Journal Of Pediatric Surgery Research Articles

Editorials

It is essential for scientific journals that they can rely on an active and professional Editorial Board and Editorial Consultants. The European Journal of Pediatric Surgery has been supported by many pediatric surgeons, whether as Editors, representatives of societies or Editorial Consultants over many years, all of whom have made important contributions to the reputation and circulation of this journal. I would like to thank these colleagues on behalf of the editors and the whole editorial team for their continuous co-operation and support.

The Most Commonly Cited Articles in Pediatric Surgical Journals

This study aimed to investigate the characteristics of the most frequently cited articles published in 3 main journals dedicated to the field of pediatric surgery (Journal of Pediatric Surgery, Pediatric Surgery International and European Journal of Pediatric Surgery). A search was initiated using the database (1985 - 2006) of the Science Citation Index of the Institute for Scientific Information. The total number of publications and their citation numbers were found and the most cited articles were investigated in detail. A total of 600 (200 from each journal) most cited articles were identified and chosen for further analysis. The total number of citations in these 3 journals was 20 271. The citations of the most cited articles ranged from 10 to 224. The articles were published between 1985 and 2003 and the mean number of citations/article was 33.78. Articles originated from 39 counties and 256 institutions. The leading countries were the United States (203 articles from 75 institutions), Germany (50 articles from 21 institutions), Japan (34 articles from 17 institutions), Switzerland (34 articles from 8 institutions), United Kingdom (32 articles from 19 institutions), and Canada (28 articles from 7 institutions). Of the institutions with the highest number of cited articles, four institutions were from the USA followed by Switzerland with two institutions. The leading topics were the gastrointestinal system (n = 239), respiratory system (n = 94), urology (n = 61) and oncology (n = 56), and diaphragmatic hernia (n = 41) was the most common special topic. There were 42 case reports (7 %) and 75 experimental research articles (12.5 %). Thirty-four authors from 14 countries and 30 institutions had articles in more than one journal. The most cited author was N. S. Adzick from the USA with 224 citations. In this study, we found that the Journal of Pediatric Surgery predominated with the greatest number of cited articles. The most cited articles, authors and institutions originated from the USA and English-speaking countries. The gastrointestinal system, respiratory system, urology and oncology were the leading topics and diaphragmatic hernia was the most common special topic.

European Journal of Pediatric Surgery EUPSA Edition: The Best Papers of the Annual Congress of the European Paediatric Surgeons' Association (EUPSA)

The Editorial Board of the European Journal of Pediatric Surgery is pleased to release the European Paediatric Surgeons' Association Issue 2007. The best manuscripts of papers presented at the 8th European Paediatric Surgeons' Association Annual Congress, which took place in May 2007 in Turin, were selected for publication.

Editorials

The European Journal of Pediatric Surgery is the official journal of the European Association of Paediatric Surgery (EUPSA). We are pleased to announce the new program of the two organizations, which was initiated this year. The best 12 papers presented at the annual congress of the European Association of Paediatric Surgery will be published yearly in a special EUPSA issue of the journal.

Gastric Outlet Obstruction: The Role of H. pylori Infection Concomitant with Ectopic Pancreatic Tissue

In issue 6 of the European Journal of Pediatric Surgery published in December 2003, Ormarsson et al. reported a nine-year-old boy with gastric outlet obstruction, caused by ectopic pancreatic tissue in the stomach [[3]]. Although ectopic pancreas is usually an incidental finding in adults, it may be associated with intussusception or obstruction during childhood [[1], [2], [4]].

Editorial

This issue of the European Journal of Pediatric Surgery has a focus on papers from Polish centers of pediatric surgery that were presented at the 11th Congress of the Polish Association of Pediatric Surgeons. This focus documents a development that reaches back to 2003 when Professor Holschneider and myself started to discuss perspectives of an intensified representation of Poland within the multinational network of the European Journal of Pediatric Surgery. Bearing in mind my shared editorial responsibility for the journal Surgery in Childhood International, which has traditionally served as the forum for Eastern-Middle and Eastern European societies of our subject, I was at first in doubt whether an affiliation to the European Journal of Pediatric Surgery with its strong Western European background would lead to a reduced representation of papers from Eastern Europe.

Response to Orvar Swenson’s Hirschsprung’s disease—A complicated therapeutic problem: Some thoughts and solutions based on data and personal experience over 56 years

IT IS TRULY a privilege and honor and a humbling experience to comment on Dr Orvar Swenson’s article in this issue of the Journal of Pediatric Surgery. Dr Swenson certainly is the father of the modern treatment of Hirschsprung’s disease. The clarity of his thinking in this article at age 95 is truly remarkable. In the current report, Dr Swenson addresses 2 very important issues in the management of Hirschsprung’s disease, namely, postoperative enterocolitis and the most effective pull-through for the definitive treatment of this disease.

Report of past meeting

Report of past meeting

Left ventricular assist devices: bridges to transplantation, recovery, and destination for whom?

Application of mechanical cardiac support now requires consideration of a wider range of goals beyond bridging to transplantation to include destination therapy and perhaps bridging to recovery.1,2 Responsible dissemination of the technology requires identification of patient populations from which to select candidates most likely to benefit. At this early stage, benefit is most apparent against a high background mortality from end-stage heart failure. Heart failure affects an estimated 5 million patients in the United States. Of those, ≈60% have heart failure with left ventricular dilation and reduced ejection fraction. Trials demonstrating benefit of therapies for heart failure have focused primarily on mild–moderate heart failure with reduced ejection fraction, generally with annual mortality in the range of 8% to 18%.3 Advanced heart failure has been defined as symptoms limiting daily activity (New York Heart Association class III and IV) despite attempted therapy with angiotensin-converting enzyme inhibitors, β-blockers, digoxin, and diuretics,4 a description that applies to ≈300 000 to 800 000 patients in the United States. Although often labeled as “refractory,” many patients enjoy improved quality of life and decreased hospitalizations after referral to experienced heart failure centers, where aggressive medical strategies focus on relief of congestion. Surgical approaches include complex revascularization, valvular repair/replacement, or ventricular reconstruction. When technically successful, biventricular pacing can improve functional status for many of the 25% to 40% of patients with marked ventricular asynchrony.5 If early stabilization allows institution of β-adrenergic–blocking agents, prognosis is further improved.6 Dedicated heart failure management programs that facilitate patient education, compliance, and fluid balance have been integral to benefits observed with these therapies. The highest-risk heart failure populations are best identified after optimization of current therapies. Low left ventricular ejection fraction is not sufficient description of either function or prognosis once heart failure has become advanced. Neither …

Critical analysis of clinical research reporting in pediatric surgery: justifying the need for a new standard

Background/Purpose: Clinical practice in surgery relies heavily on observational data in which accurate and nonbiased reporting is critical. This study aims to assess the adequacy of clinical research reporting in pediatric surgery and to develop a means to raise the standard of such reporting. Methods: The authors analyzed all observational studies published in The Journal of Pediatric Surgery from 1997 to 2002 (n = 300). Studies were assessed for 16 baseline criteria essential for the nonbiased reporting of clinical data (details regarding surgeons, cases, interventions, and statistical methods). Seven additional criteria pertaining to comparison methods were assessed in studies using controls. Results: Ninety-five percent of all studies were retrospective, and only 25% utilized a control group. Most studies met less than half of the essential reporting criteria (mean, 7.6 of 16 baseline criteria; 3.3 of 7 comparison criteria). Reporting deficiencies were found in all major aspects of study design and statistical analysis. Conclusions: More rigorous reporting of clinical data in pediatric surgery could increase the clinical utility of published results. The authors have identified the fundamental elements essential to nonbiased reporting of clinical research data in surgery. Implementation of mandatory peer-review guidelines based on these principles could set a new standard for clinical reporting in surgery.

A new Editor for Europe

AFTER MANY YEARS of valued service to the Journal of Pediatric Surgery, Professor Jan C. Molenaar has decided to step down from his position as Editor for Europe. Jan, a native of the Netherlands, has had a long and distinguished career in Pediatric Surgery. He graduated from medical school at the Free University, Amsterdam, in 1959. After graduation he served as a missionary doctor in Papua, New Guinea for 3 years (1959-1962). His training in Surgery occurred between 1962 and 1969 at the Free University where he also obtained a Master's degree in Surgery. He trained in Pediatric Surgery at Sophia Children's Hospital, Rotterdam, from 1969 to 1970. He returned to Amsterdam and began a new Department of Pediatric Surgery at Free University. In 1974 he was appointed Surgeon-in-Chief of Pediatric Surgery at Sophia Children's Hospital, Rotterdam, and the following year he was appointed the first chair of Pediatric Surgery at Erasmus University, Rotterdam. Professor Molenaar was a very productive clinician and academician. He established a rich environment for basic science pediatric surgical research and a well respected clinical center at his facility. He has published 216 scientific manuscripts in peer-reviewed journals, contributed many chapters to pediatric surgical texts, and has lectured extensively both in Europe and on the other continents. He is a founding member of the Dutch Association of Pediatric Surgeons and is an honorary member of other children's surgical associations including the British Association of Pediatric Surgeons; Section on Surgery, American Academy of Pediatrics; and the American Pediatric Surgical Association. He received the Denis Browne gold medal from the British Association for his numerous contributions to the field. He was the initiator and founder of the International Society for the History of Pediatric Surgery.

Methodology standards associated with quality reporting in clinical studies in pediatric surgery journals

Background/Purpose: Reports of clinical trials often lack adequate descriptions of design and analysis; recent attention has focused on improving this omission so readers can properly assess the strength of the findings and draw their own conclusions. Similar analysis of study design and methodologic standards associated with quality reporting has not been carried out for pediatric surgery journals. Methods: All studies (n = 642) published in 1998 in Journal of Pediatric Surgery (JPS) and Pediatric Surgery International (PSI), were reviewed for demographic data and study design. The frequency of reporting of 11 basic elements of design and analysis was evaluated in randomized clinical trials (RCT), nonrandomized clinical trials (NRCT), and retrospective cohorts (RC) from JPS by consensus of 2 assessors. Results: Of the 642 studies, 17% of articles (111 of 642) were classified as clinical studies. Sixty-three were comparative studies and consisted of RC (n = 48), NRCT (n = 12), and RCT (n = 3). Two-thirds of articles published were either case reports or case series (431 of 642), and 16% were basic science articles. Demographic analysis showed a wide range of topics addressed, 4 authors per article, and multiple country of origin of authors. More than 66% of all RCT in JPS reported on eligibility criteria, admission before allocation, random allocation, method of randomization, patients' blindness to treatment, treatment complications, statistical analyses, statistical methods, loss to follow-up, and statistical methods; 2 elements of design and analysis, however, were poorly reported: blind assessment of outcome (33%) and power (17%). Conclusions: There were few randomized, controlled trials in pediatric surgery journals, and further attention should be given to evaluate the causal factors. Nine elements of quality reporting were well reported; however, 2 others were poorly reported; this may improve if editors of pediatric surgical journals provide authors with guidelines on how to report clinical trial design and analysis. J Pediatr Surg 36:1160-1164. Copyright © 2001 by W.B. Saunders Company.

President's report of the European Board of Paediatric Surgery (EBPS).

President's report of the European Board of Paediatric Surgery (EBPS).

Editorial: Duplicate and fraudulent submission of manuscripts

Editorial: Duplicate and fraudulent submission of manuscripts

Report of past meeting: 32nd annual meeting of the Canadian association of paediatric surgeons

RETRACING THE FOOTSTEPS of world leaders, the attendees of the 32nd annual meeting of the Canadian Association of Paediatric Surgeons (CAPS) met in Montebello, Quebec, site of the G7 meeting of 1981. From September 15-18, 2000, a wide variety of subjects pertaining to our specialty were presented and discussed, as is evident by the articles published in this issue of the Journal of Pediatric Surgery.

Appreciating the past and exploring the future

Appreciating the past and exploring the future

In memoriam

ON THE 15TH of May, 2000, David Vervat died in his 86th year of life. He was one of the founding editors of the Journal of Pediatric Surgery, a founding overseas member and honorary member of the British Association of Paediatric Surgeons, honorary member of the Société Française de Chirurgie Infantile (the French Pediatric Surgical Association), of the Deutsche Arbeitsgemeinschaft für Kinderchirurgie (German Working Group for Pediatric Surgery) and of the Nederlandse Vereniging voor Kindergeneeskunde (Dutch Society for Paediatrics).

35th anniversary of the Journal of Pediatric Surgery (1966-2001): A look into the future

35th anniversary of the Journal of Pediatric Surgery (1966-2001): A look into the future

Clinical results of the shallow core-out procedure in thyroglossal duct cyst operation

Purpose: This procedure for thyroglossal duct cyst operation based on pathological studies was first published in the Journal of Pediatric Surgery in 1992. This procedure is similar to Sistrunk's operation except that the core depth of the tongue excision is more shallow (about 5 mm in young children). The purpose of this report is to report and evaluate the clinical results of this operation compared with our earlier operative results. Methods: Eighty-three patients underwent surgery for thyroglossal duct cyst from 1970 to 1997. They were divided into 3 groups. Group I consisted of 31 patients undergoing Schlange's operation (1970 to 1988). Group II were 18 patients undergoing Sistrunk's operation (1989 to 1990). Group III consisted of 34 patients operated on with the authors' procedure (1991 through 1997). The 3 groups are compared for recurrence rate. Results: Recurrence in group I was 6 of 31 (19.3%), 1 of 18 (5.6%) in group II, and 1 of 34 (2.9%) in group III. The recurrence rate showed a statistically significant difference only between group I and III ( P = .033). Conclusion: The recurrence rate with our procedure was not higher than that of Sistrunk's operation but was significantly lower than for Schlange's operation.

Evidence-based practice in pediatric surgery

Background/Purpose: The current medical environment demands the provision of quality healthcare at an affordable cost. Both payors and regulators are committed to lowering cost through initiation of best practice strategies that include practice guidelines, clinical pathways, and standards of care. The only practical way to join this debate is through the use of objective, unbiased clinical data. This study was undertaken to review the current state of the pediatric surgery literature and its value in determining best clinical practice.Methods: The National Library of Medicine Medline database was accessed using the Ovid Internet client software. All references, abstracts, and keyword indexes from the core pediatric surgery literature, the Journal of Pediatric Surgery, the European Journal of Pediatric Surgery, Pediatric Surgery International, Zeitschrift fur Kinderchirurgie, and Seminars in Pediatric Surgery were downloaded and reviewed. Search criteria were defined to identify prospective, randomized, controlled studies. References were then categorized as case reports; retrospective case series; prospective case series; randomized, controlled studies; laboratory studies; review articles; or miscellaneous studies.Results: As of March 1, 1998, there are 9,373 references, excluding citations of letters or comments, contained in the core pediatric surgery literature, as provided through Medline. Of these, 485 were identified as studies for review, possible prospective case series or prospective, randomized, controlled studies. After review, 34 studies (0.3%) were classified as prospective, randomized, controlled studies, whereas 139 (1.48%) were classified as prospective studies. There were 3,241 (34.6%) case reports, 5,619 (59.9%) retrospective case series, 1,109 (11.8%) laboratory studies, 195 (2.1%) review articles, and 36 (0.3%) miscellaneous studies that did not fit into other categories. When analyzed by decade of publication, prospective studies and prospective, randomized, controlled studies (n = 173) numbered 103 in the 1990s, 63 in the 1980s, and seven in the 1970s.Conclusions: There is a paucity of scientifically rigorous data on which to base clinical practice in pediatric surgery. The increasing numbers of prospective, case-controlled studies or the more sound prospective, randomized, controlled trials in the 1990s suggests that pediatric surgeons are aware of the need to generate unbiased data to support current clinical practice and the development of practice guidelines. Limitations exist in conducting prospective, randomized, controlled trials because of the rare nature of many pediatric surgical conditions and the lack of clinical “equipoise” over available treatment options. The authors encourage the use of multiin-stitutional trials and the prospective, randomized, controlled study methodology to develop data that can be used to guide clinical practice in our evolving healthcare environment.