European Journal of Pediatric Surgery最新文献

{"title":"Patient-Reported Long-Term Gastrointestinal Outcomes in Children with Omphalocele and Gastroschisis: A PedsQL GI Module Study.","authors":"Maaike Hogerwerf, Adinda G H Pijpers, Ramon R Gorter, Bart G P Koot, Ilan J N Koppen, Merit M Tabbers, Joep P M Derikx","doi":"10.1055/a-2817-6760","DOIUrl":"10.1055/a-2817-6760","url":null,"abstract":"<p><strong>Objective: </strong>Previous studies exploring long-term outcomes of patients with omphalocele and gastroschisis suggest an ongoing burden of gastrointestinal symptoms but also highlight substantial heterogeneity in methodology and outcomes measurement, limiting comparability. Therefore, the aim of this study was to systematically evaluate patient-reported long-term gastrointestinal symptoms, using a validated questionnaire, and compare the scores to those of healthy controls.</p><p><strong>Methods: </strong>All children treated for omphalocele and gastroschisis between 1999 and 2022 were invited to complete the Pediatric Quality of Life Inventory GI Module, consisting of twelve gastrointestinal domains. Parent proxy-reports or child self-reports were sent by mail, appropriate for the participants' age. The scores were compared with a predefined American healthy cohort (<i>n</i> = 513). Significance threshold was <i>p</i> < 0.004 (Bonferroni-corrected).</p><p><strong>Results: </strong>In total, 45/131 (34.4%) respondents completed the questionnaire, of whom 20 had omphalocele (50.0% male, median age 10.4 years [IQR: 6.4-16.4]), and 25 had gastroschisis (56.0% male, median age 9.9 years [IQR: 6.2-16.8]). Omphalocele patients reported a similar mean total score (86.5 [ ± 15.9] vs. 88.6 [ ± 12.9], <i>d</i> = 0.15, <i>p</i> = 0.566) and similar domain scores (<i>d</i> < 0.35, <i>p</i> > 0.01) compared with healthy controls. Gastroschisis patients also reported a similar mean total score compared with healthy controls (84.9 [SD ± 10.9], <i>d</i> = 0.31, <i>p</i> = 0.112). However, they scored worse on the domains \"gas and bloating\" (<i>d</i> = 0.78, <i>p</i> = 0.001), \"diarrhea\" (<i>d</i> = 0.74, <i>p</i> = 0.002), and \"constipation\" (<i>d</i> = 0.51, <i>p</i> = 0.026).</p><p><strong>Conclusion: </strong>Omphalocele patients reported a low burden of long-term gastrointestinal symptoms, indicating that routine follow-up may not be required. In contrast, gastroschisis patients reported a higher prevalence of gas and bloating, diarrhea, and constipation compared with healthy controls, highlighting the importance of early recognition and targeted management of these symptoms.</p>","PeriodicalId":56316,"journal":{"name":"European Journal of Pediatric Surgery","volume":" ","pages":"292-299"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13375281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445690","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":"Microsurgical Varicocelectomy with Spermatic Vein to Superficial Epigastric Vein Bypass in Adolescents.","authors":"Dino Papes, Stanko Cavar, Miram Pasini, Ivana Sabolic, Anko Antabak, Ivan Jelčić, Tea Rosandic, Dorotea Sinjeri, Dora Skrljak Sosa, Tomislav Luetic","doi":"10.1055/a-2770-2866","DOIUrl":"10.1055/a-2770-2866","url":null,"abstract":"<p><p>A microsurgical venous bypass between the internal spermatic vein (ISV) and inferior epigastric vein was proposed five decades ago for varicocele treatment. Limitations of this technique include a large incision, transverse fascia transection, delayed recovery, and mandatory venography to rule out external iliac vein compression (present in ∼10% of patients). To address these limitations, a modified microsurgical varicocelectomy with internal spermatic to superficial epigastric vein (SEV) bypass was developed and evaluated in this study.The ISV-SEV bypass was performed in all adolescents (≤18 years) undergoing microsurgical varicocelectomy between May 2021 and October 2023 for left testicular hypotrophy, pain, or oligospermia. The first 100 consecutive cases were analyzed. Outcomes included length of hospital stay, complications, recovery time, postoperative Doppler parameters (testicular volume, reflux, anastomosis patency), recurrence, and improvement in testicular volume and semen characteristics. Minimum follow-up was 12 months.Mean patient age was 15.5 ± 1.15 years. Main indications included hypotrophy (72%) and oligospermia (24%). Median operative time was 55 minutes (range 45-90). All patients were discharged within 24 hours. Median return to school and sports was 4.5 and 14 days, respectively. Testicular volume improved in 54/72 patients with hypotrophy. All oligospermic patients showed significant sperm count improvement (mean 15.2 to 88.2 million; <i>p</i> < 0.0001). Rates of atrophy, hydrocele, hematoma, and recurrence were 0%, 0%, 2%, and 1%, respectively. Residual Doppler reflux or persistent varices were noted in 11 patients, but without clinical relevance.Microsurgical varicocelectomy with ISV-SEV bypass appears to be a safe and feasible technique in adolescent patients, with encouraging short-term outcomes regarding testicular volume recovery and semen parameters. Low complication and recurrence rates are promising, but further studies are needed to assess the benefit over standard techniques.</p>","PeriodicalId":56316,"journal":{"name":"European Journal of Pediatric Surgery","volume":" ","pages":"339-346"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745671","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":"Artificial Intelligence Competencies and Educational Needs Among ERNICA Members: Results of a Multinational Survey.","authors":"Holger Till, Hesham Elsayed, Beate Obermüller, Richard Gnatzy, Martin Lacher, Sebastian Tschauner, Rosa Verhoeven, Rene M H Wijnen, Georg Singer","doi":"10.1055/a-2787-2213","DOIUrl":"10.1055/a-2787-2213","url":null,"abstract":"<p><strong>Introduction: </strong>Artificial intelligence (AI) is increasingly recognized as a transformative force in healthcare. In the field of rare diseases, AI can enhance diagnostic accuracy and facilitate knowledge-sharing across borders. To effectively contribute to the development and use of AI-based medical support systems, clinicians must provide specialized AI competencies. This survey assesses the AI readiness, educational needs, and perceptions of members within the European Reference Network for Rare Inherited and Congenital Anomalies (ERNICA).</p><p><strong>Methods: </strong>A structured online survey consisting of 22 questions was distributed to 389 ERNICA members, collecting data on demographics, AI awareness, current use, educational needs, concerns, and future expectations.</p><p><strong>Results: </strong>A total of 89 members responded (23%), representing a multidisciplinary group with varying experience. Most respondents (94%) reported no formal AI training yet, and rated their AI knowledge as basic (66%) or intermediate (26%). About 48% of the participants stated using AI applications already. Key educational needs included online courses and webinars. Major concerns focused on the reliability and accuracy of AI tools (80%) and ethical implications (71%). At the same time, 55% expect ERNICA to take a leading role in AI education in the diagnosis and management of rare gastrointestinal diseases.</p><p><strong>Conclusion: </strong>This survey among ERNICA members revealed a definite gap of AI understanding and training. Addressing these issues requires tailored educational initiatives focused on practical AI applications, ethical considerations, and interpretability. By adopting a proactive role in AI capacity-building, ERNICA could contribute to responsible and effective integration of AI into rare disease care.</p>","PeriodicalId":56316,"journal":{"name":"European Journal of Pediatric Surgery","volume":" ","pages":"324-329"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13375283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012990","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":"Impact of Azygos Vein Preservation on Postoperative Outcomes in Esophageal Atresia: A Systematic Review and Meta-Analysis from the Pediatric Surgery Meta-Analysis (PESMA) Study Group.","authors":"Cecilia G Heitsman, Mustafa Azizoğlu, Marta Gazzaneo, Tahsin O Kamci, Maria Escolino, Sergey Klyuev, Esra Karakas, Toni Risteski, Sonia Pérez-Bertólez, Maria F Marenco Gutierrez, Federica Pederiva, Salvatore Fabio Chiarenza, Annika Mutanen, Ciro Esposito","doi":"10.1055/a-2787-2370","DOIUrl":"10.1055/a-2787-2370","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate whether preservation of the azygos vein influences postoperative outcomes in infants undergoing repair of esophageal atresia with tracheoesophageal fistula (EA-TEF).</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted using six major databases, identifying all relevant studies published up to January 2025. Seven studies met the inclusion criteria, including five randomized controlled trials and two retrospective analyses. Outcomes assessed were anastomotic leaks, esophageal strictures, chest infections, and mortality.</p><p><strong>Results: </strong>Across studies, azygos vein preservation was generally associated with fewer postoperative complications compared with ligation. Preservation of the azygos vein appeared to reduce the risk of anastomotic leak, chest infection, and mortality, while also showing a trend toward fewer strictures. However, the strength of evidence was limited by study heterogeneity, small sample sizes, and variation in surgical techniques.</p><p><strong>Conclusion: </strong>This systematic review and meta-analysis suggest that preserving the azygos vein may be beneficial in reducing major postoperative complications. Nevertheless, because most included studies were small and of mixed quality, these findings should be interpreted with caution. Larger, high-quality randomized trials are needed to confirm whether azygos vein preservation directly improves clinical outcomes.</p>","PeriodicalId":56316,"journal":{"name":"European Journal of Pediatric Surgery","volume":" ","pages":"270-278"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012919","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":"Indirect Evidence for the Volume-Outcome Relationship in Corrective Surgery for Hirschsprung Disease: Insights from Adult Colorectal Surgery.","authors":"Miriam Wilms, Max Samans, Martin Lacher, Thomas M Boemers, Eberhard Schmiedeke, Michael Boettcher, Ekkehart Jenetzky, Anjali Röth, Ulrich K Fetzner, Carlos Reck-Burneo, Christoph Härtel, Jochen Hubertus, Valeria Solari","doi":"10.1055/a-2811-4806","DOIUrl":"10.1055/a-2811-4806","url":null,"abstract":"<p><p>Hirschsprung disease (HD) is a rare malformation that requires complex corrective surgery. Low caseload, heterogeneous patient cohorts, and difficulties in linking long-term outcomes to the initial corrective surgery limit the available direct evidence for a volume-outcome relationship. Indirect evidence from adult colorectal cancer (CRC) surgery may be transferable, given the partial similarity of the procedures.Using the Institute for Quality and Efficiency in Health Care (IQWiG) V24-07 rapid report's methodology, this study evaluated the transferability of the volume-outcome relationship from adult CRC surgery to corrective surgery for HD in children. Differences between the two populations were identified and rated for their effect on the transferability of the volume-outcome relationship by an expert panel, following predefined IQWiG V24-07 categories.Consensus was reached for 6 out of 12 criteria. For \"disease characteristics,\" \"comorbidities,\" \"intervention,\" \"follow-up,\" and \"concomitant treatments,\" differences were deemed irrelevant to transferability. For \"diagnosis,\" differences were considered to increase procedural complexity in HD, thereby reinforcing the volume-outcome relationship. Tissue sampling and frozen-section pathology were identified as key challenges. Differences of opinion arose for the remaining criteria, particularly concerning whether the transferability of evidence is limited to rectal resections in adults or includes all colorectal resections. No consensus could be reached on the appropriate caseload threshold for corrective surgery for HD in children.Using the IQWiG V24-07 framework, this study provides strong support for the transferability of the volume-outcome relationship from adult colorectal surgery to corrective surgery for HD. Despite population differences, the underlying mechanisms linking surgical complexity and institutional experience are comparable, reinforcing the relevance of volume-based quality control in pediatric surgery.</p>","PeriodicalId":56316,"journal":{"name":"European Journal of Pediatric Surgery","volume":" ","pages":"279-284"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146215086","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":"Learning Curve and Early Outcomes of Thoracoscopic Anatomical Lesion Resection for Congenital Pulmonary Airway Malformation in Children: A Single-surgeon Experience.","authors":"Minhua Lin, Jiachi Liao, Le Li","doi":"10.1055/a-2767-7356","DOIUrl":"10.1055/a-2767-7356","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the key points in performing thoracoscopic anatomic pulmonary lesion resection procedures, as well as analyze the characteristics of the learning curve associated with the surgery.</p><p><strong>Methods: </strong>We retrospectively collected clinical data and 1-year follow-up outcomes of children diagnosed with congenital pulmonary airway malformation (CPAM) who underwent thoracoscopic anatomic lesion resection in our hospital from January 2019 to December 2023. Perioperative and short-term follow-up results were analyzed and surgical experiences and insights were summarized. Furthermore, the cumulative sum (CUSUM) method was employed to plot the learning curve of a single surgeon performing thoracoscopic anatomic resection, and the impact of different phases on perioperative parameters and early follow-up outcomes was investigated.</p><p><strong>Results: </strong>This study included 154 patients undergoing thoracoscopic anatomic lesion resection. Postoperative complications occurred in three patients (1.9%), and residual lesions were identified in four cases (2.6%). When a single surgeon's procedural volume exceeded 39 cases, marking the transition to the proficiency phase, significant reductions were observed in operative time, intraoperative blood loss, postoperative hospital stay, and postoperative mechanical ventilation duration compared with the learning phase (all <i>p</i> < 0.05). No significant differences were found in postoperative drainage volume and chest tube duration.</p><p><strong>Conclusion: </strong>The key to thoracoscopic anatomic lesion resection lies in identifying the lesion boundaries and achieving precise dissection. Our study showed that this surgical approach is relatively safe and feasible for children with CPAM, with favorable perioperative and 1-year postoperative outcomes. Moreover, as surgeons progress to proficiency, perioperative outcomes improve and the incidence of residual lesions decreases. However, as a single-center study with a limited number of cases and due to a lack of long-term follow-up data, the safety and efficacy of this technique still require further validation through multi-center studies.</p>","PeriodicalId":56316,"journal":{"name":"European Journal of Pediatric Surgery","volume":" ","pages":"263-269"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145795346","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":"Weight Loss and Durability of Gastric Banding in Adolescents with Severe Obesity: 8-year Follow-up of a Randomized Controlled Trial.","authors":"Fien de Boom, Ali Talib, Yvonne G M Roebroek, Givan F Paulus, Bjorn Winkens, Nicole D Bouvy, L W Ernest van Herum","doi":"10.1055/a-2788-9950","DOIUrl":"10.1055/a-2788-9950","url":null,"abstract":"<p><strong>Objective: </strong>Metabolic and bariatric surgery is an established treatment for severe obesity. Laparoscopic adjustable gastric banding (LAGB) was once considered a promising option for adolescents. However, long-term data in this population are lacking. We aimed to evaluate the long-term effectiveness of LAGB in adolescents extending beyond 3 years postoperatively.</p><p><strong>Methods: </strong>Adolescents with severe obesity were randomly assigned to the intervention group (LAGB and multidisciplinary lifestyle intervention [MLI]) or the control group (MLI), with annual follow-ups for 3 years. We conducted a follow-up analysis of this cohort after 8.6 years (range: 5.0-12.5).</p><p><strong>Results: </strong>A total of 59 patients were randomized (29 LAGB + MLI and 30 MLI only). Early differences in weight loss were observed during the first 2 years, but no significant difference persisted after 8.7 years (mean difference body mass index: 1.8 kg/m², 95% CI: -3.2, 6.8). The band removal rate was high (52%).</p><p><strong>Conclusion: </strong>After nearly 9 years, LAGB resulted in minimal weight loss and had a high removal rate in adolescents with severe obesity. Our study was limited by loss to follow-up, self-reported weights, and crossover. Nonetheless, these findings confirm the lack of efficacy that has led to the global decline in LAGB procedures and underscore the shift toward more effective surgical procedures.</p>","PeriodicalId":56316,"journal":{"name":"European Journal of Pediatric Surgery","volume":" ","pages":"316-323"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146004859","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":"Robotic versus Open Pancreatectomy for Focal Congenital Hyperinsulinism in Infants: A Single-Center Study.","authors":"Claire Dagorno, Maxime Koffi, Louise Galmiche, Yves Aigrain, Cecile S Martin, Françoise Montravers, Dominique Berrebi, Stefania Querciagrossa, Valeria Taurisano, Olivier Bustarret, Juliette Bouchereau, Claire Marine Berat, Pascale De Lonlay, Patrick Barbet, Jean-Baptiste Arnoux, Carmen Capito","doi":"10.1055/a-2785-7843","DOIUrl":"10.1055/a-2785-7843","url":null,"abstract":"<p><strong>Objective: </strong>Focal forms of congenital hyperinsulinism (FoCHI) are rare pediatric conditions managed using established metabolic and surgical protocols. To date, the use of a robotic approach for this surgery in children has not been described. We present our initial experience with robotic pancreatectomy, compared with the open approach, for the management of FoCHI.</p><p><strong>Methods: </strong>We conducted a retrospective, single-center study involving 25 children who underwent pancreatectomy for CHI between 2011 and 2024. Collected data included patient demographics, surgical details, complications, and post-operative outcomes. The Da Vinci Xi robotic system was used for all robotic procedures.</p><p><strong>Results: </strong>Ten patients underwent robotic pancreatectomy, and 10 underwent open surgery; five children treated laparoscopically were excluded. There were no significant differences between the robotic and open groups in median weight at surgery (7.7 kg vs. 7.3 kg, <i>p</i> = 0.7), median age (7 months vs. 5.9 months, <i>p</i> = 0.48), median operative time (298 minutes vs. 285 minutes, <i>p</i> = 0.5), length of stay (14 days vs. 14.5 days, <i>p</i> = 0.26), or time to postoperative feeding resumption (4 days vs. 4.5 days, <i>p</i> = 0.68). Intraoperatively, 80% of lesions were visible on the pancreatic surface. Two cases of incomplete resection occurred in each group; after multidisciplinary review, both patients in the robotic group required a second procedure. No intraoperative bleeding or conversions were reported. The overall cure rate was 90% in the robotic group and 80% in the open surgery group.</p><p><strong>Conclusion: </strong>This preliminary study suggests that robotic pancreatectomy for congenital hyperinsulinism may be both safe and feasible. The robotic approach provides enhanced visualization of small vessels, enabling limited dissection and safe resection. Given the sample size, further studies are required to confirm these findings.</p>","PeriodicalId":56316,"journal":{"name":"European Journal of Pediatric Surgery","volume":" ","pages":"285-291"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094919","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":"Novel Bedside Ligation for Staged Closure of Congenital Portosystemic Shunts: A Single-Center Experience in 20 Children.","authors":"Sheng Chen, Huaying Zhao, Zhoulonglong Xie, Dongyu Mei, Chen Guo, Qimin Chen, Jun Chu, Zhilong Yan","doi":"10.1055/a-2789-0007","DOIUrl":"10.1055/a-2789-0007","url":null,"abstract":"<p><strong>Objective: </strong>To report our institutional experience with a portal venous pressure (PVP)-guided surgical strategy for congenital portosystemic shunts (CPSs) and introduce a novel bedside ligation technique for staged shunt closure.</p><p><strong>Methods: </strong>We retrospectively reviewed 20 children who underwent surgical CPS closure between 2013 and 2023. The surgical approach was determined by intraoperative PVP during temporary shunt occlusion. One-stage ligation was performed when PVP remained < 25 mm Hg, whereas shunts with PVP ≥ 25 mm Hg were banded for staged closure using either bedside ligation or endovascular completion.</p><p><strong>Results: </strong>Fourteen patients (70%) underwent one-stage closure (median PVP: 22.0 mm Hg, interquartile range [IQR]: 18.0-22.5), and six (30%) required two-stage closure (median PVP: 28.0 mm Hg, IQR: 25.8-29.5). Among the latter, five achieved complete shunt occlusion through the bedside technique, avoiding reoperation or readmission. The primary composite outcome-radiologic closure, fasting blood ammonia normalization, and absence of severe complications-was achieved in all 20 patients (100%) at 1-year follow-up. Significant intrahepatic portal vein (IPV) remodeling was observed, with median left and right IPV diameters increasing from 1.4 and 1.6 to 4.8 and 5.0 mm, respectively (both <i>p</i> < 0.0001). The overall complication rate was 15% (3/20), all Clavien-Dindo Grades I to II.</p><p><strong>Conclusion: </strong>In children with CPSs unsuitable for endovascular closure, a PVP-guided surgical strategy appears safe and effective. For those requiring two-stage closure due to elevated PVP, bedside ligation after Endoloop banding provides a feasible, less invasive alternative to reoperation. However, larger studies are needed to confirm its safety and efficacy.</p>","PeriodicalId":56316,"journal":{"name":"European Journal of Pediatric Surgery","volume":" ","pages":"330-338"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991939","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":"Is Preoperative Antimicrobial Prophylaxis Necessary in Testicular Torsion Surgery? Results from the National Surgical Quality Improvement Program Pediatric.","authors":"Alexandra Stone, Maithili Gopalakrishnan, Anthony Tracey, Matthew Mason, Jeffrey Villanueva","doi":"10.1055/a-2786-3629","DOIUrl":"10.1055/a-2786-3629","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the impact of surgical antimicrobial prophylaxis (SAP) on testicular torsion surgery (TTS) postoperative outcomes using data from the National Surgical Quality Improvement Program Pediatric (NSQIP-P). Across multiple studies, NSQIP-P has proven increased sensitivity in recording postoperative complications compared with similar databases.</p><p><strong>Methods: </strong>The 2021-2023 NSQIP-P participant user and SAP files were queried for all TTSs. Patients with unrecorded SAP administration data (<i>n</i> = 2,725) were excluded. Postoperative events were then compared between subjects who did or did not receive SAP. Primary outcomes included rates of surgical site infection (SSI), 30-day readmission, and 30-day reoperation. SPSS statistical software was used to perform comparative statistical analyses between groups.</p><p><strong>Results: </strong>A total of 614 patients were included in the study and divided into Group 1 (+SAP, <i>n</i> = 322) and Group 2 (-SAP, <i>n</i> = 292). In the +SAP group, there was no observation of SSI, but one case resulted in 30-day readmission and reoperation. Another 30-day readmission and 30-day reoperation were noted, as well. In the -SAP, there was one observation of a deep incisional SSI who was readmitted. There were no 30-day reoperations in this group. There was no statistical significance in outcomes between the two groups.</p><p><strong>Conclusion: </strong>To date, this is the first study assessing the impact of SAP in torsion-reduction surgeries using the NSQIP-P database. There is a low frequency of postoperative complications with this procedure. Our study suggests limited utility of SAP with this surgery despite continued use.</p>","PeriodicalId":56316,"journal":{"name":"European Journal of Pediatric Surgery","volume":" ","pages":"347-350"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13375282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991958","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}