10th Anniversary of Children: Feature Papers in Pediatric Surgery

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Surgery".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 5180

Special Issue Editors

Prof. Dr. Thomas Kohl
E-Mail Website
Guest Editor
German Center for Fetal Surgery & Minimally-Invasive Therapy (DZFT), University Medicine Mannheim (UMM), 68167 Mannheim, Germany
Interests: all aspects of minimally-invasive fetal surgery and therapy
Prof. Dr. Michael Boettcher
E-Mail Website
Guest Editor
Department of Pediatric Surgery, University Medical Centre Mannheim, University of Heidelberg, 69117 Heidelberg, Germany
Interests: paediatric surgery; minimally-invasive surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are celebrating the 10th anniversary of Children with a Special Issue in the Section “Pediatric Surgery” in 2023.

On behalf of the Editor-in-Chief, Prof. Dr. Paul R. Carney, members of the Editorial Office, and ourselves as Guest Editors, we would like to take this opportunity to thank our authors and reviewers for their valuable contributions in ensuring that Children is a successful and respected journal in its field. To celebrate the journal’s 10th anniversary, we will be serving as Guest Editors of a Special Issue that focuses on the clinical care, service delivery, and research related to the care of children within the context of pediatric surgery.

Fetal surgery has become a clinical reality in many tertiary care centers around the world. Over the past 30 years, a growing spectrum of different minimally invasive approaches have helped to save the life or improve the postnatal quality of life of thousands of patients. Spreading the word about the availability, techniques, and outcome of fetal interventions will help to save many more.

We warmly invite original research and state-of-the-art review/perspective contributions on all aspects of pediatric surgery and fetal surgery, including ethics, pain management, perioperative management, procedures, amniotic insufflation, benefits and risks, maternal and child outcomes, as well as experimental development.

Prof. Dr. Thomas Kohl
Prof. Dr. Michael Boettcher
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • fetal surgery
  • fetoscopy
  • pediatric surgery
  • congenital malformations
  • fetus
  • surgical innovation

Published Papers (7 papers)

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Research

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21 pages, 2529 KiB  
Article
An International Collaborative Initiative to Establish a Quality-of-Life Questionnaire for Children and Adolescents with Repair of Esophageal Atresia in 14 Countries
Children 2024, 11(3), 286; https://doi.org/10.3390/children11030286 - 26 Feb 2024
Viewed by 290
Abstract
The EA-QOL questionnaire measures quality-of-life specifically for children born with esophageal atresia (EA) aged 8–18 and was completed in Sweden and Germany. This study aimed to describe an international collaborative initiative to establish a semantically equivalent linguistic version of the EA-QOL questionnaires in [...] Read more.
The EA-QOL questionnaire measures quality-of-life specifically for children born with esophageal atresia (EA) aged 8–18 and was completed in Sweden and Germany. This study aimed to describe an international collaborative initiative to establish a semantically equivalent linguistic version of the EA-QOL questionnaires in 12 new countries. The 24-item EA-QOL questionnaire was translated into the target languages and the translated questionnaire was evaluated through cognitive debriefing interviews with children with EA aged 8–18 and their parents in each new country. Participants rated an item as to whether an item was easy to understand and sensitive/uncomfortable to answer. They could choose not to reply to a non-applicable/problematic item and provide open comments. Data were analyzed using predefined psychometric criteria; item clarity ≥80%, item sensitive/uncomfortable to answer ≤20%, item feasibility(missing item responses ≤5%). Decision to improve any translation was made by native experts–patient stakeholders and the instrument developer. Like in Sweden and Germany, all items in the cross-cultural analysis of child self-report (ntot = 82, 4–10 children/country) met the criteria for item clarity in all 12 new countries, and in parent-report (ntot = 86, 5–10 parents/country) in 8/12 countries. All items fulfilled the criteria for sensitive/uncomfortable to answer (child-report 1.2–9.9%; parent-report 0–11.6%) and item feasibility. Poor translations were resolved. Hence, this study has established semantically equivalent linguistic versions of the EA-QOL questionnaire for use in children aged 8–18 with repair of EA in and across 14 countries. Full article
(This article belongs to the Special Issue 10th Anniversary of Children: Feature Papers in Pediatric Surgery)
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10 pages, 1874 KiB  
Communication
Does Massive Bowel Resection in Newborns Affect Further Immunity in Children?
Children 2024, 11(1), 114; https://doi.org/10.3390/children11010114 - 17 Jan 2024
Viewed by 573
Abstract
Background: The massive resection of the small intestine leading to short bowel syndrome (SBS) deprives an organism of many immunocompetent cells concentrated in gut-associated lymphoid tissue, the largest immune organ in humans. We have aimed to access the influence of bowel resection on [...] Read more.
Background: The massive resection of the small intestine leading to short bowel syndrome (SBS) deprives an organism of many immunocompetent cells concentrated in gut-associated lymphoid tissue, the largest immune organ in humans. We have aimed to access the influence of bowel resection on adaptive immunity in children, based on peripheral lymphocyte subsets and serum immunoglobulins. Methods: 15 children who underwent bowel resection in the first months of their life and required further home parenteral nutrition were enrolled into the study. Based on flow cytometry, the following subsets of lymphocytes were evaluated: T, B, NK, CD4+, C8+, and activated T cells. Results: Statistically significant differences were found for the rates of lymphocytes B, T, CD8+, and NK cells. The absolute count of NK cells was lower in the SBS group than in the control group. Absolute counts of lymphocytes, lymphocytes B, T, CD4+, and percentages of lymphocytes CD4+, and activated T cells inversely correlated with age in SBS group. Conclusions: Children with SBS do not present with clinical signs of immunodeficiency as well as deficits in peripheral lymphocyte subsets and serum immunoglobulins. The tendency of the lymphocyte subpopulations to decrease over time points out the necessity for longer follow- up. Full article
(This article belongs to the Special Issue 10th Anniversary of Children: Feature Papers in Pediatric Surgery)
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11 pages, 672 KiB  
Article
Health-Related Quality of Life and Mental Health of Children with Embryonal Abdominal Tumors
Children 2023, 10(10), 1720; https://doi.org/10.3390/children10101720 - 23 Oct 2023
Viewed by 707
Abstract
(1) Background: Embryonal abdominal tumors are one of the most common entities of solid childhood cancer. The present study investigates the Health-Related Quality of Life (HRQoL) and the mental health of children to obtain a comprehensive picture of their health status and uncover [...] Read more.
(1) Background: Embryonal abdominal tumors are one of the most common entities of solid childhood cancer. The present study investigates the Health-Related Quality of Life (HRQoL) and the mental health of children to obtain a comprehensive picture of their health status and uncover a possible gap in healthcare. (2) Methods: The sample consisted of 54 children who were treated for embryonal abdominal tumors and a control group of 46 children who received uncomplicated outpatient surgery. The HRQoL and the mental health were assessed by the parent proxy reports of the questionnaires Pediatric Quality of Life Inventory (PedsQL) and Strengths and Difficulties Questionnaire (SDQ). (3) Results: Children with embryonal abdominal tumors showed significantly lower HRQoL and mental health values compared to the norm data. The index group showed lower values in the social subscales of HRQoL and mental health compared to the control group. (4) Conclusions: Embryonal abdominal tumors affect the well-being of children. There is still a gap in healthcare due to children’s HRQoL and mental health, especially regarding social development. It is essential to further advance the psychological care of children and improve their chances to develop social relationships. Full article
(This article belongs to the Special Issue 10th Anniversary of Children: Feature Papers in Pediatric Surgery)
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13 pages, 239 KiB  
Article
Implementing Contralateral Surgical Exploration during Hernia Repair in Children with Unilateral Inguinal Hernia: A Dutch Qualitative Study
Children 2023, 10(10), 1631; https://doi.org/10.3390/children10101631 - 29 Sep 2023
Viewed by 625
Abstract
A total of 10–15% of children undergoing unilateral inguinal hernia repair develop a metachronous contralateral inguinal hernia (MCIH) that necessitates second anesthesia and surgery. Contralateral exploration can be performed to prevent MCIH development. This study investigates (1) factors that promote or hinder the [...] Read more.
A total of 10–15% of children undergoing unilateral inguinal hernia repair develop a metachronous contralateral inguinal hernia (MCIH) that necessitates second anesthesia and surgery. Contralateral exploration can be performed to prevent MCIH development. This study investigates (1) factors that promote or hinder the adoption and (de-)implementation of contralateral groin exploration in children ≤ 6 months undergoing unilateral hernia repair and (2) strategies to overcome these barriers. A qualitative interview study was conducted using 14 semi-structured interviews and two focus groups involving healthcare professionals, stakeholders involved from a patients’ perspective and stakeholders at the organizational/policy level. The results show that the effectiveness of surgical treatment and stakeholders’ motivation and attitudes towards the intervention were reported as barriers for implementation, whereas patient and family outcomes and experience and strategies to overcome these barriers were identified as facilitating factors for future implementation. This study is unique in its contributions towards insights into facilitators and barriers for (de-)implementation of contralateral groin exploration in children with a unilateral inguinal hernia. In case the HERNIIA trial shows that contralateral exploration is beneficial for specific patient and family outcomes or a subgroup of children, the results of this study can help in the decision-making process as to whether contralateral exploration should be performed or not. Full article
(This article belongs to the Special Issue 10th Anniversary of Children: Feature Papers in Pediatric Surgery)
9 pages, 624 KiB  
Article
Exploring Comorbidities in Adolescent and Young Adults with Hypermobile Ehlers–Danlos Syndrome with and without a Surgical History: A Preliminary Investigation
Children 2023, 10(9), 1562; https://doi.org/10.3390/children10091562 - 16 Sep 2023
Viewed by 1363
Abstract
Ehlers–Danlos Syndrome (EDS) is a rare disease affecting the skin, joints, vasculature, and internal organs. Approximately 85% of those affected are categorized as the hypermobile type (hEDS), which is associated with numerous medical and psychiatric comorbidities, including chronic pain. Additionally, approximately 71% of [...] Read more.
Ehlers–Danlos Syndrome (EDS) is a rare disease affecting the skin, joints, vasculature, and internal organs. Approximately 85% of those affected are categorized as the hypermobile type (hEDS), which is associated with numerous medical and psychiatric comorbidities, including chronic pain. Additionally, approximately 71% of patients with hEDS undergo at least one surgical procedure; however, indicators for surgery and pain outcomes after surgery are poorly understood. This preliminary study used a medical chart review to identify the frequency and nature of comorbidities in a cohort of adolescents and young adult patients with hEDS and a surgical history compared to those without a surgical history. Results showed that patients diagnosed with hEDS who underwent surgery reported significantly more comorbidities (e.g., CRPS, IBS, Fibromyalgia, POTS, hypothyroidism, etc.) than those who did not have surgery. Seventy percent of individuals who presented for surgery fell within the categories of orthopedic, gastrointestinal, or laparoscopic/endometriosis-related surgeries. Identifying patients with hEDS who are at risk for needing surgery will help identify the mechanisms contributing to risk factors for poor surgical outcomes. The results of this study may be instructive in the management and care of hEDS patients undergoing surgery. Full article
(This article belongs to the Special Issue 10th Anniversary of Children: Feature Papers in Pediatric Surgery)
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Review

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12 pages, 4731 KiB  
Review
Magnetic Compression Anastomosis–Past Experience and Current Proposals for Further Development in Pediatric Minimally Invasive Surgery
Children 2023, 10(8), 1328; https://doi.org/10.3390/children10081328 - 01 Aug 2023
Cited by 1 | Viewed by 865
Abstract
Originating in the 1970s, magnetic compression anastomosis (MCA) has lately been revisited with a focus on minimal invasive surgery (MIS). The aim of this report is to reappraise our earlier experience with MCA with the intention of facilitating future MCA advancement. A retrospective [...] Read more.
Originating in the 1970s, magnetic compression anastomosis (MCA) has lately been revisited with a focus on minimal invasive surgery (MIS). The aim of this report is to reappraise our earlier experience with MCA with the intention of facilitating future MCA advancement. A retrospective review was conducted regarding preclinical experiments and clinical trials at a single institution from 1980 to 1995. The reviewed information was compiled and appraised to generate proposals for future MCA use. The experimental studies, including 250 MCA cases in gastrointestinal and urinary tract animal models, demonstrated the technical versatility of MCA as well as the superior biomechanical characteristics in comparison to hand-sewn anastomoses. Clinical trials encompassed 87 MCA procedures in 86 children, 2 to 10 years of age, involving the following techniques: non-operative esophageal recanalization (n = 15), non-operative ileostomy undiversion (n = 46), Swenson pull-through (n = 10), non-operative urethral recanalization (n = 5), and extravesical ureterocystoneostomy (n = 11). Clinical MCA was found to be successful in over 87% of cases. MCA limitations concerning anastomotic failure and scarring were thought to be mostly due to inadequate magnetic compression. Based on our historic experience, we propose further research on the technical aspects of MCA, along with the biological aspects of anastomotic tissue remodeling. Magnets should be designed and manufactured for a wide spectrum of pediatric surgical indications, particularly in combination with novel MIS techniques. Full article
(This article belongs to the Special Issue 10th Anniversary of Children: Feature Papers in Pediatric Surgery)
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Other

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12 pages, 907 KiB  
Systematic Review
Robotic Approach to Paediatric Gastrointestinal Diseases: A Systematic Review
Children 2024, 11(3), 273; https://doi.org/10.3390/children11030273 - 22 Feb 2024
Viewed by 333
Abstract
Introduction: The use of minimally invasive surgery (MIS) for paediatric surgery has been on the rise since the early 2000s and is complicated by factors unique to paediatric surgery. The rise of robotic surgery has presented an opportunity in MIS for children, and [...] Read more.
Introduction: The use of minimally invasive surgery (MIS) for paediatric surgery has been on the rise since the early 2000s and is complicated by factors unique to paediatric surgery. The rise of robotic surgery has presented an opportunity in MIS for children, and recent developments in the reductions in port sizes and single-port surgery offer promising prospects. This study aimed to present a systematic overview and analysis of the existing literature around the use of robotic platforms in the treatment of paediatric gastrointestinal diseases. Materials and Methods: In accordance with the PRISMA Statement, a systematic review on paediatric robotic gastrointestinal surgery was conducted on Pubmed, Cochrane, and Scopus. A critical appraisal of the study was performed using the Newcastle Ottawa Scale. Results: Fifteen studies were included, of which seven were on Hirschsprung’s disease and eight on other indications. Included studies were heterogeneous in their populations, age, and sex, but all reported low incidences of intraoperative complications and conversions in their robotic cohorts. Only one study reported on a comparator cohort, with a longer operative time in the robotic cohort (180 vs. 152 and 156 min, p < 0.001), but no significant differences in blood loss, length of stay, intraoperative complications, postoperative complications, or conversion. Conclusions: Robotic surgery may play a role in the treatment of paediatric gastrointestinal diseases. There is limited data available on modern robotic platforms and almost no comparative data between any robotic platforms and conventional minimally invasive approaches. Further technological developments and research are needed to enhance our understanding of the potential that robotics may hold for the field of paediatric surgery. Full article
(This article belongs to the Special Issue 10th Anniversary of Children: Feature Papers in Pediatric Surgery)
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