Seminars in Pediatric Surgery最新文献

{"title":"Intercostal spinal nerve cryoablation for analgesia following pectus excavatum repair","authors":"Mallory N. Perez ,&nbsp;Anthony Ferrantella ,&nbsp;Kevin N. Johnson ,&nbsp;Seth D. Goldstein","doi":"10.1016/j.sempedsurg.2024.151382","DOIUrl":"https://doi.org/10.1016/j.sempedsurg.2024.151382","url":null,"abstract":"<div><p>Pectus excavatum<span><span><span> is a common chest wall deformity, most often treated during adolescence, that presents a significant </span>postoperative pain<span> control challenge for pediatric surgeons following surgical correction. The purpose of this article is to review the technique and outcomes of intercostal spinal nerve cryoablation for </span></span>postoperative analgesia<span> following surgical correction of pectus excavatum. Contemporary and historic literature were reviewed. Findings are summarized to provide a concise synopsis of the benefits of intercostal spinal nerve cryoablation relative to alternative analgesic modalities, as well as advocate for more widespread inclusion of this technique into multimodal pain regimens.</span></span></p></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 1","pages":"Article 151382"},"PeriodicalIF":1.7,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139111551","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":"Applications for ultrasound in pediatric surgery","authors":"Kevin N. Johnson ,&nbsp;Jonathan Vacek ,&nbsp;Stewart Carter","doi":"10.1016/j.sempedsurg.2024.151383","DOIUrl":"https://doi.org/10.1016/j.sempedsurg.2024.151383","url":null,"abstract":"<div><p>Ultrasound (US) use within pediatric surgery is expanding rapidly. While US guidance for central line placement has been common practice for many years now, advances in the quality of images, portability of US machines, and a lack of radiation associated with imaging has led to broader application in many other aspects of surgery, ranging from diagnostics to performing operations under the direction of point-of-care ultrasound (POCUS). The relatively short learning curve for providers along with excellent image quality in children due to their small size provides an easy, effective imaging modality with diverse applications. Discussed here is a broad overview of the spectrum of US use within current pediatric surgical practices.</p></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 1","pages":"Article 151383"},"PeriodicalIF":1.7,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1055858624000040/pdfft?md5=659d67a991bd0262f3b632e976fc1f64&pid=1-s2.0-S1055858624000040-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139111467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"3D printing in pediatric surgery","authors":"Anthony Y. Tsai,&nbsp;Alicia C. Greene","doi":"10.1016/j.sempedsurg.2024.151385","DOIUrl":"10.1016/j.sempedsurg.2024.151385","url":null,"abstract":"<div><p>Pediatric surgery presents a unique challenge, requiring a specialized approach due to the intricacies of compact anatomy<span><span> and the presence of distinct congenital features in young patients. Surgeons are tasked with making decisions that not only address immediate concerns but also consider the evolving needs of children as they grow. The advent of three-dimensional (3D) printing has emerged as a valuable tool to facilitate a personalized medical approach. This paper starts by outlining the basics of 3D modeling and printing. We then delve into the transformative role of 3D printing in pediatric surgery, elucidating its applications, benefits, and challenges. The paper concludes by envisioning the future prospects of 3D printing, foreseeing advancements in personalized </span>treatment approaches, improved patient outcomes, and the continued evolution of this technology as an indispensable asset in the pediatric surgical arena.</span></p></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 1","pages":"Article 151385"},"PeriodicalIF":1.7,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139375941","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":"Use of magnets in pediatric surgery","authors":"Norah E. Liang ,&nbsp;Saunders Lin ,&nbsp;Bethany J. Slater ,&nbsp;Matias Bruzoni","doi":"10.1016/j.sempedsurg.2024.151381","DOIUrl":"10.1016/j.sempedsurg.2024.151381","url":null,"abstract":"<div><p><span>Since the 1970s, magnets have been progressively harnessed for use in minimally invasive treatment<span> of pediatric<span> surgical disease. In particular, multiple magnetic devices have been developed for treating esophageal atresia, </span></span></span>pectus excavatum<span> and scoliosis<span>. These devices, which can be placed via small incisions<span> or under endoscopic or fluoroscopic guidance, provide the added benefit of sparing patients multiple large, invasive procedures, and allowing for gradual correction of congenital anomalies over days to months, depending on the disease. In the following text, we detail the current landscape of magnetic devices used by pediatric surgeons, illustrate their use through clinical cases, and review the available body of literature with respect their outcomes and complications.</span></span></span></p></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"33 1","pages":"Article 151381"},"PeriodicalIF":1.7,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139376114","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":"Children's Anaesthesia and perioperative care challenges, and innovations","authors":"Z. Gathuya ,&nbsp;M.T. Nabukenya ,&nbsp;O. Aaron ,&nbsp;R. Gray ,&nbsp;F.M. Evans","doi":"10.1016/j.sempedsurg.2023.151355","DOIUrl":"https://doi.org/10.1016/j.sempedsurg.2023.151355","url":null,"abstract":"&lt;div&gt;&lt;p&gt;The 2015 Sustainable Development Goals emphasise good health to all with reduced inequalities, and surgical and anaesthesia care is essential to achieve these. &lt;span&gt;https://sdgs.un.org/goals&lt;/span&gt;&lt;svg&gt;&lt;path&gt;&lt;/path&gt;&lt;/svg&gt;&lt;span&gt;. However, it has been estimated that 1.7 billion children do not have access to safe anaesthesia and surgery when needed and this disproportionately affects children in low- and middle-income countries (1). It is alarming that 1 in 10 individuals in LMICs do not have access to safe surgical care. Both safe surgery and anaesthesia are essential for ensuring that individuals receive proper medical attention. Economically viable public health initiatives that can avert many disability-adjusted years are needed. (2–4)&lt;/span&gt;&lt;/p&gt;&lt;p&gt;&lt;span&gt;Morbidity and mortality from surgical disease and anaesthesia care remain high in low-income countries, unlike in high-income countries. The incidence of severe anaesthesia-related critical events and perioperative cardiac arrest is between three and ten times more in LMICs than in HICs (5–7) A baseline POMR that is 100 times higher in LMICs compared to HICs is reported. (8) This perioperative morbidity and mortality gap is more evident in neonates and younger age groups, especially in children with congenital abnormalities. The challenges facing providers of anaesthesia and perioperative care&lt;span&gt; are multifactorial and include but are not limited to the inadequate workforce, inadequate and inappropriate infrastructure, lack of adequate and appropriately sized equipment, including monitors, and safe monitoring capacity, supply chain challenges for medicines and reusable consumables, unreliable supply of oxygen and blood products, lack of data and research for policy formulation, inadequate resource allocation from governments and lack of safety culture among other things. In paediatrics, this is further multiplied by the variability in the sizes of the patients, from neonates to older children (9).&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;&lt;ul&gt;&lt;li&gt;&lt;span&gt;1.&lt;/span&gt;&lt;span&gt;&lt;p&gt;Improved perioperative care must include anaesthesia and nursing to improve perioperative outcomes for children.&lt;/p&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;2.&lt;/span&gt;&lt;span&gt;&lt;p&gt;Perioperative care for children in LMICs is predominantly by non-physician anaesthesia providers or non-specialty-trained anaesthesiologists.&lt;/p&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;3.&lt;/span&gt;&lt;span&gt;&lt;p&gt;There is a need to train physician anaesthesia leaders to direct and oversee the care of children undergoing anaesthesia&lt;/p&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;4.&lt;/span&gt;&lt;span&gt;&lt;p&gt;Infrastructure and equipment for the safe provision of paediatric anaesthesia/perioperative care are usually wanting/often times inadequate and inappropriate.&lt;/p&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;5.&lt;/span&gt;&lt;span&gt;&lt;p&gt;The GICS OReCS document provides a valuable guide for the bare minimum requirements for the provision of safe paediatric anaesthetic and surgical care services, starting at the district hospital.&lt;/p&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;6.&lt;/span&gt;&lt;span&gt;&lt;p&gt;Equipment","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"32 6","pages":"Article 151355"},"PeriodicalIF":1.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138475004","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":"Global children's surgery- A 2023 perspective","authors":"Tahmina Banu,&nbsp;Doruk Ozgediz,&nbsp;Shilpa Sharma","doi":"10.1016/j.sempedsurg.2023.151364","DOIUrl":"https://doi.org/10.1016/j.sempedsurg.2023.151364","url":null,"abstract":"","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"32 6","pages":"Article 151364"},"PeriodicalIF":1.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138473874","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(23)00121-X","DOIUrl":"https://doi.org/10.1053/S1055-8586(23)00121-X","url":null,"abstract":"","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"32 6","pages":"Article 151374"},"PeriodicalIF":1.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138577567","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":"Trauma and sexual abuse in children—Epidemiology, challenges, management strategies and prevention in lower- and middle-income countries","authors":"Abdelbasit E Ali ,&nbsp;Shilpa Sharma ,&nbsp;Olumide A Elebute ,&nbsp;Adesoji Ademuyiwa ,&nbsp;Noxolo Z. Mashavave ,&nbsp;Milind Chitnis ,&nbsp;Simone Abib ,&nbsp;Fazal Nouman Wahid","doi":"10.1016/j.sempedsurg.2023.151356","DOIUrl":"10.1016/j.sempedsurg.2023.151356","url":null,"abstract":"<div><p>Trauma is rising as a cause of morbidity and mortality in lower- and middle-income countries (LMIC). This article describes the Epidemiology<span>, Challenges, Management strategies and prevention of pediatric trauma in lower- and middle-income countries. The top five etiologies for non-intentional injuries leading to death are falls, road traffic injuries, burns, drowning and poisoning.</span></p><p><span>The mortality rate in LMICs is twice that of High-Income Countries (HICs) irrespective of injury severity adjustment. The reasons for inadequate care include lack of facilities, transportation problems, lack of prehospital care, lack of resources and trained manpower to handle pediatric trauma. To overcome these challenges, attention to protocolized care and </span>treatment<span> adaptation based on resource availability is critical. Training in management of trauma helps to reduce the mortality and morbidity in pediatric polytrauma cases. There is also a need for more collaborative research to develop preventative measures to childhood trauma.</span></p></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"32 6","pages":"Article 151356"},"PeriodicalIF":1.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135614560","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":"Barriers and challenges to achieving equity in global children's surgery: a call to action","authors":"Maryam Sherwani,&nbsp;Simone Abib,&nbsp;Lubna Samad","doi":"10.1016/j.sempedsurg.2023.151346","DOIUrl":"https://doi.org/10.1016/j.sempedsurg.2023.151346","url":null,"abstract":"<div><p>Challenges:</p><ul><li><span>•</span><span><p>1.7 billion children are deprived of surgical care due to economic, political and social factors that lead to inequitable healthcare.</p></span></li><li><span>•</span><span><p>90% of children live in LMICs where surgical ecosystems are often deficient with regards to children-specific infrastructure and health providers</p></span></li><li><span>•</span><span><p>Nearly half the population in LMICs lives in rural areas, however most surgical facilities are concentrated in urban centers with limited access due to poor infrastructure and costly or difficult transportation.</p></span></li><li><span>•</span><span><p>The cycle of poverty is difficult to break; it affects a family's ability to attain education and resources which can hinder the identification, understanding and treatment of surgical problems.</p></span></li><li><span>•</span><span><p>There is a lack of political will, both on regional and global fronts, to mobilize resources to improve surgical access in general, but particularly for children.</p></span></li></ul>A Call to Action:<ul><li><span>•</span><span><p>Children's surgery must be recognised as an essential component of both childhood and surgical care policies and initiatives.</p></span></li><li><span>•</span><span><p>To improve outcomes, the general health of a child must be made a priority. This entails promotion of a safe and healthy environment, good reproductive and antenatal health, along with regular checkups.</p></span></li><li><span>•</span><span><p>Local surgical systems must be strengthened by raising awareness, increasing training opportunities and improving infrastructure.</p></span></li><li><span>•</span><span><p>Health facilities should be categorized according to resource availability and there should be locally relevant expectations of care at each resource level. Referral systems must be developed to avoid late presentations and mismanagement.</p></span></li><li><span>•</span><span><p>Global health funders and political stakeholders must be engaged to raise funds for children's surgery, with a focus on equitable distribution of resources.</p></span></li><li><span>•</span><span><p>Population control may be a sustainable long-term solution to correct the disbalance between need and resources, particularly in rapidly growing countries with a poor economic forecast.</p></span></li></ul></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"32 6","pages":"Article 151346"},"PeriodicalIF":1.7,"publicationDate":"2023-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138466825","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":"A roadmap for starting, growing and sustaining a comprehensive pediatric surgery service in a low resource area","authors":"Gerlin Naidoo ,&nbsp;Godfrey Sama Philipo ,&nbsp;Zaitun Bokhary ,&nbsp;Kokila Lakhoo","doi":"10.1016/j.sempedsurg.2023.151350","DOIUrl":"https://doi.org/10.1016/j.sempedsurg.2023.151350","url":null,"abstract":"<div><p>The Tanzania-Oxford Children's Surgery Partnership is a longstanding capacity building and research collaboration. Over a 21-year period, this non-hierarchical partnership has worked to develop from service delivery to children surgical system strengthening in Tanzania. This has directly impacted the children's surgery and workforce by increasing the number of pediatric surgeons in the country and upskilling nurses, anesthetists, and pediatricians. Clinical skills acquisition has been complemented by the development of leadership, mentorship, and research acumen. The partnership has also delivered critical upgrading of infrastructure which has significantly increased operative volume and allowed for the provision of minimally invasive children's surgery. A children's research network has been established, with a focus on research equity and local data ownership adhering to local ethics, leading to prolific academic output. At the core of this partnership has been the recognition that achieving sustainable change requires local leadership, long-term commitment, and ‘bottom-up’ change. We described the historical events and steps taken by our partners to achieve the universal provision of children's surgery in Tanzania.</p></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"32 6","pages":"Article 151350"},"PeriodicalIF":1.7,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1055858623000975/pdfft?md5=99d22ea0a91abcaed03339eb9bc4a232&pid=1-s2.0-S1055858623000975-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138436607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}