Pediatric Surgery International最新文献

{"title":"A study of the learning curve for laparoscopic Nissen fundoplication procedure, focusing on operative times using cumulative sum (CUSUM) method and multiple regression analysis for patients with neuromuscular disease.","authors":"Kazuo Oshima, Kazuki Yokota, Shuichi Tanaka, Junko Mouri, Jumpei Shibata, Norihiro Niimi","doi":"10.1007/s00383-026-06628-8","DOIUrl":"10.1007/s00383-026-06628-8","url":null,"abstract":"<p><strong>Purpose: </strong>The number of cases necessary to achieve proficiency in laparoscopic Nissen fundoplication (Lap-Nissen) remains unclear. We analyzed operative times using the cumulative sum (CUSUM) method to construct learning curves and estimate the required case volume.</p><p><strong>Methods: </strong>We retrospectively reviewed patients who underwent Lap-Nissen at our institution beginning in October 2008. Learning curves for each surgeon were constructed using CUSUM analysis and divided into three phases (I-III) by piecewise linear regression.</p><p><strong>Results: </strong>A total of 109 cases were analyzed. For surgeon A (n = 46), the mean operative time decreased across phases I (cases 1-8, 299.4 min), II (9-32, 217.7 min), and III (33-46, 179.6 min). Similar trends were observed for surgeon B (n = 42): I (1-5, 328.2 min), II (6-30, 204.4 min), and III (31-42, 179.5 min). Surgeon C (n = 14) delivered no clear learning curve, and surgeons D-F were excluded due to low case numbers. Multiple regression analysis identified the surgeons' experience as the strongest factor associated with operative time (β = - 0.53, p < 0.001).</p><p><strong>Conclusion: </strong>Phase I comprised approximately five cases, while phase II included more than 30 cases. Larger multicenter prospective studies are warranted.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930846","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":"Pediatric peripheral vascular surgical interventions: a 13-year single-center experience.","authors":"Kenan Öztürker, Fatih Tomrukçu, Abdullah Arif Yılmaz, Babürhan Özbek, Eylem Tunçer","doi":"10.1007/s00383-026-06637-7","DOIUrl":"10.1007/s00383-026-06637-7","url":null,"abstract":"<p><strong>Background: </strong>Pediatric peripheral vascular surgical pathology is uncommon, and published experience remains limited to small institutional series or trauma-focused cohorts. We aimed to evaluate the indications, anatomic distribution, operative strategies, and 30-day outcomes of pediatric peripheral vascular surgical interventions performed at our center over a 13-year period.</p><p><strong>Methods: </strong>This retrospective single-center cohort study included all consecutive patients younger than 18 years who underwent peripheral vascular surgical intervention between January 2012 and December 2024 at a tertiary pediatric cardiovascular referral center. Demographic characteristics, etiology, anatomic site, type of vascular involvement, operative techniques, and early outcomes were analyzed. Patients were stratified into 3 age groups: infants (0-2 years), children (3-12 years), and adolescents (> 12 to < 18 years).</p><p><strong>Results: </strong>A total of 60 patients were included: 14 infants (23.3%), 16 children (26.7%), and 30 adolescents (50.0%). Trauma was the most common etiology overall (36/60, 60.0%), followed by iatrogenic lesions (18/60, 30.0%) and congenital vascular lesions (6/60, 10.0%). Marked age-related differences were observed: infants were predominantly affected by iatrogenic lesions (12/14, 85.7%), whereas trauma predominated in adolescents (27/30, 90.0%). The upper extremity was the most frequently involved anatomic region overall (37/60, 61.7%), followed by the lower extremity (21/60, 35.0%) and cervical vessels (2/60, 3.3%). Arterial lesions were most common (40/60, 66.7%). The most frequently performed procedures were primary repair or end-to-end anastomosis (23/60, 38.3%), embolectomy (12/60, 20.0%), ligation (10/60, 16.7%), and autologous saphenous vein interposition grafting (8/60, 13.3%). All patients completed the 30-day clinical and Doppler ultrasonographic assessment. There was no 30-day mortality, major amputation, vascular reintervention, or clinically evident ischemic complication.</p><p><strong>Conclusions: </strong>In this surgically selected cohort, favorable 30-day outcomes were observed following pediatric peripheral vascular surgical interventions, with no mortality, major amputation, or clinically evident ischemic complication. Etiologic patterns differed descriptively across age groups: trauma predominated overall and among adolescents, whereas iatrogenic lesions were most frequent among patients aged 0-2 years. These findings may support age-specific clinical awareness, individualized decision-making, and timely referral to specialized multidisciplinary centers. Multicenter studies with standardized long-term follow-up are needed to assess late vascular patency, growth-related changes in vascular reconstructions, and functional outcomes.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930838","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":"Preoperative predictors for endoscopic Deflux injection therapy for vesicoureteral reflux: a single-center experience during 10 years.","authors":"Michiaki Ikegami, Nana Nakazawa-Tanaka, Shuko Nojiri, Risa Masuda, Takafumi Mikami, Junya Ishii, Ryo Sueyoshi, Go Miyano, Tadaharu Okazaki","doi":"10.1007/s00383-026-06629-7","DOIUrl":"10.1007/s00383-026-06629-7","url":null,"abstract":"<p><strong>Purpose: </strong>We conducted an analysis to identify preoperative predictors of vesicoureteral reflux (VUR) correction following endoscopic Deflux injection (EDI).</p><p><strong>Methods: </strong>We retrospectively reviewed 109 patients with primary VUR (173 renal units) aged < 16 years who underwent EDI between 2016 and 2025. If grade II-V VUR persisted on postoperative voiding cystoureterography, injections were repeated up to two additional times. Preoperative variables included constipation, renal scarring, and VUR grade.</p><p><strong>Results: </strong>VUR was corrected in 86 units (49.7%) after the first injection and in 152 (87.9%) after up to three injections. Univariable analysis showed that high-grade VUR, renal scarring, and constipation were associated with failure after the first injection, whereas only constipation was associated with failure after up to three injections. Multivariable analysis identified high-grade VUR, renal scarring and constipation as independent risk factors for failure of the first injection. These associations persisted even after exclusion of clinically evident bladder and bowel dysfunction (BBD).</p><p><strong>Conclusions: </strong>Constipation was an independent risk factor for failure after the first injection and remained associated with failure after repeated injections, even after exclusion of clinically evident BBD. It may serve as a clinically relevant and easily assessable predictor, particularly in young children in whom bladder function is difficult to assess.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920583","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":"Clinical utility of vascular proximity metrics on preoperative CT imaging in pediatric retroperitoneal teratoma.","authors":"Masahiro Fukuhara, Naonori Kawakubo, Amane Kamouchi, Yoshiki Yamaguchi, Kenta Ishimoto, Yuko Hino, Junnosuke Maniwa, Yukihiro Toriigahara, Yoshiaki Takahashi, Atsuhisa Fukuta, Koichiro Yoshimaru, Kouji Nagata, Junko Miyata, Toshiharu Matsuura, Tatsuro Tajiri","doi":"10.1007/s00383-026-06623-z","DOIUrl":"10.1007/s00383-026-06623-z","url":null,"abstract":"<p><strong>Purpose: </strong>We identified quantitative cutoff values for CT-based vascular proximity metrics and evaluated their associations with intraoperative complications and extent of resection.</p><p><strong>Methods: </strong>We reviewed the records of 20 children who underwent retroperitoneal teratoma resection between 2005 and 2025. Using contrast-enhanced CT, we measured tumor-vessel contact length, counted the number of contacted major vessels, and assigned a vascular deformation score from 0 to 2.</p><p><strong>Results: </strong>Intraoperative complications occurred in seven patients (35%). The contacted vessel count was significantly higher in patients with complications (p = 0.015), and contact length showed a similar trend (p = 0.056). Receiver operating characteristic analysis demonstrated good discrimination for contacted vessel count (AUC 0.838; cutoff 3) and contact length (AUC 0.769; cutoff 58.8 mm). Complication rates were highest when the contacted vessel count was ≥ 3 and contact length was ≥ 60 mm. Complete resection was achieved in 15 patients (75%), and subtotal resection was associated with a higher vascular deformation score (p = 0.029).</p><p><strong>Conclusion: </strong>Preoperative CT-based vascular proximity assessment helped estimate surgical difficulty in pediatric retroperitoneal teratoma. A contacted vessel count ≥ 3 and contact length ≥ 60 mm indicated higher complication risk, whereas a higher vascular deformation score was associated with subtotal resection.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930875","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 diagnostic indicators using normalized CT attenuation values of the ovarian wall in contrast-enhanced CT for pediatric ovarian tumor torsion.","authors":"Michiko Ueda, Naonori Kawakubo, Junnosuke Maniwa, Yukihiro Toriigahara, Takuya Kondo, Yoshiaki Takahashi, Atsuhisa Fukuta, Koichiro Yoshimaru, Kouji Nagata, Junko Miyata, Toshiharu Matsuura, Tatsuro Tajiri","doi":"10.1007/s00383-026-06619-9","DOIUrl":"10.1007/s00383-026-06619-9","url":null,"abstract":"<p><strong>Purpose: </strong>Pediatric ovarian tumor torsion often presents with nonspecific symptoms, and delayed diagnosis can lead to ovarian necrosis. Although contrast-enhanced CT is frequently used, objective quantitative indicators have not been established. This study evaluated normalized ovarian wall CT attenuation (n-OWA) and a combined index incorporating white blood cell count (WBC).</p><p><strong>Methods: </strong>Among 82 patients with surgically-treated ovarian tumor, 52 who underwent contrast-enhanced CT (15 with torsion and 37 without torsion) were analyzed. The n-OWA was calculated as the ovarian wall CT attenuation divided by the inferior vena cava attenuation. The WBC/n-OWA ratio was also evaluated. Group comparisons were performed using the Wilcoxon test, and diagnostic performance was evaluated by an ROC analysis.</p><p><strong>Results: </strong>The n-OWA was significantly lower in the torsion group (0.25 vs. 0.31, p = 0.02), with an AUC of 0.71. The WBC/n-OWA ratio was significantly higher in the torsion group (44.8 vs. 19.9, p < 0.01) and showed improved diagnostic performance with an AUC of 0.86. At a cutoff of 25.4, the sensitivity and specificity were 1.00 and 0.70, respectively.</p><p><strong>Conclusions: </strong>The n-OWA is an objective imaging biomarker for pediatric ovarian torsion. The WBC/n-OWA ratio may further improve diagnostic accuracy, particularly for excluding ovarian torsion.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920638","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":"Characterization of stem cells from exfoliated deciduous teeth from a patient with Alagille syndrome carrying a JAG1 mutation.","authors":"Yasuyuki Uchida, Soichiro Sonoda, Lisha Dai, Koichiro Yoshimaru, Satoshi Fukumoto, Haruyoshi Yamaza, Yoshinao Oda, Kenjiro Kosaki, Tatsuro Tajiri, Takayoshi Yamaza, Toshiharu Matsuura","doi":"10.1007/s00383-026-06620-2","DOIUrl":"10.1007/s00383-026-06620-2","url":null,"abstract":"<p><strong>Purpose: </strong>Alagille syndrome (ALGS) is an autosomal dominantly inherited disorder primarily caused by mutations in the Jagged Canonical Notch Ligand 1 (JAG1) gene. Although many pluripotent stem cells are well established, no patient-derived stem cells from exfoliated deciduous teeth (SHED) have been developed. In this study, we aimed to establish SHED from an ALGS patient carrying a heterozygous JAG1^mut mutation.</p><p><strong>Methods: </strong>We isolated SHED from a deciduous tooth of an ALGS patient with a heterozygous JAG1 mutation (ALGS-SHED) by the colony-forming unit-fibroblast (CFU-F) method. We then compared the characteristics of ALGS-SHED and healthy donor-derived control SHED (CONT-SHED).</p><p><strong>Results: </strong>ALGS-SHED displayed mesenchymal stem cell features as indicated by CFU-F formation, immunophenotype, and mesenchymal multipotency into adipocytes, chondrocytes, and osteoblasts. ALGS-SHED showed reduced population doubling capacity and exhibited induced chondrogenic potency and diminished osteogenic potency, but similar hepatic potency. ALGS-SHED damaged in situ potency to form bile duct-like tubular structures in the livers of chronically CCl₄-injured mice.</p><p><strong>Conclusions: </strong>We successfully established ALGS-SHED from an ALGS patient carrying a heterozygous JAG1 mutation. Our established ALGS-SHED may represent a potential model for studying ALGS involving a JAG1 mutation.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920607","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":"Clinical characteristics and temporal trends of pediatric gastrointestinal foreign body ingestion: a single-center retrospective study.","authors":"Yuta Takeuchi, Seiichiro Inoue, Yuki Muta, Akio Odaka","doi":"10.1007/s00383-026-06625-x","DOIUrl":"10.1007/s00383-026-06625-x","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to evaluate temporal changes in the clinical characteristics and management of pediatric gastrointestinal foreign body ingestion.</p><p><strong>Methods: </strong>We retrospectively reviewed patients aged < 15 years who presented with suspected foreign body ingestion between January 2016 and June 2025. Patients were divided into early (≤ 2020) and late (≥ 2021) periods. Clinical characteristics, foreign body type, time to presentation, and outcomes were analyzed.</p><p><strong>Results: </strong>Overall, 586 patients were included, of whom 371 underwent imaging and 187 had confirmed foreign bodies. Removal was required in 52 cases. The removal rate was higher in the late period despite fewer detected cases. Button batteries were the most common foreign bodies and the only category showing an increase in the number of removal cases. Cigarette- and electronic cigarette-related ingestion was more frequent in the late period. Patients in the late period tended to present earlier after foreign body ingestion, with foreign bodies more frequently located in the esophagus or stomach. Age was not associated with the increased removal rate.</p><p><strong>Conclusions: </strong>Temporal changes in pediatric foreign body ingestion were observed, with increased removal rates in the late period. These findings may be associated with an increased proportion of high-risk button batteries and relatively earlier presentation after ingestion.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920600","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":"Tumor-to-thoracic height and width ratios as adjunct imaging markers for preoperative risk stratification in minimally invasive surgery for pediatric mediastinal masses.","authors":"Satoshi Makita, Hiroo Uchida, Akinari Hinoki, Chiyoe Shirota, Takahisa Tainaka, Hizuru Amano, Katsuhiro Ogawa, Masamune Okamoto, Aitaro Takimoto, Akihiro Yasui, Shunya Takada, Kaito Hayashi, Yoichi Nakagawa, Daiki Kato, Hiroki Ishii, Hajime Asai, Kazuki Ota, Yui Murata, Yaohui Guo, Jiahui Liu","doi":"10.1007/s00383-026-06621-1","DOIUrl":"10.1007/s00383-026-06621-1","url":null,"abstract":"<p><strong>Purpose: </strong>Selecting the optimal surgical approach for pediatric mediastinal masses is challenging because absolute tumor size does not adequately reflect the available intrathoracic working space in children. This study evaluated whether the tumor-to-thoracic height ratio (TTH) and tumor-to-thoracic width ratio (TTW) are associated with intraoperative complications during minimally invasive surgery (MIS).</p><p><strong>Methods: </strong>Sixty-five children who underwent surgical resection of mediastinal masses between 2007 and 2025 were retrospectively reviewed. Fifty-six underwent MIS, and nine underwent open thoracotomy. TTH and TTW were calculated using preoperative chest radiography and computed tomography or magnetic resonance imaging. Associations with intraoperative complications in the MIS group were analyzed, and receiver operating characteristic analysis was performed as an exploratory assessment.</p><p><strong>Results: </strong>Intraoperative complications occurred in five of 56 patients undergoing MIS. Both TTH and TTW were significantly higher in patients with complications than in those without (TTH: 0.51 vs. 0.26, p = 0.004; TTW: 0.67 vs. 0.37, p = 0.005). Positive image-defined risk factors were also more frequent in patients with complications. The area under the curve was 0.894 for TTH and 0.882 for TTW.</p><p><strong>Conclusion: </strong>TTH and TTW may serve as useful exploratory adjunct imaging markers for preoperative risk stratification in pediatric MIS for mediastinal masses.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920606","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":"Comparing thoracoscopic anatomical lesion resection and lobectomy in children with congenital lung malformations: a multicenter retrospective cohort study.","authors":"Yong Lv, Fangdi Yu, DengKe Luo, Taozhen He, Shiyi Dai, Fei Li, Guangxian Yang, Xianlun Duan, Kefeng Hou, Guozhu Yang, Chang Xu","doi":"10.1007/s00383-026-06593-2","DOIUrl":"10.1007/s00383-026-06593-2","url":null,"abstract":"<p><strong>Background: </strong>The efficacy of thoracoscopic anatomical lesion resection (TALR) for children with congenital lung malformations (CLMs) remains controversial. This multicenter cohort study aimed to compare the perioperative outcomes of TALR and thoracoscopic lobectomy (TL) in pediatric CLM patients.</p><p><strong>Methods: </strong>Clinical data of 1176 children with CLMs who underwent TALR (n = 692) or TL (n = 484) in 6 Chinese hospitals from January 2020 to December 2024 were analyzed. Propensity score matching (PSM) was used to adjust for confounding factors, and the effect of indocyanine green (ICG) navigation in the TALR subgroup was evaluated.</p><p><strong>Results: </strong>After PSM, 968 patients (484 in each group) were included in the analysis. There were significant variations in surgical volume and approach across centers, with TALR being increasingly preferred over time. Pre-matching differences in age and weight between the two groups were eliminated after PSM. In the matched cohort, no significant differences were observed in postoperative complication rates, reoperation rates, or conversion rates to open thoracotomy between the two groups. However, TALR was significantly associated with a significant prolongation of postoperative hospital stay, and the number of cases with chest tube placement was higher. Within the TALR cohort, patients who received ICG demonstrated superior outcomes, reduced operative time and shorter post-operative hospital stay.</p><p><strong>Conclusions: </strong>TALR is a safe and effective lung-sparing alternative to TL for pediatric CLMs with comparable safety profiles. ICG navigation enhances TALR precision and improves perioperative outcomes, and standardized training is essential for its promotion.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920572","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 bowel functional outcomes after surgery for Hirschsprung disease: a comparative study of Duhamel and transanal endorectal pull-through.","authors":"Aika Namba, Yunosuke Kawaguchi, Tetsuya Mitsunaga, Shugo Komatsu, Satoru Oita, Wataru Kudo, Tomoro Hishiki","doi":"10.1007/s00383-026-06632-y","DOIUrl":"10.1007/s00383-026-06632-y","url":null,"abstract":"<p><strong>Purpose: </strong>Long-term bowel dysfunction remains a major concern after surgery for Hirschsprung disease (HD). This study aimed to compare age-dependent bowel functional outcomes between the Duhamel procedure and transanal endorectal pull-through (TAEPT) up to 15 years.</p><p><strong>Methods: </strong>This retrospective single-center study included 101 patients who underwent surgery for HD between 1978 and 2025. Seventy-one patients underwent the Duhamel procedure, and 30 underwent TAEPT. Postoperative bowel function was assessed using a standardized bowel function score (BFS; maximum: 8), evaluating urge to defecate, constipation, incontinence, and soiling at 5, 7, 10, and 15 years.</p><p><strong>Results: </strong>Bowel function improved with age in both groups and plateaued by adolescence. The Duhamel group had significantly higher BFS than the TAEPT group at 5, 7, and 10 years (all P < 0.05). Domain-specific analysis exhibited improved urge to defecate at 5 and 7 years and better incontinence and soiling scores at 10 years in the Duhamel group. No significant differences were observed at 15 years.</p><p><strong>Conclusion: </strong>The Duhamel group had higher bowel function scores during childhood than the TAEPT group. However, these differences diminished with age, suggesting functional maturation. Understanding procedure-specific functional characteristics may contribute to individualized bowel management and improved long-term quality of life in HD.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913045","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}