Journal of pediatric surgery最新文献

{"title":"Summary of the 72nd British Association of Paediatric Surgeons (BAPS) conference Manchester, UK (17th -19th June 2026).","authors":"Mark Davenport","doi":"10.1016/j.jpedsurg.2026.163436","DOIUrl":"10.1016/j.jpedsurg.2026.163436","url":null,"abstract":"<p><p>The 72nd British Association of Paediatric Surgeons was held in Manchester, UK in June 2026. This commentary describes the scientific content and programme.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163436"},"PeriodicalIF":2.3,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865500","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":"Postoperative antibiotic continuation does not reduce infectious complications after elective pediatric ostomy reversal: A NSQIP Pediatric analysis.","authors":"Chidiebere Onongaya, Anmol Nigam, Eileen K Peterson, Pravin Meshram, Daniel A Saltzman, James V Harmon, Randi Lassiter Green","doi":"10.1016/j.jpedsurg.2026.163377","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2026.163377","url":null,"abstract":"<p><strong>Introduction: </strong>The optimal duration of perioperative antibiotic prophylaxis for elective ostomy reversal in children remains unclear, and antibiotic regimens vary widely despite limited evidence supporting extended use. This study evaluated whether continuation of perioperative antibiotics beyond surgery completion reduces postoperative infectious complications in pediatric ostomy reversal.</p><p><strong>Methods: </strong>A retrospective cohort study used the NSQIP Pediatric database and Surgical Antibiotic Prophylaxis files from 2021 to 2023. Children <18 years undergoing elective ostomy reversal were identified by CPT codes 44620, 44625, and 44626. Exclusion criteria included immunodeficiency, transplantation, malignancy, age <28 days, outpatient surgery, and missing antibiotic data. Patients were categorized as receiving antibiotics intraoperatively only versus postoperative continuation. The primary outcome was wound infection (superficial, deep, organ/space); secondary outcomes included pneumonia, UTI, length of stay, and days to discharge.</p><p><strong>Results: </strong>Of 2064 patients (median age 331 days), 60.4% continued antibiotics postoperatively. On multivariate analysis, postoperative antibiotic continuation was not associated with reduced wound infection. Higher preoperative albumin was protective against wound infection. No differences were observed in infection subtypes, UTI, pneumonia, or length of stay. Among children <1-year, antibiotic continuation was not protective, while term birth was associated with increased wound infection risk (OR 2.63, 95% CI 1.24-5.65).</p><p><strong>Conclusion: </strong>Postoperative antibiotic continuation was not associated with reduced infectious complications following pediatric ostomy reversal. Preoperative nutritional optimization may play a greater role in reducing SSI than postoperative antibiotic continuation.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163377"},"PeriodicalIF":2.3,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982985","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 national geospatial analysis of pediatric surgical practices and the children they serve.","authors":"Robert Ricca, Alicia C Greene, Megan T Vu, Nicholas A Hamilton, Mitchell R Ladd, Dimitra M Lotakis, Daniel K Robie, Carmelle Romain, Mary J Edwards, Alfred P Kennedy, Jessica A Zagory, Krysta M Sutyak, Mary E Fallat, Annie Zeug, Nicole M Chandler, Faidah O Badru, George Wadie, Joseph Iocono, Lindsey L Wolf, Laura N Purcell, Marybeth Browne, Patrick C Bonasso Ii, Rajeev Prasad, Samuel M Alaish, Anthony L DeRoss, Sung-Gheel Jang, Abigail E Martin, Kenneth W Gow","doi":"10.1016/j.jpedsurg.2026.163432","DOIUrl":"10.1016/j.jpedsurg.2026.163432","url":null,"abstract":"<p><strong>Purpose: </strong>This study characterizes the geographic distribution of pediatric surgical practices in the U.S. relative to the pediatric population (ages 0-17 years). Prior analyses estimated that over 10 million children (14.8%) live more than 60 miles from a pediatric surgeon, overlooking outreach clinics that extend access and reduce travel distances. Our goal was to generate a more accurate assessment of travel burden using data that includes all practice locations.</p><p><strong>Methods: </strong>The APSA membership directory was used to identify pediatric surgery practices. Practices were contacted for information on faculty and the number and location of hospitals and clinics as of July 31, 2025. Practice locations were compared to population demographics from the US 2020 Census data calculating straight-line driving distances both across and within state lines.</p><p><strong>Results: </strong>A total of 248 unique primary hospital and clinic sites were identified. An additional 684 hospital locations and 512 clinic locations were also identified. The average travel distance to the practice's primary location (hospital or clinic) for children traveling across state lines (ASL) was 55.0 miles, and within states travel (WSL) was 63.4 miles, with 13.2% of children living >60 miles from care (n = 9,662,011). Including all 932 hospitals served by these practices, average distances decreased slightly to 50.3 miles ASL and 58.2 miles WSL, with 11.1% > 60 miles (n = 8,125,546). For the 248 primary clinics; distances to care were similar to those from the primary hospitals. Considering all clinics (n = 760), distances decreased to 41.5 miles ASL and 48.1 miles WSL, with only 6.7% of children >60 miles away (n = 4,928,417).</p><p><strong>Conclusions: </strong>Pediatric surgical care is unevenly distributed in the United States. Both outreach hospitals and clinics can positively impact travel distances for patients. This impact is even greater when children are allowed to cross state lines for pediatric surgical care. These findings support workforce planning and resource allocation to ensure pediatric surgeons are available where children need them most.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163432"},"PeriodicalIF":2.3,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857281","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":"Beyond a tension-free position: What defines successful orchiopexy?","authors":"Nikolaos Baltogiannis","doi":"10.1016/j.jpedsurg.2026.163434","DOIUrl":"10.1016/j.jpedsurg.2026.163434","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163434"},"PeriodicalIF":2.3,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850688","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":"Challenging dogma on double-gloving: Doubtful value to patients or us, but harmful to our planet and expensive for hospitals.","authors":"Spencer W Beasley","doi":"10.1016/j.jpedsurg.2026.163418","DOIUrl":"10.1016/j.jpedsurg.2026.163418","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163418"},"PeriodicalIF":2.3,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840494","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 review of 87 patients with perineal, scrotal, and penoscrotal hypospadias: More than 10 Years of follow-up.","authors":"Hiroki Goto, Yuichiro Miyake, Asuka Ishiyama, Ryo Sueyoshi, Ayaka Fukada, Junya Ishi, Shiho Yoshida, Soichi Shibuya, Geoffrey J Lane, Go Miyano, Hiroyuki Koga, Atsuyuki Yamataka","doi":"10.1016/j.jpedsurg.2026.163416","DOIUrl":"10.1016/j.jpedsurg.2026.163416","url":null,"abstract":"<p><strong>Purpose: </strong>Data for long-term postoperative follow-up of perineal, scrotal, or penoscrotal subtype (\"severe\") hypospadias patients is scarce. Timing/types of complications and outcomes over at least 10 years' follow-up were reviewed.</p><p><strong>Methods: </strong>A retrospective review of all severe hypospadias patients (n = 87) who underwent surgical repair by a single surgeon between 2000 and 2015 and followed-up for at least 10 years was performed. Severe hypospadias was perineal (n = 26), scrotal (n = 21), or penoscrotal (n = 40). All had Thiersch-Duplay urethroplasties. Clinical variables analyzed included age at surgery, surgical repair procedures, follow-up duration, and incidence of specific problematic postoperative complications (urethral fistula or stenosis, recurrence of curvature, intraluminal hair growth, or ejaculatory dysfunction after puberty).</p><p><strong>Results: </strong>Overall, 20/87 developed some type of postoperative complication within 12 months; 18/20 (90.0%) recovered without sequelae and 7/87 (8.0%) developed urethral stenosis (n = 1), recurrence of curvature (n = 2), intraluminal hair growth (n = 1), or ejaculatory dysfunction (n = 3) later. Onset was 6-9 years for the stenosis, curvature, and 1 ejaculation case and after 10 years for the hair and 2 ejaculation cases. Of these, 2/7 (28.6%) had previous early complications, but 5/7 (71.4%) had no previous history of complications.</p><p><strong>Conclusions: </strong>Early postoperative complications in severe hypospadias patients recovered in 90% without sequelae. Late specific problematic complications took at least 5 years to develop in 8% with 71.4% having no previous history of postoperative complications. Consequently, follow-up should be extended at minimum and possibly life-long because of the potential for specific problematic postoperative complications to develop late, as demonstrated by this review.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163416"},"PeriodicalIF":2.3,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829495","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":"Vitamin D and infection risk in patients with short bowel syndrome and intestinal failure.","authors":"Hsi-Ming Liu, Ya-Hui Tsai, Chao-Ling Yao, Yun Chen","doi":"10.1016/j.jpedsurg.2026.163417","DOIUrl":"10.1016/j.jpedsurg.2026.163417","url":null,"abstract":"<p><strong>Purpose: </strong>Patients with short bowel syndrome (SBS) and intestinal failure (IF) are highly susceptible to micronutrient deficiencies and recurrent infections. Vitamin D plays an important role in immune modulation and has been linked to infection outcomes in other high-risk populations, yet its relevance in SBS/IF remains unclear. This study evaluated the effectiveness of vitamin D supplementation and the association between serum 25-hydroxyvitamin D [25(OH)D] levels and infection risk in SBS/IF patients.</p><p><strong>Method: </strong>In this single-center retrospective cohort study, 23 SBS/IF patients (8 pediatric, 34.8%) followed between November 2022 and November 2025 were included. Baseline 25(OH)D levels showed universal insufficiency, with 78.3% classified as deficient (<20 ng/mL). Changes in 25(OH)D levels at 6-12 months were compared between patients with and without supplementation using ANCOVA. The association between serial 25(OH)D levels and recurrent infection events was analyzed using a time-dependent Cox model with person-mean centering.</p><p><strong>Results: </strong>Vitamin D supplementation resulted in significantly greater increases in serum 25(OH)D compared with non-supplementation (mean change +15.61 vs. -0.40 ng/mL; ANCOVA F = 18.33, p = 0.001). During follow-up, 26 infection events occurred. Higher within-individual 25(OH)D levels were associated with a reduced hazard of infection (HR 0.92 per 1 ng/mL increase; 95% CI 0.869-0.976; p = 0.005).</p><p><strong>Conclusion: </strong>Vitamin D supplementation effectively improves vitamin D levels in SBS/IF patients. Higher 25(OH)D levels were associated with lower infection hazard, suggesting vitamin D status may represent a modifiable factor related to infection risk in this population.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163417"},"PeriodicalIF":2.3,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829479","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":"Serum growth differentiation factor 15: A novel biomarker for diagnostic and prognostic prediction in biliary atresia.","authors":"Masataka Hida, Kazuto Suda, Takashi Fujimoto, Hiroki Goto, Hiroko Watayo, Yosuke Tsunoda, Masahiro Shimizu, Taishi Iwakami, Satoshi Nakano, Mitsuyoshi Suzuki, Jianqin Zhang, Chengri Piao, Yuichiro Miyake, Soichi Shibuya, Miki Toma, Toshihiro Yanai, Masahiko Urao, Tadaharu Okazaki, Hiromichi Shoji, Atsuyuki Yatamaka, Go Miyano","doi":"10.1016/j.jpedsurg.2026.163415","DOIUrl":"10.1016/j.jpedsurg.2026.163415","url":null,"abstract":"<p><strong>Purpose: </strong>Growth differentiation factor 15 (GDF15), a stress-responsive cytokine, is a diagnostic biomarker of mitochondrial diseases. Given our previous finding that hepatocellular mitochondrial viability is crucial for native liver survival (NLS) in patients with biliary atresia (BA), this study investigated whether GDF15 could function as a biomarker for liver injury, diagnosis, and prognosis in BA.</p><p><strong>Methods: </strong>Using immunofluorescence, the proportion of GDF15-positive hepatocytes were determined in liver specimens obtained at treatment initiation from BA, other infantile cholestatic diseases (IC), and choledochal cysts or hepatoblastoma having normal livers (NL). Its correlation with hepatic fibrosis severity, jaundice clearance (JC) achievement, and NLS was evaluated in BA. Using ELISA, serum GDF15 levels were measured in patients with BA, IC, and age-matched healthy controls and correlated with the proportion of GDF15-positive hepatocytes and liver biochemical parameters at diagnosis.</p><p><strong>Results: </strong>The GDF15-positive hepatocyte proportion was higher in BA (n = 54) than in IC (n = 22) or NL (n = 16) (p < 0.001). This proportion was also higher in BA without JC (p < 0.01) or NLS (p < 0.05) and correlated with fibrosis severity (p < 0.001). Serum GDF15 levels were higher in BA (n = 11) than in IC (n = 9) (cutoff = 680.4 pg/mL; sensitivity = 80%, specificity = 82%) and controls (n = 40) (p < 0.001), and significantly correlated with GDF15-positive hepatocyte proportion (p < 0.001) and with total and direct bilirubin, aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase (all p < 0.05), while showing inverse correlations with platelet count (p < 0.01).</p><p><strong>Conclusion: </strong>GDF15 is a reliable indicator of hepatic dysfunction and a diagnostic and prognostic biomarker of BA.</p><p><strong>Level of evidence: </strong>Ⅱ.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163415"},"PeriodicalIF":2.3,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829533","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":"Reduction of urothelial umbrella cells and impairment of barrier function in neurogenic bladder: Identification of influencing factors.","authors":"Takamasa Suzuki, Kazuto Suda, Rumi Arii, Haruna Kawano, Xuxuan Rao, Xinmeng Yuan, Jianqin Zhang, Masafumi Tanaka, Shiho Yoshida, Atsuyuki Yamataka, Shigeo Horie, Tetsuya Nakamura, Go Miyano","doi":"10.1016/j.jpedsurg.2026.163414","DOIUrl":"10.1016/j.jpedsurg.2026.163414","url":null,"abstract":"<p><strong>Purpose: </strong>Patients with neurogenic bladder (NB) secondary to spina bifida remain at urinary tract infection (UTI) risk even without vesicoureteral reflux (VUR) or after bladder augmentation cystoplasty (BAC). We investigated urothelial barrier impairment in NB and NB-BAC by quantifying terminally differentiated CK20-positive umbrella cells and by assessing clinical factors.</p><p><strong>Methods: </strong>Bladder specimens from NB, NB-BAC, and Controls (tumor-adjacent normal bladder tissue) were assessed for CK20-positive cell proportion using immunofluorescence. Inflammatory cell infiltration was graded by hematoxylin-eosin staining. qPCR was performed using fresh bladder specimens for tight junction proteins (TJPs) and inflammatory cytokines (IL1B, IL6, TNF). Correlation of CK20-positive cells proportion and status of VUR, bacteriuria, and UTI history was assessed using multivariable linear mixed-effects model and univariable analysis.</p><p><strong>Results: </strong>Bacteriuria was more frequent in NB-BAC (n = 51, 86.3%) than in NB (n = 18, 38.9%) (p < 0.001). VUR was present in 61.1% of NB and 19.6% of NB-BAC (p < 0.05). CK20-positive cells were significantly lower in NB and NB-BAC than in Controls (n = 15) (p < 0.0001, respectively). TJP expression was lower in both NB and NB-BAC than in Controls. Severe inflammatory cell infiltration and upregulation of inflammatory cytokines were observed in NB and NB-BAC compared with Controls. Multivariable analysis revealed correlation between bacteriuria and CK20-positive cells reduction (p < 0.001). Univariable analysis showed reduced CK20-positive cells in patients with bacteriuria and UTI history.</p><p><strong>Conclusion: </strong>NB and NB-BAC demonstrated reduced CK20-positive cells and impaired barrier function. Bacteriuria may be a key factor in CK20-positive umbrella cell reduction.</p><p><strong>Level of evidence: </strong>Ⅱ.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163414"},"PeriodicalIF":2.3,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829454","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":"Testicular torsion: Is orchiopexy synonymous with true salvage?","authors":"Nikolaos Baltogiannis, Fotini Fili, Melina Eleni Baltogianni","doi":"10.1016/j.jpedsurg.2026.163408","DOIUrl":"10.1016/j.jpedsurg.2026.163408","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"163408"},"PeriodicalIF":2.3,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813277","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}