Pediatr. Surg. Int. [JOURNAL]
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200 papers
Reconstruction of high-grade post-circumcision penile injuries using fenestrated skin and oral mucosa grafts for glans resurfacing: a single-center experience.
Albaghdady A, Alansari AN
Pediatr Surg Int · 2026 Mar · PMID 41801498 · Publisher ↗
PURPOSE: We aim to present a single-center experience using this combined technique for phallic reconstruction. METHODS: Complicated circumcision cases referred to our department from June 2015 to May 2024 were reviewed....
PURPOSE: We aim to present a single-center experience using this combined technique for phallic reconstruction. METHODS: Complicated circumcision cases referred to our department from June 2015 to May 2024 were reviewed. We identified consecutive cases who had been presented with grade III to V penile injury and subjected to phallic reconstruction by release of the subcutaneous corporal remnant and covering the exteriorized corporal remnant with a full-thickness skin graft and resurfacing of the glans penis by oral mucosa graft. RESULTS: 37 male children were identified. Age at surgery ranged from 9 months to 7 years, with a mean operative time of 150 min and follow-up of 3 months-5.5 years. Uneventful graft incorporation occurred in 29 patients, with all donor sites healing without morbidity. At 6 months, urethral patency and satisfactory cosmetic outcomes were achieved in all patients. Complications included total skin graft loss in 4 patients, partial skin graft loss in 3, and buccal mucosa graft eschar in 2. CONCLUSION: Fenestrated full-thickness skin grafts for the shaft combined with fenestrated oral mucosa grafts for the glans provide a reliable approach to reconstructing severe post-circumcision penile injuries. This technique provides an encouraging aesthetic and functional result.
Risk factors for early recurrence after hydrostatic reduction of intussusception in children and development of a nomogram prediction model.
Li X, Qiang H, Ding Z … +3 more , Li X, Cao Y, Zhu D
Pediatr Surg Int · 2026 Mar · PMID 41801423 · Publisher ↗
OBJECTIVE: To identify predictors of early recurrence after hydrostatic reduction of pediatric intussusception and develop a nomogram. METHODS: A total of 412 children with intussusception treated between January 2022 an...
OBJECTIVE: To identify predictors of early recurrence after hydrostatic reduction of pediatric intussusception and develop a nomogram. METHODS: A total of 412 children with intussusception treated between January 2022 and January 2025 were enrolled. Based on recurrence within 48 h after successful hydrostatic reduction, they were assigned to a recurrent group (n = 37) or a non-recurrent group (n = 375). Clinical and ultrasonographic variables were compared between the groups, and a nomogram was developed and validated from the identified predictors. RESULTS: Following hydrostatic reduction, some independent predictors of recurrent intussusception in children were identified: symptom-onset time, maximal “target-sign” diameter on ultrasound, concentric-ring anatomic location, bowel-wall thickness, presence of intraluminal lesions, and peritoneal effusion (P < 0.05). A nomogram that integrates these ultrasound indices with clinical variables exhibited excellent calibration and discrimination. Decision-curve analysis further confirmed that the model delivered greater net clinical benefit than either “treat-all” or “treat-none” strategies across the entire range of threshold probabilities. CONCLUSION: In this study, we developed a nomogram based on clinical risk factors to predict short-term recurrence of intussusception after ultrasound-guided hydrostatic reduction in children. Age, duration of abdominal pain, maximal diameter of the “target sign” on ultrasound, concentric-ring anatomic location, bowel-wall thickness, intraluminal lesions, and peritoneal effusion were identified as predictors and incorporated into the model. Internal validation demonstrated that this nomogram provides a clear and convenient tool for stratifying recurrence risk in children undergoing ultrasound-guided hydrostatic reduction.
Mesenchymal stromal cell therapy restores intestinal integrity and attentuates inflammation in a preterm piglet model of necrotizing enterocolitis.
Lee J, Joseph S, Manohar K … +9 more , Mesfin F, Hunter C, Brokaw J, Shelley WC, Liu J, McCain R, Crain CJ, Lescun T, Markel TA
Pediatr Surg Int · 2026 Mar · PMID 41801403 · Full text
PURPOSE: Necrotizing enterocolitis (NEC) is a life-threatening gastrointestinal disease of prematurity characterized by inflammation, necrosis, and high morbidity. Current therapies are limited, necessitating the develop...
PURPOSE: Necrotizing enterocolitis (NEC) is a life-threatening gastrointestinal disease of prematurity characterized by inflammation, necrosis, and high morbidity. Current therapies are limited, necessitating the development of novel treatments. Mesenchymal stromal cells (MSCs) have shown promise in murine NEC models. Given the anatomical and physiological similarities between premature piglets and human infants, we employed a preterm piglet model to evaluate MSC efficacy. We hypothesized that intraperitoneal MSC administration would reduce intestinal injury in NEC. METHODS: Preterm piglets were delivered via cesarean section. NEC was induced on day 3 through hypertonic enteral feeding. MSCs were administered intraperitoneally at low, medium, or high doses. Piglets were monitored and euthanized based on clinical criteria. Clinical scores, weight change, gross and histologic intestinal injuries were assessed. Cytokine levels in serum and ileum were quantified via ELISA, and intestinal tissue was analyzed by RNA sequencing. Statistical significance was set at p < 0.05. RESULTS: Medium-dose MSCs significantly improved clinical scores and reduced both gross and histologic intestinal injury (p < 0.05). A corresponding decrease in pro-inflammatory cytokines was observed. CONCLUSION: This is the first study to demonstrate therapeutic benefit of MSCs in a preterm piglet NEC model, supporting their potential use in translational NEC therapies.
Somatic cell dysfunction precedes testicular degeneration in a surgical model of cryptorchidism.
He G, You C, Tu S … +3 more , Chen C, Hong Y, Wang J
Pediatr Surg Int · 2026 Mar · PMID 41793492 · Publisher ↗
PURPOSE: Cryptorchidism is the most common congenital anomaly requiring pediatric surgical correction. Although surgical repositioning of the undescended testis (orchidopexy) is effective anatomically, the molecular and...
PURPOSE: Cryptorchidism is the most common congenital anomaly requiring pediatric surgical correction. Although surgical repositioning of the undescended testis (orchidopexy) is effective anatomically, the molecular and cellular mechanisms underlying ongoing testicular damage after surgery remain poorly understood. METHODS: We established a surgically induced unilateral cryptorchidism model in adult mice, collected testicular tissues at day 0, 3, 7, 10, and 14 after induction, and performed bulk RNA sequencing on samples collected at day 0, 3, and 7. Differentially expressed genes (DEGs) were analyzed for pathway enrichment and protein-protein interactions. Cell-type-specific gene expression patterns were evaluated using publicly available single-cell RNA-seq data. Histological evaluation was performed to validate tissue-level changes. RESULTS: Transcriptomic profiling revealed rapid upregulation of extracellular matrix remodeling and inflammatory signaling by day 3, primarily in somatic cells such as Sertoli and peritubular myoid cells. By day 7, we observed activation of pro-apoptotic and TGF-β signaling pathways. Key genes including Ddr1, Ltbp1, and Spp1 were enriched in somatic compartments. Histology confirmed progressive seminiferous tubule disorganization and germ cell depletion, consistent with somatic cell-driven structural deterioration. CONCLUSIONS: This study provides hypothesis-generating evidence that somatic cell dysfunction may be an early feature of cryptorchidism-associated testicular injury in this adult mouse model. These findings identify candidate genes and pathways for further investigation. Validation in developmental cryptorchidism models and human tissue will be required to establish clinical relevance.
Comparative analysis of balloon vs solid internal bumper gastro-jejunal tubes in children: a review of outcomes.
Naeem M, Ali MS, Khan S … +2 more , Alma'aitah SW, Aworanti OM
Pediatr Surg Int · 2026 Mar · PMID 41790260 · Publisher ↗
BACKGROUND: We compared two types of gastro-jejunal (GJ) tubes used in children: Freka percutaneous endoscopic GJ tube (FPEGJ) with solid internal bumpers and balloon gastro-jejunal tubes (BGJ). Despite differences in de...
BACKGROUND: We compared two types of gastro-jejunal (GJ) tubes used in children: Freka percutaneous endoscopic GJ tube (FPEGJ) with solid internal bumpers and balloon gastro-jejunal tubes (BGJ). Despite differences in design, comparative data on safety, durability, and complications remain limited. METHODS: A retrospective review was performed of 69 children with active GJ tubes as of August 2024. Each tube episode lasted until replacement to a different tube type under general anaesthesia. Demographic data, complications, and frequency of elective and unplanned tube changes were analysed. RESULTS: Forty-one children(59%) had an initial FPEGJ, and their median weight was significantly lower than those who had an initial BGJ (7.9 vs. 21.4 kg, p < 0.001). In total, 56 FPEGJ and 48 BGJ tube episodes were reviewed. Over a median of 14.5 months for FPEGJ and 37 months for BGJ (p < 0.001), BGJ required more routine changes (0.12 vs. 0.0 changes/month). However, acute change rates were similar (0.05 vs. 0.06 changes/month, p = 0.61), with Poisson regression adjusting for duration showing no significant difference (incidence rate ratio 0.97, p = 0.82). The most common cause for acute replacement was jejunal limb displacement (32% FPEGJ, 34% BGJ), followed by FPEGJ distal migration (19%) and BGJ balloon rupture (18%). Significant complications occurred exclusively with FPEGJ, including one gastrocolic fistula and 10 buried bumpers. CONCLUSION: FPEGJ was the preferred primary tube for smaller infants, requires fewer routine changes but had significant complications. Primary BGJ insertion may reduce morbidity without increasing tube displacement risk. Innovation is needed to improve BGJ longevity and suitability for infants.
Feeding patterns and the risk of perianal abscess in early infancy: a case-control study.
Shachor M, Idan D, Kravarusic D … +3 more , Paran M, Sher N, Dreznik Y
Pediatr Surg Int · 2026 Mar · PMID 41790252 · Publisher ↗
BACKGROUND: Breastfeeding is widely recognized as protective against infectious morbidity in infancy, largely through immunologic, anti-inflammatory, and microbiome-mediated mechanisms. Whether exclusive breastfeeding al...
BACKGROUND: Breastfeeding is widely recognized as protective against infectious morbidity in infancy, largely through immunologic, anti-inflammatory, and microbiome-mediated mechanisms. Whether exclusive breastfeeding also influences the risk of perianal abscess, a relatively common condition in early infancy, remains unclear. This study aimed to evaluate the association between infant feeding patterns and the development of perianal abscess. METHODS: This retrospective case–control study with age-frequency matching was conducted at a tertiary pediatric surgery center and included male infants aged 0 to 6 months diagnosed with perianal abscess between January 2020 and December 2025. Epidemiologic characteristics, recurrence rates, microbiologic findings, and feeding practices (exclusive breastfeeding, exclusive formula feeding, or mixed feeding) were collected and compared. Logistic regression was used to assess the association between feeding pattern and odds of abscess, adjusting for age and prematurity. RESULTS: Mean age was similar between groups (2.3 vs. 2.5 months). Among infants with perianal abscess, 46% were exclusively breastfed, 23.6% exclusively formula-fed, and 30.3% mixed-fed. In controls, the corresponding rates were 39%, 40%, and 21%, respectively. Overall feeding distribution did not differ significantly (p = 0.056). Exclusive breastfeeding was not associated with reduced odds of abscess (OR 0.81; 95% CI 0.38–1.73), whereas exclusive formula feeding was associated with lower odds compared with mixed feeding (OR 0.40; 95% CI 0.18–0.91). CONCLUSIONS: In this cohort of male infants under six months, exclusive breastfeeding did not appear to protect against perianal abscess. Mixed feeding was more common among affected infants, which may reflect the transient microbiologic shifts that occur during partial weaning or combined feeding.
Negative pressure wound therapy in children: outcomes across a heterogeneous wound cohort.
Okur Ö, Tabak Z, Can M … +4 more , Boztas AE, Payza AD, Genisol I, Şencan A
Pediatr Surg Int · 2026 Mar · PMID 41790251 · Publisher ↗
PURPOSE: Pediatric negative pressure wound therapy (NPWT) is widely used, but etiology- and age-informed real-world benchmarks are limited. We compared treatment burden and closure trajectories across pediatric wound cat...
PURPOSE: Pediatric negative pressure wound therapy (NPWT) is widely used, but etiology- and age-informed real-world benchmarks are limited. We compared treatment burden and closure trajectories across pediatric wound categories. METHODS: Retrospective single-center cohort of children (< 18 years) treated with NPWT for open wounds (2020-2025). Wounds were categorized as surgical (G1), acute (G2), chronic (G3), and burns (G4). NPWT was performed in accordance with an age-adapted institutional protocol in continuous mode; dressing changes were usually performed every 72 h. RESULTS: 106 patients (median age 144 months, IQR 60-180) were included: G1 42, G2 22, G3 31, G4 11. Age distribution differed by group (p < 0.001), and instillation use varied (p = 0.014). Duration was longest in G3 (median 13 [8,-24] days) and shortest in G4 (median 6 [5,-9] days), while G1 and G2 were similar. Median cycle counts were similar across groups. Re-debridement was least frequent in G1. Definitive outcomes differed by etiology: primary closure predominated in G1, secondary healing in G3, and spontaneous closure in G4; grafting occurred mainly in burns, and flap reconstruction was rare. CONCLUSIONS: NPWT was feasible across heterogeneous pediatric wounds when used with a standardized, age-adapted approach. Etiology-specific differences in burden and outcomes inform expectations and support prospective multicenter evaluation.
Utility of bedside signs in diagnosing acute appendicitis: a neurophysiological perspective.
Yale SH, Tekiner H, Yale ES
Pediatr Surg Int · 2026 Mar · PMID 41790233 · Publisher ↗
Abstract loading — click title to view on PubMed.
Risk factors and a predictive model for testicular atrophy after laparoscopic orchiopexy in children.
Liu Y, Li L, Fan Y
Pediatr Surg Int · 2026 Mar · PMID 41784818 · Publisher ↗
OBJECTIVE: To investigate the risk factors of testicular atrophy after laparoscopic orchiopexy in children and to construct a predictive model. METHODS: A retrospective analysis was conducted on the clinical data of chil...
OBJECTIVE: To investigate the risk factors of testicular atrophy after laparoscopic orchiopexy in children and to construct a predictive model. METHODS: A retrospective analysis was conducted on the clinical data of children diagnosed with cryptorchidism and treated with laparoscopic orchiopexy in our department from June 2021 to December 2023. Patients were divided into an atrophy group (Group A, n = 36 testes) and a non-atrophy group (Group B, n = 149 testes) based on postoperative outcomes. The clinical data of the two groups were compared, including age, surgical side, weight, premature birth, preoperative testicular position, operative time, epididymal-vas deferens anomalies, patency of the processus vaginalis, postoperative complications (incision infection, hematoma, etc.), spermatic cord development, preoperative color Doppler flow imaging (CDFI), preoperative testicular volume ratio and postoperative testicular fixation position. Univariate analysis followed by multivariate logistic regression was performed to identify independent risk factors for postoperative testicular atrophy and construct a corresponding predictive model. The discriminative performance, calibration, and reliability of the model were evaluated using receiver operating characteristic (ROC) curve, calibration curve, and Bootstrap internal validation. RESULTS: A total of 152 patients (involving 185 testes) were enrolled in this study, including 36 testes in group A and 149 testes in group B. The incidence of postoperative testicular atrophy was 19.5%. Univariate analysis showed that there were significant differences between the two groups in epididymal-vas deferens anomalies, spermatic cord development, preoperative testicular position and preoperative testicular volume ratio (P < 0.05). There were no significant differences in age, surgical side, weight, premature birth, operative time, patency of the processus vaginalis, postoperative complications, preoperative color Doppler flow imaging (CDFI) and postoperative testicular fixation position (P > 0.05). Multivariate analysis showed epididymal-vas deferens anomalies (OR = 11.841, 95% CI: 4.149–33.79), intra-abdominal testis (OR = 20.522, 95% CI: 4.2–100.282) and a low preoperative testicular volume ratio (OR = 0.007, 95% CI: 0.000–0.11) were independent risk factors for testicular atrophy after laparoscopic orchiopexy (P < 0.05). CONCLUSIONS: Epididymal-vas deferens anomalies, intra-abdominal testis and a low preoperative testicular volume ratio were independent risk factors for testicular atrophy after laparoscopic orchiopexy, and the predictive model based on these three factors had high predictive value.
ICG fluorescence imaging in sentinel lymph node identification: toward a standardized protocol in paediatric renal tumour surgery.
Wojtylko A, Garnier H, Rapala M … +7 more , Murawski M, Kozakiewicz M, Jedrzejak E, Dachowska-Kalwak I, Pietras W, Czauderna P, Godziński J
Pediatr Surg Int · 2026 Mar · PMID 41784812 · Publisher ↗
PURPOSE: Adequate lymph node sampling is essential for accurate staging and treatment planning in Wilms tumour. Both SIOP and COG protocols recommend sampling more than six lymph nodes. However, median retrieval rates re...
PURPOSE: Adequate lymph node sampling is essential for accurate staging and treatment planning in Wilms tumour. Both SIOP and COG protocols recommend sampling more than six lymph nodes. However, median retrieval rates remain low in both open and minimally invasive approaches. This study aimed to assess the feasibility, safety, and efficacy of intraoperative indocyanine green (ICG) fluorescence imaging for sentinel lymph node (SLN) identification in paediatric renal tumours and to contribute to the standardization of dosage and timing protocols. METHODS: A two-centre prospective study (2023-2025) was conducted in Wrocław and Gdańsk involving 20 paediatric patients undergoing nephron-sparing surgery (n = 14) or nephrectomy (n = 6) for renal tumours with ambiguous lymphatic drainage. ICG (0.2 ml of a 5 mg/ml solution) was injected into four sites of healthy renal parenchyma, 1-2 cm from the tumour margin, after kidney exposure and before vascular pedicle preparation. Near-infrared (NIR) imaging (Stryker) was used to visualise lymphatic drainage and sentinel nodes. RESULTS: Twenty children were included (median age 3 years, IQR 1.75-5.00). The median number of lymph nodes retrieved was 4 (IQR 3-6), with a median of 3 fluorescent nodes (IQR 1.5-4.5). Sentinel lymph node visualisation was successful in six cases (one benign renal cyst and five nephroblastomas) and failed in chromophobe carcinoma and renal cell carcinoma. No ICG-related adverse events were observed. The number of lymph nodes retrieved did not differ significantly between nephron-sparing surgery and nephrectomy; however, a higher number of fluorescent nodes was observed in the nephron-sparing group (median 3.5 vs. 1.0; p = 0.0757). Compared with historical controls, the ICG-guided cohort demonstrated a significantly higher lymph node yield (median 4.0 vs. 3.0; p = 0.00468). Operative time was significantly longer in the ICG group (median 130.5 min [IQR 114.5-145.0] vs. 109.5 min [IQR 91.0-112.5]; p = 0.00513), likely reflecting the initial learning curve associated with adoption of the technique. CONCLUSION: ICG fluorescence imaging is a promising adjunct for SLN mapping in paediatric renal tumours. Standardisation of injection protocols is required to improve reproducibility. The technique is safe, feasible, and may improve staging accuracy while reducing the need for repeat surgeries.
Pediatric cholecystectomy practices and training: an International Multicenter Survey by the European Union of Medical Specialists (UEMS) Section of Paediatric Surgery.
Dotlacil V, Rolle U, Matthyssens L … +25 more , Abola Z, Bjørnland K, Capdevila Vilaró B, Czauderna P, Davenport M, Biro E, Bjørn N, Galea J, Jimenez-Gomez J, Holland-Cunz S, Kovacs T, Kuzyk A, Leshnevskyy O, Luoto T, Malcius D, Mesas Burgos C, Mortell A, Muensterer OJ, Märtson M, Sabolić I, Soyer T, Velaoras K, Senica Verbič M, Rygl M, Kucerova B
Pediatr Surg Int · 2026 Mar · PMID 41779230 · Full text
PURPOSE: Pediatric cholecystitis and cholelithiasis management is heterogeneous. We surveyed European centers to map current practices, training exposure, and outcomes of pediatric biliary cholecystectomy. METHODS: A 24-...
PURPOSE: Pediatric cholecystitis and cholelithiasis management is heterogeneous. We surveyed European centers to map current practices, training exposure, and outcomes of pediatric biliary cholecystectomy. METHODS: A 24-item cross-sectional international survey was developed by the European Union of Medical Specialists (UEMS) Section of Paediatric Surgery and distributed to centers in 31 UEMS member states. Items covered institutional resources, indications and timing, surgical approach and adjuncts (ERCP, ICG), training exposure, and center-level outcomes; results are reported as n (%), median (IQR). Outcomes were reported at the center level and were self-reported by participating institutions. RESULTS: Thirty-two centers from 23/31 states responded (74.2%). Pediatric surgeons were primary operators in 84% (shared with adult surgeons in 16%); ERCP access was 66%. Trainee operator share was 22.5% (IQR 5-50) and simulator access 56%. ICG cholangiography was routine in 12.5% and selective in 31%. Acute calculous cholecystitis: 6% always index-admission and 59.4% interval (29-41 days) cholecystectomy; post-ERCP choledocholithiasis: 16% always index-admission cholecystectomy. In 2023, 185 cases were reported: 98.9% laparoscopic with 1.6% conversion; median age 14 years (IQR 12.25-15), operative time 90 min (IQR 60-110), length of stay 2 days (IQR 1-2); 10 complications (5.4%). CONCLUSION: Substantial heterogeneity persists in both care pathways and training exposure; most centers lack formal pediatric-specific guidelines, and trainee-led operating remains limited, supporting the need for evidence-based protocols and structured training pathways.
Efficacy and safety of α1-adrenergic blockers after extracorporeal shock wave lithotripsy in pediatric kidney stones.
Kyarimov IA, Zorkin SN, Galuzinskaya AT … +2 more , Bayazitov RR, Shakhnovskiy DS
Pediatr Surg Int · 2026 Mar · PMID 41779220 · Publisher ↗
PURPOSE: The development of effective medical expulsive therapy (MET) following extracorporeal shock wave lithotripsy (ESWL) for pediatric urolithiasis is crucial for enhancing stone fragment clearance. This study aimed...
PURPOSE: The development of effective medical expulsive therapy (MET) following extracorporeal shock wave lithotripsy (ESWL) for pediatric urolithiasis is crucial for enhancing stone fragment clearance. This study aimed to evaluate the efficacy and safety of alpha-1 adrenergic blockers (tamsulosin and silodosin) in children after ESWL. METHODS: A prospective randomized comparative study was conducted involving 200 patients (aged 2-18 years) who underwent ESWL. Participants were allocated to a study group (n = 50, receiving α1-blockers: tamsulosin 0.2 mg/day for ages 2-5, silodosin 4 mg/day for ages > 5) or a control group (n = 150, receiving standard therapy). Primary endpoints were stone-free rate (SFR) and stone expulsion time. Secondary endpoints included pain dynamics (visual analog scale, VAS), analgesic requirements, and adverse events. Statistical analysis was performed using StatTech v.4.8.3. RESULTS: The odds of being stone-free were 2.11 times higher with α1-blocker therapy (OR = 2.11; 95% CI: 1.02-4.37). The median expulsion time was reduced from 7 [5-9] days in the control group to 5 [4-7] days in the study group (p = 0.010). ROC analysis identified a 6-day threshold for stone passage (sensitivity 63.6%, specificity 72.1%, AUC = 0.627; p = 0.010). Pain intensity was significantly lower in the study group on postoperative day 1 (3 [0-4] vs. 6 [5-8] points, p < 0.001), with reduced analgesic requirements (1 [0-2] vs. 2 [1-4] doses/day, p = 0.003). Adverse events were mild and infrequent (5 cases of nasal congestion, 2 of nausea). CONCLUSION: Adjunctive therapy with α1-blockers after ESWL in children with urolithiasis improves treatment efficacy, shortens stone expulsion time, reduces pain, and demonstrates a favorable safety profile. An optimal timeframe for efficacy assessment is 6 days post-ESWL.
Neonatal bedside laparotomy in the UK: a multidisciplinary survey of practice and perceptions.
Sehdev S, O'Sullivan B, Blaise BJ … +3 more , Lee G, Selman A, Yardley I
Pediatr Surg Int · 2026 Mar · PMID 41779217 · Publisher ↗
PURPOSE: Emergency neonatal laparotomy can be undertaken on the intensive care unit (ICU) or in the operating theatre. The evidence-base establishing indications, benefits or disadvantages is limited. We conducted a mult...
PURPOSE: Emergency neonatal laparotomy can be undertaken on the intensive care unit (ICU) or in the operating theatre. The evidence-base establishing indications, benefits or disadvantages is limited. We conducted a multidisciplinary survey of UK neonatal surgical centres to describe current practice. METHODS: A 16-item online survey was developed, and responses sought from one anaesthetist, one neonatologist and one surgeon at each of the 25 neonatal surgery centres in the UK. Quantitative responses were analysed with descriptive statistics (IBM SPSS Statistics v30). Free-text responses were subjected to qualitative thematic analysis. RESULTS: 23 anaesthetists, 23 neonatologists, and 23 paediatric surgeons responded (69/75; 92%). At least one response was received from every centre. Cotside laparotomy is carried out in 22 (88%) of centres. 44 (64%) respondents preferred operating in theatre although a significant minority favoured cotside surgery (13 (19%)). Only 5 (20%) centres reported having formal indications for cotside laparotomy. Centres with established pathways performed a significantly higher proportion of cotside laparotomies compared to centres without established guidelines (p < 0.001). Factors influencing decision to operate at the cotside were patient-specific: cardiovascular instability (86%), ventilator dependence (70%) and low birthweight (42%). 46 (67%) respondents recalled complications associated with theatre-based operating including hypothermia (41%), airway complications (15%) and cardiovascular instability (10%). Respondents perceived bedside surgery to be constrained by limited space (62%), disturbance to NICU families and staff (56%) and lack of neonatal surgical instruments (49%). CONCLUSION: This study establishes the first UK dataset on location of neonatal laparotomy, revealing marked variation in practice based on institutional preference, signalling need for national guideline development.
Thoracoscopic staged repair for type A and type B esophageal atresia: outcomes from a tertiary center.
Newland N, Snajdauf J, Styblova J … +4 more , Coufal S, Bartosova T, Rygl M, Kokesova A
Pediatr Surg Int · 2026 Mar · PMID 41779207 · Full text
PURPOSE: To evaluate outcomes of thoracoscopic staged internal traction combined with a waiting period in long-gap esophageal atresia (LGEA) at a single center. METHODS: Retrospective analysis of perinatal characteristic...
PURPOSE: To evaluate outcomes of thoracoscopic staged internal traction combined with a waiting period in long-gap esophageal atresia (LGEA) at a single center. METHODS: Retrospective analysis of perinatal characteristics, surgical interventions, postoperative complications, and long-term outcomes in LGEA patients undergoing delayed thoracoscopic staged repair between 2018 and 2024. RESULTS: Among141 esophageal atresia repairs, 15 patients had LGEA (13 Gross type A, 2 type B). All patients underwent gastrostomy placement. The first thoracoscopic stage occurred at a median age 2.4 months (1.1-3.7). Internal traction was applied in 13/15 (86%), two required gastric interposition (GI) for an extreme long gap diagnosed at initial thoracoscopy. Traction patients underwent a median of 2 tractions (1-3). Delayed anastomosis was achieved in 10/13 (77%) within a median 11.5 days (6-43) from first thoracoscopy. In three, anastomosis remained unfeasible after traction due to a persistent long gap, necessitating GI. Complications included one recurrent fistula, one leak, and five strictures requiring a median 1.5 dilatations (1-7). At a median 50-month follow-up (12-91), all delayed-anastomosis patients and 60% of GI patients tolerated full oral feeds. CONCLUSION: A delayed thoracoscopic staged internal traction enabled safe anastomosis with a low complication rate; however, one-third of patients required GI.
Letter to the Editor concerning Takeda M, Koga H, Lane GJ, Tanaka N, Nagakawa Y, Okazaki T, Urao M,Yamataka A. Historical aspects of anatomic landmarks during pull-through for hirschsprung disease: focusing on resection levels of the aganglionic rectum and rectal cuff issues. Pediatr Surg Int. 2025 Nov 17;42(1):14.
Wilms M, Mohideen M, Neumayr M … +1 more , Lemli A
Pediatr Surg Int · 2026 Mar · PMID 41779196 · Full text
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Efficacy of pelvic floor rehabilitation and TENS in pediatric patients with refractory functional constipation: a randomized controlled study.
Ersoy F, Gerçel G, Olgun TB … +4 more , Bozbeyoğlu SG, Anadolulu Aİ, Şengül ÖK, Durakbaşa ÇU
Pediatr Surg Int · 2026 Mar · PMID 41779176 · Publisher ↗
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In which cases of proximal hypospadias detailed investigations are necessary.
Aydınbaş G, Karaman A, Çetinkaya S … +1 more , Karaman İ
Pediatr Surg Int · 2026 Mar · PMID 41779168 · Publisher ↗
OBJECTIVE: The aim of this study was to evaluate the differences in physical examination and radiologic findings of patients with proximal hypospadias in terms of Disorders of Sex Development (DSD) groups. MATERIALS AND...
OBJECTIVE: The aim of this study was to evaluate the differences in physical examination and radiologic findings of patients with proximal hypospadias in terms of Disorders of Sex Development (DSD) groups. MATERIALS AND METHODS: The ages, physical examination and radiological findings and diagnoses of the cases aged 0-18 years who were admitted to our hospital due to proximal hypospadias between 2005 and 2022 and whose male gender was determined because of their evaluation for DSD were evaluated. RESULTS: The study population included 43 patients with a median age of 4 months (1 day-14 years): 19 presented with penoscrotal, 13 with scrotal, and 11 with perineal hypospadias. All cases exhibited severe ventral chordee, with micropenis observed in most patients. 46,XY DSD represented most cases, followed by sex chromosome DSD, 46,XX DSD, and other karyotype anomalies. Most patients in the DSD group had undescended testes and/or micropenis. Penoscrotal hypospadias was seen only in the 46,XY DSD group and no uterine remnants were seen in this group. CONCLUSION: Patients with proximal hypospadias accompanied by undescended testis and/or micropenis should be evaluated in detail before any surgical intervention. We believe that especially in cases with scrotal and perineal hypospadias should be investigated for possible uterine remnants.
Assessment of quality of life in patients with Müllerian anomalies at a referral center in Colombia.
Villamizar DM, Ladino TD, Neira MJ … +2 more , Fierro F, Valero J
Pediatr Surg Int · 2026 Mar · PMID 41779159 · Publisher ↗
OBJECTIVE: To evaluate quality of life in pediatric patients with Müllerian anomalies who underwent surgical intervention between 2018 and 2023. METHODS: A retrospective descriptive case series was conducted including pa...
OBJECTIVE: To evaluate quality of life in pediatric patients with Müllerian anomalies who underwent surgical intervention between 2018 and 2023. METHODS: A retrospective descriptive case series was conducted including patients younger than 18 years who underwent surgical correction for Müllerian anomalies between 2018 and 2023. Quality of life was assessed using the validated Spanish version of the Pediatric Quality of Life Inventory (PedsQL 4.0) through telephone follow-up at least six months after surgery. RESULTS: The most frequent anomalies were longitudinal vaginal septum and uterus didelphys (42.8%), while OHVIRA syndrome was least common (2.9%). Renal agenesis occurred in 28.6% of patients, predominantly right-sided (80%), and anorectal malformations (ARM) were associated in 57.1%. All underwent vaginoscopy and surgery, most commonly vaginal septum resection (40%). The PedsQL was applied by phone to all patients, with a mean follow-up of 48 months. Mean quality-of-life scores were good and comparable between parent-proxy and self-reports in the 13-18-year (73.34 vs. 77.51) and 8-12-year (68.75 vs. 72.82) groups. The highest scores were in the 2-4-year (80.43) and 5-7-year (79.71) groups. Emotional functioning consistently scored lowest, while physical and social functioning were highest. Currently, 25.7% of patients have initiated sexual activity, and two have had children-one by vaginal delivery and one by cesarean. CONCLUSIONS: Pediatric patients with Müllerian anomalies demonstrated good postoperative quality of life, highlighting the positive impact of timely surgical management on physical, social, and reproductive outcomes.
Reasons for performing abdominal computed tomography in pediatric emergency departments providing trauma care: a single-center experience.
Tomar Güneysu S, Derinöz Güleryüz O, Akca Çağlar A … +1 more , Türkmen T
Pediatr Surg Int · 2026 Mar · PMID 41779068 · Publisher ↗
OBJECTIVE: This study aimed to evaluate the indications for abdominal computed tomography (CT) in children aged 0–18 years presenting to the Pediatric Emergency Department. Associated factors, the use of alternative imag...
OBJECTIVE: This study aimed to evaluate the indications for abdominal computed tomography (CT) in children aged 0–18 years presenting to the Pediatric Emergency Department. Associated factors, the use of alternative imaging modalities, diagnostic outcomes, and the need for surgical intervention were also assessed. METHODS: Children aged 0–18 years who presented between January 2018 and December 2022 and underwent abdominal CT, as determined by a pediatrician or pediatric emergency physician, were included. RESULTS: A total of 562 patients were analyzed (mean age: 142 months; 55% male). In traumatic cases, the most common indications for CT were abdominal tenderness, unreliable physical examination, and hemodynamic instability, whereas abdominal pain, tenderness, and vomiting predominated in non-traumatic cases. Ultrasonography (US) was used more frequently in non-traumatic patients, while direct CT without prior US was more common in trauma patients (p < 0.01). CT contributed to diagnosis but not to surgical decision-making in traumatic patients, whereas it significantly contributed to both diagnosis and surgical decision-making in non-traumatic patients. When US findings were normal, CT most commonly identified liver and splenic lacerations in traumatic patients and acute appendicitis in non-traumatic patients. In the presence of normal US findings, pathology detected on CT was strongly associated with surgical intervention (OR = 22, p < 0.001). CONCLUSIONS : Despite the relatively high use of CT in pediatric trauma, most examinations yielded normal findings. Clinical examination and laboratory results should guide imaging decisions rather than reliance on trauma mechanism alone. A selective, clinically driven approach to CT utilization is essential in pediatric abdominal conditions, particularly in non-traumatic patients and in cases with inconclusive ultrasonographic findings.
Surgical approach to lung hydatid cysts in children.
Biçer G, Karaman A, Erdoğan D … +1 more , Karaman İ
Pediatr Surg Int · 2026 Mar · PMID 41779053 · Publisher ↗
PURPOSE: The aim of this study was to determine the treatment options for pulmonary hydatid cysts (HC) in children according to the size and location of the cyst and the presentation of the patients. METHODS: Children wi...
PURPOSE: The aim of this study was to determine the treatment options for pulmonary hydatid cysts (HC) in children according to the size and location of the cyst and the presentation of the patients. METHODS: Children with HC treated between 2004 and 2022 were evaluated. Patients were grouped according to the size of the HC and those with ruptured and intact cysts at the time of admission, and the data were compared. ROC curve was created to determine the HC size limit in operated patients. P < 0.05 was considered statistically significant. RESULTS: A total of 72 patients with a mean age of 8.9 ± 3.4 years were included in the study. HC sizes 2.5–18 cm, and half of the patients had bronchial/pleural ruptures at presentation. Forty-six patients (64%) underwent surgery. Bronchial ruptured HCs were smaller in size (p = 0.021). In cases where the cyst contents were evacuated by opening the bronchus, improvement in clinical and radiological findings was observed with anthelmintic treatment (n = 17, 81%). The cutoff point on the ROC curve was determined as 6.1 cm. CONCLUSION: Surgical treatment should be planned without delay for HC exceeding 6 cm in size. In patients with bronchial rupture and coughing up the cyst contents, only medical treatment can be applied.
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