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Children
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Challenges and Innovations in Pediatric General Surgery
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Challenges and Innovations in Pediatric General Surgery

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Surgery".

Deadline for manuscript submissions: closed (10 June 2026) | Viewed by 4956

Editors

Dr. Carlos Theodore Huerta

E-Mail Website
Guest Editor
Division of Pediatric Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
Interests: pediatric general surgery
Dr. Karishma Kodia

E-Mail Website
Guest Editor
Division of Cardiothoracic Surgery, Department of Surgery, University of Miami Health System & Sylvester Comprehensive Cancer Center, Miami, FL, USA
Interests: pediatrics; thoracic surgery; general surgery

Special Issue Information

Dear Colleagues,

The field of pediatric surgery continues to evolve rapidly, with an increasing number of technological and clinical advancements being available to surgeons more than ever before. With the advent of minimally invasive surgical techniques and more precise diagnostic modalities, there are increasing opportunities to provide high-quality surgical care to neonates, children, and adolescents. Surgeons can now perform life-saving procedures with greater precision, shorter recovery times, and improved long-term outcomes.

The aim of this Special Issue is to highlight the broad scope of research and recent applications of new surgical technologies and adjuncts within the field of pediatric surgery. Advances in minimally invasive surgery, robotic-assisted techniques, 3D printing for surgical planning, intraoperative adjuncts, and the integration of artificial intelligence and augmented reality are revolutionizing the way care is delivered. Innovations in care delivery—including enhanced recovery pathways and novel perioperative care and pain management strategies—will also be considered. This Special Issue will also include newer approaches to the education, assessment, and training of pediatric surgeons.

Contributions from pediatric surgeons and scholars presenting prospective or retrospective studies related to pediatric surgical pathology, perioperative care, experimental investigations, systematic reviews, meta-analyses, and/or review papers summarizing challenges and innovations in pediatric surgical care are highly encouraged.

We look forward to receiving your contributions.

Dr. Carlos Theodore Huerta
Dr. Karishma Kodia
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • pediatric surgery
  • minimally invasive surgery
  • robotic-assisted techniques
  • 3D printing
  • surgical planning
  • intraoperative adjuncts
  • artificial intelligence
  • augmented reality
  • enhanced recovery pathways
  • perioperative care
  • pain management
  • surgical education
  • surgical training
  • pediatric surgical pathology
  • prospective studies
  • retrospective studies
  • experimental investigations
  • systematic reviews
  • meta-analyses
  • surgical innovation

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (3 papers)

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Research

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10 pages, 558 KB  
Article
Pediatric Pilonidal Disease Surgical Approach (PPiDSA) Study
by Marta Rodríguez Ruiz, Isabella Garavis Montagut, Inmaculada Ruiz Jiménez, Noela Carrera, Pablo Aguado Roncero, Ennio Fuentes, Ricardo Díez and Carlos Delgado-Miguel
Children 2026, 13(2), 254; https://doi.org/10.3390/children13020254 - 12 Feb 2026
Viewed by 1324
Abstract
Background: Wide surgical excision is considered the traditional treatment for pilonidal sinus disease but is associated with prolonged wound healing and delayed recovery. This study aims to compare the outcomes of radical surgery versus a minimally invasive alternative in pediatric patients. Methods: A [...] Read more.
Background: Wide surgical excision is considered the traditional treatment for pilonidal sinus disease but is associated with prolonged wound healing and delayed recovery. This study aims to compare the outcomes of radical surgery versus a minimally invasive alternative in pediatric patients. Methods: A multicenter randomized comparative study was conducted on patients undergoing surgery for pilonidal sinus between January 2023 and December 2024 in four pediatric institutions. Patients were divided into two groups according to the surgical approach: Group 1 (en bloc excision) and Group 2 (endoscopic treatment). Demographic and clinical variables, postoperative complications, and recurrence rates were analyzed. Results: A total of 102 patients were included in this study (Group 1: n = 54; Group 2: n = 48). Baseline demographic and clinical characteristics were similar between groups. Postoperative complications occurred more frequently in Group 1 compared with Group 2 (53.7% vs. 20.8%; p < 0.001). Moreover, Group 1 presented a higher proportion of emergency department visits (44.4% vs. 8.36%; p < 0.001) and a longer median time to complete healing (100 vs. 45 days; p < 0.001). After a median follow-up of 19 months (interquartile range, 10–24 months), no significant differences were observed between groups in recurrence rates (14.8% vs. 16.7%; p = 0.797) or in median time from treatment to recurrence (198 vs. 184 days; p = 0.672). Conclusions: Endoscopic treatment of pilonidal sinus in pediatric patients is associated with fewer postoperative complications and faster recovery compared to radical surgery, with no observed differences in recurrence rates. Longer follow-up is needed to confirm these findings. Full article
(This article belongs to the Special Issue Challenges and Innovations in Pediatric General Surgery)
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16 pages, 619 KB  
Article
Indications, Trends and Outcomes in Pediatric Lung Resections: A 12-Year Study in a Tertiary Referral Center
by Gloria Mandrile, Giulia Barone, Vittorio Guerriero, Girolamo Mattioli and Michele Torre
Children 2025, 12(11), 1438; https://doi.org/10.3390/children12111438 - 23 Oct 2025
Cited by 1 | Viewed by 1299
Abstract
Background: Lung resections in children are rare but critical for congenital lung malformations (CLMs) and acquired pathologies; few studies have analyzed the full spectrum of indications. This study evaluated indications, complications, outcomes, and temporal trends in a tertiary pediatric center. Methods: [...] Read more.
Background: Lung resections in children are rare but critical for congenital lung malformations (CLMs) and acquired pathologies; few studies have analyzed the full spectrum of indications. This study evaluated indications, complications, outcomes, and temporal trends in a tertiary pediatric center. Methods: We retrospectively analyzed patients who underwent lung resection (2012–2024), focusing on indications, approaches, complications, and outcomes. Comparisons between pathologies (CLMs vs. acquired pathologies), approaches (thoracoscopy vs. thoracotomy), an temporal trends were evaluated. Results: Among 160 patients (mean age: 7.8 years), acquired lesions (68.6%) were more common than CLMs (31.4%), predominating in children under 8 years. Compared with thoracotomy, thoracoscopy (72.8% of cases, conversion rate: 22.8%) was correlated with shorter operative times (p < 0.001) and hospital stays (p = 0.001). The complication rate was 19.5%, with 71.9% of patients achieving disease-free, asymptomatic status at follow-up. Risk factors for conversion from thoracoscopy to open surgery included intraoperative adhesions (p = 0.003), underlying pathology (p = 0.013), and age < 8 years (p = 0.017). Compared with acquired lesions, CLMs were associated with fewer complications (14.3% vs. 23.1%, p = 0.041) and more favorable outcomes (89.2% vs. 64.7%; p < 0.05). Over time, the use of thoracoscopy increased (p = 0.012), with reduced operative time (p = 0.005); complication and outcome rates remained stable. Conclusions: Pediatric lung resections address diverse pathologies; outcomes are linked to the pathology, and CLMs are associated with lower complication rates in our cohort. Thoracoscopy has progressively become the preferred approach in the last decade, offering advantages particularly in postoperative recovery, though its success depends on careful, pathology-driven patient selection. Full article
(This article belongs to the Special Issue Challenges and Innovations in Pediatric General Surgery)
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Review

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15 pages, 1611 KB  
Review
Indications and Utility of Posterior Tracheopexy in the Pediatric Population: An Overview of Its Expanding Role in Tracheobronchial Disease
by Nicholas Jose Iglesias, Ali A. Mokdad, Nelson Vicente Guevara, Andres Mauricio Corona, Eduardo Alfonso Perez and Carlos Theodore Huerta
Children 2026, 13(2), 199; https://doi.org/10.3390/children13020199 - 31 Jan 2026
Viewed by 1765
Abstract
Background: Tracheobronchial disease, including tracheomalacia (TM) and tracheobronchomalacia (TBM), is a spectrum of congenital and acquired airway disorders characterized by the collapse of the tracheal or mainstem bronchial walls during expiration, particularly when there are increased intrathoracic pressures. Traditional surgical approaches to treat [...] Read more.
Background: Tracheobronchial disease, including tracheomalacia (TM) and tracheobronchomalacia (TBM), is a spectrum of congenital and acquired airway disorders characterized by the collapse of the tracheal or mainstem bronchial walls during expiration, particularly when there are increased intrathoracic pressures. Traditional surgical approaches to treat severe medically refractory TM include anterior approaches, such as aortopexy or anterior tracheopexy. Recently, posterior tracheopexy has emerged to address the widened and mobile posterior tracheal membrane which can cause transient airway obstruction. Method: The National Institute of Health, National Library of Medicine, PubMed, and MEDLINE databases were queried for manuscripts related to posterior tracheopexy in the pediatric population. Preoperative diagnostics, anesthetic considerations, operative technique, clinical outcomes, and operative complications were analyzed in each manuscript. Results: Patients with severe medically refractory cases of TM who are being considered for posterior tracheopexy should undergo thorough preoperative workup by a multidisciplinary team. Cross-sectional, dynamic thoracic imaging and a “quadruple endoscopy”, incorporating laryngoscopy, dynamic bronchoscopy, distal bronchoscopy, and esophagogastroduodenoscopy (EGD) should be obtained as part of a standardized preoperative assessment. Posterior tracheopexy for pre-existing TM significantly improves respiratory symptoms, respiratory infection rates, brief resolved unexplained events, and ventilatory dependence. Recently, posterior tracheopexy during TEF/EA repair has been described and aims to reduce the risk of patients developing TM, the risk of TEF recurrence, and respiratory morbidity following TEF/EA repair. An ongoing randomized controlled trial may help to elucidate the efficacy of primary posterior tracheopexy in select neonates with TEF/EA. Conclusions: Posterior tracheopexy is a valuable surgical technique for the treatment of TM or the reduction in respiratory morbidity following TEF/EA repair in select neonates. Full article
(This article belongs to the Special Issue Challenges and Innovations in Pediatric General Surgery)
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