Pub Date : 2024-03-01DOI: 10.1136/wjps-2024-reviewers
BMJ Publishing Group Ltd
The editors would like to publicly acknowledge the people listed below who served as reviewers on the journal during 2023.Without their efforts,the quality of the journal could not be sustained. Allison Aguado Gehad Ahmed Zeynep Alp Unkar Belen Aneiros Castro Kyle J Van Arendonk Einar Arnbjornsson Jugpal S.Arneja Yatin Arora Robert Baird Adam Bajinting Quentin Ballouhey Garrett Barfoot Sylvie Beaudoin Asaad G.Beshish George Bethell Arnaud Bonnard Fabio Botelho Terry L.Buchmiller Danilo Buonsenso Vito Andrea Capozzi Neil K.Chadha V.V.S.Chandrasekharam Aswin Chari Anthony Chin Chan Chui Kenneth L.Y.Chung Patrick Ho Yu Chung Jennifer N Cooper Philip Crispin Alessandro Crocoli Kanishka Das Sumit Dave …
编辑们在此公开感谢在 2023 年期间担任本刊审稿人的下列人员,没有他们的努力,本刊的质量就无法维持。Allison Aguado Gehad Ahmed Zeynep Alp Unkar Belen Aneiros Castro Kyle J Van Arendonk Einar Arnbjornsson Jugpal S.Arneja Yatin Arora Robert Baird Adam Bajinting Quentin Ballouhey Garrett Barfoot Sylvie Beaudoin Asaad G.Beshish George Bethell Arnaud Bonnard Fabio Botelho Terry L. Buchmiller Danilo Buonsenso V. Capt.Buchmiller Danilo Buonsenso Vito Andrea Capozzi Neil K.Chadha V.V.S.Chandrasekharam Aswin Chari Anthony Chin Chan Chui Kenneth L.Y.Chung Patrick Ho Yu Chung Jennifer N Cooper Philip Crispin Alessandro Crocoli Kanishka Das Sumit Dave ...
{"title":"Thank you to our reviewers","authors":"BMJ Publishing Group Ltd","doi":"10.1136/wjps-2024-reviewers","DOIUrl":"https://doi.org/10.1136/wjps-2024-reviewers","url":null,"abstract":"The editors would like to publicly acknowledge the people listed below who served as reviewers on the journal during 2023.Without their efforts,the quality of the journal could not be sustained. Allison Aguado Gehad Ahmed Zeynep Alp Unkar Belen Aneiros Castro Kyle J Van Arendonk Einar Arnbjornsson Jugpal S.Arneja Yatin Arora Robert Baird Adam Bajinting Quentin Ballouhey Garrett Barfoot Sylvie Beaudoin Asaad G.Beshish George Bethell Arnaud Bonnard Fabio Botelho Terry L.Buchmiller Danilo Buonsenso Vito Andrea Capozzi Neil K.Chadha V.V.S.Chandrasekharam Aswin Chari Anthony Chin Chan Chui Kenneth L.Y.Chung Patrick Ho Yu Chung Jennifer N Cooper Philip Crispin Alessandro Crocoli Kanishka Das Sumit Dave …","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"11 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140072939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To review postoperative necrotizing enterocolitis (NEC) in patients with jejunoileal atresia (JIA) and to explore the potential risk factors related to the concurrence of NEC. Methods Patients diagnosed with JIA who received surgical treatment from January 2016 to June 2021 were enrolled. Demographics, viral infection of the fetus, transfusion within 48 hours before NEC, sepsis before JIA repair, pathological and anatomical classification of JIA, combined malformation, occurrence time of NEC after the operation, treatment, and prognosis of patients were analyzed. Patients were divided into NEC group and non-NEC group, and all patients were followed up for 3–6 months to observe for complications. Results A total of 180 patients with JIA were included, of whom 12 were diagnosed with NEC after surgery and 1 patient with NEC died during follow-up. The average age, birth weight, gestational age, proportion of premature infants, proportion of preoperative infections, and pathological classification of JIA did not significantly differ between the two groups. The probability of patients with proximal jejunal atresia (PJA) in the NEC group (58.3%) was higher than that in the non-NEC group (22.6%) ( p =0.011), and patients with PJA had longer parenteral nutrition time than patients without PJA (26.64±9.21 days vs 15.11±6.58 days, p <0.001). Conclusion PJA was more likely to be associated with concurrent NEC after surgery, which is a highly NEC-related risk factor inherent in JIA. All data relevant to the study are included in the article or uploaded as supplementary information.
目的 回顾性分析空肠闭锁(JIA)患者术后坏死性小肠结肠炎(NEC)的情况,并探讨与NEC并发症相关的潜在风险因素。方法 纳入2016年1月至2021年6月期间接受手术治疗的确诊为JIA的患者。对患者的人口统计学、胎儿病毒感染、NEC发生前48小时内输血、JIA修复前败血症、JIA的病理解剖分类、合并畸形、术后NEC发生时间、治疗和预后进行分析。将患者分为 NEC 组和非 NEC 组,对所有患者进行 3-6 个月的随访,观察并发症的发生情况。结果 共纳入180例JIA患者,其中12例术后确诊为NEC,1例NEC患者在随访期间死亡。两组 JIA 患者的平均年龄、出生体重、胎龄、早产儿比例、术前感染比例和病理分类无显著差异。NEC 组近端空肠闭锁(PJA)患者的概率(58.3%)高于非 NEC 组(22.6%)(P =0.011),PJA 患者的肠外营养时间长于无 PJA 患者(26.64±9.21 天 vs 15.11±6.58 天,P <0.001)。结论 PJA 更有可能与术后并发 NEC 相关,这是 JIA 中固有的与 NEC 高度相关的风险因素。与该研究相关的所有数据均包含在文章中或作为补充信息上传。
{"title":"Clinical characteristics of postoperative necrotizing enterocolitis in patients with congenital jejunoileal atresia and its risk factors","authors":"Xiaofeng Xiong, Wei Lu, Fuzhong Xing, Yuan Cai, Jixin Yang, Yuhang Yuan, Jiexiong Feng, Xuyong Chen","doi":"10.1136/wjps-2023-000622","DOIUrl":"https://doi.org/10.1136/wjps-2023-000622","url":null,"abstract":"Objective To review postoperative necrotizing enterocolitis (NEC) in patients with jejunoileal atresia (JIA) and to explore the potential risk factors related to the concurrence of NEC. Methods Patients diagnosed with JIA who received surgical treatment from January 2016 to June 2021 were enrolled. Demographics, viral infection of the fetus, transfusion within 48 hours before NEC, sepsis before JIA repair, pathological and anatomical classification of JIA, combined malformation, occurrence time of NEC after the operation, treatment, and prognosis of patients were analyzed. Patients were divided into NEC group and non-NEC group, and all patients were followed up for 3–6 months to observe for complications. Results A total of 180 patients with JIA were included, of whom 12 were diagnosed with NEC after surgery and 1 patient with NEC died during follow-up. The average age, birth weight, gestational age, proportion of premature infants, proportion of preoperative infections, and pathological classification of JIA did not significantly differ between the two groups. The probability of patients with proximal jejunal atresia (PJA) in the NEC group (58.3%) was higher than that in the non-NEC group (22.6%) ( p =0.011), and patients with PJA had longer parenteral nutrition time than patients without PJA (26.64±9.21 days vs 15.11±6.58 days, p <0.001). Conclusion PJA was more likely to be associated with concurrent NEC after surgery, which is a highly NEC-related risk factor inherent in JIA. All data relevant to the study are included in the article or uploaded as supplementary information.","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"96 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140168259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1136/wjps-2023-000659
Nitinkumar Borkar, Charu Tiwari, Debajyoti Mohanty, Tridip Dutta Baruah, Manoj Mohanty, C K Sinha
Background Polyglactin (PG) and polydioxanone (PDS) sutures are extensively used based on the surgeon’s preference. The development of post-reconstruction urethrocutaneous fistula (UCF) is variably attributed to the choice of suture material for urethroplasty. This meta-analysis compares complications of hypospadias repair using PG and PDS sutures. Methods The systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The authors conducted thorough searches in databases including MEDLINE, EMBASE, CENTRAL, Scopus, Google Scholar, and clinical trial registries. Outcome measures included UCF, meatal stenosis, wound infection, urethral stricture, glans dehiscence, and overall complications. Quantitative analysis was used with fixed or random-effect models to find the pooled risk ratio and I2 heterogeneity. Results The criteria for inclusion were met by five comparative studies with the inclusion of 1244 children altogether. Pooled analysis failed to show a statistically significant difference in the incidence of meatal stenosis, urethral stricture, wound infection, and total complications using PG and PDS sutures. However, it showed a reduction in the incidence of UCF with PDS suture hypospadias repairs (risk ratio=0.66, 95% CI 0.48 to 0.92). Conclusions PDS sutures are associated with decreased incidence of UCF than PG after hypospadias repair. The incidence of meatal stenosis, urethral stricture, wound infection, and total complications was not affected by the type of suture material used for repair. Clinical implications This meta-analysis suggests decreased incidence of UCF when PDS sutures are used for hypospadias repair which may impact the choice of suture material for repair. PROSPERO registration number CRD42023409710. All data relevant to the study are included in the article or uploaded as supplemental information.
{"title":"Post-urethroplasty complications in hypospadias repair: a systematic review and meta-analysis comparing polydioxanone and polyglactin sutures","authors":"Nitinkumar Borkar, Charu Tiwari, Debajyoti Mohanty, Tridip Dutta Baruah, Manoj Mohanty, C K Sinha","doi":"10.1136/wjps-2023-000659","DOIUrl":"https://doi.org/10.1136/wjps-2023-000659","url":null,"abstract":"Background Polyglactin (PG) and polydioxanone (PDS) sutures are extensively used based on the surgeon’s preference. The development of post-reconstruction urethrocutaneous fistula (UCF) is variably attributed to the choice of suture material for urethroplasty. This meta-analysis compares complications of hypospadias repair using PG and PDS sutures. Methods The systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The authors conducted thorough searches in databases including MEDLINE, EMBASE, CENTRAL, Scopus, Google Scholar, and clinical trial registries. Outcome measures included UCF, meatal stenosis, wound infection, urethral stricture, glans dehiscence, and overall complications. Quantitative analysis was used with fixed or random-effect models to find the pooled risk ratio and I2 heterogeneity. Results The criteria for inclusion were met by five comparative studies with the inclusion of 1244 children altogether. Pooled analysis failed to show a statistically significant difference in the incidence of meatal stenosis, urethral stricture, wound infection, and total complications using PG and PDS sutures. However, it showed a reduction in the incidence of UCF with PDS suture hypospadias repairs (risk ratio=0.66, 95% CI 0.48 to 0.92). Conclusions PDS sutures are associated with decreased incidence of UCF than PG after hypospadias repair. The incidence of meatal stenosis, urethral stricture, wound infection, and total complications was not affected by the type of suture material used for repair. Clinical implications This meta-analysis suggests decreased incidence of UCF when PDS sutures are used for hypospadias repair which may impact the choice of suture material for repair. PROSPERO registration number CRD42023409710. All data relevant to the study are included in the article or uploaded as supplemental information.","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"19 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140017198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.1136/wjps-2023-000641
Yuxin Wu, ZaiYu Zhang, Ping Liang, Lusheng Li, Bin Zou, Difei Wang, Xinyu Dong, Haotian Tang, Hanli Qiu, Xuan Zhai
Objective The study aimed to explore the association between the site of interictal epileptic discharges (IEDs) on postoperative electroencephalogram (EEG) and seizure recurrence after antiepileptic drug (AED) withdrawal. The study hypothesizes that the concordance of IED sites with surgical sites indicates incomplete resection of epileptic focus, while non-concordance of IED sites with surgical sites indicates postoperative changes or cortical stimulation. The former has a higher risk of seizure recurrence. Methods We retrospectively analyzed the postoperative EEG pattern of 182 consecutive children who underwent resection surgery. To identify the risk factors for seizure recurrence, we compared the attributes of seizure recurred and seizure-free groups by univariate and multivariate analyses. AED tapering was standardized, involving a 25% reduction in the dose of a single type of AED every 2 weeks, independent of the presurgical AED load. Results We attempted AED withdrawal in 116 (63.7%) children. Twenty-eight (24.1%) children experienced seizure recurrence during or after AED withdrawal. A greater number of AEDs used at the time of surgery ( p =0.005), incomplete resection ( p =0.001), and presence of IED on postoperative EEG ( p =0.011) are predictors of seizure recurrence. The completeness of resection and seizure recurrence after AED withdrawal were related to the presence of IED on the EEG, but not to the concordance of IED with surgical sites. Conclusion For children with abnormal EEG, the decision to discontinue AED should be made more cautiously, regardless of the relative location of the discharge site and the surgical site. All data relevant to the study are included in the article or uploaded as supplementary information.
{"title":"Postoperative interictal epileptiform discharges predict seizure recurrence after antiepileptic drug withdrawal regardless of concordance with surgical site","authors":"Yuxin Wu, ZaiYu Zhang, Ping Liang, Lusheng Li, Bin Zou, Difei Wang, Xinyu Dong, Haotian Tang, Hanli Qiu, Xuan Zhai","doi":"10.1136/wjps-2023-000641","DOIUrl":"https://doi.org/10.1136/wjps-2023-000641","url":null,"abstract":"Objective The study aimed to explore the association between the site of interictal epileptic discharges (IEDs) on postoperative electroencephalogram (EEG) and seizure recurrence after antiepileptic drug (AED) withdrawal. The study hypothesizes that the concordance of IED sites with surgical sites indicates incomplete resection of epileptic focus, while non-concordance of IED sites with surgical sites indicates postoperative changes or cortical stimulation. The former has a higher risk of seizure recurrence. Methods We retrospectively analyzed the postoperative EEG pattern of 182 consecutive children who underwent resection surgery. To identify the risk factors for seizure recurrence, we compared the attributes of seizure recurred and seizure-free groups by univariate and multivariate analyses. AED tapering was standardized, involving a 25% reduction in the dose of a single type of AED every 2 weeks, independent of the presurgical AED load. Results We attempted AED withdrawal in 116 (63.7%) children. Twenty-eight (24.1%) children experienced seizure recurrence during or after AED withdrawal. A greater number of AEDs used at the time of surgery ( p =0.005), incomplete resection ( p =0.001), and presence of IED on postoperative EEG ( p =0.011) are predictors of seizure recurrence. The completeness of resection and seizure recurrence after AED withdrawal were related to the presence of IED on the EEG, but not to the concordance of IED with surgical sites. Conclusion For children with abnormal EEG, the decision to discontinue AED should be made more cautiously, regardless of the relative location of the discharge site and the surgical site. All data relevant to the study are included in the article or uploaded as supplementary information.","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"98 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139766998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.1136/wjps-2023-000719
Abirami Muthumani
Pediatric surgical interventions may represent more than one-third of the surgical caseload in humanitarian settings.1 The humanitarian crisis in Gaza has taken a devastating toll on children, many of whom have suffered injuries due to indiscriminate and heavy bombardment, resulting in severe polytraumatic injuries necessitating immediate and specialized pediatric surgical intervention. The conflict has strained the region’s fragile healthcare system, resulting in a significant number of casualties, a substantial proportion of which are children. This exacerbates the demand for specialized pediatric surgical care, especially when the existing healthcare system and infrastructure has nearly collapsed and is under-resourced to handle the influx of pediatric patients.2 The urgency for specialized pediatric surgical care and support for children in Gaza cannot be overstated. Access to healthcare in Palestine has been an ongoing challenge.3 Before the recent hostilities, 1.1 million children in Gaza and the West Bank were already in need of humanitarian aid, constituting approximately half of the child population.4 The current war in Gaza, as per a recent UNICEF report, has exacerbated the situation, with hundreds of thousands of children in desperate need of humanitarian assistance and protection.5 Team members of Médecins Sans Frontières (MSF) who are currently provding medical care in Gaza, have expressed deep concern regarding the critical medical and humanitarian crisis facing children in the region. Nearly half of the consultations MSF staff provided in the Martyrs and Beni Suheila clinics, in which they have now been forced to suspend operations in, were for children under the age of five.6 The conflict has resulted in a significant number of casualties, with a substantial proportion being children who require specialized pediatric surgical care. One child in Gaza has been killed every 10 min on average.7 Thousands more have been injured in the region. There is …
{"title":"Safeguarding children through pediatric surgical care in war and humanitarian settings: a call to action for pediatric patients in Gaza","authors":"Abirami Muthumani","doi":"10.1136/wjps-2023-000719","DOIUrl":"https://doi.org/10.1136/wjps-2023-000719","url":null,"abstract":"Pediatric surgical interventions may represent more than one-third of the surgical caseload in humanitarian settings.1 The humanitarian crisis in Gaza has taken a devastating toll on children, many of whom have suffered injuries due to indiscriminate and heavy bombardment, resulting in severe polytraumatic injuries necessitating immediate and specialized pediatric surgical intervention. The conflict has strained the region’s fragile healthcare system, resulting in a significant number of casualties, a substantial proportion of which are children. This exacerbates the demand for specialized pediatric surgical care, especially when the existing healthcare system and infrastructure has nearly collapsed and is under-resourced to handle the influx of pediatric patients.2 The urgency for specialized pediatric surgical care and support for children in Gaza cannot be overstated. Access to healthcare in Palestine has been an ongoing challenge.3 Before the recent hostilities, 1.1 million children in Gaza and the West Bank were already in need of humanitarian aid, constituting approximately half of the child population.4 The current war in Gaza, as per a recent UNICEF report, has exacerbated the situation, with hundreds of thousands of children in desperate need of humanitarian assistance and protection.5 Team members of Médecins Sans Frontières (MSF) who are currently provding medical care in Gaza, have expressed deep concern regarding the critical medical and humanitarian crisis facing children in the region. Nearly half of the consultations MSF staff provided in the Martyrs and Beni Suheila clinics, in which they have now been forced to suspend operations in, were for children under the age of five.6 The conflict has resulted in a significant number of casualties, with a substantial proportion being children who require specialized pediatric surgical care. One child in Gaza has been killed every 10 min on average.7 Thousands more have been injured in the region. There is …","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"3 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140008372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.1136/wjps-2023-000707
Nitinkumar Borkar, Charu Tiwari, Abhijit Nair, Debajyoti Mohanty, C K Sinha, Jai Kumar Mahajan
Background Hypospadias is one of the most common genital birth defects. There are around 300 various techniques available for the repair of hypospadias. This study aims to compare the reported outcomes of Tubularized incised plate urethroplasty (TIP) and Grafted TIP (GTIP) repair in children undergoing primary hypospadias repair. Methods This meta-analysisadhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and we framed our research question using the population, intervention, control and outcomes format. We conducted comprehensive electronic searches across various databases, employing a Boolean search strategy with predefined search terms. Only randomized controlled trials (RCTs) were included for quantitative analysis. Results Totally, 10 RCTs met our inclusion criteria for quantitative analysis. The results indicated that urethrocutaneous fistula, glans dehiscence, and stricture rates were comparable between the two groups. The incidence of meatal stenosis was found to be significantly lower in the GTIP group with a relative risk (RR) of 0.32 (95% confidence interval (CI) 0.15 to 0.67). Conclusion The coucomes UCF, glans dehiscence, and stricture rates were comparable between the two groups. Notably, the incidence of meatal stenosis was found to be significantly lower in the grafted TIP group. In terms of operative time, our quantitative synthesis demonstrated that the TIP group had a shorter operative time than the GTIP group with significant heterogeneity. All data relevant to the study are included in the article or uploaded as supplemental information.
{"title":"Tubularized incised plate urethroplasty and grafted tubularized incised plate urethroplasty: systematic review, meta-analysis and trial sequential analysis","authors":"Nitinkumar Borkar, Charu Tiwari, Abhijit Nair, Debajyoti Mohanty, C K Sinha, Jai Kumar Mahajan","doi":"10.1136/wjps-2023-000707","DOIUrl":"https://doi.org/10.1136/wjps-2023-000707","url":null,"abstract":"Background Hypospadias is one of the most common genital birth defects. There are around 300 various techniques available for the repair of hypospadias. This study aims to compare the reported outcomes of Tubularized incised plate urethroplasty (TIP) and Grafted TIP (GTIP) repair in children undergoing primary hypospadias repair. Methods This meta-analysisadhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and we framed our research question using the population, intervention, control and outcomes format. We conducted comprehensive electronic searches across various databases, employing a Boolean search strategy with predefined search terms. Only randomized controlled trials (RCTs) were included for quantitative analysis. Results Totally, 10 RCTs met our inclusion criteria for quantitative analysis. The results indicated that urethrocutaneous fistula, glans dehiscence, and stricture rates were comparable between the two groups. The incidence of meatal stenosis was found to be significantly lower in the GTIP group with a relative risk (RR) of 0.32 (95% confidence interval (CI) 0.15 to 0.67). Conclusion The coucomes UCF, glans dehiscence, and stricture rates were comparable between the two groups. Notably, the incidence of meatal stenosis was found to be significantly lower in the grafted TIP group. In terms of operative time, our quantitative synthesis demonstrated that the TIP group had a shorter operative time than the GTIP group with significant heterogeneity. All data relevant to the study are included in the article or uploaded as supplemental information.","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"176 2 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139918545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1136/wjps-2023-000687
Mona Takalo, Tarja Iber, Reija Autio, Topi Luoto
Purpose Various complications are associated with percutaneous endoscopic gastrostomy (PEG) procedures in children. The push technique is being increasingly used, but its complications are insufficiently characterized. We aimed to assess all complications related to PEG procedures and compare the safety of the pull and push techniques. Methods Retrospective review of consecutive pediatric patients who underwent PEG between 2002 and 2020. Results In total, 216 children underwent 217 PEG procedures. The push technique was used in 138 (64%) cases, and the pull technique in 79 (36%) cases. The median follow-up time was 6.1 (0.1–18.3) years. The complication rate was high (57%) and patients experienced complications years after the procedure. Overall, 51% and 67% of patients experienced complications in the push and pull groups, respectively. The rates of minor and major complications were higher in the pull group than in the push group (63% vs 48%, p =0.028; and 11% vs 6%, p =0.140, respectively). Reoperation was also more common in the pull group (17% vs 7%, p =0.020). Conclusions The overall complication rate of PEG procedures is high. Fortunately, most complications are mild and do not require reoperations. The increasing push technique appears to be safer than the traditional pull technique. Significant long-term morbidity is related to gastrostomies in children. Data may be obtained from a third party and are not publicly available. Data were collected from the medical records of Tampere University Hospital.
{"title":"Complications after pediatric percutaneous endoscopic gastrostomy: comparison of the push and pull technique","authors":"Mona Takalo, Tarja Iber, Reija Autio, Topi Luoto","doi":"10.1136/wjps-2023-000687","DOIUrl":"https://doi.org/10.1136/wjps-2023-000687","url":null,"abstract":"Purpose Various complications are associated with percutaneous endoscopic gastrostomy (PEG) procedures in children. The push technique is being increasingly used, but its complications are insufficiently characterized. We aimed to assess all complications related to PEG procedures and compare the safety of the pull and push techniques. Methods Retrospective review of consecutive pediatric patients who underwent PEG between 2002 and 2020. Results In total, 216 children underwent 217 PEG procedures. The push technique was used in 138 (64%) cases, and the pull technique in 79 (36%) cases. The median follow-up time was 6.1 (0.1–18.3) years. The complication rate was high (57%) and patients experienced complications years after the procedure. Overall, 51% and 67% of patients experienced complications in the push and pull groups, respectively. The rates of minor and major complications were higher in the pull group than in the push group (63% vs 48%, p =0.028; and 11% vs 6%, p =0.140, respectively). Reoperation was also more common in the pull group (17% vs 7%, p =0.020). Conclusions The overall complication rate of PEG procedures is high. Fortunately, most complications are mild and do not require reoperations. The increasing push technique appears to be safer than the traditional pull technique. Significant long-term morbidity is related to gastrostomies in children. Data may be obtained from a third party and are not publicly available. Data were collected from the medical records of Tampere University Hospital.","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"22 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139585402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1136/wjps-2023-000700
Maria Fazal, Charbel Chidiac, Raheel Ahmad, Oussama Issa, Erica Hodgman, Alejandro V Garcia
Introduction As fire pits grow in popularity, so do the associated burn injuries. Our study examines pediatric fire pit burns characteristics to raise awareness and promote safety precautions. Methods We conducted a retrospective review of pediatric patients (≤21 years) with firepit burns at a tertiary care hospital from 2016 to 2021. Results Eighty-four patients were identified, of whom 70.2% were male, with a median age of 62 months. The median percent total body surface area burned was 2% (interquartile range (IQR)=1–4). Thirty-five (41.7%) patients were admitted and 7 (8.3%) underwent grafting. Neck and trunk burns had the highest grafting rates (66% and 33%, respectively). The hands (41.7%) and the lower extremities (27.4%) were the most frequently burned body areas. The leading causes of burns were ashes/hot coals (34.5%), flames (31.0%), and direct contact (25.0%), often resulting from falling into the fire (59.5%) or running or playing in activities near it (26.2%). Thirty-five (41.7%) were admitted for inpatient management, while 49 (58.3%) were treated as outpatient. Eleven (13.2%) underwent at least one reconstructive surgery, 7 (8.4%) had at least one rehabilitation visit, and 65 (77.4%) had follow-up clinic visits. The median length of stay was 2 days (IQR=1.0–3.5). The peak months for burns were from August through October ( n =40, 46.0%), with an increase observed from 10 cases in 2016 to 20 cases in 2020. Conclusions Given the significant proportion of firepit burns resulting from unsafe fire behaviors, it is crucial that caretakers are aware of proper firepit safety precautions. Level of evidence III. No data are available.
{"title":"Characteristics and trends of pediatric firepit burns: insights for prevention and safety","authors":"Maria Fazal, Charbel Chidiac, Raheel Ahmad, Oussama Issa, Erica Hodgman, Alejandro V Garcia","doi":"10.1136/wjps-2023-000700","DOIUrl":"https://doi.org/10.1136/wjps-2023-000700","url":null,"abstract":"Introduction As fire pits grow in popularity, so do the associated burn injuries. Our study examines pediatric fire pit burns characteristics to raise awareness and promote safety precautions. Methods We conducted a retrospective review of pediatric patients (≤21 years) with firepit burns at a tertiary care hospital from 2016 to 2021. Results Eighty-four patients were identified, of whom 70.2% were male, with a median age of 62 months. The median percent total body surface area burned was 2% (interquartile range (IQR)=1–4). Thirty-five (41.7%) patients were admitted and 7 (8.3%) underwent grafting. Neck and trunk burns had the highest grafting rates (66% and 33%, respectively). The hands (41.7%) and the lower extremities (27.4%) were the most frequently burned body areas. The leading causes of burns were ashes/hot coals (34.5%), flames (31.0%), and direct contact (25.0%), often resulting from falling into the fire (59.5%) or running or playing in activities near it (26.2%). Thirty-five (41.7%) were admitted for inpatient management, while 49 (58.3%) were treated as outpatient. Eleven (13.2%) underwent at least one reconstructive surgery, 7 (8.4%) had at least one rehabilitation visit, and 65 (77.4%) had follow-up clinic visits. The median length of stay was 2 days (IQR=1.0–3.5). The peak months for burns were from August through October ( n =40, 46.0%), with an increase observed from 10 cases in 2016 to 20 cases in 2020. Conclusions Given the significant proportion of firepit burns resulting from unsafe fire behaviors, it is crucial that caretakers are aware of proper firepit safety precautions. Level of evidence III. No data are available.","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"6 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139645531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anorectal malformation (ARM) is a frequently occurring surgical condition in neonates, with a prevalence of 1 in 4000 live births.1 In boys with this anomaly, the rectum and urinary tract share a common wall for some distance, often ending up in fistulous communication. The goals of definite reconstruction are to separate the rectum from the urinary tract without injuring the urethra and mobilizing the rectum to the perineum within the muscle complex. Separating the rectum and the urinary tract is the most critical part of this operation and is associated with a significant risk of urinary tract injury.2–5 The original procedure described by Peña and Devries involves multiple stay sutures on the rectal mucosa just above the fistula, lifting the mucosa and continuing a submucosal dissection up to the prostate, where the entire thickness of the intestine can be separated from the urinary tract.6 These stay sutures have the inherent risk of incorporating the urethra within and thereby injuring the urethra. Moreover, this submucosal dissection is delicate and requires master’s expertise to avoid urethral injury, which frequently occurs in boys with relatively benign lower malformation. However, a relatively significant space separates the rectum and the urinary tract proximal to the common sharing wall (figure 1). By first mobilizing the rectum proximally in an antegrade fashion and lifting it from the urinary tract with a loop, the posterior wall of the urethra, prostate, and bladder is easily visible. This also establishes a clear boundary between the rectum and urinary tract, making it possible to resect the fistula precisely without needing a traction suture . Figure 1 Distal loopogram showing retrovesical space. We reviewed the medical records of patients who underwent posterior sagittal anorectoplasty (PSARP) for ARM between March 2021 and March 2023. The minimum follow-up was 3 months. Demographic and …
{"title":"Complete separation of the urinary tract from proximal rectum during PSARP surgery: our experience with the noveltechnique","authors":"Md Samiul Hasan, Md Nazmul Islam, Refoyez Mahmud, Umama Huq, Ashrarur Rahman","doi":"10.1136/wjps-2023-000688","DOIUrl":"https://doi.org/10.1136/wjps-2023-000688","url":null,"abstract":"Anorectal malformation (ARM) is a frequently occurring surgical condition in neonates, with a prevalence of 1 in 4000 live births.1 In boys with this anomaly, the rectum and urinary tract share a common wall for some distance, often ending up in fistulous communication. The goals of definite reconstruction are to separate the rectum from the urinary tract without injuring the urethra and mobilizing the rectum to the perineum within the muscle complex. Separating the rectum and the urinary tract is the most critical part of this operation and is associated with a significant risk of urinary tract injury.2–5 The original procedure described by Peña and Devries involves multiple stay sutures on the rectal mucosa just above the fistula, lifting the mucosa and continuing a submucosal dissection up to the prostate, where the entire thickness of the intestine can be separated from the urinary tract.6 These stay sutures have the inherent risk of incorporating the urethra within and thereby injuring the urethra. Moreover, this submucosal dissection is delicate and requires master’s expertise to avoid urethral injury, which frequently occurs in boys with relatively benign lower malformation. However, a relatively significant space separates the rectum and the urinary tract proximal to the common sharing wall (figure 1). By first mobilizing the rectum proximally in an antegrade fashion and lifting it from the urinary tract with a loop, the posterior wall of the urethra, prostate, and bladder is easily visible. This also establishes a clear boundary between the rectum and urinary tract, making it possible to resect the fistula precisely without needing a traction suture . Figure 1 Distal loopogram showing retrovesical space. We reviewed the medical records of patients who underwent posterior sagittal anorectoplasty (PSARP) for ARM between March 2021 and March 2023. The minimum follow-up was 3 months. Demographic and …","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"82 1 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139423368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1136/wjps-2023-000697
Phillip J Hsu, Sangchul Yoon, Kee B Park
Background Sixty-five percent of children worldwide lack access to surgical care, the majority of whom live in low-income and middle-income countries (LMICs). Developing surgical infrastructure requires information on surgical need; however, this information is often limited in LMICs. North Korea (Democratic People’s Republic of Korea, DPRK) has a low amount of publicly available data. Here, we analyzed available modeled data to understand the causes of pediatric deaths due to conditions treatable with surgery in DPRK. Methods We used World Bank data and models from the Institute for Health Metrics and Evaluation to identify causes of pediatric deaths affecting pediatric patients (age <20 years). We compared mortality of disease between DPRK and countries with similar economic status. Results Between 1990 and 2019, the number of overall pediatric deaths has decreased. In 2019, 32.2% of all pediatric deaths in DPRK were caused by surgical conditions. The leading categories of surgical conditions were injuries (53.9%), congenital conditions (34.2%), tumors (8.8%), and abdominal conditions (3.2%). DPRK has a lower relative rate of pediatric deaths compared with other LMICs with similar gross domestic product per capita. However, it has a higher relative rate of pediatric deaths due to conditions requiring treatment with surgery. Transport injuries contribute significantly to the high rate of pediatric deaths in DPRK. Conclusions Although DPRK may be allocating overall resources toward pediatric healthcare more efficiently than economic peers, DPRK may benefit from improvement in pediatric surgical capacity. Improved availability of data and close international collaboration could be potential solutions to bridge this gap. Data are available in a public, open access repository.
{"title":"Understanding pediatric surgical needs in North Korea: a modeling analysis","authors":"Phillip J Hsu, Sangchul Yoon, Kee B Park","doi":"10.1136/wjps-2023-000697","DOIUrl":"https://doi.org/10.1136/wjps-2023-000697","url":null,"abstract":"Background Sixty-five percent of children worldwide lack access to surgical care, the majority of whom live in low-income and middle-income countries (LMICs). Developing surgical infrastructure requires information on surgical need; however, this information is often limited in LMICs. North Korea (Democratic People’s Republic of Korea, DPRK) has a low amount of publicly available data. Here, we analyzed available modeled data to understand the causes of pediatric deaths due to conditions treatable with surgery in DPRK. Methods We used World Bank data and models from the Institute for Health Metrics and Evaluation to identify causes of pediatric deaths affecting pediatric patients (age <20 years). We compared mortality of disease between DPRK and countries with similar economic status. Results Between 1990 and 2019, the number of overall pediatric deaths has decreased. In 2019, 32.2% of all pediatric deaths in DPRK were caused by surgical conditions. The leading categories of surgical conditions were injuries (53.9%), congenital conditions (34.2%), tumors (8.8%), and abdominal conditions (3.2%). DPRK has a lower relative rate of pediatric deaths compared with other LMICs with similar gross domestic product per capita. However, it has a higher relative rate of pediatric deaths due to conditions requiring treatment with surgery. Transport injuries contribute significantly to the high rate of pediatric deaths in DPRK. Conclusions Although DPRK may be allocating overall resources toward pediatric healthcare more efficiently than economic peers, DPRK may benefit from improvement in pediatric surgical capacity. Improved availability of data and close international collaboration could be potential solutions to bridge this gap. Data are available in a public, open access repository.","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"1 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139657705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}