The need for early Kasai portoenterostomy: a Western Pediatric Surgery Research Consortium study
ConclusionEarlier surgical intervention by Kasai portoenterostomy at tertiary-level centers significantly increases likelihood for TFS. Policy-level interventions to facilitate early screening and surgical referral for infants with biliary atresia are warranted to improve outcomes. (Source: Pediatric Surgery International)
Source: Pediatric Surgery International - December 2, 2021 Category: Surgery Source Type: research

Safety and short-term efficacy of mirabegron in children with valve bladder: a pilot study
ConclusionThis pilot study establishes short-term efficacy and safety of mirabegron in valve bladder with overactivity. Further larger long-term studies are warranted. (Source: Pediatric Surgery International)
Source: Pediatric Surgery International - December 2, 2021 Category: Surgery Source Type: research

The need for early Kasai portoenterostomy: a Western Pediatric Surgery Research Consortium study
ConclusionEarlier surgical intervention by Kasai portoenterostomy at tertiary-level centers significantly increases likelihood for TFS. Policy-level interventions to facilitate early screening and surgical referral for infants with biliary atresia are warranted to improve outcomes. (Source: Pediatric Surgery International)
Source: Pediatric Surgery International - December 2, 2021 Category: Surgery Source Type: research

Safety and short-term efficacy of mirabegron in children with valve bladder: a pilot study
ConclusionThis pilot study establishes short-term efficacy and safety of mirabegron in valve bladder with overactivity. Further larger long-term studies are warranted. (Source: Pediatric Surgery International)
Source: Pediatric Surgery International - December 2, 2021 Category: Surgery Source Type: research

Effects of the COVID-19 pandemic on pediatric trauma in Southern California
ConclusionsThis multicenter retrospective study demonstrated no difference in penetrating trauma rates among pediatric patients after SAH orders but did identify a shorter LOS. (Source: Pediatric Surgery International)
Source: Pediatric Surgery International - December 1, 2021 Category: Surgery Source Type: research

Variations in analgesic, sedation, and delirium management between trauma and non-trauma critically ill children
AbstractIntroductionStudies have shown the benefit of intensive care unit (ICU) bundled protocols; however, they are primarily derived from medical patients. We hypothesized that patients and their medication profiles are different between critically ill medical, surgical, and trauma patients.MethodsThe Pediatric Health Information System 2017 dataset was used to perform a retrospective cohort study of critically ill children. The pediatric medical, surgical, and trauma cohorts were separated based on ICD-10 codes. Data collected included demographics, secondary diagnoses, outcomes, and medication data. Medications were gr...
Source: Pediatric Surgery International - December 1, 2021 Category: Surgery Source Type: research

Effects of the COVID-19 pandemic on pediatric trauma in Southern California
ConclusionsThis multicenter retrospective study demonstrated no difference in penetrating trauma rates among pediatric patients after SAH orders but did identify a shorter LOS. (Source: Pediatric Surgery International)
Source: Pediatric Surgery International - December 1, 2021 Category: Surgery Source Type: research

Variations in analgesic, sedation, and delirium management between trauma and non-trauma critically ill children
AbstractIntroductionStudies have shown the benefit of intensive care unit (ICU) bundled protocols; however, they are primarily derived from medical patients. We hypothesized that patients and their medication profiles are different between critically ill medical, surgical, and trauma patients.MethodsThe Pediatric Health Information System 2017 dataset was used to perform a retrospective cohort study of critically ill children. The pediatric medical, surgical, and trauma cohorts were separated based on ICD-10 codes. Data collected included demographics, secondary diagnoses, outcomes, and medication data. Medications were gr...
Source: Pediatric Surgery International - December 1, 2021 Category: Surgery Source Type: research

The triangular cord ratio and the presence of a cystic lesion in the triangular cord. Suggested new ultrasound findings in the early diagnosis of Biliary Atresia
We examined 24 cases of suspected BA who demonstrated acholic stools from 2006 to 2020. We retrospectively reviewed the timing of ultrasonographic diagnosis, the gallbladder diameter, gallbladder mucosal irregularity, the TC sign, TCC, and the TC ratio.ResultsIn the BA group (n = 10) vs the Non-BA group (n = 14), the age at ultrasonography was 75 ± 41.7 vs. 81 ± 39.1 days (p = 0.72), the gallbladder diameter was 12.1 ± 9.7 vs. 24.2 ± 6.96 mm (p = 0.02), irregularity of gallbl...
Source: Pediatric Surgery International - November 4, 2021 Category: Surgery Source Type: research

The protective effects of hepatocyte growth factor on the intestinal mucosal atrophy induced by total parenteral nutrition in a rat model
AbstractPurposeTotal parental nutrition (TPN) causes gastrointestinal mucosal atrophy. The present study investigated the effects of hepatocyte growth factor (HGF) on the intestinal mucosal atrophy induced by TPN.MethodsRats underwent jugular vein catheterization and were divided into four groups: oral feeding (OF), TPN alone (TPN), TPN plus low-dose HGF (0.3  mg/kg/day; TPNLH), and TPN plus high-dose HGF (1.0 mg/kg/day; TPNHH). On day 7, rats were euthanized, and the small intestine was harvested and evaluated histologically. The expression of c-MET, a receptor of HGF, and nutrition transporter protein were eval...
Source: Pediatric Surgery International - November 4, 2021 Category: Surgery Source Type: research

Clinical characteristics and outcomes of the right congenital diaphragmatic hernia compared to the left: a 10-year single-center experience
AbstractPurposeThe features of right-sided congenital diaphragmatic hernias (RCDHs) are quite different from those of left-sided CDHs (LCDHs). We have summarized the features of RCDHs experienced in our institution.MethodsThis retrospective study analyzed the cases of patients with CDH registered at our institution between 2011 and 2020. Defects on each side were compared based on prenatal diagnosis, medical treatment, type of surgery, and outcomes.ResultsA total of 101 patients underwent surgery at our institution during the neonatal period, and 11 had RCDHs. RCDHs and LCDHs were significantly different in terms of extrac...
Source: Pediatric Surgery International - November 4, 2021 Category: Surgery Source Type: research

An imaging study on tracheomalacia in infants with esophageal atresia: the degree of tracheal compression by the brachiocephalic artery is a good indicator for therapeutic intervention
This study aimed to review patients who underwent aortopexy for TM after EA repair and to compare their imaging features.MethodsThe patients who underwent thoracoscopic EA repair and contrast-enhanced computed tomography (CECT) at our hospital between 2013 and 2020 were retrospectively reviewed. The ratio of the lateral and anterior –posterior diameter of the trachea (LAR) where the brachiocephalic artery (BCA) crosses the trachea was defined. The LAR of the patients who underwent CECT for asymptomatic pulmonary disease was set as a normal reference. The Z-score of each LAR was calculated and compared between the pat...
Source: Pediatric Surgery International - November 4, 2021 Category: Surgery Source Type: research

Comparative study of open and laparoscopic Kasai portoenterostomy in children undergoing living donor liver transplantation for biliary atresia
ConclusionLaparoscopic-KPE may reduce postoperative complications that necessitate re-laparotomy in LT. (Source: Pediatric Surgery International)
Source: Pediatric Surgery International - November 4, 2021 Category: Surgery Source Type: research

Urinary N1,N12-diacetylspermine as a biomarker for pediatric cancer: a case –control study
ConclusionThe urinary DiAcSpm value is a useful TM for both screening and follow-up of ML. (Source: Pediatric Surgery International)
Source: Pediatric Surgery International - November 4, 2021 Category: Surgery Source Type: research

Infectious complications after tracheoplasty for congenital tracheal stenosis: a retrospective comparative study
AbstractPurposeThe factors related to infectious complications after tracheoplasty for congenital tracheal stenosis (CTS) remain unclear; we, therefore, assessed these factors in this study.MethodsWe divided 47 patients who underwent slide tracheostomy and tracheal resection for CTS between May 2016 and December 2020 into an infected group and a non-infected group. Their characteristics were compared between groups. Results are presented as the median (range) or incidence.ResultsInfectious complications were observed in 12 patients (25.5%). Empyema and mediastinitis were seen in 5 cases (10.6%). There was a significant dif...
Source: Pediatric Surgery International - November 4, 2021 Category: Surgery Source Type: research

Risk factors for recurrent gastroesophageal reflux disease after Thal fundoplication
ConclusionThe presence of convulsive seizures and the absence of a tracheostomy at the time of TF were significantly associated with GERD recurrence after TF. Active control of seizures and consideration of surgical indications, including assessment of respiratory status, are important in preventing the recurrence of GERD after TF. (Source: Pediatric Surgery International)
Source: Pediatric Surgery International - November 4, 2021 Category: Surgery Source Type: research

Face and construct validity assessment of training models for intestinal anastomosis in low-birth-weight infants
ConclusionsThe wet-type intestinal anastomosis model showed good face validity. Its leak pressure had a significant correlation with clinical experience; thus, construct validity was demonstrated. (Source: Pediatric Surgery International)
Source: Pediatric Surgery International - November 4, 2021 Category: Surgery Source Type: research

Exosomal miR-214-3p as a potential novel biomarker for rhabdoid tumor of the kidney
ConclusionOur data indicated that exosomal miR-214-3p has potential as a novel biomarker of RTK. (Source: Pediatric Surgery International)
Source: Pediatric Surgery International - November 4, 2021 Category: Surgery Source Type: research

Current thoracoscopic approach for mediastinal neuroblastoma in Japan –results from nationwide multicenter survey
ConclusionsMIS was performed in a limited number of mediastinal NB cases. A thoracoscopic approach would be feasible for mediastinal NB. (Source: Pediatric Surgery International)
Source: Pediatric Surgery International - November 4, 2021 Category: Surgery Source Type: research

Postoperative complications and long-term outcomes in Currarino syndrome
ConclusionPostoperative complications, especially early ones, occur at a high rate. Long-term intractable constipation and dysuria may be influenced by the degree of sacral dysplasia. (Source: Pediatric Surgery International)
Source: Pediatric Surgery International - November 4, 2021 Category: Surgery Source Type: research

Efficacy of early endoscopic intervention in pediatric pancreatic duct injury management
ConclusionTherapeutic ERP might be effective even if a patient has a PDI, therefore, early ERP should be considered as a treatment option. (Source: Pediatric Surgery International)
Source: Pediatric Surgery International - November 4, 2021 Category: Surgery Source Type: research

Meso-Rex bypass versus portosystemic shunt for the management of extrahepatic portal vein obstruction in children: systematic review and meta-analysis
ConclusionsBased on available data, our meta-analysis indicates that MRB does not increase shunt complications, mortality, or gastrointestinal bleeding after surgery. The present study did not reveal superiority for either MRB or PSS. The paucity of well conducted trials in this area justifies future multicenter studies and studies that examine long-term outcomes. (Source: Pediatric Surgery International)
Source: Pediatric Surgery International - November 4, 2021 Category: Surgery Source Type: research

Results of mass screening for neuroblastoma in 18-month-old infants in Osaka area, Japan
ConclusionThe 18MS did not screen unfavorable cases with neuroblastoma efficiently, although few participants benefited from it. (Source: Pediatric Surgery International)
Source: Pediatric Surgery International - November 4, 2021 Category: Surgery Source Type: research

Best pre-ductal PaO2 prior to extracorporeal membrane oxygenation as predictor of mortality in patients with congenital diaphragmatic hernia: a retrospective analysis of a Japanese database
ConclusionThe best PaO2 within 24  h after birth predicted mortality following ECMO initiation. This should be shared to families and caregivers to optimize the best interests of the infants with CDH. (Source: Pediatric Surgery International)
Source: Pediatric Surgery International - November 4, 2021 Category: Surgery Source Type: research

Muscle imbalance as a cause of scoliosis: a study in a fetal lamb abdominal wall defect model
ConclusionMuscle imbalance may contribute to the development of scoliosis in a fetal lamb AWD model. (Source: Pediatric Surgery International)
Source: Pediatric Surgery International - November 4, 2021 Category: Surgery Source Type: research

Recovery of bowel function after transperitoneal or retroperitoneal laparoscopic pyeloplasty. A multi-center study
AbstractAimTo document the recovery of bowel function (BF) in children after transperitoneal (TP) or retroperitoneal (RP) laparoscopic pyeloplasty.MethodsData were obtained retrospectively from four centers between 2008 and 2019 for TP (n = 51) and RP (n = 58). Each surgeon chose which technique to perform.ResultsSubject demographics were not significantly different. Differences in operative times were not significant (RP: 241  min versus TP: 225 min). Mean duration/requirement for postoperative epidural/intravenous analgesia were not significantly different (TP: 1.4 days versus R...
Source: Pediatric Surgery International - November 4, 2021 Category: Surgery Source Type: research

Editorial
(Source: Pediatric Surgery International)
Source: Pediatric Surgery International - November 4, 2021 Category: Surgery Source Type: research

Decreased incidence of intussusception during the COVID-19 pandemic. Trends in pediatric surgical emergencies
AbstractPurposeRecent reports suggest that the COVID-19 pandemic may be influencing disease morbidity. The purpose of this study was to investigate pandemic-related changes in the incidence of pediatric surgical emergencies.MethodsData from patients with one of 8 typical conditions considered to be pediatric emergencies who presented at 3 hospitals close to central Tokyo were collated retrospectively from accident and emergency (AE) department records for 2020 and compared with data for 3  years prior to 2020.ResultsAll subjects had similar demographic profiles. The total number of pediatric AE attendances from 2017 t...
Source: Pediatric Surgery International - November 4, 2021 Category: Surgery Source Type: research

The triangular cord ratio and the presence of a cystic lesion in the triangular cord. Suggested new ultrasound findings in the early diagnosis of Biliary Atresia
We examined 24 cases of suspected BA who demonstrated acholic stools from 2006 to 2020. We retrospectively reviewed the timing of ultrasonographic diagnosis, the gallbladder diameter, gallbladder mucosal irregularity, the TC sign, TCC, and the TC ratio.ResultsIn the BA group (n = 10) vs the Non-BA group (n = 14), the age at ultrasonography was 75 ± 41.7 vs. 81 ± 39.1 days (p = 0.72), the gallbladder diameter was 12.1 ± 9.7 vs. 24.2 ± 6.96 mm (p = 0.02), irregularity of gallbl...
Source: Pediatric Surgery International - November 3, 2021 Category: Surgery Source Type: research

The protective effects of hepatocyte growth factor on the intestinal mucosal atrophy induced by total parenteral nutrition in a rat model
AbstractPurposeTotal parental nutrition (TPN) causes gastrointestinal mucosal atrophy. The present study investigated the effects of hepatocyte growth factor (HGF) on the intestinal mucosal atrophy induced by TPN.MethodsRats underwent jugular vein catheterization and were divided into four groups: oral feeding (OF), TPN alone (TPN), TPN plus low-dose HGF (0.3  mg/kg/day; TPNLH), and TPN plus high-dose HGF (1.0 mg/kg/day; TPNHH). On day 7, rats were euthanized, and the small intestine was harvested and evaluated histologically. The expression of c-MET, a receptor of HGF, and nutrition transporter protein were eval...
Source: Pediatric Surgery International - November 3, 2021 Category: Surgery Source Type: research

Clinical characteristics and outcomes of the right congenital diaphragmatic hernia compared to the left: a 10-year single-center experience
AbstractPurposeThe features of right-sided congenital diaphragmatic hernias (RCDHs) are quite different from those of left-sided CDHs (LCDHs). We have summarized the features of RCDHs experienced in our institution.MethodsThis retrospective study analyzed the cases of patients with CDH registered at our institution between 2011 and 2020. Defects on each side were compared based on prenatal diagnosis, medical treatment, type of surgery, and outcomes.ResultsA total of 101 patients underwent surgery at our institution during the neonatal period, and 11 had RCDHs. RCDHs and LCDHs were significantly different in terms of extrac...
Source: Pediatric Surgery International - November 3, 2021 Category: Surgery Source Type: research

An imaging study on tracheomalacia in infants with esophageal atresia: the degree of tracheal compression by the brachiocephalic artery is a good indicator for therapeutic intervention
This study aimed to review patients who underwent aortopexy for TM after EA repair and to compare their imaging features.MethodsThe patients who underwent thoracoscopic EA repair and contrast-enhanced computed tomography (CECT) at our hospital between 2013 and 2020 were retrospectively reviewed. The ratio of the lateral and anterior –posterior diameter of the trachea (LAR) where the brachiocephalic artery (BCA) crosses the trachea was defined. The LAR of the patients who underwent CECT for asymptomatic pulmonary disease was set as a normal reference. The Z-score of each LAR was calculated and compared between the pat...
Source: Pediatric Surgery International - November 3, 2021 Category: Surgery Source Type: research

Comparative study of open and laparoscopic Kasai portoenterostomy in children undergoing living donor liver transplantation for biliary atresia
ConclusionLaparoscopic-KPE may reduce postoperative complications that necessitate re-laparotomy in LT. (Source: Pediatric Surgery International)
Source: Pediatric Surgery International - November 3, 2021 Category: Surgery Source Type: research

Urinary N1,N12-diacetylspermine as a biomarker for pediatric cancer: a case –control study
ConclusionThe urinary DiAcSpm value is a useful TM for both screening and follow-up of ML. (Source: Pediatric Surgery International)
Source: Pediatric Surgery International - November 3, 2021 Category: Surgery Source Type: research

Infectious complications after tracheoplasty for congenital tracheal stenosis: a retrospective comparative study
AbstractPurposeThe factors related to infectious complications after tracheoplasty for congenital tracheal stenosis (CTS) remain unclear; we, therefore, assessed these factors in this study.MethodsWe divided 47 patients who underwent slide tracheostomy and tracheal resection for CTS between May 2016 and December 2020 into an infected group and a non-infected group. Their characteristics were compared between groups. Results are presented as the median (range) or incidence.ResultsInfectious complications were observed in 12 patients (25.5%). Empyema and mediastinitis were seen in 5 cases (10.6%). There was a significant dif...
Source: Pediatric Surgery International - November 3, 2021 Category: Surgery Source Type: research

Risk factors for recurrent gastroesophageal reflux disease after Thal fundoplication
ConclusionThe presence of convulsive seizures and the absence of a tracheostomy at the time of TF were significantly associated with GERD recurrence after TF. Active control of seizures and consideration of surgical indications, including assessment of respiratory status, are important in preventing the recurrence of GERD after TF. (Source: Pediatric Surgery International)
Source: Pediatric Surgery International - November 3, 2021 Category: Surgery Source Type: research

Face and construct validity assessment of training models for intestinal anastomosis in low-birth-weight infants
ConclusionsThe wet-type intestinal anastomosis model showed good face validity. Its leak pressure had a significant correlation with clinical experience; thus, construct validity was demonstrated. (Source: Pediatric Surgery International)
Source: Pediatric Surgery International - November 3, 2021 Category: Surgery Source Type: research

Exosomal miR-214-3p as a potential novel biomarker for rhabdoid tumor of the kidney
ConclusionOur data indicated that exosomal miR-214-3p has potential as a novel biomarker of RTK. (Source: Pediatric Surgery International)
Source: Pediatric Surgery International - November 3, 2021 Category: Surgery Source Type: research

Current thoracoscopic approach for mediastinal neuroblastoma in Japan –results from nationwide multicenter survey
ConclusionsMIS was performed in a limited number of mediastinal NB cases. A thoracoscopic approach would be feasible for mediastinal NB. (Source: Pediatric Surgery International)
Source: Pediatric Surgery International - November 3, 2021 Category: Surgery Source Type: research

Postoperative complications and long-term outcomes in Currarino syndrome
ConclusionPostoperative complications, especially early ones, occur at a high rate. Long-term intractable constipation and dysuria may be influenced by the degree of sacral dysplasia. (Source: Pediatric Surgery International)
Source: Pediatric Surgery International - November 3, 2021 Category: Surgery Source Type: research

Efficacy of early endoscopic intervention in pediatric pancreatic duct injury management
ConclusionTherapeutic ERP might be effective even if a patient has a PDI, therefore, early ERP should be considered as a treatment option. (Source: Pediatric Surgery International)
Source: Pediatric Surgery International - November 3, 2021 Category: Surgery Source Type: research

Meso-Rex bypass versus portosystemic shunt for the management of extrahepatic portal vein obstruction in children: systematic review and meta-analysis
ConclusionsBased on available data, our meta-analysis indicates that MRB does not increase shunt complications, mortality, or gastrointestinal bleeding after surgery. The present study did not reveal superiority for either MRB or PSS. The paucity of well conducted trials in this area justifies future multicenter studies and studies that examine long-term outcomes. (Source: Pediatric Surgery International)
Source: Pediatric Surgery International - November 3, 2021 Category: Surgery Source Type: research

Results of mass screening for neuroblastoma in 18-month-old infants in Osaka area, Japan
ConclusionThe 18MS did not screen unfavorable cases with neuroblastoma efficiently, although few participants benefited from it. (Source: Pediatric Surgery International)
Source: Pediatric Surgery International - November 3, 2021 Category: Surgery Source Type: research

Best pre-ductal PaO2 prior to extracorporeal membrane oxygenation as predictor of mortality in patients with congenital diaphragmatic hernia: a retrospective analysis of a Japanese database
ConclusionThe best PaO2 within 24  h after birth predicted mortality following ECMO initiation. This should be shared to families and caregivers to optimize the best interests of the infants with CDH. (Source: Pediatric Surgery International)
Source: Pediatric Surgery International - November 3, 2021 Category: Surgery Source Type: research

Muscle imbalance as a cause of scoliosis: a study in a fetal lamb abdominal wall defect model
ConclusionMuscle imbalance may contribute to the development of scoliosis in a fetal lamb AWD model. (Source: Pediatric Surgery International)
Source: Pediatric Surgery International - November 3, 2021 Category: Surgery Source Type: research

Recovery of bowel function after transperitoneal or retroperitoneal laparoscopic pyeloplasty. A multi-center study
AbstractAimTo document the recovery of bowel function (BF) in children after transperitoneal (TP) or retroperitoneal (RP) laparoscopic pyeloplasty.MethodsData were obtained retrospectively from four centers between 2008 and 2019 for TP (n = 51) and RP (n = 58). Each surgeon chose which technique to perform.ResultsSubject demographics were not significantly different. Differences in operative times were not significant (RP: 241  min versus TP: 225 min). Mean duration/requirement for postoperative epidural/intravenous analgesia were not significantly different (TP: 1.4 days versus R...
Source: Pediatric Surgery International - November 3, 2021 Category: Surgery Source Type: research

Editorial
(Source: Pediatric Surgery International)
Source: Pediatric Surgery International - November 3, 2021 Category: Surgery Source Type: research

Decreased incidence of intussusception during the COVID-19 pandemic. Trends in pediatric surgical emergencies
AbstractPurposeRecent reports suggest that the COVID-19 pandemic may be influencing disease morbidity. The purpose of this study was to investigate pandemic-related changes in the incidence of pediatric surgical emergencies.MethodsData from patients with one of 8 typical conditions considered to be pediatric emergencies who presented at 3 hospitals close to central Tokyo were collated retrospectively from accident and emergency (AE) department records for 2020 and compared with data for 3  years prior to 2020.ResultsAll subjects had similar demographic profiles. The total number of pediatric AE attendances from 2017 t...
Source: Pediatric Surgery International - November 3, 2021 Category: Surgery Source Type: research

Different strategies, equivalent treatment approaches in terms of mortality in four university hospitals: a retrospective multicenter study of gastroschisis in Finland
ConclusionThere were no differences in short or long-term mortality between four university hospitals in Finland. However, some inter-hospital variation in postoperative outcomes was present.Level of evidenceLevel III. (Source: Pediatric Surgery International)
Source: Pediatric Surgery International - October 19, 2021 Category: Surgery Source Type: research

Intestinal malrotation in extremely premature infants: a potential trap
ConclusionsSymptomatic intestinal malrotation in extremely premature infants has a relatively high prevalence. It may present with marked abdominal distension without bilious vomiting, demanding a high index of suspicion. An atypical presentation, potential alternative abdominal pathologies, coexisting  comorbidities, and concerns about survival in these fragile babies may deter the surgeon despite the opportunity of a good outcome. (Source: Pediatric Surgery International)
Source: Pediatric Surgery International - October 19, 2021 Category: Surgery Source Type: research