World Journal of Pediatric Surgery最新文献

{"title":"Pain management for the Nuss procedure: comparison between erector spinae plane block, thoracic epidural, and control.","authors":"Lisgelia Santana,&nbsp;John Driggers,&nbsp;Norman F Carvalho","doi":"10.1136/wjps-2022-000418","DOIUrl":"https://doi.org/10.1136/wjps-2022-000418","url":null,"abstract":"<p><strong>Objective: </strong>Pectus excavatum is a congenital deformity characterized by a caved-in chest wall. Repair requires surgery. The less invasive Nuss procedure is very successful, but postoperative pain management is challenging and evolving. New pain management techniques to reduce opioid reliance include the erector spinae plane (ESP) block. We retrospectively examined opioid consumption after Nuss procedure comparing three pain management techniques: ESP block, thoracic epidural (TE), and patient-controlled analgesia (PCA).</p><p><strong>Methods: </strong>This retrospective cohort study compared pain management outcomes of three patient groups. Seventy-eight subjects aged 10-18 years underwent Nuss procedure at our institution between January 2014 and January 2020. The primary outcome measure was opioid consumption measured in morphine milligram equivalents. Secondary measures included pain ratings and length of stay (LOS). Pain was quantified using the Numeric Pain Rating Scale. Analysis of variance was performed on all outcome measures.</p><p><strong>Results: </strong>Average cumulative opioid use was significantly lower in the ESP block (67 mg) than the TE (117 mg) (p=0.0002) or the PCA group (172 mg) (p=0.0002). The ESP block and PCA groups both had a significantly shorter average LOS (3.3 and 3.7 days, respectively) than the TE group (4.7 days). ESP block performed best for reducing opioid consumption and LOS. Reduced opioid consumption is key for limiting side effects. This study supports use of ESP block as a superior choice when choosing among the three postoperative pain management options that were evaluated.</p><p><strong>Conclusion: </strong>ESP resulted in reduced opioid consumption postoperatively and shorter LOS than TE or PCA for patients undergoing the Nuss procedure for surgical repair of pectus excavatum.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f5/1c/wjps-2022-000418.PMC9717353.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10719403","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":"Laparoscopic management of benign splenic tumors in children.","authors":"Chen Qingjiang,&nbsp;Linyan Wang,&nbsp;Xiaoli Chen,&nbsp;Yuebin Zhang,&nbsp;Lifeng Zhang,&nbsp;Kun Zhu,&nbsp;Qixing Xiong,&nbsp;Zhigang Gao","doi":"10.1136/wjps-2022-000419","DOIUrl":"https://doi.org/10.1136/wjps-2022-000419","url":null,"abstract":"<p><strong>Background: </strong>The splenic tumor is relatively rare in children. However, diagnosing and managing this disease remain controversial. This study aimed to evaluate the clinical characteristics and pathological features of benign splenic tumors and to explore the feasibility and safety of laparoscopic splenectomy in children.</p><p><strong>Methods: </strong>The clinical data of all patients who were diagnosed with benign splenic tumors and admitted to our center between January 2014 and December 2020 were analyzed retrospectively. Factors that were documented included demographic criteria, clinical manifestations, preoperative examinations, surgical methods, histopathological characteristics, postoperative complications and outcomes.</p><p><strong>Results: </strong>Totally, 24 consecutive patients with a mean age of 10.21±2.59 years were operated laparoscopically. Nine patients presented with recurrent abdominal pain, vomiting or backache. The remaining 15 cases were asymptomatic and were identified incidentally. Laparoscopic total splenectomy (LTS) was performed in 12 cases, laparoscopic partial splenectomy (LPS) in 9 cases and deroofing of splenic cyst in 3 cases. No significant differences were observed in operation time, intraoperative bleeding and postoperative abdominal drainage between the LTS and LPS groups. Histopathology examination reported 12 cases of splenic epithelial cyst, 5 cases of splenic lymphangioma or lymphatic malformation, 3 cases of splenic hamartoma, 3 cases of splenic littoral cell angioma and 1 case of splenic hemangioma. No postoperative complications and tumor recurrence were observed.</p><p><strong>Conclusions: </strong>It is still difficult to precisely diagnose the splenic tumor preoperatively. Laparoscopic splenectomy is safe and feasible in treating the benign splenic tumors, and partial splenectomy is of great significance in preserving the immune function in children.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2b/d0/wjps-2022-000419.PMC9648585.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10719406","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":"Preoperative virtual video visits only: a convenient option that should be offered to caregivers beyond the pandemic.","authors":"Danielle Dougherty,&nbsp;Allison R Thompson,&nbsp;Karen Elizabeth Speck,&nbsp;Erin E Perrone","doi":"10.1136/wjps-2021-000403","DOIUrl":"https://doi.org/10.1136/wjps-2021-000403","url":null,"abstract":"<p><strong>Objective: </strong>During the COVID-19 pandemic, our group implemented preoperative video visits (VVs) to limit physical contact. The aim of this study was to determine caregivers' and providers' perceptions of this practice and to determine feasibility for continuation.</p><p><strong>Methods: </strong>All patients who had only a preoperative VV prior to an elective surgery were identified from March-October 2020. Caregivers, surgeons, and clinic staff were surveyed about their experiences.</p><p><strong>Results: </strong>Thirty-four preoperative VVs were followed by an elective surgery without a preceding in-person visit. Of the 31 caregiver surveys completed, the majority strongly agreed that the VV was more convenient (87%, n=27). Eighty-one percent (n=25) strongly agreed or agreed that the VV saved them money. Ninety-four percent (n=29) strongly agreed or agreed that they would choose the VV option again. Caregivers saved an average travel distance of 60.3 miles one way (range 6.1-480). Of the 13/17 providers who responded, 77% (n=10) expressed that the practice should continue.</p><p><strong>Conclusions: </strong>Virtual health became a necessity during the pandemic, and caregivers were overwhelmingly satisfied. Continuing VVs as an option beyond the pandemic may be a reasonable and effective way to help eliminate some of the hurdles that impede healthcare-seeking behavior and should be offered.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a9/12/wjps-2021-000403.PMC9717146.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10738443","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":"Application and prospects of robotic surgery in children: a scoping review.","authors":"Lei Ting Shen,&nbsp;Jinfa Tou","doi":"10.1136/wjps-2022-000482","DOIUrl":"https://doi.org/10.1136/wjps-2022-000482","url":null,"abstract":"<p><p>As an innovative minimally invasive surgical technology, robot-assisted surgery (RAS) has greatly improved the accuracy and safety of surgery through the advantages of three-dimensional magnification, tremor filtering, precision and flexibility, and has been carried out by an increasing number of surgeries. In recent years, robots have been gradually applied to children, bringing new ideas and challenges to pediatric surgeons. This review will describe the advantages and limitations of robotic surgery in children, summarize its application in pediatric surgery, and provide an outlook. It is believed that clinicians should actively carry out RAS under the premise of rigorously ensuring surgical indications and strive to improve the efficacy of surgical treatment for children.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4b/df/wjps-2022-000482.PMC9717356.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10430548","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":"Analysis and comparison of failure causes of minimally invasive surgical closure of ventricular septal defects in children.","authors":"Jin Yu,&nbsp;Zhuo Shi,&nbsp;Jingjing Qian,&nbsp;Lianglong Ma,&nbsp;Baofu Zhang,&nbsp;Liyang Ying,&nbsp;Qiang Shu","doi":"10.1136/wjps-2022-000432","DOIUrl":"https://doi.org/10.1136/wjps-2022-000432","url":null,"abstract":"<p><strong>Objectives: </strong>The aims of the present study were to explore the causes of minimally invasive surgical ventricular septal defect (VSD) closure failure under transesophageal echocardiography guidance and thus to improve the success rate of surgical VSD closure.</p><p><strong>Methods: </strong>From January 2015 to December 2019, 522 children with VSD underwent minimally invasive surgical closure. Nineteen procedures (3.64%) were unsuccessful. The failure causes, VSD locations and surgical incision approaches were retrospectively analyzed.</p><p><strong>Results: </strong>Among the 19 patients (3.64%) with unsuccessful outcomes, 18 were switched to cardiopulmonary bypass (CPB) surgery, and 1 was closed successfully using an occlusion device a year later. The causes of failure included occlusion device shedding or shifting (n=6), failure of the guidewire (or the sheath) to pass through a small defect (n=5), device-related valve regurgitation (n=4), significant residual shunt (n=2), ventricular fibrillation (n=1), and continuous sharp blood pressure decreases (n=1). Patients with high VSD had a slightly higher failure rate than those with perimembranous VSD (p=0.049), and its key reason is the high proportion of occlusion device shedding or shifting (p=0.001). No significant difference in the failure rate was found between patients with different surgical incision approaches.</p><p><strong>Conclusions: </strong>Minimally invasive surgery has a high success rate for perimembranous VSDs. Occlusion device shedding or shifting is the most common cause of failure. The shedding or shifting risk of eccentric occlusion devices being used only for high VSDs is much greater than that of concentric occlusion devices being used for perimembranous VSDs, which increases the risk of conversion to CPB surgery for high VSDs.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3a/87/wjps-2022-000432.PMC9933489.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10772213","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":"Plastic multilayered closure versus orthopedic surgeon closure after spinal instrumentation in pediatric neuromuscular scoliosis.","authors":"Ekene U Ezeokoli,&nbsp;Poornima L Tamma,&nbsp;Neritan Borici,&nbsp;Ifeoma Inneh,&nbsp;Edward P Buchanan,&nbsp;Brian G Smith","doi":"10.1136/wjps-2022-000485","DOIUrl":"https://doi.org/10.1136/wjps-2022-000485","url":null,"abstract":"<p><strong>Objective: </strong>To compare wound complication rates between orthopedic closure (OC) and plastic multilayered closure (PMC) in patients undergoing primary posterior spinal fusion for neuromuscular scoliosis (NMS). We hypothesize that multilayered closure will be associated with better postoperative outcomes.</p><p><strong>Methods: </strong>We collected data on pediatric patients diagnosed with NMS who underwent first time spinal instrumentation between 1 January 2018 and 31 May 2021. Patient demographics, length of surgery, spinal levels fused and operative variables, wound complication rate, treatments, and need for wound washout were reviewed in depth and recorded.</p><p><strong>Results: </strong>In total, 86 patients were reviewed: 46 with OC and 40 with PMC. There was a significant increase in operating room (OR) time with PMC compared with OC (6.7±1.2 vs 7.3±1.3, p=0.016). There was no difference in complication rate, mean postoperative day of complication or unplanned return to the OR for OC and PMC, respectively. There was a slightly significant increase in the number of patients going home with a drain in the PMC cohort compared with the OC cohort (2.1% vs 15%, p=0.046).</p><p><strong>Conclusions: </strong>PMC demonstrated longer OR times than OC and did not demonstrate a statistically significant reduction in wound complications or unplanned returns to the OR. However, other studies have demonstrated statistical and clinical significance with these variables. Surgical programs should review internal patient volumes and outcomes for spinal fusion in NMS patients and consider if PMC after spinal fusions in pediatric patients with NMS or other scoliosis subtypes is an appropriate option in their institution to minimize postoperative wound complications.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/67/c0/wjps-2022-000485.PMC9933758.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10762923","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":"Giant inflammatory myofibroblastic tumor of the hypopharynx: an unusual cause of acute upper airway obstruction in a 6-year-old child.","authors":"Liu Yang,&nbsp;Wen Li","doi":"10.1136/wjps-2021-000342","DOIUrl":"https://doi.org/10.1136/wjps-2021-000342","url":null,"abstract":"© Author(s) (or their employer(s)) 2022. Reuse permitted under CC BYNC. No commercial reuse. See rights and permissions. Published by BMJ. INTRODUCTION Acute upper airway obstruction (UAO) in children is a common disease in the emergency department. It is lifethreatening and usually caused by laryngospasm or laryngeal edema owing to infection, allergy, or a foreign body. In addition, pediatric UAO can also be the result of laryngopharyngeal spaceoccupying lesions, such as laryngeal papilloma, lymphangioma, hemangioma, or cyst. Malignancy is uncommon. Inflammatory myofibroblastic tumor (IMT) is a mesenchymal tumor consisting of differentiated spindle fibroblast cells with plasma cells and/or lymphocytes infiltration. The most common sites of IMT are the lungs, gastrointestinal tract, urogenital tract, abdominal cavity, viscera, central nervous system, upper respiratory tract, and soft tissue. IMT in the head and neck region accounts for only 14%–18% of extrapulmonary lesions, of which the orbit and nasal sinus are common locations. According to the reported cases of laryngeal IMT (fewer than 50 cases), it is usually confined to the glottic region. A lesion with supraglottic and hypopharyngeal involvement is extremely rare and only five cases have been reported in the hypopharynx to date. These cases occurred in adults, including only one female patient. We describe an extremely rare case of giant IMT in the hypopharynx of a female child with respiratory distress as the initial symptom.","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fc/15/wjps-2021-000342.PMC9648570.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10369994","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":"Needs assessment of parents for a patient decision aid in pediatric interval appendectomy via the qualitative interview method.","authors":"Viviane Grandpierre,&nbsp;Katherine Duba,&nbsp;Karine Toupin April,&nbsp;Irina Oltean,&nbsp;Arielle Weir,&nbsp;Ahmed Nasr","doi":"10.1136/wjps-2021-000371","DOIUrl":"https://doi.org/10.1136/wjps-2021-000371","url":null,"abstract":"<p><strong>Objectives: </strong>Appendicitis is one of the most commonly encountered pediatric surgical diagnoses, with non-operative management of perforated appendicitis leading to two treatment options: an interval appendectomy (IA) or expectant management. The primary objective of this study was to assess parents' need for a patient decision aid (PDA) among parents considering IA or expectant management. A secondary objective was to determine parent preferences for the format and distribution plan of a drafted patient decision aid.</p><p><strong>Methods: </strong>Coulter's systematic development process for PDA was used to guide the assessment interviews for parents. Participants included caregivers of a patient who experienced perforated appendicitis, and admission between 2019 and 2020. Semi-structured individual interviews were conducted to collect information about decision-making needs of parents of children who experienced perforated appendicitis.</p><p><strong>Results: </strong>A total of 12 different parents participated in the interviews. Results indicate decisional conflict associated with the lack of evidence for optimal treatment, supporting the need for the development of a patient decision aid to assist in clarifying information and parent values with practitioners. Parents clearly identified a need for evidence to support decision-making in various formats (eg, pamphlet or electronic). Timing of when to deliver the PDA varied (ie, during hospital admission, at discharge, or at follow-up appointment).</p><p><strong>Conclusion: </strong>Results indicated various factors contributing to parental decisional conflict, including the lack of evidence showing the optimal treatment, the need for more information, and guidance from practitioners. Overall, findings indicate a strong need for a patient decision aid.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/79/7a/wjps-2021-000371.PMC9716770.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10369996","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":"Incidental finding of intra-abdominal hemangioma in an infant presenting with intestinal obstruction: a case report.","authors":"Parveen Kumar,&nbsp;Arti Khatri,&nbsp;Somshankar Chowdhury,&nbsp;Nidhi Mahajan,&nbsp;Geetika Mathur","doi":"10.1136/wjps-2021-000335","DOIUrl":"https://doi.org/10.1136/wjps-2021-000335","url":null,"abstract":"","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0c/41/wjps-2021-000335.PMC9717406.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10370004","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":"The etiological spectrum of bowel obstruction and early postoperative outcome among neonates at a tertiary hospital in Uganda.","authors":"Paul Otim,&nbsp;Emmanuel Alex Elobu,&nbsp;Ronald Mbiine,&nbsp;Nasser Kakembo,&nbsp;David Komakech","doi":"10.1136/wjps-2021-000377","DOIUrl":"https://doi.org/10.1136/wjps-2021-000377","url":null,"abstract":"<p><strong>Background: </strong>Bowel obstruction is a common surgical emergency in newborns. One-fourth of neonates with obstruction suffer postoperative complications, with high mortality, especially in low-income countries. Factors attributed to mortality include prematurity, late presentation and associated multiple congenital anomalies. The prevalence and the predictors of mortality in our setting have not been well studied. We aimed to describe the early postoperative outcomes and to determine the predictors of mortality among neonates with bowel obstruction.</p><p><strong>Methods: </strong>We conducted a prospective cohort study during 4 months, when we recruited postoperative neonates from the pediatric surgery unit of Mulago Hospital. We collected data on demographics, clinical presentations, maternal characteristics, the surgical procedure performed, postoperative outcomes, etc. After follow-up for 2 weeks, we analyzed the data using Cox proportional hazards regression models of predictors of mortality.</p><p><strong>Results: </strong>A total of 76 neonates were recruited, with a male-to-female ratio of 2.2:1. The age ranged from 1 to 26 days, a median of 3 [interquartile range (IQR): 2, 7]. About 67.1% had birth weights ranging between 2.5 kg and 3.5 kg, a mean of 2.8 [standard deviation(SD)=0.64]; 76.3% were termed; with anorectal malformation (ARM), 31.6% as the leading cause, followed by jejunoileal atresia (JIA), 25%. Nearly 55.3% of neonates developed complications; 53.9% with post-operative fever, 15.8% had wound sepsis. The mortality rate was 44.7% (34/76) and was highest among cases of JIA, 41.2%. The predictors of mortality included prematurity, fever at admission, breastfeeding status, and mother's parity as well as the cadre of healthcare providers (p<0.005).</p><p><strong>Conclusions: </strong>ARM is the predominant cause of bowel obstruction among neonates, followed by JIA. The morbidity and mortality due to bowel obstruction among neonates are unacceptably high. The major predictors of mortality were prematurity, fever at admission, and the cadre of the healthcare providers.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5f/b3/wjps-2021-000377.PMC9648575.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10430544","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}