World Journal of Pediatric Surgery最新文献

{"title":"Ex utero intrapartum therapy in infants with congenital diaphragmatic hernia: a propensity score matching analysis.","authors":"Yunlong Zhao,&nbsp;Ying Wang,&nbsp;Chao Liu,&nbsp;Yulin Jiang,&nbsp;Yandong Wei,&nbsp;Hua Meng,&nbsp;Shan Jian,&nbsp;Xiting Zhu,&nbsp;Lijian Pei,&nbsp;Xiaochen Bai,&nbsp;Feng Feng,&nbsp;Yan Lv,&nbsp;Xiya Zhou,&nbsp;Qingwei Qi,&nbsp;Jingna Li,&nbsp;Lishuang Ma","doi":"10.1136/wjps-2022-000425","DOIUrl":"https://doi.org/10.1136/wjps-2022-000425","url":null,"abstract":"<p><strong>Objective: </strong>Previous studies have shown that ex utero intrapartum therapy (EXIT) is safe and feasible for newborns with congenital diaphragmatic hernia (CDH). This study reports our experience with EXIT in fetuses with CDH in an attempt to explore the efficacy of EXIT on the survival rate of this population.</p><p><strong>Methods: </strong>A retrospective analysis of the clinical data of 116 children with CDH was conducted. The children were assigned to EXIT and non-EXIT groups. Propensity score matching (PSM) toward clinical data was performed, and the clinical characteristics and outcomes were compared. Taking survival at discharge as the main outcome, logistic regression analysis was carried out to explore the efficacy of EXIT on survival.</p><p><strong>Results: </strong>During the study period, 30 of 116 children received EXIT. After PSM, the survival rates of the EXIT group and the non-EXIT group were 82.76% (24/29) and 48.28% (14/29), respectively (p=0.006). EXIT (OR=0.083, 95% CI=0.013to 0.525, p=0.008), liver herniation (OR=16.955, 95% CI=2.342 to 122.767, p=0.005), and gestational age at diagnosis (OR=0.662, 95% CI=0.497 to 0.881, p=0.005) were independent mortality-related risk factors of all children with CDH. Ninety-nine of 116 children underwent surgery. After PSM, the postoperative survival rates of the EXIT group and non-EXIT group were 84.6% (22/26) and 76.9% (20/26), respectively (p=0.754). Liver herniation (OR=10.451, 95% CI=1.641 to 66.544, p=0.013) and gestational age at diagnosis (OR=0.736, 95% CI=0.577 to 0.938, p=0.013) were independent mortality-related risk factors of children after surgery.</p><p><strong>Conclusion: </strong>EXIT can be performed safely for selected prenatally diagnosed CDH neonates with potentially better survival and does not cause more maternal complications compared with traditional cesarean section.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"5 4","pages":"e000425"},"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/60/79/wjps-2022-000425.PMC9716806.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10737951","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":"Factors associated with mortality in congenital malformations of the gastrointestinal tract in a tertiary center in Senegal.","authors":"Florent Tshibwid A Zeng,&nbsp;Papa Alassane Mbaye,&nbsp;Doudou Gueye,&nbsp;Ndèye Fatou Seck,&nbsp;Ibrahima Bocar Wellé,&nbsp;Rosalie Niang,&nbsp;Youssouph Diedhiou,&nbsp;Mbaye Fall,&nbsp;Ndèye Aby Ndoye,&nbsp;Aloïse Sagna,&nbsp;Oumar Ndour,&nbsp;Gabriel Ngom","doi":"10.1136/wjps-2022-000463","DOIUrl":"https://doi.org/10.1136/wjps-2022-000463","url":null,"abstract":"<p><strong>Objective: </strong>Patients with congenital malformations (CMs) of the gastrointestinal tract (GIT) have a very high mortality. However, the literature on the factors associated with mortality in these patients is scarce in sub-Saharan Africa. The aim of this study is to identify independent risk factors for mortality in patients with CMs of the GIT at our pediatric surgical department.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of cases with CMs of the GIT managed at a tertiary center from 2018 to 2021. Patients were subdivided into two groups based on the outcomes, and variables with a significant difference were analyzed by logistic regression.</p><p><strong>Results: </strong>Our review included 226 patients, 63 of whom died (27.88%). Patient age ranged from 0 to 15 years. Taking into account statistical significance, mortality was more frequent in neonates than in older patients (57.30% vs 6.15%), in patients coming out of the Dakar area than in those from the Dakar area (43.75% vs 19.18%), in patients with abnormal prenatal ultrasound than in those with normal ultrasound (100% vs 26.67%), in premature children than in those born at term (78.57% vs 21.87%), in patients with an additional malformation than in those with an isolated malformation (69.23% vs 25.35%), and in those with intestinal, esophageal, duodenal and colonic atresia than in those with other diagnoses (100%, 89%, 56.25% and 50%, respectively). Referred patients died more than those who changed hospitals or came from home (55.29% vs 25% and 9.09%, respectively). On multivariable logistic regression, two independent factors of mortality were identified: presence of associated malformation [odds ratio (OR)=13.299; 95% Confidence interval (CI) 1.370 to 129.137] and diagnosis of esophageal atresia (OR=46.529; 95% CI 5.828 to 371.425).</p><p><strong>Conclusion: </strong>The presence of an associated malformation or diagnosis of esophageal atresia increases mortality in patients with CMs of the GIT in our environment.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"6 1","pages":"e000463"},"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/6e/a1/wjps-2022-000463.PMC9887706.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10646534","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":"Pattern of congenital anomalies among pediatric surgical patients in a tertiary care hospital in northern Tanzania.","authors":"Faraja Mussa Magwesela,&nbsp;Happiness Rabiel,&nbsp;Catherine Mlelwa Mung'ong'o","doi":"10.1136/wjps-2021-000410","DOIUrl":"https://doi.org/10.1136/wjps-2021-000410","url":null,"abstract":"<p><strong>Background: </strong>Congenital anomalies are major causes of morbidity and mortality in children under 5 years of age and make a significant contribution to the surgical burden of diseases. Most anomalies have multifactorial causes and commonly affect the central nervous, cardiovascular, gastrointestinal and musculoskeletal systems. Countries with improved pediatric surgical care have shown dramatic reductions in morbidity and mortality rates. The aim of this study was to analyze the pattern of congenital anomalies presenting in our surgical departments in patients under 5 years of age.</p><p><strong>Methods: </strong>A retrospective descriptive study was done. Data were obtained from clinical records of patients under 5 years of age, who underwent surgical correction of their congenital anomalies between 2017 and 2021. Analysis was done to identify the proportion of congenital anomalies managed in our setting.</p><p><strong>Results: </strong>Congenital anomalies contributed 4.6% of overall surgical burden. Totally, 822 patients with congenital anomalies were included for analysis. The most commonly diagnosed congenital anomaly was inguinal hernia, followed by hydrocephalus, neural tube defects and cleft lips. The most commonly affected system was the central nervous system, anterior abdominal wall, orofacial and digestive system in decreasing order of frequency. Most of our patients presented outside the neonatal period (84.4%), and few (16.1%) had more than one system affected. Male children comprised 64%.</p><p><strong>Conclusions: </strong>Delayed presentation of children with congenital anomalies is still a significant problem in our area. Prevention through nutritional supplementation and antenatal screening is crucial. The true epidemiology of congenital anomalies in northern Tanzania is still obscure.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"5 4","pages":"e000410"},"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/d3/96/wjps-2021-000410.PMC9716962.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10737950","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":"Expression and possible role of Smad3 in postnecrotizing enterocolitis stricture.","authors":"Rui Chen,&nbsp;Chengjie Lv,&nbsp;Xiaoxia Zhao,&nbsp;Dong Ma,&nbsp;Dengming Lai,&nbsp;Yun Zhao,&nbsp;Luyin Zhang,&nbsp;Jinfa Tou","doi":"10.1136/wjps-2021-000289","DOIUrl":"https://doi.org/10.1136/wjps-2021-000289","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the expression of Smad3 (mothers against decapentaplegic homolog 3) protein in postnecrotizing enterocolitis stricture and its possible mechanism of action.</p><p><strong>Methods: </strong>We used immunohistochemistry to detect the expression characteristics of Smad3 and nuclear factor kappa B (NF-κB) proteins in human postnecrotizing enterocolitis stricture. We cultured IEC-6 (crypt epithelial cells of rat small intestine) in vitro and inhibited the expression of Smad3 using siRNA technique. Quantitative PCR, western blotting, and ELISA were used to detect the changes in transforming growth factor-β1 (TGF-β1), NF-κB, tumor necrosis factor-α (TNF-α), vascular endothelial growth factor (VEGF), and zonula occludens-1 (ZO-1) messenger RNA (mRNA) and protein expressions in IEC-6 cells. CCK8 kit and Transwell cellular migration were used to detect cell proliferation and migration. Changes in epithelial-mesenchymal transition (EMT) markers (E-cadherin and vimentin) in IEC-6 cells were detected by immunofluorescence technique.</p><p><strong>Results: </strong>The results showed that Smad3 protein and NF-κB protein were overexpressed in narrow intestinal tissues and that Smad3 protein expression was positively correlated with NF-κB protein expression. After inhibiting the expression of Smad3 in IEC-6 cells, the mRNA expressions of NF-κB, TGF-β1, ZO-1, and VEGF decreased, whereas the mRNA expression of TNF-α did not significantly change. TGF-β1, NF-κB, and TNF-α protein expressions in IEC-6 cells decreased, whereas ZO-1 and intracellular VEGF protein expressions increased. IEC-6 cell proliferation and migration capacity decreased. There was no significant change in protein expression levels of EMT markers E-cadherin and vimentin and also extracellular VEGF protein expression.</p><p><strong>Conclusions: </strong>We suspect that the high expression of Smad3 protein in postnecrotizing enterocolitis stricture may promote the occurrence and development of secondary intestinal stenosis. The mechanism may be related to the regulation of TGF-β1, NF-κB, TNF-α, ZO-1, and VEGF mRNA and protein expression. This may also be related to the ability of Smad3 to promote epithelial cell proliferation and migration.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"5 1","pages":"e000289"},"PeriodicalIF":0.8,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9716802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10370008","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":"Addressing barriers to evidence-based medicine in pediatric surgery: an introduction to the Canadian Association of Paediatric Surgeons Evidence-Based Resource.","authors":"Viviane Grandpierre,&nbsp;Irina Oltean,&nbsp;Manvinder Kaur,&nbsp;Ahmed Nasr","doi":"10.1136/wjps-2021-000332","DOIUrl":"https://doi.org/10.1136/wjps-2021-000332","url":null,"abstract":"<p><strong>Background: </strong>Pediatric surgical practice lags behind medicine in presence and use of evidence, primarily due to time constraints of using existing tools that are not specific to pediatric surgery, lack of sufficient patient data and unstructured pediatric surgery training methods.</p><p><strong>Method: </strong>We developed, disseminated and tested the effectiveness of an evidence-based resource for pediatric surgeons and researchers that provides brief, informative summaries of quality-assessed systematic reviews and meta-analyses on conflicting pediatric surgery topics.</p><p><strong>Results: </strong>Responses of 91 actively practicing surgeons who used the resource were analysed. The majority of participants found the resource useful (75%), improved their patient care (66.6%), and more than half (54.2%) found it useful in identifying research gaps. Almost all participants reported that the resource could be used as a teaching tool (93%).</p><p><strong>Conclusion: </strong>Lack of awareness of the resource is the primary barrier to its routine use, leading to potential calls for more active dissemination worldwide. Users of the Canadian Association of Paediatric Surgeons Evidence-Based Resource find that the summaries are useful, identify research gaps, help mitigate multiple barriers to evidence-based medicine, and may improve patient care.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"5 1","pages":"e000332"},"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/54/dd/wjps-2021-000332.PMC9717324.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10360677","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":"Prognostic factors in children with acute fulminant myocarditis receiving venoarterial extracorporeal membrane oxygenation.","authors":"Mingwei Sun,&nbsp;Qing Zong,&nbsp;Li Fen Ye,&nbsp;Yong Fan,&nbsp;Lijun Yang,&nbsp;Ru Lin","doi":"10.1136/wjps-2021-000271","DOIUrl":"https://doi.org/10.1136/wjps-2021-000271","url":null,"abstract":"<p><strong>Background: </strong>Pediatric acute fulminant myocarditis (AFM) is a very dangerous disease that may lead to acute heart failure or even sudden death. Previous reports have identified some prognostic factors in adult AFM; however, there is no such research on children with AFM on venoarterial extracorporeal membrane oxygenation (VA-ECMO). This study aimed to find relevant prognostic factors for predicting adverse clinical outcomes.</p><p><strong>Methods: </strong>A retrospective analysis was performed in an affiliated university children's hospital with consecutive patients receiving VA-ECMO for AFM from July 2010 to November 2020. These children were classified into a survivor group (n=33) and a non-survivor group (n=8). Patient demographics, clinical events, laboratory findings, and electrocardiographic and echocardiographic parameters were analyzed.</p><p><strong>Results: </strong>Peak serum creatinine (SCr) and peak creatine kinase isoenzyme MB during ECMO had joint predictive value for in-hospital mortality (p=0.011, AUC=0.962). Based on multivariable logistic regression analysis, peak SCr level during ECMO support was an independent predictor of in-hospital mortality (OR=1.035, 95% CI 1.006 to 1.064, p=0.017, AUC=0.936, with optimal cut-off value of 78 μmol/L).</p><p><strong>Conclusion: </strong>Tissue hypoperfusion and consequent end-organ damage ultimately hampered the outcomes. The need for left atrial decompression indicated a sicker patient on ECMO and introduced additional risk for complications. Earlier and more cautious deployment would likely be associated with decreased risk of complications and mortality.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"5 1","pages":"e000271"},"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/03/b2/wjps-2021-000271.PMC9717374.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10370006","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":"Ten cases of intradiaphragmatic extralobar pulmonary sequestration: a single-center experience.","authors":"Yue Gao,&nbsp;Xu Han,&nbsp;Jie Jin,&nbsp;Zheng Tan","doi":"10.1136/wjps-2021-000334","DOIUrl":"https://doi.org/10.1136/wjps-2021-000334","url":null,"abstract":"<p><strong>Background: </strong>Intradiaphragmatic extralobar pulmonary sequestration (IDEPS) is a rare type of pulmonary sequestration (PS). The purpose of this study is to assess diagnosis and operative treatment of IDEPS.</p><p><strong>Methods: </strong>Patients with PS who were diagnosed and treated in our center from January 2015 to December 2020 were analyzed retrospectively to identify patients with IDEPS.</p><p><strong>Results: </strong>Totally, 215 patients with PS were treated surgically, including 10 cases with IDEPS. Prenatal ultrasounds and postnatal-enhanced CT showed the presence of IDEPS in four cases and in seven cases, respectively. The three-dimensional (3D) reconstruction software was performed perfectly to identify the location of the lesions in 10 cases. The surgeries were performed smoothly by laparoscopic surgery in one case, video-assisted thoracic surgery (VATS) in five cases and Da Vinci robot-assisted thoracoscopic surgery (DVRATS) in four cases. In the VATS group, the average operative duration, intraoperative blood loss volume, length of stay after operation, and postoperative thoracic catheter indwelling duration were 48 min, 3.8 mL, 6.4 days and 2.2 days, respectively. That of the DVRATS group were 80 min, 3.5 mL, 4.3 days and 1.5 days, respectively. No side effects had appeared.</p><p><strong>Conclusions: </strong>The 3D reconstruction software was proven to be capable in assisting the assessment of IDEPS. We suggested early surgery to treat IDEPS, and the best path was accessing the mass from the chest. Both DVRATS and VATS for the treatment of an IDEPS are safe, feasible, and effective. Furthermore, DVRATS provides a 3D magnified view, more flexibility and precision.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"5 2","pages":"e000334"},"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/e8/37/wjps-2021-000334.PMC9716959.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10737929","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":"High platelet distribution width can independently predict testicular survival in testicular torsion among patients with steady-state sickle cell anemia.","authors":"Essa A Adawi,&nbsp;Mazen Ahmed Ghanem,&nbsp;Ahmed Mazen Ghanem,&nbsp;Manal A Safan,&nbsp;Mohamed G Elsayed,&nbsp;Mohammed A Aqeel","doi":"10.1136/wjps-2021-000358","DOIUrl":"https://doi.org/10.1136/wjps-2021-000358","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the predictive value of platelet volume indices (PVI), such as mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT), as prognostic indicators of testicular viability in torsion patients with steady-state sickle cell anemia (SCA) who underwent surgical exploration.</p><p><strong>Methods: </strong>Forty-eight patients with SCA with testicular torsion and 46 male control subjects were enrolled in the study. All patients underwent scrotal color Doppler ultrasonography before surgery, and PVI (MPV, PDW, and PCT) values were measured in all participants. Symptom duration and testicular volume were also recorded.</p><p><strong>Results: </strong>The testicular salvage rate in patients with SCA was 73% after surgery. Analyses showed that MPV, PDW, and PCT values were significantly higher in torsed SCA as compared with controls (p<0.05). Orchiectomy in patients with SCA showed significantly higher MPV, PDW, and PCT values than the orchiopexy group (p<0.05). The MPV values of orchiectomy patients showed a higher significant cut-off of ≥11.5 fL, which is higher than in torsed patients without SCA, as an indicator of testis survival. PDW also demonstrated a higher significant cut-off of ≥12.7 fL for detorsion outcomes in patients with SCA. Symptom duration of less than 7 hours was also significantly correlated with orchiopexy (p≤0.001). Univariate analysis showed that higher MPV, increased PDW, and symptom duration were indicative of the outcome of testicular detorsion in SCA. Multivariable analysis showed that increased PDW and symptom duration are prognostic parameters for testicular viability in SCA.</p><p><strong>Conclusion: </strong>Increased PDW and symptom duration can be used as parameters for predicting testicular detorsion outcomes in patients with steady-state SCA.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"5 1","pages":"e000358"},"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/e4/dc/wjps-2021-000358.PMC9716940.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10737937","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":"Postoperative apnea after pyloromyotomy for infantile hypertrophic pyloric stenosis.","authors":"Anna Camporesi,&nbsp;Veronica Diotto,&nbsp;Elena Zoia,&nbsp;Simone Rotta,&nbsp;Federica Tarantino,&nbsp;Laura Maria Giuditta Eccher,&nbsp;Valeria Calcaterra,&nbsp;Gloria Pelizzo,&nbsp;Marco Gemma","doi":"10.1136/wjps-2021-000391","DOIUrl":"https://doi.org/10.1136/wjps-2021-000391","url":null,"abstract":"<p><strong>Objective: </strong>Infantile hypertrophic pyloric stenosis (IHPS), which causes gastric outlet obstruction and hypochloremic hypokalemic metabolic alkalosis, could pose a risk of postoperative apnea in patients. The aim of this study is to evaluate the incidence of postoperative apnea in babies admitted to a tertiary-level pediatric surgical center in Milano, Italy with diagnosis of IHPS in 2010-2019. The secondary objective is to evaluate the risk factors for postoperative apnea.</p><p><strong>Methods: </strong>This is a single-center, retrospective, observational cohort study. All patients admitted to our institution with diagnosis of IHPS during the study period were enrolled. Demographic and surgical variables, along with blood gas parameters, were obtained from the population. Postoperative apnea was defined as a respiratory pause longer than 15 s or a respiratory pause lasting less than 15 s, but associated with either bradycardia (heart rate <120 per minute), desaturation (SatO₂ <90%), cyanosis, or hypotonia. Occurrence was obtained from nursing charts and was recorded as a no/yes dichotomous variable.</p><p><strong>Results: </strong>Of 122 patients, 12 (9.84%) experienced apnea and 110 (90.16%) did not. Using univariate analysis, we found that only postoperative hemoglobin was significantly different between the groups (p=0.03). No significant multivariable model was better than this univariate model for prediction of apnea.</p><p><strong>Conclusions: </strong>Postoperative anemia, possibly due to hemodilution, increased the risk of postoperative apnea. It could be hypothesized that anemia can be added as another apnea-contributing factor in a population at risk due to metabolic changes.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"5 3","pages":"e000391"},"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/bd/02/wjps-2021-000391.PMC9716955.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10738445","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":"Distribution of multiple chalazia in eyelids of pediatrics requiring surgery in southeast China: a hospital-based cross-sectional study.","authors":"Xiao-Yu Zheng,&nbsp;Robert M Dorazio,&nbsp;Bonnie Nga Kwan Choy,&nbsp;Ting-Yan Wang,&nbsp;Su-Juan Zhao,&nbsp;Zheng-Yan Zhao","doi":"10.1136/wjps-2021-000408","DOIUrl":"https://doi.org/10.1136/wjps-2021-000408","url":null,"abstract":"<p><strong>Background: </strong>Multiple chalazia are common in children, and many are treated by surgery. However, the distribution of different types of multiple chalazia has not been studied. This research aimed to investigate the location and number of multiple chalazia in pediatrics who need surgical treatments.</p><p><strong>Methods: </strong>Patients with multiple chalazia treated by incision and curettage surgery (I&C) in a tertiary children's hospital between June and December 2016 were reviewed. Demographic data, locations, and numbers of chalazia were recorded. Data were analyzed using generalized linear models of the counts and the occurrences of chalazia. Hypotheses were tested using likelihood ratio tests appropriate for each type of data.</p><p><strong>Results: </strong>The study included 128 subjects, most of which were 1-3 years old. The majority of patients had bilateral chalazia (95.3%), and the proportions of patients with internal, external, and marginal chalazion differed dramatically (99.2%, 61.7%, and 2.3%, respectively). The number of internal and external chalazia did not vary significantly with gender, age, or residence of the patients. Internal chalazia were located more frequently in the upper lids (p<0.001). External chalazia showed no preference of localization. The average number of internal chalazia in each eyelid did not relate to the presence of external chalazia.</p><p><strong>Conclusions: </strong>Multiple chalazia are common among younger children in southeast China. The anatomical distribution varies depending on the type of chalazion. Multiple chalazia often occur bilaterally and internally. If doctors are more aware of the anatomical distribution of chalazia, this might result in a higher success rate of I&C.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"5 3","pages":"e000408"},"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/2d/7b/wjps-2021-000408.PMC9648573.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10370048","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}