Factors Influencing Success in Endoscopic Treatment of Grade 4-5 Primary Vesicoureteric Reflux (VUR) in Infancy and Childhood.

Introduction: There is equipoise among pediatric urologists regarding endoscopic versus surgical intervention for symptomatic Grade 4-5 Vesicoureteric Reflux (VUR), particularly in infancy. Our aim was to assess outcomes of first-line endoscopic treatment in all cases of symptomatic Grade 4-5 VUR and we hypothesised that using endoscopic Dx/HA as first line management for primary VUR would obviate the need for ureteric reimplantation in the majority of cases.

Methods: Retrospective single-surgeon analysis of consecutive patients with primary Grade 4-5 VUR over 15 years.

Acquired colonic atresia in children: a report of three cases and review of the literature.

We describe cases of three infants who developed acquired colonic atresia presumed secondary to significant systemic cardiovascular compromise and in the absence of necrotizing enterocolitis. An acquired colonic atresia may present as feed intolerance and should be investigated with a lower gastrointestinal contrast study. We would also recommend routine lower gastrointestinal contrast study prior to stoma closure in an infant with history of significant cardiovascular compromise, even in the absence of significant widespread colonic inflammation such as necrotizing enterocolitis.

Methods of identifying surgical Necrotizing Enterocolitis-a systematic review and meta-analysis.

Background: Current data suggests potential benefit of earlier surgery for necrotizing enterocolitis (NEC) however this requires accurate prognostication early in the disease course. This study aims to identify and determine the effectiveness of previously reported methods or tests for the identification of surgical NEC.

Methods: Systematic review and meta-analysis with registration on PROSPERO including articles describing a method of identifying surgical NEC.

Adherence to General Medical Council guidance regarding disclosure of alternative treatments during the consent process.

Introduction: General Medical Council (GMC) guidelines dictate that reasonable alternatives to treatment should be disclosed during the consent process. We aimed to determine whether GMC guidelines on disclosure of alternatives during consent are being followed in a real-world example which is disclosure of non-operative management as an alternative to appendicectomy in uncomplicated paediatric appendicitis.

Methods: We undertook a retrospective single-centre observational study and national consultant specialist paediatric surgeon survey.

Congenital duodenal obstruction repair with and without transanastomotic tube feeding: a systematic review and meta-analysis.

Objective: To determine the impact of transanastomotic tube (TAT) feeding in congenital duodenal obstruction (CDO).

Design: Systematic review with meta-analysis.

Patients: Infants with CDO requiring surgical repair.