Journal of pediatric surgery最新文献

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IF 2.4 2区医学 Q1 PEDIATRICS

Journal of pediatric surgery

Pub Date : 2024-11-16 DOI: 10.1016/S0022-3468(24)00990-4

引用次数: 0

Precise Thoracoscopic Pneumonectomy Using Fluorescence Imaging After Aerosolized Indocyanine Green Inhalation: A Novel Strategy for Treating Congenital Pulmonary Airway Malformation 气溶胶吲哚菁绿吸入后利用荧光成像进行精确胸腔镜肺切除术：治疗先天性肺气道畸形的新策略。

IF 2.4 2区医学 Q1 PEDIATRICS

Journal of pediatric surgery

Pub Date : 2024-11-12 DOI: 10.1016/j.jpedsurg.2024.162063

Tianqi Zhu , Yanan Li , Jiaxin Zhang , Xiaofeng Xiong , Ye Yin , Didi Zhuansun , Ying He , Jiexiong Feng

Background

Lobectomy resection is the standard treatment for patients with congenital pulmonary airway malformation (CPAM). However, accurate localization of CPAM lesions and avoiding excessive resection of normal lung tissue are one of the critical issues that can impact postoperative pulmonary function. Indocyanine green (ICG) can be adopted in lung preservation surgery, to minimize damage to normal lung tissue during thoracoscopic pneumonectomy.

Objective

To demonstrate the potential benefits of aerosol inhalation of ICG followed by thoracoscopic precision pneumonectomy for the treatment of CPAM.

Methods

From January 2023 to March 2024, we prospectively collected clinical data from 34 pediatric patients diagnosed with CPAM and treated with thoracoscopic surgery. Patients inhaled ICG aerosol solution (0.5 mg/kg) approximately 30–60 min before the operation. During surgery, fluorescence thoracoscopy was used to clearly locate the lesion boundaries and achieve precise resection.

Results

All patients successfully underwent thoracoscopic precise resection of CPAM lesions without conversion to open surgery. The mean operation time was 100.3 ± 24.6 min, and the mean intraoperative blood loss was 30.5 ± 25.6 mL. The mean total length of hospital stay (tLOS) was 6.6 ± 3.2 days. No adverse reactions to ICG were observed. Postoperative complications included one case of pneumothorax (5.9 %) and three cases of subcutaneous emphysema (17.6 %), all of which resolved without special intervention. Follow-up CT scans and pulmonary function tests conducted 6 months post-surgery demonstrated the absence of residual or recurrent lesions and notable enhancement in pulmonary function.

Conclusion

Preliminary results indicated that the treatment of CPAM with aerosolized ICG followed by thoracoscopic precise pneumonectomy is safe and feasible.

背景：肺叶切除术是先天性肺气道畸形（CPAM）患者的标准治疗方法。然而，准确定位 CPAM 病灶和避免过度切除正常肺组织是影响术后肺功能的关键问题之一。在保肺手术中可采用吲哚菁绿（ICG），以减少胸腔镜肺切除术对正常肺组织的损伤：证明气溶胶吸入 ICG 后进行胸腔镜精确肺切除术治疗 CPAM 的潜在益处：从 2023 年 1 月到 2024 年 3 月，我们前瞻性地收集了 34 名被诊断为 CPAM 并接受胸腔镜手术治疗的儿科患者的临床数据。患者在手术前约 30-60 分钟吸入 ICG 气溶胶溶液（0.5 mg/kg）。手术过程中使用荧光胸腔镜清晰定位病灶边界，实现精确切除：结果：所有患者均成功接受了胸腔镜下 CPAM 病灶精确切除术，未转为开放手术。平均手术时间为（100.3±24.6）分钟，术中平均失血量为（30.5±25.6）毫升。平均住院总时间（tLOS）为 6.6 ± 3.2 天。未发现 ICG 不良反应。术后并发症包括一例气胸（5.9%）和三例皮下气肿（17.6%），所有并发症均在未采取特殊干预措施的情况下得到缓解。术后 6 个月的随访 CT 扫描和肺功能测试显示，没有残留或复发病灶，肺功能也明显改善：初步结果表明，用气雾化 ICG 治疗 CPAM，然后进行胸腔镜精确肺切除术是安全可行的。

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引用次数: 0

Sustained Positive Practice Change After Targeted Education in the Management of Ovarian Torsion 在卵巢扭转治疗中开展有针对性的教育后，持续的积极实践改变。

IF 2.4 2区医学 Q1 PEDIATRICS

Journal of pediatric surgery

Pub Date : 2024-11-10 DOI: 10.1016/j.jpedsurg.2024.162062

Matthew M. Byrne , Nicole A. Wilson , Elizabeth Levatino , David M. Powell , Marjorie J. Arca

Background

Failure to perform ovarian conservation surgery (OCS) for patients who present with adnexal torsion was recognized as a practice gap by the American Pediatric Surgical Association (APSA) in 2017. A targeted educational campaign was conducted to promote detorsion and ovarian conservation surgery as the standard of care for ovarian torsion. We evaluated the practice change that has occurred for pediatric and adolescent patients with ovarian torsion from 2012 to 2022.

Methods

Using the American College of Surgeons (ACS) National Safety and Quality Improvement Project-Pediatrics (NSQIP-P) Participant Use Files from 2012 to 2022, we compared surgical treatment types during the time periods that encompassed the targeted educational period.

Results

A total of 2249 patients (70 %) underwent OCS surgery and 980 (30 %) patients underwent salpingectomy and/or oophorectomy (SO). Patients who were treated with OCS were older (12.4 [SD 3.6] vs. 11.4 [SD 4.8] years, p < 0.01). Patients were more likely to be treated with SO if they were Black (11 vs. 15 %, p < 0.01) or obese (28 vs. 33 %, p < 0.01). From 2012 to 2017, 42 % of patients underwent OCS, compared to 76 % in 2018–2022 (p < 0.01). A mixed effect analysis comparing year-over-year rates of SO across pediatric surgeons and gynecologic surgeons showed a statistically significant difference in rates across specialty and time (p < 0.01), with pediatric surgeons performing fewer SOs.

Conclusion

In the treatment of ovarian torsion in pediatric and adolescent patients, we demonstrated successful adoption and sustained implementation of practice improvement coincident with the introduction of a comprehensive educational initiative.

Type of Study

Retrospective cohort.

Level of Evidence

IV.

背景：2017年，美国儿科外科学会（APSA）将未对出现附件扭转的患者实施卵巢保护手术（OCS）视为一项实践空白。美国儿科外科协会开展了一项有针对性的教育活动，旨在推广卵巢扭转的标准治疗方法--剥离术和卵巢保护手术。我们评估了从2012年到2022年，儿科和青少年卵巢扭转患者的治疗方法发生的变化：我们使用美国外科学院（ACS）2012 年至 2022 年国家安全与质量改进项目儿科（NSQIP-P）参与者使用档案，比较了目标教育期间的手术治疗类型：共有 2249 名患者（70%）接受了 OCS 手术，980 名患者（30%）接受了输卵管切除术和/或输卵管切除术 (SO)。接受卵巢综合征治疗的患者年龄较大（12.4 [SD 3.6] 岁 vs. 11.4 [SD 4.8] 岁，P 结论：接受卵巢综合征治疗的患者年龄较大（12.4 [SD 3.6] 岁 vs. 11.4 [SD 4.8] 岁）：在治疗儿童和青少年卵巢扭转的过程中，我们证明了在引入综合教育计划的同时，成功采用并持续实施了实践改进措施：研究类型：回顾性队列：证据等级：IV。

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引用次数: 0

We Must Say Good-bye to Dr. Mikko Pakarinen, but Please Say Hello to Drs. Augusto Zani and Robert Baird as Our Newest Executive Editors. 我们必须向 Mikko Pakarinen 博士道别，但请向我们最新的执行编辑 Augusto Zani 博士和 Robert Baird 博士问好。

IF 2.4 2区医学 Q1 PEDIATRICS

Journal of pediatric surgery

Pub Date : 2024-11-09 DOI: 10.1016/j.jpedsurg.2024.162061

George W Holcomb

引用次数: 0

Intercostal Nerve Cryoablation in Minimally Invasive Repair of Pectus Excavatum: National Trends, Outcomes, and Predictors of Utilization 肋间神经冷冻消融术在胸大肌微创修复术中的应用：全国趋势、结果和使用预测因素

IF 2.4 2区医学 Q1 PEDIATRICS

Journal of pediatric surgery

Pub Date : 2024-11-08 DOI: 10.1016/j.jpedsurg.2024.162060

Alyssa Green, Gabriel Ramos-Gonzalez, JoAnn DeRosa, Nicole M. Chandler, Christopher W. Snyder

Purpose

Intercostal nerve cryoablation during minimally invasive repair of pectus excavatum (MIRPE) is an effective pain control technique. Some insurers may not reimburse for cryoablation in this context, contending that it’s an experimental procedure. This study aimed to describe national trends in cryoablation use and evaluate outcomes and predictors of its use.

Methods

The Pediatric Health Information System database was queried for pectus excavatum patients aged 9–21 who underwent MIRPE between 2016 and 2023. Concurrent cryoablation use was identified using billing/supply codes. Temporal trends in cryoablation utilization were described and quantified using linear regression. Demographics, resource utilization, and outcomes were compared for patients based on cryoablation utilization using chi-square and Kruskal–Wallis tests. Predictors of cryoablation use were evaluated with logistic regression.

Results

This analysis included 2068 patients (mean age 15 ± 1.8 years; 86 % male). Cryoablation utilization increased from 33 % to 61 % from 2016 to 2023, with a strong positive trend (R² = 0.73). Cryoablation patients had fewer surgical complications (8 % vs 12 %, p = 0.004), shorter LOS (2.0 ± 1.3 vs. 2.8 ± 1.6 days, p < 0.001), fewer total mean opiate days billed (1.4 ± 1.1 vs. 1.6 ± 1.4 days, p < 0.0001) and higher total costs ($24,045 ± $9696 vs. $20,751 ± $9,237, p < 0.001). High-volume centers (odds ratio (OR) 1.9, 95 % confidence interval (CI) 1.2–3.0) and commercial HMO insurance (OR 2.7, 95 % CI 1.9–3.8) were predictors of cryoablation use.

Conclusion

Cryoablation during MIRPE has increased nationally since 2016; now being performed in nearly two-thirds of all cases. Cryoablation should be considered a standard adjunct to MIRPE rather than an experimental technique.

Level of evidence

目的在胸廓外翻微创修复术（MIRPE）中进行肋间神经冷冻消融是一种有效的疼痛控制技术。一些保险公司可能不会报销冷冻消融术的费用，认为这是一种实验性手术。本研究旨在描述全国冷冻消融术的使用趋势，并评估其使用结果和预测因素。方法在儿科健康信息系统数据库中查询了在 2016 年至 2023 年期间接受 MIRPE 的 9-21 岁乳突患者。通过账单/供应代码确定了冷冻消融的同时使用情况。使用线性回归对冷冻消融使用的时间趋势进行了描述和量化。使用卡方检验和 Kruskal-Wallis 检验比较了冷冻消融患者的人口统计学特征、资源利用率和结果。结果该分析包括 2068 名患者（平均年龄为 15 ± 1.8 岁；86% 为男性）。从 2016 年到 2023 年，冷冻消融术的使用率从 33% 增加到 61%，并呈现出强烈的正向趋势（R2 = 0.73）。冷冻消融患者的手术并发症较少（8 % vs. 12 %，p = 0.004），住院时间较短（2.0 ± 1.3 vs. 2.8 ± 1.6 天，p < 0.001），鸦片类药物的总平均结算天数较少（1.4 ± 1.1 vs. 1.6 ± 1.4 天，p < 0.0001），总费用较高（24,045 美元 ± 9696 美元 vs. 20,751 美元 ± 9,237 美元，p < 0.001）。高容量中心（几率比（OR）1.9，95 % 置信区间（CI）1.2-3.0）和商业 HMO 保险（OR 2.7，95 % CI 1.9-3.8）是使用冷冻消融的预测因素。冷冻消融应被视为 MIRPE 的标准辅助手段，而非实验性技术。

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引用次数: 0

Prevent Injury by Providing Evidence. 提供证据，预防伤害。

IF 2.4 2区医学 Q1 PEDIATRICS

Journal of pediatric surgery

Pub Date : 2024-11-07 DOI: 10.1016/j.jpedsurg.2024.162059

Minna M Wieck

引用次数: 0

A Retrospective Nationwide Comparison of Laparoscopic vs Open Inguinal Hernia Repair in Children 腹腔镜与开放式儿童腹股沟疝气修复术的全国回顾性比较。

IF 2.4 2区医学 Q1 PEDIATRICS

Journal of pediatric surgery

Pub Date : 2024-11-07 DOI: 10.1016/j.jpedsurg.2024.162056

Michela Carter , Steven T. Papastefan , Yao Tian , Stephen J. Hartman , Meredith S. Elman , Sara G. Ungerleider , Aaron P. Garrison , Tolulope A. Oyetunji , Matthew P. Landman , Mehul V. Raval , Seth D. Goldstein , Timothy B. Lautz

Background

Utilization of the laparoscopic approach for inguinal hernia repair has increased significantly over the past decade. The purpose of this study is to compare rates of second hernia operation and same side recurrence following open and laparoscopic inguinal hernia repair in a large national cohort.

Methods

This retrospective analysis utilized the Pediatric Health Information System database to identify children <18 years-old who underwent laparoscopic or open primary inguinal hernia repair from 2017 to 2021. Data were collected through 2022 to allow minimum one year follow-up. Second hernia operation rates, inclusive of same side recurrence and metachronous contralateral hernia, and same side recurrence rates were compared by multivariable mixed effects model controlling for confounders and institutional clustering. Misclassification rates were determined through data validation at four constituent institutions. Sensitivity analyses determined true outcome rates.

Results

We identified 53,287 operations (15.6% laparoscopic). Rate of second hernia operation was greater following laparoscopic repair (2.9% vs 2.6%, p = 0.04) with no difference on multivariable analysis (OR 1.14, 95% CI 0.98–1.32). Same side recurrence rate was greater following laparoscopic repair (1.5% vs 0.4%, p < 0.001) which persisted on multivariable analysis (OR 3.72, 95% CI 2.90–4.78). Sensitivity analysis demonstrated true laparoscopic and open repair rates of 14.2% and 85.8%, respectively. True rates of second hernia operation and same side recurrence were identical to those determined by PHIS.

Conclusion

Laparoscopic inguinal hernia repair in children has more than three times the odds of same side hernia recurrence than open repair which is balanced by a reduced rate of second operation for metachronous hernia.

Level of evidence

Treatment Study – Level III.

背景：在过去十年中，腹腔镜腹股沟疝修补术的使用率显著增加。本研究的目的是在全国范围内比较开腹和腹腔镜腹股沟疝修补术后的二次疝气手术率和同侧复发率：这项回顾性分析利用儿科健康信息系统数据库来识别患儿：我们确定了53287例手术（15.6%为腹腔镜手术）。腹腔镜修复术后二次疝气手术率更高（2.9% vs 2.6%，P = 0.04），多变量分析结果显示两者无差异（OR 1.14，95% CI 0.98-1.32）。腹腔镜修复术后同侧复发率更高（1.5% 对 0.4%，P=0.04）：儿童腹股沟疝气腹腔镜修补术的同侧疝气复发率是开放式修补术的三倍多，但由于异位疝气的二次手术率降低，两者相抵：治疗研究 - III 级。

{"title":"A Retrospective Nationwide Comparison of Laparoscopic vs Open Inguinal Hernia Repair in Children","authors":"Michela Carter , Steven T. Papastefan , Yao Tian , Stephen J. Hartman , Meredith S. Elman , Sara G. Ungerleider , Aaron P. Garrison , Tolulope A. Oyetunji , Matthew P. Landman , Mehul V. Raval , Seth D. Goldstein , Timothy B. Lautz","doi":"10.1016/j.jpedsurg.2024.162056","DOIUrl":"10.1016/j.jpedsurg.2024.162056","url":null,"abstract":"<div><h3>Background</h3><div>Utilization of the laparoscopic approach for inguinal hernia repair has increased significantly over the past decade. The purpose of this study is to compare rates of second hernia operation and same side recurrence following open and laparoscopic inguinal hernia repair in a large national cohort.</div></div><div><h3>Methods</h3><div>This retrospective analysis utilized the Pediatric Health Information System database to identify children <18 years-old who underwent laparoscopic or open primary inguinal hernia repair from 2017 to 2021. Data were collected through 2022 to allow minimum one year follow-up. Second hernia operation rates, inclusive of same side recurrence and metachronous contralateral hernia, and same side recurrence rates were compared by multivariable mixed effects model controlling for confounders and institutional clustering. Misclassification rates were determined through data validation at four constituent institutions. Sensitivity analyses determined true outcome rates.</div></div><div><h3>Results</h3><div>We identified 53,287 operations (15.6% laparoscopic). Rate of second hernia operation was greater following laparoscopic repair (2.9% vs 2.6%, p = 0.04) with no difference on multivariable analysis (OR 1.14, 95% CI 0.98–1.32). Same side recurrence rate was greater following laparoscopic repair (1.5% vs 0.4%, p < 0.001) which persisted on multivariable analysis (OR 3.72, 95% CI 2.90–4.78). Sensitivity analysis demonstrated true laparoscopic and open repair rates of 14.2% and 85.8%, respectively. True rates of second hernia operation and same side recurrence were identical to those determined by PHIS.</div></div><div><h3>Conclusion</h3><div>Laparoscopic inguinal hernia repair in children has more than three times the odds of same side hernia recurrence than open repair which is balanced by a reduced rate of second operation for metachronous hernia.</div></div><div><h3>Level of evidence</h3><div>Treatment Study – Level III.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 2","pages":"Article 162056"},"PeriodicalIF":2.4,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Antibiotic Prophylaxis for Elective Pediatric Laparoscopic Cholecystectomies 小儿腹腔镜胆囊切除术的抗生素预防。

IF 2.4 2区医学 Q1 PEDIATRICS

Journal of pediatric surgery

Pub Date : 2024-11-06 DOI: 10.1016/j.jpedsurg.2024.162055

Christine Rodhouse , Rachel Raymond , Dan Neal , Tyler J. Loftus , Faraz A. Khan , Ana R. Do , Janice A. Taylor , Philip A. Efron , Shawn D. Larson , Steven L. Raymond

Background

The Surgical Infection Society (SIS) guidelines recommend against the use of surgical antibiotic prophylaxis (SAP) for low-risk patients undergoing elective laparoscopic cholecystectomies.

Methods

Using National Surgical Quality Improvement Program (NSQIP) data, 5440 pediatric patients were identified who underwent laparoscopic cholecystectomy from 2021 to 2022. Patients who had immunodeficiency, active malignancy, American Society of Anesthesiologists (ASA) physical status classification 3–5, procedure indicated for infection, emergent procedure, received intravenous antibiotics before the prophylaxis window, or missing SAP data were excluded.

Results

3959 patients were included in the analysis. Among these patients, 3570 (90.2 %) received SAP. Overall incidence of 30-day superficial incisional surgical site infection (SSI), deep incisional SSI, and organ space SSI were 0.9 %, 0.0 %, and 0.1 %, respectively. The incidence of superficial incisional SSI was significantly higher in the patients who did not receive SAP (SAP 0.8 %, no SAP 2.1 %; p = 0.024). The incidence of organ space SSI was also significantly higher in the patients who did not receive SAP (SAP 0.1 %, no SAP 0.8 %; p = 0.008). There was no difference in the incidence of C. diff colitis (SAP 0.1 %, no SAP 0.0 %; p = 1.000). Multivariable modeling, controlling for Hispanic ethnicity, age, and gender, demonstrated patients that received SAP were significantly less likely to have any postoperative SSI compared to patients who did not receive SAP (OR = 0.35).

Conclusion

Hospitals are not currently compliant with SIS guidelines regarding omission of antibiotic prophylaxis for low-risk patients undergoing elective laparoscopic cholecystectomies. The authors advocate for additional studies and reassessment of current guidelines for pediatric patients given the above findings.

Type of Study

Retrospective comparative study.

Level of Evidence

III.

背景：外科感染学会（SIS）指南建议对接受择期腹腔镜胆囊切除术的低风险患者不使用外科抗生素预防（SAP）：利用国家外科质量改进计划（NSQIP）数据，确定了在2021年至2022年期间接受腹腔镜胆囊切除术的5440名儿科患者。排除了免疫缺陷、活动性恶性肿瘤、美国麻醉医师协会（ASA）身体状况分类3-5级、有感染指征的手术、紧急手术、在预防窗口期前接受静脉注射抗生素或SAP数据缺失的患者：共有 3959 例患者纳入分析。在这些患者中，3570 人（90.2%）接受了 SAP 治疗。30 天内浅切口手术部位感染 (SSI)、深切口 SSI 和器官间隙 SSI 的总发生率分别为 0.9%、0.0% 和 0.1%。未接受 SAP 治疗的患者浅切口 SSI 发生率明显更高（SAP 0.8 %，无 SAP 2.1 %；P = 0.024）。未接受 SAP 治疗的患者器官间隙 SSI 的发生率也明显更高（未接受 SAP 治疗的患者为 0.1%，未接受 SAP 治疗的患者为 0.8%；P = 0.008）。C.diff结肠炎的发生率没有差异（接受 SAP治疗的为0.1%，未接受 SAP治疗的为0.0%；P = 1.000）。控制西班牙裔、年龄和性别的多变量模型显示，与未接受 SAP 的患者相比，接受 SAP 的患者术后发生 SSI 的几率明显降低（OR = 0.35）：结论：对于接受择期腹腔镜胆囊切除术的低风险患者，医院目前并未遵守 SIS 指南中关于不使用抗生素预防的规定。鉴于上述发现，作者主张开展更多研究，并重新评估针对儿科患者的现行指南：研究类型：回顾性比较研究：证据等级：III。

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引用次数: 0

Antibiotic Management After Neonatal Enteric Operations in US Children's Hospitals 美国儿童医院新生儿肠道手术后的抗生素管理。

IF 2.4 2区医学 Q1 PEDIATRICS

Journal of pediatric surgery

Pub Date : 2024-11-05 DOI: 10.1016/j.jpedsurg.2024.162052

Priyanka Jadhav , Pamela M. Choi , Romeo Ignacio , Benjamin Keller , Gerald Gollin

Background

There are few evidence-based guidelines for perioperative antibiotic management in neonates who undergo enteric operations. We sought to assess antibiotic administration practices in a large population of patients who underwent operations involving enteric anastomoses and evaluate the incidence of postoperative infection and other outcomes based on antibiotic approach.

Methods

The Pediatric Health Information Systems database was queried for patients who underwent repair of esophageal, duodenal or jejuno-ileal atresia in 2021. The type and number of consecutive days of perioperative antibiotics was determined and ICD-10 codes corresponding to infection were noted. The incidences of post operative infections (bacterial and fungal), antibiotic-resistant infections and anti-fungal medication administration were determined.

Results

516 infants were identified. A wide variety of antibiotics were administered and 39 % of patients received more than one day of treatment. There were no differences in the incidence of postoperative infection between those who received more or less than one day of perioperative antibiotics for any of the operations assessed. The incidence of bacterial infection in patients treated with cefazolin or cefoxitin monotherapy was no different than that for all other regimens. There were no significant differences in the incidence of post-operative fungal infection based on antibiotic type or duration.

Conclusion

There was substantial variation in the duration and type of antibiotics administered after neonatal enteric operations. We identified a low incidence of infection with only one day of perioperative antibiotics and there was no evidence that longer treatment reduced infection risk. Cefazolin monotherapy was likewise associated with a low risk for perioperative infections.

Study type

Non-interventional observational database study.

Level of evidence

背景：关于接受肠道手术的新生儿围手术期抗生素管理的循证指南很少。我们试图评估大量接受肠道吻合手术的患者的抗生素使用方法，并根据抗生素使用方法评估术后感染的发生率和其他结果：方法：在儿科健康信息系统数据库中查询了2021年接受食道、十二指肠或空肠-回肠闭锁修复手术的患者。确定了围手术期抗生素的种类和连续使用天数，并记录了与感染相对应的 ICD-10 编码。确定术后感染（细菌和真菌）、抗生素耐药感染和抗真菌药物使用的发生率：结果：共发现 516 名婴儿。结果：共发现了 516 名婴儿，使用了多种抗生素，39% 的患者接受了一天以上的治疗。在所评估的所有手术中，围手术期使用抗生素超过或少于一天的患者术后感染率没有差异。接受头孢唑啉或头孢西丁单药治疗的患者的细菌感染率与所有其他治疗方案的感染率没有差异。抗生素种类或疗程不同，术后真菌感染的发生率也无明显差异：结论：新生儿肠道手术后使用抗生素的时间和类型存在很大差异。我们发现，围手术期仅使用一天抗生素的感染率较低，没有证据表明延长治疗时间会降低感染风险。头孢唑啉单药治疗同样与围手术期感染的低风险相关：研究类型：非干预性观察数据库研究：3:

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引用次数: 0

Tracheal Allotransplantation to Deliver Growing Airway Implants for Infants and Children. 气管异位移植为婴儿和儿童提供生长气道植入物。

IF 2.4 2区医学 Q1 PEDIATRICS

Journal of pediatric surgery

Pub Date : 2024-11-05 DOI: 10.1016/j.jpedsurg.2024.162048

Adam Lorio, Herra Javed, Eli Contorno, Lawrence Greiten, Brian Reemtsen, Taufiek Konrad Rajab

引用次数: 0

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