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IF 0.8 4区 医学 Q4 PEDIATRICS Pub Date : 2024-03-01 DOI: 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 ...
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引用次数: 0
Clinical characteristics of postoperative necrotizing enterocolitis in patients with congenital jejunoileal atresia and its risk factors 先天性空肠闭锁患者术后坏死性小肠结肠炎的临床特征及其风险因素
IF 0.8 4区 医学 Q4 PEDIATRICS Pub Date : 2024-03-01 DOI: 10.1136/wjps-2023-000622
Xiaofeng Xiong, Wei Lu, Fuzhong Xing, Yuan Cai, Jixin Yang, Yuhang Yuan, Jiexiong Feng, Xuyong Chen
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}
引用次数: 0
Post-urethroplasty complications in hypospadias repair: a systematic review and meta-analysis comparing polydioxanone and polyglactin sutures 尿道下裂修复术后并发症:比较聚二氧六环酮缝合线和聚乳酸缝合线的系统回顾和荟萃分析
IF 0.8 4区 医学 Q4 PEDIATRICS Pub Date : 2024-03-01 DOI: 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.
背景 根据外科医生的偏好,聚乳酸(PG)和聚二氧杂酮(PDS)缝合线被广泛使用。尿道重建术后尿道皮肤瘘(UCF)的发生与尿道成形术的缝合材料选择有关。本荟萃分析比较了使用 PG 和 PDS 缝合线进行尿道下裂修复术的并发症。方法 根据《系统综述和荟萃分析首选报告项目》指南进行了系统综述和荟萃分析。作者在 MEDLINE、EMBASE、CENTRAL、Scopus、Google Scholar 和临床试验登记处等数据库中进行了全面检索。结果指标包括尿道前列腺肥大、肉阜狭窄、伤口感染、尿道狭窄、龟头开裂和总体并发症。采用固定或随机效应模型进行定量分析,以找出汇总风险比和 I2 异质性。结果 有五项比较研究符合纳入标准,共纳入了 1244 名儿童。汇总分析表明,使用 PG 和 PDS 缝合线时,肉腔狭窄、尿道狭窄、伤口感染和总并发症的发生率在统计学上没有显著差异。不过,研究显示 PDS 缝合尿道下裂修复术降低了 UCF 的发生率(风险比=0.66,95% CI 0.48 至 0.92)。结论 尿道下裂修复术后,PDS缝合比PG缝合可降低UCF的发生率。肉腔狭窄、尿道狭窄、伤口感染和总并发症的发生率不受修复所用缝合材料类型的影响。临床意义 该荟萃分析表明,尿道下裂修复术中使用 PDS 缝合线时 UCF 的发生率降低,这可能会影响修复术中缝合材料的选择。PROSPERO 注册号为 CRD42023409710。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。
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引用次数: 0
Postoperative interictal epileptiform discharges predict seizure recurrence after antiepileptic drug withdrawal regardless of concordance with surgical site 术后发作间期癫痫样放电可预测停用抗癫痫药后癫痫复发,与手术部位无关
IF 0.8 4区 医学 Q4 PEDIATRICS Pub Date : 2024-02-01 DOI: 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.
目的 该研究旨在探讨术后脑电图(EEG)上发作间期癫痫放电(IED)的部位与停用抗癫痫药物(AED)后癫痫复发之间的关联。研究假设,IED部位与手术部位一致表明癫痫灶切除不彻底,而IED部位与手术部位不一致表明术后病变或皮质刺激。前者癫痫复发的风险更高。方法 我们对连续接受切除手术的 182 名患儿的术后脑电图模式进行了回顾性分析。为了确定癫痫复发的风险因素,我们通过单变量和多变量分析比较了癫痫复发组和无癫痫组的属性。我们对 AED 的减量进行了标准化处理,包括每两周将单一类型 AED 的剂量减少 25%,与手术前的 AED 负荷无关。结果 我们尝试对116名(63.7%)患儿停用AED。28名(24.1%)患儿在停用AED期间或之后癫痫复发。手术时使用的 AED 数量越多(p =0.005)、切除不彻底(p =0.001)以及术后脑电图上出现 IED(p =0.011)是癫痫复发的预测因素。切除的完整性和停用 AED 后的癫痫复发与脑电图上是否存在 IED 有关,但与 IED 与手术部位的一致性无关。结论 对于脑电图异常的儿童,无论出院部位和手术部位的相对位置如何,都应更加谨慎地决定停用 AED。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":"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}
引用次数: 0
Safeguarding children through pediatric surgical care in war and humanitarian settings: a call to action for pediatric patients in Gaza 在战争和人道主义环境中通过儿科外科护理保护儿童:呼吁为加沙儿科病人采取行动
IF 0.8 4区 医学 Q4 PEDIATRICS Pub Date : 2024-02-01 DOI: 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 …
1 加沙的人道主义危机对儿童造成了毁灭性的伤害,许多儿童因狂轰滥炸而受伤,造成严重的多发性创伤,需要立即进行专业的儿科手术治疗。冲突给该地区脆弱的医疗保健系统造成了压力,导致大量人员伤亡,其中很大一部分是儿童。这加剧了对专业儿科外科护理的需求,尤其是在现有医疗保健系统和基础设施几乎崩溃、资源不足,无法处理大量涌入的儿科病人的情况下。2 为加沙儿童提供专业儿科外科护理和支持的紧迫性怎么强调都不为过。3 在最近的敌对行动之前,加沙和西岸已有 110 万儿童需要人道主义援助,约占儿童人口的一半。5 目前正在加沙提供医疗服务的无国界医生组织(MSF)团队成员对该地区儿童面临的严重医疗和人道主义危机深表关切。无国界医生组织的工作人员在烈士诊所和贝尼苏海拉诊所提供的医疗服务中,近一半是为五岁以下的儿童提供的。加沙平均每 10 分钟就有一名儿童死亡。该地区还有数千名儿童受伤。
{"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}
引用次数: 0
Tubularized incised plate urethroplasty and grafted tubularized incised plate urethroplasty: systematic review, meta-analysis and trial sequential analysis 管状切口板尿道成形术和移植管状切口板尿道成形术:系统综述、荟萃分析和试验序列分析
IF 0.8 4区 医学 Q4 PEDIATRICS Pub Date : 2024-02-01 DOI: 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.
背景尿道下裂是最常见的生殖器先天缺陷之一。目前约有 300 种不同的尿道下裂修复技术。本研究旨在对接受尿道下裂原发性修复术的儿童进行管状切开板尿道成形术(TIP)和移植TIP(GTIP)修复术的疗效比较。方法 该荟萃分析遵循《系统综述和荟萃分析首选报告项目》指南,我们采用人群、干预、对照和结果的格式来确定研究问题。我们在各种数据库中进行了全面的电子检索,采用了布尔检索策略和预定义检索词。仅纳入随机对照试验(RCT)进行定量分析。结果 共有 10 项随机对照试验符合我们的纳入标准,可进行定量分析。结果显示,两组患者的尿道皮肤瘘、龟头开裂和狭窄发生率相当。GTIP 组的肉腔狭窄发生率明显较低,相对风险 (RR) 为 0.32(95% 置信区间 (CI) 0.15 至 0.67)。结论 两组的耦合UCF、龟头开裂和狭窄率相当。值得注意的是,移植 TIP 组的肉阜狭窄发生率明显较低。在手术时间方面,我们的定量综合结果表明,TIP组的手术时间短于GTIP组,但存在显著的异质性。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":"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}
引用次数: 0
Complications after pediatric percutaneous endoscopic gastrostomy: comparison of the push and pull technique 小儿经皮内镜胃造口术后的并发症:推拉技术的比较
IF 0.8 4区 医学 Q4 PEDIATRICS Pub Date : 2024-01-01 DOI: 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.
目的 儿童经皮内镜胃造口术(PEG)过程中会出现各种并发症。推入式技术的应用越来越广泛,但其并发症的特点还不充分。我们的目的是评估与 PEG 手术相关的所有并发症,并比较牵拉和推送技术的安全性。方法 回顾性分析 2002 年至 2020 年间接受 PEG 的连续儿科患者。结果 共有 216 名儿童接受了 217 例 PEG 手术。138例(64%)采用推拿技术,79例(36%)采用牵拉技术。中位随访时间为 6.1 (0.1-18.3) 年。并发症发生率很高(57%),患者在术后数年才出现并发症。总体而言,推压组和牵拉组分别有 51% 和 67% 的患者出现并发症。推拿组的轻微和严重并发症发生率高于推拿组(分别为 63% 对 48%,P =0.028;11% 对 6%,P =0.140)。再次手术在牵拉组也更常见(17% 对 7%,P =0.020)。结论 PEG 手术的总体并发症发生率较高。幸运的是,大多数并发症都很轻微,无需再次手术。与传统的牵拉技术相比,不断增加的推送技术似乎更安全。儿童胃造口术的长期发病率很高。数据可能来自第三方,不对外公开。数据来自坦佩雷大学医院的医疗记录。
{"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}
引用次数: 0
Characteristics and trends of pediatric firepit burns: insights for prevention and safety 小儿火盆烧伤的特点和趋势:对预防和安全的启示
IF 0.8 4区 医学 Q4 PEDIATRICS Pub Date : 2024-01-01 DOI: 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.
引言 随着火盆的普及,与之相关的烧伤也越来越多。我们的研究探讨了小儿火盆烧伤的特点,以提高人们的认识并推广安全预防措施。方法 我们对一家三甲医院 2016 年至 2021 年期间的火盆烧伤儿科患者(≤21 岁)进行了回顾性研究。结果 共发现 84 名患者,其中 70.2% 为男性,中位年龄为 62 个月。烧伤总面积的中位数为2%(四分位距(IQR)=1-4)。35名(41.7%)患者入院,7名(8.3%)接受了植皮手术。颈部和躯干烧伤的植皮率最高(分别为 66% 和 33%)。手部(41.7%)和下肢(27.4%)是最常见的烧伤部位。烧伤的主要原因是灰烬/热炭(34.5%)、火焰(31.0%)和直接接触(25.0%),通常是由于跌入火中(59.5%)或在火旁奔跑或玩耍(26.2%)。有 35 人(41.7%)接受了住院治疗,49 人(58.3%)接受了门诊治疗。11人(13.2%)接受了至少一次整形手术,7人(8.4%)接受了至少一次康复治疗,65人(77.4%)接受了复诊。住院时间中位数为 2 天(IQR=1.0-3.5)。烧伤的高峰月份为 8 月至 10 月(n =40,46.0%),观察到的病例从 2016 年的 10 例增加到 2020 年的 20 例。结论 鉴于不安全的用火行为导致的火盆烧伤占很大比例,因此看护人了解正确的火盆安全预防措施至关重要。证据等级 III。无数据。
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引用次数: 0
Complete separation of the urinary tract from proximal rectum during PSARP surgery: our experience with the noveltechnique 在 PSARP 手术中将尿道与直肠近端完全分离:我们使用新技术的经验
IF 0.8 4区 医学 Q4 PEDIATRICS Pub Date : 2024-01-01 DOI: 10.1136/wjps-2023-000688
Md Samiul Hasan, Md Nazmul Islam, Refoyez Mahmud, Umama Huq, Ashrarur Rahman
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 …
肛门直肠畸形(ARM)是新生儿外科手术中的常见病,发病率为每 4000 例活产中就有 1 例。1 患有这种畸形的男婴,直肠和尿道在一段距离内共用一壁,最后往往形成瘘管。明确重建的目标是在不损伤尿道的情况下将直肠与尿道分离,并在肌肉复合体内将直肠移至会阴部。分离直肠和尿道是这一手术中最关键的部分,也是尿道损伤的重要风险所在。-Peña 和 Devries 所描述的原始手术方法是在瘘管上方的直肠粘膜上进行多处留置缝合,抬起粘膜并继续进行粘膜下剥离直至前列腺,在前列腺处可将整个厚度的肠道与尿道分离。此外,这种粘膜下剥离非常精细,需要医生的专业技能才能避免尿道损伤,而这种损伤经常发生在下部畸形相对良性的男孩身上。然而,直肠和泌尿道在共用壁近端有一个相对较大的分隔空间(图 1)。首先以前向方式向近端移动直肠,并用环状物将其从泌尿道中提起,尿道、前列腺和膀胱的后壁就很容易看到了。这也在直肠和泌尿道之间建立了清晰的界限,从而可以精确切除瘘管,而无需牵引缝合。图 1 显示膀胱后间隙的远端襻图。我们回顾了 2021 年 3 月至 2023 年 3 月期间因 ARM 而接受后矢状肛门成形术(PSARP)的患者的病历。随访时间最短为 3 个月。人口统计学和...
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引用次数: 0
Understanding pediatric surgical needs in North Korea: a modeling analysis 了解北朝鲜的儿科手术需求:模型分析
IF 0.8 4区 医学 Q4 PEDIATRICS Pub Date : 2024-01-01 DOI: 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.
背景 全世界 65% 的儿童得不到外科治疗,其中大多数生活在中低收入国家(LMICs)。发展外科基础设施需要获得有关外科需求的信息;然而,这些信息在低收入和中等收入国家往往十分有限。朝鲜(Democratic People's Republic of Korea, DPRK)的公开数据较少。在此,我们对现有的模型数据进行了分析,以了解朝鲜儿童因可通过手术治疗的疾病而死亡的原因。方法 我们利用世界银行的数据和卫生计量与评估研究所的模型,找出影响儿科患者(年龄小于 20 岁)的儿科死亡原因。我们比较了朝鲜与经济状况相似的国家之间的疾病死亡率。结果 从1990年到2019年,儿科总死亡人数有所下降。2019 年,朝鲜所有儿科死亡病例中有 32.2% 是由外科疾病造成的。外科疾病的主要类别是外伤(53.9%)、先天性疾病(34.2%)、肿瘤(8.8%)和腹部疾病(3.2%)。与人均国内生产总值相近的其他低收入国家相比,朝鲜的儿科相对死亡率较低。然而,朝鲜因需要手术治疗的疾病而导致的儿科死亡相对较高。运输伤害是造成朝鲜儿科高死亡率的重要原因。结论 虽然朝鲜在儿科医疗保健方面的总体资源分配效率可能高于经济水平较低的国家,但朝鲜仍可受益于儿科手术能力的提高。改善数据的可用性和密切的国际合作可能是缩小这一差距的潜在解决方案。数据可在公开、开放的资料库中获取。
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引用次数: 0
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World Journal of Pediatric Surgery
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