Pediatric Surgery International最新文献

{"title":"Survival rate changes in children with congenital diaphragmatic hernia over the past three decades: a nationwide, population-based prospective nested case-control study.","authors":"B Kutasy, C M Burgos","doi":"10.1007/s00383-024-05860-4","DOIUrl":"10.1007/s00383-024-05860-4","url":null,"abstract":"<p><strong>Purpose: </strong>The survival rate (SR) for neonates born with congenital diaphragmatic hernia (CDH) remains high. Our aim was to investigate the change in SR in children with CDH over the past decades.</p><p><strong>Methods: </strong>The study was a nationwide, population-based prospective nested case-control study within a cohort of newborn children who was born in Sweden during the observational period from 1st January 1982 to 31st December 2015.</p><p><strong>Results: </strong>In the study period, 4654 (99.6%) control children and 684 children with CDH (70.4%, p < 0.001) were with a survival of 2 years of age. Any patients who were born with CDH had a overall 5.8 times higher chance for not surviving 2 years of age than children without CDH. The SR improved significantly in CDH in the past 3 decades. Significantly higher number of patients were prematurely born in the CDH group than in the controls (23.3 vs 6.1%, p < 0.001). The SR of premature and non-premature born CDH patients has increased significantly over the past 3 decades.</p><p><strong>Conclusion: </strong>The SR of CDH patients were significantly increased in the past 3 decades. The 2-year survival remains 5.8 times higher than those who were not born with CDH. These changes were mainly attributed to the improved SR of premature and non-premature born CDH patients.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"40 1","pages":"285"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562909","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 of partial versus total splenectomy in the treatment of hereditary spherocytosis in children: a systematic review and meta-analysis.","authors":"Xilong Tang, Jianjin Xue, Jie Zhang, Jiajia Zhou","doi":"10.1007/s00383-024-05879-7","DOIUrl":"10.1007/s00383-024-05879-7","url":null,"abstract":"<p><strong>Objective: </strong>To explore the comparative postoperative efficacy of partial splenectomy (PS) and total splenectomy (TS) in the treatment of children with hereditary spherocytosis (HS).</p><p><strong>Methods: </strong>The relevant HS studies from databases were searched and screened, comparing the differences in hemoglobin concentration, reticulocyte percentage, bilirubin concentration before and after TS and PS surgery, and during the follow-up period, as well as the incidence of postoperative adverse events. Statistical analysis was performed using Review Manager 5.4.</p><p><strong>Results: </strong>A total of 5 studies were included in this meta-analysis, with a cumulative enrollment of 312 children, 130 in the PS group and 182 in the TS group. The meta-analysis results showed that both PS and TS groups had statistically significant differences in postoperative hematological outcomes compared to before surgery, with TS showing better improvement than PS. In the postoperative follow-up, the changes in hematological outcomes between PS and TS were statistically significant for hemoglobin concentration: within 1 year [MD = 1.85, 95%CI(1.09,2.60)], 1-2 years [MD = 1.74, 95%CI(0.25,3.24)], not statistically significant for 4-6 years [MD = 1.28, 95%CI(-1.75,4.32)]; for reticulocyte percentage: within 1 year [MD = 2.23, 95%CI(0.80,3.66)] was statistically significant, not statistically significant for 4-6 years [MD = 1.77, 95%CI(-2.04,5.59)]; for serum bilirubin concentration: within 1 year [MD = 1.55, 95%CI(0.91,2.18)] was statistically significant, not statistically significant for 1-2 years [MD = 1.77, 95%CI(-2.04,5.99)]. In the incidence of postoperative adverse events, the incidence of cholelithiasis [MD = 1.77, 95%CI(-2.04,5.99)] showed a statistically significant difference between PS and TS, while there were no statistically significant differences in other included events, such as postoperative infection rate, secondary surgery rate, thrombosis rate, postoperative hemorrhage rate, and transfusion therapy rate.</p><p><strong>Conclusion: </strong>Splenectomy is a beneficial surgical strategy for children with moderate-to-severe HS, reducing; early hematological outcomes of TS are more robust than PS in the follow-up period, and there is no difference between the two in the later period; for postoperative adverse events, the incidence of cholelithiasis in children after PS is higher than after TS, and there is a risk of requiring a second surgery for total splenectomy due to hemolytic recurrences.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"40 1","pages":"280"},"PeriodicalIF":1.5,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546728","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":"Usefulness of lateral-anteroposterior dimeter ratio in patients with tracheomalacia associated with esophageal atresia.","authors":"Wataru Sumida, Takahisa Tainaka, Chiyoe Shirota, Satoshi Makita, Hizuru Amano, Akihiro Yasui, Takuya Maeda, Daiki Kato, Yosuke Goda, Hiroki Ishii, Kazuki Ota, Guo Yaohui, Liu Jiahui, Akinari Hinoki, Hiroo Uchida","doi":"10.1007/s00383-024-05877-9","DOIUrl":"10.1007/s00383-024-05877-9","url":null,"abstract":"<p><strong>Purpose: </strong>Tracheomalacia (TM) is commonly associated with esophageal atresia (EA) and compression by the brachiocephalic artery is a factor for TM. Previous research has focused on the lateral-to-anteroposterior tracheal diameter ratio (LAR). This study aimed to assess the LAR and postoperative outcomes of EA patients.</p><p><strong>Methods: </strong>Patients undergoing thoracoscopic repair for EA between March 2020 and October 2023 were enrolled. Posterior tracheopexy (PT) was performed during thoracoscopic repair of EA on patients with bronchoscopy-confirmed TM; clinical courses and LAR were retrospectively analyzed.</p><p><strong>Results: </strong>Overall, 18 patients were enrolled; 14 patients underwent PT. Their median preoperative and postoperative LARs were 2.26 and 1.50, respectively; this difference was statistically significant. Four patients without TM did not undergo PT and their median LAR was 1.59. Median LAR for patients without PT was lower than that of preoperative patients with PT and no statistical differences were observed from that of postoperative patients with PT. The patients whose LAR improved with PT did not require further surgical intervention for TM. One patient who had a postoperative LAR of 2.25 required external tracheal stenting.</p><p><strong>Conclusion: </strong>LAR is a useful index for determining the severity of TM associated with EA. LAR can reflects the efficacy of PT.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"40 1","pages":"282"},"PeriodicalIF":1.5,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546729","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":"STAT trial: stoma or intestinal anastomosis for necrotizing enterocolitis: a multicentre randomized controlled trial.","authors":"Simon Eaton, Niloofar Ganji, Mandela Thyoka, Maher Shahroor, Augusto Zani, Hazel Pleasants-Terashita, Ali El Ghazzaoui, Jayaram Sivaraj, Stavros Loukogeorgakis, Paolo De Coppi, Sandra Montedonico, Sanja Sindjic-Antunovic, Marija Lukac, James Hamill, Candy Suet Cheng Choo, Shireen Anne Nah, Jan Hulscher, Sherif Emil, Aigars Petersen, Rene Wijnen, Cornelius Sloots, David Sigalet, Edward Kiely, Jan F Svensson, Tomas Wester, Agostino Pierro","doi":"10.1007/s00383-024-05853-3","DOIUrl":"10.1007/s00383-024-05853-3","url":null,"abstract":"<p><strong>Purpose: </strong>The STAT trial is a multicenter randomized controlled trial in 12 centers worldwide aiming to determine the most effective operation for neonates with necrotizing enterocolitis (NEC) requiring intestinal resection: stoma formation (ST) or primary anastomosis (PA).</p><p><strong>Methods: </strong>Infants having a primary laparotomy for NEC were randomized intraoperatively to PA or ST if the operating surgeon thought that both were viable treatment options for that patient. The primary outcome (duration of parenteral nutrition [PN]) was evaluated by Cox regression.</p><p><strong>Results: </strong>Eighty patients were recruited from 2010 to 2019. Infants undergoing anastomosis finished PN significantly earlier than patients undergoing stoma (hazard ratio PA vs. ST 2.38, 95% CI 1.36-4.12 p = 0.004). There was no difference in mortality between the two groups (PA 4/35 vs. ST 8/38 p = 0.35) or in the rate of complications requiring further unplanned operations (p = n.s.). Multiple intestinal complications were more frequent in the stoma group compared to the anastomosis group (ST 12/26 vs. PA 5/31, p = 0.02, Fisher's Exact test).</p><p><strong>Conclusion: </strong>At laparotomy for NEC, when there is no disease distal to resected intestine, primary anastomosis should be performed as it enhances the recovery from NEC, reduces the risk of multiple intestinal complications and does not increase adverse outcomes.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"40 1","pages":"279"},"PeriodicalIF":1.5,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546726","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":"Dipeptidyl peptidase IV inhibitors reduce hepatic fibrosis and lipid accumulation in rat intestinal failure-associated liver disease models.","authors":"Ryo Sueyoshi, Junya Ishii, Susumu Yamada, Marumi Kawakami, Kenji Tanabe, Osamu Segawa","doi":"10.1007/s00383-024-05863-1","DOIUrl":"10.1007/s00383-024-05863-1","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the effectiveness of dipeptidyl peptidase IV inhibitors (DPP4-I) against liver damage, especially fibrosis and lipid accumulation, in a rat intestinal failure-associated liver disease (IFALD) model.</p><p><strong>Methods: </strong>SD rats were divided into two groups: the Control (n = 7; normal saline + IFALD model) and DPP4-I (n = 7; DPP4-I + IFALD model; short bowel syndrome (SBS) + total parenteral nutrition) groups. All rats were euthanized 21 days postoperatively to obtain tissue samples. Liver fibrosis was evaluated by Sirius Red and α-SMA staining. Liver damage was assessed using the steatosis, activity, and fibrosis score. Inflammation cytokines were examined by ELISA.</p><p><strong>Results: </strong>The survival rate was comparatively different, being 87.5% in the DPP4-I group and 70.0% in the Control group. Two rats of the Control group showed progressive liver fibrosis in the periportal area with fibrous streaks. Further, the mean area percentage of α-SMA immune-positive cells was significantly lower in the DPP4-I group than in the Control group. TGF-β levels were significantly lower in the DPP4-I group than in the Control group.</p><p><strong>Conclusion: </strong>DPP4-I administration reduced liver fibrosis in IFALD, possibly by inhibiting DPP4-I-induced adipogenesis and suppressing TGF-β. These results may contribute to elucidating the mechanism of IFALD.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"40 1","pages":"281"},"PeriodicalIF":1.5,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546725","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":"Sex-specific differences in the severity of pulmonary hypoplasia in experimental congenital diaphragmatic hernia and implications for extracellular vesicle-based therapy.","authors":"Fabian Doktor, Emily Lo, Victoria Fortuna, Kasra Khalaj, Miguel Garcia, Rebeca Lopes Figueira, Martin Lacher, Lina Antounians, Augusto Zani","doi":"10.1007/s00383-024-05856-0","DOIUrl":"10.1007/s00383-024-05856-0","url":null,"abstract":"<p><strong>Purpose: </strong>Amniotic fluid stem cell extracellular vesicles (AFSC-EVs) hold regenerative potential to treat hypoplastic lungs secondary to congenital diaphragmatic hernia (CDH). This study aims to investigate sex-specific differences in pulmonary hypoplasia severity and responses to AFSC-EV administration in an experimental CDH mouse model.</p><p><strong>Methods: </strong>C57BL/6J dams were fed with nitrofen + bisdiamine (left-sided CDH) or olive oil only (control) at embryonic day (E) 8.5. Lungs were dissected (E18.5), grown ex vivo and treated with medium ± AFSC-EVs that were collected via ultracentrifugation and characterized (nanoparticle tracking analysis, electron microscopy, Western blotting). Pulmonary hypoplasia was assessed via mean linear intercept (MLI). Gene and protein expression changes (Cd31, Enos, Il1b, TNFa) were measured via RT-qPCR and immunofluorescence. Pups were genotyped for Sry.</p><p><strong>Results: </strong>Experimental CDH showed a male predominance without sex differences for pulmonary hypoplasia severity, fetal lung vascularization, and inflammation. AFSC-EV administration led to improved lung growth (decreased MLI), improved fetal lung vascularization (increased Cd31 and Enos), and decreased fetal lung inflammation (Il1b, TNFa). There was no sex-specific response to AFSC-EV administration.</p><p><strong>Conclusion: </strong>This study shows sex-independent impaired lung growth, vascularization and fetal lung inflammation in a CDH mouse model. Antenatal administration of AFSC-EVs reverses aspects of pulmonary hypoplasia secondary to CDH independent of the biological sex.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"40 1","pages":"278"},"PeriodicalIF":1.5,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522653","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":"Angiopoietin-1 attenuates lipopolysaccharide-induced endotoxemia in a Hirschsprung's disease murine model by improving intestinal vascular integrity: implications for treating postoperative Hirschsprung-associated enterocolitis.","authors":"Asuka Ishiyama, Kazuto Suda, Xuxuan Rao, Minhua Sun, Geoffrey J Lane, Atsuyuki Yamataka, Hiroyuki Koga","doi":"10.1007/s00383-024-05867-x","DOIUrl":"10.1007/s00383-024-05867-x","url":null,"abstract":"<p><strong>Purpose: </strong>Angiopoietin-1 (Ang1) mitigates inflammation as a proangiogenic growth factor. Action of Ang1 on lipopolysaccharide (LPS)-induced endotoxemic inflammation was investigated in endothelin receptor-B null Hirschsprung's disease mice (KO).</p><p><strong>Methods: </strong>LPS or saline was injected intraperitoneally in KO (KO-LPS; n = 9, KO-sal; n = 5) and wild-type (WT) (WT-LPS; n = 6, WT-sal; n = 6) pups obtained within 24 h of birth. Normoganglionic terminal ileum harvested 6 h after LPS was used for RNA extraction and histology. IL-1β, SELE, VEGFA, Ang1, Angiopoietin-2 (Ang2), and TIE2 expression analyzed by quantitative polymerase chain reaction (qPCR), vascular permeability assessed by the Miles assay, severity of inflammation, and immunofluorescence for phospho-TIE2 and VE-cadherin were used to assess endothelial cell contact integrity and compared with KO pups pretreated with intraperitoneal Ang1 [Ang1(KO-LPS); n = 5] or saline [sal(KO-LPS); n = 6] 2 h before LPS.</p><p><strong>Results: </strong>KO-LPS pups showed significantly increased inflammation (p < 0.05) and expression of IL-1β, SELE, VEGFA, and Ang2 (p = 0.019, 0.003, 0.008 and < 0.0001, respectively); expression of Ang1 and TIE2 remained unchanged when compared with KO-saline. In Ang1(KO-LPS) ileum, changes seen in sal(KO-LPS) were eliminated and phospho-TIE2 and VE-cadherin fluorescence increased.</p><p><strong>Conclusion: </strong>Ang1 successfully attenuated LPS-induced normoganglionic intestinal inflammation, downregulated pro-inflammatory genes, and improved vascular barrier integrity in KO pups.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"40 1","pages":"277"},"PeriodicalIF":1.5,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522651","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":"Features of recurrence and contralateral metachronous inguinal hernia (CMIH) in the patients underwent laparoscopic percutaneous extraperitoneal closure (LPEC) for pediatric inguinal hernia.","authors":"Hiromu Miyake, Masaya Yamoto, Akiyoshi Nomura, Yu Sugai, Yousuke Gohda, Yutaro Yamashiro, Koji Fukumoto","doi":"10.1007/s00383-024-05859-x","DOIUrl":"10.1007/s00383-024-05859-x","url":null,"abstract":"<p><strong>Purpose: </strong>Recurrence and contralateral metachronous inguinal hernia (CMIH) are important postoperative complications in patients with inguinal hernia (IH) who undergo laparoscopic percutaneous extraperitoneal closure (LPEC). This study aimed to evaluate the incidence and causes of recurrence and CMIH after LPEC.</p><p><strong>Methods: </strong>Among the included patients, 2484 hernias were included in the analysis of recurrence. CMIH was analyzed in 2094 cases with unilateral IH without a history of contralateral IH.</p><p><strong>Results: </strong>Overall, 21 hernias (0.85%) recurred and seven patients (0.34%) experienced CMIH. Based on the video inspection, injury and skipping of the peritoneum were suspected as the cause of recurrence in eight cases, while loose ligation was suspected in five cases. The cause of recurrence could not be predicted in the remaining eight patients. Of the seven patients with CMIH, three had a mild depression around the internal inguinal ring at the first surgery. In the remaining four CMIH cases, no noteworthy findings were noted around the internal ring.</p><p><strong>Conclusions: </strong>More than half of the recurrences, in which skipping of the peritoneum and loose ligation were suspected, could have been prevented by secure ligation during the first surgery. Extending the indications of prophylactic surgery for shallow depressions may reduce CMIH.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"40 1","pages":"276"},"PeriodicalIF":1.5,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522652","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":"Enhancement of enteric neural stem cell neurogenesis by glial cell-derived neurotrophic factor in experimental Hirschsprung's disease.","authors":"Naho Fujiwara, Dorothy Lee, Bo Li, Agostino Pierro, Atsuyuki Yamataka","doi":"10.1007/s00383-024-05861-3","DOIUrl":"10.1007/s00383-024-05861-3","url":null,"abstract":"<p><strong>Purpose: </strong>Stem cell therapy offers a promising solution for congenital diseases like Hirschsprung's disease (HSCR). Optimizing stem cell efficacy by modifying the cells and their environment is crucial, but in vitro culture conditions need to be further improved. Glial cell-derived neurotrophic factor (GDNF) plays an important role in neuronal survival, proliferation, migration and differentiation during enteric nervous system (ENS) development. In this study, the effects of GDNF on neurites derived from an Ednrb knockout model were investigated with the aim of enhancing the neurogenic potential of enteric neural crest cells (ENCCs).</p><p><strong>Methods: </strong>Neurospheres were generated form Ednrb^+/+ (control) and Ednrb^-/- mice at embryonic day13.5 (E13.5) with Sox10-green fluorescent protein (Venus) transgenic expression. These neurospheres were cultured in control media and neurospheres from Ednrb^-/- were cultured with either control media or media supplemented with GDNF. ENCCs differentiation was assessed using immunofluorescence staining after 18 days.</p><p><strong>Results: </strong>GDNF-treated Ednrb^-/- neurospheres showed increased size and higher density of Sox10-positive ENCCs compared to untreated Ednrb^-/- neurospheres. GDNF also enhanced the distribution of both TUJ1-positive neurons and S100-positive glial cells.</p><p><strong>Conclusion: </strong>GDNF effectively enhanced the neurogenic potential of ENCCs from HSCR animal model. This finding is crucial for the development of cell therapy in HSCR.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"40 1","pages":"274"},"PeriodicalIF":1.5,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505545","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 biologically transparent illumination device is more useful in children for detecting the position of the nasogastric tube in the stomach.","authors":"Ryosuke Satake, Hiroshi Yamakawa, Nozomi Aoki, Rina Tanaka, Sakiko Yoshimoto, Tokiko Okunobo, Hiroki Nakamura, Takashi Doi","doi":"10.1007/s00383-024-05854-2","DOIUrl":"10.1007/s00383-024-05854-2","url":null,"abstract":"<p><strong>Purpose: </strong>The study aimed to evaluate the efficacy of the Biologically Transparent Illumination (BTI) device for confirming the correct placement of nasogastric (NG) tubes in children, as an alternative to X-ray, which exposes patients to radiation.</p><p><strong>Methods: </strong>In this prospective observational study, 106 pediatric patients (ages 0-16) undergoing NG-tube insertion after general anesthesia were evaluated. The BTI catheter was used to emit bio-permeable red light from the NG tube, which was then visually confirmed in the cervical, thoracic, and epigastric regions. X-ray confirmed NG-tube placement in all patients. The ethics committee approved the study.</p><p><strong>Results: </strong>The average patient age was 3.8 years, with a male-to-female ratio of 72:34. BTI was successfully detected in the epigastric area in 105 of 106 patients, with one 9-year-old patient having unclear BTI visibility. X-ray confirmed NG-tube placement in the stomach for all patients, resulting in a BTI sensitivity of 99%. The mean NG-tube insertion time was 38 s, and the mean abdominal thickness was 9.8 mm.</p><p><strong>Conclusions: </strong>The BTI device proved to be a safe and effective method for NG-tube placement in children, offering a radiation-free alternative with 100% successful placement when BTI was detected in the epigastric area.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"40 1","pages":"275"},"PeriodicalIF":1.5,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505544","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}