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Journal articles on the topic 'Pediatrcic Surgery'

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Author: Grafiati

Published: 14 March 2023

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1

Halimun, E. M. "Surgery in Perinatology." Paediatrica Indonesiana 35, no. 9-10 (October 8, 2018): 205–10. http://dx.doi.org/10.14238/pi35.9-10.1995.205-10.

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Although modem neonatal surgery is a very young subject, it started only after the second world war, the progress is remarkable. The well intergrated interdisciplinary team among pediatric surgeons, pediatricians, neonatologits, anaesthetists, and other relevant specialists made this progress possible. Neonatal surgrey has been influenced by the advances in prenatal diagnosis. Neonatal surgical emergencies are related to perinatal conditions such as better antenatal care, including ultrasonogram examination, encourage the high risk pregnant women to deliver at pediatric/perinatal centers where obstetricians, pediatricians or neonatologist, pediatric surgeon, anesthetist are working as a team. Prenatal diagnosis has been one of the most challenging aspects in perinatology, and may directly related to the task of the pediatric surgeons to salvage certain type of malformations. Some experience of perinatal surgery is also discussed.

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2

Pelizzo, Gloria, Sara Costanzo, Margherita Roveri, Giulia Lanfranchi, Maurizio Vertemati, Paolo Milani, Gianvincenzo Zuccotti, et al. "Developing Virtual Reality Head Mounted Display (HMD) Set-Up for Thoracoscopic Surgery of Complex Congenital Lung MalFormations in Children." Children 9, no. 1 (January 3, 2022): 50. http://dx.doi.org/10.3390/children9010050.

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Video assisted thoracoscopic surgery (VATS) has been adopted in pediatric age for the treatment of congenital lung malformations (CLM). The success of VATS in pediatrics largely depends on the surgeon’s skill ability to understand the airways, vascular system and lung parenchyma anatomy in CLM. In the last years, virtual reality (VR) and 3-dimensional (3D) printing of organ models and VR head mounted display (HMD) technologies have been introduced for completion of preoperative planning in adult patients. To date no reports about the use of VR HMD technologies in a pediatric setting are available. The aim of this report is to introduce a VR HMD model in VATS procedure to improve the quality of care in children with CLM. VR HMD set-up for planning thoracoscopic surgery was performed in a series of pediatric patients with diagnosis of CLM. The preoperative VR HMD evaluation allowed a navigation into the malformation with the aim to explore, interact, and make the surgeon more confident and skilled to answer to the traps. A development of surgical simulations models and teaching program dedicated to education and training in pediatric VATS is suitable among the pediatric surgery community. Further studies should demonstrate all the benefits of such technology in pediatric patients submitted to VATS procedure.

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3

Mosessundaram, Haris Vijila Rani, Ravikumar Ayyanar, Hemanthkumar Boopathy, Karuppasamy Nallan, Srinivasakumar Rajagopal, Aravindan Chandrasekaran, and Jayakumar Palanisamy. "Outcome of Tracheoesophageal Fistula Surgery in a Pediatric Surgery Institution: A Retrospective Study." New Indian Journal of Surgery 9, no. 4 (2018): 419–22. http://dx.doi.org/10.21088/nijs.0976.4747.9418.3.

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4

Aldana, Philipp R., and Paul Steinbok. "Prioritizing neurosurgical education for pediatricians: results of a survey of pediatric neurosurgeons." Journal of Neurosurgery: Pediatrics 4, no. 4 (October 2009): 309–16. http://dx.doi.org/10.3171/2009.4.peds0945.

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Object Pediatricians play a vital role in the diagnosis and initial treatment of children with pediatric neurosurgical disease. Exposure of pediatrics residents to neurosurgical diseases during training is inconsistent and is usually quite limited. After residency, opportunities for pediatricians' education on neurosurgical topics are few and fall mainly on pediatric neurosurgeons. The American Association of Neurological Surgery/Congress of Neurological Surgeons Joint Section on Pediatric Neurological Surgery Committee on Education undertook a survey of practicing pediatric neurosurgeons to determine whether focused education of practicing pediatricians might lead to better patient outcomes for children with a sampling of common pediatric neurosurgical conditions. Methods An Internet-based 40-item survey was administered to practicing pediatric neurosurgeons from the US and Canada identified from the roster of the American Association of Neurological Surgeons/Congress of Neurological Surgeons Joint Section of Pediatric Neurological Surgery. Survey topics included craniosynostosis and plagiocephaly, occult spinal dysraphism and tethered cord, hydrocephalus and endoscopic third ventriculostomy, Chiari malformation Type I, mild or minor head injury, spastic cerebral palsy, and brain tumors. Most questions pertained to diagnosis, initial medical treatment, and referral. Results One hundred three (38%) of the 273 practicing pediatric neurosurgeons completed the survey. Two-thirds of the respondents had completed a pediatric neurosurgery fellowship, and two-thirds were in academic practice. Eighty-two percent of the respondents agreed that the care of pediatric neurosurgical patients could be improved with further education of pediatricians. In the opinion of the respondents, the 3 disease topics in greatest need of educational effort were craniosynostosis and plagiocephaly, occult spinal dysraphism and tethered cord, and hydrocephalus. Head injury and spasticity were given the lowest priorities. Conclusions This survey identified what practicing pediatric neurosurgeons perceive to be the most important knowledge deficits of their colleagues in pediatrics. These perceptions may not necessarily be congruent with the perceptions of practicing pediatricians themselves; nevertheless, the data from this survey may serve to inform conversations between neurosurgeons and planners of continuing medical education for pediatricians, pediatrics residency program directors, and medical school pediatrics faculty.

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5

Tepaev, R. F., A. E. Aleksandrov, I. V. Kirgizov, T. N. Smirnova, and A. S. Rybalko. "PARENTERAL NUTRITION IN PEDIATRICS AND PEDIATRIC SURGERY." Pediatric pharmacology 9, no. 1 (January 19, 2012): 36. http://dx.doi.org/10.15690/pf.v9i1.163.

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6

Editorial, Article. "Theses of the XXI Russian Congress "Innovative technologies in pediatrics and pediatric surgery" with international participation." Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics) 67, no. 4 (September 22, 2022): 153–409. http://dx.doi.org/10.21508/1027-4065-congress-2022.

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7

Grosfeld, Jay L. "What's New in Pediatric Surgery—1988." Pediatrics 83, no. 4 (April 1, 1989): 586–90. http://dx.doi.org/10.1542/peds.83.4.586.

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During the past year, significant new information concerning basic science, molecular biology, imaging technology, and clinical medicine have led to a number of important advances in the field of pediatric surgery. In addition, for the first time, a segment of the Surgical Forum sessions at the annual meeting of the American College of Surgeons was devoted to pediatric surgical research projects. The following overview represents an update of the material presented at national and international pediatric surgical society meetings, recently published journal articles of importance, and some of the material presented at the 1988 meeting of the Surgical Section of the American Academy of Pediatrics.

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8

Schmedding, Andrea, Piotr Czauderna, and Udo Rolle. "European Pediatric Surgical Training." European Journal of Pediatric Surgery 27, no. 03 (May 11, 2017): 245–50. http://dx.doi.org/10.1055/s-0037-1603102.

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Introduction Pediatric surgery is essential for the surgical treatment of children in Europe and is generally a well-accepted specialty in Europe. There are still limited data on the training conditions within the European national associations of pediatric surgery. Materials and Methods A questionnaire designed by the executive committee of UEMS Section of Pediatric Surgery was distributed among all ordinary and associated UEMS members, which have national pediatric surgical associations, and to Russia. These questionnaires were completed by colleagues of the national associations and returned to the authors. Results In this study, 29 out of 37 (78%) national associations of pediatric surgery answered the questionnaire. In 90% of these countries, pediatric surgery is a distinct specialty. Training usually starts with a common surgical trunk (75%) of 1 to 2 years; the whole training lasts ∼6 years. Nonsurgical parts of the training, such as pediatrics, are part of the training program in 54% of countries. The content of the training comprises general pediatric surgery and newborn surgery in all countries, pediatric surgical oncology and pediatric urology in most countries, and pediatric traumatology and pediatric neurosurgery only in some countries. More than 90% of countries use a training logbook, and 79% require a final examination. The European Board of Pediatric Surgery exam is recognized only in 54% of the countries. Conclusion This study reveals that a uniform training schedule in pediatric surgery throughout Europe has not been achieved. This situation mandates urgent attempt to harmonize both training curricula and final exams at European level.

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Amaha, Eleni, Lydia Haddis, Senait Aweke, and Efrem Fenta. "The prevalence of difficult airway and its associated factors in pediatric patients who underwent surgery under general anesthesia: An observational study." SAGE Open Medicine 9 (January 2021): 205031212110524. http://dx.doi.org/10.1177/20503121211052436.

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Background: The airway of an anesthetized patient should be secured with an artificial airway for oxygenation or ventilation. Pediatrics are not small adults which means they are different from adults both anatomically and physiologically. This study aims to determine the prevalence of difficult airway and its associated factors in pediatric patients who underwent surgery under general anesthesia in referral hospitals of Addis Ababa. Methods: A multi-centered cross-sectional study design was employed. The bivariable and multivariable logistic regression was used to measure the association between the dependent variable (pediatrics difficult airway) and independent variables. p-value < 0.05 was used to declare statistical significance. Results: A total of 290 pediatrics patients were included in this study. The prevalence of difficult airway in pediatrics patients who underwent surgery was 19.7%. In multivariate logistic regression, pediatrics patients less than 2 years of age (adjusted odds ratio = 6.768, 95% confidence interval = 2.024, 22.636), underweight pediatrics patients (adjusted odds ratio = 4.661, 95% confidence interval = 1.196, 18.154), pediatrics patients having anticipated difficult airway (adjusted odds ratio = 18.563, 95% confidence interval = 4.837, 71.248), history of the difficult airway (adjusted odds ratio = 8.351, 95% confidence interval = 2.033, 34.302), the experience of anesthetists less than 4 years of age (adjusted odds ratio = 9.652, 95% confidence interval = 2.910, 32.050) had a significant association with pediatrics difficult airway. Conclusion: Being pediatric patients less than 2 years of age, underweight pediatrics patients, having anticipated difficult airway, those anesthetists who do not perform enough pediatric cases were identified as the main factors associated with the greater occurrence of difficult airway in pediatric patients.

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10

BAR-MAOR, JEHUDA ADONIRAM, and MENACHEM LAM. "Does Nasogastric Tube Cause Pulmonary Aspiration in Children?" Pediatrics 87, no. 1 (January 1, 1991): 113–14. http://dx.doi.org/10.1542/peds.87.1.113.

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Aspiration pneumonia due to gastroesophageal reflux is a serious and frequently encountered problem in pediatrics and pediatric surgery.1-3 Occasionally aspiration may be silent and minimal, yet chronic unexplained respiratory symptoms may appear.4 A number of authors have reported another cause of aspiration in children, namely aspiration of gastric juice while the child is receiving mechanical ventilation by means of a respirator, especially if an uncuffed endotracheal tube is used.5-7 Nasogastric tubes are frequently used in pediatrics and pediatric surgery. It was found that the incidence of postoperative pneumonia in adults was 10 times higher in patients in whom nasogastric tubes were used.8

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11

Parikh, Nirav, Vikram Naidu, Ramesh Patel, Abhishek Sharma, and Himani Pandya. "Comparison of Levosimendan vs. Milrinone in Pediatric Cardiac Surgery." Indian Journal of Anesthesia and Analgesia 6, no. 5 (P-2) (2019): 1756–65. http://dx.doi.org/10.21088/ijaa.2349.8471.6519.38.

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12

Geldt, Vadim G. "About those who are in memory." Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care 11, no. 4 (December 18, 2021): 545–52. http://dx.doi.org/10.17816/psaic1041.

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The article is devoted to the period of the authors work in three leading teams of pediatric surgeons in Russia: 1) Department of Pediatric Surgery of the Leningrad Pediatric Medical Institute under the leadership of the Corresponding Member of the Russian Academy of Medical Sciences Professor G.A. Bairov. This part described the role of the student scientific circle in the upbringing and development of future pediatric surgeons and the merits and personal qualities of G.A. Bairov. 2) Department of Pediatric Surgery of the Central Order of Lenin of the Institute for Advanced Training of Doctors, which played a leading role in the professional training and improvement of surgeons who were involved in the treatment of children. This part presents the main forms of work with cadets and requirements for the teaching staff. Much attention is paid to the merits of the Head of the Department Academician of the Russian Academy of Medical Sciences S.Ya. Doletsky and his role in the development of pediatric surgery. 3) Department of Urology and Neuro-urology of the Moscow Research Institute of Pediatrics and Pediatric Surgery under the guidance of Prof. E.L. Vishnevsky, who made great contributions to pediatric urology and created a virtually new section of the specialty pediatric neuro-urology..

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13

Akhunzyanov, A. A. "The Role of Professor V.I. Razumovskiy and His Disciples in Pediatric Surgery Formation in Kazan." Kazan medical journal 96, no. 2 (April 15, 2015): 257–64. http://dx.doi.org/10.17750/kmj2015-257.

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The history of pediatric surgery development at the Medical Faculty of the Kazan Imperial University and Kazan city is full of white spots. The most important among them, in our opinion, is that published biographies of Imperial Kazan University’s and Kazan State Medical Institute’s prominent pediatricians and surgeons almost do not contain information about their role in the formation of pediatric surgery as a separate specialty. Even in detailed biography of professors Nikolay Aleksandrovich Tolmachev and Vasiliy Ivanovich Razumovskiy, we only find a description of their activities as a pediatrician and a surgeon. In view of the above, this paper provides unpublished reliable information to reflect their contribution to the development of pediatric surgery in Kazan. The initial stage of the official establishment of the pediatric surgical diseases course at the Kazan Imperial University medical faculty, followed by foundation of pediatric surgery faculty at the Kazan State Medical Institute, is described. Biography of the first pediatric surgeon of Kazan Imperial University Vladimir L. Borman is presented. While analyzing the historical facts, it’s worth noticing that many organizational and personnel matters of delivering pediatric surgery classes to the students of Kazan Imperial University Medical Faculty and Kazan State Medical Institute were mainly resolved due to the efforts of outstanding for their time Kazan Imperial University professors: pediatricians N.A. Tolmachev, P.M. Argutinskiy-Dolgorukov, surgeon V.I. Razumovsky and his disciples - V.L. Borman, V.L. Bogolyubov, I.F. Kharitonov.

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14

Sozinov, Alexander S. "Pediatricians 64." Pediatric pharmacology 18, no. 1 (March 5, 2021): 80–83. http://dx.doi.org/10.15690/pf.v18i1.2233.

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Article is based on performance of the Rector of the Kazan State Medical University at the VIII Conference «Pediatrics and Pediatric Surgery in the Volga Federal District» September 20, 2011, devoted to the 70th anniversary of the famous Russian pediatricians — academician A.A. Baranov, professors V.Yu. Albitsky, A.V. Kuznetsova, S.V. Maltsev, O.I. Pikuza, who graduated Department of Pediatrics KSMA in 1964. Presents data on scientific creativity and contribution of anniversaries in pediatric science, to the protection of the health of the child population of Tatarstan and Russia.

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15

Keane, Allison, Darrin V. Bann, Meghan N. Wilson, and David Goldenberg. "Pediatric Thyroid Cancer: To Whom Do You Send the Referral?" Cancers 13, no. 17 (September 1, 2021): 4416. http://dx.doi.org/10.3390/cancers13174416.

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Pediatric thyroid cancer is rare, but increasing in annual incidence. Differentiated thyroid cancer in pediatric patients is treated surgically. Pediatric thyroidectomies are performed by general surgeons, otolaryngologists, general pediatric surgeons, and pediatric otolaryngologists. In a comprehensive literature review, we discuss the evidence supporting the importance of surgeon subspecialty and surgeon volume on outcomes for pediatric thyroid cancer patients. Pediatric general surgeons and pediatric otolaryngologists perform most pediatric thyroidectomies. Certain subpopulations specifically benefit from a combined approach of a pediatric surgeon and a high-volume thyroid surgeon. The correlation between high-volume surgeons and lower complication rates in adult thyroid surgery applies to the pediatric population; however, the definition of high-volume for pediatric thyroidectomies requires further investigation. The development of dedicated pediatric thyroid malignancy centers and multidisciplinary or dual-surgeon approaches are advantageous.

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16

Sataev, Valery U. "In memory of Munavara G. Mavlyutova." Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care 12, no. 2 (July 24, 2022): 281–82. http://dx.doi.org/10.17816/psaic1266.

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17

Judge, Paul D., Joseph Menousek, Jordan C. Schramm, Robert Cusick, and William Lydiatt. "Does Surgical Volume Influence the Need for Second Surgery? A Pilot Study." OTO Open 1, no. 3 (July 2017): 2473974X1772825. http://dx.doi.org/10.1177/2473974x17728257.

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Objective To examine outcomes of pediatric thyroidectomy in the context of training background, institution, and experience of the surgeon. Study Design Case series with chart review. Setting A tertiary academic medical center and a pediatric hospital. Subjects and Methods Eighty-one thyroidectomy patients younger than 18 years. Outcomes were major complications (recurrent laryngeal nerve injury, permanent hypocalcemia, and wound infection), length of stay (LOS), and need for repeat surgery. Results Eighty-one patients, 39 from the University of Nebraska Medical Center and 42 from the Children’s Hospital and Medical Center–Omaha, were identified over a 12-year time period. No difference was found in surgeon training (otolaryngology/head and neck surgery vs general/pediatric surgery) for complications (1 vs 1, odds ratio [OR] = 0.76, 95% confidence interval [CI] = [0.05, 13.1]), LOS >1 day (5 vs 13, OR = 0.39, 95% CI = [0.13, 1.24]), or need for second surgery (4 vs 7, OR = 1.47, 95% CI = [0.39, 5.49]). Higher surgeon volume (≥12 surgeries) was found to be significant for decreased need for second surgery (3 vs 8, OR = 6.67, 95% CI = [1.57, 27.17]). Patients of higher-volume surgeons were 4.2 times more likely to stay in the hospital 1 day or less compared with those patients operated on by surgeons with less experience (7 vs 11, 95% CI = [1.59, 15.0]). Conclusions Need for second surgery in pediatric thyroidectomy may be predicted by surgical volume.

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18

Rozinov, Vladimir M. "To the 75th anniversary of Vladimir I. Petlakh." Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care 12, no. 3 (November 2, 2022): 391–92. http://dx.doi.org/10.17816/psaic1294.

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The paper describes the professional activities and merits of the pediatric surgeon, science editor of Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care, Vladimir I. Petlakh in celebration of his anniversary.

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19

Stokes, Sean M., Joseph A. Iocono, Samuel Brown, and John M. Draus. "Intussusception Clinical Pathway: A Survey of Pediatric Surgery Practices." American Surgeon 80, no. 9 (September 2014): 846–48. http://dx.doi.org/10.1177/000313481408000914.

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Therapeutic reduction of intussusception by air or contrast enema may require surgery if the bowel is irreducible or perforates. There is no standard for the involvement of a pediatric surgeon in the workup of the condition. A regional survey of clinical practices was therefore undertaken to attempt to establish a consensus as to when the presence of a pediatric surgeon is required. Distributed to pediatric surgeons at 32 institutions, a questionnaire asked the process of imaging and reduction of infants with intussusception and the extent of pediatric surgical involvement. Surgeons at 29 institutions responded (91%). Ultrasound was used in diagnosis in 16 (55%), 13 (45%) requiring a positive ultrasound diagnosis of intussusception before attempting reduction. Three-fourths (22 [76%]) required surgeon notification that enema reduction was taking place, and one-fourth (seven [24%]) required prior surgical consultation. Only three (10%) required the presence of a surgery team member. Most (21 [72%]) did not demand one, and five (18%) indicated that surgical presence was desirable but not a necessity. There is no consensus for pediatric surgical involvement before and during reduction of an intussusception.

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Akhunzyanov, A. A. "Vladimir Leonidovich Borman - the first pediatric surgeon of the Imperial Kazan University." Kazan medical journal 94, no. 2 (April 15, 2013): 283–84. http://dx.doi.org/10.17816/kmj1606.

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Vladimir Leonidovich Borman was the first pediatric surgeon of the Imperial Kazan University, participated in the Russo-Japanese War, World War I and the Civil War. In 1900 a novel course of pediatric surgical diseases was started at the university. A new pediatric clinic was launched among other new clinics, and Vladimir Leonidovich Borman, a surgeon and a doctor of medicine, was invited to head one of the departments there. Since then the teaching of pediatric surgical diseases for Imperial Kazan University medical faculty students has been performed at the pediatric ward of the faculty surgery clinic. Then Vladimir Leonidovich participated in surgical service foundation in many parts of the country both at peace and wartime, he became the founder of the Omsk State Medical University department of hospital surgery. The contribution of that amazing, energetic, talented doctor and teacher to Russian medicine can not be overestimated.

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Sakandar, Gilbert, Juhara Haron, Adam Mohamad, Irfan Mohamad, and Ramiza R. Ramli. "Adult and Pediatric Lateral Lamella Cribriform Plate Height: In Need for a Comparative Study." Allergy & Rhinology 10 (January 2019): 215265671987477. http://dx.doi.org/10.1177/2152656719874775.

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Surgery for sinuses has evolved with the advancement of instruments and modification in techniques. Endoscopes have expanded the surgical roles for lesions in the nose and para-nasal sinuses with reduced rate of complications and cosmetic side effects. Nevertheless sinus surgery in pediatrics patients has its own challenges. Pre-operative imaging is of paramount important especially when embarking on skull base procedures. The differences between adult and pediatric anatomy need to be further studied.

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Pogorelić, Zenon, Dario Huskić, Tin Čohadžić, Miro Jukić, and Tomislav Šušnjar. "Learning Curve for Laparoscopic Repair of Pediatric Inguinal Hernia Using Percutaneous Internal Ring Suturing." Children 8, no. 4 (April 11, 2021): 294. http://dx.doi.org/10.3390/children8040294.

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Background: Percutaneous internal ring suturing (PIRS) is a simple and popular technique for the treatment of inguinal hernia in children. The aim of this study was to analyze the learning curves during implementation of PIRS in our department. Methods: A total of 318 pediatric patients underwent hernia repair using the PIRS technique by three pediatric surgeons with different levels of experience in laparoscopic surgery. These patients were enrolled in a prospective cohort study during the period October 2015–January 2021. Surgical times, intraoperative and postoperative complications, in addition to outcomes of treatment were compared among the pediatric surgeons. Results: Regarding operative time a significant difference among the surgeons was found. Operative time significantly decreased after 25–30 procedures per surgeon. The surgeon with advanced experience in laparoscopic surgery had significantly less operative times for both unilateral (12 (interquartile range, IQR 10.5, 16.5) min vs. 21 (IQR 16.5, 28) min and 25 (IQR 21.5, 30) min; p = 0.002) and bilateral (19 (IQR 14, 21) min vs. 28 (IQR 25, 33) min and 31 (IQR 24, 36) min; p = 0.0001) hernia repair, compared to the other two surgeons. Perioperative complications, conversion, and ipsilateral recurrence rates were higher at the beginning, reaching the benchmarks when each surgeon performed at least 30 PIRS procedures. The most experienced surgeon had the lowest number of complications (1.4%) and needed a fewer number of cases to reach the plateau. The other two surgeons with less experience in laparoscopic surgery had higher rates of complications (4.4% and 5.4%) and needed a higher number of cases to reach the plateau (p = 0.190). Conclusions: A PIRS learning curve for perioperative and postoperative complications, recurrences, and conversion rates reached the plateau after each surgeon had performed at least 30 cases. After that number of cases PIRS is a safe and effective approach for pediatric hernia repair. A surgeon with an advanced level of experience in pediatric laparoscopic surgery adopted the technique more easily and had a significantly faster learning curve.

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Shinoka, Toshiharu. "Tissue-Engineered Vascular Grafts in Pediatric Cardiovascular Surgery -Past, Now, and Future." Pediatric Cardiology and Cardiac Surgery 30, no. 5 (2014): 514–22. http://dx.doi.org/10.9794/jspccs.30.514.

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Touloukian, Robert J. "What's New in Pediatric Surgery." Pediatrics 81, no. 5 (May 1, 1988): 692–96. http://dx.doi.org/10.1542/peds.81.5.692.

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Advances in the pathophysiology, diagnosis, and treatment of congenital malformations, trauma, tumors, and innovations in organ transplantation form the cornerstones of progress in pediatric surgery during the past year. Significant new contributions presented at the past year's meeting of pediatric surgical organizations, including the 56th Annual Meeting of the Surgical Section of the American Academy of Pediatrics, are summarized, and selected references from the pediatric and surgical literature are presented. PRENATAL DIAGNOSIS/FETAL SURGERY In the area of fetal surgery, Manning et al1 summarized the experience with 74 cases of catheter decompression for fetal hydronephrosis and hydrocephalus reported to the International Fetal Surgery Register. The center reported an overall survival rate of 41% for urinary obstruction with a procedure-related death rate of 4.6%. The results of ventriculoamniotic shunt procedure for obstructive hydrocephalus were even less encouraging with a procedure-related mortality of 10%; moreover, more than 50% of survivors had serious neurologic handicaps. Sauer et al2 studied the relative importance of an abdominal mass and oligohydramnios causing pulmonary hypoplasia in fetal rabbits. Animals having bladder outlet obstruction developed severe pulmonary hypoplasia, whereas other subjects having a synthetic mass inserted into the abdomen of a size equal to that of the obstructed bladder showed minimal signs of pulmonary hypoplasia. Results of the study suggest that prenatal catheter decompression be limited to the fetus with oligohydramnios. The wisdom of planning the mode of delivery for babies with major congenital malformations referred to a maternal high-risk unit for evaluation remains controversial.

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Dasenbrock, Hormuzdiyar H., Timothy R. Smith, and Shenandoah Robinson. "Preoperative laboratory testing before pediatric neurosurgery: an NSQIP-Pediatrics analysis." Journal of Neurosurgery: Pediatrics 24, no. 1 (July 2019): 92–103. http://dx.doi.org/10.3171/2018.12.peds18441.

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OBJECTIVESThe goal of this study was to evaluate clinical predictors of abnormal preoperative laboratory values in pediatric neurosurgical patients.METHODSData obtained in children who underwent a neurosurgical operation were extracted from the prospective National Surgical Quality Improvement Program–Pediatrics (NSQIP-P, 2012–2013) registry. Multivariable logistic regression evaluated predictors of preoperative laboratory values that might require further evaluation (white blood cell count < 2000/μl, hematocrit < 24%, platelet count < 100,000/μl, international normalized ratio > 1.4, or partial thromboplastin time > 45 seconds) or a preoperative transfusion (within 48 hours prior to surgery). Variables screened included patient demographics; American Society of Anesthesiologists (ASA) physical designation classification; comorbidities; recent steroid use, chemotherapy, or radiation therapy; and admission type. Predictive score validation was performed using the NSQIP-P 2014 data.RESULTSOf the 6556 patients aged greater than 2 years, 68.9% (n = 5089) underwent laboratory testing, but only 1.9% (n = 125) had a critical laboratory value. Predictors of a laboratory abnormality were ASA class III–V; diabetes mellitus; hematological, hypothrombotic, or oncological comorbidities; nutritional support; recent chemotherapy; systemic inflammatory response syndrome; and a nonelective hospital admission. These 9 variables were used to create a predictive score, with a single point assigned for each predictor. The prevalence of critical values in the validation population (NSQIP-P 2014) of patients greater than 2 years of age was 0.3% with a score of 0, 1.0% in those with a score of 1, 1.6% in those with a score of 2, and 6.2% in those with a score ≥ 3. Higher score was predictive of a critical value (OR 2.33, 95% CI 1.91–2.83, p < 0.001, C-statistic 0.76) and with the requirement of a perioperative transfusion (intraoperatively or within 72 hours postoperatively; OR 1.42, 95% CI 1.22–1.67, p < 0.001) in the validation population. Moreover, when the same score was applied to children aged 2 years or younger, a greater score was predictive of a critical value (OR 2.47, 95% CI 2.15–2.84, p < 0.001, C-statistic 0.76).CONCLUSIONSCritical laboratory values in pediatric neurosurgical patients are largely predicted by clinical characteristics, and abnormal preoperative laboratory results are rare in patients older than 2 years of age without comorbidities who are undergoing elective surgery. The NSQIP-P critical preoperative laboratory value scale is proposed to indicate patients with the highest odds of an abnormal value. The scale can assist with triaging preoperative testing based on the surgical risk, as determined by the treating surgeon and anesthesiologist.

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Morozov, D. A. "PROBLEMS OF LEGISLATIVE REGULATION OF PEDIATRIC SURGERY AND FETAL SURGERY IN THE RUSSIAN FEDERATION." Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care 8, no. 2 (October 10, 2018): 6–15. http://dx.doi.org/10.30946/2219-4061-2018-8-2-6-15.

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The article deals with the recommendations accepted during the round table discussion of the Health Protection Committee of the State Duma of Russia (Pediatric surgery and surgery of the fetus in Russia: legislation regulation of practice, science and training of personnel). The general characteristics of the issue related to the provision of surgical aid to children, legal status of the pediatric surgeon, law enforcement when providing surgical aid to children, training of specialists and scientific personnel are reviewed. The recommendations for the Government of the country, Ministry of health, associations of pediatric surgeons and other executive agencies are presented in detail.

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Simien, Christopher, Kathleen D. Holt, and Thomas H. Richter. "The Impact of ACGME Work-Hour Reforms on the Operative Experience of Fellows in Surgical Subspecialty Programs." Journal of Graduate Medical Education 3, no. 1 (March 1, 2011): 111–17. http://dx.doi.org/10.4300/jgme-d-10-00174.1.

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Abstract Background In July 2003, the Accreditation Council for Graduate Medical Education (ACGME) introduced a set of regulations that mandated a reduction in the number of hours that medical residents can work. These requirements have generated controversy among medical educators, with some expressing concern that reducing resident hours may limit clinical exposure and competency, particularly in surgical specialties. Objective This study examines the impact of duty hour restrictions on resident operative experience in residents in 2 surgical subspecialties since the implementation of the ACGME duty hour limits. Method We examined operative log data for vascular surgery and pediatric surgery, using the academic year immediately preceding the duty hour restrictions, 2002 to 2003, as a baseline for comparison to subsequent academic years through 2006 to 2007 for vascular surgery and 2007 to 2008 for pediatric surgery. Results Graduating fellows in pediatric surgery showed no change in their total operative volume following duty hour restrictions. The pediatric-defined category of neonate procedures showed an increase following duty hour restrictions. Graduating fellows in vascular surgery showed an increase in total major procedures as surgeon. The vascular-defined categories of endovascular-diagnostic, endovascular-therapeutic, and endovascular-graft procedures also increased. Conclusions The reduction of duty hours has not resulted in a decrease in operative volume as some have predicted. Operative volume in pediatric surgery remained mainly unchanged, whereas operative volume in vascular surgery increased. We explore possible explanations for the observed findings.

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Kuburovic, Nina, Slavisa Djuricic, Andjelija Neskovic, Velimir Dedic, and Vladimir Kuburovic. "Assessment of health care quality in the tertiary level pediatric hospitals in Serbia." Vojnosanitetski pregled 68, no. 1 (2011): 21–27. http://dx.doi.org/10.2298/vsp1101021k.

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Background/Aim. It is necessary to improve the quality of health care for children. Assessment data would provide new insights into better treatment outcomes. The aim of this descriptive study was to estimate and to compare applied quality indicators in five pediatric inpatient tertiary level institutions in Serbia during the period from January 1st to December 31st 2008. Methods. Quality data and indicators were collected in the Institute for Public Health of Serbia ?Dr. Milan Jovanovic Batut?. Descriptive statistics and chisquare test were used for data analysis. Results. The average length of stay (ALOS) in pediatric departments was 7.51 ? 1.30 days (5.88-8.91 days). In the same period, ALOS in pediatric surgery departments was 5.85 ? 1.50 days (3.58-7.57 days). The average number of nurses per occupied bed was 0.76 ? 0.20 and 1.09 ? 0.36 in pediatric and in pediatric surgery departments, respectively. The number of operated patients per surgeon was in the range 51.0-160.5. The annual case fatality rate in pediatric departments was estimated to 0.72% ? 0.20%, whereas in pediatric surgery departments it was 0.34% ? 0.25%. The autopsy rate was estimated to 0.00%-63.16% in pediatric departments, and 37.14%-80.00% in pediatric surgery departments. There was statistically significant difference among the five hospitals regarding the following indicators of quality of work: total annual mortality rate of patients, autopsy rate, number of rate of patients, autopsy rate, number of patients referred to other institutions, both in pediatric and pediatric surgery departments. Conclusion. There is a significant difference among the five hospitals regarding indicators of quality of work. Obligatory set of quality indicators on the basis of legislative acts are the indicators of general quality of work in hospital. It is necessary to establish specific pediatric quality indicators and to define national standards related to these indicators.

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Taub, Peter J., and Joshua A. Lampert. "Pediatric Craniofacial Surgery: A Review for the Multidisciplinary Team." Cleft Palate-Craniofacial Journal 48, no. 6 (November 2011): 670–83. http://dx.doi.org/10.1597/08-051.

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Pediatric craniofacial surgery is a specialty that grew dramatically in the 20th century and continues to evolve today. Out of the efforts to correct facial deformities encountered during World War II, the techniques of modern craniofacial surgery developed. An analysis of the relevant literature allowed the authors to explore this historical progression. Current advances in technology, tissue engineering, and molecular biology have further refined pediatric craniofacial surgery. The development of distraction osteogenesis and the progressive study of craniosynostosis provide remarkable examples of this momentum. The growing study of genetics, biotechnology, the influence of growth factors, and stem cell research provide additional avenues of innovation for the future. The following article is intended to reveal a greater understanding of pediatric craniofacial surgery by examining the past, present, and possible future direction. It is intended both for the surgeon, as well as for the nonsurgical individual specialists vital to the multidisciplinary craniofacial team.

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HORTON, JOHN D. "Pediatric Surgery." Surgical Clinics of North America 102, no. 5 (October 2022): i. http://dx.doi.org/10.1016/s0039-6109(22)00119-0.

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Hendren, William Hardy. "Pediatric Surgery." Pediatrics 102, Supplement_2 (July 1, 1998): 275–78. http://dx.doi.org/10.1542/peds.102.s2.275.

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Ieiri, Satoshi, Satoshi Obata, Takahiro Jinbo, Ryota Souzaki, Makoto Hashizume, and Tomaki Taguchi. "Pediatric surgery." Journal of Japan Society of Computer Aided Surgery 17, no. 1 (2015): 5–9. http://dx.doi.org/10.5759/jscas.17.5.

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Adzick, N. Scott, and Michael L. Nance. "Pediatric Surgery." New England Journal of Medicine 342, no. 22 (June 2000): 1651–57. http://dx.doi.org/10.1056/nejm200006013422207.

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Adzick, N. Scott, and Michael L. Nance. "Pediatric Surgery." New England Journal of Medicine 342, no. 23 (June 8, 2000): 1726–32. http://dx.doi.org/10.1056/nejm200006083422307.

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35

Iwanaka, Tadashi, Atsuyuki Yamataka, Sadashige Uemura, Hiroomi Okuyama, Osamu Segawa, Masaki Nio, Joji Yoshizawa, et al. "Pediatric Surgery." Asian Journal of Endoscopic Surgery 8, no. 4 (November 2015): 390–407. http://dx.doi.org/10.1111/ases.12263.

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Azizkhan, R. "Pediatric Surgery." Journal of the American College of Surgeons 186, no. 2 (February 1998): 203–11. http://dx.doi.org/10.1016/s1072-7515(98)00006-4.

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Rodgers, Bradley M. "Pediatric surgery." Journal of the American College of Surgeons 188, no. 2 (February 1999): 152–60. http://dx.doi.org/10.1016/s1072-7515(98)00324-x.

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Rescorla, F. "Pediatric surgery." Journal of the American College of Surgeons 190, no. 2 (February 2000): 196–205. http://dx.doi.org/10.1016/s1072-7515(99)00279-3.

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Azarow, Kenneth S., and Robert A. Cusick. "Pediatric Surgery." Surgical Clinics of North America 92, no. 3 (June 2012): xvii—xix. http://dx.doi.org/10.1016/j.suc.2012.03.018.

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Martin, Ronald F. "Pediatric Surgery." Surgical Clinics of North America 92, no. 3 (June 2012): xiii—xv. http://dx.doi.org/10.1016/j.suc.2012.03.019.

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Ricketts, Richard R. "Pediatric surgery." Journal of Pediatric Surgery 28, no. 7 (July 1993): 970. http://dx.doi.org/10.1016/0022-3468(93)90710-3.

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Hendren, W. Hardy, and Craig W. Lillehei. "Pediatric Surgery." New England Journal of Medicine 319, no. 2 (July 14, 1988): 86–96. http://dx.doi.org/10.1056/nejm198807143190205.

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Klayton, Ronald J. "PEDIATRIC SURGERY." Military Medicine 160, no. 1 (January 1, 1995): A7c. http://dx.doi.org/10.1093/milmed/160.1.a7c.

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Burrington, John D. "Pediatric Surgery." JAMA: The Journal of the American Medical Association 257, no. 17 (May 1, 1987): 2361. http://dx.doi.org/10.1001/jama.1987.03390170117040.

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Rowe, Marc I. "Pediatric Surgery." JAMA: The Journal of the American Medical Association 258, no. 6 (August 14, 1987): 780. http://dx.doi.org/10.1001/jama.1987.03400060056020.

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Fallat, Mary E. "Pediatric Surgery." American Journal of Surgery 154, no. 1 (July 1987): 41–48. http://dx.doi.org/10.1016/0002-9610(87)90310-2.

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Bond, Sheldon. "Pediatric surgery." American Journal of Surgery 167, no. 3 (March 1994): 373. http://dx.doi.org/10.1016/0002-9610(94)90228-3.

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Lobe, Thom E. "Pediatric surgery." Current Problems in Pediatrics 23, no. 9 (October 1993): 348–57. http://dx.doi.org/10.1016/0045-9380(93)90030-g.

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Hendren, W. Hardy. "Pediatric Surgery." Archives of Surgery 129, no. 4 (April 1, 1994): 345. http://dx.doi.org/10.1001/archsurg.1994.01420280011002.

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Groner, Jonathan I. "Pediatric Surgery." JAMA 308, no. 20 (November 28, 2012): 2151. http://dx.doi.org/10.1001/jama.308.20.2151-a.

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