Pediatric Surgery International最新文献

{"title":"Enhanced recovery after minimally invasive pneumonectomies in children.","authors":"Shuai Li, Mijing Fang, Rui Yin, Yali Wang, Rong Chen, Chen Wang, Kang Li, Wenjia Shi, Shao-Tao Tang","doi":"10.1007/s00383-025-05977-0","DOIUrl":"https://doi.org/10.1007/s00383-025-05977-0","url":null,"abstract":"<p><strong>Purpose: </strong>The study aimed to explore the feasibility and effect of pulmonary rehabilitation (PR) in the recovery of children who underwent thoracoscopic pulmonary resection.</p><p><strong>Methods: </strong>From January 2015 to December 2021, consecutive patients who underwent thoracoscopic pulmonary resection were divided into group A and group B. All of them were treated with the same perioperative protocols except for group A with perioperative lung rehabilitation management, while group B was not. Demographics, operative data, postoperative complications and clinical outcomes were compared between these two groups.</p><p><strong>Results: </strong>Sixty eight cases enrolled with 33 in group A and 35 in group B. Demographic data was comparable between the two groups, as well as the dose of tramadol and diclofenac sodium. Few patients in group A had temperature higher than 38℃ in the first 3 days after the surgery. The mean time of the first ambulation after the operation was shorter in group A than that in group B. The drainage time and the postoperative hospital stay were similar. No interventions needed for complications.</p><p><strong>Conclusion: </strong>The application of perioperative PR in children who underwent thoracoscopic pulmonary resection is safe and feasible.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"81"},"PeriodicalIF":1.5,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of local volume reduction of the dorsal glans groove in the repair of hypospadias with small glans: A retrospective study.","authors":"Hai Lin, Yu-Yun Wang, Shi-Bing Li, Ze-Ting Chen, Liang-Ju Su","doi":"10.1007/s00383-025-05980-5","DOIUrl":"https://doi.org/10.1007/s00383-025-05980-5","url":null,"abstract":"<p><strong>Objective: </strong>To assess the efficacy of local volume reduction of the dorsal glans groove in hypospadias repair with small glans.</p><p><strong>Methods: </strong>This retrospective comparative study included 107 children treated between January 2017 and December 2020. Patients were divided into two groups: Group 1 (2017-2018) underwent onlay island flap urethroplasty alone, while Group 2 (2019-2020) underwent the procedure with additional local volume reduction of the dorsal glans groove. Hypospadias objective scoring evaluation (HOSE) scores and postoperative complications, including glans dehiscence, meatal stenosis, and urethrocutaneous fistula, were compared.</p><p><strong>Results: </strong>The mean follow-up was 40 months (Group 1) and 32 months (Group 2). Urethrocutaneous fistula rates were 4% (Group 1) and 2% (Group 2; P = 1). Glans dehiscence occurred in 16% (Group 1) and 4% (Group 2; P = 0.0451). Meatal stenosis rates were 16% (Group 1) and 2% (Group 2; P = 0.0184). Overall success rates were 65% (Group 1) and 92% (Group 2; P = 0.0008). HOSE scores showed no significant difference (P = 0.219).</p><p><strong>Conclusions: </strong>Local volume reduction of the dorsal glans groove significantly reduces postoperative complications in hypospadias repair with small glans.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"80"},"PeriodicalIF":1.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post pubertal outcome after use of oral mucosa in urethral reconstruction for hypospadias in prepubertal boys: a systematic review.","authors":"George Tsachouridis, Rien Nijman, Laetitia M O de Kort, Petra de Graaf","doi":"10.1007/s00383-025-05982-3","DOIUrl":"10.1007/s00383-025-05982-3","url":null,"abstract":"<p><p>Oral mucosa graft urethroplasty (OMGU) is a surgical technique used in complex hypospadias repair. However, long-term outcomes in prepubertal boys, particularly through and after puberty, are not well established. To systematically review the long-term outcomes of OMGU in prepubertal boys with hypospadias, focusing on changes observed after puberty. A systematic literature search was conducted in PubMed, Embase, and Cochrane Library. Studies reporting long-term outcomes of OMGU in prepubertal boys with hypospadias were included. The quality of evidence was assessed using the ROBINS-I tool. Three studies of moderate quality met the inclusion criteria. Outcomes were mixed, with some patients experiencing favorable results and others facing complications such as meatal stenosis, urethral strictures, and fistulas. The scarcity of high-quality, long-term studies highlights a significant knowledge gap in this area. This systematic review reveals insufficient evidence to establish the long-term efficacy and safety of OMGU in prepubertal boys with hypospadias, particularly concerning pubertal development and post-pubertal outcomes. Future research should prioritize prospective, longitudinal studies with larger sample sizes and standardized outcome measures to address these critical gaps in understanding.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"79"},"PeriodicalIF":1.5,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143409859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Internal jugular vein versus external jugular vein as the insertion site for totally implantable venous access ports in children: a randomized comparative study.","authors":"Chen Zhen, Wei Yandong, Ye Mao, Liu Chao, Zhang Jun","doi":"10.1007/s00383-025-05981-4","DOIUrl":"https://doi.org/10.1007/s00383-025-05981-4","url":null,"abstract":"<p><strong>Background and aims: </strong>Various venous approaches are possible during implanting a totally venous access port. In this study, we compare the result of venous access port implantation using external and internal jugular vein cut-down in young children to determine the safest method, associated with less complications and higher quality of life.</p><p><strong>Patients and methods: </strong>January 2018 to January 2022 who received a TIVAP were included in the study and written informed consent was obtained from parents of all children at least 24 h prior to the intervention. One hundred and seven patients who needed TIVAP were randomly allocated into external jugular vein cut-down group (EJVCP) (n = 55) and internal jugular vein cut-down group (IJVCP) (n = 52) in this study.</p><p><strong>Results: </strong>Mean operative time was 32.5 ± 17.1 min in EJVCP group, and 63.6 ± 28.3 min in IJVCP group. The difference of operation time between the two groups was statistically significant (P < 0.05). The overall incidence of late complications found in this study was 14.5% in EJVCP group and 13.4% in IJVCP group, indicating that no statistical difference was observed.</p><p><strong>Conclusions: </strong>Compared with internal jugular vein, external jugular vein access has obvious advantages: the location of external jugular vein is superficial and easy to find, the utilization of external jugular vein is easy to learn and master, and the external jugular vein is of little importance to the human body. Through our study, we found that the external jugular vein access does not increase complications. External jugular vein access can be used as the first choice.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"78"},"PeriodicalIF":1.5,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical and psychosocial factors related to Pediatric Medical Traumatic Stress (PMTS) in children following surgery: a follow-up study.","authors":"Devprabha Bhagat, Manish Pathak, Tanu Gupta, Kirtikumar Rathod, Avinash Jadhav, Rahul Saxena, Shubhalaxmi Nayak, Naresh Nebhinani, Arvind Sinha","doi":"10.1007/s00383-025-05975-2","DOIUrl":"10.1007/s00383-025-05975-2","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical procedures in children involve significant psychological traumatic stress leading to the development of psychologic distress and dysfunction after surgery. Pediatric medical traumatic stress (PMTS) ensues from negative medical experiences which is a trauma that can have a devastating effect on children and their families. Awareness and early identification are important to provide psychological intervention at the correct time.</p><p><strong>Aims and objectives: </strong>This study aims to determine the prevalence of PMTS along with the associated surgical and psychosocial factors involved in pediatric surgical patients at our institute.</p><p><strong>Methods: </strong>We included patients admitted to the pediatric surgery ward, for elective or emergency surgeries, and a three-point assessment was done. It was done pre-surgery, at 1 month for diagnosis of PMTS, and at 3 months for any spontaneous resolution. Along with we recorded data regarding surgical and psychosocial factors in play for each child.</p><p><strong>Results: </strong>A PMTS prevalence of 16.26% was seen in the age group of 1 to 7 years and 12.64% in 8 to 18 years on evaluation at 1 month after surgery. A significant association was calculated with factors like duration of surgery, duration of hospital stay, staged approach of surgery, malignancy or congenital anomalies, postoperative pain, postoperative complications, multiple admissions, creation of stoma, need for additional interventions on follow-up, parental anxiety, and socioeconomic status. A significant spontaneous resolution at 3 months was also noted.</p><p><strong>Conclusion: </strong>With this study we can establish a significant prevalence of PMTS in pediatric patients undergoing surgery and the significantly associated determinants have been identified. The healthcare team as a whole can work toward reducing the risk of the development of PMTS, both in parents and children.</p><p><strong>Level of evidence: </strong>Level II.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"77"},"PeriodicalIF":1.5,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current practice and barriers for transition of care (TOC) in pediatric surgery: perspectives of adult surgeons from different subspecialties.","authors":"Woon Teen Sia, Jia Chyi Tay, Tiong Chan Lee, Shireen Anne Nah, Mohan Arunasalam A Nallusamy, Hans Alexander Mahendran","doi":"10.1007/s00383-025-05969-0","DOIUrl":"10.1007/s00383-025-05969-0","url":null,"abstract":"<p><strong>Introduction: </strong>The advancements in neonatal resuscitation and surgical care have enabled children with congenital abnormalities to receive corrective surgeries and achieve lifespans well into adulthood. These patients may require long-term follow-up as they continue to have risks of developing sequelae from their original diseases or surgical interventions.</p><p><strong>Purpose: </strong>This study aimed to investigate the current practice and barriers to the transition of care (TOC) from the perspectives of adult surgeons.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with purposive sampling of adult surgeons from different subspecialties. An online self-administered questionnaire was distributed.</p><p><strong>Results: </strong>There were 60 respondents. 62% of the respondents had experience managing referrals for continuation of care or complications in patients with congenital abnormalities. 38% of the respondents believed that TOC should be implemented when patients reached ages 17-18 years. 93% of the respondents agreed that a proper TOC model would greatly benefit patient care, and 97% asserted the need to develop TOC pathways in Malaysia. The absence of a proper guideline was the greatest barrier to a smooth TOC.</p><p><strong>Conclusion: </strong>This study offered insights into the obstacles to TOC based on the perspectives and experiences of adult surgeons who participated. While not exhaustive, our study provided a better understanding of the challenges in developing the appropriate referral pathways for the continued care of these patients.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"76"},"PeriodicalIF":1.5,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Antenatal detection of pediatric surgical congenital abnormalities and its effect on maternal anxiety: a multicentre prospective study in a middle‑income country.","authors":"Chai Hoon Soh, Shireen Anne Nah, Wei Sheng Tan, Srihari Singaravel, Yew-Wei Tan, Seet Fai Woon, Bathmavathy Chandran, Anand Sanmugam","doi":"10.1007/s00383-025-05971-6","DOIUrl":"https://doi.org/10.1007/s00383-025-05971-6","url":null,"abstract":"","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"75"},"PeriodicalIF":1.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How low should we go? Outcomes of ECMO in neonates with low gestational age or birth weight.","authors":"Faraz A Khan, Humza Thobani, Dan Neal, Saleem Islam","doi":"10.1007/s00383-025-05972-5","DOIUrl":"https://doi.org/10.1007/s00383-025-05972-5","url":null,"abstract":"<p><strong>Purpose: </strong>Initial recommendations for ECMO had relative contraindications for low birth weight (BW) or low gestational age (GA) babies. However, more recent literature has demonstrated improved and acceptable outcomes of ECMO in smaller neonates. The purpose of this study was to understand both utilization and survival in patients with lower GA and BW.</p><p><strong>Methods: </strong>All neonates captured in the Extracorporeal Life Support Organization (ELSO) registry who underwent a single ECMO run from 2009 to 2019 were included. The primary outcome measure was mortality and the secondary outcome measure was major adverse outcomes, defined as a composite outcome variable any severe ECMO complications. Univariate and multivariable statistical tests were performed to estimate the association between GA and BW with both outcome variables.</p><p><strong>Results: </strong>A total of 14,167 cases met inclusion criteria. Univariate analysis noted that birth weight, gestational age, ECMO mode, pulmonary support type, pH and ventilator settings were highly significant predictors of survival. Multivariable assessment noted significant linear relationship of mortality rates with increasing GA and BW (p < 0.001, OR = 0.82 GA, 0.51 BW). The highest ECMO-related mortality was observed in neonates with GA 30-31 weeks and BW 1.5-2.0 kg, with a 70-75% in-hospital mortality rate.</p><p><strong>Conclusions: </strong>Decreasing GA and BW were strongly correlated with increasing odds of mortality and/or ECMO-related complications. However, even in low GA or BW neonates, survival may be possible in up to a quarter of patients put on ECMO.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"74"},"PeriodicalIF":1.5,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143040776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficacy analysis of robotic versus laparoscopic ipsilateral uretero-ureterostomy for upper urinary tract duplications in pediatric population.","authors":"Bin Yu, Luping Li, Yingzhong Fan","doi":"10.1007/s00383-024-05948-x","DOIUrl":"https://doi.org/10.1007/s00383-024-05948-x","url":null,"abstract":"<p><strong>Objective: </strong>To review and compare robot-assisted ipsilateral ureteroureterostomy (RALUU) and laparoscopic ipsilateral uretero-ureterostomy (LUU) in terms of efficacy and outcomes.</p><p><strong>Methods: </strong>Clinical data of 65 children with complete renal ureteral duplication deformity admitted to the First Affiliated Hospital of Zhengzhou University from January 2015 to December 2022 were collected. Among these, 42 patients underwent laparoscopic ureteroureterostomy (LUU), designated as the LUU group, while 23 patients received robot-assisted laparoscopic ureteroureterostomy (RALUU), designated as the RALUU group. We compared the two groups regarding surgical duration, intraoperative blood loss, postoperative drainage duration, length of hospital stay, changes in anterior-posterior diameter (APD) of the affected renal pelvis pre- and postoperatively, changes in ureteral diameter, and alterations in renal function.</p><p><strong>Results: </strong>The postoperative drainage duration (Z = 2.375, P = 0.024) and length of hospital stay (t = 2.142, P = 0.038) were shorter in the RALUU group compared to the LUU group, with statistically significant differences. However, there were no statistically significant differences in surgical duration (t = - 1.465, P = 0.153) and intraoperative blood loss (Z = 1.679, P = 0.097) between the two groups. Complications occurred in three patients in the LUU group (two cases of anastomotic stricture and one case of stump syndrome), while no long-term complications were reported in the RALUU group, with no significant difference between the groups (χ² = 0.482, P = 0.488). Both groups exhibited a tendency for improvement in APD, ureteral diameter (UD), and differential renal function (DRF) pre- and postoperatively. However, further analysis revealed that changes in APD (ΔAPD, t = - 1.132, P = 0.284), DRF (ΔDRF, Z = 1.865, P = 0.073), and UD (ΔUD, t = 1.562, P = 0.064) did not show statistically significant differences between the two groups.</p><p><strong>Conclusion: </strong>Both RALUU and LUU are safe and effective treatments for children with complete renal ureteral duplication anomalies. Compared to LUU, RALUU is associated with shorter postoperative drainage duration and hospital stay.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"73"},"PeriodicalIF":1.5,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143040788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Day-case gastrostomy insertion in children: an achievable reality.","authors":"David Thompson, Maddie Allam, Karen Dick, Jo Leigh, Rhoda Taylor, Charlie Keys, Lara Kitteringham, Ori Ron, Michael Stanton, Francesca Stedman, Nigel J Hall","doi":"10.1007/s00383-024-05929-0","DOIUrl":"10.1007/s00383-024-05929-0","url":null,"abstract":"<p><strong>Purpose: </strong>Recent efforts have sought to streamline gastrostomy insertion care, particularly length of stay (LOS). We report our initial experience with day-case gastrostomy (DCG) insertion.</p><p><strong>Method: </strong>Retrospective review (April 2018-2024) of all primary gastrostomy insertions. Patients discharged the same day as the procedure were defined as DCG. Demographic, operative, and clinical data were recorded. All cases were treated according to a standardized feeding pathway.</p><p><strong>Results: </strong>Of 432 gastrostomies formed, 15 were DCG; median age 3.5 (0.7-16.9) years, LOS 12 h (9-15 h). The most common indication was nutritional supplementation (n = 9). Gastrostomy technique was single-stage percutaneous rapid insertion of gastrostomy button (SPRING n = 5) or percutaneous endoscopic gastrostomy (PEG n = 10). Prior to insertion, 6/15 DCG were established on nasogastric (NG) feeding, 8 did not use NG feeding, and 1 had occasional NG feeds. The majority (13/15) were performed on morning operating lists. There were 4 minor complications; 2 required readmission.</p><p><strong>Conclusion: </strong>DCG in selected cases is feasible and safe. Most cases were performed on morning operating list, but fewer than half had prior experience of nasogastric tube feeding. We suggest additional pathway modifications to improve DCG uptake.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"72"},"PeriodicalIF":1.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}