Pediatric Surgery International最新文献

{"title":"Outcomes of bariatric surgery in adolescents: comparing high volume adult bariatric and pediatric general surgery hospitals.","authors":"Monique Motta, Lucia Hernandez Castro, Joshua Parreco, Tamar Levene","doi":"10.1007/s00383-026-06570-9","DOIUrl":"10.1007/s00383-026-06570-9","url":null,"abstract":"<p><strong>Purpose: </strong>With the increasing prevalence of bariatric surgery in adolescents, it remains unclear whether centers specializing in pediatric general surgery or adult bariatric surgery are better equipped to perform these procedures. This study aimed to compare outcomes following pediatric bariatric surgery based on surgical volume.</p><p><strong>Methods: </strong>Using the Nationwide Readmissions Database for 2016-2018, all patients aged 10-19 years undergoing bariatric surgery were identified. High-volume hospitals, defined as those in the highest quartile of procedures per year, were analyzed. Outcomes included conversion to open surgery, prolonged length of stay (LOS) and hospital readmission.</p><p><strong>Results: </strong>Among 4,385 eligible patients, 44.5% underwent surgery in high-volume hospitals. The rate of conversion to open surgery was 0.7%, with high-volume hospitals associated with decreased risk (OR 0.42 [0.18-0.96], p=0.04). Prolonged LOS occurred in 10.1% of patients, less likely at high-volume hospitals (OR 0.63 [0.51-0.78], p<0.001). Readmission rate was 3.1%, with similar rates in high-volume hospitals (2.9%, p=0.5).</p><p><strong>Conclusion: </strong>Hospitals performing the highest volumes of bariatric and pediatric general surgeries demonstrated superior outcomes, despite accounting for less than half of the procedures analyzed. Accounting for hospital volumes of pediatric general and bariatric surgeries is crucial for enhancing patient outcomes.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906700","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":"Natural history of inguinal hernia in neonates and infants: clinical regression and incarceration.","authors":"Ko Miyazaki, Makoto Hayashida, Shoma Koga, Akihiko Tamaki","doi":"10.1007/s00383-026-06626-w","DOIUrl":"10.1007/s00383-026-06626-w","url":null,"abstract":"<p><strong>Purpose: </strong>In our institution, infants with inguinal hernias are managed with elective repair at approximately 1 year of age to reduce perioperative complications and allow for possible clinical regression. This study aimed to clarify the natural history of infantile inguinal hernia and identify factors associated with clinical regression and incarceration.</p><p><strong>Methods: </strong>We conducted a retrospective chart review of patients diagnosed before 1 year of age between 2015 and 2023, supplemented with telephone follow-ups to confirm clinical regression. Factors associated with clinical regression were analyzed, and the time to incarceration was evaluated using a Fine-Gray competing risks model with surgery as a competing event.</p><p><strong>Results: </strong>In total, 357 patients were included. Clinical regression was confirmed in 45 patients, including 33 term infants with a median follow-up period of 5.3 (IQR 3.9-8.0) years. In multivariable analysis, older age at diagnosis was independently associated with a lower likelihood of clinical regression (odds ratio: 0.65 [0.51-0.82]). Incarceration occurred in 43 patients and was associated with male sex (multivariable subdistribution hazard ratio: 2.68 [1.19-6.02]).</p><p><strong>Conclusion: </strong>Despite the risk of incarceration, a watchful waiting strategy may be acceptable for selected patients when careful follow-up and prompt access to care are available.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900903","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":"Macrophage-enteric nervous system crosstalk in Hirschsprung disease and associated enterocolitis: a focused narrative review with clinical implications.","authors":"Xin Wang, Hongxi Guo, Hua Liu","doi":"10.1007/s00383-026-06635-9","DOIUrl":"10.1007/s00383-026-06635-9","url":null,"abstract":"<p><p>Hirschsprung disease (HSCR) results from incomplete distal bowel colonization by enteric neural crest-derived cells. Macrophage-enteric nervous system (ENS) interactions may influence postnatal neuromuscular function and Hirschsprung-associated enterocolitis (HAEC), but direct evidence that macrophages initiate embryonic aganglionosis is limited. This focused narrative review therefore treats postnatal dysmotility and HAEC as its primary focus and examines prenatal development chiefly to define the boundary of causal claims. In the normal muscularis, macrophage-neuron interactions contribute to ENS refinement and maintenance. A proposed bone morphogenetic protein 2 and colony-stimulating factor 1 circuit has influenced the field, although recent deletion studies question whether macrophage-derived bone morphogenetic protein 2 controls motility. In HSCR, the strongest disease-specific evidence concerns secondary neuromuscular dysfunction and HAEC. Pro-inflammatory macrophages can induce an interstitial cell of Cajal C-KIT phenotypic switch through a TNF-α, NF-κB and miR-221 pathway, while microbial, stromal and epithelial signals can further modify macrophage function. These mechanisms may help explain persistent dysmotility and enterocolitis susceptibility, but no macrophage biomarker or macrophage-directed treatment has established clinical utility. Current care remains based on prompt recognition, bowel decompression, antibiotics and correction of obstructive causes. Available evidence supports macrophages as modifiers of postnatal dysfunction, not as a proven primary cause of aganglionosis.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900990","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":"Outcomes and learning curve of single-kidney transplantation from small pediatric donors in children: a retrospective cohort study with meta-analysis.","authors":"Zaohang Yan, Chengjun Yu, Jie Zhang, Meifang Wu, Xing Liu, Deying Zhang, Shengde Wu, Sheng Wen, Guanghui Wei, Yi Hua","doi":"10.1007/s00383-026-06622-0","DOIUrl":"10.1007/s00383-026-06622-0","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate clinical outcomes of single-kidney transplantation from small pediatric donors (weight ≤ 15 kg or age ≤ 3 years).</p><p><strong>Methods: </strong>This retrospective cohort study included 77 children transplanted at our center (Oct 2022-May 2026): 26 small-donor vs. 51 large-donor recipients. CUSUM learning curve analysis and meta-analysis of seven studies (527 patients) were performed.</p><p><strong>Results: </strong>In the cohort, small-donor group had lower 1-year graft survival (73.1% vs. 100%, P < 0.001) and higher acute rejection (19.2% vs. 2.0%, P = 0.026), while thrombosis, DGF, and patient survival were similar. EGFR at 1 year was comparable between groups. CUSUM showed an inflection at Case 16 in the small-donor group, with operative time decreasing from 187.6 to 146.3 min. Meta-analysis yielded 1-year patient survival of 98%, graft survival 91%, and pooled thrombosis, DGF, and acute rejection rates of 5%, 13%, and 10%, respectively.</p><p><strong>Conclusions: </strong>Early graft loss risk in small-donor single-kidney transplantation declines after the learning phase, with acceptable short-term outcomes and high organ utilization. This approach appears feasible in experienced centers, though long-term efficacy requires prospective validation.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900917","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 clinical characteristics and prognostic factors of neonatal gastric perforation and rupture: a multicenter retrospective study in Japan.","authors":"Toshio Harumatsu, Koshiro Sugita, Ayano Hidaka, Tsubasa Goshima, Shohei Yoshimura, Daisuke Masui, Tokuro Baba, Hirofumi Tomita, Naoki Shimojima, Tadashi Hatakeyama, Motofumi Torikai, Tatsuru Kaji, Satoshi Ieiri","doi":"10.1007/s00383-026-06616-y","DOIUrl":"10.1007/s00383-026-06616-y","url":null,"abstract":"<p><strong>Purpose: </strong>Neonatal gastric perforation is a life-threatening surgical emergency with high mortality rates. The confounding effect of tracheoesophageal fistula (TEF) on prognostic analyses remains inadequately addressed. This study aimed to identify the prognostic factors for in-hospital mortality using a multicenter analysis.</p><p><strong>Methods: </strong>We conducted a retrospective study at six tertiary pediatric surgery centers in Japan, including all neonates who underwent surgical treatment for either gastric perforation or rupture between 1994 and 2025. Logistic regression and sensitivity analyses, excluding TEF cases, were performed.</p><p><strong>Results: </strong>Thirty-seven patients were identified, with a median birth weight of 1202 g, of whom 56.8% had a very low birth weight. The overall mortality rate was 37.8% (14/37). On a multivariate analysis, TEF was the strongest independent prognostic factor (OR 51.85, 95% CI 3.26-824.6; p = 0.005). In the sensitivity analysis excluding TEF cases (n = 28), the age at surgery (OR 1.23, 95% CI 1.01-1.51; p = 0.041) and the perforation length (OR 1.09, 95% CI 1.00-1.18; p = 0.043) were significant predictors of mortality.</p><p><strong>Conclusion: </strong>TEF is the strongest prognostic factor for neonatal gastric perforation. Excluding TEF confounding factors revealed the prognostic importance of the age at surgery and the perforation size, highlighting the value of early diagnosis and management.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900971","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 clinical features and outcomes of acute-on-chronic liver failure in biliary atresia patients on a waiting list for liver transplantation.","authors":"Toshiharu Matsuura, Yukihiro Toriigahara, Shohei Maeda, Yoshiaki Takahashi, Atsuhisa Fukuta, Naonori Kawakubo, Koichiro Yoshimaru, Kouji Nagata, Tatsuro Tajiri","doi":"10.1007/s00383-026-06630-0","DOIUrl":"10.1007/s00383-026-06630-0","url":null,"abstract":"<p><strong>Purpose: </strong>Acute-on-chronic liver failure (ACLF) in adults has an extremely poor prognosis. However, reports on the epidemiology and outcomes of ACLF in biliary atresia (ACLF-BA) are scarce.</p><p><strong>Methods: </strong>Among 123 BA cases deemed eligible for liver transplantation (LT), we retrospectively evaluated them according to the Japanese ACLF diagnostic criteria established in 2018 and categorized them into ACLF-BA and non-ACLF-BA groups. We also retrospectively reviewed the liver and extrahepatic organ failures during the waitlist period in both groups.</p><p><strong>Results: </strong>Fourteen patients (11.4%) were categorized as ACLF-BA. The liver function in ACLF-BA dramatically worsened both in the Child-Pugh and MELD scores in the short term after ACLF onset. Seven cases (50%) in ACLF-BA were categorized as grade 3 with more than three extrahepatic organ failures. The waitlist mortality rate for deceased donors in ACLF-BA was as high as 50%. However, the post-LT patient survival rate in ACLF-BA was 90.9%, and not statistically significantly different compared to non-ACLF-BA.</p><p><strong>Conclusion: </strong>Although ACLF-BA awaiting LT carries an increased waitlist mortality, the post-LT patient survival was comparable to recipients without ACLF. The type and number of extrahepatic organ failures could correlate with patient mortality. The prioritization of organ allocation for ACLF-BA warrants further discussion.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897633","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":"Ultrasound pattern of upper urinary tract remodeling after pyeloplasty: a prospective multicentric study.","authors":"Luciana Lerendegui, Luis Garcia Aparicio, Andres Gomez Fraile, Alejandro Calvillo-Ramirez, Sonia Perez Bertolez, Cristian Demeco, Tamara Kreindel, Roberto Vagni, Francisco de Badiola, Maria Ormaechea, Ignacio Arenas Norton, Pedro Mercado, Joaquin Camacho, Juan Pablo Corbetta, Luciana Diaz Zabala, Nicolas Rosiere, María Tatiana Szklarz, Javier Ruiz, Santiago Weller, Maria Pons Vilalta, María Santos Couve, Francisco Reed, Pedro-José Lopez, Cristina Tordable Ojeda, Daniel Cabezali Barbancho, Pilar Etcheverria, Carolina M Acuña, Juan Manuel Moldes","doi":"10.1007/s00383-026-06557-6","DOIUrl":"10.1007/s00383-026-06557-6","url":null,"abstract":"<p><strong>Introduction: </strong>Ureteropelvic junction obstruction can cause significant changes in the upper urinary tract (UUT). Although pyeloplasty may successfully restore normal flow through the UPJ, those modifications do not resolve immediately and may persist. We aimed to characterize the sonographic remodeling pattern of the UUT following successful pyeloplasty.</p><p><strong>Methods: </strong>Prospective multicenter study, including pediatric patients status post-pyeloplasty (2021-2022) with standardized US assessments at 2, 6 and 9 months, 1 and 2 years after double J stent removal. The primary outcome was the percentage reduction in anteroposterior diameter (APD) of the renal pelvis compared to baseline.</p><p><strong>Results: </strong>31 patients, median age at surgery was 6.5 months (IQR 6.5-105.5). Median preoperative APD was 24 mm (21-31 mm), with median reductions of 30% at 2 months, 60% at 6 months, 64.5% and 71.4% (40.9-82.5%) at 1 and 2 years. Median cortical thickness on the operated side improved from 4.9 mm (3.3-5.5 mm) to 8 mm at 2 years (63% increase). Median renal lengths were 72 mm (55-123 mm) on the operated side and 60 mm (50-120 mm) on the unaffected side at baseline, increasing to 88 mm (62-138 mm) and 76 mm (60-120 mm) respectively at 2 years.</p><p><strong>Conclusions: </strong>The UUT undergoes progressive and measurable remodeling on US following pyeloplasty. Most cases show a 30% APD reduction within the first 2 months and 60% by 6 months, with minimal changes thereafter. Cortical thickness also progressively improves but typically does not reach normal values.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897611","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":"Gastrointestinal symptoms and association to food items in children with hirschsprung disease: a multinational patient-reported outcome study from Latin America and Spain.","authors":"Carla Scaramella, Lovisa Telborn, Joseph Davidson, Hannah Day, Marta de Andres Crespo, Verónica Busoni, Pablo Lobos, Judith Lindert","doi":"10.1007/s00383-026-06605-1","DOIUrl":"10.1007/s00383-026-06605-1","url":null,"abstract":"<p><strong>Purpose: </strong>Children with Hirschsprung disease (HD) frequently experience persistent bowel dysfunction after definitive surgery. Although many families report that diet influences gastrointestinal symptoms, evidence guiding dietary management remains limited. This study evaluated dietary habits, food-related gastrointestinal symptoms, and bowel function in children with HD across Spain and Latin America.</p><p><strong>Methods: </strong>A Spanish-language version of the OASIS Nutrition Questionnaire was developed by the multinational Holistic Care in Hirschsprung Disease Network and distributed through patient associations and social media. Children aged 6 months to 18 years with HD and their caregivers completed an anonymous online survey addressing demographics, disease characteristics, dietary habits, bowel function, and perceived food-related gastrointestinal symptoms. Functional outcomes were assessed using the Rintala Bowel Function Score in toilet-trained participants without an enterostomy.</p><p><strong>Results: </strong>A total of 108 responses from 11 Spanish-speaking countries were analysed. Disease extent included short-segment HD (39%), long-segment HD (36%), total colonic aganglionosis (16%), and small-bowel involvement (6.5%). Most participants (70%) followed a regular omnivorous diet.13% of participants used probiotics. Whereas 72% reported dietary exclusions and 66% had modified eating habits because of HD. Eating behaviors were affected in 66%, and 80% identified specific food items that worsened gastrointestinal symptoms. High-sugar foods (21%), dairy products (20%), pulses (12%), and fruits (10%) were the most frequently reported food items associated with adverse symptoms. The most common reported symptoms were soiling (51%) and abdominal bloating (29%). Patients with total colonic aganglionosis or small-bowel involvement reported more dietary gastrointestinal symptoms and the highest number of food-related symptoms.</p><p><strong>Conclusion: </strong>This first multinational Spanish speaking cohort survey demonstrates an association between food items and gastrointestinal symptoms in children with HD. Diet-related gastrointestinal symptoms are common in children with HD and increase with disease extent. Most families identified food items causing symptoms themselves. These findings highlight the need for individualized nutritional counselling as part of multidisciplinary long-term follow-up. Soiling was the main reported symptom in this Hispanic/Latino cohort. These findings emphasize the need for individualized dietary guidance supported by dietitian advice to support bowel function, growth, and quality of life, while preventing nutritional deficiencies.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888156","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":"Conjoined twins in Cameroon: a single-centre case series highlighting the burden of care in Central Africa.","authors":"Gacelle Fossi Kamga, Patricia Mengue Foe, Salihou Aminou Sadjo, Caroline Eugenie Dikongue Dikongue, Evelyn Mungeh Mah, Faustin Felicien Mouafo Tambo","doi":"10.1007/s00383-026-06608-y","DOIUrl":"10.1007/s00383-026-06608-y","url":null,"abstract":"<p><strong>Purpose: </strong>Conjoined twins are rare congenital anomalies associated with high mortality, particularly in low-resource settings. We report our 19-year experience at a single paediatric surgery centre in Cameroon, describing the epidemiological, clinical, and therapeutic characteristics of this condition.</p><p><strong>Methods: </strong>This was a retrospective descriptive case series including all conjoined twins managed at our institution between August 2005 and August 2025. Epidemiological, clinical, diagnostic, therapeutic, and outcome data were analysed descriptively.</p><p><strong>Results: </strong>Seventeen pairs of conjoined twins were identified. Females predominated, and thoracopagus was the commonest type. Overall mortality was 76.5% (13/17). Ten pairs died during the neonatal period before surgical intervention, while two died from sepsis at one and nine months of age while awaiting separation. Five pairs underwent attempted separation abroad; four were successfully separated, with all surviving children alive at a mean follow-up of 6.5 years, whereas one pair died perioperatively. Thoracopagus twinning and sharing of vital organs, particularly the heart, lungs, and liver, were associated with increased mortality.</p><p><strong>Conclusion: </strong>Mortality remains high and is largely attributable to delayed referral, inadequate neonatal referral and transport system, and extensive shared organ involvement. Earlier antenatal diagnosis, coordinated multidisciplinary care, and strengthening local surgical infrastructure, perioperative resources, and intensive care capacity are essential to support complex separation procedures locally and improve outcomes.</p><p><strong>Level of evidence: </strong>I.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888158","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":"Sequential laparoscopic percutaneous extraperitoneal closure for inguinal hernia during NICU/GCU hospitalization in low birth weight infants.","authors":"Goki Uchida, Kenei Furukawa, Kazuki Hirohara, Kazuaki Miyaguni, Tetsuro Sugihara, Shinsuke Ohashi, Masashi Kurobe, Takao Ohki","doi":"10.1007/s00383-026-06595-0","DOIUrl":"10.1007/s00383-026-06595-0","url":null,"abstract":"<p><strong>Background: </strong>Inguinal hernia is common in low birth weight infants and carries a risk of incarceration. Although laparoscopic percutaneous extraperitoneal closure (LPEC) is widely used in pediatric patients, the safety of sequential LPEC during NICU/GCU hospitalization remains unclear. This study evaluated the safety and feasibility of sequential LPEC during NICU/GCU hospitalization.</p><p><strong>Methods: </strong>We retrospectively reviewed infants who underwent LPEC between September 2018 and July 2024. Infants aged ≤ 6 months diagnosed with inguinal hernia and treated with sequential LPEC during hospitalization were included. For comparison, infants aged ≤ 6 months with a history of NICU/GCU hospitalization who were diagnosed with inguinal hernia after NICU/GCU discharge and underwent LPEC were identified.</p><p><strong>Results: </strong>Among 302 patients, 13 met the inclusion criteria. One patient required postoperative reintubation, postoperative testicular atrophy occurred in three patients, and no hernia recurrence was observed during a median follow-up of 48 months. Compared with infants diagnosed after NICU/GCU discharge, the sequential LPEC group had significantly lower gestational age, lower birth weight, lower body weight at surgery, and more comorbidities, whereas postoperative outcomes were comparable.</p><p><strong>Conclusion: </strong>Sequential LPEC during continuous NICU/GCU hospitalization is feasible and can be safely performed in low birth weight infants with appropriate technical refinements.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866352","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}