Although the impact of age, gender, and obesity on the skin wound healing process has been extensively studied, the data related to gender differences in aspects of skin scarring are limited. The present study performed on abdominal human intact and scar skin focused on determining gender differences in extracellular matrix (ECM) composition, dermal white adipose tissue (dWAT) accumulation, and Foxn1 expression as a part of the skin response to injury. Scar skin of men showed highly increased levels of COLLAGEN 1A1, COLLAGEN 6A3, and ELASTIN mRNA expression, the accumulation of thick collagen I-positive fibers, and the accumulation of α-SMA-positive cells in comparison to the scar skin of women. However, post-injured skin of women displayed an increase (in comparison to post-injured men’s skin) in collagen III accumulation in the scar area. On the contrary, women’s skin samples showed a tendency towards higher levels of adipogenic-related genes (PPARγ, FABP4, LEPTIN) than men, regardless of intact or scar skin. Intact skin of women showed six times higher levels of LEPTIN mRNA expression in comparison to men intact (p < 0.05), men post-injured (p < 0.05), or women post-injured scar (p < 0.05) skin. Higher levels of FOXN1 mRNA and protein were also detected in women than in men’s skin. In conclusion, the present data confirm and extend (dWAT layer) the data related to the presence of differences between men and women in the skin, particularly in scar tissues, which may contribute to the more effective and gender-tailored improvement of skin care interventions.

Introduction: Heminephrectomy is considered the method of choice in the treatment of symptomatic or poorly working moiety of a duplex kidney as well as in oncology. Aim: The study aims to retrospectively analyze the laparoscopic approach to heminephrectomy (LHN) in comparison with the open approach (OHN). Material and methods: From 2011 to 2020, 28 heminephrectomies were performed in the Clinical Ward of Pediatric Surgery and Urology of the Regional Specialized Children’s Hospital in Olsztyn: 10 with the laparoscopic transperitoneal method (LHN), and 18 with the open method (OHN). The mean age was 37.4 months (1–197 months). In total, 20 patients were female, and 8 were male. Loss of function of the moiety was a prerequisite for surgery. Hydronephrosis, dysplasia of the moiety, and vesicoureteral reflux were the most prevalent in both groups. Data regarding patients were collected based on available medical documentation and retrospectively analyzed. Results and discussion: There was no significant difference between the LHN and OHN groups regarding mean operating time (157 vs 128 minutes; P = 0.226) and mean postoperative hospital stay (5.20 vs 6.53; P = 0.64). The refeeding time is comparable and not statistically significant (1.90 vs 1.83 days; P = 0.555). Postoperative analgesic intake was found to be significantly lower (10.4 vs 17.5 doses, P = 0.004). Conclusions: Both open and laparoscopic approaches are safe and feasible in the pediatric population. Both are comparable in operative time, hospital stay and refeeding time. LHN displays a better cosmetic effect and requires significantly lesser analgesic use.

Introduction: The use of ultrasonography (USG) is no longer restricted to the radiology department. It is becoming the equivalent of a stethoscope. Point-of-care ultrasound (POCUS) is an USG examination method designed to answer specific clinical questions. Aim: To encourage doctors to use POCUS in their everyday practice based on a presentation of its use in diagnostics of acute appendicitis in the paediatric patient. Material and methods: A retrospective evaluation was performed of 95 cases of abdominal pain referred by a paediatrician for surgical assessment at emergency department between November 2021 and October 2022. The assessment included a clinical examination supplemented with POCUS. Based on the assessment made by the emergency department doctor, the patients were divided into two groups – those who did not require hospitalisation in the paediatric surgery department (group 1) and those who did (group 2). Each group was subsequently divided into subgroup A, where no abdominal cavity USG was performed by a radiologist and subgroup B, where the patients were examined by a radiologist. Results and discussion: The use of POCUS in the context of clinical symptoms allows for achieving the same degree of detectability as in an examination performed by a radiologist. A positive result of POCUS or clinical symptoms indicative of acute appendicitis requires continuing the diagnostic process. Conclusions: The application of USG in abdominal pain diagnostics in a paediatric patient helps to reduce the time needed for the correct diagnosis and, in consequence, for the patient's treatment. Due to its availability, USG should be widely used to supplement clinical examination by each physician.

Introduction: The first thoracoscopic esophageal atresia (EA) surgery in Poland was performed by Professor Dariusz Patkowski in 2005 in Wrocław. In the Clinical Ward of Pediatric Surgery and Urology, Regional Specialistic Children’s Hospital in Olsztyn, thoracoscopic EA surgery was performed on 16 January 2009. Aim: Data presentation on thoracoscopic treatment of congenital EA. Material and methods: Between 2009 and 2018 in our Clinical Ward, 28 children (11 females and 17 males) diagnosed with EA underwent treatment. All patients presented with type III EA based on the Gross classification (lower tracheoesophageal fistula and atresia of the upper segment of the trachea) and 8 of them (29.6%) were diagnosed with coexisting diseases. Results and discussion: The duration of the surgery was 70–290 minutes with a mean time of 180 minutes. Conversion was performed in 6 (21.4%) cases. Leakage of the lymph occurred in 2 (7.1%) cases . In 3 (10.7%) cases, a radiographic image showed leakage of the anastomosis. Only 1 (3.6%) patient needed reoperation due to re-canalization of tracheoesophageal fistula. Pneumothorax occurred in 2 (7.1%) cases. In total, 4 (14.3%) patients died and 23 (82.1%) patients required additional esophageal dilatation due to its narrowing. Conclusions: The treatment results of thoracoscopic EA surgeries and undeniable advantages for the patient makes this technique a highly recommended method.

Introduction: Pectus excavatum is the most common congenital chest wall deformity, characterized by posterior displacement of the sternum and adjacent costal cartilages. In severe cases, it can impair cardiopulmonary function and negatively affect the quality of life due to physical limitations and psychosocial distress.Aim: To present current modifications of the Nuss procedure and assess their impact on the safety, postoperative outcomes, and patient comfort of surgical treatment for pectus excavatum.Methods: A narrative review based on a comprehensive analysis of relevant literature was conducted, focusing on advancements and technical modifications of the original Nuss technique.Results: Since its introduction in 1998, the Nuss procedure has become the standard minimally invasive approach for correcting pectus excavatum. Various modifications – such as changes in bar design, stabilization methods, use of thoracoscopy, and postoperative pain management protocols – have improved surgical outcomes and reduced complication rates. These advancements have increased the procedure’s safety and patient comfort, while maintaining high correction efficacy.Conclusions: The evolution of the Nuss procedure has significantly enhanced the surgical management of pectus excavatum. Ongoing refinements continue to optimize patient outcomes, making the technique safer, more comfortable, and more widely applicable across age groups.

Introduction: The Nuss procedure is the gold standard for correcting pectus excavatum. Despite its effectiveness, the postoperative period is often associated with significant pain, which may persist for weeks and typically requires intravenous analgesia, often opioid-based. Cryoanalgesia, a reversible method that induces temporary intercostal nerve block, offers a safe alternative providing both early and long-lasting pain relief. Aim: This study evaluates the impact of intraoperative intercostal nerve cryoanalgesia on postoperative pain intensity and hospitalisation duration in patients undergoing the Nuss procedure for pectus excavatum. Material and methods: A retrospective analysis was performed on 57 patients treated over a 7-year period at a single centre. Patients were divided into two groups: those who received intraoperative cryoanalgesia (n = 41) and those without additional intraoperative analgesia (n = 16). Statistical analysis was performed using the Mann–Whitney test and Spearman rank correlation, with significance set at p < 0.05. Results and discussion: Among the 57 patients, 53 (93%) were male, with a mean Haller Index of 3.98 and Correction Index of 33.78. Cryoanalgesia was applied in 71.9% of cases. Patients treated with cryoanalgesia demonstrated shorter hospital stays compared with the control group (3 ± 2 days vs. 5.5 ± 2 days; p < 0.001). Postoperative pain intensity measured by NRS was comparable between groups; however, opioid requirements were significantly lower in the cryogroup on day 3 (34% vs. 69%; p = 0.02) and day 4 (7% vs. 62.5%; p < 0.001). Conclusions: Intraoperative cryoanalgesia reduces hospitalisation time and postoperative opioid use, offering an effective adjunct for pain management after the Nuss procedure.