Purpose: to review recent literature concerning long-term health issues and transitional care in esophageal atresia (EA) patients. PubMed, Scopus, Embase and Web of Science databases were screened for studies regarding EA patients aged more than or equal to 11 years, published between August 2014 and June 2022. Sixteen studies involving 830 patients were analyzed. Mean age was 27.4 years (range 11–63). EA subtype distribution was: type C (48.8%), A (9.5%), D (1.9%), E (0.5%) and B (0.2%). 55% underwent primary repair, 34.3% delayed repair, 10.5% esophageal substitution. Mean follow-up was 27.2 years (range 11–63). Long-term sequelae were: gastro-esophageal refux (41.4%), dysphagia (27.6%), esophagitis (12.4%), Barrett esophagus (8.1%), anastomotic stricture (4.8%); persistent cough (8.7%), recurrent infections (4.3%) and chronic respiratory diseases (5.5%). Musculo-skeletal deformities were present in 36 out of 74 reported cases. Reduced weight and height were detected in 13.3% and 6% cases, respectively. Impaired quality of life was reported in 9% of patients; 9.6% had diagnosis or raised risk of mental disorders. 10.3% of adult patients had no care provider. Meta-analysis was conducted on 816 patients. Estimated prevalences are: GERD 42.4%, dysphagia 57.8%, Barrett esophagus 12.4%, respiratory diseases 33.3%, neurological sequelae 11.7%, underweight 19.6%. Heterogeneity was substantial (>50%). Conclusion: EA patients must continue follow-up beyond childhood, with a defned transitional-care path by a highly specialized multidisciplinary team due to the multiple long-term sequelae.

Primary ovarian torsion (POT) affects a morphologically normal ovary without associated adnexal lesions and that carries a high recurrence risk. The role of oophoropexy in preventing POT recurrence remains unclear. To evaluate the effectiveness of oophoropexy in reducing recurrence rates after the first episode of POT. A systematic review and meta-analysis was conducted following PRISMA 2020 guidelines. Retrospective studies including girls <18 years undergoing surgery for POT were considered. The primary outcome was torsion recurrence. Study quality was assessed using the MINORS tool. Twelve studies (209 patients; mean age 7.8 ± 4.1 years) met inclusion criteria. Detorsion alone was performed in 168 patients (80.4 %) and detorsion + oophoropexy in 41 patients (19.6 %). Recurrence occurred in 17.3 % of patients after ovarian detorsion alone versus 4.9 % after detorsion + oophoropexy. Three comparative studies (106 patients) were included in the meta-analysis. Pooled analysis showed a trend toward reduction in recurrence for oophoropexy (OR 0.54, 95 % CI 0.17-1.72, p = 0.15, I² = 0 %). Ultrasonography demonstrated preserved ovarian vascularization and trophism in most patients. POT carries a substantial risk of recurrence. Oophoropexy may reduce recurrence compared with detorsion alone without negatively affecting ovarian trophism, although statistical significance was not reached. At present, oophoropexy cannot yet be recommended as routine after a first episode of POT, but it appears to hold promise as a strategy to reduce recurrence.

Open ureteral reimplantation (OUR) is the benchmark for vesicoureteral reflux (VUR). Robotic-assisted laparoscopic ureteral reimplantation (RALUR) has emerged as a minimally invasive alternative, offering potential advantages in recovery, though with more variable reported outcomes. We compared OUR and RALUR in children, focusing on success, complications, length of stay, and analgesia. PRISMA-guided systematic review and meta-analysis of comparative pediatric studies (PubMed, Cochrane Library, Web of Science; 1 January 2010-31 March 2025). Eight retrospective studies met criteria (n = 546; 249 OUR, 297 RALUR). OUR included intravesical and extravesical repairs; RALUR was predominantly extravesical. Mean age/weight were 5.1 years/19.4 kg (OUR) and 7.2 years/26.5 kg (RALUR); mean VUR grade was 3.2 in both groups. Operative time was shorter for OUR (143 vs 193 min), but hospital stay was longer (2.5 vs 1.5 days). Early postoperative complications occurred in 19.1 % (OUR) and 16.6 % (RALUR). Analgesic requirements were lower after RALUR (0.14 vs 0.33 mg/kg morphine equivalents). At a median 15.1-month follow-up, success was 92.5 % (OUR) and 94.1 % (RALUR). Meta-analysis showed no difference in complications (7 studies, n = 434; OR 0.80, 95 % CI 0.32-1.97; p = 0.56; I² = 23.7 %) or success (7 studies, n = 433; OR 1.22, 95 % CI 0.42-3.55; p = 0.67; I² = 0 %). RALUR appears to be a safe, feasible alternative to OUR for pediatric VUR, with comparable success and complication rates, shorter hospital stay, and longer operative time. Limitations include heterogeneity in surgical techniques and baseline age differences between cohorts.

Aim This survey analyzed techniques in laparoscopic inguinal hernia repair (LIHR) across pediatric age groups. Materials and Methods Data were collected through an online survey for pediatric surgeons, comprising of 38 questions, conducted by the European Pediatric Surgeons' Association (EUPSA) Trainees of European Pediatric Surgery (TEPS) LIHR Working Group. Results The survey was completed by 183 surgeons from 22 countries. Seventy-seven percent of respondents had performed LIHR at least once. Regarding preferences about the patient's gender, 7% respondents perform LIHR only in selected females, 9% routinely in females, 15% in both genders with age/weight restrictions, 24% routinely in both genders, 31% in selected cases, and 14% never perform LIHR. Percutaneous internal ring suturing (PIRS) was the preferred technique in all age groups, with totally extraperitoneal and transabdominal preperitoneal repairs preferred by 9% in adolescents. The majority (59%) repaired a contralateral patent processus vaginalis if present. Hydro-dissection (21%) and additional intra-abdominal instruments (42%) were preferred more often for male patients. The distal hernia sac was left intact by most respondents (92%). Responses regarding recurrence rates varied: 40% responded that LIHR had recurrence rates comparable to open surgery, whereas 10% reported increased recurrences and hence limited its use, and 10% consider that slightly increased recurrences are outweighed by lower complication rates associated with laparoscopic methods and thus continue LIHR. Conclusions PIRS is the preferred choice for pediatric LIHR. Surgical techniques vary and are influenced by patient gender and age. The survey gives insights into demographics, case selection, and approaches among pediatric surgeons with regard to LIHR.

Background Pediatric renal cancer survivors have higher rate of chronic renal disease and hypertension. These patients have similar survival rates when treated according to either Children's Oncology Group (COG) or International Society of Pediatric Oncology (SIOP) protocols. We aimed to compare the late outcome of these two approaches. Methods We performed a meta-analysis of all studies from 2000 to 2021; database search using keywords: long-term outcomes OR late effects, nephrectomy, pediatric renal cancer. For each protocol, data were collected, and the “pooled” outcomes were compared. Continuous and dichotomous variables were obtained with a 95% odds ratio. Results Sixteen studies with a total of 715 pediatric renal cancer survivors were analyzed. The mean follow-up time was 17.4 (standard deviation 5.6) years. Reduced renal function and hypertension were the most encountered long-term complications. The mean estimated glomerular filtration rate was similar in both protocols (101.62 vs. 101.70 mL/min/1.73 m²), while the prevalence of hypertension was 23% in COG and 10% in SIOP. The prevalence of secondary malignancy was 1.1% in COG and 6.7% in SIOP (1.1% vs. 6.7%, p ≤ 0.001). Chronic kidney disease was similar in both groups. Conclusion A high prevalence of hypertension was observed among pediatric renal cancer survivors, as well as an increased risk of a secondary tumor. These results emphasize the importance of long-term follow-up into adulthood, to promptly diagnose any long-term side effects of the treatment. Thanks to the increased overall survival, future protocols will pay attention to the reduction of long-term sequelae. ^* These authors contributed equally to the research and retain the first authorship. Received: 03 June 2022 Accepted: 22 August 2022 Article published online: 26 December 2022 © 2022. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany