Adequate intestinal perfusion is essential in pediatric colorectal surgery. Indocyanine green fluorescence angiography (ICG-FA) is increasingly used to assess perfusion, yet its impact on postoperative outcomes remains unclear. We evaluated the association between ICG-FA use and clinical outcomes in children undergoing colorectal procedures. We performed a retrospective cohort study of pediatric patients undergoing posterior sagittal anorectoplasty (PSARP) for anorectal malformations, pull-through for Hirschsprung disease, or cloacal repair between 2016 and 2025. Primary outcomes included anastomotic disruption, stricture, and reoperation. Among 184 patients, 37 (20.1
Extremely low birth weight infants (ELBWIs) and very low birth weight infants (VLBWIs) are at high risk of developing intestinal perforation in the early postnatal period, and improvements in diagnosis and management are required. Since the optimal first surgical intervention may differ between necrotizing enterocolitis (NEC) and spontaneous intestinal perforation (SIP), reliable preoperative differentiation is needed. This study aimed to identify factors associated with survival and determine predictors useful for differentiating NEC from SIP. We retrospectively reviewed ELBWIs and VLBWIs who underwent surgical treatment for intestinal perforations at our institution between 2005 and 2025. Forty patients were included in the study. The underlying diseases differed significantly between survivors and non-survivors. Non-survivors had lower platelet counts and higher C-reactive protein levels during perforation. NEC patients were more likely than SIP patients to receive enteral feeding (> 0.5 mL) before perforation and had lower platelet counts at the time of perforation. Underlying diseases and severity of inflammation are associated with mortality. Tolerated enteral feeding volume and platelet count may aid in preoperative differentiation between NEC and SIP and in surgical decision-making.
Skin-level anal stricture following posterior sagittal anorectoplasty and congenital short-segment anal stenosis are known causes of obstructive defecation in children. This study evaluated the feasibility and preliminary outcomes of Heineke–Mikulicz anoplasty for these superficial stenoses. This retrospective study reviewed 21 pediatric patients who underwent HMA between January 2021 and December 2025 at a tertiary children’s hospital. Patients included those with either postoperative skin-level strictures or congenital short-segment anal stenosis. Demographic, clinical, surgical, and follow-up data were analyzed. The cohort included 15 males and 6 females, with a mean age of 13.3 ± 6.2 months at the time of surgery. Fourteen patients had postoperative strictures, and seven had congenital stenosis. The average increase in anal caliber was from Hegar size 8.9 ± 1.0 to 14.7 ± 0.8. No intraoperative or postoperative complications occurred, and none required repeat HMA. All patients with preoperative constipation showed functional improvement. Sixteen patients were discharged within 24 h postoperatively, and five stayed for 6 days due to concurrent colostomy closure. HMA was technically feasible and associated with immediate anal enlargement and encouraging preliminary clinical outcomes in selected children with superficial anal stenoses. No complications or repeat HMA were recorded during available follow-up. Long-term functional outcomes, late recurrence, and comparative effectiveness remain uncertain.
Surgery remains the mainstay of treatment for hepatic cystic echinococcosis (CE) in children, but the laparoscopic approach is incompletely standardized, particularly for giant, multisegment, and posterior-superior cysts. We report the evolution of surgical management following the establishment of a dedicated hepatopancreatobiliary minimally invasive program and compare a standardized laparoscopic technique with conventional open surgery. This retrospective single-center comparative cohort study included pediatric patients who underwent surgery for hepatic CE between January 2020 and January 2025, grouped by surgical approach (open vs. laparoscopic). Perioperative outcomes, complications (Clavien–Dindo), and recurrence were analyzed. Independent predictors of recurrence were assessed by multivariable Firth logistic regression. Given the differing follow-up duration, recurrence was additionally expressed per 100 patient-years and evaluated with a 12-month landmark analysis and Kaplan–Meier/log-rank testing. Of 63 children, 39 (61.9
To evaluate parental self-efficacy, parenting attitudes, and maternal anxiety and depression in mothers of preschool children with and without functional constipation (FC) and to examine their associations with FC. This cross-sectional study included 145 preschool children (72 with FC and 73 controls) and their mothers. FC was diagnosed according to Rome IV criteria. Parental self-efficacy, parenting attitudes, and maternal anxiety and depression were assessed using the BPSE-R, Parenting Attitude Scale, and Hospital Anxiety and Depression Scale, respectively. Multivariable logistic regression was performed to identify factors independently associated with FC. Mothers of children with FC had lower child-development teaching and total BPSE-R scores than controls (p = 0.002 and p = 0.019, respectively). Parenting attitudes and mean anxiety and depression scores did not differ between groups. Higher BPSE-R total scores were independently associated with lower odds of FC (aOR = 0.952, 95
