Pediatric Surgery International最新文献

{"title":"No manometric differences after surgical intervention for anal fistula in infants and toddlers.","authors":"Yi Fu, Yu-Wen Ding, Yun-Yuan Li, Hong-Tao Liang, Yan-Ting Sun, Jin-Gen Lu, Chen Wang","doi":"10.1007/s00383-025-06035-5","DOIUrl":"https://doi.org/10.1007/s00383-025-06035-5","url":null,"abstract":"<p><strong>Background: </strong>The current study aims to comprehensively evaluate the surgical impact on anal function in pediatric patients with anal fistulas, incorporating anorectal manometry, histopathological examination, and various rating scales.</p><p><strong>Methods: </strong>The study focuses on infants and toddlers diagnosed with anal fistulas who underwent surgical intervention at Longhua Hospital, Shanghai University of Traditional Chinese Medicine, between November 2020 and January 2024. The participants were divided into two age cohorts: infants (0-12 months) and toddlers (13-36 months). Data were meticulously collected for both cohorts, with anal function assessed through intraoperative anorectal manometry, Masson staining of fistula tissue, and the Heikkinen clinical continence scoring (CCS) scale during the postoperative period RESULTS: (1) Both cohorts demonstrated a 100% postoperative healing rate. The average healing duration was 15.58 ± 3.21 days for the infant cohort and 16.57 ± 3.65 days for the toddler cohort. Anorectal manometry indicated the presence of the anorectal inhibitory reflex (RAIR) in both cohorts. Postfistulotomy, there was a slight decrease in anal rectal pressure (ARP), although this reduction was not statistically significant (p > 0.05) and was unrelated to the complexity of the fistula. Pathological examination of the fistula tissues revealed low muscle content in both cohorts, accounting for 14.1 ± 1.35% in the infant cohort and 17.2 ± 2.86% in the toddler cohort. The muscle composition varied between the cohorts; the infant cohort predominantly had smooth muscle with minimal striated muscle, whereas the toddler cohort had both smooth and striated muscle, with a relatively higher proportion of striated muscle. The CCS scores showed significant improvement at 6 months postoperation and during long-term follow-up compared to preoperative scores, with long-term follow-up results being superior to those at six months (p < 0.01).</p><p><strong>Conclusion: </strong>Surgical treatment for pediatric anal fistulas demonstrates is both effective and safe, with a potential for long-term improvement in anorectal function over time.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"275"},"PeriodicalIF":1.6,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964419","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":"Splenic vein diameter/portal vein diameter ratio as a predictor of portal vein thrombosis after laparoscopic splenectomy in children.","authors":"Atsuhisa Fukuta, Toshiharu Matsuura, Yasuyuki Uchida, Naonori Kawakubo, Takuya Kondo, Yoshiaki Takahashi, Koichiro Yoshimaru, Kouji Nagata, Tatsuro Tajiri","doi":"10.1007/s00383-025-06171-y","DOIUrl":"https://doi.org/10.1007/s00383-025-06171-y","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to identify predictors of portal vein thrombosis (PVT) after laparoscopic splenectomy (LS) in children.</p><p><strong>Methods: </strong>Patients who underwent LS between September 2014 and August 2024 were retrospectively reviewed. Preoperative and intraoperative clinical data were compared between those with and without PVT. The splenic vein diameter (SVD) was measured at 2, 4, and 6 cm from the portal vein (PV) junction using preoperative transaxial computed tomography images.</p><p><strong>Results: </strong>Among 21 patients who underwent LS, those with PVT were significantly older, more likely to be female, and had a higher body mass index. Although splenic maximum diameter, PV diameter, and the spleen volume/standard spleen volume ratio showed no significant differences, SVD was significantly larger at all measured locations in patients with PVT. Additionally, the SVD/portal vein diameter (PVD) ratio was significantly higher at all measured locations in these patients. Receiver operating characteristic analysis identified the SVD/PVD ratio as the most reliable predictor of PVT development, with an optimal cutoff value of 0.7.</p><p><strong>Conclusion: </strong>An SVD/PVD ratio ≥ 0.7 is a strong predictor of PVT after LS in children. Measuring this ratio preoperatively may identify high-risk patients, allowing for closer monitoring and potential preventive interventions to reduce PVT incidence.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"276"},"PeriodicalIF":1.6,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964474","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 for symptomatic choledochal cysts with hyperamylasemia in children: a retrospective analysis.","authors":"Ruyue Gao, Xin Ding, Wei Chen, Xianhua Hao, Yidi Chi, Jiawei Zhao, Hao Liu, Jie Shi, Yandong Zhang, Long Li","doi":"10.1007/s00383-025-06173-w","DOIUrl":"https://doi.org/10.1007/s00383-025-06173-w","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to investigate the optimal surgical timing for symptomatic choledochal cyst (CDC) with hyperamylasemia in children.</p><p><strong>Methods: </strong>We retrospectively reviewed 61 symptomatic CDC patients with hyperamylasemia who underwent cyst excision and Roux-en-Y hepaticojejunostomy between July 2020 and November 2021. Patients were either in symptomatic phase or in remission at the time of surgery.</p><p><strong>Results: </strong>Thirty-seven patients were assigned to the symptomatic group and 24 to the remission group, with no significant difference in conversion rates (5.4% vs. 4.2%, P = 1.000). In the symptomatic group, two patients (5.4%) developed biliary fistulas, and two (5.4%) experienced pancreatitis. In the remission group, one patient (4.2%) had active bleeding, and one (4.2%) developed a biliary fistula without statistically significant difference (P = 1.000). The median total, preoperative, and postoperative hospital stays were comparable between the groups (P = 0.411, P = 0.159, and P = 0.731, respectively). However, costs were higher in the symptomatic group (P = 0.043). The two groups exhibited similar pathological inflammation severity (P = 0.065).</p><p><strong>Conclusion: </strong>Postponing surgery until symptom remission demonstrates no therapeutic advantage for children with CDC and hyperamylasemia. Early surgery should be considered, provided that the general condition of the patient permits.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"272"},"PeriodicalIF":1.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964512","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":"Three-year experience with GLP-2 analog in intestinal rehabilitation for pediatric-onset short bowel syndrome.","authors":"Yuko Tazuke, Takeshi Kimura, Takehisa Ueno, Kengo Nakahata, Koichi Deguchi, Naoko Uga, Hiroomi Okuyama, Takaharu Oue","doi":"10.1007/s00383-025-06154-z","DOIUrl":"https://doi.org/10.1007/s00383-025-06154-z","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the impact of three-year Glucagon-like peptide 2 (GLP-2) analog therapy on parenteral nutrition (PN) dependency, intestinal rehabilitation, and quality of life in pediatric-onset short bowel syndrome (SBS).</p><p><strong>Methods: </strong>Between August 2021 and December 2024, 18 pediatric-onset SBS patients underwent GLP-2-based intestinal rehabilitation. The remaining length of the small intestine ranged from 20 to 50 cm in adults and averaged 20 cm in children. Clinical data were retrospectively analyzed over a three-year period.</p><p><strong>Results: </strong>PN requirements in adults decreased by up to 54.6%, with one patient achieving PN independence. Paediatric patients showed gradual reductions of up to 31.9%. Serum citrulline levels improved, suggesting enhanced intestinal adaptation. Stool consistency improved in all patients, and stool frequency decreased in six patients. PN duration per week decreased in eight patients, with one paediatric patient successfully being weaned off PN. All patients maintained social participation, though six children required special educational support due to ongoing PN　use. No intestinal polyps were detected, and any adverse events were mild and self-limiting.</p><p><strong>Conclusions: </strong>GLP-2 analog therapy, which is based on intestinal rehabilitation, contributed to a sustained reduction in PN and enhanced clinical outcomes over three years, particularly in adult SBS patients. Continuous GLP-2 analog therapy might improve quality of life in paediatric-onset SBS.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"273"},"PeriodicalIF":1.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964454","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":"Whole blood transfusion in pediatric trauma patients with traumatic brain injury may decrease the risk of early death.","authors":"Robert Painter, Jeffry Nahmias, Peter D Nguyen, Yigit Guner, Laura F Goodman, Patrick M Chen, Jefferson Chen, Tyler Liang, Areg Grigorian","doi":"10.1007/s00383-025-06175-8","DOIUrl":"https://doi.org/10.1007/s00383-025-06175-8","url":null,"abstract":"<p><strong>Objective: </strong>There has been a resurgence in the use of whole blood for trauma resuscitation, however the outcomes for pediatric trauma patients with traumatic brain injury (TBI) resuscitated with whole blood are unknown. We hypothesized a lower risk of mortality and complications for pediatric trauma patients with TBI resuscitated with whole blood compared with those resuscitated exclusively with component blood therapy.</p><p><strong>Methods: </strong>The 2020-2021 TQIP database was queried for pediatric trauma patients (≤ 17 years-old) with TBI requiring blood product resuscitation. Multivariable analysis was performed to determine associated risk of overall and early (within 24 h) mortality and overall complications.</p><p><strong>Results: </strong>From 1740 transfused pediatric trauma patients with TBI, 195 (11%) received whole blood. The whole blood cohort received a similar amount of overall blood products and had similar overall rates of complications and death (all p > 0.05). After adjusting for age, injury severity score, and vitals on arrival, whole blood patients continued to have no difference in risk of complications and overall mortality (both p > 0.05). However, whole blood had decreased associated risk of early mortality (OR 0.49, CI 0.29-0.83, p = 0.008).</p><p><strong>Conclusions: </strong>This study found only 11% of pediatric trauma patients with TBI received whole blood, however whole blood patients had a lower associated risk of early death compared with component blood therapy. Future prospective research is needed to validate these findings.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"270"},"PeriodicalIF":1.6,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12391162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964447","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":"Establishment and evaluation of an animal model of acquired tracheomalacia following tracheostomy in rabbits.","authors":"Juma Obayashi, Maho Wada, Junki Koike, Kanji Otsubo, Koji Kojima, Shigeyuki Furuta","doi":"10.1007/s00383-025-06167-8","DOIUrl":"https://doi.org/10.1007/s00383-025-06167-8","url":null,"abstract":"<p><strong>Purpose: </strong>Acquired tracheomalacia (TM) following tracheostomy can hinder decannulation and affect the quality of life of pediatric patients. Therefore, a reproducible animal model of type III TM is required for further research and therapeutic development.</p><p><strong>Methods: </strong>We established a rabbit model of acquired TM by resecting the anterior walls of the 2nd to 4th tracheal cartilage rings, while preserving the mucosa. Bronchoscopic evaluations were conducted at three time points: before surgery (term 1), immediately after surgery (term 2), and 3-4 months post-surgery (term 3). The area of the tracheal lumen was measured under varying negative suction pressures using image analysis.</p><p><strong>Results: </strong>Five of the six rabbits survived and successfully modeled TM. Progressive luminal narrowing was observed, particularly at term 3, where the area decreased to 15.0 ± 18.8% under 30 cmHg suction. Compared with term 1, the same suction pressures resulted in a greater collapse at terms 2 and 3, indicating gradual structural weakening. No respiratory symptoms were observed during the follow-up.</p><p><strong>Conclusion: </strong>This rabbit model of acquired type III TM is reproducible and enables the quantitative evaluation of airway collapsibility. This may be useful for investigating TM pathophysiology and testing new treatment strategies.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"271"},"PeriodicalIF":1.6,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964404","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":"Short-interval intravenous indocyanine green administration in pediatric laparoscopic cholecystectomy: a prospective evaluation of visualization and safety.","authors":"Vojtech Dotlacil, Eliska Pajerova, Dagmar Sovadinova, Barbora Kucerova, Martin Vyhnanek, Michal Rygl","doi":"10.1007/s00383-025-06172-x","DOIUrl":"10.1007/s00383-025-06172-x","url":null,"abstract":"<p><strong>Purpose: </strong>Indocyanine green (ICG) fluorescence imaging enhances biliary visualization during pediatric laparoscopic cholecystectomy (LC), helping to identify anatomical variants and prevent bile duct injury. Standard pediatric recommendations suggest ICG administration 16-24 h preoperatively; however, this may be impractical. This study aims to evaluate the safety and effectiveness of short-interval ICG administration.</p><p><strong>Methods: </strong>A prospective single-center study (October 2024-June 2025) included pediatric LC patients receiving intravenous Verdye® preoperatively. Visualization of extrahepatic biliary anatomy was assessed intraoperatively using a 5-point Likert scale, HELPFUL (usefulness), and DISTURBED (liver background interference) scores. Data included indication, ICG timing, operative time, and complications according to the Clavien-Dindo classification (C-D).</p><p><strong>Results: </strong>Eleven patients (64% female), median age 14 years (IQR 12,7-15,7) and median weight 65,5 kg (IQR 46,5-80), were included. Five had BMI > 25 kg/m²; five (46%) underwent preoperative ERCP. ICG (median dose 0.34 mg/kg) was administered a median of 225 min before surgery. Median operative time was 65 min (IQR 58-68). Median Likert score was 5; HELPFUL 3; DISTURBED 1. No ICG-related or C-D complications occurred.</p><p><strong>Conclusion: </strong>Short-interval ICG administration was safe, feasible, and effective in enhancing biliary visualization during pediatric LC. This approach was well-tolerated and provided high-quality imaging without complications.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"269"},"PeriodicalIF":1.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12380915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964489","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":"Sennosides vs magnesium hydroxide vs polyethylene glycol as a treatment for constipation in anorectal malformation: a randomized crossover trial.","authors":"Butsarin Nate-Anong, Jiraporn Khorana, Sireekarn Chantakhow, Jesda Singhavejsakul, Kanokkan Tepmalai","doi":"10.1007/s00383-025-06174-9","DOIUrl":"https://doi.org/10.1007/s00383-025-06174-9","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the efficacy and user preference of Sennosides, magnesium hydroxide (Mg(OH)₂), and polyethylene glycol (PEG) in treating constipation in ARM patients.</p><p><strong>Methods: </strong>A randomized crossover trial was conducted from January 2018 to December 2019. Fifteen patients with surgically corrected ARM and diagnosed constipation were enrolled. Each patient received all three laxatives in a random order for 21-day periods, separated by washout periods. The primary outcome was post-treatment fecal loading assessed by Leech score on abdominal radiography. Secondary outcomes included the rate of clean fecal loading (Leech score ≤ 6) and user preference scores.</p><p><strong>Results: </strong>The mean post-treatment Leech scores were 6.67 ± 2.09 for Sennosides, 6.80 ± 2.37 for Mg(OH)₂, and 5.80 ± 2.04 for PEG(p = 0.841). Clean fecal loading was achieved in 40% of cases with Sennosides, 46.67% with Mg(OH)₂, and 60% with PEG(p = 0.655). User preference scores favored Sennosides (7.00 ± 2.36) over Mg(OH)₂ (6.33 ± 2.94) and PEG (5.06 ± 2.28) with p = 0.582. No significant differences in treatment, period, or sequence effects were found, with the exception of a decrease in preference for Mg(OH)₂ compared with Sennosides in the third treatment period (p = 0.045).</p><p><strong>Conclusion: </strong>While PEG showed a trend towards better fecal clearance and Sennosides was preferred by users, no statistically significant differences in efficacy or user preference were found among the three laxatives.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"268"},"PeriodicalIF":1.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964544","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":"Is prophylactic fundoplication necessary? Laparoscopic fundoplication after gastrostomy vs non-gastrostomy patients.","authors":"Takahiro Jimbo, Kouji Masumoto, Yasuhisa Urita, Naoya Sakamoto, Takato Sasaki, Yuichi Shibui, Yudai Goto, Tomohiro Aoyama, Yuri Kinuta, Akio Kawami, Hinako Sakai, Yuki Take","doi":"10.1007/s00383-025-06170-z","DOIUrl":"10.1007/s00383-025-06170-z","url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopic fundoplication is a standard surgical procedure for gastroesophageal reflux disease (GERD). In Japan, it is frequently performed in children with severe motor and intellectual disabilities (SMID), many of whom also require gastrostomy for enteral nutrition. Prophylactic fundoplication during gastrostomy remains controversial due to concerns about post-operative complications and the limited number of patients who subsequently require fundoplication.</p><p><strong>Patients and methods: </strong>This study retrospectively analyzed 47 cases of fundoplication at Tsukuba University Hospital from 2013 to 2024, comparing patients who underwent fundoplication after gastrostomy (post-G group) with those undergoing primary fundoplication (Primary group).</p><p><strong>Results: </strong>Outcomes including operative time, blood loss, and post-operative hospital stay showed no significant differences between both groups. No cases required open conversion, and post-operative complication rate was not significantly different.</p><p><strong>Discussion: </strong>Our findings indicate that fundoplication can be safely performed after gastrostomy without increased surgical risks, contradicting concerns about adhesions or operative difficulties. Previous studies have also failed to establish a direct link between gastrostomy and GERD progression. Given the low incidence of GERD requiring fundoplication after gastrostomy, routine prophylactic fundoplication is unnecessary.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"267"},"PeriodicalIF":1.6,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964396","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":"Serum matrix metalloproteinase-7 (MMP-7) as a Biomarker for differentiating biliary atresia from neonatal hepatitis: evidence synthesis through systematic review and meta-analysis.","authors":"Prativa Choudhury, Anjan Kumar Dhua, Vishesh Jain, Devendra Kumar Yadav, Teg Rabab Singh, Masarrat Afroz, Vikas Dhikav, Sandeep Agarwala, Prabudh Goel","doi":"10.1007/s00383-025-06169-6","DOIUrl":"https://doi.org/10.1007/s00383-025-06169-6","url":null,"abstract":"<p><strong>Purpose: </strong>Biliary atresia (BA) requires timely differentiation from neonatal hepatitis (NH) and early surgery for optimal outcomes. This systematic review and meta-analysis evaluated the diagnostic performance of serum Matrix metalloproteinase-7 (MMP-7) as a biomarker for differentiating BA from NH.</p><p><strong>Methods: </strong>The PRISMA-DTA compliant synthesis was based upon primary data available till date, assessing the role of MMP-7 in diagnosing BA. Studies reporting diagnostic accuracy metrics were included. Pooled sensitivity, specificity, likelihood ratios, diagnostic odds ratio (DOR) and area under the summary receiver operating characteristic (SROC) curve were calculated.</p><p><strong>Results: </strong>Twenty-four studies (7298 participants: 3301 BA, 2,930 NH and 1067 controls) were analysed. The serum MMP-7 values ranged from 1.2 to 10.3 ng/mL in controls, 1.88-12.57 ng/mL in NH and 10.26-121.1 ng/mL in BA, with interquartile ranges spanning 1.08-25.3, 0.78-34.0 and 3.38-368.0 ng/mL, respectively. Median serum MMP-7 levels were consistently higher in BA vis-a-vis NH and the control population. Pooled sensitivity and specificity of MMP-7 as a diagnostic biomarker were 0.94 and 0.88, respectively. The DOR was 120.09 and the SROC AUC was 0.967.</p><p><strong>Conclusion: </strong>Serum MMP-7 demonstrates excellent diagnostic accuracy for differentiating BA from NH. Further research should focus on assay standardization and age-specific reference ranges to optimize clinical utility.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"265"},"PeriodicalIF":1.6,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964469","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}