{"title":"Advances in the surgical technique of Kasai portoenterostomy","authors":"Joel Cazares, Hiroyuki Koga, Atsuyuki Yamataka","doi":"10.1016/j.sempedsurg.2025.151481","DOIUrl":"10.1016/j.sempedsurg.2025.151481","url":null,"abstract":"<div><div>Biliary atresia is a rare, degenerative, and obliterative inflammatory disease of the bile ducts in neonates, affecting both the intra- and extrahepatic biliary tract. With an unknown etiology and no parallel condition in adults or older children, biliary atresia affects 1 in 10,000–18,000 live births and, if untreated, progresses to liver cirrhosis and death by the age of two. The Kasai portoenterostomy, introduced in 1950, remains the primary palliative procedure to restore bile drainage and delay the need for liver transplantation, which is required in cases of biliary flow failure. Biliary atresia continues to be the leading cause of pediatric liver transplants, accounting for up to 75 % of procedures in children under two years. While the Kasai technique has undergone numerous modifications; surgeons at Juntendo University Hospital, Japan, have modernized the procedure while preserving Dr. Kasai's original portoenterostomy principles. Since 2009, the hospital has been a pioneer in laparoscopic Kasai portoenterostomy; this article presents a detailed description of the state-of-the-art approaches and postoperative management, along with analysis of the latest outcomes. These advancements highlight the hospital's role as a leader in treatment of biliary atresia.</div></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 6","pages":"Article 151481"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Qiongfen Lin , Paul Kwong-hang Tam , Clara Sze-man Tang
{"title":"Genetics of biliary atresia: Approaches, pathological insights and challenges","authors":"Qiongfen Lin , Paul Kwong-hang Tam , Clara Sze-man Tang","doi":"10.1016/j.sempedsurg.2025.151477","DOIUrl":"10.1016/j.sempedsurg.2025.151477","url":null,"abstract":"<div><div>Biliary atresia (BA) is a severe neonatal cholestatic disorder marked by fibro-obliteration of the extrahepatic and intrahepatic bile ducts. It is the most common cause of pediatric end-stage liver disease and the leading indication for liver transplantation in children. There is significant heterogeneity in the etiology, involving various genetic and environmental factors such as viral infection, immune dysregulation and genetic predisposition to defective hepatobiliary development. In this review, we discuss the strategies to uncover the genetic factors underlying BA and highlight their associated molecular and pathological mechanisms, as well as the challenges faced in this area of research.</div></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 6","pages":"Article 151477"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brynn FitzGerald , Krishna Jagannathan , Nicholas Burjek , Matthew Rowland
{"title":"The development and benefits of a pediatric airway response team in a children's hospital","authors":"Brynn FitzGerald , Krishna Jagannathan , Nicholas Burjek , Matthew Rowland","doi":"10.1016/j.sempedsurg.2024.151453","DOIUrl":"10.1016/j.sempedsurg.2024.151453","url":null,"abstract":"","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 5","pages":"Article 151453"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142441509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eric C. Cheon , Mehul V. Raval , Alexander Froyshteter , Hubert A. Benzon
{"title":"Utilizing national surgical quality improvement program-pediatric for assessing anesthesia outcomes","authors":"Eric C. Cheon , Mehul V. Raval , Alexander Froyshteter , Hubert A. Benzon","doi":"10.1016/j.sempedsurg.2024.151454","DOIUrl":"10.1016/j.sempedsurg.2024.151454","url":null,"abstract":"","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 5","pages":"Article 151454"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142434371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Perioperative considerations in anesthesia for minimally invasive repair of pectus excavatum, Nuss procedure","authors":"Aaron R. Brussels , Michelle S. Kim","doi":"10.1016/j.sempedsurg.2024.151459","DOIUrl":"10.1016/j.sempedsurg.2024.151459","url":null,"abstract":"<div><div>Pectus excavatum (PE) is a common anterior chest wall deformity that affects the heart and lungs depending on the severity of compression. The Nuss procedure, a minimally invasive repair of pectus excavatum, has evolved over the years with thoracoscopic assistance and minimal incision. Despite improved surgical techniques, pain and nausea are often the most common factors determining hospital length of stay. This review will explore the preoperative, intraoperative, and postoperative anesthetic considerations necessary for improving patient outcomes, reducing surgical stress, and shortening hospital stays for patients undergoing the Nuss procedure.</div></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 5","pages":"Article 151459"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142444603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The impact of current pediatric anesthesiology fellows shortfall on freestanding children's hospitals and practices","authors":"Doyle Lim , Marco Corridore , Concetta Lupa","doi":"10.1016/j.sempedsurg.2024.151452","DOIUrl":"10.1016/j.sempedsurg.2024.151452","url":null,"abstract":"<div><div>The pediatric anesthesiology workforce is currently facing a critical shortage, which will have significant consequences for patient care and the healthcare system as a whole. The workforce is aging, and despite increasing numbers of anesthesiology residents, fewer graduates are entering the field of pediatrics. It should also be noted that fewer medical school graduates are entering pediatrics as well. This situation raises concerns about the availability of specialists and the training of future physicians. To address this shortage, a comprehensive strategy is urgently needed, including outreach, mentorship, financial incentives, and policy changes to attract and retain new talent in pediatric anesthesiology. Immediate intervention is necessary to prevent a severe impact on the availability and quality of pediatric anesthesia care.</div></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 5","pages":"Article 151452"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"fm i -- Contents","authors":"","doi":"10.1053/S1055-8586(24)00087-8","DOIUrl":"10.1053/S1055-8586(24)00087-8","url":null,"abstract":"","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 5","pages":"Article 151466"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142594103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brent Schakett, Grace Huang, Heena Pranav, Chris D Glover
{"title":"Perioperative considerations in anesthesia for pediatric bariatric procedures","authors":"Brent Schakett, Grace Huang, Heena Pranav, Chris D Glover","doi":"10.1016/j.sempedsurg.2024.151460","DOIUrl":"10.1016/j.sempedsurg.2024.151460","url":null,"abstract":"<div><div>Obesity is a global epidemic affecting a broad range of individuals, regardless of economic and social strata. In 2022, the World Health Organization (WHO) reported that 16 % of adults and 160 million children were living with this condition. The economic impact is significant, with a recent Milken report estimating the annual cost of obesity in the US at 1.4 trillion dollars, accounting for almost 7 % of the United States gross domestic product. It is widely recognized that the most severe forms of pediatric obesity (120 % of the 95th percentile for age and sex) represent an epidemic within an epidemic, given their potential for diminished long-term health and shortened lifespan. The treatment paradigm for obesity covers a range of approaches, with the American Academy of Pediatrics (AAP) recommending behavior and lifestyle modification as initial components of care. Since 2004, bariatric surgery has increasingly been utilized as an additional option for treating adolescent obesity, as long-term findings have shown sustained reductions in BMI and improvements in comorbid conditions. For anesthesiologists, these patients present specific challenges that require review.</div></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 5","pages":"Article 151460"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Perioperative considerations for non-cardiac procedures in patients with congenital heart disease: A practical overview","authors":"Viviane G. Nasr, James A. DiNardo","doi":"10.1016/j.sempedsurg.2024.151461","DOIUrl":"10.1016/j.sempedsurg.2024.151461","url":null,"abstract":"<div><div>Providing thorough care for children with congenital heart disease (CHD) undergoing non-cardiac surgery requires a strong understanding of common heart defects and the procedures used to treat them. To care for these patients, multidisciplinary teams must consider the severity of the underlying cardiac disease, comorbid conditions, and preoperative severity of illness. The American Heart Association's Scientific Statement on Perioperative Considerations for Pediatric Patients with Congenital Heart Disease Presenting for Noncardiac Procedures offers valuable guidance.</div></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 5","pages":"Article 151461"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}