World Journal of Pediatric Surgery最新文献

{"title":"Exploring causality with biliary atresia at different levels: two-sample Mendelian randomization study.","authors":"Shaowen Liu, Jiayinaxi Musha, Zhiru Wang, Xueting Wang, Tengfei Li, Jianghua Zhan","doi":"10.1136/wjps-2023-000754","DOIUrl":"10.1136/wjps-2023-000754","url":null,"abstract":"<p><strong>Background: </strong>In recent years, Mendelian randomization (MR) has been widely used to infer causality of related disease risk exposures. However, this strategy has not been applied to biliary atresia (BA).</p><p><strong>Methods: </strong>Genome-wide association studies (GWAS) data of 41 inflammatory cytokines, 731 immune cell traits, and 1400 metabolites were obtained from public databases as exposure factors. The outcome information was obtained from a GWAS meta-analysis of 499 children with BA and 1928 normal controls. Inverse variance weighting was the primary causality analysis. Cochran Q-test, MR-Egger intercept, MR pleiotropy residual sum and outlier, and 'leave-one-out' analyses were used for sensitivity analysis. Reverse MR, MR-Steiger, and Linkage Disequilibrium Score were used to exclude the effects of reverse causality, genetic association, and linkage disequilibrium.</p><p><strong>Results: </strong>MR results showed that a total of seven traits had potential causal relationships with BA, including three inflammatory cytokines: eotaxin (odds ratio (OR)=1.45, 95% confidence interval (CI): 1.08 to 1.95, <i>p</i> _<i>FDR</i>=0.18), G-CSF (OR=4.21, 95% CI: 1.75 to 10.13, <i>p</i> _<i>FDR</i>=0.05) and MCP-1/MCAF (OR=1.53, 95% CI: 1.12 to 2.10, <i>p</i> _<i>FDR</i>=0.14); three immune cell traits: CD8dim NKT/T cells ratio (OR=0.59, 95% CI: 0.45 to 0.77, <i>p</i> _<i>FDR</i>=0.06), CD8dim NKT counts (OR=0.58, 95% CI: 0.43 to 0.78, <i>p</i> _<i>FDR</i>=0.06), CD8dim NKT/lymphocyte ratio (OR=0.63, 95% CI: 0.49 to 0.81, <i>p</i> _<i>FDR</i>=0.06); one metabolite: X-12261 levels (OR=2.86, 95% CI: 1.73 to 4.74, <i>p</i> _<i>FDR</i>=0.06).</p><p><strong>Conclusions: </strong>In this study, eotaxin, G-CSF, MCP-1/MCAF, and X-12261 levels were shown to be risk factors for BA. However, CD8dim NKT/T cells ratio, CD8dim NKT counts, and CD8dim NKT/lymphocyte ratio were protective factors for BA. These findings provided a promising genetic basis for the etiology, diagnosis, and treatment of BA.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"7 2","pages":"e000754"},"PeriodicalIF":0.8,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11086552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140910793","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":"Hemodynamic management of congenital diaphragmatic hernia: the role of targeted neonatal echocardiography.","authors":"Aimann Surak, Linda Mahgoub, Joseph Y Ting","doi":"10.1136/wjps-2024-000790","DOIUrl":"10.1136/wjps-2024-000790","url":null,"abstract":"<p><p>Congenital diaphragmatic hernia (CDH) is a major congenital anomaly, resulting from the herniation of abdominal contents into the thoracic cavity, thereby impeding the proper development of the lungs and pulmonary vasculature. CDH severity correlates with a spectrum of pulmonary hypoplasia, pulmonary hypertension (PHT), and cardiac dysfunction, constituting the pathophysiological triad of this complex condition. The accurate diagnosis and effective management of PHT and cardiac dysfunction is pivotal to optimizing patient outcomes. Targeted neonatal echocardiography is instrumental in delivering real-time data crucial for the bespoke, pathophysiology-targeted hemodynamic management of CDH-associated PHT.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"7 2","pages":"e000790"},"PeriodicalIF":0.8,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11086387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140910874","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":"Perforation of Meckel's diverticulum in two neonates with single umbilical artery.","authors":"Lifeng Zhang, Shannan Wu, Xuefeng Miao, Yonglin Li, Xiaojian Yuan, Zhigang Gao","doi":"10.1136/wjps-2024-000770","DOIUrl":"10.1136/wjps-2024-000770","url":null,"abstract":"","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"7 2","pages":"e000770"},"PeriodicalIF":0.8,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11086476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140910965","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 role of extracorporeal life support and timing of repair in infants with congenital diaphragmatic hernia","authors":"Daniel B Gehle, Logan C Meyer, Tim Jancelewicz","doi":"10.1136/wjps-2023-000752","DOIUrl":"https://doi.org/10.1136/wjps-2023-000752","url":null,"abstract":"Extracorporeal life support (ECLS) serves as a rescue therapy for patients with congenital diaphragmatic hernia (CDH) and severe cardiopulmonary failure, and only half of these patients survive to discharge. This costly intervention has a significant complication risk and is reserved for patients with the most severe disease physiology refractory to maximal cardiopulmonary support. Some contraindications to ECLS do exist such as coagulopathy, lethal chromosomal or congenital anomaly, very preterm birth, or very low birth weight, but many of these limits are being evaluated through further research. Consensus guidelines from the past decade vary in recommendations for ECLS use in patients with CDH but this therapy appears to have a survival benefit in the most severe subset of patients. Improved outcomes have been observed for patients treated at high-volume centers. This review details the evolving literature surrounding management paradigms for timing of CDH repair for patients receiving preoperative ECLS. Most recent data support early repair following cannulation to avoid non-repair which is uniformly fatal in this population. Longer ECLS runs are associated with decreased survival, and patient physiology should guide ECLS weaning and eventual decannulation rather than limiting patients to arbitrary run lengths. Standardization of care across centers is a major focus to limit unnecessary costs and improve short-term and long-term outcomes for these complex patients. No data are available.","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"19 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140617635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Childhood opportunity and appropriate use of child safety restraints in motor vehicle collisions","authors":"Stephanie Y Chen, Iris Garcia, Shadassa Ourshalimian, Chantel Lowery, Pradip P Chaudhari, Ryan G Spurrier","doi":"10.1136/wjps-2023-000703","DOIUrl":"https://doi.org/10.1136/wjps-2023-000703","url":null,"abstract":"Objectives Safety restraints reduce injuries from motor vehicle collisions (MVCs) but are often improperly applied or not used. The Childhood Opportunity Index (COI) reflects social determinants of health and its study in pediatric trauma is limited. We hypothesized that MVC patients from low-opportunity neighborhoods are less likely to be appropriately restrained. Methods A retrospective cross-sectional study was performed on children/adolescents ≤18 years old in MVCs between January 1, 2011 and December 31, 2021. Patients were identified from the Children’s Hospital Los Angeles trauma registry. The outcome was safety restraint use (appropriately restrained, not appropriately restrained). COI levels by home zip codes were stratified as very low, low, moderate, high, and very high. Multivariable regression controlling for age identified factors associated with safety restraint use. Results Of 337 patients, 73.9% were appropriately restrained and 26.1% were not appropriately restrained. Compared with appropriately restrained patients, more not appropriately restrained patients were from low-COI (26.1% vs 20.9%), high-COI (14.8% vs 10.8%) and very high-COI (10.2% vs 3.6%) neighborhoods. Multivariable analysis demonstrated no significant associations in appropriate restraint use and COI. There was a non-significant trend that children/adolescents from moderate-COI neighborhoods were more likely than those from very low-COI neighborhoods to be appropriately restrained (OR=1.82, 95% CI 0.78, 4.28). Conclusion Injury prevention initiatives focused on safety restraints should target families of children from all neighborhood types. Level of evidence III. Data are available upon reasonable request.","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"41 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140560062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term follow-up of patients with congenital diaphragmatic hernia","authors":"Nicole Cimbak, Terry L Buchmiller","doi":"10.1136/wjps-2023-000758","DOIUrl":"https://doi.org/10.1136/wjps-2023-000758","url":null,"abstract":"Neonates with congenital diaphragmatic hernia encounter a number of surgical and medical morbidities that persist into adulthood. As mortality improves for this population, these survivors warrant specialized follow-up for their unique disease-specific morbidities. Multidisciplinary congenital diaphragmatic hernia clinics are best positioned to address these complex long-term morbidities, provide long-term research outcomes, and help inform standardization of best practices in this cohort of patients. This review outlines long-term morbidities experienced by congenital diaphragmatic hernia survivors that can be addressed in a comprehensive follow-up clinic. No data are available.","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"209 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140560274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of practice standardization in outcome optimization for CDH","authors":"Alexandra Dimmer, Robert Baird, Pramod Puligandla","doi":"10.1136/wjps-2024-000783","DOIUrl":"https://doi.org/10.1136/wjps-2024-000783","url":null,"abstract":"Standardization of care seeks to improve patient outcomes and healthcare delivery by reducing unwanted variations in care as well as promoting the efficient and effective use of healthcare resources. There are many types of standardization, with clinical practice guidelines (CPGs), based on a stringent assessment of evidence and expert consensus, being the hallmark of high-quality care. This article outlines the history of CPGs, their benefits and shortcomings, with a specific focus on standardization efforts as it relates to congenital diaphragmatic hernia management.","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"86 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140198954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thank you to our reviewers","authors":"BMJ Publishing Group Ltd","doi":"10.1136/wjps-2024-reviewers","DOIUrl":"https://doi.org/10.1136/wjps-2024-reviewers","url":null,"abstract":"The editors would like to publicly acknowledge the people listed below who served as reviewers on the journal during 2023.Without their efforts,the quality of the journal could not be sustained. Allison Aguado Gehad Ahmed Zeynep Alp Unkar Belen Aneiros Castro Kyle J Van Arendonk Einar Arnbjornsson Jugpal S.Arneja Yatin Arora Robert Baird Adam Bajinting Quentin Ballouhey Garrett Barfoot Sylvie Beaudoin Asaad G.Beshish George Bethell Arnaud Bonnard Fabio Botelho Terry L.Buchmiller Danilo Buonsenso Vito Andrea Capozzi Neil K.Chadha V.V.S.Chandrasekharam Aswin Chari Anthony Chin Chan Chui Kenneth L.Y.Chung Patrick Ho Yu Chung Jennifer N Cooper Philip Crispin Alessandro Crocoli Kanishka Das Sumit Dave …","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"11 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140072939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics of postoperative necrotizing enterocolitis in patients with congenital jejunoileal atresia and its risk factors","authors":"Xiaofeng Xiong, Wei Lu, Fuzhong Xing, Yuan Cai, Jixin Yang, Yuhang Yuan, Jiexiong Feng, Xuyong Chen","doi":"10.1136/wjps-2023-000622","DOIUrl":"https://doi.org/10.1136/wjps-2023-000622","url":null,"abstract":"Objective To review postoperative necrotizing enterocolitis (NEC) in patients with jejunoileal atresia (JIA) and to explore the potential risk factors related to the concurrence of NEC. Methods Patients diagnosed with JIA who received surgical treatment from January 2016 to June 2021 were enrolled. Demographics, viral infection of the fetus, transfusion within 48 hours before NEC, sepsis before JIA repair, pathological and anatomical classification of JIA, combined malformation, occurrence time of NEC after the operation, treatment, and prognosis of patients were analyzed. Patients were divided into NEC group and non-NEC group, and all patients were followed up for 3–6 months to observe for complications. Results A total of 180 patients with JIA were included, of whom 12 were diagnosed with NEC after surgery and 1 patient with NEC died during follow-up. The average age, birth weight, gestational age, proportion of premature infants, proportion of preoperative infections, and pathological classification of JIA did not significantly differ between the two groups. The probability of patients with proximal jejunal atresia (PJA) in the NEC group (58.3%) was higher than that in the non-NEC group (22.6%) ( p =0.011), and patients with PJA had longer parenteral nutrition time than patients without PJA (26.64±9.21 days vs 15.11±6.58 days, p <0.001). Conclusion PJA was more likely to be associated with concurrent NEC after surgery, which is a highly NEC-related risk factor inherent in JIA. All data relevant to the study are included in the article or uploaded as supplementary information.","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"96 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140168259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-urethroplasty complications in hypospadias repair: a systematic review and meta-analysis comparing polydioxanone and polyglactin sutures","authors":"Nitinkumar Borkar, Charu Tiwari, Debajyoti Mohanty, Tridip Dutta Baruah, Manoj Mohanty, C K Sinha","doi":"10.1136/wjps-2023-000659","DOIUrl":"https://doi.org/10.1136/wjps-2023-000659","url":null,"abstract":"Background Polyglactin (PG) and polydioxanone (PDS) sutures are extensively used based on the surgeon’s preference. The development of post-reconstruction urethrocutaneous fistula (UCF) is variably attributed to the choice of suture material for urethroplasty. This meta-analysis compares complications of hypospadias repair using PG and PDS sutures. Methods The systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The authors conducted thorough searches in databases including MEDLINE, EMBASE, CENTRAL, Scopus, Google Scholar, and clinical trial registries. Outcome measures included UCF, meatal stenosis, wound infection, urethral stricture, glans dehiscence, and overall complications. Quantitative analysis was used with fixed or random-effect models to find the pooled risk ratio and I2 heterogeneity. Results The criteria for inclusion were met by five comparative studies with the inclusion of 1244 children altogether. Pooled analysis failed to show a statistically significant difference in the incidence of meatal stenosis, urethral stricture, wound infection, and total complications using PG and PDS sutures. However, it showed a reduction in the incidence of UCF with PDS suture hypospadias repairs (risk ratio=0.66, 95% CI 0.48 to 0.92). Conclusions PDS sutures are associated with decreased incidence of UCF than PG after hypospadias repair. The incidence of meatal stenosis, urethral stricture, wound infection, and total complications was not affected by the type of suture material used for repair. Clinical implications This meta-analysis suggests decreased incidence of UCF when PDS sutures are used for hypospadias repair which may impact the choice of suture material for repair. PROSPERO registration number CRD42023409710. All data relevant to the study are included in the article or uploaded as supplemental information.","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"19 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140017198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}