European Journal of Pediatric Surgery最新文献

{"title":"Explainable AI: Ethical Frameworks, Bias, and the Necessity for Benchmarks.","authors":"Rosa Verhoeven, Wiam Bouisaghouane, Jan Bf Hulscher","doi":"10.1055/a-2702-1843","DOIUrl":"10.1055/a-2702-1843","url":null,"abstract":"<p><p>Artificial intelligence (AI) is increasingly integrated into pediatric healthcare, offering opportunities to improve diagnostic accuracy and clinical decision-making. However, the complexity and opacity of many AI models raise concerns about trust, transparency, and safety, especially in vulnerable pediatric populations. Explainable AI (XAI) aims to make AI-driven decisions more interpretable and accountable. This review outlines the role of XAI in pediatric surgery, emphasizing challenges related to bias, the importance of ethical frameworks, and the need for standardized benchmarks. Addressing these aspects is essential to developing fair, safe, and effective AI applications for children. Finally, we provide recommendations for future research and implementation to guide the development of robust and ethically sound XAI solutions.</p>","PeriodicalId":56316,"journal":{"name":"European Journal of Pediatric Surgery","volume":" ","pages":"168-173"},"PeriodicalIF":1.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132937","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":"Lateral Release in Neonatal Congenital Diaphragmatic Hernia Is Associated with Faster Recovery Compared to Abdominal Wall Patch Repair: A Preliminary Prospective Cohort Study.","authors":"Kaja Riebesell, Julia Elrod, Patrick Thees, Richard Martel, Christoph Mohr, Christel Weiss, Thomas Schaible, Carolin Riemer, Nina Dietze, Michael Boettcher, Michaela Klinke","doi":"10.1055/a-2709-5368","DOIUrl":"10.1055/a-2709-5368","url":null,"abstract":"<p><strong>Background: </strong>Open repair of congenital diaphragmatic hernia (CDH) in neonates often requires surgical reconstruction of the abdominal wall. Lateral release (LR) of the abdominal wall fascia, a novel technique avoiding prosthetic patches, offers potential advantages. However, data comparing its outcomes to traditional patch repair are limited.</p><p><strong>Materials and methods: </strong>A preliminary prospective cohort study was conducted at the University Medical Center Mannheim from 2021 to 2024, including neonates undergoing CDH surgery with abdominal wall reconstruction via direct closure, LR, or patch repair based on intraoperative surgeon decision. Perioperative, postoperative, and short-term outcome data were analyzed during our standardized follow-up protocols and compared between groups.</p><p><strong>Results: </strong>Among 77 eligible neonates, 11 underwent patch repair and 10 received LR. Baseline characteristics between groups were comparable. The median follow-up was 391 days in the patch group and 215 days in the LR group (<i>p</i> = 0.1971). The LR group had significantly shorter median intubation duration, neonatal intensive care unit stay, and overall length of stay compared with the patch group (32.0 days vs. 43.0 days, <i>p</i> = 0.0445; 33.5 days vs. 66.0 days, <i>p</i> = 0.0309; 68.0 days vs. 97.0 days, <i>p</i> = 0.0435). There were no significant differences in recurrence rates, short-term complications, or motor developmental outcomes.</p><p><strong>Conclusion: </strong>LR appears to be associated with shorter hospital stays and faster recovery, without an increase in perioperative or long-term complications. While these findings suggest potential benefits of LR, they must be interpreted with caution due to the limited sample size. Further randomized, multicenter studies with larger cohorts, including long-term assessment of complications, are needed to confirm its efficacy and refine clinical guidelines.</p>","PeriodicalId":56316,"journal":{"name":"European Journal of Pediatric Surgery","volume":" ","pages":"221-228"},"PeriodicalIF":1.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152036","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":"AI in Robotic-assisted Pediatric Surgery: Current Applications and Future Directions.","authors":"Ciro Esposito, Claudia Di Mento, Fulvia Del Conte, Francesco Tedesco, Roberta Guglielmini, Giovanni Esposito, Maria Escolino","doi":"10.1055/a-2722-3348","DOIUrl":"10.1055/a-2722-3348","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) is increasingly integrated into surgical practice, offering enhanced decision-making, precision, and workflow efficiency. In pediatric surgery, the convergence of AI and robotic-assisted platforms represents a promising frontier, addressing the unique anatomical, physiological, and technical challenges of operating on children. Aim of this review is to provide an overview of the current state of art of AI use in pediatric robotic-assisted surgery (RAS), outlining the available evidence, potential benefits, existing limitations, and prospective developments.</p><p><strong>Materials and methods: </strong>A literature-based search of PubMed and Scopus was performed to identify articles covering any aspect of AI application in pediatric RAS. Selection criteria included English language, pediatric patients (under 18 years of age), and AI application to pediatric RAS. Additionally, studies reporting AI applications in adult RAS or for surgical training, which were not primarily focused on pediatric surgery but presented potential translational applicability to pediatric RAS, were considered.</p><p><strong>Results: </strong>A total of 746 papers published until July 2025 were collected. A total of 15 full-text articles were assessed for eligibility, meeting the inclusion criteria. The other studies were excluded because they did not address pediatric surgery, did not involve robotic-assisted procedures, or did not include applications of AI.</p><p><strong>Conclusion: </strong>Although RAS is well established in pediatric practice, the direct application of AI remains limited, with AI-like features such as machine vision and augmented reality serving mainly as supportive tools rather than autonomous decision-making systems. Nevertheless, emerging AI-like technologies and ongoing research hold promising potential for future applications in pediatric robotic surgery.</p>","PeriodicalId":56316,"journal":{"name":"European Journal of Pediatric Surgery","volume":" ","pages":"184-189"},"PeriodicalIF":1.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294416","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":"Recurrent Tracheoesophageal Fistula A Systematic Review and Meta-Analysis on Surgical and Endotracheal Treatment.","authors":"Julia Elizabeth Hut, Marit J B van Stigt, Abdulqader Alitani, Ellen Marie Brigitte Paulien Reuling, Robert J Stokroos, Stefaan Hendrik Andreas Jozef Tytgat, Johannes Willem Verweij, Arnold Joost Nicolaas Bittermann, Maud Yvonne Amalia Lindeboom","doi":"10.1055/a-2868-4226","DOIUrl":"https://doi.org/10.1055/a-2868-4226","url":null,"abstract":"<p><strong>Background: </strong>Recurrent tracheoesophageal fistula (rTEF) is a complication of Esophageal Atresia (EA), with treatment posing a significant challenge. Surgical treatment (ST) can be performed through thoracotomy, thoracoscopy, or via endotracheal treatment (ET) with de-epithelialization and/or sealants. The optimal treatment option for rTEF, however, remains unclear.</p><p><strong>Aim: </strong>This study systematically reviewed the outcomes of ST and ET for rTEF to determine which treatment approach yields the best outcome.</p><p><strong>Methods: </strong>The study was conducted following PRISMA guidelines. PubMed, Embase, and the Cochrane Library were comprehensively searched for studies published from 2000 to December 2024. Two reviewers independently screened and analyzed the relevant studies. Success and complication rates were pooled using a random effects model for the meta-analysis. For additional outcomes, descriptive statistics were used.</p><p><strong>Results: </strong>Twenty-seven studies (15 case series, 12 cohort studies) including 540 patients with rTEF were eligible for inclusion for the systematic review. Meta-analysis showed a pooled success rate after the first procedure of 92.4% [95% CI: 87.8% - 95.4%] for ST and 27.7% [95% CI: 18.3% - 39.6%] for ET. After revisional procedures, the success rates increased to 97.7% [95% CI: 92.7% - 99.3%] for ST and 72.6% [95% CI: 59.5% - 82.6%] for ET. The mean number of procedures ranged from 1.0 to 1.2 for ST and from 1.3 to 3.8 for ET. The pooled complication rate for ST was 31.0% [95% CI: 5.7% - 77.1%]. The pooled complication rate for ET was 2.1% [95% CI: 0.01% - 24.1%]. The most reported complications for ST included anastomotic strictures and leakage, while postoperative respiratory tract infections were the primary complications for ET.</p><p><strong>Conclusion: </strong>These findings demonstrate that although ST is highly effective and efficient, it is also associated with a high risk of severe complications. In contrast, ET demonstrates a lower success rate, but complications occur less frequently and are less severe. Despite the lower success rate, the minimally invasive techniques and reduced complication risk of endotracheal repair may support its consideration as a first-line treatment option.</p><p><strong>Type of study: </strong>systematic review and meta-analysis.</p>","PeriodicalId":56316,"journal":{"name":"European Journal of Pediatric Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846635","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":"Thoracoscopic Mobilization and Intraoperative Internal Traction-A Novel Approach for Treatment of Long-gap Type C Esophageal Atresia with Distal Carinal Fistula.","authors":"Ludovica Magni, Chiara Barbera, Tobias G H Teunissen, Demi K Focke, Julia E Hut, Lucas F Townsend, Sarah K Rushforth, Arnold J N Bittermann, Johannes W Verweij, Maud Y A Lindeboom, Ellen M B P Reuling, Stefaan H A J Tytgat","doi":"10.1055/a-2844-1481","DOIUrl":"10.1055/a-2844-1481","url":null,"abstract":"<p><strong>Introduction: </strong>Long-gap esophageal atresia (LGEA) is challenging due to the substantial distance between the proximal and distal esophageal pouches. Traditionally, it includes Gross types A and B, while inclusion of long-gap type C cases remains debated. In type C esophageal atresia (EA), the distal tracheoesophageal fistula (TEF) varies in location; when situated at the carina, the effective pouch distance may be markedly increased, making it one of the most complex anatomical subtypes.</p><p><strong>Introduction: </strong>We hypothesized that early primary anastomosis in type C with carinal fistula (TEFC) is feasible using thoracoscopic mobilization and intraoperative internal traction, and aimed to compare outcomes with type C cases where the TEF is higher on the tracheal wall (TEFT).</p><p><strong>Materials and methods: </strong>We analyzed 134 EA patients treated thoracoscopically at the Wilhelmina Children's Hospital in Utrecht between 2012 and 2024, including 25 TEFC and 109 TEFT patients. TEF location was determined by perioperative tracheobronchoscopy, and the surgical approach was tailored accordingly. TEFC patients underwent thoracoscopic esophageal mobilization with intraoperative internal traction, while TEFT patients received conventional primary thoracoscopic anastomosis. Primary outcomes were early successful anastomosis, preservation of the native esophagus, and anastomotic leakage. Secondary outcomes included postoperative morbidity and clinical results during childhood.</p><p><strong>Results: </strong>All patients underwent successful thoracoscopic repair shortly after birth, without requiring esophageal replacement. In the TEFC group, single-stage anastomosis was achieved in 23 patients; two required temporary external traction followed by delayed repair. TEFC patients showed higher rates of anastomotic leakage (40% vs. 20.2%), recurrent stenosis (24% vs. 10.1%), and need for anti-reflux surgery (26.1% vs. 11.3%). Early feeding difficulties affected weight gain in both groups, with 10 to 20% underweight at 6 to 12 months and no significant group difference. By 5.5 years, growth improved markedly, with no TEFC patients and 8.6% of TEFT patients remaining underweight.</p><p><strong>Conclusion: </strong>Although TEFC represents a more complex subgroup with higher complication rates, early thoracoscopic anastomosis with preservation of the native esophagus is achievable in these long-gap type C patients. Routine tracheobronchoscopy may support accurate classification and optimized surgical planning.</p>","PeriodicalId":56316,"journal":{"name":"European Journal of Pediatric Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147629328","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":"Esophagus Bioengineering.","authors":"Marta Gazzaneo, Soichi Shibuya, Natalie Durkin, Simon Eaton, Marco Pellegrini, Paolo De Coppi","doi":"10.1055/a-2839-5608","DOIUrl":"10.1055/a-2839-5608","url":null,"abstract":"<p><strong>Abstract: </strong>Tissue engineering represents a promising and innovative strategy for the treatment of complex congenital and acquired esophageal disorders, particularly in patients for whom conventional therapies have failed or current options for organ replacement remain inadequate. Current approaches have explored the use of synthetic and biological scaffolds, cell-based therapies, or combinations of both to promote tissue regeneration and restoration of function. Increasing evidence suggests that, in order to achieve a functional esophagus, hybrid strategies incorporating exogenous cell delivery may further enhance regenerative outcomes while simultaneously modulating inflammatory responses.</p><p><strong>Abstract: </strong>Importantly, the feasibility and effectiveness of esophageal tissue engineering are strongly influenced by the extent and depth of the defect. Encouraging results achieved in partial-thickness defects and patch repair models have supported early clinical translation. Reconstruction of full-thickness circumferential esophageal defects, as required in long-gap esophageal atresia, remains a challenge, primarily due to luminal stenosis, anastomotic leakage, and incomplete regeneration of organized muscular and neuromuscular structures. Recently, the first preclinical demonstration of secondary peristalsis and stent independence in a circumferential, cell-seeded esophageal graft in a growing large-animal model has provided important proof of concept, though translation to longer grafts and clinical application remains to be established. Further preclinical and translational research is required to develop safe, reproducible, and standardized strategies for circumferential esophageal replacement, supported by transparent and comprehensive reporting of experimental outcomes.</p><p><strong>Abstract: </strong>Consequently, further preclinical and translational research is required to develop safe, reproducible, and standardized strategies for circumferential esophageal replacement. Such efforts must be supported by transparent and comprehensive reporting of experimental outcomes to facilitate meaningful comparison and clinical translation. In this review, we summarize current esophageal tissue engineering strategies relevant to esophageal atresia, critically evaluate the available evidence, and discuss future directions in the field.</p>","PeriodicalId":56316,"journal":{"name":"European Journal of Pediatric Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610314","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":"Round Ligament Management in Percutaneous Inguinal Hernia Repair: Comparative Outcomes Using the FLAIR Technique in Girls.","authors":"Anas Shikha, Zahraa Zaghloul, Mashal Ahmed, Khalid Eltaeb, Janice Wong","doi":"10.1055/a-2646-2153","DOIUrl":"10.1055/a-2646-2153","url":null,"abstract":"<p><p>Fenestrated laparoscopic-assisted internal ring-rrhaphy (FLAIR) is a refined percutaneous technique for pediatric inguinal hernia repair. Although its outcomes have been reported in boys, its application in girls, particularly in relation to round ligament management, remains underexplored. Whether to include or exclude the ligament during internal ring closure is still debated.This study evaluated the impact of round ligament management on surgical outcomes in girls undergoing FLAIR. A retrospective cohort of 69 hernias, operated on between July 2016 and December 2023, was reviewed. Patients were divided into two groups: those in whom the round ligament was included in the closure (Inclusion group) and those in whom it was deliberately spared (Exclusion group). Recurrence rates and postoperative complications were compared.All four recurrences (11%) occurred in the Inclusion group, while no recurrences were observed in the Exclusion group (<i>p</i> = 0.048). All recurrences occurred within 3 months postoperatively and were successfully reoperated using the exclusion technique, with no further recurrence during follow-up. No significant differences in other postoperative complications were identified between groups.FLAIR appears to be a safe and effective approach in girls, particularly when the round ligament is excluded from the closure. Exclusion was associated with zero recurrences and no increase in complications. These findings, observed over intermediate-term follow-up, suggest that sparing the round ligament may enhance repair integrity and potentially protect the ligament from entrapment, thereby preserving its anatomical function. Larger, multicenter studies with extended follow-up are needed to validate these results and guide pediatric hernia repair strategies.</p>","PeriodicalId":56316,"journal":{"name":"European Journal of Pediatric Surgery","volume":" ","pages":"85-94"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644254","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":"Success of Antegrade Continence Enema (ACE) in Pediatric Patients with Impaired Fecal Control.","authors":"Minna Tervahartiala, Antti Koivusalo, Mikko Pakarinen","doi":"10.1055/a-2646-1919","DOIUrl":"10.1055/a-2646-1919","url":null,"abstract":"<p><p>We aimed to describe long-term outcome, treatment success, and complications of antegrade continence enema (ACE) procedures considering underlying etiologies and associated disorders.Overall, 180 patients undergoing ACE procedure at our institution during 1997-2019 were included in this retrospective study. Treatment success was defined as patient staying clean.The main underlying etiologies included spina bifida (<i>n</i> = 65, 36%), anorectal malformations (<i>n</i> = 58, 32%), Hirschsprung disease (<i>n</i> = 25, 14%), and functional constipation (<i>n</i> = 7, 4%). The most common complications were stomal leakage (<i>n</i> = 39, 22%), stenosis (<i>n</i> = 38, 21%), infection (<i>n</i> = 35, 19%), and granuloma/mucosal prolapse of the stoma (<i>n</i> = 34, 19%), and 29% (<i>n</i> = 52) of the patients reported functional problems. Overall, 48% of the patients (<i>n</i> = 87) experienced at least one ACE-related complication. At the latest follow-up, 61% of the patients were using ACE (<i>n</i> = 110), of whom 86% stayed clean (<i>n</i> = 95). Overall, ACE treatment was successful in 81% of patients (<i>n</i> = 144), defined as being clean with ACE in current use or after discontinuing ACE treatment as unnecessary. In total, 31% of the patients had stopped using ACE as unnecessary (<i>n</i> = 45). Spina bifida patients were least likely to discontinue ACE usage (<i>n</i> = 9, 14%), followed by anorectal malformation patients (<i>n</i> = 17, 29%), while 32% of Hirschsprung patients (<i>n</i> = 8) and 71% of constipation patients (<i>n</i> = 5) discontinued ACE as unnecessary.As previous studies have also shown, we demonstrated that ACE treatment can be successfully utilized in majority of children with impaired fecal control. Two-thirds of patients continued ACE treatment over 5 years of whom 86% patients were staying clean.</p>","PeriodicalId":56316,"journal":{"name":"European Journal of Pediatric Surgery","volume":" ","pages":"95-101"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546346","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":"Postoperative Flank Bulge in Infants After Open CDH Repair: An Underreported Complication.","authors":"Mikal Obed, Jens Dingemann, Benno Ure, Rim Kiblawi","doi":"10.1055/a-2649-0722","DOIUrl":"10.1055/a-2649-0722","url":null,"abstract":"<p><p>Flank bulge (FB) is a rare postoperative complication, most commonly following surgery with retroperitoneal access through flank incision. It is characterized by relaxation of anterolateral wall muscles with abnormal protrusion of the abdominal wall. The assumed pathomechanism is iatrogenic injury of the intercostal nerves T11/T12. During congenital diaphragmatic hernia (CDH) repair, dissection and sutures are necessary at this thoracic level. We aimed to assess the risk of FB in a consecutive series of patients after CDH repair.We retrospectively analyzed charts of all patients after CDH repair (2007-2024) with a follow-up of ≥3 months. FB was diagnosed during clinical follow-up examinations and defined as protrusion of abdominal wall with no sonographic evidence for hernia. Surgical variables and their association with FB were evaluated. For statistical analysis, Pearson's and Student's t-test were used. Multivariate logistic regression was performed to identify independent risk factors associated with FB development after CDH repair.Among 67 infants undergoing CDH repair with follow-up, 76% underwent open surgery and 48% required patch repair. Postoperative FB occurred in 11% of patients, exclusively following open repair with patch, and was significantly associated with rib sutures and higher birth weight. One-third of FB cases resolved spontaneously, while the remainder persisted, though without functional impairment.FB may be an underestimated complication after open CDH repair. Routine assessment of abdominal wall tone is recommended during follow-up after CDH repair. Larger studies are needed to clarify the clinical impact, patient-perceived level of disability, and long-term sequelae.</p>","PeriodicalId":56316,"journal":{"name":"European Journal of Pediatric Surgery","volume":" ","pages":"130-135"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661128","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":"Latest Developments in Artificial Intelligence and Machine Learning Models in General Pediatric Surgery.","authors":"Hesham Elsayed, Georg Singer, Tristan Till, Holger Till","doi":"10.1055/a-2689-8280","DOIUrl":"10.1055/a-2689-8280","url":null,"abstract":"<p><p>Artificial intelligence (AI) and machine learning (ML) models rapidly transform health care with applications ranging from diagnostic image interpretation, predictive modeling, personalized treatment planning, real-time intraoperative guidance, and outcome prediction. However, their implementation in general pediatric surgery remains limited due to the rarity and complexity of pediatric surgical conditions, small and heterogeneous datasets, and a lack of formal AI training and competencies among pediatric surgeons.This narrative review explores the current landscape of AI and ML applications in general pediatric surgery, focusing on five key conditions: appendicitis, necrotizing enterocolitis, Hirschsprung's disease, congenital diaphragmatic hernia, and biliary atresia. For each, we summarize recent developments, including the use of AI in image analysis, diagnostic support, prediction of disease severity and outcome, postoperative monitoring, and histopathological evaluation. We also highlight novel tools such as explainable AI models, natural language processing, and wearable technologies.Recent findings demonstrate promising diagnostic and prognostic capabilities across multiple conditions. However, most AI/ML models still require external validation and standardization. The review underscores the importance of collaborative, multicenter research based on joint datasets as well as targeted AI education for pediatric surgeons to fully explore the benefits of these technologies in clinical practice.AI and ML offer significant potential to improve pediatric surgical care, but broader implementation will require multicenter collaboration, a robust dataset, and targeted AI education for pediatric surgeons.</p>","PeriodicalId":56316,"journal":{"name":"European Journal of Pediatric Surgery","volume":" ","pages":"157-164"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980417","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}