Interdisciplinary Radical "En-Bloc" Resection of Ewing Sarcoma of the Chest Wall and Simultaneous Chest Wall Repair Achieves Excellent Long-Term Survival in Children and Adolescents.

Ewing sarcomas of the chest wall, historically known as "Askin tumors" represent highly aggressive pediatric malignancies with a reported 5-year survival ranging only between 40 and 60% in most studies. Multimodal oncological treatment according to specific Ewing sarcoma protocols and radical "en-bloc" resection with simultaneous chest wall repair are key factors for long-term survival. However, the surgical complexity depends on tumor location and volume and potential infiltrations into lung, pericardium, diaphragm, esophagus, spine and major vessels.

Nutritional and pharmacological strategy in children with short bowel syndrome.

Short bowel syndrome in neonates is a severe and life-threatening disease after a major loss of small bowel with or without large bowel. Intestinal adaptation, by which the organism tries to restore digestive and absorptive capacities, is entirely dependent on stimulation of the active enterocytes by enteral nutrition. This review summarizes recent knowledge about the pathophysiologic consequences after the loss of different intestinal parts and outlines the options for enteral nutrition and pharmacological therapies to support the adaptation process.

Diagnostic Workup of Neonates With Esophageal Atresia: Results From the EUPSA Esophageal Atresia Registry.

Controversies exist on the optimal diagnostic workup for neonates with esophageal atresia (EA) with/without tracheoesophageal fistula (TEF). Aim of this study was to describe the current diagnostic policies in EA/TEF patients enrolled in an International multicenter registry. All patients consecutively registered from July 2014 to December 2017 in the EUPSA Esophageal Atresia Registry (EUPSA-EAR) were included in the study.

Postoperative Complications and Functional Outcome after Esophageal Atresia Repair: Results from Longitudinal Single-Center Follow-Up.

Background: Esophageal atresia (EA) and tracheoesophageal fistula (TEF) represent major therapeutic challenges, frequently associated with serious morbidities following surgical repair. The aim of this longitudinal study was to assess temporal changes in morbidity and mortality of patients with EA/TEF treated in a tertiary-level center, focusing on postoperative complications and their impact on long-term gastroesophageal function.

Methods: One hundred nine consecutive patients with EA/TEF born between 1975 and 2011 were followed for a median of 9.

Surgical strategies in short bowel syndrome.

Extensive loss of small bowel in all age groups has significant morbidity and mortality consequences. Despite the astonishing ability of the small bowel to compensate for an extensive loss, long-term parenteral nutrition and enteral nutrition, tailored to the need of the patients in relation to the missing intestinal regions is needed. Organ-preserving surgical intervention becomes necessary in patients with a very short intestinal transit time and in an other group of patients with impaired propulsive peristalsis.

Long-term results of total colonic agangliosis patients treated by preservation of the aganglionic right hemicolon and the ileo-cecal valve.

Purpose: In 1989, Sauer introduced a technique to treat patients with total colonic aganglionosis (TCA) where he preserved the ileo-cecal valve and the right hemicolon to retain water and electrolyte absorption. This report examines the long-term outcome of patients who underwent this technique.

Methods: All TCA patients treated between 1981 and 2005 according to Sauer were invited in 2013 to participate in a questionnaire survey to assess their long-term outcome focusing on bowel function and quality of life (QoL), using standardized scores.

Gastroschisis-related complications requiring further surgical interventions.

Purpose: The aim of this study was to determine the incidence of gastroschisis-related complications (GRCs) after closure of the abdominal wall defect, with a focus on frequency, type and timing of required surgical interventions, and to identify the impact of these on further outcome.

Methods: All gastroschisis patients treated from 1975 to 2008 in a tertiary-level center were retrospectively reviewed. Surgical procedures for GRCs following abdominal wall closure of simple gastroschisis [SG (intact continuous bowel)] and complex gastroschisis [CG (additional gastrointestinal malformations)] were compared, and outcomes were determined.

Proton pump inhibitors for reflux therapy in infants: effectiveness determined by impedance pH monitoring.

Purpose: To evaluate the influence of proton pump inhibitors (PPI) in predominantly milk-fed infants with symptoms of GERD by 24-h pH-multichannel intraluminal impedance (24-h pH-MII).

Methods: Ten infants (8 males and 2 females) with a mean gestational age of 39 weeks (28-40) were included. 24-h pH-MII was performed before prescription and during intake of PPI.

Straddle injuries in female children and adolescents: 10-year accident and management analysis.

Objective: To analyze unintentional straddle injuries in girls with regards to epidemiology, etiology and injury management.

Methods: The hospital database was retrospectively reviewed (1999-2009) for female patients managed for genital trauma. Patients were evaluated based on age, causative factors, type of injury, area of genitals affected, management and outcomes.

Pre- and postoperative rectal manometric assessment of patients with anorectal malformations: should we preserve the fistula?

Background: Surgical correction of congenital anorectal malformations could be complicated by fecal incontinence. Some authors believe that preservation of the fistula is associated with improved outcome. Rectal manometry is a well-established method to evaluate postoperative functional outcome in these patients and can demonstrate successful transplantation of the fistula.

Outcomes after interdisciplinary management of 7 patients with Askin tumor.

Purpose: Askin tumors are rare but highly malignant chest wall tumors, which require multimodal therapy including often extensive resection of the thoracic wall. This study evaluated the outcome of Askin tumor in seven patients with an interdisciplinary approach.

Methods: Patients' records, treated between 1994 and 2011, were reviewed retrospectively.

Trends in the treatment and outcome of congenital diaphragmatic hernia over the last decade.

Purpose: Congenital diaphragmatic hernia (CDH) remains a challenging and life-threatening congenital anomaly. The aim was to evaluate whether treatment and survival has changed during the last decade.

Methods: We retrospectively analysed all consecutive infants with CDH referred to two European tertiary paediatric surgical centres over 11 years (January 1999 to December 2009).

Closure of bronchopleural fistula with porcine dermal collagen and fibrin glue in an infant.

The management of an 11-month-old infant who developed a bronchopleural fistula (BPF) 3 weeks after video-assisted thoracic surgery for congenital cystic adenomatoid malformation of the right lower pulmonary lobe is presented. Being refractory to treatment with chest tubes, the BPF was managed using a bronchoscopic approach using porcine dermal collagen (PDC) combined with a fibrin glue plug. The single session was sufficient to manage the BPF and the postoperative course was uneventful.

The 100 most-cited articles in Pediatric Surgery International.

Purpose: Citation analysis within specific journals and subject areas has become a popular method to assess the impact of a journal, article or author. To date, only a few evaluations of citation reports have been published in the field of pediatric surgery. Twenty-six years after its inception, Pediatric Surgery International (PSI) is a firmly established journal in pediatric surgery.

Pre-pubertal presentation of peritoneal inclusion cyst associated with congenital lower extremity venous valve agenesis.

Peritoneal inclusion cysts are uncommon lesions that usually occur in the pelvis of reproductive-age females. The case of a 7-year-old girl with an inflamed peritoneal inclusion cyst with unusual right paracolic localization and congenital lower extremity superficial and deep venous valve agenesis is presented. Inflammation of the peritoneal inclusion cyst was responsible for the signs of acute abdomen and subsequent presentation at our center.

Management of isolated and associated colonic atresia.

Purpose: Colonic atresia is a rare cause of congenital intestinal obstruction in the neonate. A review of the management and outcome of children with colonic atresia was performed.

Methods: A retrospective analysis of the complete records of children treated for colonic atresia during the 30-year period.

The impact of preoperative ultrasound on correct diagnosis of urachal remnants in children.

Background: Ultrasound is a noninvasive imaging method used widely in urachal diagnostics. This study investigated the effectiveness of ultrasonography in correctly depicting urachal anomalies in children.

Methods: Preoperative ultrasound findings of all patients who were operated on for suspected urachal anomalies between 1990 and 2008 were retrospectively compared with the final diagnosis.

Comparison of suturing techniques in the formation of collagen scaffold tubes for composite tubular organ tissue engineering.

In order to construct tubes for tissue engineering of composite tubular organs in the gastrointestinal tract, suturing techniques were investigated with regards to (a) type of suture material, (b) state of scaffold, (c) technical variations and (d) changes in scaffold morphology. Collagen scaffolds of 13 mm diameter and 3 mm thickness, in both dry and wet states, were sutured using braided and monofilament sutures. Four suture techniques were employed (a) continuous loop, (b) interrupted loops, (c) interrupted edge sutures and (d) continuous running edge suture.

Esophagus tissue engineering: in situ generation of rudimentary tubular vascularized esophageal conduit using the ovine model.

Purpose: Esophagus replacement using the present surgical techniques is associated with significant morbidity. Tissue engineering of the esophagus may provide the solution for esophageal loss. In our attempts to engineer the esophagus, this study aimed to investigate the feasibility of generating vascularized in situ esophageal conduits using the ovine model.

Fluorescence-activated cell sorting of PCK-26 antigen-positive cells enables selection of ovine esophageal epithelial cells with improved viability on scaffolds for esophagus tissue engineering.

Objective: For esophagus tissue engineering, isolation and proliferation of esophageal epithelial cells (EEC) is a pre-requisite for scaffold seeding to create constructs. The aim of this study was to sort EEC expressing cytokeratin markers and their proliferative subpopulations; also, to investigate the viability of differentiated EEC subpopulations on collagen scaffolds.

Methods: Ovine esophageal epithelial cells (OEECs) from sheep esophagus were analyzed using flow cytometry for pan cytokeratin (PCK-26) and proliferation cell nuclear antigen (PCNA).

Nonoperative treatment of tibial spine fractures in children-38 patients with a minimum follow-up of 1 year.

Objectives: The aim of this study was to determine if nonoperative treatment of fractures of the tibial spine (intercondylar eminence) in pediatric patients is the treatment of choice for these injuries.

Design/setting: Retrospective clinical analysis in a single department.

Patients: All patients younger than 17 years presenting with a fracture of the intercondylar eminence between January 1, 1995 and December 31, 2004 were included in this retrospective study.

Esophagus tissue engineering: in vitro generation of esophageal epithelial cell sheets and viability on scaffold.

Purpose: Management of long gap esophageal atresia poses challenges. The surgical techniques for esophageal replacement are associated with complications and high morbidity. The aim of this study was to develop protocols to obtain single layer sheets of esophageal epithelial cells (EECs) and to investigate their survival on collagen scaffolds.

Culture of ovine esophageal epithelial cells and in vitro esophagus tissue engineering.

Background: Esophagus replacement presents major surgical challenges both in the pediatric and in adult patients since the various surgical techniques presently employed are associated with complications and high morbidity.

Aim: The aim of this study was to establish protocols for isolation and culture of ovine esophageal epithelial cells (OEEC) and to investigate their viability on collagen scaffolds for in vitro tissue engineering.

Methods: OEEC were sourced from adult Austrian mountain sheep.