World Journal of Pediatric Surgery最新文献

{"title":"Risk factors for perioperative respiratory adverse events and unplanned intensive care admission in children with juvenile-onset recurrent respiratory papillomatosis undergoing carbon dioxide laser resection.","authors":"Xueying Yang, Dongni Xu, Rongjian Zhan, Yanan Lu","doi":"10.1136/wjps-2025-001115","DOIUrl":"https://doi.org/10.1136/wjps-2025-001115","url":null,"abstract":"<p><strong>Objective: </strong>To identify risk factors for perioperative respiratory adverse events (PRAEs) and unplanned intensive care admission (UIA) in children with juvenile-onset recurrent respiratory papillomatosis (JORRP) undergoing carbon dioxide (CO₂) laser resection.</p><p><strong>Methods: </strong>This retrospective nested case-control study included 148 JORRP patients who underwent CO₂ laser resection between 2014 and 2023 at Sun Yat-sen Memorial Hospital. Univariate and multivariate logistic regression analyses were used to identify independent risk factors. Predictive nomograms were constructed based on the multivariate model. PRAEs were defined as laryngeal edema, bronchospasm, desaturation, emergency reintubation, or tracheostomy occurring within 24 hours post-surgery.</p><p><strong>Results: </strong>Forty patients (27.0%) required UIA, of whom 36 (24.3% of the total cohort) experienced PRAEs that led to ICU admission. Median age at surgery was 3.8 years. Female sex (OR=4.00, 95% CI 1.07 to 15.87), number of previous surgeries (OR=16.05, 95% CI 3.86 to 66.78), younger age (per year increase, OR=0.70, 95% CI 0.53 to 0.94), longer duration of surgery (OR=1.01, 95% CI 1.01 to 1.02), and tracheal involvement (OR=5.58, 95% CI 1.27 to 24.55) were identified as significant independent risk factors for PRAEs. Similar patterns were observed for UIA. Nomogram analysis demonstrated that young female patients with multiple previous surgeries, prolonged surgical times, and tracheal tumors had the highest risk of respiratory complications.</p><p><strong>Conclusions: </strong>Patients who are female, younger, have tracheal involvement, multiple previous surgeries, and prolonged operative duration are at significantly higher risk for PRAEs and UIA following CO₂ laser resection for JORRP. These findings provide valuable insights for optimizing perioperative management and improving patient safety in this vulnerable population.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 2","pages":"e001115"},"PeriodicalIF":1.3,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12927348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285301","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":"Safety and efficacy of three-port thoracoscopic patent ductus arteriosus ligation in children.","authors":"Yongyu Ma, Xichen Zhang, Ming Zhang, Yanjie Cao, Rutao Dai, Ya Dao, Shuyu Wang, Yulei Hu, Yunshan Gao, Xian Zhu, Jun Wu","doi":"10.1136/wjps-2025-001062","DOIUrl":"https://doi.org/10.1136/wjps-2025-001062","url":null,"abstract":"<p><p>This study aimed to evaluate the safety and efficacy of three-port thoracoscopic surgery for patent ductus arteriosus (PDA) ligation in children. A retrospective analysis was conducted on 50 pediatric patients with PDA (median age: 30 months; median weight: 12.00 kg; median ductal diameter: 2.50 mm) treated with three-port thoracoscopic surgery in the Department of Cardiothoracic Surgery at Kunming Children's Hospital from January 2021 to June 2024. All 50 patients successfully underwent surgery without conversion to open thoracotomy; there was no mortality. The median hospitalization cost was 25 211.00 CNY. Postoperatively, three (6.00%) patients developed chylothorax and three (6.00%) patients had residual shunts. During the 6-36 month follow-up period, no instances of ductal recanalization or other complications were reported. In conclusion, three-port thoracoscopic PDA ligation is a safe and effective approach, offering cosmetic incisions, definitive efficacy, and low complication rates. However, meticulous handling during ductus arteriosus ligation is essential to minimize complications and residual shunts.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 2","pages":"e001062"},"PeriodicalIF":1.3,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12918681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272134","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":"Tribute to reviewers (January 1, 2025 to December 31, 2025).","authors":"","doi":"10.1136/wjps-2026-reviewers","DOIUrl":"https://doi.org/10.1136/wjps-2026-reviewers","url":null,"abstract":"","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 1","pages":"ereviewers"},"PeriodicalIF":1.3,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12918659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272100","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":"Care pathways for pediatric surgical conditions.","authors":"Madhurima Vuddemarry, Siddhesh Zadey, Ajeya Sp, Dhruv Ghosh, Bistra Zheleva","doi":"10.1136/wjps-2025-001126","DOIUrl":"10.1136/wjps-2025-001126","url":null,"abstract":"","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 1","pages":"e001126"},"PeriodicalIF":1.3,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12887486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146166976","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":"Predictors of perioperative mortality in children undergoing surgery at a Nigerian tertiary hospital: insights from Sagamu.","authors":"Lukmon Olusesan Amosu, Chigbundu C Nwokoro, Oluwakemi A Shotayo, Ibukunolu Olufemi Ogundele, Adeleke Owolabi Adekoya, Adekunle O Ajayi, Solomon O Ariyibi, Adeduntan Sarah Olagbenro, Olusola Ayodele Sogebi, Lateef Olatunji Adedokun Thanni","doi":"10.1136/wjps-2025-001123","DOIUrl":"10.1136/wjps-2025-001123","url":null,"abstract":"<p><strong>Background: </strong>The burden of perioperative complications following pediatric surgery in sub-Saharan Africa is high. Assessment of the patterns and determinants of such complications and their relationship to perioperative mortality are important in identifying indicators of poor outcomes. In this study, we aim to define predictors of perioperative mortality at a tertiary hospital in Nigeria.</p><p><strong>Methods: </strong>This was a retrospective review of medical records between January 2014 and December 2023. We included patients aged 15 years and below, who had general pediatric, oncological or urological surgery under general anesthesia. Information extracted included biodata, diagnosis, American Society of Anesthesiology (ASA) classification of physical status, time of death after surgery, cause of death, and duration of surgery. Data were processed using univariate and multivariate statistical analysis.</p><p><strong>Results: </strong>A total of 1621 patients were analyzed. The 30-day perioperative mortality rate was 2.96% (296 per 10 000 patients). Jejuno-ileal atresia, gastrochisis, and bladder exstrophy were associated with the highest mortality rates, well above 50%. Logistic regression identified neonatal age, ASA class greater than II, prolonged surgery, and repeated surgical procedures as significant predictors of mortality. Sepsis and intestinal or anastomotic failure were identified as the most common direct causes of death.</p><p><strong>Conclusions: </strong>Neonatal age, ASA class greater than II and prolonged and repeated surgery are significant predictors of mortality in children's surgery in our practice. Efforts should be made to combat sepsis and provide physiologic support and intensive care provision to improve outcomes.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 1","pages":"e001123"},"PeriodicalIF":1.3,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12878468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143748","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":"Efficacy and safety of oral paracetamol for the management of acute postoperative pain in neonates and infants: a randomized clinical trial.","authors":"Chengpeng Shi, Jie Tang, Wen Sun, Wei Li, Xiaofeng Lv, Weibing Tang","doi":"10.1136/wjps-2025-001131","DOIUrl":"10.1136/wjps-2025-001131","url":null,"abstract":"<p><strong>Background: </strong>Neonates and infants presenting for surgery experience not only pain but also heightened pain sensitivity due to immaturity of the nervous system, which may increase the risk of neurodevelopmental disorders. Improving awareness, assessment, and timely intervention of pediatric postoperative pain is critical.</p><p><strong>Methods: </strong>Neonates and infants aged 0-12 months who underwent abdominal and/or sacroperineal surgeries between September 2022 and July 2023 were randomly assigned to a treatment group (oral paracetamol suspension, 0.1 mL/kg [10 mg/kg] administered every 6 hours for four doses after recovery from general anesthesia) or a control group (oral sterile water, 0.1 mL/kg). The primary outcome was postoperative pain intensity. Secondary outcomes included changes in liver and kidney function indices-aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN), and creatinine (Cr)-measured preoperatively and 48 hours postoperatively.</p><p><strong>Results: </strong>A total of 220 neonates and infants were included. Postoperative pain scores were significantly lower in the treatment than in the control group at each time point at all assessed time points (1, 6, 12, 18, 24, 36, and 48 hours after recovery from general anesthesia, <i>p</i><0.001). No significant differences were observed between groups in changes in AST, ALT, BUN, or Cr levels from baseline to 48 hours postoperatively.</p><p><strong>Conclusions: </strong>Repeated oral administration of paracetamol after recovery from general anesthesia effectively reduces postoperative pain in neonates and infants without adversely affecting hepatic or renal function. This approach is safe and suitable for routine clinical use.</p><p><strong>Trial registration number: </strong>NCT05564819.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 1","pages":"e001131"},"PeriodicalIF":1.3,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12878376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143693","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":"Multidimensional long-term outcomes after pediatric esophageal replacement following caustic injuries: a comparative study of two techniques.","authors":"Michaël de Sousa Amaral, Esperance Houmenou, Natacha Nouwakpo, Nicoletta Bianchi, Natalie Divjak, Olivier Reinberg, Sabine Vasseur Maurer, Anthony de Buys Roessingh","doi":"10.1136/wjps-2025-001109","DOIUrl":"10.1136/wjps-2025-001109","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare multidimensional long-term outcomes between children who underwent colonic pedicled flap surgery versus gastric tube esophageal replacement in the mediastinum after caustic injuries.</p><p><strong>Methods: </strong>This cross-sectional observational study was conducted in patients who were operated on during their childhood between 1989 and 2022. Patients completed a comprehensive assessment using Pediatric Quality of Life Inventory Gastrointestinal Symptoms Scale (PedsQL GI), KIDSCREEN-52 for psychosocial dimensions, the 36-Item Short Form Health Survey, the International Dysphagia Diet Standardization Initiative (IDDSI) scale and the 6-Minute Walk Test (6MWT).</p><p><strong>Results: </strong>A total of 26 patients (aged 6-22 years with mean 14 years) were included. Among these, 17 had a colonic pedicled flap and 9 had a gastric tube. Mean operation-to-questionnaire interval was 8 years. No significant differences were observed between groups in PedsQL GI, SF-36 or 6MWT outcomes. Mean PedsQL GI scores indicated mild-to-moderate gastrointestinal symptoms, with lower score in trouble swallowing and heartburn and reflux. Significant psychosocial disparities emerged in KIDSCREEN-52 with higher scores in psychological well-being (<i>p</i><0.05) for colonic patients. Dietary texture modifications were needed in 38% of patients (IDDSI levels 5 and 6), but these were equally distributed between groups.</p><p><strong>Conclusion: </strong>Both colonic and gastric esophageal replacements provide satisfactory long-term outcomes and quality of life after pediatric caustic injury. Although gastrointestinal and functional results were comparable, psychosocial quality of life domains showed differences. Persistent dietary adaptations underline the necessity for tailored, multidisciplinary and culturally sensitive follow-up.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 1","pages":"e001109"},"PeriodicalIF":1.3,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12878198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143759","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":"Ethical considerations and challenges in pediatric surgical artificial intelligence.","authors":"Raquel González","doi":"10.1136/wjps-2025-001102","DOIUrl":"10.1136/wjps-2025-001102","url":null,"abstract":"","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 1","pages":"e001102"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12863341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114345","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":"Remote detection of the critical view of safety in pediatric laparoscopic cholecystectomy using artifitial intelligence.","authors":"Sean Exequiel Olivieri, Santiago Darrigran, Enrique Petracchi, Paula Bidone, Anahí Pérez, Leandro Cardozo, Melissa Fernández, Hugo Zandalazini, Ignacio Della Pia","doi":"10.1136/wjps-2025-001125","DOIUrl":"10.1136/wjps-2025-001125","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic cholecystectomy (LC) is increasingly performed in pediatric patients. Bile duct injury remains one of its most serious complications. The critical view of safety (CVS) aims to reduce this risk, but its identification is subjective. Artificial intelligence (AI) has shown promise in adult surgery for CVS detection but it has not been applied in pediatrics. Remote implementation of AI could reduce subjectivity and improve access to advanced tools.</p><p><strong>Methods: </strong>A prospective, observational, cross-sectional, single-blind study was conducted between May and August 2025. An AI algorithm trained with 346 validated adult LC cases was tested live in 50 pediatric patients. Surgeries were transmitted in real time via teleconferencing to a second center where the algorithm processed the surgical image and identified CVS structures. Two expert surgeons, blinded to the algorithm, assessed CVS presence independently.</p><p><strong>Results: </strong>A total of 50 patients (38 females and 12 males were classified as middle childhood to early adolescence) were included. The mean body mass index was 29.3±5.8. CVS was detected fully in 37 cases. In 13 cases, one or more elements were absent. Agreement between the algorithm and surgeons assessments was 100%. No postoperative complications were reported.</p><p><strong>Conclusion: </strong>Remote AI-assisted CVS detection in pediatric LC is feasible, safe and consistent with expert evaluation.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 1","pages":"e001125"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12863403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114399","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":"Hemiuvulectomy: is it a suitable alternative?","authors":"Norma Samanta Romero-Castro, Leonel Ponce-Ávila, Daniel Sandoval-Guevara, Rafael Luna-Aguilar, Alicia García-Verónica, Natalia Hernández-Treviño, Salvador Reyes-Fernandez","doi":"10.1136/wjps-2025-001139","DOIUrl":"10.1136/wjps-2025-001139","url":null,"abstract":"","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 1","pages":"e001139"},"PeriodicalIF":1.3,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12853484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107461","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}