Pediatric Surgery International最新文献

{"title":"Clinical characteristics and management of reoperation for high jejunal atresia: a retrospective study.","authors":"Shuqi Hu, Yijiang Han, Rui Chen, Xiaoxia Zhao, Dengming Lai, Shoujiang Huang, Jinfa Tou, Lizhong Du","doi":"10.1007/s00383-025-05966-3","DOIUrl":"https://doi.org/10.1007/s00383-025-05966-3","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the clinical characteristics and available treatment strategies for reoperation of neonatal high jejunal atresia, and recommend preventive measures to reduce the reoperation rate of high jejunal atresia.</p><p><strong>Methods: </strong>The clinical data of 16 children with high jejunal atresia who underwent reoperation in the Neonatal Surgery Department at Children's Hospital of Zhejiang University School of Medicine from January 2018 to January 2023 were retrospectively analyzed.</p><p><strong>Results: </strong>Among the 16 unplanned reoperations, 7 (43.6%) were performed for functional ileus, 3 (18.8%) for anastomotic stenosis, 3 (18.8%) for adhesive ileus, and 3 (18.8%) for postoperative proximal septum. Surgical procedures for reoperations include duodenoplasty, resection and re-anastomosis of the original anastomosis, resection of the duodenal septum and enterolysis. Among the 16 patients, 1 had short-bowel syndrome that required repeated hospital admission for parenteral nutrition treatment, and 1 patient died of recurrent pneumonia and heart failure after surgery. The other 14 patients recovered from reoperation and were discharged. The patients were followed up from 1 month to 5 years after surgery, and showed good growth.</p><p><strong>Conclusion: </strong>For children with high jejunal atresia, the operative procedure will vary according to each patient's circumstances. If postoperative functional obstruction occurs, a wider range of bowel cutting and re-anastomosis can be performed. During the first operation, the diaphragm at the proximal end of jejunal atresia should not be missed.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"64"},"PeriodicalIF":1.5,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979551","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":"Evaluation of the risk factors for postoperative pectus excavatum and scoliosis in cystic lung disease.","authors":"Tainaka Takahisa, Shirota Chiyoe, Sumida Wataru, Makita Satoshi, Amano Hizuru, Kano Yoko, Yasui Akihiro, Kato Daiki, Maeda Takuya, Gohda Yousuke, Ishii Hiroki, Ota Kazuki, Hinoki Akinari, Uchida Hiroo","doi":"10.1007/s00383-024-05925-4","DOIUrl":"10.1007/s00383-024-05925-4","url":null,"abstract":"<p><strong>Purpose: </strong>To analyze the frequency and predictive factors of the development of postoperative pectus excavatum and scoliosis in children who underwent surgery for cystic lung disease.</p><p><strong>Methods: </strong>This study examined patients who underwent surgery for cystic lung disease (open and thoracoscopic) between July 2000 and December 2018 with a > 3-year follow-up period. Lesion size, surgical outcomes, and subsequent musculoskeletal complications were compared between the open surgery and thoracoscopic surgery groups. Univariate and multivariate analyses were performed to identify predictive factors.</p><p><strong>Results: </strong>Overall, 90 patients (19 and 71 patients in the open and thoracoscopic groups, respectively) were included in this study. There was no significant difference in the incidence of pectus excavatum or scoliosis between open and thoracoscopic surgery; however, Haller's index and Cobb angle were significantly higher in the open surgery group. In the univariate analysis, neonatal surgery and lesion size were substantial predictors of musculoskeletal malformations.</p><p><strong>Conclusion: </strong>Postoperative musculoskeletal deformities emerge after surgical treatment for cystic lung disease, with thoracoscopic surgery showing advantages in selected dimensions. Neonatal surgery and lesion size are pivotal prognostic factors for musculoskeletal complications. Further corroborative multicenter studies are imperative to substantiate these findings and foster enhanced patient outcomes.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"62"},"PeriodicalIF":1.5,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142966152","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":"Vitamin A enhances PI3K/Akt signaling and mitigates enterocyte apoptosis in a mouse model of necrotizing enterocolitis.","authors":"Qian Su, Li Chen, Dong Liu, Yanzhen Xu, Jinxing Feng, Jialin Yu, Zhaoxia Zhang, Zhangbin Yu","doi":"10.1007/s00383-025-05963-6","DOIUrl":"https://doi.org/10.1007/s00383-025-05963-6","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to elucidate the roles of the PI3K-Akt signaling pathway and enterocyte apoptosis in necrotizing enterocolitis (NEC) pathogenesis and investigate the impact of vitamin A intervention on these factors.</p><p><strong>Methods: </strong>We employed an NEC mouse model and administered vitamin A treatment. Retinol levels in mouse blood were quantified using ELISA. Intestinal cell apoptosis in NEC mice was assessed via the TUNEL assay. We evaluated mRNA and protein expressions of Bcl-2, Bax, cytochrome C (CytoC), Caspase 3, and PI3K/Akt signaling pathway components using qPCR and western blotting.</p><p><strong>Results: </strong>In NEC models, PI3K, Akt, and Bcl-2 were downregulated, accompanied by upregulated Bax, CytoC, and Caspase 3 at both mRNA and protein levels. These molecular changes were associated with an increase in enterocyte apoptosis in the NEC models. Vitamin A supplementation increased PI3K, Akt, and Bcl-2 expression while decreasing Bax, CytoC, and Caspase 3 levels in the NEC models, resulting in reduced apoptosis.</p><p><strong>Conclusion: </strong>Vitamin A has the potential to mitigate enterocyte apoptosis in NEC by upregulating the PI3K/Akt signaling pathway and modulating apoptotic signals, providing new insights into the inhibitory effect of vitamin A on enterocyte apoptosis in NEC.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"61"},"PeriodicalIF":1.5,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952785","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":"Correspondence: same-day discharge for pediatric Nuss procedure; an analysis of the NSQIP-pediatric database from 2017-2022.","authors":"Todd A Glenski, Christian Taylor, Emily Weisberg, Nichole Doyle","doi":"10.1007/s00383-024-05962-z","DOIUrl":"https://doi.org/10.1007/s00383-024-05962-z","url":null,"abstract":"","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"60"},"PeriodicalIF":1.5,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952783","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 outcomes of treatment between primary closure and staged closure in gastroschisis in the pre and post era of the bedside wound retractor silo placement technique.","authors":"Sireekarn Chantakhow, Pattamaporn Thaivutinukul, Kanokkan Tepmalai, Chutjongkol Intatong, Jiraporn Khorana","doi":"10.1007/s00383-024-05940-5","DOIUrl":"https://doi.org/10.1007/s00383-024-05940-5","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare the treatment outcomes of the closure methods between pre and post-eras of bedside wound retractor silo placement technique (BSC).</p><p><strong>Methods: </strong>This retrospective cohort study included infants diagnosed with gastroschisis from 2006-2013, pre-BSC era, and from 2014-2021, BSC era. Infants who had fetal anomalies did not survive before receiving treatment and were treated with the delayed closure method were excluded. Pretreatment covariates were adjusted using propensity score in the multivariable logistic regression.</p><p><strong>Results: </strong>From 170 patients, 5 were excluded. 111 patients underwent primary closure (PC), 54 patients were staged closure (SC). Successful early enteral feeding was achieved in 70(42%) of patients. Among these patients, 52.2% were in the PC group, and 22.2% in the SC group. PC had a significantly higher rate of successful early enteral feeding compared to SC in the pre-BSC era (OR 21.98, 95%CI 2.59-186.51, p-value 0.005). The BSC era, there was no significant difference between the groups (OR 2.04, 95%CI 0.41-1.20, p-value 0.386). There were no differences in complications between PC and SC.</p><p><strong>Conclusions: </strong>SC was not inferior in terms of achieving early feeding compared with PC. BSC is an acceptable procedure when a PC was not appropriate and accessible.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"59"},"PeriodicalIF":1.5,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952784","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":"Ultrasonography-guided aspiration and sclerotherapy for simple renal cysts in children: a comparative study with laparoscopic deroofing and optimization of therapeutic approaches.","authors":"Jiali He, Xianhai Yu, Li Zhang, Chunjiang Yang, Qitong Guo, Ping Li, Shengde Wu, Yi Hua, Xing Liu, Dawei He, Tao Lin, Deying Zhang, Guanghui Wei","doi":"10.1007/s00383-024-05960-1","DOIUrl":"https://doi.org/10.1007/s00383-024-05960-1","url":null,"abstract":"<p><strong>Objective: </strong>To compare the clinical outcomes of ultrasonography-guided aspiration and sclerotherapy and laparoscopic deroofing for the treatment of simple renal cysts in children, providing evidence for clinical decision-making in the management of pediatric renal cysts.</p><p><strong>Methods: </strong>A total of 49 patients with simple renal cysts were divided into two groups based on the treatment method: 29 patients (group 1) underwent laparoscopic deroofing, 20 patients (group 2) underwent ultrasonography-guided aspiration and sclerotherapy. The clinical efficacy differences between the two groups were compared. During the study period, optimizations were made to the aspiration and sclerotherapy procedure in terms of sclerosant injection volume, sclerosing time, frequency, and intervals.</p><p><strong>Results: </strong>The complete disappearance rate of cysts in group 2(95.0%) was significantly higher than that in group 1 (33.3%) (P < 0.001). The recurrence rate of cysts in group 2 was 0%, significantly lower than that in group 1 (33.3%) (P = 0.014). The group 2 had shorter hospital duration, indwelling catheterization duration, indwelling drainage duration, intraoperative blood loss, and operative time compared to the group 1 (P < 0.001). No severe complications such as intra-abdominal organ injury occurred in either group. However, in the group 2, 6 cases experienced transient low back pain and/or \"alcoholic reaction\", which resolved spontaneously.</p><p><strong>Conclusion: </strong>Compared to laparoscopic deroofing, aspiration and sclerotherapy for simple renal cysts in children demonstrates a higher complete disappearance rate. It is an economical, minimally invasive, and effective treatment option. The modified aspiration and sclerotherapy in this study showed good clinical outcomes and is worthy of further promotion.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"58"},"PeriodicalIF":1.5,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932424","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":"Small bowel duplication cyst in the pediatric population-when to operate?","authors":"Yael Dreznik, Anastasia Almog, Maya Paran, Osnat Konen, Dragan Kravarusic","doi":"10.1007/s00383-024-05959-8","DOIUrl":"10.1007/s00383-024-05959-8","url":null,"abstract":"<p><strong>Introduction: </strong>AIM: The aim of the study is to determine the optimal timing for surgery in patients with small bowel duplications.</p><p><strong>Methods: </strong>A retrospective cohort study, including all patients younger than 18 years who were diagnosed with small bowel duplications from 2013 until 2024 in a single tertiary medical center, was performed. Patients' demographics, duplication size and location, pathological results, and clinical outcomes were collected.</p><p><strong>Results: </strong>Sixteen patients (nine boys, seven girls) underwent laparoscopic-assisted resection of small bowel duplication at an average age of 3 years. A prenatal diagnosis was made in 11 patients, 10 (91%) of whom underwent elective surgery at a median age of 1.3 years. Overall, six patients required semi-elective or urgent surgery due to bowel obstruction, abdominal discomfort, or symptomatic anemia, with most (83%) lacking prenatal evaluation. Elective surgery patients had significantly smaller duplications (13 cm³ vs. 135 cm³). Post-operative recovery was satisfactory in all patients, with an average hospital stay of 6 days.</p><p><strong>Conclusion: </strong>In conclusion, asymptomatic, small duplication cysts in the small bowel of pediatric patients can be managed expectantly and can be operated after the first year of age. This approach is safe and allows for laparoscopic exploration in older infants, yielding satisfactory outcomes.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"56"},"PeriodicalIF":1.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11698872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922451","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":"Advantage of bedside versus conventional operating room surgery in the management of term and preterm newborn infants: a single center retrospective observational study.","authors":"Simonetta Costa, Simona Fattore, Cecilia Brughitta, Paola Catalano, Nicola Frattaruolo, Liliana Sollazzi, Marco Rossi, Paola Aceto, Filomena Valentina Paradiso, Lorenzo Nanni, Giovanni Vento","doi":"10.1007/s00383-024-05937-0","DOIUrl":"10.1007/s00383-024-05937-0","url":null,"abstract":"<p><strong>Purpose: </strong>To compare postoperative outcomes of bedside surgery (BS) with those of surgery performed in the operating room (ORS) in preterm and full-term neonates.</p><p><strong>Methods: </strong>Data from neonates undergoing major surgical interventions were retrospectively evaluated. Primary outcome was the incidence of postoperative hypothermia. Secondary outcomes were the mortality rate within 30 days of surgery and the occurrence of post-operative infection within 48 h of surgery.</p><p><strong>Results: </strong>374 interventions performed on 222 neonates were analysed: 55 interventions on 47 neonates in the BS group and 319 interventions on 175 neonates in the ORS group. Compared to the ORS group, infants in the BS group had lower gestational age (GA) and birthweight, higher incidence of morbidity and mortality at discharge. No difference was found in the incidence of postoperative hypothermia and infections within 48 h of surgery, while mortality within 30 days of surgery was higher in the BS group. To multivariable logistic regression analysis, weight at the time of surgery [OR (IC 95%) 0.711 (0.542-0.931); p 0.013] and emergency/urgency modality [OR (IC 95%) 1.934 (1.221-3.063); p 0.005] were identified as variables associated with the risk of hypothermia, while GA [OR (IC 95%) 0.830 (0.749-0.920); p 0.000] and need for pre-surgery inotropes [OR (IC 95%) 8.221 (2.128-31.760); p 0.002] were associated with mortality within 30 days of surgery.</p><p><strong>Conclusions: </strong>BS resulted safe and effective in not increasing the risk of postoperative adverse events despite being performed in worse clinical conditions than ORS.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"57"},"PeriodicalIF":1.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11698754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922401","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":"Effect of hand massage after abdominal surgery on pain, emotional symptoms and physiological parameters among children.","authors":"Sevim Çimke, Meral Bayat","doi":"10.1007/s00383-024-05954-z","DOIUrl":"10.1007/s00383-024-05954-z","url":null,"abstract":"<p><strong>Aim: </strong>This randomized controlled study aimed to evaluate the effect of hand massage on pain, emotional symptoms, and physiological parameters in children after abdominal surgery.</p><p><strong>Materials and methods: </strong>The study included 40 children aged 7-12 years who underwent abdominal surgery (20 intervention, 20 control). Data were collected using the Faces Pain Scale-Revised, Children's Emotion Manifestation Scale, Physiological Measurements Chart, and Child Information Form. The intervention group received a 10-min hand massage 3 h after surgery, and measurements were taken before the massage, immediately after the massage, and 30 min after the massage. Statistical analyses were performed using the Mann-Whitney U, Friedman, and Bonferroni tests.</p><p><strong>Results: </strong>Immediately after the massage, the pain and emotional manifestation scores were significantly lower in the intervention group compared to the control group (p < 0.05). However, no significant difference was found between the two groups at the third measurement (p = 0.478). Heart rate significantly decreased in the intervention group immediately after the massage (p < 0.001), while it significantly increased in the control group (p < 0.001).</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"55"},"PeriodicalIF":1.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922447","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 many cases do young pediatric surgeons need to experience to achieve autonomy in performing pediatric endoscopic surgery? A nationwide survey to establish an ideal curriculum for pediatric endoscopic surgery in Japan.","authors":"Masakazu Murakami, Yo Kurashima, Katsuhiro Ogawa, Shinichiro Yokoyama, Satoshi Obata, Go Miyano, Tetsuya Ishimaru, Hiroshi Kawashima, Hiroo Uchida, Tatsuro Tajiri, Atsuyuki Yamataka, Hiroomi Okuyama, Satoshi Ieiri","doi":"10.1007/s00383-024-05958-9","DOIUrl":"https://doi.org/10.1007/s00383-024-05958-9","url":null,"abstract":"<p><strong>Purpose: </strong>To ensure the safe prevalence of pediatric endoscopic surgery in Japan, a training curriculum should be established. In addition, the number of pediatric surgical cases is decreasing due to the decreasing birth rate in Japan, and it is necessary to clarify the number of surgical cases required for young pediatric surgeons to achieve autonomy in pediatric endoscopic surgery.</p><p><strong>Methods: </strong>An online nationwide survey was conducted among young pediatric surgeons with 3-15 years of clinical experience in Japan. We assessed training experience, opinions concerning the ideal training curriculum, and the correlation between surgical experience and the level of autonomy for pediatric endoscopic surgeries.</p><p><strong>Results: </strong>One hundred seventy participants responded to the survey (response rate: 35.2%). Only 18% answered that their training facility had a regular educational off-the-job training program. Ninety percent of respondents answered that an educational curriculum for pediatric endoscopic surgery was necessary. It took 11-20 cases to achieve autonomy in laparoscopic appendectomy and laparoscopic inguinal hernia repair.</p><p><strong>Conclusion: </strong>This survey revealed that off-the-job training programs were insufficient. The results of this study are expected to aid in the establishment of an effective curriculum for pediatric endoscopic surgery in the era of declining birth rates.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"54"},"PeriodicalIF":1.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909888","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}