Pediatric Surgery International最新文献

{"title":"Critical considerations in urogenital sinus management in persistent cloaca repair.","authors":"Ismael Elhalaby, Essam Elhalaby","doi":"10.1007/s00383-025-06199-0","DOIUrl":"https://doi.org/10.1007/s00383-025-06199-0","url":null,"abstract":"","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"292"},"PeriodicalIF":1.6,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058521","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 timing of cryptorchidism surgery: analysis of the contradiction between guideline consensus and clinical practice implementation.","authors":"Weiyan Tang, Yi Wei","doi":"10.1007/s00383-025-06187-4","DOIUrl":"https://doi.org/10.1007/s00383-025-06187-4","url":null,"abstract":"<p><p>Cryptorchidism is one of the most common reproductive malformations in children, and the timing of surgery significantly impacts fertility and the risk of testicular cancer. Although international guidelines currently recommend testicular fixation within 6-18 months to improve prognosis, many children worldwide undergo surgery later than the recommended age. Delays in surgery are particularly significant in developing countries. This discrepancy may be influenced by factors such as ethnicity, comorbid malformations, economic status, and disease staging. This article provides an overview of global cryptorchidism guideline development and clinical realities, exploring the reasons behind surgical timing disparities to inform the revision of guidelines and improve treatment strategies and prognosis for children with cryptorchidism.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"291"},"PeriodicalIF":1.6,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030221","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":"Long-term complications in patients with bladder-prostate rhabdomyosarcoma treated with brachytherapy: a systematic review.","authors":"Giulia Brooks, Filippo Ghidini, Calogero Virgone, Federica De Corti","doi":"10.1007/s00383-025-06112-9","DOIUrl":"10.1007/s00383-025-06112-9","url":null,"abstract":"<p><strong>Introduction: </strong>Brachytherapy has been used for the multimodal treatment of pediatric bladder-prostate rhabdomyosarcoma in the last two decades. The aim of this systematic review is to gather the current evidence about this innovative technique with a special focus on long-term outcomes.</p><p><strong>Methods: </strong>According to PRISMA criteria, PubMed, Scopus, and Web of Science were searched for papers published between 2000 and 2022.</p><p><strong>Results: </strong>The search yielded 7338 papers but only seven were eligible, for a total of 196 children with a median age ranging from 23 to 32 months and a median follow-up ranging from eight to 64 months. The five-year overall survival was superior to 90%. However, at least one complication involving the urogenital apparatus was reported in 66 children (35%).</p><p><strong>Conclusion: </strong>Brachytherapy presented positive outcomes in terms of overall survival. On the other hand, further efforts should be made to decrease the risk of functional urogenital side effects.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"290"},"PeriodicalIF":1.6,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12420684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023927","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":"Thoracoscopic versus conventional thoracotomy for esophageal atresia/tracheoesophageal fistula repair: a comprehensive meta-analysis of 25 comparative studies.","authors":"Amani N Alansari, Marwa Messaoud, Salma Mani, Mohamed Sayed Zaazouee, Hanan Youssif, Amine Ksia","doi":"10.1007/s00383-025-06182-9","DOIUrl":"10.1007/s00383-025-06182-9","url":null,"abstract":"<p><strong>Purpose: </strong>This meta-analysis compares thoracoscopic versus open thoracotomy repair of esophageal atresia with tracheoesophageal fistula (EA/TEF).</p><p><strong>Methods: </strong>We systematically searched PubMed, Web of Science, Cochrane Library, and Scopus from inception to April 2025 for studies comparing thoracoscopic versus conventional thoracotomy approaches. Two independent reviewers screened studies, extracted data, and assessed risk of bias using appropriate tools. Meta-analyses were conducted using RevMan 5.4 software.</p><p><strong>Results: </strong>A total of 25 studies (24 observational and one randomized controlled trial, including 3087 patients) were included. Thoracoscopic repair was associated with longer operative time (mean difference [MD] = 20.94 min; p = 0.005) but showed significant advantages in reducing mortality (risk ratio [RR] = 0.52; p = 0.01), musculoskeletal complications (RR = 0.08; p < 0.0001), and wound infections (RR = 0.21; p = 0.02). It also led to shorter ICU stays (MD = -1.09 days; p = 0.005) and earlier initiation of oral feeding (MD = -1.12 days; p = 0.02). However, the risk of anastomotic stricture requiring dilation was higher (RR = 1.54; p < 0.00001). No significant differences were found in anastomotic leak rates, recurrent fistula, respiratory complications, or need for fundoplication.</p><p><strong>Conclusions: </strong>Thoracoscopic repair of EA/TEF is associated with perioperative benefits over conventional thoracotomy, including significantly lower mortality and a markedly reduced incidence of musculoskeletal complications. However, this approach is associated with a higher risk of anastomotic stricture requiring dilation, and these differences may partly reflect patient selection factors.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"289"},"PeriodicalIF":1.6,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12420690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023947","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":"Timing of surgery and outcomes in patients with congenital pulmonary airway malformation: a national inpatient database study.","authors":"Naohiro Takamoto, Shotaro Aso, Takaaki Konishi, Michimasa Fujiogi, Kaori Morita, Mai Kutsukake, Yoshitsugu Yanagida, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga, Jun Fujishiro","doi":"10.1007/s00383-025-06188-3","DOIUrl":"10.1007/s00383-025-06188-3","url":null,"abstract":"<p><strong>Purpose: </strong>The timing of elective surgery for asymptomatic congenital pulmonary airway malformation (CPAM) at birth remains controversial. We aimed to describe characteristics and outcomes of patients who underwent surgery for CPAM.</p><p><strong>Methods: </strong>We retrospectively identified patients aged < 18 years who were hospitalized for CPAM during the neonatal period and underwent surgery between July 2010 and March 2022 using the Diagnosis Procedure Combination database in Japan. We grouped eligible patients into those aged < 28 days (neonatal group) and ≥ 28 days (infant group) at surgery. Outcomes included in-hospital mortality, morbidity, duration of anesthesia, and hospital stay.</p><p><strong>Results: </strong>We identified 105 neonates and 287 infants (including 89, 107, and 91 aged 28 days to 5 months, 6-12 months, and > 12 months, respectively). In-hospital mortality and morbidity were similar among the groups. In the infant group, duration of anesthesia was longer in those with preoperative admission due to bacterial pneumonia or who underwent thoracoscopic surgery. Infants with congenital malformation or emergency admission had longer hospital stays.</p><p><strong>Conclusions: </strong>In-hospital mortality and morbidity were comparable among the different timings of surgery for CPAM. Preoperative bacterial pneumonia and thoracoscopic surgery could be risk factors for long duration of anesthesia but not for long hospital stay.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"288"},"PeriodicalIF":1.6,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016055","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":"Evaluating AI performance in pediatric surgery: temporal bias and multimodal limitations in large language model assessment.","authors":"Enjian Liu, Zekai Yu","doi":"10.1007/s00383-025-06189-2","DOIUrl":"https://doi.org/10.1007/s00383-025-06189-2","url":null,"abstract":"","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"287"},"PeriodicalIF":1.6,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008386","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 roadmap of artificial intelligence applications in pediatric surgery: a comprehensive review of applications, challenges, and ethical considerations.","authors":"Miriam Duci, Arianna Bossi, Francesca Uccheddu, Francesco Fascetti-Leon","doi":"10.1007/s00383-025-06185-6","DOIUrl":"10.1007/s00383-025-06185-6","url":null,"abstract":"<p><p>Artificial intelligence (AI) and machine learning (ML) are rapidly transforming healthcare, with growing interest in their application to rare pediatric surgical conditions. In these settings, limited data availability often brakes traditional research. Although pediatric surgery has historically been slower than other specialties in adopting ML, recent years have seen an increase in AI-driven tools designed for surgical care. This review presents an overview of AI applications in pediatric surgery, highlighting current uses, benefits, challenges, and their potential clinical impact. A comprehensive literature search was conducted to identify studies on AI and ML models relevant to pediatric surgery. The findings indicate that ML is mainly applied in predictive decision support, particularly for preoperative risk stratification, intraoperative navigation, and postoperative outcome prediction. AI is especially valuable in endoscopic and minimally invasive procedures, where it enhances the visualization of anatomical landmarks. In pediatric oncologic surgery, AI aids in the accurate localization and delineation of tumors. Additionally, AI improves pathology workflows through automated image analysis and annotation, supporting both diagnosis and education. Despite these advances, ethical and regulatory challenges remain. Ensuring data privacy and obtaining informed consent are essential. When responsibly implemented, AI can significantly improve pediatric surgical care.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"286"},"PeriodicalIF":1.6,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006483","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":"Meckel's diverticulum: differences in clinical features between children and adults.","authors":"N Srisan, P Songsiri, S Liukitithara, A Sriniworn, K Decharun, P Rajatapiti, S Reukvibunsi, B Nonthasoot, S Prichayudh, C Tharavej, S Manasnayakorn, P Vejchapipat","doi":"10.1007/s00383-025-06183-8","DOIUrl":"https://doi.org/10.1007/s00383-025-06183-8","url":null,"abstract":"<p><strong>Purpose: </strong>The objectives were to describe and to compare the clinical features of patients with MD in terms of demographic data, clinical presentation, investigations, treatment, histopathology, and postoperative complications between children and adults.</p><p><strong>Methods: </strong>Patients with MD were retrospectively reviewed from two tertiary hospitals (2002-2021). These included patients with symptomatic MD and patients whose MD was incidentally found during operations. Demographic data, clinical presentation, investigation, treatment, histopathology, and postoperative complications were reviewed.</p><p><strong>Results: </strong>A total of 123 cases with MD (69 children vs 54 adults) were studied. Of 69 children with MD, symptomatic MD was reported in 48 cases (69.6%). Lower GI bleeding was the most common presentation (52.1%), followed by obstruction (29.1%), umbilical problems (10.4%), and diverticulitis (8.3%). For children with bleeding MD (25 cases), Meckel scan was an important investigation to confirm the diagnosis, with a sensitivity value of 95%. Of 54 adults with MD, symptomatic MD was recorded in 30 cases (55.6%). Diverticulitis was the most common presentation (46.7%), followed by obstruction (30.0%), GI bleeding (20.0%), and umbilical problems (3.3%). For incidentally found MD during operations, 80% were resected. Interestingly, ectopic gastric tissue was found in 27.4% of the resected MD specimens. Moreover, there was no significant difference in postoperative complications between patients with symptomatic MD and patients with incidentally found MD.</p><p><strong>Conclusion: </strong>The most common symptom of MD was lower GI bleeding in children, and diverticulitis in adults. Meckel scan is an important tool to investigate bleeding MD. Since ectopic gastric tissue was found in 19% of asymptomatic MD, our findings seem to support the concept of resection of MD incidentally found during the operations.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"284"},"PeriodicalIF":1.6,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992973","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":"Evaluating the role of Kasai portoenterostomy in biliary atresia older than 90 days.","authors":"Yu Tian, Haoran Lian, Mao Ye, Yifeng Shao, Yuanyuan Geng, Zhen Chen, Shuai Chen, Xuli, Longli","doi":"10.1007/s00383-025-06184-7","DOIUrl":"10.1007/s00383-025-06184-7","url":null,"abstract":"<p><strong>Purpose: </strong>Biliary atresia (BA) patients presenting after 90 days of age face contentious treatment decisions between Kasai portoenterostomy and direct liver transplantation. This study evaluated outcomes of Kasai portoenterostomy in older BA patients to inform therapeutic decision-making.</p><p><strong>Methods: </strong>A retrospective multicenter study analyzed 32 BA patients who underwent Kasai portoenterostomy beyond 90 days of age. Primary outcomes included jaundice clearance (total bilirubin < 20 μmol/L) and two-year native liver survival. Patients were stratified by jaundice clearance status for comparative analysis.</p><p><strong>Results: </strong>The median surgical age was 110 days (IQR: 98-119 days). Twenty patients (62.5%) achieved jaundice clearance, while 12 (37.5%) failed to clear jaundice. All patients achieving jaundice clearance survived with their native Liver at two years, with only one requiring transplantation in the fourth postoperative year. Conversely, none of the non-clearance patients achieved two-year native Liver survival, with 11 undergoing transplantation for progressive cholestasis at a median of 5 months postoperatively and one death after declined transplantation. Surgical age was the most significant predictor of success, with ROC analysis yielding an optimal cutoff of 109 days (AUC: 0.779), while histological fibrosis stage also showed significant association with outcomes\".</p><p><strong>Conclusion: </strong>Kasai portoenterostomy remains clinically meaningful in selected older BA patients, with 109 days representing a critical surgical threshold. This approach is particularly valuable in resource-limited settings where liver transplantation availability is constrained.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"285"},"PeriodicalIF":1.6,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001286","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":"Correction: Outcomes of CDH patients receiving PDA ligation: a propensity score matched analysis.","authors":"Hamzah Mansoura, Chelsea Drennan, Vikas S Gupta, Matthew T Harting, Neil Patel, Ashley H Ebanks, Shobhan Vachhrajani, Daniel K Robie","doi":"10.1007/s00383-025-06176-7","DOIUrl":"https://doi.org/10.1007/s00383-025-06176-7","url":null,"abstract":"","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"283"},"PeriodicalIF":1.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964400","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}