World Journal of Pediatric Surgery最新文献

{"title":"Follow-up of jaundice-free biliary atresia survivors using M2BPGi and APRI in a local hospital.","authors":"Takeshi Shirai, Sotaro Okuya","doi":"10.1136/wjps-2025-001156","DOIUrl":"10.1136/wjps-2025-001156","url":null,"abstract":"<p><p>In local hospitals with resource-limited regions lacking access to liver transplantation (LT) centers, it is important to detect early warning signs of liver damage and portal hypertension in jaundice-free biliary atresia (BA) survivors with native livers. Twenty-three blood samples and scorings from six BA survivors (Child-Pugh score 5 points) were evaluated using serum Mac-2 binding protein glycosylation isomer (M2BPGi) and aspartate aminotransferase to platelet ratio index (APRI) at a local hospital. The levels of M2BPGi and APRI were positively correlated (<i>r</i>=0.93, <i>p</i><0.001), and these also correlated with liver biochemistry. In cases with signs of portal hypertension, such as varices and a dilatation of vein associated with portal vein, the levels of M2BPGi and APRI were significantly higher than in cases without these signs (<i>p</i><0.001). High levels of M2BPGi and APRI suggest progressive liver damage and portal hypertension. In local hospitals with limited medical resources, evaluation using M2BPGi and APRI may be useful for the follow-up of jaundice-free BA survivors.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 2","pages":"e001156"},"PeriodicalIF":2.1,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12993318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147481884","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 strategy to identify biliary atresia efficiently: A perspective from a Texas center.","authors":"Sanjiv Harpavat, Tebyan A Rabbani, Ashley M Upton, Sridevi Devaraj, Jose A Hernandez, Benjamin L Shneider","doi":"10.1136/wjps-2025-001142","DOIUrl":"10.1136/wjps-2025-001142","url":null,"abstract":"<p><p>Infants with biliary atresia are often diagnosed after 60 days of life because the disease is difficult to detect in its early stages. However, infants treated before 30-45 days of life have the best long-term outcomes. To help accelerate the biliary atresia diagnosis, we have developed a streamlined strategy that involves two sequential tests: (1) direct or conjugated bilirubin measurements and (2) a feeding abdominal ultrasound exam. In this review, the strategy is shared to encourage others to provide feedback as well as to consider incorporating portions into their own clinical workflows.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 2","pages":"e001142"},"PeriodicalIF":2.1,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12993355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147481907","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":"Anesthesia for thoracic surgery in infants with congenital lung malformations.","authors":"Ruofan Wang, Yi He, Yuyi Zhao, Yunxia Zuo, Bin Du, Miao Yuan, Zhen Luo","doi":"10.1136/wjps-2025-001091","DOIUrl":"10.1136/wjps-2025-001091","url":null,"abstract":"<p><p>Congenital lung malformations (CLMs) are disorders arising from defective embryonic development of the airways, lung parenchyma, and pulmonary vasculature, often presenting as heterogeneous lesions like congenital pulmonary airway malformation (CPAM), pulmonary sequestration (PS), and congenital lobar overinflation (CLO). CLMs in infants present unique anesthetic challenges -particularly the risk of progressive distention in cystic areas and the anatomical difficulty of achieving stable lung isolation- but institutional rarity limits clinical experience and consensus-driven practices. This review examines recent clinical anesthesia practices for infants with CLMs undergoing thoracic surgery, offering comprehensive guidance on perioperative anesthesia management, with an emphasis on ventilation management. Crucially, we evaluate the selection and precise positioning of lung isolation devices, such as left endobronchial intubation and bronchial blockers. Furthermore, it provides a structured management strategy for intraoperative hypoxemia and outlines lung-protective ventilation frameworks-incorporating low tidal volumes and personalized PEEP-to consolidate contemporary evidence and optimize the perioperative anesthetic approach for this vulnerable population.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 2","pages":"e001091"},"PeriodicalIF":2.1,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12993364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147481946","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":"Pretransplant mortality in children awaiting living donor liver transplantation: a prospective center-based study.","authors":"Tri Hening Rahayatri, Ni Made Sarastri Widyani, Hanifah Oswari","doi":"10.1136/wjps-2025-001138","DOIUrl":"10.1136/wjps-2025-001138","url":null,"abstract":"<p><strong>Background: </strong>High mortality in children awaiting liver transplantation is a significant concern. At Cipto Mangunkusumo Hospital, the only active and established pediatric living-donor liver transplantation (LDLT) center in Indonesia, similar challenges persist. This study aims to determine the mortality rate, time to death or transplantation and causes of death in children listed for LDLT at our center.</p><p><strong>Methods: </strong>This prospective single-center cohort study was conducted from January 2023 to December 2024. Consecutive sampling included all eligible children age 0-18 listed for LDLT. Participants were monitored from listing until pretransplant death, transplantation, loss to follow-up or study completion. The primary outcome was all-cause mortality on the LDLT waiting list.</p><p><strong>Results: </strong>Sixty-two children were enrolled; 64.51% (<i>n</i>=40) were female with biliary atresia accounting for 72.58% of diagnoses. Malnutrition was identified in 70.97% (<i>n</i>=44) and 35.48% (<i>n</i>=22) had a history of cytomegalovirus (CMV) infection. Median duration from listing to death was 87.5 days. Median time to transplantation was 263.5 days. During follow-up, 22 children died with sepsis as the leading cause, 22 underwent LDLT, 13 were lost to follow-up and 5 remained on the waiting list. Donor scarcity contributed substantially to prolonged listing and loss to follow-up.</p><p><strong>Conclusions: </strong>Children listed for liver transplantation experience a high waiting list mortality at our center. This is primarily due to infection, malnutrition and socioeconomic factors. Sepsis persists as the principal cause of death. LDLT remains the only feasible option for children requiring liver transplantation in Indonesia.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 2","pages":"e001138"},"PeriodicalIF":2.1,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12983830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147464005","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 mortality and short-term outcomes after emergency pediatric abdominal surgery in South-Western Uganda.","authors":"James Alfred Okello, Felix Oyania, Carlos Cabrera Dreque, David Mutiibwa, David Komakech","doi":"10.1136/wjps-2025-001112","DOIUrl":"10.1136/wjps-2025-001112","url":null,"abstract":"<p><strong>Background: </strong>Emergency abdominal surgeries (EASs) in children are often necessary to address life-threatening congenital and acquired conditions. This study aimed to determine short-term outcomes and predictors of in-hospital mortality after EAS in children at Mbarara Regional Referral Hospital (MRRH), South-Western Uganda.</p><p><strong>Methods: </strong>This prospective study was conducted from June to September 2024 and included children aged 0-17 years who underwent EAS at MRRH. Outcomes measured were 30-day in-hospital mortality, complications, and length of hospital stay. Overall survival after EAS was plotted using Kaplan-Meier curves. Cox regression analysis was used to determine predictors of in-hospital mortality after EAS.</p><p><strong>Results: </strong>The 30-day mortality rate for all pediatric abdominal surgery was 152 per 10 000 person-days of hospitalization. Among 96children who required EAS at MRRH, the risk of death was significantly increased in those who had hypoxemia (adjusted hazard ratio (aHR) 12.4, <i>p</i>=0.011) and hypokalemia (aHR 5.02, <i>p</i>=0.044). Forty-one patients (42.7%) developed postoperative complications, the most common being surgical site infection (14.58%) and pneumonia (5.2%).</p><p><strong>Conclusion: </strong>The 30-day mortality rate after pediatric EAS in our setting is high and children who present with hypokalemia and hypoxemia are at increased risk of mortality after EAS.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 2","pages":"e001112"},"PeriodicalIF":2.1,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12970129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436138","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":"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":"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":2.1,"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":"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":2.1,"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}