow-up. KPI compliance was dichotomized and defined as >70% of neonates exposed to the specific KPI. An institution was deemed \"guidelines compliant\" if ≥ 6/8 KPIs were achieved. Standard statistical analyses were performed, including regression analyses to calculate adjusted odds ratios (aOR).</p><p><strong>Results: </strong>The study cohort included 213 and 166 patients pre- and post-guideline publication, respectively. Overall network mortality was similar pre- (36/213; 16.9%) and post-guideline (22/166; 13.3%) publication. There was inter-site variability in individual KPI responsiveness to guidelines publication in both guidelines compliant (n = 2) and non-compliant (n = 6) sites. However, the two sites that achieved overall guidelines compliance (n = 114 comprising both pre- and post-guideline epochs) demonstrated a 3-fold pre-to post-implementation decrease in overall mortality (11.5% v 3.8%, aOR 0.36 [CI 0.06, 2.06]). Furthermore, compared to sites that remained non-compliant after guidelines publication, compliant sites demonstrated a lower mortality rate (3.8% v 17.7% aOR 5.51 [CI 1.2-25.38]) after adjustment using the CDH Study Group Mortality Prediction Score. Secondary outcomes (length of stay, aggregate complications, oxygen supplementation, enteral access) between compliant and non-compliant sites did not demonstrate a difference.</p><p><strong>Conclusions: </strong>Adherence to guidelines-driven KPIs is associated with improved survival in Canadian CDH patients. Dissemination and implementation of existing guidelines recommendations, and understanding both barriers and enablers of site-specific adoption can meaningfully impact patient outcomes.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163448"},"PeriodicalIF":2.3,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002013","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":"Review: The return of vaccine-preventable diseases: Implications for pediatric surgical and perioperative care.","authors":"Cornelia Griggs, Katherine Gonzalez, Justin Long, Donny Suh, Isdin Oke, Kavita Dedhia, Saleem Islam, Elizabeth A Beierle, Jennifer E Dietrich, Alexandra Dunham, Chevon Brooks, Erica Caffrey, Sandi Lam, Arun K Gosain, Gabrielle C Rodriguez, Hansel Otero, Kim M Strupp, Jesse M Hackell, Kenneth W Gow","doi":"10.1016/j.jpedsurg.2026.163470","DOIUrl":"10.1016/j.jpedsurg.2026.163470","url":null,"abstract":"<p><p>Vaccine-preventable diseases (VPDs) have long been considered rare in modern pediatric practice, a success attributable to sustained high immunization coverage. However, recent declines in vaccination rates have reintroduced the possibility that surgical teams will encounter conditions once thought largely historical. This review examines the emerging intersection of vaccine hesitancy and pediatric surgical care, highlighting the clinical, perioperative, and systems-level implications of the increasing number of under-immunized children. The resurgence of VPDs presents new and renewed challenges across surgical specialties, including complex airway emergencies, invasive infections requiring operative management, and long-term reconstructive needs following disease sequelae. These conditions demand technical expertise, multidisciplinary coordination, and familiarity with disease processes that many contemporary trainees have not previously encountered. Beyond direct patient care, implications extend to infection control practices, perioperative risk stratification, and institutional preparedness for episodic surges in disease burden. This review also explores how vaccination trends affect surgical workforce training and capacity, emphasizing the need for simulation-based education and curriculum adaptation. Importantly, it frames the perioperative period as a critical opportunity for vaccination advocacy and intervention, positioning surgical teams as key stakeholders in broader public health efforts. As vaccine hesitancy reshapes the clinical landscape, pediatric surgeons and perioperative providers must adapt to evolving disease profiles while reinforcing their role in prevention. Addressing this challenge will require coordinated efforts in education, policy, and clinical practice to ensure preparedness for diseases that are no longer theoretical. CLINICAL TRIAL REGISTRATION: Not applicable.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163470"},"PeriodicalIF":2.3,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001803","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":"From aspiration to attrition: A qualitative study of general surgery residents' career decisions away from pediatric surgery.","authors":"Nicole M Santucci, John M Woodward, Madeleine Yancy, Michael A Kochis, Matthew T Grant, Patrick A Dillon, Colin A Martin, Kathryn J Rowland","doi":"10.1016/j.jpedsurg.2026.163474","DOIUrl":"10.1016/j.jpedsurg.2026.163474","url":null,"abstract":"<p><strong>Background: </strong>Pediatric surgery (PS) has a long-standing reputation as a highly desirable and competitive specialty. However, recent years have demonstrated a decline in the number of fellowship applicants, raising concerns about trainee interest in the specialty. We sought to understand why general surgery (GS) residents who once meaningfully considered PS ultimately did not pursue the specialty.</p><p><strong>Methods: </strong>Current and recently graduated (2022-2025) GS residents across the United States who previously aspired to pursue PS but ultimately did not apply were recruited via purposive sampling. Participant recruitment and semi-structured qualitative interviews took place from June to September 2025. Interview transcripts were inductively coded and thematically analyzed.</p><p><strong>Results: </strong>Twelve participants were interviewed, including 9 current postgraduate year 4-7 GS residents and 3 recent graduates from 9 institutions. Five themes characterized participants' decisions: (1) disillusionment with the specialty, (2) perceived barriers and uncertainty in the fellowship match process, (3) rigor of fellowship training, (4) absence of effective mentorship, and (5) limited future career opportunities. Participants proposed strategies for PS to attract and retain interested residents, including re-consideration of research expectations for fellowship applicants, consideration of new training pathways to expand care delivery opportunities, interventions to improve fellowship culture, efforts to foster mentorship, and increased transparency regarding the job market.</p><p><strong>Conclusion: </strong>Personal, interpersonal, and specialty-specific factors influence residents' decisions to pursue other specialties. While some of these factors are intrinsic to the field of PS, there are opportunities for interventions to promote and sustain future trainee interest.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163474"},"PeriodicalIF":2.3,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990410","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}