Fetal cystoscopy (FC) and vesicoamniotic shunting (VAS) in lower urinary tract obstruction (LUTO): a meta-analysis of long-term outcome and current technical limitations.

Purpose: To compare obstetrical, survival, and nephro-urological outcomes of fetuses diagnosed with lower urinary tract obstruction (LUTO) undergoing antenatal procedures by vesicoamniotic shunting (VAS) or fetal cystoscopy (FC).

Methods: This study was a literature search using MEDLINE, Scopus, Embase, and Cochrane reference lists. All studies reporting VAS and FC's effectiveness, complications, and technical issues in the prenatal treatment of LUTO were selected for a single-proportion meta-analysis.

Comparison of Three Different Staging Systems Capable of Predicting the Severity of Congenital Lower Urinary Tract Obstruction (LUTO) and Its Prognosis.

Lower urinary tract obstruction (LUTO) is a rare but severe fetal condition associated with significant morbidity and long-term renal risk. Several prenatal staging systems have been proposed to guide management and predict outcomes, yet their comparative prognostic value remains uncertain. This review provides a structured evaluation of three staging systems currently used in clinical practice: those proposed by Ruano, Fontanella, and Nassr.

Delayed diagnosis of isolated congenital H-type tracheoesophageal fistula: a case report of surgical repair supported by TachoSil as an adjunct in chronically inflamed tissues.

Background: H-type tracheoesophageal fistulas (TEFs) are rare congenital malformations characterized by an abnormal connection between the trachea and esophagus in the absence of esophageal atresia. These lesions may remain undiagnosed for years due to subtle and non-specific symptoms, often resulting in chronic pulmonary complications. Delayed diagnosis can contribute to the development of long-standing inflammation and fibrosis, which significantly complicates surgical intervention.

Endoscopic Sleeve Gastroplasty: a Proposal for a Minimal Invasive Endoscopic Approach to Adolescent Obesity.

Adolescent obesity is a growing global health concern, often refractory to conventional interventions. While bariatric surgery remains the most effective treatment, its invasiveness and long-term implications limit its use in pediatric patients. Endoscopic sleeve gastroplasty (ESG) has recently emerged as a minimally invasive alternative.

Advancing Neuroblastoma Surgery through the Clinical Integration of Virtual Reality and Indocyanine Green Fluorescence-Guided Imaging: A Case Report.

Background: Neuroblastoma, the most common extracranial solid tumor in children, requires meticulous surgical interventions due to its complex anatomical location and proximity to vital structures. Emerging technologies, such as virtual reality (VR) and indocyanine green (ICG) fluorescence-guided imaging, offer promising solutions to enhance surgical precision and outcomes. Despite their potential, their use in pediatric oncology remains underexplored.

Ureteral clipping for managing persistent urinary dribbling caused by ectopic ureters associated with non-functioning renal moieties in girls with complex duplex kidneys: a narrative review of the literature.

Background And Objective: Persistent urinary dribbling in girls with duplex renal systems and ectopic ureters originating from poorly functioning renal moieties represents a complex clinical problem in pediatric urology. The incontinence associated with these anomalies is socially distressing and often refractory to conservative management. Traditional surgical options, including upper pole heminephrectomy or ureteroureterostomy, are effective but may be associated with significant operative morbidity, particularly when renal function is negligible and surgical access is challenging.

Metabolic and Hormonal Changes in Pediatric Burn Patients: Mechanisms, Evidence, and Care Strategies.

Background: Burn injuries constitute a significant global health challenge, especially in pediatric populations, where they are a leading cause of morbidity and mortality. Pediatric burns require particular attention due to their unique pathophysiology, long-term consequences on growth and development, and psychological impacts.

Methods: We propose a comprehensive review of recent advancements in understanding the key aspects of hormonal and metabolic changes in burned children, aiming to guide therapeutic interventions, improve outcomes, and reduce the global burden of these injuries.

Virtual Reality for Preoperative Planning and Education in Pediatric Surgery: Preliminary Results for the Treatment of Congenital Malformations and Tumors.

Purpose: Virtual reality (VR) has emerged as a valuable tool in surgical planning, offering detailed anatomical spatial orientation and three-dimensional (3D) navigation. This study explores using virtual reality head-mounted display (VR-HMD) technology in preoperative planning for pediatric surgery, aiming to improve outcomes in treating congenital malformations and tumors while advancing surgical education.

Methods: A retrospective analysis was performed on pediatric patients diagnosed with congenital malformations and tumors who received treatment between 2021 and 2024 at the "V.

EGFR-KDD Myofibroblastic Neoplasm or Congenital Peribronchial Myofibroblastic Tumor (CPMT)? Report of a Congenital Myofibroblastic Neoplasm With Unusual Histologic Features.

EGFR-kinase-domain duplication (KDD) has been reported in Infantile fibrosarcoma-like myofibroblastic tumors and cellular mesoblastic nephroma. We report a pulmonary neoplasm with EGFR-(KDD) and infantile fibrosarcoma-like histologic features in a female infant with an unusual clinical and histologic evolution, characterized by persistent disease with morphologic features of Congenital Peribronchial Myofibroblastic Tumor (CPMT) after chemotherapy and targeted therapy. The CPMT morphology with EGFR-KDD in the post-therapy specimen might be an evolution induced by the treatment, which suggests the hypothesis that CPMT is part of the morphologic spectrum of infantile fibrosarcoma/cellular mesoblastic nephroma.

Non-operative management of uncomplicated appendicitis in children, why not? A meta-analysis of randomized controlled trials.

Background: This study aims to provide a meta-analysis of randomized controlled trials (RCTs) comparing non-operative management (NOM) and operative management (OM) in a pediatric population with uncomplicated acute appendicitis.

Methods: A systematic literature review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and Meta-analyses of Observational Studies in Epidemiology (MOOSE) guidelines. A comprehensive search was conducted in MEDLINE, Embase, and CENTRAL from inception to June 2024.

Artificial Intelligence in Fetal Growth Restriction Management: A Narrative Review.

This narrative review examines the integration of Artificial Intelligence (AI) in prenatal care, particularly in managing pregnancies complicated by Fetal Growth Restriction (FGR). AI provides a transformative approach to diagnosing and monitoring FGR by leveraging advanced machine-learning algorithms and extensive data analysis. Automated fetal biometry using AI has demonstrated significant precision in identifying fetal structures, while predictive models analyzing Doppler indices and maternal characteristics improve the reliability of adverse outcome predictions.

Indications and Outcomes of Fetal Cystoscopy for Lower Urinary Tract Obstruction: A Comprehensive Review.

Fetal lower urinary tract obstruction (LUTO) encompasses a spectrum of rare congenital anomalies affecting the fetal urinary system, leading to significant morbidity and mortality. This condition, arising from various anatomical anomalies such as posterior urethral valves (PUV), urethral atresia, and cloacal malformations, disrupts normal urine flow, resulting in secondary complications such as pulmonary hypoplasia and renal impairment. Current management strategies, including fetal vesicoamniotic shunting (VAS) and fetal cystoscopy, aim to alleviate obstruction and mitigate associated risks.

Efficacy of core biopsies for diagnosing inflammatory myofibroblastic tumors in pediatric patients: case series from a single tertiary referral center.

Background: Inflammatory myofibroblastic tumors (IMTs) are rare, often non-metastasizing neoplasms characterized by fibro/myofibroblastic spindle cells with varying infiltrates of plasma cells, lymphocytes, and/or eosinophils. Despite their generally indolent nature, IMTs can exhibit locally aggressive behavior and a significant tendency for local recurrence, making complete surgical resection the standard treatment approach. Accurate diagnosis can be challenging due to the overlap in imaging features with more aggressive tumors, necessitating preoperative biopsies to enable differential diagnosis and guide treatment decisions.

A retrospective analysis of alimentary tract duplications in pediatric patients: a 14-year single-center experience.

Purpose: Alimentary tract duplications (ATDs) are rare congenital lesions often associated with anomalies such as spinal, urinary and GI tract malformations. The purpose of this study was to report the experience of a single center with ATDs in children, focusing on the natural history, associated malformations, and their impact on patient management.

Methods: We performed a retrospective analysis over 14 years, collecting prenatal, clinical, surgical, and follow-up data.

The impact of hormones on lung development and function: an overlooked aspect to consider from early childhood.

The impact of hormones on the respiratory system constitutes a multifaceted and intricate facet of human biology. We propose a comprehensive review of recent advancements in understanding the interactions between hormones and pulmonary development and function, focusing on pediatric populations. We explore how hormones can influence ventilation, perfusion, and pulmonary function, from regulating airway muscle tone to modulating the inflammatory response.

Lung ultrasound assessment of atelectasis following different anesthesia induction techniques in pediatric patients: a propensity score-matched, observational study.

Introduction: Atelectasis is a well-documented complication in pediatric patients undergoing general anesthesia. Its incidence varies significantly based on surgical procedures and anesthesia techniques. Inhalation induction, commonly used to avoid the discomfort of venipuncture, is suspected to cause higher rates of respiratory complications, including atelectasis, compared to intravenous induction.

Virtual Reality Head-Mounted Display (HMD) and Preoperative Patient-Specific Simulation: Impact on Decision-Making in Pediatric Urology: Preliminary Data.

Aim Of The Study: To assess how virtual reality (VR) patient-specific simulations can support decision-making processes and improve care in pediatric urology, ultimately improving patient outcomes.

Patients And Methods: Children diagnosed with urological conditions necessitating complex procedures were retrospectively reviewed and enrolled in the study. Patient-specific VR simulations were developed with medical imaging specialists and VR technology experts.

Case Report: Chronic pancreatitis in children as the cumulative effect of bilio-pancreatic abnormalities and genetic mutations.

Pancreatitis, in general, is a high-morbidity condition. Genetic conditions and anatomic variants are sometimes seen, especially in children, where biliary etiologies and alcohol are less common than in adults. The decision to intervene, the combined operative-endoscopic strategy, and the timing pose unique challenges.

Efficacy of Three Different Injection Techniques for the Endoscopic Treatment of Vesicoureteral Reflux (VUR) in Children: A Review of 10 Years of Experience.

Aim: To review our 10 years of experience with the endoscopic treatment of vesicoureteral reflux (VUR) in children, emphasizing the long-term efficacy of the "combined STING-HIT" technique.

Materials And Methods: A retrospective study was performed including all children with symptomatic VUR undergoing the cystoscopic injection of bulking agents from January 2013 to December 2022 in our pediatric tertiary referral center. Three different endoscopic techniques were adopted: the "combined STING-HIT" technique, the STING technique, and the HIT technique.

Leveraging User-Friendly Mobile Medical Devices to Facilitate Early Hospital Discharges in a Pediatric Setting: A Randomized Trial Study Protocol.

Background: Mobile technology is increasingly prevalent in healthcare, serving various purposes, including remote health monitoring and patient self-management, which could prove beneficial to early hospital discharges.

Aims: This study investigates the transitional care program experience facilitating early discharges in a pediatric setting through the use of an easy-to-use mobile medical device (TytoCare™, TytoCare Ltd., Natanya, Israel).

Minimal Access in Pediatric Surgery: An Overview on Progress towards Dedicated Instrument Developments and Anesthesiologic Advances to Enhance Safe Completion of Procedures.

Surgical techniques are evolving in Pediatric Surgery, especially in the area of minimal access surgery (MAS) where indications for applications are expanding. Miniaturization of instruments, using natural orifices, single incisions, or remotely controlled robot-assisted procedures, promises to increase the benefits of MAS procedures in pediatrics. Many pediatric pathologies are rare, and specialized surgical and anesthesiologic instruments are necessary to manage them, defined as "orphan devices", for which development and dissemination on the market are slowed down or sometimes hindered by regulatory standards and limiting financial conflicts of interest.

Duodenal stenosis, an unusual presentation of eosinophilic gastroenteritis: a case report.

Eosinophilic gastrointestinal diseases (EGIDs) are rare, chronic inflammatory disorders characterized by eosinophilic infiltration of the gastrointestinal tract. Symptoms and clinical presentations vary depending on the site and layer of the gastrointestinal wall infiltrated by eosinophils. Gastrointestinal obstruction is a serious, though uncommon, presentation.