EUROPEAN JOURNAL OF PEDIATRIC SURGERY欧洲小儿外科杂志
EUROPEAN JOURNAL OF PEDIATRIC SURGERY(英文缩写 EUR J PEDIATR SURG),ISSN 0939-7248,eISSN 1439-359X,中文译名:欧洲小儿外科杂志 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-10-01 至 2026-09-30，按本站收录文献的发表日期统计。
期刊介绍
历年影响因子趋势
| JCR 数据年份 | 影响因子 | JCR 分区 |
|---|---|---|
| 2021 | 1.794 | Q3 |
| 2022 | 1.800 | Q3 |
| 2023 | 1.500 | Q2 |
| 2024 | 1.400 | Q3 |
| 2025 | 1.800 | Q2 |
EUROPEAN JOURNAL OF PEDIATRIC SURGERY 最新收录文献
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1. Practice Variability in Anorectal Malformations Management Across Europe: a TEPS-EUPSA Survey with Analysis of Center Volume Effects.
PMID:期刊:日期:2026-09-22Objective To evaluate management strategies for anorectal malformations (ARM) across Europe and assess the impact of institutional case volume on clinical decision-making. Methods A cross-sectional online survey developed within the Trainees in European Paediatric Surgery (TEPS) and endorsed by the European Paediatric Surgeons' Association (EUPSA) Network Office was distributed among pediatric surgeons involved in ARM care. The questionnaire addressed diagnostic workup, surgical management, perioperative care and long-term follow-up. European responses were analyzed and compared by institutional case volume. Results A total of 94 responses from 21 countries were analyzed. Substantial variability was observed across all domains of care. Ultrasound-based screening and invertogram were widely used, whereas high-pressure distal colostography was variably applied. MRI and vaginoscopy were used more selectively. Primary neonatal repair in cases with the rectum located <1 cm from the perineal skin was commonly performed, and staged reconstruction was most frequently undertaken at 3-6 months. Non-divided stomas were more frequently used in high-volume centers (p = 0.002), with increasing center volume associated with higher odds of their use (OR 2.98, 95% CI 1.51 - 5.87, p = 0.002). Routine anal dilations were reported by 44.7% of respondents and were less common in high-volume centers (p = 0.005); increasing volume was associated with lower odds of routine dilation (OR 0.38, 95% CI 0.20 - 0.72, p = 0.003). Conclusion ARM management across Europe remains highly variable. Institutional case volume is associated with practice differences, particularly in stoma configuration and postoperative dilation strategies.
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2. Stress Exposure of Camera-Holders Versus Primary Surgeons During Laparoscopic Surgery: Best Evidence Analysis.
PMID:期刊:日期:2026-09-22To evaluate and compare stress exposure between camera-holders (CHs) and primary surgeons (PSs) during laparoscopic surgery across cognitive, physiological, ergonomic, fatigue-related and psychosocial domains. A best evidence review was conducted according to PRISMA guidelines. PubMed, Web of Science, Cochrane Library, Embase and Scopus were searched for studies published between January 2000 and December 2025. Eligible studies reported objective or subjective stress-related outcomes in CHs and/or PSs during laparoscopic surgery. Methodological quality was assessed using Joanna Briggs Institute critical appraisal tools. Owing to heterogeneity in study designs and outcome measures, findings were synthesized narratively. Seven heterogeneous studies met the inclusion criteria, with only one study specifically evaluating pediatric procedures. Available evidence suggested role-specific patterns of stress exposure. PSs generally reported higher subjective cognitive workload, whereas EEG-based findings suggested comparable cognitive engagement between PSs and CHs. CH-related ergonomic findings included greater trapezius activation, asymmetric loading, non-neutral posture and less favorable viewing angles. Musculoskeletal discomfort was reported in both roles, while one large cross-sectional study found greater intraoperative fatigue and psychosocial stress related to image control and negative verbal interactions among CHs. The single pediatric study identified less favorable viewing angles and greater procedural discomfort among CHs than PSs. Available evidence suggests that the CH role is an active and demanding component of laparoscopic surgery, with stressors that differ from those experienced by PSs. However, conclusions are limited by the small number of heterogeneous studies and the predominance of adult data. Pediatric evidence is particularly limited and currently relates mainly to ergonomic outcomes.
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3. Management Strategy is Not Predictive of Mortality after Blunt Aortic Injury in Children.
PMID:期刊:日期:2026-09-21To improve treatment algorithms for blunt aortic injury (BAI) in the endovascular era, we investigate predictors of mortality and compare outcomes by management strategy. The Trauma Quality Program national database was queried for BAI in patients ≤ 18 years from 2016 to 2022. Survivors, emergency department (ED) mortalities, and inpatient mortalities were compared. Predictors of inpatient mortality were identified via logistic regression. Outcomes were compared by management strategy (non-operative [NOM], endovascular [EM], vs. operative [OM]). Comparisons were performed via Kruskal-Wallis or chi-square tests. -Values < 0.05 were considered significant. A total of 359 patients were included. The median age was 16 [IQR 12, 18] years. Of the total patients 298 (83%) underwent NOM, 21 (5.8%) OM, and 40 (11%) EM. Overall mortality was 27% (14% ED, 13% inpatient). On multivariable analysis, management style (endovascular: OR 0.39 [0.1, 1.25], = 0.135, operative: OR 3.82 [0.76, 16.7], = 0.082 vs. NOM), age (OR 1.03 [0.93, 1.14], = 0.608), sex (OR 0.64 [0.27, 1.56], = 0.323), location of aortic injury (thoracic vs. abdominal, OR 1.38 [0.56, 3.45], = 0.491), and severity of aortic injury (OR 1.11 [0.45, 2.73], = 0.883) were not significant predictors of inpatient mortality. Rather, Injury Severity Score (ISS) (OR 1.06 [1.03, 1.11], = 0.001) and head injuries (OR 7.85 [2.92, 23.21], < 0.001) were significant predictors of mortality. While limited by lack of detailed injury grading in this database study, after adjustment for age, sex, injury severity, head injuries, location of aortic injury, and severity of aortic injury, management strategy (endovascular, operative, non-operative) was not a significant predictor of inpatient mortality after BAI in this analysis. ISS and severe head injuries were predictive of mortality in these cases.
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4. Hypothermic-Oxygenated Perfusion in Pediatric Liver Transplantation: Beyond Graft Preservation, Facilitating Safer Surgeries in a Donor-Limited Environment.
PMID:期刊:日期:2026-09-17Pediatric liver transplantation (PLT) increasingly faces a landscape of limited and suboptimal donor grafts, alongside a rising proportion of complex recipients. Hypothermic-oxygenated perfusion (HOPE) mitigates ischaemia-reperfusion injury and may support graft function in this context. To evaluate feasibility and outcomes of backbench HOPE in complex PLT, compared with a historical cohort of static cold storage (SCS). Prospective cohort of 22 PLT recipients who received a HOPE-perfused liver graft between September 2024 and December 2025, compared with a historical cohort of 32 PLT recipients transplanted after SCS. Variables: donor/recipient/graft characteristics, surgical complexity markers, postoperative complications, and survival outcomes. Recipients in both groups had a similar baseline profile, but the HOPE group showed a trend toward greater surgical complexity, with longer hepatectomy times (2.3 vs. 2.1 hours, = 0.002). Cold ischaemia time was shorter (5.8 [5.1-6.7] vs. 8 [6.8-9.1] hours; < 0.001). Median HOPE perfusion was 4.1 hours. Seventy-seven percent of the grafts were reduced/split on HOPE. Postoperative complications did not differ significantly between groups, and no biliary strictures occurred in the HOPE group compared with five in the SCS group. At 1 year, although patient survival was numerically lower in the HOPE group (77.3% vs. 90.6%, = 0.200), all deaths occurred with functioning graft; and death-censored graft survival (95.5% vs. 96.8%, = 0.880) was comparable. In a donor-limited environment with complex recipients, routine backbench HOPE showed graft outcomes and survival comparable to a historical SCS group. These findings suggest a potential role for HOPE beyond graft preservation, supporting surgical synchronization in complex PLT.
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5. Laparoscopic Repair of Primary Hiatal Hernia in Children: Systematic Review of Surgical Techniques and Outcomes.
PMID:期刊:日期:2026-09-15This systematic review analyzed laparoscopic repair of primary hiatal hernia (HH) in children, focusing on presentation, diagnosis, surgical techniques, and postoperative outcomes. Studies published between 2000 and 2025 on laparoscopic repair of primary pediatric HH were identified according to PRISMA guidelines (PROSPERO: CRD420261295203). Due to heterogeneity in study design and outcome reporting, a meta-analysis was not feasible. Data were summarized descriptively. Selected comparisons used Fisher's exact test and odds ratios (ORs) with 95% confidence intervals (CIs; < 0.05). Twenty-seven studies reporting 353 patients met the inclusion criteria. The evidence was of low certainty, consisting predominantly of case reports ( = 12) and case series ( = 10), with only five retrospective cohorts and no prospective studies. Estimated median age was 18.6 months (range 6 days to 16 years). Gastroesophageal reflux disease was the most common symptom. Laparoscopic repair was performed in all patients, with 1.4% conversion rate and one intraoperative complication. Recurrence occurred in 21/331 (6.3%). Patch-reinforced repair showed a non-significantly higher recurrence rate than primary repair (OR 2.63, 95% CI: 0.54-12.8; = 0.24). Esophageal stenosis was the most frequent postoperative complication ( = 40/331; 12.1%) and was more common after Nissen-Rossetti than Thal fundoplication (OR 2.63, 95% CI: 1.11-6.25; = 0.027), although heterogenous reporting and missing data limit this comparison. Laparoscopic repair of primary pediatric HH appears feasible, with low reported perioperative morbidity and acceptable recurrence rates, but evidence is low certainty. Fundoplication appears reasonable but the observed association of complete wraps with stenosis requires cautious interpretation. Current evidence does not support routine patch reinforcement.
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6. The Impact of Delayed Diagnosis on Outcomes in Hirschsprung Disease: A Comparative Analysis.
PMID:期刊:日期:2026-08-21Hirschsprung disease (HD) is a congenital disease characterized by a lack of neural innervation of the distal bowel. This causes fecal stasis, which results in a wide variety of non-specific fecal obstructive symptoms. Identification of patients with HD can, therefore, be challenging, causing a delayed diagnosis. This may lead to complications such as Hirschsprung-associated enterocolitis (HAEC) and bowel perforation. Current evidence regarding the short postoperative and long-term outcomes in patients with delayed diagnosis is inconclusive. Therefore, the aims of this study were to examine (1) short-term postoperative complications, (2) long-term occurrence of HAEC, (3) requirement of interventions, (4) functional outcomes, and (5) quality of life comparing patients diagnosed with HD before and after 6 months of age. We retrospectively analyzed patients with HD undergoing surgery at our center between 2000 and 2022. Each patient diagnosed after 6 months of age was matched to two controls diagnosed before 6 months of age, controlling for potential confounders such as sex and length of aganglionosis. Functional outcomes and quality of life were assessed using the Hirschsprung/Anorectal Malformation Quality of Life Questionnaire and relevant items from the Groningen Defecation and Continence Scale. Outcomes also included the occurrence of HAEC and the need for interventions (laxatives, rectal irrigations, botulinum toxin injections). Statistical analyses included independent -tests, Mann-Whitney U tests, chi-square tests, or Fisher's exact tests as appropriate. The follow-up duration was from the time of operation until follow-up. Seventeen patients older than 6 months at the time of diagnosis were matched with 34 control patients. No significant differences between groups were found in the number of short-term postoperative complications ( = 0.166) and the long-term occurrence of HAEC ( = 0.569), laxative use ( = 0.771), rectal irrigation use ( = 0.156), number of botulinum toxin injections ( = 0.715), functional outcomes ( = 0.412), and quality of life ( = 0.783). Our findings suggest that delayed diagnosis does not impact short-term postoperative complications and the long-term occurrence of HAEC, requirement of intervention, functional outcomes, and quality of life between patients with delayed diagnosis of HD and patients diagnosed early in life. Future work should focus on identifying risk factors for poor outcomes, standardizing diagnostic criteria, and refining surgical strategies to improve care for all patients with HD.
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7. Interpretable Deep Learning Applied to Fluorescence Confocal Microscopy for Intraoperative Tissue Assessment in Pediatric Surgical Oncology.
PMID:期刊:日期:2026-08-21In pediatric surgical oncology, intraoperative tissue assessment is limited by small specimen size and the absence of real-time histopathology. Ex vivo fluorescence confocal microscopy (FCM) provides rapid histology like imaging of fresh tissue, yet interpretation relies on expert visual assessment. We tested the hypothesis that deep learning applied directly to ex vivo FCM images enables automated, accurate, and spatially interpretable tumor detection in pediatric specimens. FCM images were prospectively acquired during routine clinical activity from 42 children, yielding 141 surgical and biopsy specimens. For this analysis, anonymized mosaics were retrospectively collected and manually annotated as malignant, benign, or healthy tissue by expert, then decomposed into 256 × 256 pixel tiles at 0.5 µm per pixel. A convolutional neural network was trained, validated, and tested on stratified datasets. Performance metrics were calculated at the tile level using accuracy, sensitivity, specificity, and F1 score. Tile level activation heatmaps were generated to localize regions influencing predictions. Overall, 243,659 tiles were analyzed, including 124,348 malignant, 48,441 benign, and 70,870 healthy tissue tiles. The independent testing dataset comprised 84,751 tiles. Malignant tissue was identified with 91.35% accuracy, 95.88% sensitivity, 86.28% specificity, and an F1 score of 92.13%. Healthy tissue achieved 94.41% accuracy and 95.58% specificity. Benign tissue showed 90.14% accuracy and 91.78% specificity. Heatmaps consistently highlighted at a cellular level the architectural distortion in malignant tiles. This work introduces the first pediatric integration of deep learning with ex vivo FCM, demonstrating the feasibility of rapid and interpretable tissue classification and providing the basis for future prospective intraoperative validation.
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8. Laparoscopic-Assisted Swenson-Like versus Soave Pull-Through in Hirschsprung Disease: A Randomized Comparative Study of Functional Outcomes.
PMID:期刊:日期:2026-07-27In Hirschsprung disease (HD), the laparoscopic-assisted Yancey-Soave (LAYaSo) procedure retains an aganglionic muscular cuff, which may cause obstructive symptoms. The laparoscopic-assisted Swenson-like (LASwL) technique completely excises the aganglionic segment, potentially improving peristalsis. However, randomized evidence comparing these techniques with combined functional and quality-of-life outcomes is lacking. This study aimed to compare surgical, functional, and quality-of-life outcomes between LASwL and LAYaSo pull-through procedures in a randomized controlled trial. This prospective, single-center, randomized study included 110 children with HD at Al-Azhar University Hospitals (2020-2025). The inclusion criterion was biopsy-confirmed rectosigmoid HD. Exclusion criteria were ultrashort or total colonic aganglionosis, prior pull-through procedures, and major congenital anomalies. Patients were randomized to LASwL ( = 55) or LAYaSo ( = 55) using a computer-generated sequence and sequentially numbered, opaque, sealed envelopes (SNOSE). The primary outcome was the Rintala Bowel Function Score (BFS) at 2 years. Secondary outcomes included BFS at 1 year (exploratory), operative time, blood loss, hospital stay, Hirschsprung-associated enterocolitis (HAEC), and health-related quality of life (Pediatric Quality of Life Inventory [PedsQL] 4.0). All procedures were completed laparoscopically without conversion. Mean total operative time was shorter for LASwL (145.5 ± 36.8 vs. 160.3 ± 28.6 minutes, = 0.081), with a significantly shorter transanal phase ( = 0.019). At the primary endpoint of 2 years, BFS was significantly higher in the LASwL group (18.20 ± 1.80 vs. 17.10 ± 2.30, = 0.037). HAEC rates were 14.5% versus 20.0% ( = 0.61), all mild/moderate. At 2 years, total PedsQL scores were comparable (88.6 ± 7.5 vs. 86.2 ± 8.4, = 0.12), though social functioning was numerically higher in LASwL ( = 0.055). Three LAYaSo patients required redo surgery for cuff-related stricture. Both techniques are safe and effective. LASwL offers a modest but statistically significant advantage in bowel function at intermediate follow-up (1.1 points on the Rintala score) without a corresponding improvement in overall quality of life. LAYaSo was associated with a 5.5% risk of cuff-related stricture requiring reoperation. The limited clinical magnitude of the benefit supports individualized technique selection based on surgeon experience and patient factors. Single-center design and the need for longer follow-up are limitations of this study.
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9. Population-Based Analysis of Prevalence, Associated Anomalies, and Mortality in Anorectal Malformations in Finland (2004-2017).
PMID:期刊:日期:2026-07-15Anorectal malformations (ARMs) represent the most common form of congenital gastrointestinal malformations. ARMs range from mild anal stenosis to complex abnormalities involving the rectum, genitals, and urinary tract. The aim of this study is to investigate prevalence, mortality, and associated anomalies of ARMs in the Finnish population. This study offers comprehensive updated population-based estimates on stillbirths and terminations of pregnancy due to fetal anomalies (TOPFA). The data were obtained on all live births, TOPFA, and stillbirths from registers maintained by the Finnish Institute for Health and Welfare and Statistics Finland. All individuals diagnosed with ARM between January 1, 2004 and December 31, 2017, were included in the study. This population-based study identified 646 ARM cases, including 545 (84.4%) live births, 8 (1.2%) stillbirths, and 93 (14.4%) TOPFA. The total prevalence for ARM in Finland was 8.00 per 10,000 births, without significant variation in prevalence between 2004 and 2017. Neonatal mortality was 4.6% ( = 25), and infant mortality was 6.0% ( = 33). Neonatal and infant mortality were both associated with very low birth weight ( = 0.0001), prematurity ( = 0.0001), congenital heart defects ( = 0.02 and < 0.001), and VACTERL (vertebral, anal, cardiac, tracheoesophageal, renal, limb; = 00002 and < 0.001, respectively). Postnatal survival rate for isolated ARM was 100%. Most commonly associated anomalies were urinary tract, heart, and limb malformations. The overall prevalence of ARMs has remained stable in the Finnish population. Neonatal and infant mortality remains a significant concern, particularly among patients with severe associated anomalies, highlighting the importance of systematic screening for co-occurring malformations.
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10. The Minimally Invasive Pilonidal Protocol: Low Short-Term Recurrence after Completion in a Single-Center Retrospective Cohort Study.
PMID:期刊:日期:2026-07-15The optimal treatment of pilonidal disease remains uncertain, with recurrence rates up to 30% after resection or sinusectomy. This retrospective single-center cohort study evaluates the recurrence rate after graduation from our Pilonidal Care Clinic's (PCC) Minimally Invasive Pilonidal Protocol (MIPP). We conducted a retrospective review of a single center's prospectively collected demographic and treatment data for patients with pilonidal disease who completed the MIPP between January 2021 and December 2024. Follow-up appointments were scheduled every 6 to 8 weeks, continuing until disease resolution and completion of laser ablation sessions. The analysis focused on patients who graduated. Patients still receiving care at study completion and those lost to follow-up were excluded. Recurrence was defined as any PCC visit after graduation with pilonidal disease on examination. Graduated patients who had not returned to the PCC were contacted via text message and queried about new symptoms since graduation. Of the initial 884 patients, 8 patients presented for a second opinion only, 353 were lost to follow-up, and 226 were still receiving care, leaving the study group of 297 patients who completed the protocol and graduated. They graduated after an average of 6.4 PCC visits, two pit-picking procedures, and 5.3 laser epilations. The average disease duration before treatment was 11.4 months. The mean treatment duration was 12.3 months (standard deviation: 8), with a median of 10 months (interquartile range: 6-17). The follow-up period for these patients ranged from 4 to 55 months. Of the 297 graduates, 17 patients (5.7%) returned to the PCC with recurrence concerns; however, only 12 (4.0%) showed physical evidence of recurrence: 8 of them (66.7%) had new pits and 4 (33.3%) had both pits and a nidus. The other 5 showed no signs of pilonidal disease on examination. Recurrence occurred on average 16.3 months after graduating, and 9 of 12 patients with a recurrence were successfully regraduated; 3 were lost to follow-up. Among the 280 patients who did not revisit the clinic, 72 (25.7%) replied to the text survey: 68 (94.4%) of respondents remained disease-free, whereas 4 (5.6%) reported recurrence, 2 of whom sought medical care. Completion of the MIPP at this center is associated with a 4.0% recurrence rate within 16 months, with most recurrences mild and again resolved with minimally invasive care.