Abstract：
BACKGROUND/PURPOSE:American pediatric surgical education has more than a 65-year history of formalizing the organization and the curriculum of the training process. However, never before have so many simultaneous internal and external forces appeared on the horizon that have the collective potential of influencing the quality of future pediatric surgeons. It is the purpose of this study to identify and detail these opportunities, compare them with the historical past, and propose the beginnings of a strategy to control the destiny. The ultimate goal should be to continue to assure that pediatric surgeons are of the highest attainable quality that will optimize the surgical health of America's children. METHODS AND RESULTS:Using a current literature review, 7 specific influencing forces have been identified: a declining applicant pool, the generation-X factor, medical economics, early specialization of training, restricted residency work hours, pediatric surgical manpower, and competency-based surgical education. An effective response to these forces is multifactorial, but a first need might be consideration of a new educational oversight organizational structure for pediatric surgery. Thereafter, specific curricular reform is needed to match the strengths of the candidates as well as the training programs. Finally, as a specialty field we must assert the leadership needed to define optimal educational outcomes. CONCLUSIONS:This report defines the educational history and the contemporary influencing forces, and it proposes a strategy to assure that pediatric surgical education exceeds the needs of America's children into the future.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Ziegler MMdoi
10.1016/j.jpedsurg.2004.04.002subject
Has Abstractpub_date
2004-08-01 00:00:00pages
1159-72issue
8eissn
0022-3468issn
1531-5037pii
S0022346804002532journal_volume
39pub_type
历史文章,杂志文章abstract：:Renal cell carcinoma arising from epithelial cells of the renal tubule is a highly aggressive and malignant tumor in all ages. Less than 2% of cases occur in childhood, relatively in older age group. Only a few pediatric series have been presented in the English literature. Tumor is presented with characteristic findi...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章,评审
doi：10.1016/j.jpedsurg.2005.02.013
更新日期：2005-05-01 00:00:00
abstract：:Histopathological study of the remnant of extrahepatic bile ducts in 40 cases of so-called uncorrectable biliary atresia, upon which we operated the last three years, has been performed. The histological findings of the remnant were classified into three types. Only two cases were found to have type 1a ducts in the po...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(77)90291-3
更新日期：1977-02-01 00:00:00
abstract：INTRODUCTION:In experiments involving tracheal wall defects in rabbits, metallic coil stents inevitably induce granulation formation in the defects. We examined the involvement of the mammalian target of rapamycin (mTOR) signaling pathway in granulation formation and examined the effects of rapamycin. METHODS:The ante...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2013.08.013
更新日期：2013-12-01 00:00:00
abstract：:To determine the extent of progress in the treatment of sacrococcygeal teratomas (SCTs), we evaluated the experience with 73 patients over 40 years. The medical records of the children were reviewed for demographics, histology, clinical course, and outcome. Therapy differed depending on the type of SCT, histology, and...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(92)90563-m
更新日期：1992-08-01 00:00:00
abstract：PURPOSE:Surgical correction of torticollis is occasionally necessary to curtail the facial deformity that can result from this condition. The resultant neck scar can be of suboptimal cosmesis, with consequent psychological distress for the child. We have previously described an endoscopic approach to forehead and brow ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2007.10.008
更新日期：2008-03-01 00:00:00
abstract：:Acquired gastric outlet obstruction occurred in a neonate following gastrostomy, after surgery to salvage a dehisced primary repair of an esophageal atresia. Despite free drainage of the gastrostomy and total support of the neonate, the gastric outlet obstruction persisted and required a further operation. An anterogr...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(88)80400-7
更新日期：1988-10-01 00:00:00
abstract：PURPOSE:The aim of this study was to examine the feasibility, safety, and short-term outcome of complete one-stage repair of high imperforate anus in the newborn boy. METHODS:A retrospective review was conducted of five full-term male infants who underwent posterior sagittal anorectoplasty without a colostomy within t...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(99)90382-2
更新日期：1999-05-01 00:00:00
abstract：:The need for feeding gastrostomy seems to be increasing in children with neurological impairment and swallowing incoordination. Because gastrostomy can cause or increase gastroesophageal reflux, an antireflux procedure has been advocated at the time of gastrostomy placement in neurologically impaired children. A gastr...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(90)90209-r
更新日期：1990-10-01 00:00:00
abstract：PURPOSE:Expandable metallic stents (Palmaz stents) have been used in the treatment of tracheobronchial obstruction in children and adults. The authors investigated their utility in the management of acute airway stenosis in a growing animal model. METHODS:A model for tracheal stenosis was developed in young lambs (mea...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(98)90527-9
更新日期：1998-07-01 00:00:00
abstract：BACKGROUND/PURPOSE:The optimal management of neonates with gastroschisis is unclear, and there is a significant morbidity. We performed a review of neonates with gastroschisis treated at our center of pediatric surgery over the last 21 years to determine predictive factors of outcome. METHODS:Single-center retrospecti...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2011.07.012
更新日期：2011-11-01 00:00:00
abstract：BACKGROUND:A small percentage of patients who undergo surgical correction of a chest wall deformity will have results so unsatisfactory that a second procedure, the so-called "re-do," will be required. CONCLUSIONS:The literature contains very little information regarding the technique and results of these procedures. ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(97)90299-2
更新日期：1997-09-01 00:00:00
abstract：:Varicella (chickenpox) affects approximately 90,000 children each year. Although most cases resolve, some develop necrotizing soft tissue infections secondary to group A streptococcus and staphylococcus. Delay in diagnosis is common. At the time of initial presentation, the need for surgical intervention is not always...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(96)90103-7
更新日期：1996-08-01 00:00:00
abstract：BACKGROUND:The efficiency of medical care in the United States has become intensely scrutinized with expectations from patients, families, payors, lawmakers, and, currently, the President. The most effective vehicle to bring more efficient care is the employment of evidence-based medicine whenever possible. Evidence-ba...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章,评审
doi：10.1016/j.jpedsurg.2010.05.008
更新日期：2010-10-01 00:00:00
abstract：:Intradural extension of a sacrococcygeal teratoma (SCT) is extremely rare and only well-documented in presacral tumors that have been associated with a familial history, anorectal stenosis, and sacral dysraphism. This case documents the extension of a type I SCT into the dural sac with attachment to the filum terminal...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(93)90322-c
更新日期：1993-06-01 00:00:00
abstract：BACKGROUND:Conventionally, an adult's standard of a 40-cm loop is adopted in Roux-Y hepatojejunostomy (RYHJ) in choledochal cyst (CDC) in children, irrespective of patient size. The redundant length of the jejunal limb may lead to complications. We compared the outcome of an individualized short Roux loop with the stan...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jpedsurg.2009.12.022
更新日期：2010-04-01 00:00:00
abstract：:Neutropenic enterocolitis (NE) is a clinicopathologic condition characterized by bowel wall inflammation, which can proceed to necrosis and perforation. It is mostly seen in neutropenic patients with leukemia who undergo induction treatment with chemotherapy. Most often the cecum is involved. The authors present a 12-...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1053/jpsu.2001.24754
更新日期：2001-07-01 00:00:00
abstract：OBJECTIVE:To compare the efficacy of transumbilical multiport (TMLP) and standard laparoscopic pyeloplasty (SLP) for the treatment of congenital ureteropelvic junction obstruction in children. METHODS:Forty-eight patients were included in this matched-pair study. The TMLP applied three transumbilical incisions for one...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2016.08.013
更新日期：2017-03-01 00:00:00
abstract：:Dysphagia and gastroesophageal reflux (GER) probably caused by structural disorganization of the esophagus occur frequently after repair of tracheoesophageal fistula (TEF), and the extent to which they may improve beyond childhood is not known. The aim of the present study is to assess by combined ambulatory 24-hour m...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(95)90029-2
更新日期：1995-08-01 00:00:00
abstract：BACKGROUND:We have previously reported that rejected allografts show dysmotility, which can be detected by real-time monitoring in swine. We examined the correlation between the motility and the mucosal histology to detect rejection at an early stage by real-time monitoring. METHODS:Intestinal transplantation was perf...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2007.03.038
更新日期：2007-08-01 00:00:00
abstract：PURPOSE:Congenital midureteric strictures (CMUS) are an uncommon cause of obstructive uropathy. There are only a few case reports of laparoscopic management of CMUS. We present our experience with laparoscopic repair of CMUS in 7 children. PATIENTS AND METHODS:The records of all children (n=7, 5 infants) undergoing la...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2015.07.013
更新日期：2015-11-01 00:00:00
abstract：:Pancreatic pseudocysts have not been reported to occur in the fetus or newborn. The authors report two cases of histologically proven pancreatic pseudocysts in neonates, which were detected using prenatal ultrasonography. Surgical management included external marsupialization followed by internal drainage in one case,...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(96)90185-2
更新日期：1996-11-01 00:00:00
abstract：:We present a case of intestinal obstruction owing to a gallstone ileus in a patient 20 years after a Kasai procedure for biliary atresia in which a stapled antireflux valve was constructed to treat recurrent cholangitis. The etiology of this rare presentation is discussed. ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2006.09.027
更新日期：2007-01-01 00:00:00
abstract：:Fifteen children with cholelithiasis who were treated at the Royal Hospital for Sick Children, Glasgow between 1973 and 1985 are reviewed. Ten patients had idiopathic gallstones and five had gallstones in association with hereditary spherocytosis. All patients have been followed up for between 4 months and 12 years (m...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(88)80732-2
更新日期：1988-03-01 00:00:00
abstract：PURPOSE:Retinoids play an important role in lung development. Recently, prenatal treatment with retinoic acid (RA) has been reported to stimulate alveologenesis in hypoplastic lungs in the nitrofen model of congenital diaphragmatic hernia (CDH). Chicken ovalbumin upstream promoter-transcription factor II (COUP-TFII) is...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2009.04.027
更新日期：2009-10-01 00:00:00
abstract：BACKGROUND/PURPOSE:The purpose of the study was to determine variables associated with attending postoperative clinic follow-up (POFU) in pediatric surgical patients, predictors of clinical value, and visit cost estimates. METHODS:POFU patterns of children undergoing eight common pediatric surgical procedures over one...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2019.01.045
更新日期：2019-05-01 00:00:00
abstract：BACKGROUND/PURPOSE:CDH occurs in approximately 1 in 2,450 live births. Bilateral CDH, previously identified through a limited number of case reports, is extremely rare. The care of CDH patients is a challenge for neonatologists and surgeons. This report details the management and outcome of patients with bilateral CDH....
journal_title：Journal of pediatric surgery
pub_type： 杂志文章,评审
doi：10.1053/jpsu.2003.50092
更新日期：2003-03-01 00:00:00
abstract：:The authors report 3 cases of liver transplantations in children between 4 and 10 years of age, complicated with malignant hepatic tumors after biliary atresia. The preoperative abdominal computed tomography (CT) scans of all 3 cases showed hepatic masses. The serum alpha-fetoprotein levels were elevated highly in 2 c...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章,评审
doi：10.1053/jpsu.2001.21600
更新日期：2001-03-01 00:00:00
abstract：PURPOSE:The aim of this study was to elucidate the urodynamic features of patients with Y-type urethral duplication. METHODS:Patients with Y-type urethral duplication were retrospectively analyzed. Clinical presentation, urodynamic findings, surgical methods, and treatment outcomes were reviewed. RESULTS:From 2014 to...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2017.06.001
更新日期：2018-07-01 00:00:00
abstract：:Menkes' kinky hair disease is a rare congenital disorder of copper metabolism with X-linked recessive inheritance. It is well known that it is frequently associated with urologic abnormalities. The authors experienced three such cases, but each of them was different. Multiple bladder diverticula, right vesico-ureteral...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(97)90035-x
更新日期：1997-05-01 00:00:00
abstract：PURPOSE:Heterotaxy syndrome is associated with intestinal abnormalities. We sought to define the gastrointestinal anatomy and determine both the risk of volvulus and benefit of screening upper gastrointestinal fluoroscopy (UGI) in these patients. METHODS:Medical records from 2003 until 2011 at Children's Hospital Los ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2012.10.033
更新日期：2013-01-01 00:00:00
