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Single-staged in vivo co-transplantation of autologous muscular and urothelial micrografts as a composite tissue tube for urogenital reconstruction. 自体肌肉和尿路上皮微移植物单阶段体内联合移植复合组织管用于泌尿生殖器官重建。
IF 1.6 3区 医学 Q2 PEDIATRICS Pub Date : 2026-01-09 DOI: 10.1007/s00383-025-06259-5
Alexander Guldmann Clausen, Nikolai Juul, Mahboobeh Amoushahi, Oliver Willacy, Magdalena Fossum
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引用次数: 0
Role of heminephrectomy for poorly functioning upper pole of complete duplex systems in children. 儿童全双肾系统上极功能不佳的半肾切除术的作用。
IF 1.6 3区 医学 Q2 PEDIATRICS Pub Date : 2026-01-07 DOI: 10.1007/s00383-025-06280-8
Hakan Keskin, Ihsan Batuhan Demir, Serdar Tekgul, Hasan Serkan Dogan

Introduction: The management of duplex renal systems remains controversial. Depending on patient characteristics, conservative management, minimally invasive techniques, or open surgery may be considered, each offering distinct advantages and limitations. In this study, we aimed to present the outcomes of upper-pole heminephrectomy for poorly functioning moieties in duplex systems while preserving the lower urinary tract.

Materials and methods: All patients underwent routine clinical evaluation, including medical history, physical examination, biochemical tests, and radiological imaging. Surgical intervention was indicated in symptomatic patients or based on shared decision-making after counseling the parents. Thirty-six patients who underwent upper-pole heminephrectomy between 2014 and 2024 were retrospectively analyzed with respect to demographic characteristics, preoperative and perioperative findings, and postoperative follow-up. Postoperative outcomes were classified as short-term and long-term. Patients who required reoperation were compared with those who did not.

Results: The cohort consisted of 28 female and 8 male children with a mean age of 36.1 ± 39.5 months at the time of surgery. In the short term, only one patient required reoperation due to suspected urinary leakage. Over a mean postoperative follow-up of 29.83 ± 31.50 months, eight patients underwent additional procedures: two stump excisions, five endoscopic interventions, and one open anti-reflux surgery. All six patients who required anti-reflux intervention were female and had high-grade vesicoureteral reflux (VUR) prior to heminephrectomy. Younger age at surgery and preoperative VUR were identified as significant risk factors for reoperation.

Conclusions: Upper-pole heminephrectomy prevented the need for open bladder surgery in 97% of patients during follow-up. However, parents of female patients and those with high-grade VUR should be counseled regarding the increased risk of secondary procedures related to postoperative VUR and febrile urinary tract infections. The likelihood of additional surgery during follow-up appears to be primarily driven by the preoperative VUR status.

简介:双肾系统的管理仍然存在争议。根据患者的特点,可以考虑保守治疗、微创技术或开放手术,每种方法都有其独特的优点和局限性。在这项研究中,我们的目的是在保留下尿路的同时,对双系统中功能不良的部分进行上极半肾切除术的结果。材料和方法:对所有患者进行常规临床评价,包括病史、体格检查、生化检查和影像学检查。在有症状的患者中或在咨询父母后共同决策的基础上进行手术干预。回顾性分析2014 - 2024年间36例上极半肾切除术患者的人口学特征、术前、围手术期表现及术后随访情况。术后结果分为短期和长期。需要再手术的患者与不需要再手术的患者进行比较。结果:该队列包括28名女性和8名男性儿童,手术时平均年龄为36.1±39.5个月。短期内,仅有1例患者因怀疑尿漏需要再次手术。在平均29.83±31.50个月的术后随访中,8例患者接受了额外的手术:2例残端切除,5例内镜干预,1例开放式抗反流手术。所有6例需要抗反流干预的患者均为女性,且在半肾切除术前患有高度膀胱输尿管反流(VUR)。手术年龄较小和术前VUR被认为是再次手术的重要危险因素。结论:在随访期间,97%的患者行上极半肾切除术后无需开膀胱手术。然而,女性患者和高度VUR患者的父母应被告知与术后VUR和发热性尿路感染相关的二次手术风险增加。在随访期间进行额外手术的可能性似乎主要由术前VUR状态驱动。
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引用次数: 0
Naringin attenuates testicular ischemia/reperfusion injury in a mouse torsion/detorsion model via intraperitoneal administration. 柚皮苷通过腹腔注射减轻小鼠扭转/扭转模型睾丸缺血/再灌注损伤。
IF 1.6 3区 医学 Q2 PEDIATRICS Pub Date : 2026-01-05 DOI: 10.1007/s00383-025-06286-2
Khashayar Khorsand, Alireza Najafpour, Mohammadreza Valilou, Ali Soleimanzadeh

This study investigated the protective effects of naringin, a flavanone glycoside with established antioxidant, anti-inflammatory, and anti-apoptotic properties, against testicular ischemia/reperfusion (I/R) injury in a mouse torsion/detorsion model. Forty adult male mice underwent a 720° torsion for two hours, followed by detorsion. Five groups (n = 8) received naringin (50, 100, or 200 mg/kg) administered intraperitoneally 30 min prior to detorsion: sham, T/D, and three T/D + naringin groups. After 30 days, sperm quality (concentration, motility, kinematics), oxidative stress markers, histological alterations, apoptotic markers (Bcl-2, Bax, caspase-3), hormonal profiles, and fertility outcomes were evaluated. The T/D group exhibited deteriorated sperm quality, reduced antioxidant levels (TAC, SOD, GPx), decreased hormones (testosterone, FSH, LH), elevated MDA and apoptotic markers, and impaired fertility. Notably, FSH levels decreased after T/D - in contrast to the typical increase in chronic damage models - possibly due to acute-phase pituitary suppression in this short-term mouse model. Naringin (particularly 100 and 200 mg/kg) dose-dependently improved sperm parameters, antioxidant status, testicular histology, hormonal levels, and fertility. The 50 mg/kg dose showed limited efficacy. Naringin inhibited apoptosis by upregulating Bcl-2 and downregulating Bax and caspase-3. These results indicate that intraperitoneal naringin, especially at 100-200 mg/kg, exerts significant protective effects against testicular I/R injury and may warrant further investigation as a potential adjunctive therapy in the clinical management of testicular torsion.

在小鼠扭转/扭转模型中,研究了具有抗氧化、抗炎和抗凋亡特性的黄酮苷柚皮苷对睾丸缺血/再灌注(I/R)损伤的保护作用。40只成年雄性小鼠接受720°扭转2小时,随后进行扭转。5组(n = 8)在变形前30分钟腹腔注射柚皮苷(50、100或200 mg/kg):假手术组、T/D组和T/D +柚皮苷组。30天后,评估精子质量(浓度、活力、运动学)、氧化应激标志物、组织学改变、凋亡标志物(Bcl-2、Bax、caspase-3)、激素谱和生育结果。T/D组表现为精子质量恶化,抗氧化水平(TAC、SOD、GPx)降低,激素水平(睾酮、FSH、LH)降低,MDA和凋亡标志物升高,生育能力受损。值得注意的是,在T/D后,FSH水平下降-与慢性损伤模型的典型增加相反-可能是由于在这个短期小鼠模型中急性期垂体抑制。柚皮苷(特别是100和200 mg/kg)剂量依赖性地改善了精子参数、抗氧化状态、睾丸组织学、激素水平和生育能力。50mg /kg剂量效果有限。柚皮苷通过上调Bcl-2,下调Bax和caspase-3抑制细胞凋亡。这些结果表明,腹腔内柚皮苷,特别是在100-200 mg/kg水平,对睾丸I/R损伤具有显著的保护作用,值得进一步研究作为临床治疗睾丸扭转的潜在辅助治疗方法。
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引用次数: 0
Is percutaneous internal ring suturing (PIRS) a safe option for adolescent inguinal hernia repair? A comparative analysis. 经皮内环缝合术(PIRS)是青少年腹股沟疝修补的安全选择吗?比较分析。
IF 1.6 3区 医学 Q2 PEDIATRICS Pub Date : 2026-01-05 DOI: 10.1007/s00383-025-06290-6
Kutay Bahadir, Ilayda Sagpazar, Ergun Ergun, Gulnur Gollu, Meltem Bingol-Kologlu, Aydin Yagmurlu, Murat Cakmak, Ufuk Ates

Purpose: The aim of this study was to compare the clinical efficacy, diagnostic concordance, and recurrence rates of open high ligation versus laparoscopic percutaneous internal ring suturing (PIRS) in adolescent inguinal hernia repair.

Methods: A retrospective review was conducted of 87 adolescent patients who underwent inguinal hernia repair via open high ligation (n = 44) or laparoscopic PIRS (n = 43) between 2012 and 2024 at a single tertiary care center. Demographic data, postoperative complications, recurrence, diagnostic concordance (kappa), and follow-up duration were analyzed.

Results: The median age in both groups was 12 years (range 10-17). Intraoperative diagnostic laparoscopy was performed in 44 patients in the open surgery group to evaluate the contralateral inguinal region, and contralateral hernia was detected and repaired simultaneously in one patient. Diagnostic concordance was perfect in the open group (κ = 0.945) and near-perfect in the PIRS group (κ = 0.885), both statistically significant (p < 0.001). No recurrences were observed in the open group, whereas recurrence occurred in one patient in the laparoscopic group (p = 0.99). The mean follow-up duration was 103.8 months (range 11-150) and 31.7 months (range 4-137) in the open and laparoscopic group, respectively.

Conclusion: Laparoscopic PIRS repair in adolescents demonstrated outcomes comparable to open high ligation in terms of recurrence and complication rates.

目的:比较开放式高位结扎术与腹腔镜下经皮内环缝合术(PIRS)在青少年腹股沟疝修补术中的临床疗效、诊断一致性和复发率。方法:回顾性分析2012年至2024年在一家三级医疗中心接受开放式高位结扎(n = 44)或腹腔镜PIRS (n = 43)修补腹股沟疝的87例青少年患者。分析人口统计学资料、术后并发症、复发率、诊断一致性(kappa)和随访时间。结果:两组患者中位年龄均为12岁(范围10-17岁)。开放手术组44例患者术中行诊断性腹腔镜检查对侧腹股沟区,1例患者对侧疝同时发现并修复。结论:青少年腹腔镜下PIRS修复术在复发率和并发症发生率方面与开放式高位结扎术相当。结论:腹腔镜下PIRS修复术在复发率和并发症发生率方面与开放式高位结扎术相当。
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引用次数: 0
The impact of urologic transitional care program on change in transition readiness and healthcare resource utilization among adolescent patients with congenital urogenital conditions needing lifelong care. 需要终身护理的先天性泌尿生殖疾病青少年患者中,泌尿科过渡护理方案对转变准备和医疗资源利用的影响。
IF 1.6 3区 医学 Q2 PEDIATRICS Pub Date : 2026-01-05 DOI: 10.1007/s00383-025-06281-7
Michael E Chua, Seung-Yup Lee, Stacy Tanaka, Kristine Ria Hearld, Christy Harris Lemak

Objective: Advances in pediatric healthcare have improved survival rates of congenital urogenital conditions, emphasizing the need for effective transition programs from pediatric to adult care. However, transition challenges often lead to suboptimal outcomes. This study evaluated a structured urologic transitional care program's impact on transition readiness and healthcare resource utilization in a single-payer healthcare system.

Methods: A retrospective comparative study included 106 patients aged 12-21 with congenital urogenital conditions. The intervention group (n = 53) participated in a urologic transitional care program, while the control group (n = 53) received standard care. Transition readiness was assessed using the Good2Go questionnaire, evaluating self-advocacy, knowledge, self-care, and social support. Healthcare resource utilization was measured through emergency room (ER) visits, admissions, and complications.

Results: At baseline, transition readiness scores showed no significant differences between groups, although higher ER-to-admission ratios were observed in the intervention group. Post-intervention, the intervention group demonstrated significant improvements in knowledge readiness (mean difference: +12.78, p = 0.005) and reductions in ER visits (mean difference: - 0.64, p = 0.022) and admissions (mean difference: - 0.28, p = 0.007) compared to controls. Difference-in-differences analysis confirmed significant improvements in knowledge readiness in the intervention group, although reductions in all ER metrics were inconclusive.

Conclusions: The urologic transitional care program effectively enhanced knowledge readiness and possibly reduced ER visits among adolescents with congenital urogenital conditions. These findings underscore the importance of structured interventions to support successful transitions. Additional strategies are needed to address other readiness domains, healthcare resource utilization and the sustainability of long-term benefits.

Clinical trials registry: This study was not registered in a clinical trials registry as it is a retrospective observational study. IRB study approval granted by UAB # 300012178; SickKids REB # 1000079219.

目的:儿科医疗保健的进步提高了先天性泌尿生殖系统疾病的存活率,强调了从儿科到成人护理有效过渡方案的必要性。然而,转型挑战往往会导致次优结果。本研究评估了一个结构化的泌尿科过渡护理计划对过渡准备和单一付款人医疗保健系统的医疗资源利用的影响。方法:对106例年龄在12-21岁的先天性泌尿生殖疾病患者进行回顾性比较研究。干预组(n = 53)接受泌尿外科过渡性护理方案,对照组(n = 53)接受标准护理。使用Good2Go问卷评估过渡准备情况,评估自我宣传、知识、自我护理和社会支持。通过急诊室(ER)访问、入院和并发症来测量医疗资源利用。结果:在基线时,虽然在干预组观察到更高的er -to-入院比率,但两组之间的转换准备得分没有显着差异。干预后,与对照组相比,干预组在知识准备(平均差异:+12.78,p = 0.005)和急诊就诊(平均差异:- 0.64,p = 0.022)和入院(平均差异:- 0.28,p = 0.007)方面表现出显著改善。差异中的差异分析证实了干预组在知识准备方面的显著改善,尽管所有ER指标的降低尚无定论。结论:泌尿外科过渡护理方案有效地提高了知识准备,并可能减少了先天性泌尿生殖系统疾病青少年的急诊就诊。这些发现强调了结构化干预对支持成功转型的重要性。需要其他战略来解决其他准备领域、医疗保健资源利用和长期利益的可持续性问题。临床试验注册:本研究未在临床试验注册中注册,因为它是一项回顾性观察性研究。通过UAB # 300012178的IRB研究批准;病童REB # 1000079219。
{"title":"The impact of urologic transitional care program on change in transition readiness and healthcare resource utilization among adolescent patients with congenital urogenital conditions needing lifelong care.","authors":"Michael E Chua, Seung-Yup Lee, Stacy Tanaka, Kristine Ria Hearld, Christy Harris Lemak","doi":"10.1007/s00383-025-06281-7","DOIUrl":"https://doi.org/10.1007/s00383-025-06281-7","url":null,"abstract":"<p><strong>Objective: </strong>Advances in pediatric healthcare have improved survival rates of congenital urogenital conditions, emphasizing the need for effective transition programs from pediatric to adult care. However, transition challenges often lead to suboptimal outcomes. This study evaluated a structured urologic transitional care program's impact on transition readiness and healthcare resource utilization in a single-payer healthcare system.</p><p><strong>Methods: </strong>A retrospective comparative study included 106 patients aged 12-21 with congenital urogenital conditions. The intervention group (n = 53) participated in a urologic transitional care program, while the control group (n = 53) received standard care. Transition readiness was assessed using the Good2Go questionnaire, evaluating self-advocacy, knowledge, self-care, and social support. Healthcare resource utilization was measured through emergency room (ER) visits, admissions, and complications.</p><p><strong>Results: </strong>At baseline, transition readiness scores showed no significant differences between groups, although higher ER-to-admission ratios were observed in the intervention group. Post-intervention, the intervention group demonstrated significant improvements in knowledge readiness (mean difference: +12.78, p = 0.005) and reductions in ER visits (mean difference: - 0.64, p = 0.022) and admissions (mean difference: - 0.28, p = 0.007) compared to controls. Difference-in-differences analysis confirmed significant improvements in knowledge readiness in the intervention group, although reductions in all ER metrics were inconclusive.</p><p><strong>Conclusions: </strong>The urologic transitional care program effectively enhanced knowledge readiness and possibly reduced ER visits among adolescents with congenital urogenital conditions. These findings underscore the importance of structured interventions to support successful transitions. Additional strategies are needed to address other readiness domains, healthcare resource utilization and the sustainability of long-term benefits.</p><p><strong>Clinical trials registry: </strong>This study was not registered in a clinical trials registry as it is a retrospective observational study. IRB study approval granted by UAB # 300012178; SickKids REB # 1000079219.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":"62"},"PeriodicalIF":1.6,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145900517","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}
引用次数: 0
The effect of electric ride-on cars use during transport to the operating room on preoperative anxiety in children: a cluster randomized controlled trial. 在运送到手术室的过程中使用电动汽车对儿童术前焦虑的影响:一项随机对照试验。
IF 1.6 3区 医学 Q2 PEDIATRICS Pub Date : 2026-01-05 DOI: 10.1007/s00383-025-06291-5
Bilgen Arikan, Berat Temiz
{"title":"The effect of electric ride-on cars use during transport to the operating room on preoperative anxiety in children: a cluster randomized controlled trial.","authors":"Bilgen Arikan, Berat Temiz","doi":"10.1007/s00383-025-06291-5","DOIUrl":"https://doi.org/10.1007/s00383-025-06291-5","url":null,"abstract":"","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":"60"},"PeriodicalIF":1.6,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145900447","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}
引用次数: 0
Transanal irrigation in pediatric bowel dysfunction: a prospective study on clinical outcomes and quality of life. 经肛门冲洗治疗儿童肠功能障碍:一项关于临床结果和生活质量的前瞻性研究。
IF 1.6 3区 医学 Q2 PEDIATRICS Pub Date : 2025-12-29 DOI: 10.1007/s00383-025-06279-1
Marco Di Mitri, Annalisa Di Carmine, Simone D'Antonio, Francesca Ruspi, Cristian Bisanti, Edoardo Collautti, Sara Maria Cravano, Michele Libri, Riccardo Coletta, Roberto Lo Piccolo, Tommaso Gargano, Enrico Ciardini, Mario Lima

Objectives: Transanal irrigation (TAI) is an emerging minimally invasive therapy for children with severe bowel dysfunction, including fecal incontinence and refractory constipation. The aim of this study was to evaluate the impact of TAI on bowel habits, medication use, quality of life, and caregiver burden in a pediatric population.

Methods: A prospective observational study was conducted on 20 pediatric patients with fecal incontinence. A structured questionnaire assessing bowel function and quality of life was administered at baseline and after 60 days of TAI. Outcomes were compared using Fisher's exact and Wilcoxon signed-rank tests.

Results: Significant improvements were observed in bowel care time (p < 0.01), frequency of soiling (p < 0.01), fecal incontinence episodes (p < 0.01), and dependence on laxatives or enemas (p < 0.01). Social participation and emotional well-being also improved. Most patients reported better autonomy and reduced discomfort related to bowel management.

Conclusions: TAI is an effective strategy to improve continence, reduce the burden of bowel care, and enhance quality of life in children with refractory bowel dysfunction.

目的:经肛门冲洗(TAI)是一种新兴的微创治疗儿童严重肠功能障碍,包括大便失禁和难治性便秘。本研究的目的是评估TAI对儿科人群排便习惯、药物使用、生活质量和照顾者负担的影响。方法:对20例小儿大便失禁患者进行前瞻性观察研究。在基线和TAI治疗60天后,采用结构化问卷评估肠功能和生活质量。使用Fisher精确检验和Wilcoxon符号秩检验比较结果。结论:TAI是改善顽固性肠功能障碍患儿尿失禁、减轻肠护理负担、提高生活质量的有效策略。
{"title":"Transanal irrigation in pediatric bowel dysfunction: a prospective study on clinical outcomes and quality of life.","authors":"Marco Di Mitri, Annalisa Di Carmine, Simone D'Antonio, Francesca Ruspi, Cristian Bisanti, Edoardo Collautti, Sara Maria Cravano, Michele Libri, Riccardo Coletta, Roberto Lo Piccolo, Tommaso Gargano, Enrico Ciardini, Mario Lima","doi":"10.1007/s00383-025-06279-1","DOIUrl":"10.1007/s00383-025-06279-1","url":null,"abstract":"<p><strong>Objectives: </strong>Transanal irrigation (TAI) is an emerging minimally invasive therapy for children with severe bowel dysfunction, including fecal incontinence and refractory constipation. The aim of this study was to evaluate the impact of TAI on bowel habits, medication use, quality of life, and caregiver burden in a pediatric population.</p><p><strong>Methods: </strong>A prospective observational study was conducted on 20 pediatric patients with fecal incontinence. A structured questionnaire assessing bowel function and quality of life was administered at baseline and after 60 days of TAI. Outcomes were compared using Fisher's exact and Wilcoxon signed-rank tests.</p><p><strong>Results: </strong>Significant improvements were observed in bowel care time (p < 0.01), frequency of soiling (p < 0.01), fecal incontinence episodes (p < 0.01), and dependence on laxatives or enemas (p < 0.01). Social participation and emotional well-being also improved. Most patients reported better autonomy and reduced discomfort related to bowel management.</p><p><strong>Conclusions: </strong>TAI is an effective strategy to improve continence, reduce the burden of bowel care, and enhance quality of life in children with refractory bowel dysfunction.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":"58"},"PeriodicalIF":1.6,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12748105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850544","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}
引用次数: 0
Long-term follow-up of scar quality and satisfaction after surgical closure of congenital abdominal wall defects: a single center perspective. 先天性腹壁缺损闭合术后瘢痕质量及满意度的长期随访:单中心视角。
IF 1.6 3区 医学 Q2 PEDIATRICS Pub Date : 2025-12-29 DOI: 10.1007/s00383-025-06287-1
Natalie Reindl, Sigurd Seitz, Maria Schleier, Manuel Besendörfer, Sonja Diez

Purpose: Postoperative scarring remains a major concern for patients and parents following repair of congenital abdominal wall defects. This study evaluated perceptions of postoperative scars in children after omphalocele or gastroschisis repair, comparing self-assessments with parental evaluations. We hypothesized that parents perceive scarring more negatively than their children.

Methods: A single-center study was conducted among patients treated for omphalocele or gastroschisis at the Department of Pediatric Surgery, University Hospital Erlangen (2001-2011). Between July 2022 and March 2023, patients and their parents completed the Patient and Observer Scar Assessment Scale (POSAS) 2.0, Patient Scar Assessment Questionnaire (PSAQ), and Short Form-36 (SF-36). Exclusion criteria were death or psychomotor impairment precluding reliable self-assessment.

Results: Twenty-eight participants (61% gastroschisis, 39% omphalocele) were included. Parents rated scar appearance more negatively than their children (POSAS overall impression p = 0.040; appearance p = 0.002 in omphalocele). PSAQ revealed discrepancies regarding scar-related symptoms (p = 0.006) and satisfaction (p = 0.009 total; p = 0.038 omphalocele). Parents tended to underestimate children's physical complaints (p = 0.099). No differences were found between defect types. SF-36 indicated high overall quality of life (mean 79.9 ± 13.3).

Conclusion: Significant parent-child differences exist in scar perception. Parents emphasize cosmetic concerns, whereas children report physical symptoms. Larger studies are warranted to guide tailored postoperative support.

目的:先天性腹壁缺损修复术后瘢痕形成仍然是患者和家长关注的主要问题。本研究评估了脐膨出或胃裂修复后儿童对术后疤痕的认知,比较了自我评估和父母评估。我们假设父母比他们的孩子更消极地看待伤疤。方法:对2001-2011年在埃尔兰根大学医院儿科外科治疗的脐膨出或胃裂患者进行单中心研究。在2022年7月至2023年3月期间,患者及其父母完成了患者和观察者疤痕评估量表(POSAS) 2.0,患者疤痕评估问卷(PSAQ)和简短表格36 (SF-36)。排除标准为死亡或排除可靠自我评估的精神运动障碍。结果:共纳入28例(胃裂61%,脐膨出39%)。父母对疤痕外观的评价比孩子更负面(POSAS总体印象p = 0.040;脐膨出外观p = 0.002)。PSAQ显示疤痕相关症状(p = 0.006)和满意度(总p = 0.009;脐膨出p = 0.038)存在差异。父母倾向于低估儿童的身体疾患(p = 0.099)。在缺陷类型之间没有发现差异。SF-36表示整体生活质量较高(平均79.9±13.3)。结论:亲子在瘢痕感知上存在显著差异。家长们强调的是外表问题,而孩子们报告的是身体症状。需要更大规模的研究来指导量身定制的术后支持。
{"title":"Long-term follow-up of scar quality and satisfaction after surgical closure of congenital abdominal wall defects: a single center perspective.","authors":"Natalie Reindl, Sigurd Seitz, Maria Schleier, Manuel Besendörfer, Sonja Diez","doi":"10.1007/s00383-025-06287-1","DOIUrl":"10.1007/s00383-025-06287-1","url":null,"abstract":"<p><strong>Purpose: </strong>Postoperative scarring remains a major concern for patients and parents following repair of congenital abdominal wall defects. This study evaluated perceptions of postoperative scars in children after omphalocele or gastroschisis repair, comparing self-assessments with parental evaluations. We hypothesized that parents perceive scarring more negatively than their children.</p><p><strong>Methods: </strong>A single-center study was conducted among patients treated for omphalocele or gastroschisis at the Department of Pediatric Surgery, University Hospital Erlangen (2001-2011). Between July 2022 and March 2023, patients and their parents completed the Patient and Observer Scar Assessment Scale (POSAS) 2.0, Patient Scar Assessment Questionnaire (PSAQ), and Short Form-36 (SF-36). Exclusion criteria were death or psychomotor impairment precluding reliable self-assessment.</p><p><strong>Results: </strong>Twenty-eight participants (61% gastroschisis, 39% omphalocele) were included. Parents rated scar appearance more negatively than their children (POSAS overall impression p = 0.040; appearance p = 0.002 in omphalocele). PSAQ revealed discrepancies regarding scar-related symptoms (p = 0.006) and satisfaction (p = 0.009 total; p = 0.038 omphalocele). Parents tended to underestimate children's physical complaints (p = 0.099). No differences were found between defect types. SF-36 indicated high overall quality of life (mean 79.9 ± 13.3).</p><p><strong>Conclusion: </strong>Significant parent-child differences exist in scar perception. Parents emphasize cosmetic concerns, whereas children report physical symptoms. Larger studies are warranted to guide tailored postoperative support.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":"57"},"PeriodicalIF":1.6,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12748123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850548","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}
引用次数: 0
Comparative efficacy of Soave versus Swenson procedures for Hirschsprung disease: a systematic review and meta-analysis. Soave和Swenson手术治疗先天性巨结肠疾病的比较疗效:一项系统回顾和荟萃分析
IF 1.6 3区 医学 Q2 PEDIATRICS Pub Date : 2025-12-27 DOI: 10.1007/s00383-025-06260-y
Zhihua Ma, Jie Tang, Nan Xie, Weibing Tang

Objective: To compare the efficacy of Soave and Swenson procedures in the treatment of Hirschsprung disease (HSCR) through meta-analysis, and to provide evidence-based support for surgical choice.

Methods: A systematic search of Chinese and English databases was performed to identify clinical studies comparing the two procedures. Extracted outcomes included perioperative parameters, postoperative complications, and long-term bowel function. Data were analyzed using Review Manager 5.4.1 and Stata 17.0.

Results: Eleven retrospective cohort studies involving 972 children (506 Soave, 466 Swenson) were included. Compared with Soave, Swenson was associated with shorter operative time (MD: 26.39 min; 95% CI: 11.32-41.46; P < 0.001), reduced intraoperative blood loss (MD: 15.53 ml; 95% CI: 13.83-17.24; P < 0.001), and shorter postoperative hospital stay (MD: 1.50 days; 95% CI: 0.27-2.72; P = 0.02). No significant differences were found in early complications. Postoperative constipation was less frequent after Swenson (OR = 2.20; 95% CI: 1.04-4.64; P = 0.04), while no significant differences were observed for Hirschsprung-associated enterocolitis (HAEC), urinary retention, or other long-term outcomes.

Conclusion: The Soave and Swenson procedures each have their own characteristics. Swenson improves surgical efficiency and reduces constipation, while Soave, with its clearer anatomical planes, may lower the risk of pelvic nerve injury and remains widely applied. Surgical choice should be individualized, and prospective multicentre studies are needed to optimize long-term outcomes in HSCR.

目的:通过meta分析比较Soave和Swenson手术治疗先天性巨结肠病(HSCR)的疗效,为手术选择提供循证支持。方法:系统检索中英文数据库,找出比较两种方法的临床研究。提取的结果包括围手术期参数、术后并发症和长期肠功能。使用Review Manager 5.4.1和Stata 17.0对数据进行分析。结果:纳入了11项回顾性队列研究,涉及972名儿童(506名Soave, 466名Swenson)。与Soave手术相比,Swenson手术时间更短(MD: 26.39 min; 95% CI: 11.32-41.46; P)结论:Soave和Swenson手术各有特点。Swenson可提高手术效率,减少便秘,而Soave解剖平面更清晰,可降低盆腔神经损伤风险,仍被广泛应用。手术选择应个体化,需要前瞻性多中心研究来优化HSCR的长期预后。
{"title":"Comparative efficacy of Soave versus Swenson procedures for Hirschsprung disease: a systematic review and meta-analysis.","authors":"Zhihua Ma, Jie Tang, Nan Xie, Weibing Tang","doi":"10.1007/s00383-025-06260-y","DOIUrl":"10.1007/s00383-025-06260-y","url":null,"abstract":"<p><strong>Objective: </strong>To compare the efficacy of Soave and Swenson procedures in the treatment of Hirschsprung disease (HSCR) through meta-analysis, and to provide evidence-based support for surgical choice.</p><p><strong>Methods: </strong>A systematic search of Chinese and English databases was performed to identify clinical studies comparing the two procedures. Extracted outcomes included perioperative parameters, postoperative complications, and long-term bowel function. Data were analyzed using Review Manager 5.4.1 and Stata 17.0.</p><p><strong>Results: </strong>Eleven retrospective cohort studies involving 972 children (506 Soave, 466 Swenson) were included. Compared with Soave, Swenson was associated with shorter operative time (MD: 26.39 min; 95% CI: 11.32-41.46; P < 0.001), reduced intraoperative blood loss (MD: 15.53 ml; 95% CI: 13.83-17.24; P < 0.001), and shorter postoperative hospital stay (MD: 1.50 days; 95% CI: 0.27-2.72; P = 0.02). No significant differences were found in early complications. Postoperative constipation was less frequent after Swenson (OR = 2.20; 95% CI: 1.04-4.64; P = 0.04), while no significant differences were observed for Hirschsprung-associated enterocolitis (HAEC), urinary retention, or other long-term outcomes.</p><p><strong>Conclusion: </strong>The Soave and Swenson procedures each have their own characteristics. Swenson improves surgical efficiency and reduces constipation, while Soave, with its clearer anatomical planes, may lower the risk of pelvic nerve injury and remains widely applied. Surgical choice should be individualized, and prospective multicentre studies are needed to optimize long-term outcomes in HSCR.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":"53"},"PeriodicalIF":1.6,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145846261","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}
引用次数: 0
Characteristics of children born to mothers with an anorectal malformation. 肛门直肠畸形母亲所生儿童的特征。
IF 1.6 3区 医学 Q2 PEDIATRICS Pub Date : 2025-12-27 DOI: 10.1007/s00383-025-06278-2
Joshua Gertler, Anna Gunnarsdóttir, Jenny Oddsberg, Anna Svenningsson, Lisa Örtqvist, Anna Löf Granström, Tomas Wester

Purpose: To describe characteristics of offspring born to mothers having an anorectal malformation (ARM).

Methods: This was a national population-based cohort study. The exposed group was the offspring of females with an ARM diagnosis (ICD-codes) in the Swedish National Patient Register 1964-2008. The unexposed group was the offspring of mothers without ARM. Five age-matched mothers without ARM were randomly identified for each mother with ARM by Statistics Sweden. Females with chromosomal aberrations were excluded prior to analysis. Outcomes of the mothers were retrieved from the National Patient Register (1964-2021) and Medical Birth Register (1973-2021). Outcomes of the offspring were based on data from Medical Birth Register. Using descriptive statistics, the children of mothers with an ARM were compared to children of mothers not having an ARM. The ethical review authorities approved the study.

Results: The mothers included 464 females with ARM and 2313 females without ARM. Of the 464 females with ARM, 132 (28.4%) gave birth to at least one child compared with 895 (38.7%) females without ARM (p < 0.001). The 132 first-born children of mothers with ARM were born at an 8-day younger median gestational age (272 days) when compared to children to mothers without ARM (280 days) (p < 0.001). The infants to mothers with ARM were more commonly small for gestational age (n = 10, 7.6%) than infants to mothers without ARM (n = 28, 3.1%) (p = 0.012). Initial results also showed that the first offspring to ARM mothers were statistically lighter and shorter than the offspring to mothers without ARM (p < 0.001), however, after adjusting for gestational age in a linear regression model, this was no longer the case (p = 0.398 and p = 0.255, respectively). Three first-born offspring in the group of mothers with an ARM, whereas no offspring from mothers without ARM had an ARM.

Conclusion: The first-born child of mothers with ARM are more commonly small for gestational age than the first-born of mothers without ARM. The offspring to mothers with ARM more commonly had an ARM.

Level of evidence iii:

目的:描述有肛门直肠畸形(ARM)母亲所生后代的特征。方法:这是一项基于全国人群的队列研究。暴露组是1964-2008年瑞典国家患者登记中诊断为ARM (icd代码)的女性的后代。未暴露组是没有ARM的母亲的后代。瑞典统计局随机为每位患有ARM的母亲确定了5位年龄匹配的无ARM母亲。有染色体畸变的女性在分析前被排除。母亲的结果从国家患者登记册(1964-2021)和医疗出生登记册(1973-2021)中检索。后代的结局基于医学出生登记的数据。使用描述性统计,将有ARM的母亲的孩子与没有ARM的母亲的孩子进行比较。伦理审查当局批准了这项研究。结果:有ARM的母鼠464只,无ARM的母鼠2313只。在464名患有ARM的女性中,132名(28.4%)至少生育了一个孩子,而没有ARM的女性为895名(38.7%)。(p)结论:有ARM的母亲的第一胎比没有ARM的母亲的第一胎更常见。患有ARM的母亲的后代更普遍患有ARM。证据等级iii:
{"title":"Characteristics of children born to mothers with an anorectal malformation.","authors":"Joshua Gertler, Anna Gunnarsdóttir, Jenny Oddsberg, Anna Svenningsson, Lisa Örtqvist, Anna Löf Granström, Tomas Wester","doi":"10.1007/s00383-025-06278-2","DOIUrl":"10.1007/s00383-025-06278-2","url":null,"abstract":"<p><strong>Purpose: </strong>To describe characteristics of offspring born to mothers having an anorectal malformation (ARM).</p><p><strong>Methods: </strong>This was a national population-based cohort study. The exposed group was the offspring of females with an ARM diagnosis (ICD-codes) in the Swedish National Patient Register 1964-2008. The unexposed group was the offspring of mothers without ARM. Five age-matched mothers without ARM were randomly identified for each mother with ARM by Statistics Sweden. Females with chromosomal aberrations were excluded prior to analysis. Outcomes of the mothers were retrieved from the National Patient Register (1964-2021) and Medical Birth Register (1973-2021). Outcomes of the offspring were based on data from Medical Birth Register. Using descriptive statistics, the children of mothers with an ARM were compared to children of mothers not having an ARM. The ethical review authorities approved the study.</p><p><strong>Results: </strong>The mothers included 464 females with ARM and 2313 females without ARM. Of the 464 females with ARM, 132 (28.4%) gave birth to at least one child compared with 895 (38.7%) females without ARM (p < 0.001). The 132 first-born children of mothers with ARM were born at an 8-day younger median gestational age (272 days) when compared to children to mothers without ARM (280 days) (p < 0.001). The infants to mothers with ARM were more commonly small for gestational age (n = 10, 7.6%) than infants to mothers without ARM (n = 28, 3.1%) (p = 0.012). Initial results also showed that the first offspring to ARM mothers were statistically lighter and shorter than the offspring to mothers without ARM (p < 0.001), however, after adjusting for gestational age in a linear regression model, this was no longer the case (p = 0.398 and p = 0.255, respectively). Three first-born offspring in the group of mothers with an ARM, whereas no offspring from mothers without ARM had an ARM.</p><p><strong>Conclusion: </strong>The first-born child of mothers with ARM are more commonly small for gestational age than the first-born of mothers without ARM. The offspring to mothers with ARM more commonly had an ARM.</p><p><strong>Level of evidence iii: </strong></p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":"52"},"PeriodicalIF":1.6,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12743687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145846266","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}
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Pediatric Surgery International
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