World Journal of Pediatric Surgery最新文献

{"title":"Radiomic-based machine learning model for predicting the surgical risk in children with abdominal neuroblastoma.","authors":"Xuan Jia,&nbsp;Jiawei Liang,&nbsp;Xiaohui Ma,&nbsp;Wenqi Wang,&nbsp;Can Lai","doi":"10.1136/wjps-2022-000531","DOIUrl":"https://doi.org/10.1136/wjps-2022-000531","url":null,"abstract":"<p><strong>Background: </strong>Preoperative imaging assessment of surgical risk is very important for the prognosis of these children. To develop and validate a radiomics-based machine learning model based on the analysis of radiomics features to predict surgical risk in children with abdominal neuroblastoma (NB).</p><p><strong>Methods: </strong>A retrospective study was conducted from April 2019 to March 2021 among 74 children with abdominal NB. A total of 1874 radiomic features in MR images were extracted from each patient. Support vector machines (SVMs) were used to establish the model. Eighty percent of the data were used as the training set to optimize the model, and 20% of the data were used to validate its accuracy, sensitivity, specificity and area under the curve (AUC) to verify its effectiveness.</p><p><strong>Results: </strong>Among the 74 children with abdominal NB, 55 (65%) had surgical risk and 19 (35%) had no surgical risk. A t test and Lasso identified that 28 radiomic features were associated with surgical risk. After developing an SVM-based model using these features, predictions were made about whether children with abdominal NB had surgical risk. The model achieved an AUC of 0.94 (a sensitivity of 0.83 and a specificity of 0.80) with 0.890 accuracy in the training set and an AUC of 0.81 (a sensitivity of 0.73 and a specificity of 0.82) with 0.838 accuracy in the test set.</p><p><strong>Conclusions: </strong>Radiomics and machine learning can be used to predict the surgical risk in children with abdominal NB. The model based on 28 radiomic features established by SVM showed good diagnostic efficiency.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"6 3","pages":"e000531"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8c/3f/wjps-2022-000531.PMC10201264.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9871959","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":"Cases of pediatric intra-abdominal solid organ injury induced by blunt trauma experienced over a 15-year period at two centers in Japan.","authors":"Mayu Matsui,&nbsp;Koshiro Sugita,&nbsp;Takafumi Kawano,&nbsp;Nanako Nishida,&nbsp;Ayaka Nagano,&nbsp;Masakazu Murakami,&nbsp;Keisuke Yano,&nbsp;Toshio Harumatsu,&nbsp;Shun Onishi,&nbsp;Koji Yamada,&nbsp;Waka Yamada,&nbsp;Mitsuru Muto,&nbsp;Tatsuru Kaji,&nbsp;Satoshi Ieiri","doi":"10.1136/wjps-2023-000560","DOIUrl":"https://doi.org/10.1136/wjps-2023-000560","url":null,"abstract":"<p><strong>Objective: </strong>The present study attempts to clarify the clinical features of pediatric intra-abdominal solid organ injury at two institutions.</p><p><strong>Methods: </strong>The injured organ, patient age, sex, injury grade, imaging findings, intervention, length of hospital stay, and complications were retrospectively reviewed using medical records at two centers from 2007 to 2021.</p><p><strong>Results: </strong>There were 25 cases of liver injury, 9 of splenic injury, 8 of pancreatic injury, and 5 of renal injury. The mean age of all patients was 8.6±3.8 years old, with no difference between organ injury types. Radiological intervention was performed in four cases of liver injury (16.0%) and one case of splenic injury (11.1%), and surgery was performed in two cases of liver injury (8.0%) and three cases of pancreatic injury (37.5%). All other cases were treated conservatively. Complications included adhesive ileus in one case of liver injury (4.0%), splenic atrophy in one case of splenic injury (11.1%), pseudocysts in three cases of pancreatic injury (37.5%), atrophy of the pancreatic parenchyma in one case of pancreatic injury (12.5%), and urinoma in one case of renal injury (20.0%). No mortalities were observed.</p><p><strong>Conclusion: </strong>Pediatric patients with blunt trauma had favorable outcomes at two pediatric trauma centers covering a broad medical area, including remote islands.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"6 3","pages":"e000560"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1d/7e/wjps-2023-000560.PMC10277529.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9710493","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":"Epigastric hernias in children and the use of ultrasound in its diagnosis.","authors":"Tatjana T König,&nbsp;Laura S Oerters,&nbsp;Ljuba Spiller,&nbsp;Martin Schwind,&nbsp;Mark Born,&nbsp;Christina Oetzmann von Sochaczewski,&nbsp;Andreas C Heydweiller","doi":"10.1136/wjps-2022-000544","DOIUrl":"https://doi.org/10.1136/wjps-2022-000544","url":null,"abstract":"<p><strong>Introduction: </strong>There is a paucity of clinical data on pediatric epigastric hernias despite them accounting for up to 6% of all hernia repairs in children. We aimed to provide additional data to supplement those 117 cases of a recent systematic review and to further clarify the role of ultrasound in diagnosing pediatric epigastric hernia.</p><p><strong>Methods: </strong>We retrospectively included all 60 patients treated for epigastric hernias in children in two tertiary pediatric surgical departments within 12 years. Associations were tested via point-biserial correlation analyses.</p><p><strong>Results: </strong>Epigastric hernias primarily affected preschool children with a median age of 39 months. The vast majority of patients (88%) presented with swelling that was occasionally (30%) accompanied by pain. Fascial defects could be found during clinical examination in 45% of patients with a median size of 5 mm (95% CI 3 to 10). Smaller defects were less likely to be palpable (r=-0.44, 95% CI -0.08 to -0.7, p=0.021). Likewise, ultrasound was used more frequently with smaller fascial defect sizes (r=-0.51, 95% CI -0.16 to -0.74, p=0.007). Laparoscopic repair was used in 11 patients (19%) and more often (4/11) in combination with another simultaneous procedure than open repair (11/48).</p><p><strong>Conclusions: </strong>Epigastric hernias are primarily a condition of the preschool child. Ultrasound can be beneficial if the diagnosis cannot be made clinically; otherwise, it is abdicable if it does not change the management of the patient's epigastric hernia. Laparoscopic repairs might be beneficial for children with multiple defects or simultaneous procedures.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"6 2","pages":"e000544"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9b/61/wjps-2022-000544.PMC10083873.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9304961","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":"Association between high deductible health plan coverage and age at pediatric umbilical hernia repair.","authors":"Morgan E Doty,&nbsp;Lindsay A Gil,&nbsp;Jennifer N Cooper","doi":"10.1136/wjps-2022-000526","DOIUrl":"https://doi.org/10.1136/wjps-2022-000526","url":null,"abstract":"<p><strong>Background: </strong>High deductible health plans (HDHPs) are associated with the avoidance of both necessary and unnecessary healthcare. Umbilical hernia repair (UHR) is a procedure that is frequently unnecessarily performed in young children, contrary to best practice guidelines. We hypothesized that children with HDHPs, as compared with other types of commercial health plans, are less likely to undergo UHR before 4 years of age but are also more likely to have UHR delayed beyond 5 years of age.</p><p><strong>Methods: </strong>Children aged 0-18 years old residing in metropolitan statistical areas (MSAs) who underwent UHR in 2012-2019 were identified in the IBM Marketscan Commercial Claims and Encounters Database. A quasi-experimental study design using MSA/year-level HDHP prevalence among children as an instrumental variable was employed to account for selection bias in HDHP enrollment. Two-stage least squares regression modeling was used to evaluate the association between HDHP coverage and age at UHR.</p><p><strong>Results: </strong>A total of 8601 children were included (median age 5 years, IQR 3-7). Univariable analysis revealed no differences between the HDHP and non-HDHP groups in the likelihood of UHR being performed before 4 years of age (27.7% vs 28.7%, p=0.37) or after 5 years of age (39.8% vs 38.9%, p=0.52). Geographical region, metropolitan area size, and year were associated with HDHP enrollment. Instrumental variable analysis demonstrated no association between HDHP coverage and undergoing UHR at <4 years of age (p=0.76) or >5 years of age (p=0.87).</p><p><strong>Conclusions: </strong>HDHP coverage is not associated with age at pediatric UHR. Future studies should investigate other means by which UHRs in young children can be avoided.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"6 2","pages":"e000526"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/33/82/wjps-2022-000526.PMC10030914.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9561093","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":"Umbilical cord sparing technique of umbilicoplasty in infants with giant omphalocele.","authors":"Peng Wang,&nbsp;Jinfa Tou","doi":"10.1136/wjps-2023-000574","DOIUrl":"https://doi.org/10.1136/wjps-2023-000574","url":null,"abstract":"","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"6 3","pages":"e000574"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10335491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9817452","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":"Digestive perianastomotic ulcerations after intestinal resection in children.","authors":"Weicheng Zhang,&nbsp;Jinfa Tou","doi":"10.1136/wjps-2022-000533","DOIUrl":"https://doi.org/10.1136/wjps-2022-000533","url":null,"abstract":"<p><p>Digestive perianastomotic ulceration (DPAU) is a rare complication after intestinal resection and anastomosis occurring at or near the anastomosis site. The purpose of this review is to summarize the characteristics of DPAU, including the etiology, diagnosis and differential diagnosis, clinical manifestations, treatment, and future research. All recent literature on DPAU was searched in PubMed, Embase, and Cochrane and then reviewed. The clinical manifestations of DPAU are mainly gastrointestinal symptoms such as bloody stool and chronic anemia. The diagnosis of DPAU is difficult. Specific diseases, such as Crohn's disease, must be ruled out before a diagnosis can be made. In addition, there are no clear treatment guidelines due to the high degree of heterogeneity in response to drugs and surgery. It is recommended to adjust medication in time and combine various treatment methods. In addition, the mechanism that causes DPAU is not well understood; however, several possible mechanisms have been proposed, such as scar tissue ischemia and underlying diseases. Moreover, there is a high risk of relapses, and a long-term follow-up is necessary. Numerous issues remain to be solved in this area; therefore, more randomized controlled trials and studies should be carried out to further understand this disease.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"6 3","pages":"e000533"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9d/f6/wjps-2022-000533.PMC10410847.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10033144","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":"Comparison of pediatric ventriculo-peritoneal shunt infections arising in antibiotic-impregnated and standard catheters: a multicenter observational study.","authors":"Joan Robinson,&nbsp;Archana Balamohan,&nbsp;Michelle Barton,&nbsp;Marie-Astrid Lefebvre,&nbsp;Ahmed Almadani,&nbsp;Dolores Freire,&nbsp;Alastair McAlpine,&nbsp;Jocelyn Srigley,&nbsp;Patrick Passarelli,&nbsp;John Bradley,&nbsp;Dele Davies,&nbsp;Gwenn Skar,&nbsp;Isabelle Viel-Theriault,&nbsp;Sarah Khan,&nbsp;Rupeena Purewal,&nbsp;Nicole LeSaux,&nbsp;Jennifer Bowes,&nbsp;Michael Hawkes","doi":"10.1136/wjps-2023-000566","DOIUrl":"https://doi.org/10.1136/wjps-2023-000566","url":null,"abstract":"Antibiotic-impregnated ventricular shunt catheters","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"6 3","pages":"e000566"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/50/60/wjps-2023-000566.PMC10410850.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10033145","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":"Parents making surgical decisions for their children: a pilot study.","authors":"Adrian Chi Heng Fung,&nbsp;Kenneth Kak Yuen Wong","doi":"10.1136/wjps-2023-000587","DOIUrl":"https://doi.org/10.1136/wjps-2023-000587","url":null,"abstract":"","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"6 2","pages":"e000587"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/29/21/wjps-2023-000587.PMC10193069.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9875125","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":"Population-based prevalence study of common congenital malformations of the alimentary tract and abdominal wall in Thailand: a study using data from the National Health Security Office.","authors":"Kulpreeya Sirichamratsakul,&nbsp;Wison Laochareonsuk,&nbsp;Komwit Surachat,&nbsp;Surasak Sangkhathat","doi":"10.1136/wjps-2022-000540","DOIUrl":"https://doi.org/10.1136/wjps-2022-000540","url":null,"abstract":"<p><strong>Background: </strong>The study aimed to estimate the prevalence of major congenital anomalies of the alimentary system and the abdominal wall in Thailand using a nationwide hospital discharge database from the National Health Security Office (2017-2020).</p><p><strong>Methods: </strong>The study extracted data from records with International Classification of Diseases-10 (ICD-10) codes related to esophageal malformation (ESO), congenital duodenal obstruction (CDO), jejunoileal atresia (INTES), Hirschsprung's disease (HSCR), anorectal malformation (ARM), abdominal wall defects (omphalocele (OMP) and gastroschisis (GAS)), and diaphragmatic hernia from the database with patient age selection set to less than 1 year.</p><p><strong>Results: </strong>A total of 2539 matched ICD-10 records were found in 2376 individuals over the 4-year study period. Concerning foregut anomalies, the prevalence of ESO was 0.88/10 000 births, while that of CDO was 0.54/10 000 births. The prevalence figures of INTES, HSCR, and ARM were 0.44, 4.69, and 2.57 cases per 10 000 births, respectively. For abdominal wall defects, the prevalences of OMP and GAS were 0.25 and 0.61 cases/10 000 births, respectively. The mortality in our cases was 7.1%, and survival analysis found that associated cardiac defects had a statistically significant influence on survival in most anomalies studied. In HSCR, both Down syndrome (DS) (hazard ratio (HR)=7.57, 95% confidence interval (CI)=4.12 to 13.91, p<0.001) and cardiac defects (HR=5.82, 95% CI=2.85 to 11.92, p<0.001) were significantly associated with poorer survival outcomes. However, only DS (adjusted HR=5.55, 95% CI=2.63 to 11.75, p<0.001) independently predicted worse outcomes by multivariable analysis.</p><p><strong>Conclusions: </strong>Our analysis of the hospital discharge database found that the prevalence of gastrointestinal anomalies in Thailand was lower than that reported in other countries, except for HSCR and anorectal malformations. Associated Down syndrome and cardiac defects influence the survival outcomes of these anomalies.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"6 3","pages":"e000540"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/42/d2/wjps-2022-000540.PMC10254801.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9620237","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":"Biliary complications post liver resection for pediatric liver tumors.","authors":"Mohd Yusran Othman,&nbsp;Kok Hoi Teh,&nbsp;Zakaria Zahari","doi":"10.1136/wjps-2023-000589","DOIUrl":"https://doi.org/10.1136/wjps-2023-000589","url":null,"abstract":"<p><strong>Objective: </strong>To review biliary complications following liver resection for liver tumors in children and their associated risk factors.</p><p><strong>Methods: </strong>Retrospectively, we reviewed children who underwent liver resection for liver tumors from 2010 to 2019. Demographic data, operative details, types of complications, interventions and outcomes were studied.</p><p><strong>Results: </strong>Eighty-six out of 108 liver resections were included in this study. The median age of patients was 1.8 years old, and 55% were male. The majority (95%) were malignant tumors, of which 87% were hepatoblastoma (n=71). The most common procedure performed was extended right hepatectomy (37%, n=32). Twelve (14%) patients had primary biliary complications: nine bile leakages and three biliary obstructions. Six cases of bile leakage were treated non-operatively with drainage only; however, one developed bilothorax. Three bile leakages underwent early operative intervention. Four patients underwent biliary reconstruction. Biliary complications were not significantly associated with age, sex, ethnicity or pathology of the tumor. Ten of them (83%) developed following extended hepatectomies (five right, five left), in which the left side had a higher rate of complications (63% vs 16%). None of the central hepatectomies had biliary complications. Biliary complication rates were significantly higher among those who had segmentectomy 1 (p=0.023).</p><p><strong>Conclusions: </strong>Biliary complication is a significant morbidity following liver resection in children. Surgery is eventually required for complicated bile leakage and primary biliary strictures. Follow-up is mandatory since secondary biliary complications may occur after the initial resolution of bile leakage. The groups at high risk of developing biliary complications are extended left hepatectomies and segmentectomy 1.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"6 3","pages":"e000589"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/75/68/wjps-2023-000589.PMC10335567.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9820004","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}