Pediatric Surgery International最新文献

{"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}

{"title":"Impact of socioeconomic and geographical factors on clinical care of biliary atresia patients: a cross-sectional study.","authors":"Palak Singhai, Shailesh Solanki, Ravi P Kanojia, Nitin James Peters, Chimmani Sai Kiran, Pramod Kumar Gupta, Sadhna B Lal, Jai Kumar Mahajan","doi":"10.1007/s00383-024-05949-w","DOIUrl":"10.1007/s00383-024-05949-w","url":null,"abstract":"<p><strong>Purpose: </strong>Biliary atresia (BA) is a critical pediatric condition requiring timely intervention through Kasai portoenterostomy (KPE), and up to two-thirds of patients need liver transplantation (LT). The outcomes for BA patients still need improvement in low- and middle-income countries. This study aims to assess the socioeconomic and geographical profile of BA patients in India, focusing on their compliance with follow-up care, treatment-seeking behaviour, and acceptability of LT in addition, it provides recommendations to overcome identified challenges.</p><p><strong>Methods: </strong>A retrospective observational study was conducted in a tertiary care centre in India, including 48 patients who underwent KPE between 2018 and 2022. SES was assessed using the modified Kuppuswamy scale, and geographical areas were classified as per the criteria of the Indian Census 2011. Compliance with follow-up, treatment-seeking behaviour, and LT acceptability were evaluated.</p><p><strong>Results: </strong>The majority of patients belonged to rural areas and lower middle SES. Compliance with follow-up decreased over time, with financial and geographical barriers being significant challenges. Only one patient underwent LT due to prohibitive costs and limited accessibility.</p><p><strong>Conclusion: </strong>Socioeconomic and geographical factors significantly impact the clinical outcomes of BA patients in India. Improving education, healthcare infrastructure, and financial support is crucial for enhancing patient compliance and access to necessary treatments.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"53"},"PeriodicalIF":1.5,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909901","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":"Factors affecting intensive care length of stay in critically ill pediatric patients with burn injuries.","authors":"Reut Kassif Lerner, Amit Gibori, Evyatar Hubara, Tal Sadeh, Marina Rubinstein, Gidi Paret, Itai M Pessach","doi":"10.1007/s00383-024-05945-0","DOIUrl":"https://doi.org/10.1007/s00383-024-05945-0","url":null,"abstract":"<p><strong>Background: </strong>Burns in children are often complex injuries, leading to prolonged length of stay (LOS) and significant morbidity. LOS in pediatric intensive care units (PICUs) is a key measure for evaluating illness severity, clinical outcomes, and quality of care. Accurate prediction of LOS is vital for improving care planning and resource allocation. There is limited data for predicting LOS in severely burned children in PICU. This study aims to identify significant factors associated with prolonged PICU stays and offer a simple LOS-predicting model.</p><p><strong>Methods: </strong>This historical cohort study included all patients < 18 years, admitted for severe burn injuries to Israel's largest tertiary hospital PICU, from 2015 to 2020. Statistical analyses were conducted to identify factors linked to prolonged LOS and a predictive model was designed.</p><p><strong>Results: </strong>The study included 39 pediatric burn patients and identified several factors associated with longer PICU stays. Patients with LOS of ˃7 days (i.e.-\"long LOS\") had significantly higher %TBSA (33.11 ± 17.87% vs. 16.67 ± 7.98%, p < 0.001. During the first 24 and 48 h, the \"long LOS\" group had lower minimal systolic blood pressure (SBP) (70.67 ± 17.49 mmHg vs. 84.38 ± 16.73 mmHg, p = 0.015 and 69.39 mmHg ± 16.44 vs. 81.10 mmHg ± 19.67, p = 0.018). Although serum lactate levels were higher in the \"long LOS\" group, the difference was not significant, and platelet counts in this group were significantly lower during the first 48 h (184 K/µL vs. 264.5 K/µL, p = 0.003). A predictive model based on %TBSA, SBP, lactate, and platelet count was developed, demonstrating 100% specificity and positive predictive value for predicting LOS over 7 days in severely burned children.</p><p><strong>Conclusions: </strong>Key clinical indicators at PICU admission in severely burned children were associated with LOS > 7 days. The resulting predictive model, although requiring further validation in multi-site studies, offers a promising tool for enhancing care planning in this population.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"51"},"PeriodicalIF":1.5,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896571","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}