Journal of pediatric surgery最新文献

{"title":"Sex differences in postoperative outcomes of Hirschsprung disease: Propensity score matching analysis","authors":"Wei Feng,&nbsp;Yuanyuan Liu,&nbsp;Xiaohong Die,&nbsp;Jinping Hou,&nbsp;Zhenhua Guo,&nbsp;Wei Liu,&nbsp;Yi Wang","doi":"10.1016/j.jpedsurg.2025.162655","DOIUrl":"10.1016/j.jpedsurg.2025.162655","url":null,"abstract":"<div><h3>Purpose</h3><div>Sex differences in Hirschsprung disease (HSCR) incidence have been well documented, yet little is known about whether the effect of sex on postoperative outcomes. This study aims to investigate the sex differences of postoperative outcomes of HSCR using propensity score matching (PSM) analysis.</div></div><div><h3>Methods</h3><div>Retrospective review of 304 patients with HSCR who received single-stage laparoscopic transanal pull-through modified Swenson procedure in a single-center was conducted with assessments of clinical data. By using PSM, baseline characteristics and postoperative outcomes between different sexes were compared. Furthermore, Univariate/multivariate Logistic regression analysis was used to identify sex as an independent factor of postoperative complications within 30 days and bowel dysfunction.</div></div><div><h3>Results</h3><div>Of the 304 patients, the proportion of females was 18.1 % (55/304). After one-to-one PSM, results showed that female patients had significantly longer length of postoperative hospital stay (12.60 ± 4.13 days vs. 10.62 ± 2.83 days, P = 0.005), lower health-related quality of life score (93.9 ± 4.2 vs. 97.3 ± 3.3, P &lt; 0.001), higher rates of postoperative complications within 30 days (31 % vs. 13 %, P = 0.033) and bowel dysfunction (65.4 % vs. 36.5 %, P = 0.003) than males. However, statistically insignificant differences were observed among females and males in the surgical time, severity of complications, postoperative nutritional status, Hirschsprung-associated enterocolitis, and health-related quality of life (HRQoL) in physical and social domains (all P &gt; 0.05). Furthermore, Multivariate Logistic regression analysis revealed that female was an independent risk factor for postoperative complications within 30 days (OR = 5.065, P = 0.024) and bowel dysfunction (OR = 3.153, P = 0.019).</div></div><div><h3>Conclusions</h3><div>Following adjustment for HSCR patient characteristics, females may face more severe postoperative outcomes than males. In clinical practice, pediatric surgeons should pay more attention to these differences and develop individualized response measures, eg. optimizing the preoperative nutritional status and surgical procedure, formulating gender-specific strategies for defecation function management and perineal-anal care, and emphasizing the dynamic assessment of HRQoL.</div></div><div><h3>Level of Evidence</h3><div>Level 4.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 12","pages":"Article 162655"},"PeriodicalIF":2.5,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033544","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":"Redefining pediatric general surgery: A generational paradigm shift toward specialization.","authors":"Rayan A Rahmani, Timothy B Lautz, Steven J Fishman, Sundeep G Keswani, Kevin P Mollen, Erika A Newman, Jose M Prince, Eric R Scaife, Mehul V Raval","doi":"10.1016/j.jpedsurg.2025.162650","DOIUrl":"10.1016/j.jpedsurg.2025.162650","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162650"},"PeriodicalIF":2.5,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023558","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 endoscopic pilonidal sinus treatment combined with platelet-rich plasma and excision with primary closure in pediatric patients: A retrospective comparative cohort study on short-term outcomes","authors":"Kutay Bahadir ,&nbsp;Aysel Mammadli ,&nbsp;Ozlem Dogan ,&nbsp;Mehmet Erdem Altinorgu ,&nbsp;Furkan Aktay ,&nbsp;Ergun Ergun ,&nbsp;Gulnur Gollu ,&nbsp;Meltem Bingol-Kologlu ,&nbsp;Murat Cakmak ,&nbsp;Ufuk Ates","doi":"10.1016/j.jpedsurg.2025.162644","DOIUrl":"10.1016/j.jpedsurg.2025.162644","url":null,"abstract":"<div><h3>Background</h3><div>Pilonidal sinus disease (PSD) is a common condition in adolescents, often resulting in recurrence, prolonged recovery, and significant discomfort. Although multiple surgical approaches exist, the optimal treatment for pediatric patients remains unclear. This study aimed to compare the short-term outcomes of endoscopic pilonidal sinus treatment combined with platelet-rich plasma application (EPSIT + PRP) and excision with primary closure (EPC) in children and adolescents with PSD.</div></div><div><h3>Material and methods</h3><div>This retrospective comparative cohort study analyzed two historical cohorts of pediatric patients with pilonidal sinus disease treated during different time periods at the same institution. A total of 104 patients under 18 years of age were included. EPC was performed in 73 patients between 2010 and 2015, with data retrospectively analyzed. Starting in 2024, 31 newly diagnosed patients were prospectively treated with EPSIT + PRP. PRP was prepared by centrifuging 15 mL of autologous blood at 4000 rpm for 10 min. Patients were evaluated based on demographic features, length of hospital stay, recurrence and complication rates, analgesic use, return to daily life, cosmetic outcomes, and satisfaction.</div></div><div><h3>Results</h3><div>Of the 104 patients, 65.4 % were male and 34.6 % female. Median age was 16 years in the EPC group and 17 years in the EPSIT + PRP group. Hospital stay was significantly shorter in the EPSIT + PRP group (same-day discharge vs. mean 2.79 days; p &lt; 0.05). In the postoperative 1st year follow-up, recurrence rates were 13.7 % (EPC) and 9.7 % (EPSIT + PRP), not statistically significant (p = 0.750). Cosmetic satisfaction and return to social life favored the EPSIT + PRP group (p = 0.031).</div></div><div><h3>Conclusion</h3><div>EPSIT + PRP appears to be a feasible and well-tolerated minimally invasive alternative to EPC in the treatment of PSD in children and adolescents. Despite differences in follow-up duration and study design, short-term outcomes suggest lower recurrence, faster recovery, and better cosmetic satisfaction with EPSIT + PRP.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 11","pages":"Article 162644"},"PeriodicalIF":2.5,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023584","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":"Impact of initial healthcare setting and family caregiving structure on pediatric appendicitis outcomes in resource-limited settings: A 10-year retrospective cohort study with external validation","authors":"Xia He ,&nbsp;Yazheng Sun ,&nbsp;Dongmei Du ,&nbsp;Zedong Bian ,&nbsp;Geng Xiong ,&nbsp;Min Liu ,&nbsp;Ning Luo","doi":"10.1016/j.jpedsurg.2025.162636","DOIUrl":"10.1016/j.jpedsurg.2025.162636","url":null,"abstract":"<div><h3>Background</h3><div>Acute appendicitis is a common pediatric surgical emergency worldwide. Misdiagnosis and perforation remain frequent, particularly among younger children in low- and middle-income countries. Prior studies have explored healthcare access or caregiving structures separately, but few long-term, large-sample retrospective studies in resource-limited settings have assessed their combined impact.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 1839 children (0–14 years) undergoing appendectomy at a tertiary hospital in southwestern China (2008–2017). Exposures included initial healthcare facility level (tertiary vs non-tertiary) and caregiving structure (biparental, single-parent, non-parental). Multivariable logistic regression evaluated predictors of misdiagnosis and perforation, adjusting for age, sex, year, and imaging. Phi coefficient assessed correlation between misdiagnosis and perforation. All key findings were validated in an independent external 2018cohort. Nomograms were subsequently constructed based on significant predictors identified in the primary cohort.</div></div><div><h3>Results</h3><div>Initial presentation to non-tertiary facilities was associated with higher odds of misdiagnosis (aOR 2.39, 95 % CI 1.89–3.02) and perforation (aOR 2.97, 95 % CI 2.38–3.72). Non-biparental caregiving increased the risk of diagnostic error and complications: single-parent caregiving (misdiagnosis: aOR 2.57; perforation: aOR 2.54), non-parental caregiving (misdiagnosis: aOR 5.26; perforation: aOR 2.94). A significant interaction between non-parental caregiving and non-tertiary healthcare increased risks of misdiagnosis (OR 7.52) and perforation (OR 8.19). Younger age, particularly 0–3 years, was the strongest predictor. Additionally, lack of imaging was independently associated with increased risk of both misdiagnosis (aOR 1.78, 95 % CI 1.34–2.36) and perforation (aOR 2.06, 95 % CI 1.50–2.83). Misdiagnosis and perforation were moderately correlated (ϕ = 0.352). These findings were statistically significant and validated in an external cohort.</div></div><div><h3>Conclusion</h3><div>Younger age, no imaging, non-traditional caregiving, and lower-level initial healthcare independently and interactively contribute to misdiagnosis and perforation in pediatric appendicitis.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 12","pages":"Article 162636"},"PeriodicalIF":2.5,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023517","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":"Lobectomy or total thyroidectomy in pediatric differentiated thyroid cancer? A systematic review and meta-analysis","authors":"Ioanna Gkalonaki ,&nbsp;Athina Stamati ,&nbsp;Athanasios Christoforidis ,&nbsp;Dimitrios G. Goulis ,&nbsp;Ioannis Valioulis","doi":"10.1016/j.jpedsurg.2025.162633","DOIUrl":"10.1016/j.jpedsurg.2025.162633","url":null,"abstract":"<div><h3>Background</h3><div>Thyroid cancer in pediatric patients is distinct from adult-onset thyroid cancer due to differences in disease presentation, management and outcomes. This meta-analysis delves into contemporary data on managing pediatric differentiated thyroid cancer (DTC), assessing outcomes, such as recurrence and mortality, in children with radical total thyroidectomy versus the more conservative lobectomy approach.</div></div><div><h3>Methods</h3><div>MEDLINE (via PubMed), Cochrane Central Register of Controlled Trials (CENTRAL), trial registry websites (ClinicalTrials.gov), and relevant congress abstracts were searched to identify eligible articles from the database inception to September 2023. Assessing study quality involved the Cochrane risk of bias tools (ROBINS-I), and overall evidence quality was gauged with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool. Investigated outcomes included recurrence rates, mortality rates, postoperative complications and independently permanent hypoparathyroidism and recurrent laryngeal nerve palsy (RLNP), postoperative radioiodine (RAI) and reoperation.</div></div><div><h3>Results</h3><div>Twenty-two observational studies with 11,684 patients were included. No significant difference was seen between the two groups regarding the mortality rates, overall postoperative complications and RLNP. The meta-analysis demonstrated that in the thyroid lobectomy group, the recurrence rate [relative risk (RR 1.80, 95 % confidence interval (CI) 1.22–2.67] and need for reoperation were higher (RR 3.99, 95 % CI 2.01–7.92), while permanent hypoparathyroidism (RR 0.23, 95 % CI 0.11–0.49) and postoperative RAI (RR 0.42, 95 % CI 0.20–0.87) decreased.</div></div><div><h3>Conclusion</h3><div>Total thyroidectomy is favored in pediatric thyroid cancer, showing lower recurrence and reoperation rates compared to lobectomy. For more robust findings, we strongly advocate for the implementation of well-designed randomized controlled trials.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 12","pages":"Article 162633"},"PeriodicalIF":2.5,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015627","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":"Commentary on \"Outcomes of allogenic umbilical cord mesenchymal stem cell infusion for liver cirrhosis due to biliary atresia after Kasai operation\" JPEDSURG-D-25-00654R2.","authors":"Mark Davenport","doi":"10.1016/j.jpedsurg.2025.162649","DOIUrl":"10.1016/j.jpedsurg.2025.162649","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162649"},"PeriodicalIF":2.5,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015686","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":"Refining management of pediatric first rib fractures without major trauma","authors":"Nzuekoh N. Nchinda ,&nbsp;Deepika P. Kamineni ,&nbsp;Jeffrey P. Otjen ,&nbsp;David H. Rothstein ,&nbsp;Patrick J. Javid","doi":"10.1016/j.jpedsurg.2025.162652","DOIUrl":"10.1016/j.jpedsurg.2025.162652","url":null,"abstract":"<div><h3>Purpose</h3><div>First rib fractures in children are typically associated with high-impact trauma; atraumatic etiologies remain understudied. The purpose of this study is to evaluate the presentation and management of pediatric first rib fractures in the absence of major trauma.</div></div><div><h3>Methods</h3><div>This is a retrospective study of pediatric patients diagnosed with first rib fractures between 2000 and 2023 at a quaternary, free-standing children's hospital. Exclusion criteria were major trauma and baseline bone disease.</div></div><div><h3>Results</h3><div>We identified 24 patients with a first rib fracture in the absence of major trauma (median age 14 years, 15 (63 %) male). The most common etiologies were exercise (n = 8, 33 %), stretching (n = 5, 21 %), and idiopathic (n = 5, 21 %). The most common symptom was ipsilateral shoulder pain (n = 16, 67 %). Chest x-ray (CXR) was the primary diagnosis modality (n = 16, 67 %). Seven patients (29 %) had chest computed tomography (CT), which showed no additional pathology. Most first rib fractures were non-displaced (n = 19, 79 %), and the rest were minimally displaced (n = 5, 21 %). Most patients did not have any associated injuries (n = 20, 83 %), 3 patients (13 %) had additional rib fractures, and one patient (4 %) had concurrent pneumonia. All patients were managed non-operatively; 12 patients (50 %) were seen for follow-up with repeat radiological imaging, primarily CXR. Most patients had appropriate healing on initial follow-up; one patient had delayed healing on initial CXR, requiring follow-up CT.</div></div><div><h3>Conclusion</h3><div>Pediatric first rib fractures can occur in the absence of major trauma; extensive additional workup is often not necessary. Diagnostic chest computed tomography did not yield clinically significant findings beyond x-ray.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 11","pages":"Article 162652"},"PeriodicalIF":2.5,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015614","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":"Stent it and Forget it? Not in Kids: Endovascular Treatment of Traumatic Arterial Injuries in Adolescents","authors":"Krysta M. Sutyak ,&nbsp;Jeannette M. Joly ,&nbsp;S. Keisin Wang ,&nbsp;KuoJen Tsao ,&nbsp;Mary T. Austin ,&nbsp;Natalie A. Drucker","doi":"10.1016/j.jpedsurg.2025.162646","DOIUrl":"10.1016/j.jpedsurg.2025.162646","url":null,"abstract":"<div><h3>Background</h3><div>Repair strategies for pediatric vascular injuries must consider vascular growth and intervention durability. Endovascular interventions are increasingly utilized in pediatrics, particularly in unstable patients or for injuries in surgically morbid regions. This study describes a single-center experience with endovascular stenting in adolescent pediatric trauma.</div></div><div><h3>Methods</h3><div>A mixed prospective/retrospective study of patients (&lt;18 years) who underwent endovascular stent-grafting for traumatic arterial injuries at a Level 1 trauma center (2011–2024) was performed. Demographics, injury characteristics, operative details, postoperative course, anticoagulation, and follow-up were collected.</div></div><div><h3>Results</h3><div>Eighteen patients underwent endovascular stenting (median age 15.7 years (range 14.1–17.9); median weight 65.7 kg (range 45.6–99.2)). Median injury severity score was 38 (IQR 17–41). Injuries were blunt in 67% and penetrating in 33%. Stents were used exclusively for aorta (10) or axillosubclavian injuries (7). Four patients (23.5%) had early complications requiring reintervention; one died secondary to comorbid injuries. Fifteen patients (83%) were successfully treated with stenting, without death or limb loss, at discharge. Antiplatelet therapy was prescribed in 76% of patients, with one bleeding complication. Two late complications were identified and required intervention. 86% (6/7) of the patients contacted prospectively were asymptomatic (median follow-up time of 7.0 years (IQR 4.3–12.6)).</div></div><div><h3>Conclusions</h3><div>Endovascular stenting is a valuable and potentially lifesaving alternative in adolescents with aortic or axillosubclavian traumatic injury, especially when the morbidity of an open repair is prohibitive. Complications occur frequently, and current vascular surgery recommendations are for lifelong surveillance, highlighting the need for robust follow-up systems.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 12","pages":"Article 162646"},"PeriodicalIF":2.5,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008363","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":"William Ladd's procedure for malrotation and volvulus: Convincing the world","authors":"Don K. Nakayama","doi":"10.1016/j.jpedsurg.2025.162645","DOIUrl":"10.1016/j.jpedsurg.2025.162645","url":null,"abstract":"<div><div>For one considered “the father of pediatric surgery,” William Ladd (1880–1967) has few eponymous procedures and terms that bear his name. The Ladd procedure is a series of procedures to address malrotation of the intestine and midgut volvulus. Also bearing his name are Ladd's bands, obstructing adhesions that cross the duodenum as they bind the nonrotated cecum high in the right upper quadrant to the retroperitoneum. Other surgeons before him, however, recognized each element of the Ladd procedure: the urgency of untwisting the intestine, the necessity of dividing obstructing Ladd's bands, and separating the duodenum and colon to prevent retwisting. Ladd's contribution was a 1932 review of six cases of malrotation, with and without volvulus, where he presented the steps as a coherent approach to its surgical management. To paraphrase Francis Darwin's aphorism, Ladd was not the first to come up with the elements of the Ladd procedure, but he convinced the world and thus earned the eponymous honor.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 11","pages":"Article 162645"},"PeriodicalIF":2.5,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008333","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":"Diagnostic and therapeutic strategies for intraoperative and postoperative hypocalcemia in pediatric thyroidectomy patients: A single-center experience","authors":"Monika Kujdowicz ,&nbsp;Anna Taczanowska-Niemczuk ,&nbsp;Aleksandra Kiszka-Wiłkojć ,&nbsp;Marcin Maślanka ,&nbsp;Damian Młynarski ,&nbsp;Grażyna Drabik ,&nbsp;Maria Szwarkowska ,&nbsp;Wojciech Górecki ,&nbsp;Dominika Januś","doi":"10.1016/j.jpedsurg.2025.162627","DOIUrl":"10.1016/j.jpedsurg.2025.162627","url":null,"abstract":"<div><h3>Background</h3><div>The primary goals of surgical management in thyroid disorders are the treatment of malignancy, goiter, and thyrotoxicosis, while adhering to the principle of ‘primum non nocere’. Hypocalcemia is among the most common complications, primarily resulting from inadvertent injury to the parathyroid glands.</div></div><div><h3>Methods</h3><div>A retrospective analysis of 2015–2023 records of Polish pediatric patients who underwent thyroid surgery.</div></div><div><h3>Results</h3><div>In our cohort of 217 children, 98 underwent hemithyroidectomy (HT) and 119 total thyroidectomy (TT). Postoperatively, 32–55 % exhibited decreased total calcium, 8–44 % had reduced ionized calcium, 9–27 % demonstrated diminished parathyroid hormone, and 28–54 % had elevated serum phosphate levels. These biochemical disturbances, along with malignancies detected in cytological and histopathological evaluations, the extent of surgery (TT and lateral neck lymph node dissection), and inadvertent parathyroid gland resection, were associated with prolonged hospitalization. Intraoperative parathyroid biopsies enabled parathyroid gland reimplantation in 7 % and 21 % of HT and TT cases, respectively.</div></div><div><h3>Conclusions</h3><div>The presence of malignant thyroid nodules and the consequent extensive surgical intervention substantially elevate the risk of postoperative hypoparathyroidism, prolonged hospitalization, and the requirement for calcium and 1-alpha-hydroxycholecalciferol supplementation. Intraoperative parathyroid biopsy enables gland reimplantation, reduces the risk of postoperative complications, and shortens hospital stays.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 11","pages":"Article 162627"},"PeriodicalIF":2.5,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006255","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}