Major stoma related morbidity in young children following stoma formation and closure: A retrospective cohort study
Stoma creation can be necessary and lifesaving in young children with a bowel perforation, necrosis or obstruction.[1, 2] In these critically ill children, a stoma is often created instead of a primary anastomosis to avoid the risk of anastomotic leakage. Stoma formation can result in major stoma related morbidity such as stoma necrosis, stenosis, prolapse, and incisional or parastomal hernia [3]. Additionally, excessive fluid loss might lead to dehydration and failure to thrive most specifically in case of ileostomies. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - November 27, 2021 Category: Surgery Authors: Irene Vogel, Laurens D. Eeftinck Schattenkerk, Esm ée Venema, Karan Pandey, Justin R. de Jong, Pieter J. Tanis, Ramon Gorter, Ernest van Heurn, Gijs D. Musters, Joep P.M. Derikx Source Type: research

Patient-reported physical and psychosocial significance of abdominal scarring in anorectal malformations
Anorectal malformations (ARM), with an incidence of 1/5000 live births, cover a spectrum of heterogenous congenital conditions mainly affecting the hind gut and pelvic floor [1 –3]. The malformations are often associated with urogenital-, gastrointestinal-, spinal- and heart malformations [4–6]. The genesis is unknown, but probably multifactorial [7,8]. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - November 27, 2021 Category: Surgery Authors: Louise Tofft, Stina Klasson, Martin Sal ö, Mette Hambraeus, Einar Arnbjörnsson, Pernilla Stenström Tags: Original article Source Type: research

Letter to the Editor Regarding Blood Group AB is Associated with Poor Outcomes in Infants with Necrotising Enterocolitis
Despite being distant in time and place from the challenges of present paediatric practice, I hope I shall be allowed the privilege of commenting on a recent article in the Journal of Pediatric Surgery [1]. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - November 26, 2021 Category: Surgery Authors: Ian Munro Rogers Tags: Correspondence Source Type: research

Telemedicine (Virtual Clinic) Effectively Delivers the Required Healthcare Service for Pediatric Ambulatory Surgical Patients During the Current Era of COVID-19 Pandemic: A Mixed Descriptive Study
Since WHO declared COVID-19 as a pandemic disease, the whole healthcare sector had become enormously affected, including the field of pediatric surgery. Parents usually seek clinic appointments for medical advice. Obtaining an OPD appointment for pediatric ambulatory surgical problem at a suitable date is a challenging issue. The first appointment could often be available after 3-6 months and even may exceed. The COVID-19 pandemic-associated restrictions and regulatory precautions had complicated the accessibility and physical attendance of outpatient clinics. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - November 26, 2021 Category: Surgery Authors: Muhammad Abdelhafez Mahmoud, Mohammad Daboos, Samir Gouda, Alsayed Othman, Mohamed Abdelmaboud, Mohamed Elsayed Hussein, Mabrouk Akl Source Type: research

Letter to the Editor regarding “Long-term protective effects of the combination of intermittent reperfusion and hypothermia on reperfusion injury in an experimental testicular torsion model”
Dear Editor, (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - November 26, 2021 Category: Surgery Authors: Marko Ba šković, Davor Ježek Source Type: research

Employment Search, Initial Employment Experience, and Career Preferences of Recent Pediatric Surgical Fellowship Graduates: An APSA Survey, Part of the Right Child/Right Surgeon Initiative
APSA's Right Child/Right Surgeon Initiative addresses issues concerning patient access to appropriate pediatric surgical care and workforce distribution. The APSA Workforce Committee sought to understand the experiences and motivations of recent graduates of Pediatric Surgery Training Programs entering the workforce. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - November 26, 2021 Category: Surgery Authors: Abigail E Martin, Christian S McEvoy, Kimberly Lumpkins, Stefan Scholz, Anthony L DeRoss, Claudia Emami, Michael R Phillips, Faisal Qureshi, Brian W Gray, Shawn D Safford, Patrick J Healey, Samuel M Alaish, Stephen P Dunn Tags: Original article Source Type: research

I-PASS Enhances Effectiveness and Accuracy of Hand-off for Pediatric General Surgery Patients.
: I-PASS is a validated and standardized hand-off protocol shown to reduce medical error and improve hand-off efficiency in the pediatric medical population. Our aim was to evaluate the feasibility, effectiveness, accuracy and resident satisfaction of implementing I-PASS on a pediatric surgery service. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - November 25, 2021 Category: Surgery Authors: Justyna M Wolinska, Eveline Lapidus-Krol, Erica M Fallon, Yuriy Kolivoshka, Annie Fecteau Source Type: research

Potential therapeutic effects of ethyl pyruvate in an experimental rat appendicitis model
In this study, we aimed to investigate the effects of EP on the treatment of appendicitis and to examine whether adding EP to the antibiotic treatment could increases the effectiveness of the treatment in a rat appendicitis model. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - November 25, 2021 Category: Surgery Authors: Sefa Sag, Levent Elemen, Kaan Masrabaci, Selenay Furat Recber, Yagmur Sonmez, Seval Aydin, Karolin Yanar, Esmanur Seker, Yusufhan Yazir Tags: Original Article Source Type: research

Ketorolac Use and Risk of Bleeding After Appendectomy in Children with Perforated Appendicitis
Appendicitis is a common cause of pediatric abdominal pain and is the most common abdominal surgery in children, occurring in nearly 70,000 children in the United States per year [1]. Children with perforated appendicitis who undergo an appendectomy often require several day hospitalization to ensure adequate antibiotic coverage, improve oral intake, and manage pain [2,3]. Opioids are often prescribed after surgery for pain control, but can be associated with prolonged hospitalization [4]. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - November 25, 2021 Category: Surgery Authors: Paige Kingston, Danny Lascano, Shadassa Ourshalimian, Christopher J. Russell, Eugene Kim, Lorraine I. Kelley-Quon Tags: Original article Source Type: research

Most Children Experience Resolution of Idiopathic Pediatric Rectal Prolapse with Bowel Management Alone
Recent studies in children with idiopathic rectal prolapse report up to 48% require surgical intervention to manage refractory disease. We sought to examine outcomes of our non-surgical approach to managing rectal prolapse using a bowel management program. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - November 24, 2021 Category: Surgery Authors: Scott S. Short, Elisabeth K. Wynne, Sarah Zobell, Katherine Gaddis, Michael D. Rollins Source Type: research

Table of Contents
(Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - November 23, 2021 Category: Surgery Source Type: research

Announcements of Future Meetings
(Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - November 23, 2021 Category: Surgery Source Type: research

Development and Validation of Machine Learning Models for the Prediction of Blunt Cerebrovascular Injury in Children
: Blunt cerebrovascular injury (BCVI) is a rare finding in trauma patients. The previously validated BCVI (Denver and Memphis) prediction model in adult patients was shown to be inadequate as a screening option in injured children. We sought to improve the detection of BCVI by developing a prediction model specific to the pediatric population. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - November 20, 2021 Category: Surgery Authors: Cyrus A. Farzaneh, John Schomberg, Brittany Sullivan, Yigit S. Guner, Michael L. Nance, David Gibbs, Peter T. Yu Tags: Review Article Source Type: research

Scoping out the scope of scoping reviews in neonatal and pediatric pain management: A scoping review methodological framework
: This methodological framework was purposed to discuss the considerations for conducting scoping reviews for neonatal and pediatric pain management (NPPM) from the perspectives of Arksey and O ’ Malley and Joanna Briggs Institute (JBI) framework. Till now, there is no scoping review or standard methods are available for identifying, prioritizing, or reporting research gaps in the area of NPPM. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - November 20, 2021 Category: Surgery Authors: Neha Sharma, Vencita Priyanka Arahna, Shikha Saxena, Mahamed Ateef, Asir John Samuel Tags: Review article Source Type: research

Intraoperative Electromagnetic Navigation Bronchoscopy (IENB) to Localize Peripheral Lung Lesions: A New Technique in the Pediatric Oncology Population
Pediatric surgeons are often called on for the evaluation of new lung lesions in pediatric oncology patients to determine the etiology and guide treatment [1,2]. These lesions appear in all types of oncology patients, especially in patients who have undergone autologous transplantation. The lesions are often quite small and located peripherally making their identification during blind, or unguided, thoracoscopy a challenge. The diagnostic efficacy of biopsy in the evaluation of pulmonary disease in the pediatric oncology population is variable. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - November 20, 2021 Category: Surgery Authors: Kassem Harris, Edo Schaefer, Jeremy Rosenblum, F. Dylan Stewart, Marc S. Arkovitz Tags: Original Article Source Type: research

Ceftriaxone with Metronidazole Versus Piperacillin/Tazobactam in the Management of Complicated Appendicitis in Children: Results from a Multicenter Pediatric NSQIP Analysis
Acute appendicitis is the most common abdominal pediatric surgical emergency in the United States, with approximately 80,000 cases diagnosed each year [1,2]. Appendicitis is also associated with the greatest relative burden of organ space infections (OSI) among all pediatric surgical conditions and ranks third in antibiotic treatment days for hospitalized children behind pneumonia and cystic fibrosis [3]. Approximately 30% of children present with complicated appendicitis, which is associated with relatively high OSI rates, prolonged length of stay, and increased hospital cost [4 –10]. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - November 20, 2021 Category: Surgery Authors: Mark A. Kashtan, Dionne A. Graham, Patrice Melvin, Jonathan L. Hills-Dunlap, Seema P. Anandalwar, Shawn J. Rangel Tags: Original Article Source Type: research

Umbilical Access in Laparoscopic Surgery in Infants Less than 3 Months: A Single Institution Retrospective Review
Laparoscopy and minimally invasive techniques in pediatric surgery have been refined over the past decade with the introduction of smaller tools and specialized insufflators for use in more complex procedures. Laparoscopy has decreased operative time as surgeon experience increases and subsequent decreases in time under anesthesia, better pain control, and improved cosmesis [1,2]. Laparoscopy in neonates and children is safe, with data to support the safety of this approach in infants less than 5kg and less than 3 months of age [3 –5]. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - November 20, 2021 Category: Surgery Authors: James A. Fraser, Kayla B. Briggs, Wendy Jo Svetanoff, Rebecca M. Rentea, Pablo Aguayo, David Juang, Jason D. Fraser, Charles L. Snyder, Richard J. Hendrickson, Shawn D. St. Peter, Tolulope A. Oyetunji Source Type: research

Emanuel Syndrome and Congenital Diaphragmatic Hernia: A Systematic Review
Emanuel syndrome (ES) is a rare chromosomal disorder caused by a supernumerary chromosome 22 derivative known as der(22)t(11;22). Affected individuals are the offspring of a parent with a balanced translocation, and suffer from physical and cognitive disabilities from birth [1, 2]. Common phenotypic manifestations associated with ES include ear pits, micrognathia, heart defects, cleft palate, genitourinary malformations, and intestinal atresia [1]. Patients with ES have severe developmental delay, with survivors exhibiting severe-to-profound intellectual disability and only a few learning to walk, and none living unassiste...
Source: Journal of Pediatric Surgery - November 19, 2021 Category: Surgery Authors: Lauren E. Adams, Alison Chapman, Carrie L. Cormack, Kirstin Campbell, Ashley H. Ebanks, David J. Annibale, Laura E. Hollinger, Congenital Diaphragmatic Hernia Study Group Source Type: research

Conversions in Pediatric Robot-Assisted Laparoscopic Surgery
This study analyses our 11-year experience of conversions from a dedicated pediatric robot-assisted laparoscopic surgery service. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - November 15, 2021 Category: Surgery Authors: Thomas P Cundy, Donatella Di Fabrizio, Naved K Alizai, Azad S Najmaldin Source Type: research

An Imperative for the Pediatric Surgical Community to Prioritize Climate Change
United States (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - November 14, 2021 Category: Surgery Authors: Hannah C. Cockrell, Jamie E. Anderson, Elizabeth E. Hansen, John H.T. Waldhausen, Sarah L.M. Greenberg Tags: Correspondence Source Type: research

Variability in the Management of Adhesive Small Bowel Obstruction in Children
Intraabdominal adhesions commonly form as a component of normal wound healing following abdominal operations, for both laparotomy and laparoscopy.1,2 Given their young surgical age, infants and children undergoing laparotomies are at particular risk for an adhesive small bowel obstruction (ASBO) over their lifetime, with an estimated aggregate incidence of 4.2% following abdominal operations, which rises to 25 –30% for some disease-specific surgeries.3,4 For patients without signs of bowel ischemia, a trial of nonoperative management is warranted given that 70–80% of ASBOs resolve without surgical intervention....
Source: Journal of Pediatric Surgery - November 13, 2021 Category: Surgery Authors: Jordan C. Apfeld, Jennifer N. Cooper, Lindsay A. Gil, Afif N. Kulaylat, Nathan S. Rubalcava, Carley M. Lutz, Katherine J. Deans, Peter C. Minneci, K. Elizabeth Speck Tags: Original article Source Type: research

Child Self-Reported Quality of Life in Pediatric Intestinal Failure
Pediatric intestinal failure (IF) is defined as a reduction of functional gut mass below the minimum required for nutrient and fluid absorption to allow proper growth in children. Once considered a fatal condition, pediatric IF now demonstrates long-term survival rates of 90% and higher when treated in dedicated, multidisciplinary intestinal rehabilitation programs [1,2]. Clinical advances such as safe parenteral nutrition (PN) regimens, bowel lengthening procedures, management of bacterial overgrowth and sepsis, and intestinal and multivisceral transplantation have contributed to the improved survival of children with IF ...
Source: Journal of Pediatric Surgery - November 13, 2021 Category: Surgery Authors: Melissa Wong, Victoria C. Neam, Simon Horslen, Anna Faino, Patrick J. Javid Tags: Original Article Source Type: research

Cautionary tales in the use of magnets for the treatment of long gap esophageal atresia
The use of magnets for the treatment of long gap esophageal atresia or “magnamosis” is associated with increased incidence of anastomotic strictures; however, little has been reported on other complications that may provide insight into refining selection criteria for appropriate use. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - November 13, 2021 Category: Surgery Authors: Hester F. Shieh, Russell W. Jennings, Michael A. Manfredi, Peter D. Ngo, Benjamin Zendejas, Thomas E. Hamilton Source Type: research

Deep Extubation with No Touch (DENT) Technique
Dear Editor: (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - November 12, 2021 Category: Surgery Authors: Ban C.H. Tsui MD Source Type: research

Parental Attitudes Towards Choosing between Operative and Nonoperative Management of Pediatric Acute Appendicitis
Making healthcare decisions for children can be challenging for parents or guardians. We aimed to characterize the decision-making preferences and stress of parents or guardians who were offered both appendectomy or nonoperative management (NOM) for children with acute appendicitis. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - November 10, 2021 Category: Surgery Authors: R.L. Massoumi, G. Dubrovsky, M. Nguyen, C. Gomez, M. Blahut, G.D. Sacks, C. Cho, S.L. Lee, H.C. Jen, D.A. DeUgarte, S. Shekherdimian Tags: Original article Source Type: research

Comparison of 2k and 4k imaging systems for laparoscopic repair of choledochal cyst in children
Image quality is crucial for the success and safety of all laparoscopic procedures and involves a complex interplay between scope lenses, magnification coefficients, and monitor resolution/distortion. Traditional high-definition (HD) laparoscopy (2K) is known to be associated with some loss of depth perception and an operating surgeon must move a scope around regularly and use motion parallax to confirm the relative position of instruments and points of interest to transform the two-dimensional (2D) image seen on a monitor to a three-dimensional (3D) image in their mind. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - November 10, 2021 Category: Surgery Authors: Hiroyuki Koga, Takanori Ochi, Shogo Seo, Yuichiro Miyake, Geoffrey J Lane, Atsuyuki Yamataka Source Type: research

Oesophageal atresia with very low birth weight: clinical characteristics and long-term outcome
In paediatric surgery the outcome of infants with oesophageal atresia (OA) has been one of the key indicators for the quality of neonatal surgical care. Very soon after the first successful repairs of OA in 1940s paediatric surgeons realized that the outcome and especially mortality in infants with OA depended on two important factors, the presence of significant congenital heart disease and birth weight (BW). These two factors have been the basis of outcome classifications including those of Waterston [1], Spitz [2] and Okamoto [3] and all three classifications indicate the disadvantage of low BW on the outcome. (Source: ...
Source: Journal of Pediatric Surgery - November 10, 2021 Category: Surgery Authors: Antti I Koivusalo, Janne S Suominen, Mikko P Pakarinen Source Type: research

Higher rates of regional disease but improved outcomes in pediatric versus adult melanoma
Malignant melanoma is rare in the pediatric population and management is largely extrapolated from adult guidelines. Adult data have shown that immediate completion lymph node dissection (CLND) does not improve overall survival in selected patients with clinically node negative, sentinel lymph node-positive disease. Current nodal management in children is unknown. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - November 9, 2021 Category: Surgery Authors: Timothy B Lautz, Aodhnait S Fahy, Irene Helenowski, Jeffrey D Wayne, Reto M. Baertschiger, Jennifer H Aldrink Source Type: research

Evaluating the Use of Laparoscopic-Assisted Gastrostomy Tube Feeding in Children with Epidermolysis Bullosa: A Single-Centre Retrospective Study
Nutritional management of children with epidermolysis bullosa (EB) presents multiple challenges including reduced oral intake compounded by mucosal fragility. Gastrostomy tube feeding is effective in improving nutritional status however there is limited data on the safety and tolerance of this technique in EB children. We aim to review the effectiveness and morbidity of our minimally invasive two-port laparoscopic-assisted gastrostomy (LAG) approach using Seldinger techniques with serial dilatations in children with EB. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - November 7, 2021 Category: Surgery Authors: Aishah Zubaida Mughal, Thejasvi Subramanian, Rosie Jones, Dawn James, Malobi Ogboli, Giampiero Soccorso Source Type: research

Remote treatment of pectus carinatum (Telepectus) during the COVID-19 pandemic
To report telemedicine's feasibility and satisfaction rates for treating patients with pectus carinatum using a Dynamic Compressor System. We analyzed treatment adherence in comparison with the previous, non-pandemic year. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - November 6, 2021 Category: Surgery Authors: Cecilia Gigena, Marcela Di Vincenzo, Luzia Toselli, Gast ón Bellia-Munzon, Daniela Sanjurjo, Jorge Martinez, Maxroxia Valle, Maximiliano Nazar-Peirano, Marcelo Martinez-Ferro Source Type: research

Success in Pediatric Surgery: An Updated Survey of Program Directors 2020
After completing general surgery residency, a surgeon can proceed to a subspecialty fellowship for additional education and training. Over time, the percentage of graduating residents seeking additional fellowship training has increased and is now the majority with a reported rate ranging from 77 to 91.4% [1,2]. As defined by the American Board of Surgery (ABS), the pediatric surgery (PS) fellowship is a two-year clinical fellowship focusing on the diagnostic, operative, and postoperative surgical care for children with congenital and acquired anomalies and diseases [3]. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - November 6, 2021 Category: Surgery Authors: Shreya Gupta, Jordan E. Jackson, Mackenzie L. Shindorf, L. Grier Arthur, Nicole Chandler, Paul Danielson, Cynthia Downard, Peter Ehrlich, Barbara Gaines, Brian Gray, Patrick Javid, Michel Lallier, Benedict Nwomeh, Edward Tagge, Richard Weiss, Grace Mak, A Source Type: research

Evaluation of a Fluid Resuscitation Protocol for Patients with Hypertrophic Pyloric Stenosis
hypertrophic pyloric stenosis, (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - November 6, 2021 Category: Surgery Authors: James A. Fraser, Obiyo Osuchukwu, Kayla B. Briggs, Wendy Jo Svetanoff, Rebecca M. Rentea, Pablo Aguayo, David Juang, Jason D. Fraser, Charles L. Snyder, Richard J. Hendrickson, Shawn D. St. Peter, Tolulope A. Oyetunji Source Type: research

Association of Prematurity with Complications and Failure to Rescue in Neonatal Surgery
Quality improvement (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - November 6, 2021 Category: Surgery Authors: Steven C. Mehl, Jorge I. Portuondo, Rowland W. Pettit, Sara C. Fallon, David E. Wesson, Sohail R. Shah, Adam M. Vogel, Monica E. Lopez, Nader N. Massarweh Source Type: research

Corrigendum to: Early enteral feeding versus traditional feeding in neonatal congenital gastrointestinal malformation undergoing intestinal anastomosis: A Randomized Multicenter Controlled Trial of an Enhanced Recovery after Surgery (ERAS) Component [J Pediatr Surg 2021 Sep; 56 (9): 1479 –1484]
Unfortunately, the authors confirmed that there was a mistake about the first authors in the original version. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - November 5, 2021 Category: Surgery Authors: Yanfen Peng, Dong Xiao, Shangjie Xiao, Liucheng Yang, Hui Shi, Qiuming He, Haozhong Xu, Xiaochun Zhu, Wei Zhong, Jiakang Yu Source Type: research

Opportunities for novel diagnostic and cell-based therapies for Hirschsprung disease
Despite significant progress in our understanding of the etiology and pathophysiology of Hirschsprung disease (HSCR), early and accurate diagnosis and operative management can be challenging. Moreover, long-term morbidity following surgery, including fecal incontinence, constipation, and Hirschsprung-associated enterocolitis (HAEC), remains problematic. Recent advances applying state-of-the art imaging for visualization of the enteric nervous system and utilizing neuronal stem cells to replace the missing enteric neurons and glial cells offer the possibility of a promising new future for patients with HSCR. (Source: Journa...
Source: Journal of Pediatric Surgery - November 5, 2021 Category: Surgery Authors: Weikang Pan, Allan M. Goldstein, Ryo Hotta Tags: Review Article Source Type: research

Retrospective Study of Postoperative Mortality at a Tertiary Children's Hospital in Iran: A Cross Sectional Study
Child mortality rate is one of the most important health indicators and is used globally to assess the overall quality of healthcare in various countries. The Millennium Development Goals (MDGs), penned at the United Nations Millennium Summit in 2000, aimed to reduce the mortality rate of children younger than 5 years old by two-thirds between 1990 and 2015. Nearly 11 million children worldwide die each year before the age of five, and these deaths occur mainly in low-income and middle-income countries, especially in the Middle East [2]. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - November 4, 2021 Category: Surgery Authors: Mohammad Gharavifard, Majid Sharifian, Amir R. Reihani Source Type: research

Letter to the Editor Regarding "Five Hundred Patients with Gut Malrotation: Thirty Years of Experience with the Introduction of a New Surgical Procedure"
In the October 2021 edition of Annals of Surgery, Abu-Elmagd, et al, present a manuscript titled “Five hundred patients with gut malrotation: Thirty years of experience with the introduction of a new surgical procedure.”1 Among the authors’ stated objectives are to define the clinical spectrum and long-term outcomes of intestinal malrotation as well as to introduce a new procedure and est ablish predictive models. The new procedure is described as a 3-4 hour operation that involves liberation of the duodenum and mobilization of the entire midgut, with completion of the 270-degree counterclockwise-rotation...
Source: Journal of Pediatric Surgery - November 2, 2021 Category: Surgery Authors: Aaron M Lipskar, Jeremy T Aidlen, Stephen E Dolgin Tags: Correspondence Source Type: research

Retained intravascular catheter fragment at removal of implantable vascular access device: incidence, risk factors, and outcomes
Implantable vascular access devices (IVAD) are essential for medium to long-term administration of intravenous medication. Typical uses in the paediatric population include: chemotherapy, total parenteral nutrition (TPN), and prolonged antibiotic administration [1]. The devices in common use are tunnelled central venous lines (TCVL) e.g. Hickman © lines and implantable devices (ID) e.g. Port-a-caths©. The complications encountered at device insertion and during usage are well-documented such as line infection, blockage, and displacement [2]. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - October 30, 2021 Category: Surgery Authors: Joseph Rassam, Georgina Bough, Go Ito, William Mullins, Anna-May Long Source Type: research

Effectiveness of table salt versus copper sulphate in treating umbilical granuloma: A pilot randomized controlled trial
Umbilical discharge is one of the commonest presentations to health care in infancy, and umbilical granuloma is the leading cause [1]. Umbilical granuloma is defined as moist and fleshy granulation tissue at the centerof the umbilicus which becomes apparent after separation of the umbilical cord [2]. Subclinical infection from a devitalized umbilical stump can lead to inflammation resulting in overgrowth of endothelial cells and inadequate epithelialization which eventually results in an umbilical granuloma. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - October 29, 2021 Category: Surgery Authors: Kuet Jun Chung, Yen Ming Chin, Mei Shinq Wong, Anand Sanmugam, Srihari Singaravel, Shireen Anne Nah Source Type: research

Interventional radiology and open surgery: An effective partnership for solid organ trauma
Traumatic injuries are the leading cause of avoidable mortality in children in the UK [1] with blunt force trauma accounting for about 90% of all paediatric trauma admissions. The management of blunt abdominal solid organ injury (BASOI) has evolved to be largely non-operative, regardless of the initial grade of injury, with the establishment of imaging protocols to detect early and late complications. However, there is still a proportion that require damage control surgery who are haemodynamically unstable and not responding to fluid resuscitation or who require definitive reparative surgery. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - October 29, 2021 Category: Surgery Authors: Mirana Leung-Tack, Evelyn Geok Peng Ong, Simon McGuirk Source Type: research

Laparoscopic inguinal herniotomy: recreating the open operation optimises outcomes
Indirect inguinal herniae (IH) are one of the most common presentations in paediatric surgical practice [1]. Traditional open surgery constitutes exposure of the inguinal canal and spermatic cord, isolation of the hernial sac and ligation of the patent processus vaginalis (PPV) at the level of the deep ring. Key complications and indeed core outcome measures include recurrence, testicular ascent, and iatrogenic damage to the vas deferens and testicular vasculature. Advantages of laparoscopic IH management include inspection of the contralateral ring for metachronous IH, avoidance of groin dissection (and potential correlat...
Source: Journal of Pediatric Surgery - October 29, 2021 Category: Surgery Authors: Jonathan Ducey, Robert T Peters, David J Wilkinson, Christian Verhoef, Nick Lansdale Source Type: research

Management of Post Appendicectomy Intra-Abdominal Collections: A Volumetric Cut Off for Drainage?
The optimal management of intra-abdominal collections (IAC) following appendicectomy remains ambiguous. Appendicitis has long been the most common indication for emergency abdominal surgery in children with approximately 12,000 emergency appendicectomies performed in children annually in the UK [1]. IAC develops in 0.8-1.7% of those with simple appendicitis and 14-18% of those with complicated appendicitis [2]. Post-appendicectomy IAC can occur during initial antibiotic treatment following appendicectomy or after completion of therapy. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - October 29, 2021 Category: Surgery Authors: Georgina M. Bough, Rashmi R. Singh, Bethan Johnson, Mathanki Soorasangaram, Krishnaa T. Mahbubani, Ashwini Joshi, Shazia P. Sharif Source Type: research

Pediatric Firearm Injury Trends in the United States: A National Trauma Data Bank (NTDB) Analysis
The USA ranks poorly in pediatric firearm injury and fatality amongst developed countries and firearm violence has become an increasing public health concern for the pediatric population [1]. Firearm injuries are now the second leading cause of injury-related death in United States children under 18 [2]. In 2019 alone, 2541 children and adolescents under 18 suffered fatal injuries due to firearms [3]. These two papers used the National Electronic Injury Surveillance System and the CDC [Centers for Disease Control& Prevention] National Violent Death Reporting System. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - October 29, 2021 Category: Surgery Authors: Tiffany Cheng, Sathyaprasad Burjonrappa Source Type: research

Oesophageal lengthening by traction in oesophageal atresia: the uk experience
Management of long gap oesophageal atresia (LGOA) remains a major challenge for paediatric surgeons worldwide. There are many ways to define LGOA, however, the term usually denotes cases when a surgically-satisfactory primary anastomosis of the proximal and distal pouches of the oesophagus is not possible [1]. Oesophageal replacement (by gastric pull-up, tubularised gastric conduit or intestinal interposition) was the only means of achieving enteral continuity until the introduction of traction techniques. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - October 29, 2021 Category: Surgery Authors: Ms Kirsty Brennan, Mr Paul Cullis, Mr Iain Yardley, Children's Upper Gastrointestinal Surgery (ChUGS) Network* Source Type: research

Intra-Abdominal Hypertension in Neonates Following Congenital Diaphragmatic Hernia Repair: Correlation with Early Postoperative Respiratory and Gastrointestinal Outcomes
The incidence of CDH varies from 1:3000 to 1:5000 live births with an overall mortality of 30-40% [1]. In recent years, advancement in ventilatory strategies have improved pre-operative clinical conditions in experienced tertiary centres [2]. Increased intra-abdominal pressure (IAP) is seen in 50% of neonates after CDH repair due to the reduction of thoracic contents into the relatively smaller abdominal cavity [3]. This may lead to intra-abdominal hypertension (IAH) and subsequently abdominal compartment syndrome (ACS) if unaddressed [3]. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - October 29, 2021 Category: Surgery Authors: Elango Thambusamy, CR Thambidorai, Shireen Anne Nah, Chin Seng Gan, Justin Wang, Srihari Singaravel, Anand Sanmugam Source Type: research

Compensatory Sweating after Thoracoscopic Sympathectomy for Primary Focal Hyperhidrosis In Children: Are there Patient-Related Risk Factors?
Primary focal hyperhidrosis (PFH) is a disorder characterized by regional sweating exceeding the amount required for thermoregulation [1 –6]. It may develop in multiple regions such as axillae, palms, soles and craniofacial [1–3] and usually appears during childhood with an estimated prevalence of 3% [2, 5]. Affected patients often suffer from severe emotional and social discomfort with a major interference in their daily activit ies. This may extend to an excessive need for clothing changes (axillae and soles), social evasion of normal behaviors such as handshaking or difficulty writing and holding small objec...
Source: Journal of Pediatric Surgery - October 29, 2021 Category: Surgery Authors: Catarina Carvalho, Ana Sofia Marinho, Joana Barbosa-Sequeira, M ário Rui Correia, José Banquart-Leitão, Fátima Carvalho Source Type: research

Ultrasound-Guided Erector Spinae Plane Block Versus Thoracic Epidural Analgesia: Postoperative Pain Management After Nuss Repair for Pectus Excavatum
Postoperative pain management is a significant challenge in patients undergoing Nuss repair for pectus excavatum chest wall deformity [1,2]. Therapeutic anesthetic options have included patient-controlled analgesia, thoracic epidural analgesia, paravertebral nerve block, subcutaneous catheter anesthetic infusion, and cryoanalgesia [3 –16]. In many centers, thoracic epidural analgesia or cryoanalgesia have been the preferred techniques for postoperative pain relief [6,8,14-17]. However, thoracic epidural analgesia is confined to in-patient usage, carries the risk of rare catastrophic neurologic injury [19], often requ...
Source: Journal of Pediatric Surgery - October 29, 2021 Category: Surgery Authors: David P. Bliss, Thomas B. Strandness, Sarkis C. Derderian, Alexander M. Kaizer, David A. Partrick Source Type: research

Next day discharge after the nuss procedure using intercostal nerve cryoablation, intercostal nerve blocks, and a perioperative eras pain protocol
The Nuss procedure for pectus excavatum has historically been associated with significant postoperative pain, which has been the major factor contributing to hospital length of stay (LOS). (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - October 29, 2021 Category: Surgery Authors: John W. DiFiore, Jason O. Robertson, Surendrasingh Chhabada, Anthony L. DeRoss, Mir S. Hossain, Lorena Rincon-Cruz, Wai Sung Source Type: research

Functional Outcomes, Quality of Life, Sexual Function, and Fertility of Adult Patients Undergoing Ileo-Anal Pouch Anastomosis in Childhood
First described in 1978, formation of an ileal pouch-anal anastomosis (IPAA) following pan proctocolectomy allows anal defaecation for patients who would otherwise require ileostomy [1]. Indications in children include ulcerative colitis (UC) refractory to medical management, familial adenomatous polyposis (FAP), and other functional disorders [2, 3]. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - October 29, 2021 Category: Surgery Authors: Lucy Henderson, Victoria Lane, Ian Sugarman, Bruce Jaffray Source Type: research

Risk factor analysis of irreversible renal dysfunction based on fetal ultrasonographic findings in patients with persistent cloaca: results from a nationwide survey in japan
Persistent cloaca (PC) malformation is the most severe type of anorectal and urogenital malformation. Such patients require surgical treatment postnatally, and some go on to develop chronic kidney disease, sometimes developing end-stage renal disease in childhood [1, 2]. Therefore, a prenatal diagnosis is important to ensure effective management and treatment during the newborn period and to counsel the parents about what kind of treatment their baby is eligible for and how their child will live [3]. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - October 29, 2021 Category: Surgery Authors: Toshio Harumatsu, Koshiro Sugita, Satoshi Ieiri, Masayuki Kubota Source Type: research