World Journal of Pediatric Surgery最新文献

{"title":"Current operative approaches for necrotizing enterocolitis.","authors":"Taylor H Jacobs, Sarah J Chen, Colton D Wayne, Zachary Dumbauld, Gail E Besner","doi":"10.1136/wjps-2026-001200","DOIUrl":"10.1136/wjps-2026-001200","url":null,"abstract":"<p><p>Necrotizing enterocolitis is an overwhelming, catastrophic gastrointestinal disease largely affecting premature infants. The disease is manifested by exaggerated intestinal inflammation, which can progress to necrosis of the bowel and systemic sepsis. Prognosis is poor, with unacceptably high mortality. There is currently no known cure, with management focused on supportive measures, including bowel rest, gastric decompression, and antibiotic administration. Surgical intervention is required for cases unresponsive to medical management. In this review, we describe the determination of the need for surgical intervention, the surgical procedures commonly employed, and novel perioperative adjuncts being developed to improve outcomes.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 3","pages":"e001200"},"PeriodicalIF":2.1,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13239691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200094","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":"Family perspective: raising a child with NEC and the need for multidisciplinary care.","authors":"David Russell","doi":"10.1136/wjps-2026-001198","DOIUrl":"https://doi.org/10.1136/wjps-2026-001198","url":null,"abstract":"","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 3","pages":"e001198"},"PeriodicalIF":1.3,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151757","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":"Feasibility of neonatal intravenous nutrition for the management of gastroschisis in sub-Saharan Africa.","authors":"Naomi Wright, Piero Alberti, Aarinola Olaiya, Francis Abantanga, Alhassan Abdul-Mumin, Michael Amoah, William Appeadu-Mensah, Zaitun Bokhary, Bruce Bvulani, Mulenga Mulewa, Bip Nandi, Boateng Nimako, Godfrey Sama Philipo, Stephen Tabiri, Abiboye Yifieyeh, Kate Arnold, Anne Greenough, Nick Sevdalis, Andrew Leather, Sandhia Naik, Niyi Ade-Ajayi","doi":"10.1136/wjps-2025-001133","DOIUrl":"10.1136/wjps-2025-001133","url":null,"abstract":"<p><strong>Introduction: </strong>Parenteral nutrition (PN) is a life-saving intervention for neonates with gastroschisis. As most low and middle-income countries lack access to comprehensive neonatal PN, we evaluated the feasibility and safety of a pragmatic intravenous nutrition strategy for neonates with gastroschisis in sub-Saharan Africa.</p><p><strong>Methods: </strong>Local protocols for partial parenteral nutritional support and early enteral feeding were developed across the seven pediatric surgery centers participating in the Gastroschisis Interventional Study (<i>n</i>=192). Protocols aimed to provide up to 100 kcal/kg/day using 10% dextrose as maintenance fluid, with amino acid preparations and lipid emulsions added when locally available. Trophic breastmilk was commenced on admission, with enteral feeds advanced from the day following defect closure.</p><p><strong>Results: </strong>In the postintervention phase (<i>n</i>=127), all centers administered 10% dextrose as maintenance fluid. Six centers provided parenteral amino acid, and two centers additionally provided parenteral lipid. The proportion of neonates receiving parenteral nutritional support with 10% dextrose and amino acids increased from 18.5% to 66.1% between the pre- and postintervention phases. The median duration of parenteral nutritional support among survivors was 14 days (interquartile range (IQR): 9-22 days). Intravenous nutritional support was mainly administered by peripheral venous access, with no major clinical complications observed.</p><p><strong>Conclusions: </strong>Partial neonatal intravenous nutritional support using locally available products was feasible and safe across study centers. This approach represents a pragmatic interim strategy in settings where neonatal PN is unavailable. Expanding access to neonatal PN remains essential to achieving Sustainable Development Goal 3.2 to end preventable neonatal deaths by 2030.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 3","pages":"e001133"},"PeriodicalIF":2.1,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148043890","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":"Histopathological differences between antrochoanal polyps and chronic rhinosinusitis with nasal polyps in pediatric patients.","authors":"Yiyuan Han, Yang Liu, Bo Yu, Xiaoyan Lin, Jing Bi, Yong Fu","doi":"10.1136/wjps-2025-001119","DOIUrl":"10.1136/wjps-2025-001119","url":null,"abstract":"<p><strong>Background: </strong>In pediatric patients, nasal polyps primarily manifest as anthrochoanal polyps (ACP) or chronic rhinosinusitis with nasal polyps (CRSwNP). This study compares the histopathological differences between pediatric ACP and CRSwNP, analyzes pathological indicators associated with postoperative recurrence and provides evidence for subtype-specific diagnosis and treatment.</p><p><strong>Materials and methods: </strong>This retrospective study analyzed demographic factors, comorbidities and a structured histopathologic report of six variables from 172 pediatric patients (86 with ACP and 86 with CRSwNP) who underwent functional endoscopic sinus surgery. Differences between recurrent and non-recurrent presentations were further examined.</p><p><strong>Results: </strong>Mean age in the ACP group was significantly lower than the CRSwNP group (<i>p</i>=0.007). The CRSwNP group exhibited higher overall severity of inflammation (38.3% <i>v.s.</i> 18.6%, <i>p</i>=0.010). The ACP group showed greater subepithelial edema (65.1% <i>v.s.</i> 37.2%, <i>p</i><0.001). In the ACP group, the overall degree of inflammation correlated significantly with inflammatory type, and severity of subepithelial edema correlated with collagen deposition. In the CRSwNP group, overall severity of inflammation correlated with eosinophil count per high power field and inflammatory predominance. In the ACP group, the proportion of collagen deposition was significantly lower in recurrent cases (5.6% <i>v.s.</i> 44.1%, <i>p</i>=0.004). In the CRSwNP group, the overall degree of inflammation was significantly higher in recurrent cases (46.7% <i>v.s.</i> 36.6%, <i>p</i>=0.003).</p><p><strong>Conclusion: </strong>Pediatric ACP is characterized by prominent subepithelial edema. A lack of collagen deposition indicates a higher risk of recurrence. CRSwNP features severe inflammation, which positively correlates with recurrence.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 3","pages":"e001119"},"PeriodicalIF":2.1,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13185017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147983540","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":"Mid-term outcomes of valvuloplasty versus mechanical valve replacement for the common atrioventricular valve in single-ventricle pediatric patients.","authors":"Shicheng Zhang, Yixin Chen, Fan Yang, Keming Yang, Shoujun Li, Benqing Zhang","doi":"10.1136/wjps-2026-001165","DOIUrl":"10.1136/wjps-2026-001165","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the mid-term outcomes of mechanical valve replacement of the common atrioventricular valve (CAVV) in single-ventricle pediatric patients and compare this with valvuloplasty.</p><p><strong>Methods: </strong>We conducted a retrospective study of 91 single-ventricle pediatric patients who underwent CAVV surgery between 2014 and 2025. Patients were divided into two groups according to the initial surgery: valvuloplasty and mechanical valve replacement groups. Baseline and perioperative characteristics were compared between groups. Overall survival and freedom from reintervention were analyzed using Kaplan-Meier curves. Receiver operating characteristic (ROC) curve analysis and maximally selected rank statistics were used to determine the optimal cut-off values for cardiopulmonary bypass (CPB) and aortic cross-clamp (ACC) time in predicting in-hospital and late mortality.</p><p><strong>Results: </strong>There were 78 cases in valvuloplasty and 13 cases in the mechanical valve replacement group. The replacement group had significantly longer CPB and ACC time (<i>p</i><0.001). In-hospital mortality was 2 out of 13 (15.4%) in the replacement group and 8 out of 78 (10.3%) in the valvuloplasty group (<i>p</i>>0.050). The median follow-up was 39 months. Kaplan-Meier analysis showed no significant difference in overall survival (<i>p</i>=0.280) and freedom from reintervention (<i>p</i>=0.270). Reintervention for recurrent regurgitation was required in eight patients after ventriculoplasty, whereas no reintervention was observed following valve replacement. ROC analysis identified a CPB time of 173.5 min as the optimal cut-off for predicting in-hospital mortality,with an area under the curve (AUC) of 0.751. Patients with CPB duration exceeding 180 min had significantly poorer survival (<i>p</i>=0.003).</p><p><strong>Conclusions: </strong>Mechanical valve replacement of the CAVV in single-ventricle pediatric patients provides satisfactory mid-term survival comparable to valvuloplasty, but with superior valve durability. Prolonged CPB time is associated with poorer survival and should be minimized whenever possible.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 3","pages":"e001165"},"PeriodicalIF":2.1,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13182480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147975826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A diagnosis and treatment algorithm for adnexal masses in female children and adolescents.","authors":"Liying Sun, Jiayu Shen, Symphorosa S C Chan, Karen Ng, Ani Amelia Zainuddin, Zoran Stankovic, Yasmin Jayasinghe, Sonia Grover, Hafizur Rahman, Huihui Gao","doi":"10.1136/wjps-2025-001162","DOIUrl":"10.1136/wjps-2025-001162","url":null,"abstract":"","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 3","pages":"e001162"},"PeriodicalIF":2.1,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13141211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843542","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 anomalies of the kidney and urinary tract in children treated at a tertiary hospital in Northern Tanzania: assessment of coexisting congenital  anomalies.","authors":"Magdalena Benitho Mahenge, Zerra Israel Cheyo, Jasper Said Mbwambo, Frank B Bright, Orgeness Jasper Mbwambo","doi":"10.1136/wjps-2025-001108","DOIUrl":"10.1136/wjps-2025-001108","url":null,"abstract":"<p><strong>Background: </strong>A high burden of complications, including death, among children with congenital anomalies of the kidney and urinary tract (CAKUT) has been reported in African settings. We aimed to determine the pattern, age at diagnosis, and presence of coexisting anomalies in CAKUT in children at a tertiary referral hospital in northern Tanzania.</p><p><strong>Methods: </strong>A hospital-based retrospective study was conducted that retrieved data for children aged below 18 years who attended the urology clinic between January 2018 and December 2024. Variables from their clinical history, laboratory, and imaging investigations, including voiding cystourethrogram, transabdominal ultrasound, and CT, were extracted.</p><p><strong>Results: </strong>Of the 2214 children reviewed, 493 (22%) were diagnosed with CAKUT. The median age at presentation was 3 years (IQR 1-6). Of these, 60% had anomalies of the urethra, especially hypospadias and posterior urethral valves. This was followed by anomalies of the kidney (in 26% of 493), in which either a single kidney or ectopic kidneys were frequently diagnosed. The majority of children diagnosed with CAKUT had coexisting anomalies (67%). Most coexisting anomalies were genital malformations (24%).</p><p><strong>Conclusion: </strong>A high proportion of CAKUT is seen among children referred to the urology clinic of a tertiary referral hospital in northern Tanzania. The majority of children with CAKUT present late. Most are diagnosed with anomalies of the urethra and kidneys. Common coexisting anomalies are of the genitalia.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 3","pages":"e001108"},"PeriodicalIF":2.1,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783129","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":"Global expert profiles, research hotspots, and journal networks in pediatric surgery: an AI-assisted bibliometric analysis.","authors":"Rongqi Zhang, Xumeng Liu, Qi Qi, Yicheng Xie, Xinglong Wu, Qiang Shu","doi":"10.1136/wjps-2025-001160","DOIUrl":"10.1136/wjps-2025-001160","url":null,"abstract":"","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 2","pages":"e001160"},"PeriodicalIF":2.1,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13052750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634467","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":"Targeted immune response gene expression profiles linked with necrosis and mortality in preterm infants with surgical necrotizing enterocolitis.","authors":"Parvesh Mohan Garg, Robin Riddick, Pengbo Zhang, Jeffrey Shenberger, Neha Varshney, David Sawaya, Padma Garg","doi":"10.1136/wjps-2026-001172","DOIUrl":"10.1136/wjps-2026-001172","url":null,"abstract":"<p><strong>Background: </strong>We sought to determine changes in the expression of immune response-related genes occurring in surgical necrotizing enterocolitis (NEC) tissues from infants with necrosis severity and survival status.</p><p><strong>Methods: </strong>Targeted RNA sequencing of a select panel of 395 immune response genes was performed on RNA isolated from formalin-fixed, paraffin-embedded intestinal tissue samples (<i>n</i>=36). DESeq2 was used to analyze differential expressions between infants with mild to moderate and severe necrosis and with respect to survival status after correcting for RNA integrity.</p><p><strong>Results: </strong>Thirty-five genes were differentially expressed (FDR-adjusted <i>p</i><0.1) between mild-moderate necrosis and severe necrosis. Principal component analysis identified alternations in genes involved in host defense, natural killer (NK) cell signaling and development, and apoptosis which were overexpressed in severe necrosis (<i>IGJ</i>, <i>GZMA</i>, <i>TNFSF10</i>, <i>KLRB1</i>, and <i>CD160</i>). Expression of leukocyte antigens (<i>ITGAM</i>, <i>ITGAX</i>) and cytokine and chemokine receptors (such as <i>IL1A</i>, <i>IL1B</i>, <i>CCL2</i>, <i>CCL3</i>) was increased in patients with mild necrosis. Six genes were significantly differentially expressed (FDR-adjusted <i>p</i><0.1) between survivors and the non-survivors. Genes related to chemokine neutrophil attractants (<i>CXCL1</i>, <i>GBP</i>, <i>PTGS2</i>, <i>CXCL11</i>, <i>CXCL9</i>, and <i>CXCL10</i>) were upregulated in non-survivors.</p><p><strong>Conclusion: </strong>Severe necrosis and non-survival in NEC infants were associated with differential gene expression related to host defense, NK cell signaling and development, and apoptosis. Understanding the role of these pathways in severe NEC may guide the development of prognostic and treatment pathways.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 2","pages":"e001172"},"PeriodicalIF":2.1,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13034352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595213","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":"Preface to topic collection: biliary atresia.","authors":"Mark Davenport","doi":"10.1136/wjps-2025-001159","DOIUrl":"10.1136/wjps-2025-001159","url":null,"abstract":"","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 2","pages":"e001159"},"PeriodicalIF":2.1,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13034195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595229","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}