World Journal of Pediatric Surgery最新文献

{"title":"Umbilical cord sparing technique of umbilicoplasty in infants with giant omphalocele.","authors":"Peng Wang, Jinfa Tou","doi":"10.1136/wjps-2023-000574","DOIUrl":"https://doi.org/10.1136/wjps-2023-000574","url":null,"abstract":"","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"6 3","pages":"e000574"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10335491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9817452","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":"Association between high deductible health plan coverage and age at pediatric umbilical hernia repair.","authors":"Morgan E Doty,&nbsp;Lindsay A Gil,&nbsp;Jennifer N Cooper","doi":"10.1136/wjps-2022-000526","DOIUrl":"https://doi.org/10.1136/wjps-2022-000526","url":null,"abstract":"<p><strong>Background: </strong>High deductible health plans (HDHPs) are associated with the avoidance of both necessary and unnecessary healthcare. Umbilical hernia repair (UHR) is a procedure that is frequently unnecessarily performed in young children, contrary to best practice guidelines. We hypothesized that children with HDHPs, as compared with other types of commercial health plans, are less likely to undergo UHR before 4 years of age but are also more likely to have UHR delayed beyond 5 years of age.</p><p><strong>Methods: </strong>Children aged 0-18 years old residing in metropolitan statistical areas (MSAs) who underwent UHR in 2012-2019 were identified in the IBM Marketscan Commercial Claims and Encounters Database. A quasi-experimental study design using MSA/year-level HDHP prevalence among children as an instrumental variable was employed to account for selection bias in HDHP enrollment. Two-stage least squares regression modeling was used to evaluate the association between HDHP coverage and age at UHR.</p><p><strong>Results: </strong>A total of 8601 children were included (median age 5 years, IQR 3-7). Univariable analysis revealed no differences between the HDHP and non-HDHP groups in the likelihood of UHR being performed before 4 years of age (27.7% vs 28.7%, p=0.37) or after 5 years of age (39.8% vs 38.9%, p=0.52). Geographical region, metropolitan area size, and year were associated with HDHP enrollment. Instrumental variable analysis demonstrated no association between HDHP coverage and undergoing UHR at <4 years of age (p=0.76) or >5 years of age (p=0.87).</p><p><strong>Conclusions: </strong>HDHP coverage is not associated with age at pediatric UHR. Future studies should investigate other means by which UHRs in young children can be avoided.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"6 2","pages":"e000526"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/33/82/wjps-2022-000526.PMC10030914.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9561093","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":"Digestive perianastomotic ulcerations after intestinal resection in children.","authors":"Weicheng Zhang,&nbsp;Jinfa Tou","doi":"10.1136/wjps-2022-000533","DOIUrl":"https://doi.org/10.1136/wjps-2022-000533","url":null,"abstract":"<p><p>Digestive perianastomotic ulceration (DPAU) is a rare complication after intestinal resection and anastomosis occurring at or near the anastomosis site. The purpose of this review is to summarize the characteristics of DPAU, including the etiology, diagnosis and differential diagnosis, clinical manifestations, treatment, and future research. All recent literature on DPAU was searched in PubMed, Embase, and Cochrane and then reviewed. The clinical manifestations of DPAU are mainly gastrointestinal symptoms such as bloody stool and chronic anemia. The diagnosis of DPAU is difficult. Specific diseases, such as Crohn's disease, must be ruled out before a diagnosis can be made. In addition, there are no clear treatment guidelines due to the high degree of heterogeneity in response to drugs and surgery. It is recommended to adjust medication in time and combine various treatment methods. In addition, the mechanism that causes DPAU is not well understood; however, several possible mechanisms have been proposed, such as scar tissue ischemia and underlying diseases. Moreover, there is a high risk of relapses, and a long-term follow-up is necessary. Numerous issues remain to be solved in this area; therefore, more randomized controlled trials and studies should be carried out to further understand this disease.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"6 3","pages":"e000533"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9d/f6/wjps-2022-000533.PMC10410847.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10033144","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":"Comparison of pediatric ventriculo-peritoneal shunt infections arising in antibiotic-impregnated and standard catheters: a multicenter observational study.","authors":"Joan Robinson,&nbsp;Archana Balamohan,&nbsp;Michelle Barton,&nbsp;Marie-Astrid Lefebvre,&nbsp;Ahmed Almadani,&nbsp;Dolores Freire,&nbsp;Alastair McAlpine,&nbsp;Jocelyn Srigley,&nbsp;Patrick Passarelli,&nbsp;John Bradley,&nbsp;Dele Davies,&nbsp;Gwenn Skar,&nbsp;Isabelle Viel-Theriault,&nbsp;Sarah Khan,&nbsp;Rupeena Purewal,&nbsp;Nicole LeSaux,&nbsp;Jennifer Bowes,&nbsp;Michael Hawkes","doi":"10.1136/wjps-2023-000566","DOIUrl":"https://doi.org/10.1136/wjps-2023-000566","url":null,"abstract":"Antibiotic-impregnated ventricular shunt catheters","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"6 3","pages":"e000566"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/50/60/wjps-2023-000566.PMC10410850.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10033145","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":"Parents making surgical decisions for their children: a pilot study.","authors":"Adrian Chi Heng Fung,&nbsp;Kenneth Kak Yuen Wong","doi":"10.1136/wjps-2023-000587","DOIUrl":"https://doi.org/10.1136/wjps-2023-000587","url":null,"abstract":"","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"6 2","pages":"e000587"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/29/21/wjps-2023-000587.PMC10193069.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9875125","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":"Population-based prevalence study of common congenital malformations of the alimentary tract and abdominal wall in Thailand: a study using data from the National Health Security Office.","authors":"Kulpreeya Sirichamratsakul,&nbsp;Wison Laochareonsuk,&nbsp;Komwit Surachat,&nbsp;Surasak Sangkhathat","doi":"10.1136/wjps-2022-000540","DOIUrl":"https://doi.org/10.1136/wjps-2022-000540","url":null,"abstract":"<p><strong>Background: </strong>The study aimed to estimate the prevalence of major congenital anomalies of the alimentary system and the abdominal wall in Thailand using a nationwide hospital discharge database from the National Health Security Office (2017-2020).</p><p><strong>Methods: </strong>The study extracted data from records with International Classification of Diseases-10 (ICD-10) codes related to esophageal malformation (ESO), congenital duodenal obstruction (CDO), jejunoileal atresia (INTES), Hirschsprung's disease (HSCR), anorectal malformation (ARM), abdominal wall defects (omphalocele (OMP) and gastroschisis (GAS)), and diaphragmatic hernia from the database with patient age selection set to less than 1 year.</p><p><strong>Results: </strong>A total of 2539 matched ICD-10 records were found in 2376 individuals over the 4-year study period. Concerning foregut anomalies, the prevalence of ESO was 0.88/10 000 births, while that of CDO was 0.54/10 000 births. The prevalence figures of INTES, HSCR, and ARM were 0.44, 4.69, and 2.57 cases per 10 000 births, respectively. For abdominal wall defects, the prevalences of OMP and GAS were 0.25 and 0.61 cases/10 000 births, respectively. The mortality in our cases was 7.1%, and survival analysis found that associated cardiac defects had a statistically significant influence on survival in most anomalies studied. In HSCR, both Down syndrome (DS) (hazard ratio (HR)=7.57, 95% confidence interval (CI)=4.12 to 13.91, p<0.001) and cardiac defects (HR=5.82, 95% CI=2.85 to 11.92, p<0.001) were significantly associated with poorer survival outcomes. However, only DS (adjusted HR=5.55, 95% CI=2.63 to 11.75, p<0.001) independently predicted worse outcomes by multivariable analysis.</p><p><strong>Conclusions: </strong>Our analysis of the hospital discharge database found that the prevalence of gastrointestinal anomalies in Thailand was lower than that reported in other countries, except for HSCR and anorectal malformations. Associated Down syndrome and cardiac defects influence the survival outcomes of these anomalies.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"6 3","pages":"e000540"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/42/d2/wjps-2022-000540.PMC10254801.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9620237","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":"Biliary complications post liver resection for pediatric liver tumors.","authors":"Mohd Yusran Othman,&nbsp;Kok Hoi Teh,&nbsp;Zakaria Zahari","doi":"10.1136/wjps-2023-000589","DOIUrl":"https://doi.org/10.1136/wjps-2023-000589","url":null,"abstract":"<p><strong>Objective: </strong>To review biliary complications following liver resection for liver tumors in children and their associated risk factors.</p><p><strong>Methods: </strong>Retrospectively, we reviewed children who underwent liver resection for liver tumors from 2010 to 2019. Demographic data, operative details, types of complications, interventions and outcomes were studied.</p><p><strong>Results: </strong>Eighty-six out of 108 liver resections were included in this study. The median age of patients was 1.8 years old, and 55% were male. The majority (95%) were malignant tumors, of which 87% were hepatoblastoma (n=71). The most common procedure performed was extended right hepatectomy (37%, n=32). Twelve (14%) patients had primary biliary complications: nine bile leakages and three biliary obstructions. Six cases of bile leakage were treated non-operatively with drainage only; however, one developed bilothorax. Three bile leakages underwent early operative intervention. Four patients underwent biliary reconstruction. Biliary complications were not significantly associated with age, sex, ethnicity or pathology of the tumor. Ten of them (83%) developed following extended hepatectomies (five right, five left), in which the left side had a higher rate of complications (63% vs 16%). None of the central hepatectomies had biliary complications. Biliary complication rates were significantly higher among those who had segmentectomy 1 (p=0.023).</p><p><strong>Conclusions: </strong>Biliary complication is a significant morbidity following liver resection in children. Surgery is eventually required for complicated bile leakage and primary biliary strictures. Follow-up is mandatory since secondary biliary complications may occur after the initial resolution of bile leakage. The groups at high risk of developing biliary complications are extended left hepatectomies and segmentectomy 1.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"6 3","pages":"e000589"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/75/68/wjps-2023-000589.PMC10335567.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9820004","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":"Congenital diaphragmatic hernia survival in an English regional ECMO center.","authors":"Elizabeth O'Connor,&nbsp;Ryo Tamura,&nbsp;Therese Hannon,&nbsp;Sundeep Harigopal,&nbsp;Bruce Jaffray","doi":"10.1136/wjps-2022-000506","DOIUrl":"https://doi.org/10.1136/wjps-2022-000506","url":null,"abstract":"<p><strong>Introduction: </strong>Congenital diaphragmatic hernia (CDH) remains a cause of neonatal death. Our aims are to describe contemporary rates of survival and the variables associated with this outcome, contrasting these with our study of two decades earlier and recent reports.</p><p><strong>Materials and methods: </strong>A retrospective review of all infants diagnosed in a regional center between January 2000 and December 2020 was performed. The outcome of interest was survival. Possible explanatory variables included side of defect, use of complex ventilatory or hemodynamic strategies (inhaled nitric oxide (iNO), high-frequency oscillatory ventilation (HFOV), extracorporeal membrane oxygenation (ECMO), and Prostin), presence of antenatal diagnosis, associated anomalies, birth weight, and gestation. Temporal changes were studied by measuring outcomes in each of four consecutive 63-month periods.</p><p><strong>Results: </strong>A total of 225 cases were diagnosed. Survival was 60% (134 of 225). Postnatal survival was 68% (134 of 198 liveborn), and postrepair survival was 84% (134 of 159 who survived to repair). Diagnosis was made antenatally in 66% of cases. Variables associated with mortality were the need for complex ventilatory strategies (iNO, HFOV, Prostin, and ECMO), antenatal diagnosis, right-sided defects, use of patch repair, associated anomalies, birth weight, and gestation. Survival has improved from our report of a prior decade and did not vary during the study period. Postnatal survival has improved despite fewer terminations. On multivariate analysis, the need for complex ventilation was the strongest predictor of death (OR=50, 95% CI 13 to 224, p<0.0001), and associated anomalies ceased to be predictive.</p><p><strong>Conclusions: </strong>Survival has improved from our earlier report, despite reduced numbers of terminations. This may be related to increased use of complex ventilatory strategies.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"6 2","pages":"e000506"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ed/1b/wjps-2022-000506.PMC10152044.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9415020","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":"Identifying the potential transcriptional regulatory network in Hirschsprung disease by integrated analysis of microarray datasets.","authors":"Wenyao Xu,&nbsp;Hui Yu,&nbsp;Dian Chen,&nbsp;Weikang Pan,&nbsp;Weili Yang,&nbsp;Jing Miao,&nbsp;Wanying Jia,&nbsp;Baijun Zheng,&nbsp;Yong Liu,&nbsp;Xinlin Chen,&nbsp;Ya Gao,&nbsp;Donghao Tian","doi":"10.1136/wjps-2022-000547","DOIUrl":"https://doi.org/10.1136/wjps-2022-000547","url":null,"abstract":"<p><strong>Objective: </strong>Hirschsprung disease (HSCR) is one of the common neurocristopathies in children, which is associated with at least 20 genes and involves a complex regulatory mechanism. Transcriptional regulatory network (TRN) has been commonly reported in regulating gene expression and enteric nervous system development but remains to be investigated in HSCR. This study aimed to identify the potential TRN implicated in the pathogenesis and diagnosis of HSCR.</p><p><strong>Methods: </strong>Based on three microarray datasets from the Gene Expression Omnibus database, the multiMiR package was used to investigate the microRNA (miRNA)-target interactions, followed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses. Then, we collected transcription factors (TFs) from the TransmiR database to construct the TF-miRNA-mRNA regulatory network and used cytoHubba to identify the key modules. Finally, the receiver operating characteristic (ROC) curve was determined and the integrated diagnostic models were established based on machine learning by the support vector machine method.</p><p><strong>Results: </strong>We identified 58 hub differentially expressed microRNAs (DEMis) and 16 differentially expressed mRNAs (DEMs). The robust target genes of DEMis and DEMs mainly enriched in several GO/KEGG terms, including neurogenesis, cell-substrate adhesion, PI3K-Akt, Ras/mitogen-activated protein kinase and Rho/ROCK signaling. Moreover, 2 TFs (<i>TP53</i> and <i>TWIST1</i>), 4 miRNAs (<i>has-miR-107</i>, <i>has-miR-10b-5p</i>, <i>has-miR-659-3p</i>, and <i>has-miR-371a-5p</i>), and 4 mRNAs (<i>PIM3</i>, <i>CHUK</i>, <i>F2RL1</i>, and <i>CA1</i>) were identified to construct the TF-miRNA-mRNA regulatory network. ROC analysis revealed a strong diagnostic value of the key TRN regulons (all area under the curve values were more than 0.8).</p><p><strong>Conclusion: </strong>This study suggests a potential role of the TF-miRNA-mRNA network that can help enrich the connotation of HSCR pathogenesis and diagnosis and provide new horizons for treatment.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"6 2","pages":"e000547"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10111925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9442719","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":"Evaluation of the regional distribution of the pediatric surgery workforce and surgical load in Brazil.","authors":"Joaquim Bustorff-Silva,&nbsp;Marcio Lopes Miranda,&nbsp;Amanda Rosendo,&nbsp;Ayla Gerk,&nbsp;Antonio Gonçalves Oliveira-Filho","doi":"10.1136/wjps-2022-000522","DOIUrl":"https://doi.org/10.1136/wjps-2022-000522","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study is to examine the regional distribution of the pediatric surgery workforce and the expected local demand for pediatric surgical procedures in Brazil.</p><p><strong>Methods: </strong>We collected data on the pediatric surgical workforce, surgical volume, Gross Domestic Product per capita, and mortality for gastrointestinal tract malformations (MGITM) across the different regions of Brazil for 2019.</p><p><strong>Results: </strong>Data from the Federal Medical Council reported 1515 pediatric surgery registries in Brazil, corresponding to 1414 pediatric surgeons (some pediatric surgeons are registered in more than one state), or 2.4 pediatric surgeons per 100 000 children 14 years of age and younger. There were 828 men and 586 women. The mean age was 51.5±12.8 years, and the mean time from graduation was 3.4±5.7 years. There is a higher concentration of pediatric surgeons in the wealthier Central-West, South, and Southeast regions. Individual surgical volume ranged from 88 to 245 operations/year (average 146 operations/year) depending on the region. Of these, only nine (6.1%) were high-complexity (including neonatal) operations. MGITM tended to be higher in the poorer North and Northeast regions than in other regions of Brazil.</p><p><strong>Conclusions: </strong>Our findings suggest significant disparities in the surgical workforce and workload across Brazil related to socioeconomic status. Regions with an increased surgical workforce were associated with lower MGITM. The average number of complex operations performed annually by each pediatric surgeon was considerably low. Strategic investment and well-defined health policies are imperative to enhance the quality of surgical care in the different regions of Brazil.</p><p><strong>Level of evidence: </strong>Retrospective review; level IV.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"6 2","pages":"e000522"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9d/dd/wjps-2022-000522.PMC10193071.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9858901","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}