Pediatric Surgery International最新文献

{"title":"Characteristics, progression, management, and outcomes of NEC: a retrospective cohort study.","authors":"Maher Shahroor, Mohamed Elkhouli, Kyong-Soon Lee, Agostino Pierro, Prakesh S Shah","doi":"10.1007/s00383-024-05918-3","DOIUrl":"https://doi.org/10.1007/s00383-024-05918-3","url":null,"abstract":"<p><strong>Background: </strong>Necrotising enterocolitis (NEC) in preterm infants is associated with high morbidity and mortality. In most neonates, it is a progressive disease from medical NEC (mNEC) to surgical NEC (sNEC); however, in some, it presents as sNEC from onset.</p><p><strong>Objective: </strong>To evaluate the rate, the timing of progression, different surgical approaches, and outcomes of mNEC and sNEC in preterm neonates.</p><p><strong>Design: </strong>A retrospective cohort study of preterm infants with diagnosis of NEC between 2010 and 2020 was conducted. Data on clinical presentation, NEC progression, treatment received, different surgical approaches, resource utilization, and outcomes were abstracted. Infants were classified into 3 groups: mNEC, mNEC that progressed to sNEC, and sNEC at presentation.</p><p><strong>Results: </strong>Among 208 included infants with NEC, 109 (52%) were mNEC, 66 (32%) progressed from mNEC to sNEC, and 33 (16%) presented with sNEC. Gestational age, birth weight, and postnatal age at NEC were inversely associated with the development of sNEC. mNEC progressed to sNEC occurred after a median of 2.5 (IQR 1-4.25) days. Ninety (91%) of sNEC patients underwent interventions: peritoneal drain only in 19 (21%), laparotomy in 59 (66%), or both in 12 (13%). In comparison with mNEC, those with sNEC infants had longer duration on antibiotics, inotropes, respiratory support, length of stay, and time to reaching full enteral feeds; and were more likely to have recurrent NEC episodes, BPD, and mortality.</p><p><strong>Conclusion: </strong>There is a high burden of illness for sNEC cases. Insight into the expected clinical course of sNEC patients can facilitate anticipatory management and provide a window of opportunity for timely interventions that may ameliorate the course of sNEC.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"13"},"PeriodicalIF":1.5,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755467","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":"Peter Paul Rickham: the Liverpool neonatal surgery unit 1953.","authors":"Paul D Losty","doi":"10.1007/s00383-024-05910-x","DOIUrl":"10.1007/s00383-024-05910-x","url":null,"abstract":"<p><p>This article highlights the evolution, birth and legacy of the world's first neonatal surgical unit established at Alder Hey Children's Hospital Liverpool in 1953. Peter Paul Rickham, a creative pioneering and innovative surgeon, is credited here as a major driving force that helped shape and progress the modern day development of neonatal surgery. Rickham's vision was realised by studying neonatal surgical disorders and the mortality rate of congenital anomalies in Mersey Region while working as a young senior registrar with Isabella Forshall. Rickham defined the extent of the problem(s) and set to work as a newly appointed consultant a vision for improving outcomes with the creation and establishment of a preeminent world leading neonatal surgical unit. Surgeons from all over the world travelled to work, learn and train with Rickham and the paediatric surgical staff team at Alder Hey in the subsequent years to follow. Neonatal anaesthesia greatly advanced by Jackson Rees a colleague working in Liverpool with Rickham allowed huge success to flourish-'the impossible became possible'. The neonatal surgical unit in Liverpool became the benchmark and prototype for units to develop around the world immediately resulting in improvement in the survival of newborn infants undergoing surgery from 22 to 74%. Rickham's contributions to neonatal and paediatric surgery are truly remarkable. Alder Hey hosts an international symposium and special dinner with Rickham family members as VIP guests in its calendar of events. A symposium highlight is the Rickham Lecture with the PPR Gold Medal awarded to an international renowned leader in the field of paediatric surgery and the surgical sciences.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"12"},"PeriodicalIF":1.5,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751301","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":"Prophylactic surgical drain placement with irrigation reduces abscess formation in patients with severe, uncontained, perforated appendicitis.","authors":"Michael A Stellon, Devashish S Joshi, Russell Herberg, Brittany Walker, Jessica Hellner, Kevin M Riggle, Hau D Le","doi":"10.1007/s00383-024-05892-w","DOIUrl":"10.1007/s00383-024-05892-w","url":null,"abstract":"<p><strong>Background: </strong>20-25% of perforated appendicitis cases are complicated by abscess formation. This study assesses whether prophylactic closed-suction surgical drain (SD) placement after irrigation can decrease postoperative abscess formation in patients with extensively contaminated, perforated appendicitis.Affiliations: Journal instruction requires country for affiliations; however, these are missing in all affiliations. Please verify if the provided country names are correct and amend if necessary.They're correct METHODS: A multicenter retrospective review was performed on pediatric patients with uncontained perforated appendicitis from January 1, 2020 to August 1, 2023. Limited irrigation was performed. All SDs were oriented towards the pelvis. Data were analyzed in four groups: (G1) SD and irrigation, (G2) only SD, (G3) only irrigation, (G4) neither SD nor irrigation.</p><p><strong>Results: </strong>One hundred and fifteen patients (44 in G1, 3 in G2, 21 in G3, 47 in G4) were included. The abscess rate was 5.1% (G1), 33.3% (G2), 33.3% (G3), and 37.0% (G4) (p = 0.001). No interventional radiology (IR) drains were placed in G1 and G2. SD duration was 4.1 ± 2.1 days in G1 and 2.7 ± 0.6 days in G2. IR drain duration was 14 ± 10.7 days in G3 and 8.3 ± 3.9 days in G4 (p < 0.001). There were no significant differences in total length of stay and antibiotic duration.</p><p><strong>Conclusions: </strong>Irrigation with prophylactic SD placement may prevent postoperative abscesses in patients with severe, uncontained, perforated appendicitis, but prospective data are needed.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"11"},"PeriodicalIF":1.5,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740060","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":"Feeding jejunostomy in children: safety, effectiveness and perspectives.","authors":"Valentina Forlini, Caterina Sacchetti, Paolo Gandullia, Stefano Avanzini, Girolamo Mattioli, Michela Cing Yu Wong","doi":"10.1007/s00383-024-05915-6","DOIUrl":"https://doi.org/10.1007/s00383-024-05915-6","url":null,"abstract":"<p><strong>Purpose: </strong>Jejunal feeding (JF) indications in children have recently increased. However, surgical jejunostomy (SJ) is reported to be subjected to a high complication rate. The aim of the study is to focus on safety, effectiveness, and complications of SJ and to identify those categories of patients who could most benefit from it.</p><p><strong>Methods: </strong>A retrospective analysis of all SJ performed at Giannina Gaslini Children's Hospital between 2014 and 2022 was performed. Data were collected regarding demographics characteristics, past medical history, surgical indications, surgical technique (Roux-en-y (REYJ), omega jejunostomy (OJ)), complications and nutritional outcomes.</p><p><strong>Results: </strong>Fourteen patients were included. Nine (64%) had severe neurological impairment. The most frequent indication for SJ was gastroesophageal reflux. REYJ was performed in five (36%) patients, OJ in nine (64%); no technique appears to be superior. One patient experienced a major long-term complication. After a follow-up of 40 months (range: 1-152), five (36%) patients discontinued JF: three (21%) successfully completed JF cessation, and two (14%) had their jejunostomy closed due to JF intolerance.</p><p><strong>Conclusions: </strong>Based on our experience and on data available in the literature, SJ should be recommended in selected patients as temporary procedure or as bridge treatment to prevent or at least delay more invasive surgeries.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"10"},"PeriodicalIF":1.5,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740058","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":"Comparison of different Kasai portoenterostomy techniques in the outcomes of biliary atresia: a systematic review and network meta-analysis.","authors":"Yanran Zhang, Shaowen Liu, Qianhui Yang, Rongjuan Sun, Jiaying Liu, Yu Meng, Jianghua Zhan","doi":"10.1007/s00383-024-05920-9","DOIUrl":"10.1007/s00383-024-05920-9","url":null,"abstract":"<p><strong>Background: </strong>Biliary atresia (BA) is a progressive disease affecting the bile duct structure and function, leading to poor outcomes without timely surgical intervention. Kasai portoenterostomy (KPE) is a commonly used treatment to restore bile flow. However, the success rate and postoperative outcomes of KPE vary with different surgical techniques, including laparoscopic, robot-assisted, and open approaches.</p><p><strong>Methods: </strong>Following the PRISMA guidelines, this study systematically searched PubMed, EMBASE, and Cochrane databases for literature on BA surgical techniques of KPE. Studies comparing two or all three techniques-laparoscopic, robot-assisted, and open-in terms of postoperative outcomes of KPE in BA patients were included. Utilizing the \"gemtc\" package in R version 4.3.3, NMA was conducted to compare postoperative clearance of jaundice (COJ) among different surgical techniques. We also performed traditional paired meta-analysis in which multiple surgical outcomes were compared.</p><p><strong>Results: </strong>According to the traditional definition of a successful KPE surgery, in terms of successful postoperative COJ, robotic-assisted Kasai portoenterostomy (RAKPE) shows advantage over open Kasai portoenterostomy (OKPE) and laparoscopic Kasai portoenterostomy (LKPE), while the outcomes between OKPE and LKPE are equivalent. However, statistically speaking, there is no significant difference among the three techniques. LKPE has a longer operation time and less intraoperative bleeding compared to OKPE. There are no statistically significant differences in hospital stay, cholangitis incidence, or liver survival rates at 6 months, 1 year, 2 years, or 5 years.</p><p><strong>Conclusion: </strong>The surgical success rates of KPE with various technical aids are similar, highlighting the need to consider individual patient conditions and cost when choosing a surgical technique. Effective postoperative management is vital for preventing complications and slowing liver fibrosis. Future research should focus on improving surgical techniques and postoperative care to enhance long-term outcomes for BA patients. For those who cannot maintain liver function with KPE, timely LT consideration is crucial.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"6"},"PeriodicalIF":1.5,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142731583","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":"Chyme reinfusion practices in the neonatal population.","authors":"Alexandria H Lim, Georges Tinawi, Taylor Harrington, Emma Ludlow, Helen Evans, Ian Bissett, Celia Keane","doi":"10.1007/s00383-024-05904-9","DOIUrl":"10.1007/s00383-024-05904-9","url":null,"abstract":"<p><strong>Introduction: </strong>Chyme reinfusion therapy (CRT) is a safe and effective method to improve nutritional outcomes and promote intestinal adaptation in patients with stomas. This practice involves refeeding the proximal stoma output, down the distal limb, and mimics a state of intestinal continuity; thereby promoting growth and adaption of the distal bowel. Despite its promise, CRT in neonates is a relatively underutilised practice and can be of significant value in neonates with congenital bowel anomalies or necrotising enterocolitis. We aimed to identify the frequency, methodology and adverse effects associated with CRT in our neonatal population. We aimed to identify the frequency, methodology and adverse events associated with CRT in our neonatal population.</p><p><strong>Methods: </strong>A ten-year retrospective cohort study was conducted using database searches at two major paediatric hospitals in New Zealand. All patients with suitable anatomy were identified, and data on CRT methodology and outcomes were recorded.</p><p><strong>Results: </strong>Of the 49 eligible neonates, 23 (47%) underwent CRT. Indications for CRT included high stoma output, malnutrition with poor weight gain, and routine refeeding prior to stoma reversal. A nasogastric feeding tube was inserted into the distal limb and collected chyme was reinfused via manual bolus or automated syringe driver. The median (IQR) weight gain increased from 13.9 (3.50-22.89) to 24.37 (19.68-29.99) g/day during CRT (p = 0.04). 18 infections requiring medical intervention but unrelated to CRT occurred in 13 patients (56%). Amongst our cohort, there was a high rate of non-infectious events, including peri-stomal skin irritation (60%), stoma prolapse (43%) and stomal bleeding (26%).</p><p><strong>Conclusion: </strong>CRT is an underutilised method of improving nutrition in neonates with intestinal failure. Premature neonates requiring double enterostomy formation are at high risk of infectious and non-infectious complications, but few of these are related to CRT. Standardised protocols providing clear eligibility criteria and detailed methodology for CRT are required to promote uniform utilisation of this practice.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"7"},"PeriodicalIF":1.5,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142731580","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":"A comparative study on the efficacy of laparoscopic ureteroureterostomy versus single ureteral bladder reimplantation in treating pediatric complete renal duplication.","authors":"Bin Yu, Luping Li, Yingzhong Fan","doi":"10.1007/s00383-024-05908-5","DOIUrl":"https://doi.org/10.1007/s00383-024-05908-5","url":null,"abstract":"<p><strong>Objective: </strong>To explore the therapeutic value of laparoscopic ureteroureterostomy compared to single ureteral bladder reimplantation in the treatment of pediatric complete renal duplication.</p><p><strong>Methods: </strong>This retrospective study included 80 pediatric patients with complete renal duplication who underwent surgical treatment at the First Affiliated Hospital of Zhengzhou University from January 2015 to December 2022. Patients were divided into two groups based on the surgical approach: the laparoscopic ureteroureterostomy group (LUU group, n = 45) and the single ureteral bladder reimplantation group (UR group, n = 35). The two groups were compared in terms of operative time, intraoperative blood loss, number of stent placements, postoperative length of hospital stay, changes in ante-posterior diameter (APD) of the affected upper kidney pelvis before and after surgery, changes in upper ureteral diameter (UD), changes in upper renal cortex thickness (RCT) and variations in renal function.</p><p><strong>Results: </strong>The LUU group demonstrated significantly shorter operative time (t = 3.480, P = 0.004), less intraoperative blood loss (t = -2.465, P = 0.0196), and reduced postoperative length of stay (t = 2.308, P = 0.027) compared to the UR group. There was no significant difference between the two groups regarding the number of stent placements (x² = 0.762, P = 0.383). The UR group had four cases of long-term complications (two cases of anastomotic stricture, one case of vesicoureteral reflux, and one case of recurrent urinary tract infection), while the LUU group experienced one case of long-term complication (one case of anastomotic stricture), with no significant difference between groups (x² = 1.493, P = 0.222). Both groups showed significant improvement in preoperative and postoperative APD, UD, RCT and affected side differential renal function (DRF). However, the differences in improvement values for upper kidney pelvis APD (ΔAPD; t = -0.032, P = 0.962), upper RCT (ΔRCT; t = -0.042, P = 0.957), ureteral diameter (ΔUD; t = 1.832, P = 0.079), and differential renal function (ΔDRF; Z = 1.895, P = 0.073) were not statistically significant.</p><p><strong>Conclusion: </strong>Both LUU and UR procedures are safe and effective in treating pediatric complete renal duplication. Compared to UR, LUU results in shorter operative time, less intraoperative blood loss, and reduced postoperative length of stay, while also causing less damage to the bladder.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"8"},"PeriodicalIF":1.5,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142731577","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 burden of adhesive bowel obstruction requiring surgery in children: a single-center retrospective review.","authors":"Jonathan Hencke, Gabriel Nonnenmacher, Steffan Loff","doi":"10.1007/s00383-024-05914-7","DOIUrl":"https://doi.org/10.1007/s00383-024-05914-7","url":null,"abstract":"<p><strong>Purpose: </strong>Investigate causes, predictors, and complications of adhesive bowel obstruction (ABO) necessitating surgery in children.</p><p><strong>Methods: </strong>Single-center retrospective review of operative cases classified as 'adhesive bowel obstruction ' between May 2014 and December 2023. Parameters assessed included previous surgeries, operative time (indicative of adhesion extent), length of stay and postoperative complications. Results were statistically analyzed afterward.</p><p><strong>Results: </strong>We identified 71 patients with ABO; seven had recurrences. Age (11 d-18 y, median 5.9 y) and time after surgery (four days-16 years, median 6.4 months) varied considerably. Preceding appendicitis (16 cases), NEC (seven cases) and gastroschisis (five cases) were most prevalent. Operative time ranged from 43 min to 8.4 h, was longer after previous surgery during infancy (median 177 vs. 124 min), recurrent ABO (median 213 vs. 150 min) and significantly shorter after appendicitis (82 vs. 175 min). ICU stay (median 2 days) and hospital stay (median 11 days) reduced with age. 32 patients (41%) suffered complications, doubling mean lengths of stay. Bowel resection and longer surgery were associated with complications, while age and enterostomy creation were not.</p><p><strong>Conclusion: </strong>ABO is an impactful complication with limited predictors. The high incidence of complications adds to the burden for patients, parents, and health systems.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"9"},"PeriodicalIF":1.5,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740032","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":"Innovative minimally invasive gastric pull-up techniques in children: SILS and robot-assisted gastric pull-up.","authors":"Zafer Dokumcu, Ulgen Celtik, Samir Hasan, Coskun Ozcan, Ata Erdener","doi":"10.1007/s00383-024-05900-z","DOIUrl":"https://doi.org/10.1007/s00383-024-05900-z","url":null,"abstract":"<p><strong>Aim: </strong>This study aims to explore the rationality, feasibility, safety, and effectiveness of single-incision laparoscopic gastric pull-up (SILS-GPU) and robot-assisted gastric pull-up (R-GPU) methods.</p><p><strong>Methods: </strong>Hospital records of patients who underwent gastric pull-up with either SILS-GPU or R-GPU between May2016 and January 2024 were reviewed. Demographics, diagnosis, surgical techniques, and postoperative outcomes were evaluated.</p><p><strong>Results: </strong>Out of the total 12 patients (eight persistent corrosive esophageal stricture-PCES, four long gap esophageal atresia-LGEA), seven underwent SILS-GPU, while the remaining five underwent R-GPU. The choice of conduit route was based on the primary pathology (PCES/EA) and the presence of posterior mediastinal fibrosis and/or tracheomalacia. The posterior mediastinum was preferred in seven, intrathoracic in three, and retrosternal in two patients. Transhiatal esophagectomy was performed in seven patients, while transthoracic esophagectomy was performed in three. There were no instances of mortality or intraoperative complications related to the preferred technique. All patients except one with Down syndrome were able to feed orally.</p><p><strong>Conclusion: </strong>SILS-GPU and R-GPU are demonstrated to be safe and effective in the pediatric population, with relatively lower complication rates in children.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"4"},"PeriodicalIF":1.5,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710762","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":"Association between nighttime/weekend visits and patient outcomes in children with blunt liver and spleen injuries.","authors":"Hiraku Funakoshi, Shogo Shirane, Morihiro Katsura","doi":"10.1007/s00383-024-05895-7","DOIUrl":"10.1007/s00383-024-05895-7","url":null,"abstract":"<p><strong>Purpose: </strong>The \"out-of-hours effect,\" which indicates hospital admittance during weekends or nighttime, has poorer outcomes for patients than for those admitted on weekdays and is widely documented in various medical conditions. However, this effect remains understudied in pediatric trauma cases, including blunt liver and spleen injuries (BLSIs).</p><p><strong>Methods: </strong>This was a secondary analysis of a nationwide multicenter retrospective study, focusing on pediatric patients with trauma (≤ 16 years old) with BLSI admitted from 2008 to 2019. This study evaluated the association between out-of-hour admissions and outcomes. The primary outcome was the intervention rate and secondary outcomes were 30-day mortality and time from hospital arrival to the first intervention.</p><p><strong>Results: </strong>This study identified 1414 pediatric patients with BLSI. In total, 681 events occurred during the daytime and 733 during the nighttime, with 927 weekday and 487 weekend events. Out-of-hour admissions did not significantly associate with a higher rate of intervention. This association remained after adjusting for five potential confounders and patient clustering within the hospital. In addition, Out-of-hour admissions did not significantly associated with 30-day mortality, or time from hospital arrival to the first intervention.</p><p><strong>Conclusions: </strong>The current study showed no significant difference in treatment strategy and outcomes between weekday and out-of-hour among children with BLSI.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"5"},"PeriodicalIF":1.5,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710758","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}