Translational pediatrics最新文献

{"title":"Development and validation of a machine learning model for predicting co-infection of <i>Mycoplasma pneumonia</i> in pediatric patients.","authors":"Xiaohan Liu, Wenbei Xu, Lingjian Meng, Juan Long, Xiaonan Sun, Qiang Li, Haiquan Kang, Yiping Mao, Chunfeng Hu, Kai Xu, Yankai Meng","doi":"10.21037/tp-2024-562","DOIUrl":"10.21037/tp-2024-562","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;&lt;i&gt;Mycoplasma pneumoniae&lt;/i&gt; pneumonia (MPP) is endemic in China, while &lt;i&gt;Mycoplasma&lt;/i&gt; co-infection with other pathogens (Co-MPP) linked to severe outcomes. Despite radiomics and machine learning potential in pneumonia, pediatric Co-MPP differentiation remains underexplored. This study aimed to bridge this gap by evaluating machine learning models, particularly radiomics features derived from high-resolution computed tomography (HRCT) scans, to differentiate between MPP and Co-MPP, and to compare their predictive performance with traditional clinical models.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a retrospective analysis of hospitalized pediatric pneumonia patients from June to December 2023 at Affiliated Hospital of Xuzhou Medical University. Chest computed tomography (CT) scans were performed using a multi-slice CT scanner with over 64 detectors. Fluorescent quantitative polymerase chain reaction (PCR) was used to detect 14 pathogens in bronchoalveolar lavage (BAL) fluid. The most recent laboratory results prior to BAL were included in multifactorial logistic regression (LR) analysis, selecting variables with P&lt;0.05 for constructing the clinical model. The largest cross-section of the lesion was selected, and image segmentation was performed using ITK-SNAP software. Radiomics features were extracted with Pyradomics. Features were filtered using t-tests, Mann-Whitney &lt;i&gt;U&lt;/i&gt; tests, and Spearman rank correlation coefficients. The least absolute shrinkage and selection operator (LASSO) regression and ten-fold cross-validation were used for feature selection and to construct the radiomics model, optimizing the dimensionality of the dataset. Eight different machine learning models [LR, support vector machine (SVM), K-nearest neighbor (KNN), RandomForest, ExtraTrees, eXtreme gradient boosting (XGBoost), light gradient boosting machine (LightGBM), and multi-layer perceptron (MLP)] were trained with the selected features, with five-fold cross-validation yielding the final radiomics model. The clinical and radiomics models were combined to create a nomogram model. Data analysis was performed using R software and SPSS 26.0.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 124 cases of MPP and children with Co-MPP were included. The extracted radiomics features consisted of first-order signal intensity features (n=360), morphological features (n=14), and texture features (n=1,460). LASSO regression and ten-fold cross-validation identified 23 non-zero correlation coefficient features for constructing Radscore. The LR model demonstrated superior predictive performance for Co-MPP in the validation cohort, with an area under the curve (AUC) of 0.951, sensitivity of 0.778, and specificity of 0.875. The nomogram model combining clinical and radiomics labels significantly outperformed the clinical model (P=0.004). Calibration curve analysis indicated that the nomogram model exhibited the best agreement with actual values. Both","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 6","pages":"1201-1212"},"PeriodicalIF":1.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gut microbiota-derived 4-hydroxyphenylacetic acid (4-HPAA) inhibits weight gain and is negatively associated with childhood obesity.","authors":"Qianru Li, Jiahui Zhang, Minhao Fan, Ningxi Wu, Tianyu Li, Mingxin Wang, Le Zhang","doi":"10.21037/tp-2025-158","DOIUrl":"10.21037/tp-2025-158","url":null,"abstract":"<p><strong>Background: </strong>Childhood obesity has rapidly increased, becoming a significant global public health concern. Obese children exhibit distinct gut microbiome compositions compared to their normal-weight peers, leading to differences in the metabolic products derived from gut microbiota between the two groups. However, the causal relationship between these microbial-derived metabolites and childhood obesity remains unclear. Therefore, we investigate association between the microbial-derived metabolites and childhood obesity.</p><p><strong>Methods: </strong>In this study, we conducted an analysis of multiple childhood obesity gut microbiota databases. We utilized curated children's microbiota data at the genus level from the GMrepo database. To investigate metabolic pathways, we used the MetOrigin database to analyze the gut microbiota metabolites.</p><p><strong>Results: </strong>We found that the abundances of <i>Prevotella</i>, <i>Sutterellaceae</i>, <i>Lachnospiraceae</i>, <i>Veillonellaceae</i>, <i>Streptococcaceae</i>, <i>Fusobacteriaceae</i>, and <i>Klebsiella</i> were increased in the gut microbiome of obese children, while <i>Akkermansia</i>, <i>Faecalibacterium</i>, <i>Porphyromonadaceae</i>, <i>Rikenellaceae</i>, <i>Eubacteriaceae</i>, <i>Odoribacter</i>, and <i>Erysipelotrichaceae</i> were decreased compared to their normal-weight counterparts. Furthermore, the gut microbial metabolites acetic acid, propionic acid, and butyric acid were elevated in the feces of obese children, while 4-hydroxyphenylacetic acid (4-HPAA), valeric acid, and lactic acid were decreased in the feces or urine of obese children. Trace analysis and literature review revealed that <i>Eubacteriaceae</i> produces 4-HPAA via the tyrosine metabolism pathway, while <i>Bacteroides</i> generates lactic acid through glycolysis, gluconeogenesis, and pyruvate metabolism pathways. Notably, 4-HPAA treatment reduced weight gain and improved glucose intolerance in mice on a high-fat diet.</p><p><strong>Conclusions: </strong>Our study analyzed the gut microbiota characteristics of obese children across multiple regions and suggests that the downregulation of 4-HPAA may be associated with the development of obese children.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 6","pages":"1156-1167"},"PeriodicalIF":1.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Loss-of-function of lipopolysaccharide-responsive beige-like anchor protein causes inflammatory bowel disease-a case report and literature review.","authors":"Zhixin Wang, Youhong Fang, Jindan Yu, Jie Chen, Youyou Luo","doi":"10.21037/tp-2024-567","DOIUrl":"10.21037/tp-2024-567","url":null,"abstract":"<p><strong>Background: </strong>Most cases of childhood inflammatory bowel disease (IBD) are polygenic in origin, although a subset of patients exhibits monogenic etiologies. Some studies have identified the lipopolysaccharide-responsive beige-like anchor protein (LRBA) gene as a susceptibility gene, but the majority of research has focused on genetic mutations without extensive clinical data. Furthermore, there is a paucity of long-term data on pediatric patients receiving biologic therapy.</p><p><strong>Case description: </strong>An 11-year-old female patient presented to the Gastroenterology Department with a 1-month history of chronic abdominal pain, diarrhea, and weight loss. Laboratory investigations revealed marked inflammation, anemia, hypoproteinemia, and elevated counts of naive B-cell. Endoscopic examination identified ulcers and polyp proliferation, which was consistent with an initial diagnosis of Crohn's disease. However, despite several months of standardized treatment, there was no significant clinical improvement. Subsequent genetic testing identified LRBA deficiency with a novel mutation. Following the adjustment of her biologic treatment regimen, the patient eventually achieved clinical remission. We also conducted a literature review on LRBA deficiency and IBD. The effective therapies mentioned were hematopoietic stem cell transplantation (HSCT) and abatacept.</p><p><strong>Conclusions: </strong>We described a Chinese IBD and LRBA-deficient patient carrying a novel mutation. In this context, the patient achieved remission under regular biologic therapy, which may offer valuable insights for the treatment of similar cases.</p><p><strong>Keywords: </strong>Lipopolysaccharide-responsive beige-like anchor protein deficiency (LRBA deficiency); inflammatory bowel disease (IBD); Crohn's disease (CD); biologic therapy; case report.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 6","pages":"1344-1352"},"PeriodicalIF":1.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracking of physical activity and sport from childhood and adolescence to adulthood: a systematic review and meta-analysis.","authors":"Antonio García-Hermoso, José Francisco López-Gil, Yasmin Ezzatvar","doi":"10.21037/tp-2025-89","DOIUrl":"10.21037/tp-2025-89","url":null,"abstract":"<p><strong>Background: </strong>The transition from children and adolescents to adulthood involves significant lifestyle changes, making it important to understand how physical activity and sports participation remain stable over time to promote lifelong health. This study analyzed the tracking of physical activity from early years to adulthood through both physical activity and sports participation.</p><p><strong>Methods: </strong>Two researchers searched for relevant articles in MEDLINE, Embase, and Web of Science electronic databases from inception to July 2024. Studies involving individuals aged 6 to 18 years, examining the tracking of physical activity from childhood to adulthood through both physical activity and sports participation, were included. Correlation coefficients (r) and their corresponding standard errors or sample sizes were used to calculate pooled values with a 95% confidence interval (CI) using a random-effects inverse-variance model.</p><p><strong>Results: </strong>The meta-analysis included 38 studies, involving 63,158 participants (mean follow-up: 20.9 years). Results showed low tracking of physical activity from childhood/adolescence to adulthood (r=0.14; 95% CI: 0.11 to 0.16), consistent across sexes and age groups, but higher tracking in young adulthood compared to adulthood (P<0.001). Sports participation showed low tracking (r=0.26; 95% CI: 0.20 to 0.31) with similar patterns across sexes and age groups, but higher tracking in young adulthood compared to adulthood (P=0.03). Follow-up duration moderates these associations, indicating a small but consistent decline in correlation coefficients over time.</p><p><strong>Conclusions: </strong>This study highlights the need for public health initiatives to prioritize promoting physical activity and sports participation among children and adolescents to support long-term health benefits.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 6","pages":"1117-1128"},"PeriodicalIF":1.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric pulmonary mucoepidermoid carcinoma in a 5-year-old patient.","authors":"Qixun Lai, Chao Yang, Yidong Wang, Guilin Peng, Mengyang Liu, Xin Xu, Yuan Zeng","doi":"10.21037/tp-2024-490","DOIUrl":"10.21037/tp-2024-490","url":null,"abstract":"","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 6","pages":"1380-1382"},"PeriodicalIF":1.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare <i>de novo</i> mutation, m.1630A>G, in the mitochondrial trnAVal (<i>MT-TV</i>) gene in a child with epilepsy.","authors":"Qiong Wang, Yan Chen, Jun Li, Baomin Li","doi":"10.21037/tp-2025-258","DOIUrl":"10.21037/tp-2025-258","url":null,"abstract":"","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 6","pages":"1385-1386"},"PeriodicalIF":1.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurodevelopmental disorder due to a frameshift mutation in the <i>GRIN2A</i> gene: a case report.","authors":"Chen Xu, Man-Li Wang, Wei-Hao Ling, Ji-Hong Tang","doi":"10.21037/tp-2025-93","DOIUrl":"10.21037/tp-2025-93","url":null,"abstract":"<p><strong>Background: </strong>Pathogenic variants in <i>GRIN2A</i>, encoding the GluN2A subunit of the N-methyl-D-aspartate receptor (NMDAR), are increasingly recognized as causes of neurodevelopmental disorders, particularly within the epilepsy-aphasia spectrum. However, presentations without clinical seizures-especially those initially manifesting as isolated ataxia-are rarely reported. We describe a previously unreported <i>GRIN2A</i> frameshift variant associated with early-onset ataxia, delayed-onset electrographic abnormalities, and favorable response to immunotherapy.</p><p><strong>Case description: </strong>A 23-month-old boy presented with subacute gait ataxia following a viral illness. Neuroimaging, cerebrospinal fluid analysis, and an extensive autoimmune panel were unremarkable. Initial immunotherapy with high-dose corticosteroids and intravenous immunoglobulin (IVIG) led to transient improvement. Five months later, he developed recurrent ataxia, speech regression, drooling, and global developmental delay, still without overt seizures. Video electroencephalogram (EEG) revealed electrical status epilepticus during slow-wave sleep (ESES) with a spike-wave index exceeding 85%. Trio-based whole genome sequencing identified a novel heterozygous frameshift variant in <i>GRIN2A</i> (c.1717delG, p.Val573Phefs*16), predicted to result in loss of all transmembrane domains. Repeat immunotherapy produced significant clinical improvement, including restored ambulation, cessation of drooling, enhanced speech output, and marked reduction in epileptiform discharges. The patient remained seizure-free during the reported treatment period. Notably, his mother, a carrier of the same variant, reported only a brief history of childhood seizures with minimal residual speech disturbance.</p><p><strong>Conclusions: </strong>This case expands the phenotypic spectrum of <i>GRIN2A</i>-related disorders to include early isolated ataxia and delayed electrographic epilepsy in the absence of clinical seizures. It highlights the diagnostic value of early genetic testing in atypical neurodevelopmental syndromes and suggests that immunotherapy may confer clinical and electrophysiological benefits, even in presumed NMDAR loss-of-function states. Integration of genomics, neurophysiology, and immune-modulating strategies may inform future precision therapies for <i>GRIN2A</i>-associated encephalopathies.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 6","pages":"1353-1361"},"PeriodicalIF":1.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and overlap of white blood cell counts, procalcitonin and C-reactive protein in neonates with invasive bacterial infections.","authors":"Zhanghua Yin, Jintong Tan, Yujie Xie, Jianyuan Zhao, Yan Chen, Yongjun Zhang","doi":"10.21037/tp-2025-97","DOIUrl":"10.21037/tp-2025-97","url":null,"abstract":"<p><strong>Background: </strong>Neonatal invasive bacterial infections (IBIs) are associated with substantial mortality. We aimed to elucidate the prevalence and overlapping effects of white blood cell (WBC), procalcitonin (PCT), and C-reactive protein (CRP) in neonates with IBIs.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study in 17 Chinese hospitals from 2012 to 2021. Full-term neonates who had suspected IBIs and underwent blood cultures and lumbar punctures were enrolled. We investigated the prevalence of WBC counts, PCT, CRP, and their combinations for predicting IBIs risk.</p><p><strong>Results: </strong>Of 1,825 patients, 121 were identified with early-onset IBIs and 314 with late-onset IBIs. Restricted Cubic Spline plots indicated positive relationships between PCT, CRP levels and IBIs risk, but PCT curve was relatively flat in early-onset IBIs. A U-shaped association was found between leukocyte counts and late-onset IBIs risk, whereas no such correlation in early-onset cases was found. Neonates with normal WBC counts, elevated PCT and CRP accounted for the highest proportion in early-onset IBIs (28.1%), as did those with leukocytosis, increased PCT and CRP in late-onset IBIs (26.1%). Heat map showed that the highest overlapping risks of early- [adjusted odds ratio (aOR) =23.6; 95% confidence interval (CI): 5.7-98.4] and late-onset IBIs (aOR =30.3, 95% CI: 12.7-72.3) were both in leukopenia with increased PCT and CRP. Statistical interaction effects were affirmed between leukopenia and elevated PCT in both IBIs types.</p><p><strong>Conclusions: </strong>Leukocyte counts, PCT, CRP and their overlaps contribute unequally in neonatal IBIs risk assessment, with differences observed even for the same combinations between early- and late-onset IBIs. This multi-marker approach provides new perspectives on rapidly and conveniently identifying neonates at high risk of IBIs for further clinical management.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 6","pages":"1245-1255"},"PeriodicalIF":1.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repair of tetralogy of Fallot in neonates: a single-center case series.","authors":"Can Jin, Yongtao Wu, Yalun Qu, Zhiyi Wang, Bin Li, Jun Yan, Francesco Nappi, Stiljan Hoxha, Qiang Wang","doi":"10.21037/tp-2025-133","DOIUrl":"10.21037/tp-2025-133","url":null,"abstract":"<p><strong>Background: </strong>The optimal timing for surgical intervention in the management of tetralogy remains a subject of ongoing debate. This investigation involved a retrospective analysis of neonatal patients who had received continuous treatment for tetralogy of Fallot (TOF) at our centre. The objective of this study was to examine the feasibility and necessity of treating TOF in the neonatal period.</p><p><strong>Methods: </strong>A retrospective analytical investigation was undertaken of 33 cases of neonates who underwent consecutive one-stage surgical repair for TOF at the Beijing Anzhen Hospital from June 2022 to December 2023. The subjects had an average gestational age of 38.1 weeks (range, 31.3-40.0 weeks) and a median age at surgery of 14.0 days [interquartile range (IQR): 9.75-20.0 days]. Their mean weight at the time of surgery was 3.25±0.53 kg, and their mean pulse blood oxygen saturation (SpO₂) level was 93.0% (range, 80-98%).</p><p><strong>Results: </strong>The mean duration for which aortic cross-clamping was performed during the surgical procedure was 74.24 minutes, with a standard deviation of ±16.33 minutes. The average duration of cardiopulmonary bypass (CPB) was 118.85±17.94 minutes. The average duration of postoperative mechanical ventilation was 110.6 hours (±89.2 hours). The patients' average postoperative intensive care unit (ICU) stay was 10 days (range, 6.75-13.25 days), and their median postoperative stay was 14 days (IQR, 11.75-15.5 days). Postoperative complications were observed in two patients (6%), who required peritoneal dialysis catheter insertion at the bedside to manage fluid imbalances. No further interventions nor mortalities occurred during the follow-up period. The median follow-up period after surgery was 201 days (range, 51-417 days).</p><p><strong>Conclusions: </strong>The curative effect of TOF repair in the neonatal period is well-documented, with its ability to prevent the effects of pulmonary artery development and collateral circulation formation. Consequently, we suggest considering TOF repair during the neonatal period.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 6","pages":"1278-1286"},"PeriodicalIF":1.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel use of a light-emitting nasogastric tube to enhance oesophageal dissection during laparoscopic fundoplication in children: a case report.","authors":"Adrian Chi Heng Fung, Patrick Ho Yu Chung, Eugene Chin Tung Lau, Kenneth Kak Yuen Wong","doi":"10.21037/tp-2024-584","DOIUrl":"10.21037/tp-2024-584","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic Nissen fundoplication is the standard treatment for gastroesophageal reflux disease in children. The proper dissection of the oesophagus and the hiatus is essential yet may be associated with higher morbidities in scenarios where dense adhesions obscuring a clear tissue plane were anticipated, for instance, patients with previous laparotomies, redo-fundoplication, etc. We hereby report the first experience of the novel use of a light-emitting nasogastric tube to enhance oesophageal dissection during laparoscopic fundoplication in children.</p><p><strong>Case description: </strong>In this case report, we report a four-year-old girl with known cystic fibrosis who required supplemental milk to improve nutrition and medications administered via a nasogastric tube. Since long-term tube feeding was expected, the patient's parents were advised of the need for gastrostomy tube insertion and a pre-operative potential of hydrogen (pH) study. The 24-hour pH study revealed significant gastroesophageal reflux; therefore, laparoscopic fundoplication and gastrostomy were planned. An infrared illumination system urethral kit was put inside a feeding tube for identification of the boundary of the intra-abdominal oesophagus and aiding dissection in real time. Laparoscopic fundoplication and gastrostomy were smoothly performed. The patient resumed feeding 1 day after the procedure and was fit for discharge 3 days after the operation.</p><p><strong>Conclusions: </strong>Light-emitting nasogastric tube is safe and potentially facilitates oesophageal dissection during laparoscopic fundoplication in children.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"14 6","pages":"1332-1335"},"PeriodicalIF":1.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}