Pediatric Surgery International最新文献_第9页

Clinical significance of sarcopenia in children with neuroblastic tumors. 神经母细胞瘤患儿肌少症的临床意义。

IF 1.5 3区医学

Pediatric Surgery International Pub Date : 2024-08-21 DOI: 10.1007/s00383-024-05815-9

Wataru Kudo, Keita Terui, Ryoya Furugane, Ayako Takenouchi, Shugo Komatsu, Yunosuke Kawaguchi, Katsuhiro Nishimura, Daisuke Katsumi, Tomoro Hishiki

{"title":"Clinical significance of sarcopenia in children with neuroblastic tumors.","authors":"Wataru Kudo, Keita Terui, Ryoya Furugane, Ayako Takenouchi, Shugo Komatsu, Yunosuke Kawaguchi, Katsuhiro Nishimura, Daisuke Katsumi, Tomoro Hishiki","doi":"10.1007/s00383-024-05815-9","DOIUrl":"10.1007/s00383-024-05815-9","url":null,"abstract":"Purpose: To elucidate the clinical significance of sarcopenia in children with neuroblastic tumors (NTs).Methods: We conducted a retrospective observational study and analyzed the z-scores for height, body weight, body mass index, and skeletal muscle index (HT-z, BW-z, BMI-z, and SMI-z) along with the clinical characteristics of 36 children with NTs. SMI-z was calculated from 138 computed tomography scans at diagnosis, during treatment, and at follow-up. The International Neuroblastoma Risk Group classification was used to identify high-risk groups. We analyzed the data at diagnosis for prognostic analysis and changes over time after diagnosis in the HT-z, BW-z, BMI-z, and SMI-z groups.Results: Among the four parameters at diagnosis, only SMI-z predicted overall survival (hazard ratio, 0.58; 95% confidence interval, 0.34-0.99). SMI-z, HT-z, and BW-z significantly decreased over time after diagnosis (P < 0.05), while BMI-z did not (P = 0.11). In surviving high-risk NT cases without disease, SMI-z, HT-z, and BW-z significantly decreased over time (P < 0.05), while BMI-z did not (P = 0.43).Conclusion: In children with NT, the SMI-z at diagnosis was a significant prognostic factor and decreased during treatment and follow-up along with HT-z and BW-z. Monitoring muscle mass is important because sarcopenia may be associated with growth impairment.","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"40 1","pages":"237"},"PeriodicalIF":1.5,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11335913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009235","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}

引用次数: 0

Muscle regeneration therapy using dedifferentiated fat cell (DFAT) for anal sphincter dysfunction. 利用再分化脂肪细胞（DFAT）治疗肛门括约肌功能障碍的肌肉再生疗法。

IF 1.5 3区医学

Pediatric Surgery International Pub Date : 2024-08-21 DOI: 10.1007/s00383-024-05812-y

Yusuke Kamidaki, Takashi Hosokawa, Naoko Abe, Eri Fujita, Bin Yamaoka, Kako Ono, Shumpei Goto, Tomohiko Kazama, Taro Matsumoto, Shuichiro Uehara

{"title":"Muscle regeneration therapy using dedifferentiated fat cell (DFAT) for anal sphincter dysfunction.","authors":"Yusuke Kamidaki, Takashi Hosokawa, Naoko Abe, Eri Fujita, Bin Yamaoka, Kako Ono, Shumpei Goto, Tomohiko Kazama, Taro Matsumoto, Shuichiro Uehara","doi":"10.1007/s00383-024-05812-y","DOIUrl":"https://doi.org/10.1007/s00383-024-05812-y","url":null,"abstract":"Purpose: We investigated the effects of mouse-derived DFAT on the myogenic differentiation of a mouse-derived myoblast cell line (C2C12) and examined the therapeutic effects of rat-derived DFAT on anal sphincter injury using a rat model.Methods: C2C12 cells were cultured using DMEM and DFAT-conditioned medium (DFAT-CM), evaluating MyoD and Myogenin gene expression via RT-PCR. DFAT was locally administered to model rats with anorectal sphincter dysfunction 3 days post-CTX injection. Therapeutic effects were assessed through functional assessment, including anal pressure measurement using solid-state manometry pre/post-CTX, and on days 1, 3, 7, 10, 14, 17, and 21 post-DFAT administration. Histological evaluation involved anal canal excision on days 1, 3, 7, 14, and 21 after CTX administration, followed by hematoxylin-eosin staining.Results: C2C12 cells cultured with DFAT-CM exhibited increased MyoD and Myogenin gene expression compared to control. Anal pressure measurements revealed early recovery of resting pressure in the DFAT-treated group. Histologically, DFAT-treated rats demonstrated an increase in mature muscle cells within newly formed muscle fibers on days 14 and 21 after CTX administration, indicating enhanced muscle tissue repair.Conclusion: DFAT demonstrated the potential to enhance histological and functional muscle tissue repair. These findings propose DFAT as a novel therapeutic approach for anorectal sphincter dysfunction treatment.","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"40 1","pages":"238"},"PeriodicalIF":1.5,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142018226","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}

引用次数: 0

Qualitative inductive analysis of the lives of women with persistent cloaca based on their narratives. 根据患有顽固性泄殖腔的妇女的叙述，对她们的生活进行定性归纳分析。

IF 1.5 3区医学

Pediatric Surgery International Pub Date : 2024-08-20 DOI: 10.1007/s00383-024-05807-9

Junko Miyata, Yuko Hamada, Satomi Hayashishita, Ayaka Fujita, Tomoko Izaki, Satoshi Obata, Takuya Kondo, Atsuhisa Fukuta, Naonori Kawakubo, Kouji Nagata, Akihiko Tamaki, Junnosuke Maniwa, Yoshiaki Takahashi, Toshiharu Matsuura, Tomoaki Taguchi, Tatsuro Tajiri

{"title":"Qualitative inductive analysis of the lives of women with persistent cloaca based on their narratives.","authors":"Junko Miyata, Yuko Hamada, Satomi Hayashishita, Ayaka Fujita, Tomoko Izaki, Satoshi Obata, Takuya Kondo, Atsuhisa Fukuta, Naonori Kawakubo, Kouji Nagata, Akihiko Tamaki, Junnosuke Maniwa, Yoshiaki Takahashi, Toshiharu Matsuura, Tomoaki Taguchi, Tatsuro Tajiri","doi":"10.1007/s00383-024-05807-9","DOIUrl":"https://doi.org/10.1007/s00383-024-05807-9","url":null,"abstract":"Purpose: The study aimed to explore and describe the lives of patients with persistent cloaca (PC) from childhood to adulthood.Methods: Semistructured interviews were conducted with nine adult patients with PC. Their experiences and thoughts regarding this disease were analyzed qualitatively and inductively.Results: After classifying the experiences and thoughts of patients with PC, 13 categories were extracted. The following five themes emerged from these categories. (1) Difficulties with excretion and vaginal management because of the disease. (2) The degree of understanding of those around them and society has a huge effect on their way of life. (3) The inferiority of a woman who is not a \"normal woman.\" (4) A \"never-ending disease\" in which problems continue even after the transition period. (5) Differences in the central point of the narrative depending on the age group.Conclusions: In this study, qualitative and inductive analyses of data from semistructured interviews with patients with PC revealed their experiences and thoughts. The results will provide a guide for young patients and the medical professionals who treat them. Accordingly, monitoring their lives until adulthood is necessary.","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"40 1","pages":"236"},"PeriodicalIF":1.5,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142004975","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}

引用次数: 0

Early post-operative fever after colorectal surgery in infants is common and rarely associated with infection. 婴儿结肠直肠手术后早期发烧很常见，但很少与感染有关。

IF 1.5 3区医学

Pediatric Surgery International Pub Date : 2024-08-19 DOI: 10.1007/s00383-024-05823-9

Jacky Z Kwong, Eveline Lapidus-Krol, Jacob C Langer, Brian C Gulack

{"title":"Early post-operative fever after colorectal surgery in infants is common and rarely associated with infection.","authors":"Jacky Z Kwong, Eveline Lapidus-Krol, Jacob C Langer, Brian C Gulack","doi":"10.1007/s00383-024-05823-9","DOIUrl":"https://doi.org/10.1007/s00383-024-05823-9","url":null,"abstract":"Purpose: Early post-operative fever (< 48 h) is common in adults and children and seldom indicative of an infection. Guidance to limit excessive evaluation in adults is well-characterized but similar studies for the pediatric population is scarce. This study was performed to better clarify which infants should undergo investigation for post-operative fever after colorectal reconstructive surgical procedures.Methods: We performed a retrospective chart review of all infants under one year of age who underwent elective reconstruction for anorectal malformations (ARM) and Hirschsprung Disease (HD) between June 2018 and April 2020 at a single institution. Patient and perioperative characteristics were analyzed to evaluate for possible factors associated with infection.Results: Sixty-eight infants met study criteria - 38 (55.9%) had HD and 30 (44.1%) had ARM. Twenty-two infants (32.4%) had early post-operative fever. A definitive infectious cause was identified in only two infants. The presence of a colostomy pre-operatively and longer operative times were associated with increased risk of post-operative fever (62.5% vs. 22.7% and 175 min vs. 150 min respectively, p < 0.05).Conclusion: Early post-operative fever in infants after colorectal surgery is common and rarely associated with an infection. Further research is needed to determine which infants require further work-up and which can be safely observed.","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"40 1","pages":"235"},"PeriodicalIF":1.5,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142004974","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}

引用次数: 0

Effect of emergent nephrostomy on long-term total and split renal function in patients with upper urinary tract obstruction due to pelvic malignant tumors. 紧急肾造瘘术对盆腔恶性肿瘤所致上尿路梗阻患者长期总肾功能和分肾功能的影响。

IF 1.5 3区医学

Pediatric Surgery International Pub Date : 2024-08-19 DOI: 10.1007/s00383-024-05810-0

Katsuhiro Nishimura, Ayako Takenouchi, Shugo Komatsu, Yunosuke Kawaguchi, Wataru Kudo, Shota Takiguchi, Tomoro Hishiki

{"title":"Effect of emergent nephrostomy on long-term total and split renal function in patients with upper urinary tract obstruction due to pelvic malignant tumors.","authors":"Katsuhiro Nishimura, Ayako Takenouchi, Shugo Komatsu, Yunosuke Kawaguchi, Wataru Kudo, Shota Takiguchi, Tomoro Hishiki","doi":"10.1007/s00383-024-05810-0","DOIUrl":"10.1007/s00383-024-05810-0","url":null,"abstract":"Purpose: This study aimed to investigate the impact of nephrostomies on the outcome of total renal function (TRF) and split renal function (SRF) in patients with malignant pelvic tumors associated with upper urinary tract obstruction (UUTO).Methods: Patients with pelvic tumors suffering severe unilateral hydronephrosis treated at our hospital from 2000 to 2022 were included. Data for nephrostomy placement, short- and long-term renal function, and radiological and nuclear imaging studies were collected. The TRF and SRF of patients who underwent nephrostomy were compared to those who did not.Results: Seven patients were included (rhabdomyosarcoma: 5, ovarian germ cell tumor: 1, malignant rhabdoid tumor: 1). Nephrostomies were placed in four, which were successfully managed without severe infections. Estimated glomerular filtration rate (eGFR) was significantly improved at the end of treatment in patients with nephrostomy. In contrast, eGFR in patients who did not undergo nephrostomy was not improved. Nuclear imaging studies (renograms or renal scintigrams) revealed impaired SRF of the affected kidney compared to the contralateral kidney, even in patients whose eGFR was within normal levels. Notably, SRF showed a trend to improve over time in one patient treated with nephrostomy.Conclusion: Nephrostomy for UUTO caused by pelvic tumors may improve renal outcome.","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"40 1","pages":"234"},"PeriodicalIF":1.5,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11333509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000535","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}

引用次数: 0

Expert classification of hypospadias: an external validation and evaluation of agreement for Glans-Urethral Meatus-Shaft (GMS) and Hypospadias Objective Penile Evaluation (HOPE) scores. 尿道下裂的专家分类：外部验证和评估尿道下裂客观阴茎评估（HOPE）评分的一致性。

IF 1.5 3区医学

Pediatric Surgery International Pub Date : 2024-08-19 DOI: 10.1007/s00383-024-05816-8

Kellie J Kim, Jin K Kim, Michael E Chua, Jan Michael Silangcruz, Priyank Yadav, Mandy Rickard, Armando J Lorenzo, Nicolas Fernandez

{"title":"Expert classification of hypospadias: an external validation and evaluation of agreement for Glans-Urethral Meatus-Shaft (GMS) and Hypospadias Objective Penile Evaluation (HOPE) scores.","authors":"Kellie J Kim, Jin K Kim, Michael E Chua, Jan Michael Silangcruz, Priyank Yadav, Mandy Rickard, Armando J Lorenzo, Nicolas Fernandez","doi":"10.1007/s00383-024-05816-8","DOIUrl":"https://doi.org/10.1007/s00383-024-05816-8","url":null,"abstract":"Purpose: This study evaluates the inter-rater agreements of both the Glans-Urethral Meatus-Shaft (GMS) hypospadias score and Hypospadias Objective Penile Evaluation (HOPE) score, aiming to standardize disease classification for consistent agreement in clinically relevant characteristics of hypospadias.Methods: Photos of hypospadias in children were collected from two separate institutions. Three raters scored the photos using GMS and HOPE, excluding penile torsion and curvature assessment in HOPE due to photo limitations.Results: A total of 528 photos were included. With GMS, Fleiss' multi-rater kappa showed an agreement of 0.745 for glans-urethral plate, 0.869 for meatus, and 0.745 for shaft. For HOPE scores, the agreements were 0.888 for position of meatus, 0.669 for shape of meatus, 0.730 for shape of glans, and 0.708 for the shape of the skin. The lower agreement in the shape of the meatus evaluation may be attributed to the lack of a quantitative classification method in HOPE. Experts rely on their subjective judgment based on the provided example photos and their index patient.Conclusions: While there is high agreement among experts when evaluating hypospadias using the GMS and HOPE scoring criteria, only the position of the meatus achieved nearly perfect agreement highlighting that the current scoring systems entail a subjective element in disease classification.","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"40 1","pages":"233"},"PeriodicalIF":1.5,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000536","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}

引用次数: 0

Effect of medial stabilizer chest position on pectus bar dislocation. 内侧稳定器胸腔位置对栉孔棒脱位的影响。

IF 1.5 3区医学

Pediatric Surgery International Pub Date : 2024-08-18 DOI: 10.1007/s00383-024-05822-w

Caroline Melhado, Alexandra Highet, Neal Mukherjee, Doruk Ozgediz, Olajire Idowu, Sunghoon Kim

{"title":"Effect of medial stabilizer chest position on pectus bar dislocation.","authors":"Caroline Melhado, Alexandra Highet, Neal Mukherjee, Doruk Ozgediz, Olajire Idowu, Sunghoon Kim","doi":"10.1007/s00383-024-05822-w","DOIUrl":"10.1007/s00383-024-05822-w","url":null,"abstract":"Purpose: The current standard method for pectus excavatum (PE) repair is the Nuss procedure. One major postoperative complication is the displacement of the implanted metal bar, which is used to remodel the chest wall. Blocking the possible ways that the bar can be displaced with the use of stabilizers and peri/intracostal sutures has reduced the incidence of bar displacement. Despite the modifications, bar dislocation is often reported. We adopted the medial position stabilizer placement method and imposed no postoperative restrictions. In this study, we analyzed the bar dislocation rate with this modification and concurrent postoperative full activity.Methods: Nuss procedure modification where stabilizers are placed bilaterally in the medial location was done on patients irrespective of age and Haller index greater than 3.25. A single bar was used for all patients. Cryoanalgesia was performed on every patient. No postoperative restrictions were imposed on the patients. Full immediate activities, including sports, were allowed.Results: 114 patients (103 male, 11 female) were analyzed from 2016 to 2023. The median age was 15 years old. There was zero incidence of bar displacement. The combined incidence of other postoperative complications was 4%: 2 wound infections and 2 hematoma formations, both needing incision and drainage.Conclusion: Bilateral medial stabilizer placement resulted in no incidence of bar dislocation. Return to immediate full activities after the Nuss procedure did not appear to increase the incidence of bar displacement if stabilizers were placed medially.","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"40 1","pages":"232"},"PeriodicalIF":1.5,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11330410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996300","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}

引用次数: 0

Quality of life after colectomy and ileo-jpouch-anal anastomosis in paediatric patients with ulcerative colitis. 溃疡性结肠炎儿科患者结肠切除术和回肠-结肠-肛门吻合术后的生活质量。

IF 1.5 3区医学

Pediatric Surgery International Pub Date : 2024-08-17 DOI: 10.1007/s00383-024-05824-8

M C Y Wong, G Rotondi, M Roso, P Avanzini, P Gandullia, S Arrigo, G Mattioli

{"title":"Quality of life after colectomy and ileo-jpouch-anal anastomosis in paediatric patients with ulcerative colitis.","authors":"M C Y Wong, G Rotondi, M Roso, P Avanzini, P Gandullia, S Arrigo, G Mattioli","doi":"10.1007/s00383-024-05824-8","DOIUrl":"https://doi.org/10.1007/s00383-024-05824-8","url":null,"abstract":"Introduction: Ulcerative Colitis (UC) is an Inflammatory Bowel Disease (IBD). Surgery is required in cases of severe acute colitis, massive hemorrhage, toxic megacolon, and perforation; in such cases colectomy and JpouchIleoanal anastomosis (IPAA) are performed. The aim of this study was to evaluate functional outcome, and patient satisfaction and Quality of Life (QoL) after surgery.Material and methods: Questionnaires were administered to 24 patients with UC undergoing surgery from 2011 to 2022.Results: Mean age at IPAA was 10.8 years. Twenty patients underwent IPAA in 3 operations, 4 patients in 2. All patients underwent laparoscopic surgery. 6 months after surgery mean level of satisfaction was 8.7/10, perception of health status was 7.4. Twenty-three patients (95.8%) recommended IPAA. For 20 patients (83.3%) surgery did not cause delay in education, while 14 patients (58.3%) played sport. The lowest number of evacuations was 9.2 per day, the highest 13.3. Seventeen patients (70.8%) had no incontinence and 15 patients (62.5%) were not affected by pouchitis. After 12 months mean satisfaction level raised up to 9.2/10, perception of health status to 8.5. School absences decreased and no other patients showed any delay in education. Seventeen (70.8%) patients played sports. The number of evacuations decreased: the lowest number was 5.1 per day, the highest 7.5. Twenty patients (83.3%) were continent and 12 (50%) did not use antibiotics.Conclusion: Most patients show a good functional outcome in defecation frequency and continence, which has improved through time, number of pouchitis episodes has increased. Patients appear satisfied after surgery.","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"40 1","pages":"231"},"PeriodicalIF":1.5,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996302","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}

引用次数: 0

Hepatic resections for pediatric hepatoblastoma: analysis of 30-day outcomes using the National Surgical Quality Improvement Program-Pediatric database. 小儿肝母细胞瘤的肝切除术：利用国家外科质量改进计划儿科数据库对 30 天结果进行分析。

IF 1.5 3区医学

Pediatric Surgery International Pub Date : 2024-08-17 DOI: 10.1007/s00383-024-05820-y

Humza Thobani, Rafia Durrani, Steven L Raymond, Adil A Shah, Saleem Islam, Faraz A Khan

{"title":"Hepatic resections for pediatric hepatoblastoma: analysis of 30-day outcomes using the National Surgical Quality Improvement Program-Pediatric database.","authors":"Humza Thobani, Rafia Durrani, Steven L Raymond, Adil A Shah, Saleem Islam, Faraz A Khan","doi":"10.1007/s00383-024-05820-y","DOIUrl":"https://doi.org/10.1007/s00383-024-05820-y","url":null,"abstract":"Background: Surgical resection remains the cornerstone of treatment for hepatoblastoma in children and offers the best chance of disease-free survival. We aimed to analyze the 30 day outcomes of hepatic resection for hepatoblastoma stratified by extent using the National Surgical Quality Improvement Program-Pediatric (NSQIP-P).Methods: We queried NSQIP-P for children undergoing resection of Hepatoblastoma from 2012 to 2021. Relevant clinical characteristics and outcomes were extracted for multivariate logistic regression to identify predictors of common adverse outcomes.Results: We included 458 children with a median age of 1.90 years. Overall complications were rare, and perioperative blood transfusion (64.2%) and postoperative ventilation > 48 h (10.0%) were the only adverse events prevalent in more than 5% of patients. Median transfusion volume was 15.7 ml/kg. On multivariate regression, only patients undergoing Trisectionectomy (aOR = 3.387, 95% C.I. = 1.348-8.510) had higher odds of receiving > 75th percentile blood transfusion. Furthermore, only perioperative transfusion and postoperative ventilation > 48 h were statistically more common in patients undergoing extended versus standard resections.Conclusions: Outcomes following resection of hepatoblastoma are excellent, with low rates of postoperative adverse events. Although children undergoing trisectionectomy likely require greater transfusion volume, extended hepatic resections do not appear to have worse 30 day outcomes despite greater operative complexity and duration.","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"40 1","pages":"230"},"PeriodicalIF":1.5,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996301","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}

引用次数: 0

A retrospective study investigating the risk of graft loss in living donor liver transplant cases where size mismatching is predicted from graft-to-recipient weight ratio. 一项回顾性研究，调查了根据移植物与受体重量比预测大小不匹配的活体肝移植病例中移植物丢失的风险。

IF 1.5 3区医学

Pediatric Surgery International Pub Date : 2024-08-16 DOI: 10.1007/s00383-024-05814-w

Yukihiro Toriigahara, Toshiharu Matsuura, Yoshiaki Takahashi, Yasuyuki Uchida, Keisuke Kajihara, Shohei Maeda, Naonori Kawakubo, Kouji Nagata, Tatsuro Tajiri

{"title":"A retrospective study investigating the risk of graft loss in living donor liver transplant cases where size mismatching is predicted from graft-to-recipient weight ratio.","authors":"Yukihiro Toriigahara, Toshiharu Matsuura, Yoshiaki Takahashi, Yasuyuki Uchida, Keisuke Kajihara, Shohei Maeda, Naonori Kawakubo, Kouji Nagata, Tatsuro Tajiri","doi":"10.1007/s00383-024-05814-w","DOIUrl":"https://doi.org/10.1007/s00383-024-05814-w","url":null,"abstract":"Background/purpose: Living donor liver transplantation (LDLT) is vital for pediatric end-stage liver disease due to organ shortages. The graft-to-recipient weight ratio (GRWR) preoperatively measured predicts the outcomes of LDLT. We typically target between 0.8 and 3.0-4.0%, but the ideal GRWR remains controversial. We compared the outcomes of LDLT according to the GRWR to examine whether the criteria could be expanded while ensuring safety.Methods: We retrospectively reviewed 99 patients who underwent LDLT in our department by dividing them into three groups according to their GRWR: Group S, with GRWR values lower than the normal range (GRWR < 0.8%); Group M, with GRWR values in the normal range (GRWR ≥ 0.8 to < 3.5%); and Group L, with GRWR values above the normal range (GRWR ≥ 3.5%).Results: In Groups S and L, 46.2 and 44.4% of patients underwent splenectomy and delayed abdominal wall closure, respectively. After these intraoperative adjustments, there were no significant differences between the groups in 5-year patient survival, 5-year graft survival, or the occurrence of post-transplantation thrombosis.Conclusion: When the GRWR is beyond the normal threshold, the risk of complications associated with graft size might be reduced by adjustments to provide appropriate portal blood flow and by delayed abdominal wall closure.","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"40 1","pages":"229"},"PeriodicalIF":1.5,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996299","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}

引用次数: 0