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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Pediatrics".

Deadline for manuscript submissions: closed (20 May 2023) | Viewed by 5855

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Prof. Dr. Bo Xiang

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Guest Editor

Department of Pediatric Surgery, West China Hospital of Sichuan University, Chengdu, China
Interests: pediatric minimal-access surgery; Da Vinci robot-associated surgery; pediatric generall surgery; pediatric solid oncology; pediatric liver transplantation; congenital choledochal cyst; hirschsprung disease

Dr. Min Yang

E-Mail Website
Guest Editor

Special Issue Information

Dear Colleagues,

With the development of our society and our medical capabilities, the progress of surgery in the pediatric disease field is remarkable. Minimal-access surgery has been the area of major improvement amongst surgical procedures for many pediatric diseases. For example, for pediatric abdominal disease, congenital choledochal cysts have been increasingly diagnosed in the past decade. The surgical procedure of choice for the removal of congenital choledochal cysts has changed over time, from laparotomy initially, to the subsequent laparoscopic surgery, and to now popular Da Vinci robot-associated surgery. Moreover, pediatric liver transplantation has been increasingly performed for patients with liver failure, such as biliary atresia. Additionally, pediatric surgery has been playing more and more importan role in the treatment of pediatric solid tumors. For pediatric, thoracic, or urinary system disease, minimal-access surgery has also been an area of significant development, tackling more challenges than ever before. In this Special Issue, we welcome authors to submit papers on the development and challenge of pediatric surgery in various diseases. We are particularly interested in minimal-access surgery for the treatment of pediatric, abdominal, and thoracic diseases.

Prof. Dr. Bo Xiang
Dr. Min Yang
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. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly 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 2600 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

minimal-access surgery
laparoscopic surgery
Da Vinci robot surgery
thoracoscopic surgery
liver transplantation
oncology surgery

Published Papers (4 papers)

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10 pages, 237 KiB

Open AccessArticle

Vesicoscopic vs. Open Ureteral Reimplantation According to Cohen and Leadbetter-Politano for Vesicoureteral Reflux

by Christian Kruppa, Alexandra Wilke, Carola Hörz, Thomas Kosk, Tina Hörz, Guido Fitze and Katrin Schuchardt

J. Clin. Med. 2023, 12(17), 5686; https://doi.org/10.3390/jcm12175686 - 31 Aug 2023

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Abstract

Background: The minimally invasive implementations of the established open methods for the correction of primary vesicoureteral reflux have proven to be successful in terms of feasibility and safety. The aim of this study was to investigate to what extent pediatric patients benefit from vesicoscopic operations. Methods: Between 2010 and 2022, 224 children (359 ureters) underwent ureteral reimplantation for vesicoureteral reflux in our clinic. Children, operated on according to the COHEN technique, underwent an open approach in 39 cases, whereas 151 patients were operated on vesicoscopically. A total of thirty-four children have received a ureteral reimplantation according to the LEADBETTER-POLITANO technique: twenty-nine openly and five vesicoscopically. The open and vesicoscopic groups were compared with regards to perioperative data and postoperative course. Results: The mean operating time was significantly shorter for open than for the vesicoscopic procedures in the COHEN group (99 vs. 149 min, p < 0.001). Similarly, a comparison of ureteral reimplantations, according to LEADBETTER-POLITANO, favored the open procedure, although this was not significant (161 vs. 196 min, p = 0.135). There was no significant difference in the recurrence rate of all the groups. All procedures remained within the accepted range with a success rate of at least 96%. In the postoperative course, a significantly shorter hospital stay (4.1 vs. 7.9 days, p < 0.001 for COHEN-patients; 5.6 vs. 9.2 days for LEADBETTER-POLITANO-patients), as well as a significantly lower need for continuous analgesic administration, was observed for the vesicoscopic approaches of both methods (0.8 days in both vesicoscopic groups vs. 3.7 resp. 3.8 days in open groups, p < 0.001). In addition, the time of bladder drainage was significantly shorter in open techniques (7.2 vs. 1.9 days, p < 0.001 for COHEN-patients; 3 vs. 8.7 days for LEADBETTER-POLITANO-patients). Conclusions: For almost all underlying causes, the surgical treatment of vesicoureteral reflux can be performed vesicoscopically, even if bilateral, in one session. Patients benefit significantly from the use of minimally invasive surgery in the postoperative course with faster mobilization, less need for analgesics, a shorter bladder drainage and a reduced hospital stay, compared with its open counterparts. Full article

(This article belongs to the Special Issue New Challenges in Pediatric Surgery)

10 pages, 796 KiB

Open AccessArticle

Diagnostic Utility of Serum Leucine-Rich α-2-Glycoprotein 1 for Acute Appendicitis in Children

by Goran Tintor, Miro Jukić, Daniela Šupe-Domić, Ana Jerončić and Zenon Pogorelić

J. Clin. Med. 2023, 12(7), 2455; https://doi.org/10.3390/jcm12072455 - 23 Mar 2023

Cited by 7 | Viewed by 1228

Abstract

Purpose: The aim of this study is to assess the diagnostic utility of serum leucine-rich α-2-glycoprotein 1 (LRG1) in pediatric patients with acute abdominal pain, admitted to the emergency surgical unit, in order to make a prompt and accurate diagnosis of acute appendicitis. Patients and methods: Pediatric patients older than 5 years of age who presented to the emergency department from 15 October 2021 to 30 June 2022 with acute abdominal pain and suspected acute appendicitis were prospectively recruited in the study. Demographic and clinical data, as well as operative and postoperative data, were recorded. A total of 92 patients were equally distributed into two groups: children with acute appendicitis who underwent laparoscopic appendectomy and non-appendicitis patients, presenting with non-specific abdominal pain. LRG1 levels were determined using a commercially available LRG1 enzyme-linked immunosorbent assay (ELISA) kit. Serum LRG1 levels, as well as other inflammatory markers (white blood cell count (WBC), C-reactive protein (CRP) and absolute neutrophil count) were compared between groups. Results: The median level of LRG1 in serum was significantly higher in the group of children with pathohistologically confirmed acute appendicitis than in the control group, at 350.3 µg/mL (interquartile range (IQR) 165.2–560.3) and 25.7 µg/mL (IQR 14.7–36.8) (p < 0.001), respectively. Receiver operating characteristic area under the curve for LRG1 from serum was 1.0 (95% CI 0.96–1.00; p < 0.001) and the value of >69.1 µg/mL was found to perfectly separate acute appendicitis cases from controls. Additionally, as expected, each of the examined laboratory inflammatory markers provided a significantly higher values in the acute appendicitis group compared to the control group: WBC 14.6 × 10⁹/L (IQR 12.7, 18.7) vs. 7.0 × 10⁹/L (IQR 5.4, 9.0) (p < 0.001), CRP 16.3 mg/dL (IQR 6.9, 50.4) vs. 2.2 mg/dL (IQR 2, 2) (p < 0.001) and absolute neutrophil count 84.6% (IQR 79.5, 89.0) vs. 59.5% (IQR 51.5, 68.6) (p < 0.001). Conclusions: LRG1 in the serum was found to be a promising novel biomarker, with excellent differentiation of acute appendicitis from non-appendicitis cases in children presenting with non-specific abdominal pain. Full article

(This article belongs to the Special Issue New Challenges in Pediatric Surgery)

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12 pages, 544 KiB

Open AccessArticle

Current Challenges in the Treatment of the Omphalocele—Experience of a Tertiary Center from Romania

by Elena Ţarcă, Elena Cojocaru, Laura Mihaela Trandafir, Alina Costina Luca, Răzvan Călin Tiutiucă, Lăcrămioara Ionela Butnariu, Claudia Florida Costea, Iulian Radu, Mihaela Moscalu and Viorel Ţarcă

J. Clin. Med. 2022, 11(19), 5711; https://doi.org/10.3390/jcm11195711 - 27 Sep 2022

Cited by 3 | Viewed by 1475

Abstract

Omphalocele is a congenital abdominal wall defect with a constant incidence in recent decades, sometimes representing a real burden for neonatal intensive care units due to prolonged hospitalization and the evolution to death. In our study, we aimed to detect the main risk factors of an unfavorable evolution in the case of omphalocele. Methods: Retrospective cohort study of all neonates with omphalocele treated in our tertiary pediatric hospital during the last three decades; from 158 patients, 139 patients were eligible for the study. We tried to determine the risk of death using logistic regression model. Results: If the neonate develops sepsis, then there is an increased risk (13.03 times) of evolution to death. Similarly, the risk of death is 10.82 times higher in the case of developing acute renal failure, 6.28 times higher in the case of associated abnormalities, 5.54 in the case of developing hemorrhagic disease, and 3.78 in the case of conservative treatment (applied for giant omphalocele or severe chromosomal abnormalities). Prematurity increases by 3.62 times the risk of death. All six independent variables contributed 61.0% to the risk of death. The area under the ROC curve is 0.91, meaning that the diagnostic accuracy of our logistic regression model is very good for predicting the contribution of the six independent variables to the risk of death. Conclusion: Although in the past 30 years we witnessed several improvements in the antenatal diagnosis and management of omphalocele, survival rate remained constant, 47.5% overall. Much effort is still needed to eliminate the risk factors for death in this condition. Full article

(This article belongs to the Special Issue New Challenges in Pediatric Surgery)

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13 pages, 4081 KiB

Open AccessCase Report

Subcapsular Liver Hematoma—A Life-Threatening Condition in Preterm Neonates—A Case Series and Systematic Review of the Literature

by Paraskevi Liakou, Anastasia Batsiou, Aikaterini Konstantinidi, Martha Theodoraki, Paschalia Taliaka Kopanou, Evangelia-Filothei Tavoulari, Andreas G. Tsantes, Daniele Piovani, Stefanos Bonovas, Argirios E. Tsantes, Nicoletta Iacovidou and Rozeta Sokou

J. Clin. Med. 2022, 11(19), 5684; https://doi.org/10.3390/jcm11195684 - 26 Sep 2022

Cited by 1 | Viewed by 1964

Abstract

The subcapsular hematoma (SLH) of the liver is a rare finding in living infants. The clinical presentation of rupture is non-specific, with the signs of hypovolemic shock dominating. The causes are several, with prematurity, trauma and sepsis playing a leading role in the creation of an SHL. Umbilical vein catheterization and an increased bleeding tendency have also been associated with this usually fatal diagnosis. Abdominal ultrasonography, among other imaging methods, comprises the gold standard examination for early diagnosis. It should be differentiated from other possible causes of shock, such as sepsis and intraventricular hemorrhage, which have similar clinical presentation. We report a case series of three very low birth weight preterms (VLBW), with an SHL, during the first days of life, one of which survived from this usually catastrophic condition. A comprehensive review of the literature regarding this clinical entity was also conducted. A high index of suspicion is essential for early identification of such a case, with conservative or surgical treatment being the way to go. Full article

(This article belongs to the Special Issue New Challenges in Pediatric Surgery)

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