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Latest Advances in Pediatric Surgery
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Latest Advances in Pediatric Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "General Surgery".

Deadline for manuscript submissions: closed (15 December 2025) | Viewed by 3251

Special Issue Editors

Dr. Francesco Macchini

E-Mail Website
Guest Editor
Pediatric Surgery, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy
Interests: pediatric thoracic surgery; airway surgery; congenital lung malformation; neonatal surgery; pediatric gas-tro-intestinal surgery
Dr. Andrea Zanini

E-Mail Website1 Website2
Guest Editor
Pediatric Surgery, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy
Interests: pediatric thoracic surgery; airway surgery; congenital lung malformation; pediatric surgical oncology; neonatal surgery

Special Issue Information

Dear Colleagues,

As pediatric surgery continues to evolve with technological advancements and innovative approaches, staying updated with the latest developments is crucial in providing the best care for our patients. The ability to integrate new techniques and research into our practices is essential to improving surgical outcomes and ensuring patient safety.

We are pleased to announce an upcoming Special Issue dedicated to the latest advances in pediatric surgery. This issue aims to synthesize and present recent research, innovative techniques, and clinical advancements in the field of pediatric surgery.

Special attention will be given to the role of technological innovations such as minimally invasive surgery, robotic surgery, fluorescence-guided techniques and artificial intelligence, offering a platform to highlight the transformative contributions being made to improving surgical care for children.

We invite all surgeons, researchers, and clinicians to submit original research papers or reviews that explore emerging trends, novel approaches, and advancements in pediatric surgery.

We look forward to your contributions and to advancing knowledge and practices in this field.

Dr. Francesco Macchini
Dr. Andrea Zanini
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-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly 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 2600 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
  • innovations
  • fluorescence-guided surgery
  • pediatric robotic surgery
  • minimally invasive surgery

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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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13 pages, 1217 KB  
Article
Cylinder Bicuspid Pulmonary Valve Reconstruction Using Equine Pericardium: A Novel Technique for Right Ventricular Outflow Tract Repair
by Ahmed F. Elmahrouk, Abdelmonem M. Helal, Mohammad F. Babgi, Abdulbadee Bogis, Amjad A. Kouatli and Mohammad S. Shihata
J. Clin. Med. 2026, 15(4), 1457; https://doi.org/10.3390/jcm15041457 - 12 Feb 2026
Viewed by 814
Abstract
Background: Right ventricular outflow tract (RVOT) reconstruction is frequently performed for pediatric patients with pulmonary valve anomalies, yet optimal techniques remain debated. The equine pericardium offers a promising substrate for pulmonary valve reconstruction but has been understudied in pulmonary valve reconstruction. This [...] Read more.
Background: Right ventricular outflow tract (RVOT) reconstruction is frequently performed for pediatric patients with pulmonary valve anomalies, yet optimal techniques remain debated. The equine pericardium offers a promising substrate for pulmonary valve reconstruction but has been understudied in pulmonary valve reconstruction. This study evaluated a novel technique using the equine pericardium to create a cylinder bicuspid pulmonary valve for RVOT reconstruction. Methods: In this retrospective cohort study, 17 pediatric patients (median age: 10 months; 53% male) underwent RVOT reconstruction with equine pericardium between 2023 and 2024. The valve was fashioned from a patch of equine pericardium into a cylinder to create a functionally bicuspid valve. The height of the cylinder ranged from 1.5–2 cm. The diameter was measured around a Hegar dilator corresponding to a valve size z-score of +3. The outcomes included the degree of postoperative pulmonary regurgitation, RVOT pressure gradients, postoperative complications, and reinterventions. Results: Postoperatively, the median peak RVOT pressure gradient decreased significantly from 70 mmHg (IQR: 65–90) to 25 mmHg (IQR: 20–40; p < 0.001). Mild pulmonary regurgitation persisted in one patient (5.9%). Five patients had mild right ventricular dysfunction (29.41%). At a median 3-month follow-up (IQR: 1–8), 17.7% (n = 3) underwent cardiac catheterization. There was no postoperative mortality. Conclusions: Cylinder bicuspid pulmonary valve reconstruction using the equine pericardium effectively reduces RVOT obstruction while maintaining pulmonary valve competence and demonstrates acceptable short-term safety. Having a competent pulmonary valve after repairing the hypoplastic pulmonary valve annulus is very promising; however, the small cohort and limited follow-up preclude definitive conclusions about long-term durability. Larger prospective studies with longer follow-up periods are needed to validate this technique for RVOT reconstruction. Full article
(This article belongs to the Special Issue Latest Advances in Pediatric Surgery)
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11 pages, 1181 KB  
Systematic Review
Intrapericardial Extralobar Pulmonary Sequestration: A Case Report and Systematic Review of a Unique Embryologic Variant
by Margherita Roveri, Giada Pedroni, Alessandra Preziosi, Luigi Arcieri, Stefano Marianeschi, Francesco Macchini and Andrea Zanini
J. Clin. Med. 2026, 15(3), 932; https://doi.org/10.3390/jcm15030932 - 23 Jan 2026
Viewed by 443
Abstract
Background: Intrapericardial extralobar pulmonary sequestration (ELPS) is an exceptionally rare congenital malformation. The location may mimic neoplastic lesions and poses diagnostic and surgical challenges. We present a new case and a systematic review of the literature. Case Presentation: A 3-month-old male [...] Read more.
Background: Intrapericardial extralobar pulmonary sequestration (ELPS) is an exceptionally rare congenital malformation. The location may mimic neoplastic lesions and poses diagnostic and surgical challenges. We present a new case and a systematic review of the literature. Case Presentation: A 3-month-old male infant was referred for evaluation of a congenital intrathoracic mass suspected to be an extralobar sequestration. However, intrapericardial location was not recognized. MRI and CT demonstrated a circumscribed lesion with arterial supply from the right pulmonary artery. Thoracoscopic exploration was attempted but converted to sternotomy. The mass was excised en bloc. Histopathological analysis confirmed extralobar pulmonary sequestration with cystic components, consistent with a hybrid lesion. Postoperative recovery was uneventful. Methods: A systematic literature review was conducted according to PRISMA guidelines across PubMed, Scopus and Embase databases, including only histologically confirmed intrapericardial ELPS. Results: Ten cases were identified. Including the present case, eleven cases have been reported. Prenatal detection occurred in 54% of cases. Fetal demise occurred in two cases due to cardiac tamponade. Aberrant arterial supply originated from the pulmonary arteries in 54% of patients and venous drainage into the right atrium or superior vena cava in 45%. Surgery via sternotomy was performed in all cases with excellent outcomes. Conclusions: Intrapericardial ELPS is an exceptionally rare but surgically curable entity. Early recognition and complete resection are essential to prevent life-threatening complications. This systematic review highlights a consistent vascular pattern supporting its classification as a unique embryologic variant within the CPAM–sequestration spectrum. Full article
(This article belongs to the Special Issue Latest Advances in Pediatric Surgery)
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18 pages, 2094 KB  
Systematic Review
Scrotal Migration of the Ventriculoperitoneal Shunt in a 1-Year-Old Pediatric Patient: A Case Report and Systematic Literature Review
by Zenon Pogorelić, Stipe Ninčević, Vlade Babić, Miro Jukić and Stipe Vidović
J. Clin. Med. 2025, 14(15), 5183; https://doi.org/10.3390/jcm14155183 - 22 Jul 2025
Viewed by 1513
Abstract
Background: Migration of the peritoneal end of the ventriculoperitoneal shunt (VPS) into the scrotum is a rare but recognized complication. Inguinoscrotal migration typically occurs as a result of increased intra-abdominal pressure combined with a patent processus vaginalis. A 14-month-old pediatric patient presented to [...] Read more.
Background: Migration of the peritoneal end of the ventriculoperitoneal shunt (VPS) into the scrotum is a rare but recognized complication. Inguinoscrotal migration typically occurs as a result of increased intra-abdominal pressure combined with a patent processus vaginalis. A 14-month-old pediatric patient presented to the emergency department with abdominal pain, vomiting, and swelling of the right scrotum that had persisted for two days. The patient had a history of a head injury that had resulted in a large secondary arachnoid cyst for which a VPS had been placed at eight months of age. Examination of the inguinoscrotal region revealed a swollen and painful right side of the scrotum with a hydrocele and a palpable distal portion of the ventriculoperitoneal catheter in the right groin extending to the scrotum. After a brief preoperative preparation, the patient underwent laparoscopic abdominal emergency exploration, during which shunt repositioning and laparoscopic closure of the patent processus vaginalis were performed. Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: A total of 30 case reports and six case series were included, analyzing 52 pediatric patients with scrotal migration of the VPS. The median age at presentation was 24 months (range: 1–169 months). The indication for VPS placement was hydrocephalus. Migration of the VPS catheter occurred on the right side in 34 cases. The median interval from VPS placement to the onset of symptoms was 9.0 months (range: 1 day–72 months). The most frequently reported symptoms were scrotal/inguinoscrotal swelling (n = 50), vomiting (n = 7), and fever (n = 3). Diagnostic methods included abdominal X-ray (n = 43), ultrasound (n = 5), scrotal transillumination test (n = 5), and computed tomography (n = 1). Regarding treatment, surgical repositioning of the VPS catheter into the peritoneal cavity was performed in 47 patients (90.4%), with no intraoperative or postoperative complications reported. Conclusions: Laparoscopic repositioning of the VPS into the peritoneal cavity, combined with closure of the processus vaginalis, appears to be a safe and effective treatment option for scrotal migration of the VPS. However, further well-designed studies are warranted to provide more comprehensive, generalizable, and unbiased evidence regarding this complication in the pediatric population. Full article
(This article belongs to the Special Issue Latest Advances in Pediatric Surgery)
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