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Asian Journal of Urology 2023年第1期10卷 101-102页

作者： Ciro Esposito Lorenzo Masieri Giuseppe Autorino Maria Escolino Division of Pediatric Surgery Federico II University of NaplesNaplesItaly division of pediatric Urology Meyer Children HospitalFlorenceItaly

Dear Editor,The advantages of robotic technology including improved dexterity and visualization are particularly evident in challenging reconstructive procedures of the lower urinary tract[1,2].A recent literature review confirmed the feasibility and efficacy of robot-assisted ureteral reimplantation in case of complex anatomy or prior surgery[3].Intra-corporeal ureteral tapering and dismembering are also feasible options using robot-assisted surgery[4].

关键词： ureteral anatomy surgery

Treatment of isolated and recurrent tracheoesophageal fistula in children: a case series and literature review

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World Journal of pediatric surgery 2021年第4期4卷 52-56页

作者： Aleh Sautin Kiryl Marakhouski Aleh Pataleta Aliaksandr Svirsky Vasili Averyn Diagnostic division Republican Scientific and Practical Center of Pediatric SurgeryMinskBelarus Department of pediatric surgery Republican Scientific and Practical Center of Pediatric SurgeryMinskBelarus Department of pediatric surgery Belarusian State Medical UniversityMinskBelarus

Background Despite improvements in the treatment of esophageal atresia with tracheoesophageal fistula(TEF)in recent decades,complications still exist.The rate of fistula recanalization after surgical repair is~5%in large cohorts.However,there is controversy regarding the gold standard of treatment.This research aimed to evaluate the efficacy of treatment of pediatric patients with isolated(H-type)and recurrent TEF in our clinic.Methods We retrospectively analyzed 12 patients(7 boys,5 girls)aged 35 days-14.6 years.The median age of our patients was 632 days[95%CI(confident interval)120.1 to 2118.7];the mean birth weight was 2713 g(95%CI 2258 to 3169;median:2763 g);and the mean gestational age was 37.1 weeks(95%CI 35.4 to 38.8;median:37 weeks).All patients were managed for isolated or recurrent TEF between January 1,2015 and December 31,2020 using endoscopy(laser de-epithelialization).Results Laser de-epithelialization alone was effective in 8 of 12 patients(66.67%),with a mean number of de-epithelializations of 2.25(range:1-4).After one attempt at de-epithelialization,success was achieved in only two patients(n=16.67%).The mortality rate was 0%.The median follow-up for patients who received endoscopic treatment exclusively(n=8)was 3.7 years(95%CI 1.38 to 4.87)after the last stage of de-epithelialization.Conclusion Flexible endoscopy is an alternative treatment to open surgical repair of isolated and recurrent TEF in children.The effectiveness of endoscopic laser de-epithelialization alone with subsequent fistula obliteration was 66.7%,with a median follow-up of 3.7 years.

关键词： fistula mortality alone

Kids gone wild–Alcohol use and patient characteristics in pediatric trauma during the coronavirus disease 2019 pandemic

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pediatric Investigation 2023年第4期7卷 225-232页

作者： Neesha S Patel Brett H Waibel Bennett J Berning WT Hillman Terzian Charity H Evans Angela M Hanna Mark E Hamill Department of surgery Division of AcuteCare SurgeryUniversity of Nebraska Medical CenterOmahaNebraskaUSA Department of surgery Division of General and Thoracic Pediatric SugeryChildren’s Hospital and Medical CenterOmahaNebraskaUSA

Importance:Reported coronavirus disease 2019(COVID-19)pandemic effects on pediatric trauma have been variable.Objective:We investigated the characteristics of pediatric trauma including alcohol use during the pandemic at our urban trauma center.Methods:The trauma database of our adult level 1 trauma center was queried for all pediatric(age≤18 years)patients presenting between March 1,2020,and October 30,2020.Data from 2017 to 2019 served as a control.Variables analyzed included demographics,mechanisms,injury severity,hospitalization characteristics,and positive blood alcohol.Results:Pandemic pediatric trauma volumes increased by 67.5%(330/year vs.197/year).Pandemic patients were younger(median age 13 vs.14 years,P=0.011),but similar in gender,ethnicity,severity,hospital length of stay,mortality,and rates of penetrating injury.Falls doubled(79/year vs.34/year)and shifted away from high falls>6 meters(0%vs.7.9%)to moderate falls 1–6 meters(58.2%vs.51.5%)(P=0.028).Transportation injury rates were similar however mechanisms shifted from motor vehicle crashes(−13.5%)towards recreational vehicles including motorcycles(+2.1%),all-terrain vehicles(+8.6%),and bicycles(+3.8%)(P=0.018).pediatricpositive blood alcohol was significantly higher(11.2%vs.5.1%,Ppediatric trauma volumes during the COVID-19 pandemic increased.Pandemic patients had more recreational vehicle injuries and higher rates of positive blood alcohol.This suggests an increased need for alcohol assessment and targeted interventions in the pediatric population during pandemics or periods of school closures.

关键词： Alcohol COVID-19 pediatric trauma pediatrics

Balloon dilation of congenital perforated duodenal web in newborns: Evaluation of short and long-term results

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World Journal of Gastrointestinal Endoscopy 2024年第6期16卷 343-349页

作者： Kirill Marakhouski Elena Malyshka Katsiaryna Nikalayeva Larysa Valiok Aleh Pataleta Kiryl Sanfirau Aliaksandr Svirsky Vasily Averin division of Diagnostic Republican Scientific and Practical Centre of Paediatric SurgeryMinsk 220113Belarus Department of Newborn surgery Republican Scientific and Practical Center of Pediatric SurgeryMinsk 220013Belarus Department of pediatric surgery Republican Scientific and Practical Center of Pediatric SurgeryMinsk 220013Belarus division of Diagnostic Republican Scientific and Practical Center of Pediatric SurgeryMinsk 220013Belarus Academic Chair of pediatric surgery Belarusian State Medical UniversityMinsk 220116Belarus

BACKGROUND Incomplete congenital duodenal obstruction(ICDO)is caused by a congenitally perforated duodenal web(CPDW).Currently,only six cases of balloon dilatation of the PDW in newborns have been described.AIM To present our experience of balloon dilatation of a perforated duodenal memb-rane in newborns with ICDO.METHODS Five newborns who underwent balloon dilatation of the CPDW along a prein-stalled guidewire between 2021 and 2023 were included.Nineteen newborns diagnosed with ICDO who underwent laparotomy were included in the control group.RESULTS In all cases,good anatomical and clinical results were obtained.In three cases,a follow-up study was conducted after 1 year.The average time to start enteral feeding per os was significantly earlier in the study group(4.4 d)than in the laparotomic group(21.2 days;P<0.0001).The time spent by patients in the intensive care unit and hospital after balloon dilatation was also significantly shorter.We determined the selection criteria for possible and effective CPDW balloon dilatation in newborns as follows:(1)Presence of dynamic radiographic signs of the passage of a radiopaque substance beyond the zone of narrowing or radiographic signs of pneumatisation of the duodenum and small bowel distal to the web;(2)presence of endoscopic signs of CPDW;(3)successful cannulation with a guidewire performed parallel to the endoscope,with holes in the congenital duodenal web;and(4)successful positioning of the balloon performed along a freestanding guidewire on the web.CONCLUSION Strictly following selection criteria for newborns with ICDO caused by CPDW ensures that endoscopic balloon dilatation using a pre-installed guidewire is safe and effective and shows good 1-year follow-up results.

关键词： Newborns Congenital duodenal obstruction Perforated duodenal membrane Endoscopy Balloon dilation

Postoperative adhesions after abdominal surgery in children:a pilot study in the Philippines

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World Journal of pediatric surgery 2019年第2期2卷 42-46页

作者： Jan Miguel C Deogracias Josefina R Almonte Department of surgery Division of Pediatric SurgeryUniversity of the Philippines-Philippine General HospitalManilaPhilippines

background Postoperative adhesions(POAs)causing mechanical bowel obstruction is a challenging problem for children who underwent prior abdominal surgeries.Unlike in adults,the role of conservative management remains controversial and children tend to require re-operation.However,despite the longer lifetime risk inherent to the pediatric population,studies are still lacking to come up with guidelines on diagnosis and management.This study aimed to review the profiles and outcomes of patients who underwent surgery for POA and to identify significant risk factors.Methods This was a retrospective review of 172 patients admitted at the Philippine General Hospital from 2010 to 2018 with the diagnosis of POA.Patients who did not undergo surgery and patients who had a different cause of bowel obstruction with the adhesions being only incidental were excluded from the study.results Ninety-one patients were included in the study.The mean age at surgery was 92.32 months and the male:female ratio was 2.8:1.The most common primary diagnoses were appendicitis,intussusception,and abdominal trauma.POA occurred within the first postoperative year in 63%.The 30-day morbidity and mortality rates were 9.89%and 7.69%,respectively.The most common complications were fascial and anastomotic dehiscences,and sepsis was the most common cause of death.Stoma creation during the index operation,and the presence of bowel gangrene,intestinal resection,and stoma creation during the surgery for POA were statistically significant risk factors for morbidity and mortality.Conclusion The findings in this study support the experience in literature that timely operative intervention can prevent bowel strangulation in cases of mechanical bowel obstruction from POA.However,more data and studies are recommended to arrive at an evidence-based guideline in the management of these children.

关键词： surgery diagnosis abdominal

One-Stage Correction with Intra- and Extraatrial Rerouting of Anomalous Systemic and Pulmonary Venous Return and Intraventricular Repair of Double Outlet Right Ventricle in a Patient with Heterotaxy Syndrome

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Congenital Heart Disease 2022年第1期17卷 25-30页

作者： Helena Staehler Carina Hopfner Masamichi Ono Jurgen Horer Department of Congenital and pediatric Heart surgery German Heart Center MunichTechnische Universitat MünchenDivision of Congenital and Pediatric Heart SurgeryUniversity Hospital of MunichLudwig-Maximilians-UniversitatMunichGermany Department of pediatric Cardiology and pediatric Intensive Care University Hospital of MunichLudwig-Maximilians-UniversitatMunichGermany

We report a very rare case of successful intracardiac correction in a patient with heterotaxy syndrome.The cardiac malformations included dextrocardia,double outlet right ventricle,pulmonary stenosis,interrupted inferior vena cava,hemiazygos continuation and total anomalous pulmonary venous return.One-stage correction was performed.The atrial procedure consisted of intra-and extraatrial rerouting of the anomalous systemic and pulmonary venous return.The hepatic veins were detached and diverted to the left atrium via an extracardiac conduit.The correction of the double outlet right ventricle was accomplished by intraventricular redirection of the blood flow from the left ventricle to the aorta.The right ventricular outflow was ultimately remodeled using a valved conduit.For better perception of the complex morphology,a three-dimensional model was designed,using CT scan images.This proved to be very useful for surgical planning,especially with regard to the intraatrial reconstruction of the systemic and pulmonary venous rerouting.

关键词： Heterotaxy syndrome anomalous systemic venous return anomalous pulmonary venous return azygos continuation double outlet right ventricle 3D modeling

Emerging role of regulated cell death in intestinal failure-associated liver disease

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 228-233页

作者： Si-Yang Cheng Lu Jiang Ying Wang Wei Cai Department of pediatric surgery Xinhua HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai 200092China Shanghai Key Laboratory of pediatric Gastroenterology and Nutrition Shanghai 200092China Shanghai Institute for pediatric Research Shanghai 200092China division of pediatric Gastroenterology and Nutrition Xinhua HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai 200092China

Intestinal failure-associated liver disease(IFALD)is a common complication of long-term parenteral nutrition that is associated with significant morbidity and mortality.It is mainly characterized by cholestasis in children and steatohepatitis in adults.Unfortunately,there is no effective approach to prevent or reverse the disease.Regulated cell death(RCD)represents a fundamental biological paradigm that determines the outcome of a variety of liver diseases.Nowadays cell death is reclassified into several types,based on the mechanisms and morphological phenotypes.Emerging evidence has linked different modes of RCD,such as apoptosis,necroptosis,ferroptosis,and pyroptosis to the pathogenesis of liver diseases.Recent studies have shown that different modes of RCD are present in animal models and patients with IFALD.Understanding the pathogenic roles of cell death may help uncover the underlying mechanisms and develop novel therapeutic strategies in IFALD.In this review,we discuss the current knowledge on how RCD may link to the pathogenesis of IFALD.We highlight examples of cell death-targeted interventions aiming to attenuate the disease,and provide perspectives for future basic and translational research in the field.

关键词： Parenteral nutrition Apoptosis Necroptosis Cholestasis Steatosis

Early relaparotomy following pediatric living-donor liver transplantation:experience in an Indonesian national referral hospital

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World Journal of pediatric surgery 2023年第1期6卷 42-47页

作者： Tri Hening Rahayatri Alif Rizqy Soeratman Rusdah Binti Muhammad Amin Dalia Benchamas Margiadi Riana Pauline Tamba Mureo Kasahara Division of Pediatric Surgery Department of SurgeryRumah Sakit Umum Pusat Nasional Dr Cipto MangunkusumoCentral JakartaIndonesia Division of Pediatric Surgery Department of SurgeryUniversitas Indonesia Fakultas KedokteranCentral JakartaIndonesia Department of surgery Rumah Sakit Umum Pusat Nasional Dr Cipto MangunkusumoCentral JakartaIndonesia Rumah Sakit Umum Pusat Nasional Dr Cipto Mangunkusumo Central JakartaIndonesia Department of Transplantation National Center for Child Health and DevelopmentSetagaya-kuJapan

Background Living donor liver transplantation(LDLT)remains the only curative treatment for children with end-stage liver disease;however,complications of the procedure are associated with indications for early relaparotomy.Several risk factors associated with early relaparotomy after liver transplantation include pediatric end-stage liver disease(PELD)score,warm ischemia time(WIT),and cold ischemia time(CIT).Our study investigated the incidence and indications of early relaparotomy in postoperative pediatric LDLT recipients and compared the outcomes with patients who did not require relaparotomy.Methods A retrospective cohort study of pediatric LDLT recipients from Cipto Mangunkusumo Hospital,Jakarta,Indonesia,was collected from 2010 to August 2022.Indications for early relaparotomy were investigated.Factors analyzed in the early relaparotomy group compared with the nonrelaparotomy group included intraoperative blood loss,surgery duration,CIT,WIT,and PELD score.Results The highest indication for early relaparotomy was biliary leakage.Most patients who underwent early relaparotomy only had one incidence of relaparotomy(60%).The surgery duration in subjects with early relaparotomy was longer by a median of 3 hours compared with those without early relaparotomy(p=0.289).Intraoperative blood loss was greater in early relaparotomy subjects than in subjects without early relaparotomy(95 vs 77mL/kg,p=0.552).Other factors,such as PELD score,CIT,and WIT,also showed no significant difference between the two groups.Conclusion Biliary leakage was the most common indication for early relaparotomy in our center.There were no preoperative or intraoperative factors that significantly influenced the incidence of early relaparotomy due to the limited sample size and the early advancement of our liver transplant center.

关键词： laparotomy pediatric donor

Stubborn Hypoxia in Neonates with D-Transposition of the Great Arteries afterArterial Switch Operation: Central Sleep Apnea as the Cause and PotentialIndicator of Brain Immaturity

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Congenital Heart Disease 2024年第2期19卷 185-195页

作者： Camden L.Hebson Kyle Bliton Amr Y.Hammouda Kaitlyn Barr W.Hampton Gray Mohini Gunnett Waldemar F.Carlo Department of pediatrics Division of Pediatric CardiologyUniversity of Alabama BirminghamBirmingham35233USA Department of pediatrics Division of Pediatric PulmonologyUniversity of Alabama BirminghamBirmingham35233USA Department of pediatrics University of Alabama BirminghamBirmingham35233USA Department of surgery Division of Cardiothoracic SurgeryUniversity of Alabama BirminghamBirmingham35233USA

D-transposition of the great arteries(d-TGA)is surgically repaired with the arterial switch operation(ASO)with excellent results,however short and long-term morbidities still develop including neurocognitive delay.Clinically signiﬁcant central sleep apnea is uncommon in non-premature infants,but when present indicates immature autonomic control of respiration likely due to a neurologic disorder.We report the unanticipatedﬁnding of central sleep apnea in four-term neonates with d-TGA after uncomplicated ASO,with the short-term complication of delayed hospital discharge and long-term concerns regarding this early marker of brain immaturity and its hindrance to normal development.Within this report,we will review each patient’s clinical course and then examine the literature on pediatric central sleep apnea,neurodevelopmental outcomes after ASO,and the important overlap of these entities in the care of patients going forward.

关键词： Transposition congenital heart disease sleep apnea polysomnography

Small-for-size syndrome in liver transplantation:Definition,pathophysiology and management

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Hepatobiliary & Pancreatic Diseases International 2020年第4期19卷 334-341页

作者： Yuichi Masuda Kazuki Yoshizawa Yasunari Ohno Atsuyoshi Mita Akira Shimizu Yuji Soejima division of Gastroenterological Hepato-Biliary-PancreaticTransplantation and Pediatric SurgeryDepartment of SurgeryShinshu University School of Medicine3-1-1 AsahiMatsumotoNaganoJapan

Background:Since the first success in an adult patient,living donor liver transplantation(LDLT)has become an universally used procedure.Small-for-size syndrome(SFSS)is a well-known complication after partial LT,especially in cases of adult-to-adult LDLT.The definition of SFSS slightly varies among transplant physicians.The use of a partial liver graft has risks of SFSS development.Persistent portal vein(PV)hypertension and PV hyper-perfusion after LT were identified as the main factors.Hence,various approaches were explored to modulate PV flow and decrease PV pressure in order to alleviate this syndrome.Herein,the definition,clinical symptoms,pathophysiology,basic research,as well as preventive and treatment strategies for SFSS are reviewed based on an extensive review of the literature and on our own experiences.Data sources:The articles were collected through PubMed using search terms“liver transplantation”,“living donor liver transplantation”,“living liver donation”,“partial graft”,“small-for-size graft”,“small-forsize syndrome”,“graft volume”,“remnant liver”,“standard liver volume”,“graft to recipient body weight ratio”,“sarcopenia”,“porcine”,“swine”,and“rat”.English publications published before March 31,2020 were included in this review.Results:Many transplant surgeons performed PV flow modulation,including portocaval shunt,splenic artery ligation and splenectomy.With these techniques,patient outcome has been improved even when using a"small"graft.Other factors,such as preoperative recipients’nutritional and skeletal muscle status,graft congestion,and donor factors,were also identified as risk factors which all have been addressed using various strategies.Conclusions:The surgical approach controlling PV flow and pressure could help to prevent SFSS especially in severely ill recipients.In the absence of efficacious medications to resolve SFSS,conservative treatments,including aggressive fluid balance correction for massive ascites,anti-microbiological therapy to prevent or control sepsis and intensive nutrit

关键词： Liver transplantation Living donor liver transplantation Small-for-size graft Small-for-size syndrome