https://www.thieme-connect.com/products/ejournals/journal/10.1055/s-00024358

European Journal of Pediatric Surgery Reports, Bandipora (2025)

01/08/2025

🍼🩺 New Study Alert
(NEC) remains a leading threat to very infants — but can we better predict its most devastating form?

In our multicenter study of 401 infants with NEC, we identified key risk factors for 30-day mortality and NEC totalis (NEC-T):
🔹 Male s*x
🔹 Low birthweight
🔹 Portal venous gas
🔹 support
🔹 Shorter time from diagnosis to surgery

Understanding these predictors may help improve early risk stratification and guide parental counseling before surgery.

🧠

12/07/2025

🟢💡 Shedding Light on Tiny Bile Ducts!

Can fluorescence improve safety in pediatric hepatobiliary surgery? This prospective study explores the use of in children with , , and .

🔬 Key Takeaways:
✅ ICG-guided surgery was safe and feasible in all 17 patients
✅ Enabled real-time visualization of key structures
✅ Aided precise dissection during complex procedures
❌ No ICG-related side effects reported

👶 This early evidence suggests ICG-Guided Surgery may improve surgical navigation and reduce risks in pediatric liver and bile duct surgeries. More research is needed—but the future is looking bright (literally)! 💡

Read the whole article here: https://www.thieme-connect.com/products/ejournals/abstract/10.1055/a-2509-4463 Deutsche Gesellschaft Für Kinderchirurgie EUPSA European Paediatric Surgeonss Association

04/07/2025

🔬 T-PEG vs. P-PEG in Pediatric Patients: Which is Safer?

In this retrospective study of 146 children undergoing placement, we compared outcomes between the traditional pull-technique PEG (P-PEG) and the increasingly used T-fastener PEG (T-PEG) in .

📌 Key Findings:

Similar overall rates (P-PEG 24.2% vs. T-PEG 21.0%)
P-PEG required for button change in 97% vs. only 2.6% in T-PEG
Early tube was more common with P-PEG (7.2% vs. 1.4%)
Serious complications needing urgent or were significantly higher in the P-PEG group (18.6% vs. 6.6%)
⚠️ Conclusion: T-PEG may be a safer, less invasive alternative with fewer serious complications and reduced need for sedation in .

01/07/2025

🫁 GERD and Lung Transplantation in Children: Time to Rethink Post-Op Protocols?

Garrisi et al. present compelling data on the prevalence and impact of gastroesophageal reflux disease (GERD) after pediatric lung transplantation (LuTx) – and the potential of surgical intervention to protect graft function.

🔍 Key findings:

1/3 of pediatric LuTx recipients developed GERD symptoms

GERD was associated with lung function decline, even in patients on PPIs

Fundoplication was safe and led to symptom remission and lung function improvement in all cases

The authors advocate for a standardized diagnostic workup post-transplant, including pH impedance monitoring

📈 Take-home message: GERD is common and underdiagnosed after pediatric LuTx. PPIs may not be enough. Fundoplication should be considered early to preserve graft function.

📝 Read the full article:
Garrisi EC, Müller C, Ure B, et al. Eur J Pediatr Surg. 2025;35(1):52-59.
https://doi.org/10.1055/s-0044-1791801
https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0044-1791801

27/06/2025

🍼 This surgical approach in high shows promising outcomes!

A study comparing jejunal turnover and bowel plication (JTBP) with standard techniques in high jejunal atresia reveals:
✅ Streamlined duodenojejunal anatomy
✅ Faster return to oral feeding
✅ Reduced complications

Over 75 neonates studied (2012–2021) — JTBP significantly improved recovery by optimizing bowel morphology and fluid dynamics.

📖 Read more in the full study: https://www.thieme-connect.com/products/ejournals/abstract/10.1055/a-2155-7781

24/06/2025

📢 **Can Electrical Stimulation Improve Bowel Function?**
🔬 *New Experimental Insights from a Porcine Model*

Constipation can severely affect children’s quality of life. Interferential Current Stimulation (IFC) is a non-invasive therapy under investigation—but how exactly does it work?

👨‍⚕️ What did the study do?
Researchers tested IFC on *isolated perfused porcine rectums* to assess its effects on re**al motility, comparing different frequencies and blocking neuronal activity to identify the mechanism.

💡 What did they find?
✅ Low-frequency IFC (5–25 Hz) increased re**al motility by 30%
✅ The effect lasted at least 30 minutes—suggesting enteric ganglia modulation
✅ Higher frequencies (80–150 Hz) were less effective
✅ Effects were abolished by nerve blockers (TTX, HXN), confirming a neuronal mechanism

📉 Limitations
⚠️ Ex vivo animal model
⚠️ Short observation period
⚠️ No central nervous system involvement

🎯 **Takeaway**
IFC—especially low-frequency settings—may enhance re**al motor activity via enteric nervous system modulation. A promising lead for pediatric constipation treatment? Possibly. But we need human trials to confirm.

👉 *Study by Richard Martel, Michael Boettcher et al.*
PMID:** 39587047 | DOI:[10.1055/a-2482-5997](https://doi.org/10.1055/a-2482-5997)
https://www.thieme-connect.com/products/ejournals/abstract/10.1055/a-2482-5997

💬 What do you think? Could this pave the way for better non-invasive treatments in pediatric GI care? Let's discuss below 👇

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21/06/2025

🧵 Unexpected Finding in a Case of Long-Gap in a Neonate.

In a preterm infant (31+1 weeks, 1,470 g) with gross type C esophageal atresia, a long gap made primary impossible. After fistula release via thoracotomy, traction sutures were used to approximate the esophageal ends. A gastrostomy was placed for feeding.

Surprisingly, 6 weeks later, a spontaneous suture fistula developed—allowing via NG tube. After six dilations, full enteral feeding was established by 6 months of age.

➡️ Our case supports the emerging concept of deliberately inducing a suture fistula when a primary anastomosis isn’t feasible.

Read the full here: https://www.thieme-connect.com/products/ejournals/html/10.1055/a-2227-6252?issue=10.1055/s-015-61841

13/06/2025

🍼 Post-NEC Strictures are a Complication After Conservative Treatment

(NEC) is one of the most serious causes of acute abdomen in . When possible, conservative management avoids early surgery—but nearly 1 in 5 of these infants develop post-NEC (PNS) requiring delayed surgery.

📊 In a 10+ year retrospective study:
🔹 57.5% of NEC cases were initially treated conservatively
🔹 19% of these developed PNS
🔹 Strictures were typically diagnosed ~5 weeks after NEC
🔹 Most located in the colon (cecum, ascending, transverse)
🔹 25% of PNS cases were asymptomatic
🔹 All treated with primary resection and anastomosis

✅ Key takeaway: Delayed surgery—after the acute NEC phase—allows for safer procedures and better outcomes.

📌 Routine post-NEC follow-up is essential to detect PNS early, even in asymptomatic infants.

Read the full article here: https://www.thieme-connect.com/products/ejournals/abstract/10.1055/a-2426-9723

07/06/2025

🚸 New in 🏃‍♀️🏥

Children and adolescents with isolated (EA) and associated were associated with reduced , especially in females and teenagers.
💡 This multicenter study compared MVPA (moderate-to-vigorous physical activity) across
✔️ EA patients (w/o CHD)

📉 Not linked to Gross type, current symptoms, or surgical approaches.

🗣️ Take-home message: Promote physical activity in EA

🔗 Read more in the European Journal of Pediatric Surgery: https://www.thieme-connect.com/products/ejournals/abstract/10.1055/a-2420-0202
EUPSA European Paediatric Surgeonss Association

26/05/2025

🔬 Rethinking Fistula Preservation in ARM Surgery?

New data from a prospective study published in the European Journal of Pediatric Surgery (Feb 2025) questions the histopathological suitability of using fistulous tissue in neoanus reconstruction.

📌 Key findings in 24 male patients with recto-urethral fistula:

❌ No internal sphincter detected

🧬 Ganglion cells adequate in only 25%

🧱 Submucosal fibrosis in 100% of cases

⚠️ Urothelial metaplasia in 42%

🧠 The authors conclude: Fistula tissue lacks the structural and functional features of normal a**l ca**l tissue and may compromise bowel function and long-term outcomes.

💡 Time to revisit surgical strategies?

📖 Read the study:
Agarwal P, Roy S, Pandey A, Tyagi N, Pant N, Kumar P, Rawat J. Rethinking Fistula Preservation in Anore**al Malformation Surgery: A Histopathological Perspective. Eur J Pediatr Surg. 2025 Feb;35(1):15-21.
Free Access:https://www.thieme-connect.com/products/ejournals/pdf/10.1055/a-2389-7550.pdf

**alMalformation **alSurgery

19/05/2025

🚨 Testicular torsion: same diagnosis, very different treatments.
A new survey in European Journal of Pediatric Surgery reveals just how unstandardized our approaches are across Europe. 🩺🧠

🔎 Key findings from 88 surgeons:

🧪 Only 38% routinely perform sonography

🌀 15% always try manual detorsion, 44% sometimes

✂️ 93% use scrotal approach — but pediatric surgeons prefer transscrotal, others go midline (p=0.002)

🧷 57% use three-point fixation, 42% use two

💀 52% remove necrotic te**is, 33% orchiectomy, 6% leave it in situ

🔬 54% take biopsy of borderline te**es

🧵 82% fix the contralateral side prophylactically

💊 Only 12% always give antibiotics post-op, 52% sometimes

🔁 Follow-up? Often done by pediatric surgeons/urologists, while others defer to pediatricians

💡Bottom line: Major differences exist — from diagnosis to follow-up.
Time to talk standardization. 🚦

Beher A, Moreno-Alfonso JC, Garnier H, Darici D, Salö MJ, Aubert O. A Survey of Preoperative, Perioperative, and Postoperative Management Practices for Testicular Torsion in Pediatric Patients among European Surgeons. Eur J Pediatr Surg. 2025 Feb;35(1):36-42.

📖 Full paper https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0044-1790244

16/05/2025

🦠 A rare and life-threatening complication of in a 15-year-old girl:
Simultaneous rupture of a hepatic into both the biliary tree and the pleural cavity.

🔍 Nonspecific symptoms:
Abdominal & chest pain, fever, ,

🧪 Diagnosis:
Ultrasound, CT, MRCP → hepatic cyst, biliary obstruction, pleural hydatidosis

🚫 failed to resolve jaundice
🔧 Definitive solution: complex open surgery with bile duct clearance, cholecystectomy, pleural resection & diaphragmatic repair
💊 Albendazole + antibiotics
✅ 2-year follow-up: no relapse

📌 This case highlights the importance of considering rare hepatothoracic hydatid disease in pediatric patients with unexplained biliary and respiratory symptoms.

read article here: https://www.thieme-connect.com/products/ejournals/abstract/10.1055/a-2590-5917

European Journal of Pediatric Surgery Reports

01/08/2025

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