Journal of pediatric surgery最新文献

{"title":"Outcomes of allogeneic umbilical cord mesenchymal stem cell infusion for liver cirrhosis due to biliary atresia after Kasai operation.","authors":"Thanh Liem Nguyen, Hoang-Phuong Nguyen, Thi Hang Bui, Thi Kieu Trang Phan, Duy Minh Ngo, Thi Thu Hien Ha, Thanh Tri Tran, Nguyen Anh Thuan Luu, Tuan Kiet Phan, Phi Duy Ho","doi":"10.1016/j.jpedsurg.2025.162624","DOIUrl":"10.1016/j.jpedsurg.2025.162624","url":null,"abstract":"<p><strong>Background and aim: </strong>Although Kasai surgery has saved many patients with biliary atresia, the long-term survival rate remains low. Recently, cell therapy has been explored as a potential strategy to improve post-surgical survival. This study aims to evaluate the safety and outcomes of allogeneic umbilical cord mesenchymal stem cell (UC-MSC) infusion in management of liver cirrhosis due to Biliary Atresia after Kasai operation.</p><p><strong>Methods: </strong>A matched case-control study was conducted from April 2019 to May 2023, including 32 patients with the cirrhosis after Kasai portoenterostomy for biliary atresia. Sixteen patients in the cell therapy (CT) group, who received a single hepatic-artery infusion of UC-MSC plus standard care after a modified Kasai procedure at a median age of 9.0 ± 2.1 months (median 9.1, range 6.1-13). Sixteen matched controls underwent the same Kasai technique but received standard care only. Matching required the age at Kasai to differ by no more than 14 days (81.5 days [58-103] in the therapy group vs 76.0 days [52-112] in controls; p = 0.77) and that stool-color scores on the Stool Color Card (Taiwan Infant Stool Color Card) be identical. At enrollment the groups were comparable for age (9.0 ± 2.1 vs 9.4 ± 5.2 months; p = 0.52) and PELD score (2.31 ± 4.16 vs 2.69 ± 4.09; p = 0.80).</p><p><strong>Results: </strong>No severe adverse events related to cell therapy were observed. Over 12 months, the CT group showed significantly better biochemical profiles than controls: serum albumin 3.9 ± 0.3 vs. 3.5 ± 0.4 g/dL (p = 0.02), total bilirubin 9 ± 3 vs. 30 ± 10 μmol/dL (p = 0.04) and greater improvement in alkaline phosphatase (p = 0.03). Reductions in AST, ALT and GGT also favored the UC-MSC group but did not reach statistical significance. The CT group demonstrated a significant improvement in disease severity, with PELD scores decreased to -3.56 in the UC-MSC group and 1.64 in the control group (p < 0.01).</p><p><strong>Conclusion: </strong>Allogeneic umbilical cord mesenchymal stem cell administration was safe and may help preserve or improve liver function in patients with liver cirrhosis due to biliary atresia.</p><p><strong>Clinicaltrials: </strong></p><p><strong>Gov identifier: </strong>NCT04522869 on June 6th, 2024.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162624"},"PeriodicalIF":2.5,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000792","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 pain in children: Near-infrared spectroscopy cannot differentially diagnose underlying","authors":"Daniela Carolina ,&nbsp;Mounia Hamzy ,&nbsp;Philippe Buisson ,&nbsp;Xavier Delforge ,&nbsp;Elodie Haraux","doi":"10.1016/j.jpedsurg.2025.162635","DOIUrl":"10.1016/j.jpedsurg.2025.162635","url":null,"abstract":"<div><h3>Introduction</h3><div>No rapid test to diagnose testicular torsion (TT) exists. The usefulness of trans-scrotal near-infrared spectroscopy (NIRS) remains to be proven in children. Here, we measured testicular oxygenation (StO₂%) in children with unilateral TT and compared values to those measured in children with another cause of testicular pain and in control subjects.</div></div><div><h3>Material and methods</h3><div>StO₂% values were measured in 32 boys with unilateral testicular pain (group 1: 19 with TT, 7 without TT, 6 with torsion-detorsion) and in a control group (group 2: CG) of 35 healthy boys, aged 0–16 years.</div><div>The difference in StO₂% between the two testicles for the groups was compared (paired or unpaired Student's tests, or Wilcoxon and Mann–Whitney tests; p &lt; 0.05).</div></div><div><h3>Results</h3><div>In the CG, the mean StO₂% was 74.2 % (SD:15.5) on the right and 73.4 % (SD:14.0) on the left. In group 1 TT, the mean StO₂% was 68.3 % (SD:15.3) on the TT side <em>vs</em> 69.8 % (SD:16.9) on the contralateral side. The difference between the two sides was not significant for either group (CG: 3.2 % [SD:16.8], p = 0.6; Group 1 TT: −2.8 % [SD:16.6], p = 0.4). For patients with severe testicular inflammation without TT, a non-significant trend for greater differences between sides was observed (71.8 % [SD:12.6] <em>vs</em> 82.8 % [SD:14.6]; Delta −14.8 % [SD:18.5], p = 0.2).</div></div><div><h3>Conclusion</h3><div>NIRS is not suitable to diagnose TT in children in clinical practice. StO₂% values showed extensive intra- and inter-individual variability in both control and TT subjects, with or without necrosis. Inflammatory pathologies appear to have a greater impact on StO₂%.</div></div><div><h3>Level of evidence</h3><div>II.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 11","pages":"Article 162635"},"PeriodicalIF":2.5,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000848","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":"Bleomycin electrosclerotherapy (BEST) of slow-flow vascular malformations (SFVMs) in children","authors":"Julia Haehl ,&nbsp;Beate Haeberle ,&nbsp;Oliver Muensterer ,&nbsp;Alexandra Hartel ,&nbsp;Alexandra Fröba-Pohl ,&nbsp;Chakravarthy U. Dussa ,&nbsp;Christian M. Ziegler ,&nbsp;Florian Obereisenbuchner ,&nbsp;Daniel Puhr-Westerheide ,&nbsp;Max Seidensticker ,&nbsp;Jens Ricke ,&nbsp;Richard Brill ,&nbsp;Walter A. Wohlgemuth ,&nbsp;Martin Olivieri ,&nbsp;Vanessa F. Schmidt ,&nbsp;Moritz Wildgruber","doi":"10.1016/j.jpedsurg.2025.162631","DOIUrl":"10.1016/j.jpedsurg.2025.162631","url":null,"abstract":"<div><h3>Rationale and objectives</h3><div>Bleomycin electrosclerotherapy (BEST) is a promising treatment for slow-flow vascular malformations (SFVMs). Due to limited paediatric data, this study aimed to assess the safety, effectiveness, and patient-reported outcomes of BEST in children with SFVMs.</div></div><div><h3>Material and methods</h3><div>This monocenter cohort study included patients &lt;18 years with symptomatic SFVMs treated by BEST. Patient records were analysed for procedural details and complications. Symptom severity was objectively classified before and after BEST. A treatment-specific, patient-reported questionnaire assessed mobility, aesthetic concerns, swelling, social participation, pain using a visual analogue scale (VAS), and post-procedural skin discoloration. Outcomes were compared between simple and infiltrative lesions.</div></div><div><h3>Results</h3><div>Overall, 68 BEST sessions were performed in 45 children. Total complication rate was 10/68 (14.7 %), most commonly pes equinus deformities (5/68, 7.4 %) after treating SFVMs in calf muscles. Physician-rated overall symptom severity improved significantly (p &lt; 0.001). Treatment-specific, patient-reported questionnaire revealed improved mobility in 14/41 (34.1 %) and symptom-free patients in 10/41 (24.4 %). Outcome in both aesthetic measure and social participation was mostly rated as improved or perfect (33/41, 80.5 %; 35/41, 85.4 %). Median VAS pain scale improved significantly (2.0 vs. 0.0, p &lt; 0.001). Postprocedural swelling occurred in all children, in 26/41 cases (64.4 %) persisting for 2–4 weeks. Postprocedural skin discoloration (41/41, 100 %) was mostly (25/41, 61.0 %) reported to fade over time. No differences between simple and infiltrative lesions were revealed in all outcome parameters.</div></div><div><h3>Conclusion</h3><div>BEST is effective for paediatric SFVMs by objective and subjective measures while maintaining low complication rates. Notably, BEST achieves therapeutic success even in infiltrative SFVMs expanding the range of available treatment options.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 11","pages":"Article 162631"},"PeriodicalIF":2.5,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000850","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":"Systematic review of reported outcomes for antegrade continence enema in patients with anorectal malformation and Hirschsprung disease","authors":"Signe Olsbø ,&nbsp;Sara George Kiserud ,&nbsp;Anders Telle Hoel ,&nbsp;Kjetil Stensrud ,&nbsp;Kristin Bjørnland","doi":"10.1016/j.jpedsurg.2025.162634","DOIUrl":"10.1016/j.jpedsurg.2025.162634","url":null,"abstract":"<div><h3>Aim</h3><div>To identify reported parameters and study characteristics in the literature on antegrade continence enema (ACE) in patients with anorectal malformations (ARM) and Hirschsprung disease (HD).</div></div><div><h3>Methods</h3><div>Following PRISMA guidelines, we performed a search using the terms “anorectal malformation” or “Hirschsprung disease”, combined with “appendicostomy,” “antegrade continence enema,” “ACE”, “Malone”, or “cecostomy” in the databases Ovid MEDLINE, Cochrane Central, Embase, and CINAHL. Two reviewers independently screened and extracted data. Exclusion criteria included &lt;10 patients with ARM and/or HD, age at ACE &gt;18 years, non-English papers, opinion articles, conference abstracts, reviews, and meta-analyses.</div></div><div><h3>Results</h3><div>257 papers were identified, and 48 met the inclusion criteria. 76 % were retrospective studies and 9 % multi-center studies. Most studies (84 %) mixed three or more diagnoses, with a median of 16 ARM and 3 HD patients per study. A total of 301 different parameters were identified. Nine (3 %) parameters were mentioned in more than 50 % of the publications. The most frequent baseline parameters were sex (98 %) and age at surgery (88 %). Common outcome parameters included success of enema (92 %), complication rate (80 %) and revision surgery (79 %). Patient reported outcome measures were utilized in 12 (25 %) papers, and 3 (6 %) assessed quality of life.</div></div><div><h3>Conclusion</h3><div>There is substantial heterogeneity when reporting ACE outcomes. The use of validated questionnaires and PROMs is rare.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 11","pages":"Article 162634"},"PeriodicalIF":2.5,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000838","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 reduction of liver fibrosis surrogates in syndromic biliary atresia","authors":"David Schwarz,&nbsp;Christine Lam,&nbsp;Mark Davenport","doi":"10.1016/j.jpedsurg.2025.162626","DOIUrl":"10.1016/j.jpedsurg.2025.162626","url":null,"abstract":"<div><h3>Aim</h3><div>Biliary atresia (BA) has a known association with other congenital anomalies and specifically the Biliary Atresia Splenic Malformation syndrome (BASM). Although initial response to the Kasai portoenterostomy (KPE) appear similar, it seems that they have less liver fibrosis in the longer term. We aimed to test this hypothesis.</div></div><div><h3>Methods</h3><div>Single-centre prospective database with a 2:1 ratio of contemporaneous controls. We used native liver survivors (at 3+ yrs) as the principal comparison. Three surrogate markers of liver fibrosis were used: AST-to-Platelet-index (APRi), Varices Prediction Rule (VPR) and endoscopic presence of clinically significant varices (grade 2 or 3). [N.B. higher APRI and lower VPR are predictive of liver fibrosis]. Data were quoted as median (IQR where applicable), and non-parametric comparisons were used throughout. P≤0.05 was regarded as significant.</div></div><div><h3>Results</h3><div>During the period 1990 – 2024 there were 154 infants with Syndromic BA (BASM, n= 95 and Non-BASM, n= 59) and Isolated BA (n=252), and of these 55 (35.7%), and 104 (41.3%) were 3+ year native liver survivors. There was no significant difference in age at KPE between the 3 groups and both the APRi was lower in the BASM than both, Non-BASM and IBA (0.63 vs 0.76 vs. 0.72, P&lt;0.01) and VPR was higher in the BASM than IBA (23 vs. 18, P =0.02) respectively. In the 3+ year native liver survivors’ group, APRi was lower in both BASM and Non-BASM groups compared to IBA (0.78 vs. 0.45 vs 1.03, P&lt;0.05) and VPR higher 10.6 vs. 10.9 vs 8.1 (P &lt; 0.05). Clinically significant varices were less prevalent in the syndromic groups [2 (3.6%) vs. 22 (21.1%), P=0.002].</div></div><div><h3>Conclusion</h3><div>There is <em>prima faci</em><em>e</em> clinical and biomarker evidence for reduced portal hypertension and presumably liver fibrosis in both syndromic BA groups, compared to those with Isolated BA. This might suggest that the ongoing pathobiology post-KPE in such syndromic groups is different to that of isolated BA.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 11","pages":"Article 162626"},"PeriodicalIF":2.5,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000869","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 - Congenital cardiac disease and biliary atresia - Not a benign relationship.","authors":"Mark Davenport","doi":"10.1016/j.jpedsurg.2025.162622","DOIUrl":"10.1016/j.jpedsurg.2025.162622","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162622"},"PeriodicalIF":2.5,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000860","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":"Tracheal work of breathing in neonates with tracheoesophageal fistula before and after surgical repair via computational fluid dynamics assessment","authors":"Christopher R. Boles ,&nbsp;Chamindu C. Gunatilaka ,&nbsp;Qiwei Xiao ,&nbsp;Jason C. Woods ,&nbsp;Paul S. Kingma ,&nbsp;Nara S. Higano ,&nbsp;Eric A. Nauman ,&nbsp;Alister J. Bates","doi":"10.1016/j.jpedsurg.2025.162630","DOIUrl":"10.1016/j.jpedsurg.2025.162630","url":null,"abstract":"<div><h3>Introduction</h3><div>Tracheoesophageal fistula (TEF), often occurring with esophageal atresia (EA), presents significant respiratory challenges in neonates. Neither the effect of EA/TEF, nor the effect of post-surgical complications such as tracheomalacia, on respiratory effort has been previously quantified. This study calculates the tracheal resistive component of work of breathing (TR-WOB) to quantify breathing effort pre- and post-surgical repair of EA/TEF. The primary objective of this study was to calculate the TR-WOB before and after surgical repair and compare it to normal values.</div></div><div><h3>Methods</h3><div>Five neonates with EA/TEF underwent ultrashort echo time (UTE) MRI before and after surgical repair. Virtual airway models were segmented from the MRI, with airway motion calculated via registration of respiratory-gated MRI. Computational fluid dynamic (CFD) simulations based on these virtual airways modeled patient-specific airflow calculated TR-WOB. Tracheal cross-sectional area (CSA) was quantified to reveal the relationship between airway anatomy and TR-WOB.</div></div><div><h3>Results</h3><div>Mean TR-WOB decreased from 686 ± 1013 J/day pre-surgery to 116 ± 159 J/day post-surgery (p = 0.299, Cohen's d = 0.301). In some subjects, TR-WOB remained elevated post-surgically compared to healthy neonates reported in previous studies. Four of five subjects showed increased tracheal CSA post-surgery (23 % mean increase). A strong negative correlation was found between average CSA and TR-WOB post-surgery (ρ = −0.90, p = 0.037), suggesting anatomical improvements reduce breathing effort.</div></div><div><h3>Conclusion</h3><div>Surgical repair of EA/TEF reduces TR-WOB, but TR-WOB remains abnormally high in some patients. CFD-based assessments offer a quantitative tool for identifying neonates who may benefit from additional interventions to reduce TR-WOB during their EA-TEF repair.</div></div><div><h3>Level of Evidence</h3><div>4 Case Series.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 12","pages":"Article 162630"},"PeriodicalIF":2.5,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000867","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":"Endoscopic implantation of a biodegradable tracheal stent: Toward pediatric applications in airway surgery — A preclinical study","authors":"Felipe Colombo de Holanda ,&nbsp;Paulo Inforçatti Neto ,&nbsp;Jorge Vicente Lopes da Silva ,&nbsp;Jane Ulbrich ,&nbsp;Caroline Gargioni Barreto ,&nbsp;Gabriela Silveira Viana ,&nbsp;Marcelo Costamilan Rombaldi ,&nbsp;Jose Carlos Fraga","doi":"10.1016/j.jpedsurg.2025.162632","DOIUrl":"10.1016/j.jpedsurg.2025.162632","url":null,"abstract":"<div><h3>Background</h3><div>Obstructions of the tracheobronchial tree can result from various etiologies. Most cases of tracheal stenosis or tracheomalacia are associated with patient-specific anatomical and functional abnormalities, making treatment challenging. Despite progress in the development of tracheal support devices, the optimal or near-optimal stent design remains elusive.</div></div><div><h3>Methods</h3><div>A multidisciplinary team developed a novel endoscopically implantable tracheal stent using three-dimensional (3D)-printed bioabsorbable polymer caprolactone. The stents were implanted into the trachea of 6 healthy adult male Texel sheep and after 8 weeks the animals were euthanized. Clinical, endoscopic, and histopathological findings were analyzed.</div></div><div><h3>Results</h3><div>All animals exhibited normal feeding habits, no significant weight loss (<em>P</em> = 0.82), and no significant clinical manifestations (<em>P</em> = 0.48) over the 8-week follow-up period. At the time of euthanasia, the stents were fully covered by respiratory epithelium in 2 animals (33 %) and partially covered in 3 (50 %). Complete regenerative epithelialization of the inner stent surface was observed in all animals. Cartilage reaction, squamous metaplasia/atrophy, and polyp formation did not differ significantly between the stented and unstented regions.</div></div><div><h3>Conclusion</h3><div>The 3D-printed caprolactone stent was well tolerated, demonstrating remarkable biocompatibility and rapid degradation with little residual inflammation. Its open design allowed tracheal secretion clearance, facilitated re-epithelialization along the inner stent surface, and should permit dynamic customization. Clinical studies of this novel tracheal support device in adult and pediatric patients are warranted.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 11","pages":"Article 162632"},"PeriodicalIF":2.5,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000876","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":"Early postoperative fever in pediatric oncology patients undergoing solid tumor resection","authors":"John Lundstedt ,&nbsp;Emily Vore ,&nbsp;Joseph Brungardt ,&nbsp;Meera Kotagal ,&nbsp;Todd Jenkins ,&nbsp;Chloe Boehmer ,&nbsp;Roshni Dasgupta","doi":"10.1016/j.jpedsurg.2025.162629","DOIUrl":"10.1016/j.jpedsurg.2025.162629","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative fever is common following cancer resection and often prompts extensive, costly workups. The purpose of this study was to determine the incidence of and risk factors for postoperative fever in oncology patients, evaluate incidence of true infection, and determine the utility of fever workup.</div></div><div><h3>Methods</h3><div>Single institution retrospective chart review (2018–2023) identified postoperative oncology patients who developed postoperative fever (≥38.0 °C) on postoperative days 0, 1, or 2 following solid tumor resection. Collected variables included preoperative chemotherapy, presence of central line, operation type, bowel resection, operative length, wound class, intraoperative hypothermia (&lt;35 °C), transfusion, hyperglycemia (&gt;180 mg/dL), preoperative neutrophil count, and antibiotic administration. Fever workup included urinalysis, urine culture, blood culture, and chest x-ray. Fever predictors were analyzed using a generalized linear mixed model.</div></div><div><h3>Results</h3><div>Cohort included 222 patients, aged 0.01–40.35 years (median 5.27, SD = 8.32). Ninety-four patients (42 %) developed early postoperative fever. Factors predictive of developing fever included intraoperative transfusion (p = 0.032), postoperative transfusion (p = 0.032), foley catheter (p &lt; 0.001), neutropenia (p = 0.001), and sarcoma histology (p = 0.006). Of those who developed fever, 36 % (34/94) were treated with empiric antibiotics and 73.4 % (69/94) underwent febrile workup (average cost $455). Only 2.8 % (2/94) of febrile patients had an infectious etiology requiring treatment. Both had hemodynamic instability and positive blood cultures.</div></div><div><h3>Conclusions</h3><div>Postoperative fever is common in pediatric cancer patients. Infectious etiology is rare, empiric treatment is common, and workup is costly. Fever alone may not necessitate a workup within the first 2 postoperative days following solid tumor resection. Testing and treatment should be reserved for those with significant symptomatology.</div></div><div><h3>Type of study</h3><div>Retrospective Study.</div></div><div><h3>Level of evidence</h3><div>Level I.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 11","pages":"Article 162629"},"PeriodicalIF":2.5,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000879","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: A Report on Testicular Tissue Cryopreservation for Fertility Preservation in Children: Confirmation of Germ Cell Preservation and Few Surgical Complications","authors":"Charles L. Snyder","doi":"10.1016/j.jpedsurg.2025.162392","DOIUrl":"10.1016/j.jpedsurg.2025.162392","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 9","pages":"Article 162392"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187211","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}