Pediatric Surgery - Pediatric Surgery General Principles and newborn surgery

Preface
Contents
About the Editor
Contributors
Part I: General
	1 Embryology of Congenital Malformations
		Misconceptions and/or Outdated Theories Concerning Normal and Abnormal Embryology
			A Shortage of Study Material (Both Normal and Abnormal Embryos)
			A Shortage of Explanatory Images of Embryos and Developing Embryonic Organs
			Difficulties in the Interpretation of Serial Sections
		Animal Models Used for Applied Embryology
			Embryos of Different Species for the Study of Normal Embryology
			Surgical Models
			Chemical Models
			Genetic Models
			Spontaneous Malformations Without Genetic Background
		Scanning Electron Microscopic Atlas of Normal and Abnormal Development in Embryos
			Foregut Development
				Normal Foregut Development
			Development of the Diaphragm
				Normal Development
				Abnormal Development
				Animal Model
			Development of the Hindgut
				Normal Development
				Abnormal Development
			Development of the External Genitalia and the Urethra
				Normal Development of the External Genitalia
				Abnormal Development of the External Genitalia (Hypospadia Formation)
			The Development of the Midgut
				Traditional Theories
				Own Observations
			Testicular Descent
				The Role of the Gubernaculum
		References
	2 The Epidemiology of Birth Defects
		Introduction
			Birth Prevalences Are the Cornerstone of Birth Defects Epidemiology
			Why Is It Important to Collect Birth Defects Data?
			The Practical Challenges of Birth Defects Epidemiology
			Ethical and Scientific Considerations
			On the ``Causation´´ of Birth Defects
			Birth Defects Epidemiology and the Pediatric Surgeon
		Conclusion and Future Directions
		Cross-References
		References
	3 Prenatal Diagnosis of Congenital Malformations
		Introduction
		Ultrasound
		MRI
		Amniocentesis
			Chorionic Villus Sampling (CVS)
		Biochemical Markers
			Percutaneous Umbilical Blood Sampling (PUBS)
		Fetal Cells in the Maternal Circulation
		Prenatal Diagnosis of Specific Surgical Lesions
			Neck Masses
		Sacrococcygeal Teratoma (SCT)
			Congenital Chest Lesions: Congenital Pulmonary Adenomatoid Malformation and Bronchopulmonary Sequestration
		Congenital Diaphragmatic Hernia (CDH)
		Gastrointestinal Lesions
			Esophageal and Bowel Atresias
			Abdominal Wall Defects
			Prenatal Diagnosis of Renal Anomalies
			Upper Urinary Tract Obstruction
			Lower Urinary Tract Obstruction (LUTO)
		Myelomeningocele
		Conclusion and Future Directions
		Cross-References
		References
	4 Fetal Counseling for Congenital Malformations
		Introduction
		Congenital Malformation
		Prenatal Diagnosis
			Fetal Imaging
				Ultrasound Examination
				Fetal Echocardiography
				Magnetic Resonance Imaging
			Minimally Invasive Diagnostic Tests
				Prenatal Maternal Serum Screening
				Genetic Diagnoses
			Invasive Diagnostic Tests
				Amniocentesis
				Chorionic Villus Sampling (CVS)
				Fetal Blood Sampling (FBS)
			Future Developments
			Fetal Surgery
		Specific Surgical Conditions
			Congenital Diaphragmatic Hernia (CDH)
			Cystic Lung Lesions
			Abdominal Wall Defects
				Exomphalos
				Gastroschisis
			Tracheoesophageal Fistula (TOF) and Esophageal Atresia (OA)
			Gastrointestinal Lesions
		Abdominal Cysts
			Sacrococcygeal Teratomas
			Renal Anomalies
				Upper Urinary Tract Obstruction
				Lower Urinary Tract Obstruction
		Conclusion and Future Directions
		Cross-References
		References
	5 Anatomy of the Infant and Child
		Introduction
		Growth and Proportions
		Cardiovascular System
			The Fetal Circulation
			Circulatory Changes After Birth
			The Heart
			Central Veins
			Umbilical Vessels
			Arteries
		Respiratory System
			Upper Airway
			Trachea
			Bronchial Tree
			Thorax and Mechanics of Breathing
		Abdominal Wall and Gastrointestinal Tract
			Abdominal and Pelvic Cavities
			Gastrointestinal Tract
			Liver, Gallbladder, and Spleen
		Genitourinary System
			Kidneys and Suprarenal Glands
			Bladder and Ureter
			Genitalia and Reproductive Tract
		Musculoskeletal System
			Skull and Face
			Vertebral Column, Pelvis, and Limbs
		Nervous System
		Skin and Subcutaneous Tissue
		Conclusion
		Cross-References
		References
	6 Perinatal Physiology
		Introduction
		The Fetal Circulation and Its Transition at Birth
			Closure of the Ductus Venosus
			Closure of the Foramen Ovale
			Fall in Pulmonary Vascular Resistance
			Closure of the Ductus Arteriosus
			The Respiratory System
				Fetal Breathing Movements (FBM)
				Peripheral Chemoreceptor Function In Utero
				Pharmacological Control
				Lung Growth Associated with FBM
				Changes at Birth
		Conclusion
		References
	7 Fetal Surgery
		Introduction
		Imaging and Diagnostics
		Principles of Maternal-Fetal Surgery
			Indications and Contraindications
			Anesthesia
			Positioning and Draping
			Incision and Exposure
			Closure
			Postoperative Care
			Outcomes
			Fetoscopy
			Ex Utero Intrapartum Therapy (EXIT)
		Anatomic Anomalies Currently Managed by Fetal Surgery
			Congenital Bronchopulmonary Malformations
				Pathophysiology
				Diagnosis
				Treatment
				Outcomes
			Congenital Diaphragmatic Hernia
				Pathophysiology
				Diagnosis
				Treatment of CDH
				Outcomes in CDH
			Myelomeningocele
				Pathophysiology and Natural History
				Diagnosis
				Treatment
				Outcomes
			Sacrococcygeal Teratoma
				Pathophysiology and Natural History
				Diagnosis
				Treatment
				Outcomes
			Twin-to-Twin Transfusion Syndrome
				Pathophysiology of TTTS
				Diagnosis of TTTS
				Treatment of TTTS
				Outcomes of TTTS
		Conclusion and Future Directions
		Cross-References
		References
	8 Specific Risks for the Preterm Infant
		Introduction
		General
		Respiratory
			Respiratory Distress Syndrome
			Pneumothorax
			Pulmonary Hemorrhage
			Bronchopulmonary Dysplasia (BPD) and Chronic Lung Disease (CLD)
			Apnea of Prematurity
		Cardiovascular
			Blood Pressure
			Patent Ductus Arteriosus
			Congenital Heart Disease
			Central Nervous System
				Intraventricular Hemorrhage
				Periventricular Leucomalacia
		Retinopathy of Prematurity (ROP)
		Gastrointestinal Tract
			Feeding and Nutrition
			Necrotizing Enterocolitis
			Spontaneous Bowel Perforation
			Inguinal Hernia
			Umbilical Hernia
		Infection
		Other
			Hyperbilirubinemia
			Electrolytes
			Anemia
		References
	9 Pediatric Clinical Genetics
		Introduction
		Diagnosis of Malformation Syndromes
			Introduction
			Definitions Used with Congenital Anomalies
			A Clinical Genetic Approach to Diagnosis of Malformation Syndromes
		Genetic Etiology of Congenital Anomalies
			Introduction
			Chromosome Disorders
				Down´s Syndrome
				Patau´s Syndrome
				Edward´s Syndrome
				Other Chromosome Disorders
			Single-Gene Disorders
				Autosomal Dominant Inheritance
				Single-Gene Disorders and Autosomal Recessive Inheritance
				Single-Gene Disorders and X-Linked Recessive Inheritance
				Single-Gene Disorders and Atypical Forms of Inheritance
			Polygenic/Multifactorial Disorders
		Genetic Testing
			Chromosomal G-Banding Analysis (Standard Karyotyping)
			Fluorescent In Situ Hybridization
			Array Comparative Genomic Hybridization/Chromosomal Microarray Analysis
			Specific Testing for Common Known Single-Gene Mutations
			Next-Generation Sequencing and Gene Panels
		Conclusions and Future Directions
		Cross-References
		Further Reading
	10 Transport of Sick Infants and Children
		Introduction
		Transport Management
			Airway Management
			Circulation and Homeostasis
			Documentation
		Transport Team
		Vehicles and Equipment
			Transport Vehicles
			Monitoring and Equipment
		Transport Procedure
		Receiving Center
		Special Considerations for Neonates
			Prenatal Transfer
			Neonatal Transfer
			Temperature Regulation
			Transport Incubators
		Conclusion and Future Directions
		Cross-References
		References
	11 Pediatric Respiratory Physiology
		Introduction
			Embryonic Phase (Until Eighth Week of Gestation)
			Pseudoglandular Phase (5th-17th Week of Gestation)
			Canalicular Phase (16th-26th Week of Gestation)
			Saccular Phase (24th Week of Gestation Until Birth)
			Alveolar Phase (36th Week of Gestation to 18 month-4 years Postnatal)
			Prenatal Development of the Pulmonary Surfactant System
			The Role of Lung Fluid and Fetal Breathing Movements in Lung Organogenesis and Growth
		Physiology of Transition from Intra- to Extrauterine Life
		Respiratory Physiology of the Neonatal Period
			Anatomy
			Pulmonary Circulation
			Pulmonary Gas Exchange
			Lung Volumes
			Airway Resistance
			Lung Compliance
		Respiratory Distress Syndrome
			Pathophysiology
			Incidence
			Clinical Symptoms
			X-Ray Findings in RDS
			Prevention/Therapy
				Antenatal Corticosteroids
				CPAP
				Surfactant
			Perspective
		Persistent Pulmonary Hypertension of the Newborn
			Etiology of PPHN
			Diagnosing PPHN
			General Management of PPHN
			Specific Medical Treatment
		Conclusion and Future Directions
		Cross-References
		References
	12 Pediatric Cardiovascular Physiology
		Introduction
		Determinants of Cardiac Output
			Preload
				General Principles
				Therapeutic Implications
			Afterload
				General Principles
				Therapeutic Implications
			Contractility
				General Principles
				Therapeutic Implications
			Heart Rate
				General Principles
				Therapeutic Implications
		Regulation of Whole-Body Oxygen Delivery
		The Fetal Circulation
		How Selected Types of Congenital Heart Disease Affect Cardiovascular Physiology
		Conclusions and Future Directions
		Cross-References
		References
	13 Pediatric Hepatic Physiology
		Introduction
		Liver Blood Flow
			Fetal Life and Transitional Circulation
			Postnatal Life
		Metabolic Functions of Liver
			Bile Formation
			Bilirubin
				Physiology of Newborn Jaundice
			Bile Acids
			Hepatic (or Canalicular) Bile
			Hormonal Control of Bile Flow
		Carbohydrate Metabolism
		Protein Synthesis
			Albumin
		Nitrogen Metabolism
		Lipid Metabolism
		The Role of the Liver in Hemostasis and Clotting
		Conclusions and Future Directions
		Cross-References
		References
			General Reading
	14 Metabolism of Infants and Children
		Introduction
		The Metabolic Response to Stress
		Nutritional Assessment/Estimation of Energy Expenditure During Illness
		Nutrient Reserves and Requirements
		Macronutrient Intake
			Review of Protein Metabolism and Requirement During Illness
		Protein Quality
		Modulating Protein Metabolism
		Carbohydrate Metabolism
		Glucose Control
		Lipid Metabolism
		Conclusion and Future Directions
		Cross-References
		References
	15 Fluid and Electrolyte Balance in Infants and Children
		Introduction
			Water Distribution in Infants and Children
				Effective Circulating Volume (ECV)
				Serum Osmolality
			Water Homeostasis
			Insensible Water Loss
				Sweating
				Renal Blood Flow
					Glomerular Filtration Rate
		Disorders of Body Fluid Volume: Dehydration and ECF Depletion
			Volume Depletion
				Dehydration
					Risk Factors for Dehydration
					Consequences of Dehydration
					Symptoms and Signs of Dehydration
					Degree of Dehydration
					Laboratory Testing
			Fluid and Electrolyte Management
		Electrolytes
			Sodium
				Dysnatremia
					Hyponatremia
					Hypernatremia
			Potassium
				Hyperkalemia
					Symptoms and Signs of Hyperkalemia
					Diagnostic Tests
					Treatment of Hyperkalemia
				Hypokalemia
					Causes of Hypokalemia
					Symptoms and Signs of Hypokalemia
					Complications of Hypokalemia
					Investigations of Hypokalemia
					Treatment of Hypokalemia
			Calcium
				Hypercalcemia
				Hypocalcemia
			Magnesium
				Hypomagnesemia
				Hypermagnesemia
			Phosphate
				Hypophosphatemia
					Treatment of Hypophosphatemia
				Hyperphosphatemia
		Acid-Base Balance
			Acid-Base Balance Disorders
				Metabolic Acidosis
				Metabolic Alkalosis
		Perioperative Management in Infants and Children
			Intraoperative Management
			Postoperative Management
		Fluid and Electrolyte Balance in Septic Shock
			Clinical Manifestations
				Management
			Total Parenteral Nutrition (TPN)
		Conclusions and Future Directions
		Cross-References
		References
	16 Vascular Access in Infants and Children
		Introduction
		Peripheral Venous Access
		Central Venous Access
			Peripherally Inserted Central Catheter (PICC)
			Umbilical Venous Catheters (UVC)
			Tunneled and Cuffed Catheter
			Implantable Vascular Access Devices (Ports)
		Intraosseous Access
		Arterial Vascular Access
			Umbilical Artery Catheterization
			Radial Artery Cannulation
			Pedal Arterial Cannulation
			Axillary and Femoral Arterial Cannulation
			Complications and Their Management
				Acute Complications
				Long-Term Complications
		Conclusions and Future Directions
		Cross-References
		References
	17 Nutrition in Infants and Children
		Introduction
		Changes in Body Composition
		Components of Energy Needs
		Energy Requirements of Surgical and Critically Ill Infants
		Parenteral Nutrition
			Indications
			Route of Administration
			Components of Parenteral Nutrition
				Fluid Requirements
				Glucose
				Lipids
				Amino Acids
					Minerals, Vitamins, and Trace Elements
			Complications of Parenteral Nutrition
				Infectious Complications
				Mechanical Complications
				Hepatic Complications
		Enteral Nutrition
			Feeding Routes
			Selection of Enteral Feeds
			Administration of Enteral Feeds
			Complications of Enteral Tube Feeding
		Conclusion and Future Directions
		References
	18 Access for Enteral Nutrition
		Introduction
		Naso-, Orogastric or Naso-, Oroenteric Access
		Gastrostomy
			Historical Perspective
			Indications
				Esophageal Abnormalities
				Duodenal Obstruction
				Major Abdominal Wall Defects
				Short-Gut Syndrome
				Other Surgical Pathologies
				``Nonsurgical´´ Pathologies
			Choice of Procedure/Technique
				Open Technique
				Percutaneous Endoscopic Gastrostomy
				Minimally Invasive Gastrostomies
				Choice of Access Device
			Complications and Management
				Complications Related to Operative Technique
				Complications Related to Care of Stoma
				Complications Related to Catheters
			Gastrostomy Closure and Persistent Gastrocutaneous Fistula
		Jejunostomy
			Indications
			Choice of Procedure
				Needle Catheter Jejunostomy
				Catheter Placement Directly into the Jejunum
				Catheter Placement in a Partially Excluded Loop
			Devices
			Postoperative Care and Complications
		Conclusion and Future Directions
		Cross-References
		References
	19 Tracheostomy in Infants
		Introduction
		Indications for Tracheostomy
		Preoperative Work-up and Planning
		Technique
			Position of Patient
			Incision and Dissection to Expose the Trachea
			Opening the Trachea and Insertion of the Cannula
				Early Postoperative Care
		Home Instruction and Care
		Complications
			During Procedure
			Immediate Post-Op
				Surgical Emphysema
				Bleeding
				Obstruction, for Example, Clot and Mucus
				Dislodgement
			Late Post-Op and Homecare
		Special Considerations
			Ex Utero Intrapartum Therapy (EXIT)
			Emergency Needle Cricothyroidotomy
		Decannulation
			Practical Steps of the Procedure
				Weaning
				Capping
		Conclusion and Future Directions
		Cross-References
		References
	20 Pediatric Airway Assessment
		Introduction
		Anatomy
		Assessment of the Pediatric Airway
		Examination
		Radiology Investigations
		Rigid Microlaryngoscopy Bronchoscopy
		Differential Diagnosis of Pediatric Stridor
		Conclusion
		Cross-References
		References
	21 Stomas of Small and Large Intestine
		Introduction
		Most Common Errors in Colostomies
			Stoma Mislocation
			Prolapse
			Stenosis
			Retraction
				Stomas in Cloacal Exstrophy (Soffer et al. 2000)
				Colostomies in Hirschsprung´s Disease
				Ileostomies
				Colostomy Closure
				Surgical Technique
		Conclusion and Future Direction
		Cross-References
		References
	22 Preoperative Assessments in Pediatric Surgery
		Introduction
		Preoperative Assessment for Day Case Surgery
		Clinic Design
		Patient Assessment
		History and Clinical Examination
			Perinatal History
			Medical History
			Medication History
			Allergy History
			Immunization History
			Anesthetic History
			Social History
		Clinical Examination
		Investigations
		Further Information
			Fasting Guidelines
			Follow-Up
		General Education Opportunities
		Completion of the Assessment
		Preoperative Assessment for Inpatient Surgery
		Investigations
		Blood Grouping and Crossmatching
		Preoperative Mechanical Bowel Preparation
		Optimization of Nutrition
		Specific Considerations
			The Child with an Incidental Murmur
		Endocarditis Prophylaxis
		The Child with an Upper Respiratory Tract Infection (URTI)
		The Obese Child
		The Child with Diabetes
		The Child with Cystic Fibrosis
		Preoperative Assessment of the Neonate
		History and Clinical Examination
		Temperature Regulation
		Respiratory Function
		Cardiovascular Status
		Metabolic Status
			Acid-Base Balance
			Hypoglycemia
			Hypocalcemia
			Hypomagnesemia
			Hyperbilirubinemia
		Coagulation Abnormalities
		Laboratory Investigations
		Fluid and Electrolytes and Metabolic Responses
		Conclusion and Future Directions
		Cross-References
		References
	23 Principles of Pediatric Surgical Imaging
		Introduction
		Effects of Radiation on Children
			Environmental Issues for a Pediatric Radiology Department
				Patient Preparation
				Order of Examinations
				Waiting Area
				Examination/Procedure Rooms
		Sedation and Anesthesia in the Radiology Department
		Techniques
			Natural Sleep
			Sedation
			General Anesthesia
			Assessment
			Consent
			Monitoring
			Equipment
			Personnel
		Contrast Media and Use in the Pediatric Radiology Department
			Barium Preparations
			Iodinated Contrast Agents
			Contrast Use in the Fluoroscopy Suite
			Contrast Use in the CT Suite
			Contrast Use in the MRI Suite
			Contraindications/Side Effects/Adverse Reactions
		Pediatric Interventional Radiology
		Conclusion and Future Directions
		Cross-References
		References
	24 Hematological Problems in Pediatric Surgery
		Introduction
		Hematological Basic Science
			Blood Formation (Hematopoiesis)
			Mechanisms of Hemostasis
			Natural Anticoagulation Control Mechanisms
			Platelets
			Blood Groups and Antibodies
		Hematological Disorders Encountered in Pediatric Practice: A Surgical Perspective
			Hemophilia
				Clinical Features
				Treatment
			Central Venous Access Devices (CVADs)
			von Willebrand Disease
			Platelet Disorders
			Immune Thrombocytopenia Purpura (ITP)
				Clinical Features
				Pathophysiology
				Clinical Course and Treatment (Provan et al. 2010)
			Disseminated Intravascular Coagulation (DIC)
				Treatment
			Thrombotic Disorders
				Treatment
			Asplenia/Splenectomy/Hyposplenism
			Anemia
			Hereditary Spherocytosis
			Sickle Cell Disease (SCD)
				Clinical Features and Management (Yawn et al. 2014)
				Chronic Complications
			Disease-Modifying Therapy
				Surgery in Sickle Cell Disease
					Key Principles of Perioperative Management
			Thalassemia
			Neutropenia
			Leukemia
				Management of Acute Leukemia
				Surgical Issues in the Leukemic Patient
			Blood Products and Their Transfusion
				Acute Complications of Blood Transfusion
			Other Adverse Reactions to Blood Product Transfusion
		Conclusion and Future Directions
		Cross-References
		References
	25 Surgical Safety in Children
		Introduction
			Background: The History of Surgical Error
		Tackling Concerns - Improvement Methodology
			Improvement Programs
			Policy-Based Care
		Human Factors in Surgery
			Definitions and Examples in Other Industries
			The Evolution of Non-technical Skills in Aviation: Crew Resource Management (CRM)
			From Aviation to Surgery
			NOTSS (Non-technical Skills for Surgeons)
			NOTSS and Implications for Surgical Performance
				Situation Awareness
				Decision-Making
				Leadership
				Communication and Teamwork
		Personal Awareness
		Surgical Checklists
			Surgical Briefings
		Conclusion and Future Directions
		References
	26 Anesthesia and Pain Management
		Introduction
		Preoperative Optimization
			Fasting Prior to Anesthesia and Surgery
		The Operating Theater and Anesthetic Equipment
			Breathing System
			Laryngoscopes
			Ventilators
		Anesthesia
			Monitoring
			Cardiovascular Monitoring
			Respiratory Monitoring
			Temperature
			Neuromuscular Blockade
		Induction and Maintenance of Anesthesia
			Recovery
			Fluid Balance
		Postoperative Pain Management
			Pain Assessment
			Analgesia
			Regional Anesthesia
		Special Considerations in the Premature Infant
		Anesthesia and the Developing Brain
		Anesthesia for Specific Surgical Conditions in the Newborn
			Esophageal Atresia
			Congenital Diaphragmatic Hernia
			Intestinal Obstruction
			Exomphalos and Gastroschisis
			Herniotomy for the Ex-premature Infant
		Postoperative Admission to Surgical NICU/PICU
		Conclusion and Future Directions
		Cross-References
		References
	27 Immunology and Immunodeficiencies in Children
		Introduction
			Monocytes
		Neutrophils
		Toll-Like Receptors
		Mucosal Immunity, Human Milk, and Necrotizing Enterocolitis (NEC)
		Neonatal Innate Immunity
		Pediatric Adaptive Immune Response
		Lymphocyte Phenotype
		B-Cell Responses
		Immunoglobulins
		Cytokines
		The Inflammatory Response Syndromes
		Clinical Outcomes in Neonatal Sepsis and Inflammation
		Pediatric Sepsis
		Primary Immunodeficiencies
			B-Cell Deficiencies
			T-Cell Deficiencies
			Combined B- and T-Cell Deficiencies
		Complement Deficiencies
			Phagocytic Cell Deficiencies
		Acquired Immunodeficiency
			Immunomodulation
		Conclusion and Future Directions
		Cross-References
		References
	28 Sepsis
		Introduction
		Terminology
		Epidemiology
		Pathogenesis
			Barriers to Infection
		Host Response
			Cellular Immunity
			Macrophages
			Lymphocytes
		Humoral Factors
			Complement
			Immunoglobulins
			Cytokines
		Bacterial Virulence
		Neonatal Defenses
		Diagnosis
		Treatment of Sepsis in Children
		Neonatal Septic Shock
		Conclusion and Future Directions
		Cross-References
		References
	29 Principles of Minimally Invasive Surgery in Children
		Introduction
		Basic Principles
			Patient Selection and Preoperative Workup
			Ergonomics
			Advances in Technology and Intraoperative Considerations
			Technical Considerations
		Risks and Benefits
			Evolution of Single Site Laparoscopic Surgery (SILS)
			Role of Robotics in Pediatrics
		Conclusion
		Cross-References
		References
	30 Innovations in Minimally Invasive Surgery in Children
		Introduction
			From Open to Laparoscopic in Pediatric Surgery
			Laparoscopes and Hand Instruments
			Trocars
			Insufflators
			Neonatal Laparoscopy
			Needlescopic Surgery
			Laparoscopic Inguinal Hernia Repair
		Hiding the Scars
			Single-Incision Laparoscopy
			Single-Incision Laparoscopic Techniques in Pediatric Patients
			Single-Port Laparoscopic Cholecystectomy: Considerations in Children
				Key Steps
			``2x2´´ Laparoscopic Cholecystectomy: Scarless Surgery in Children
				Key Steps
			Single-Incision Laparoscopic Gastrostomy: Utilizing an Operative Hysteroscope
				Key Steps
			Appendectomy
				Key Steps
			Natural Orifice Endoluminal Surgery (NOTES)
		Other Innovations
			Robotic Surgery
			Technical Benefits of Robotic Surgery
			Technical Limitations of Robotic Surgery
			Patient Benefits of Robotic Surgery
			Costs
			Safety
			Learning Curve
			Future
			Telemedicine
			Gastric Stimulators
		Conclusion and Future Directions
		Cross-References
		References
	31 Fast-Track Pediatric Surgery
		Introduction
			Historical Aspects
			Current Concept
		The Evolution of Fast-Track Pediatric Surgery
		The Concepts and Components of Fast-Track Pediatric Surgery
		Conclusion and Future Directions
		Cross-References
		References
	32 Ethical Considerations in Pediatric Surgery
		Introduction
		Defining the Best Interests Standard
		Applying the Best Interests Standard
		Guidelines for Ethical Decision-Making
		Informed Consent and Assent
		Multiculturalism
		Prenatal Surgical Consultation and Fetal Surgery
		Ethical Issues in Pediatric Bariatric Surgery
		Surgeons and Industry
		Surgical Error
		Best Interests and Innovation and Clinical Research
		Conclusion and Future Directions
		Cross-References
		References
	33 Childhood Obesity
		Introduction
		Measuring Overweight and Obesity in Children
			Indices Based on Weight for Height Measures
			Consequences of Different Growth Standards
			Skinfolds and Body Circumference
		Global Burden of Childhood Obesity
			Childhood Obesity in LMICs
			Childhood Obesity and Social Economic Class
		Pathways to Childhood Obesity
			Developmental Mismatch
			Maternal Obesity and Gestational Diabetes Mellitus
		Health Consequences of Childhood Obesity
		Childhood Obesity and Surgery Related Complications
		How Early Should Prevention for Childhood Obesity Start?
		Conclusion and Future Directions
		Cross-References
		References
	34 Surgical Problems of Children with Physical Disabilities
		Introduction
			Multidisciplinary Management
			Family-Centered Care
			Non-accidental Trauma: Abuse and Neglect
		General Perioperative Issues
			Ethical Complexity
		Perioperative Considerations in Specific CSHCN Conditions
			Cerebral Palsy
				Spasticity, Body Habitus, and Scoliosis
				General Perioperative Neurologic Considerations
				Nutrition, Feeding, and Gastroesophageal Reflux
					Neurologic Dysphagia and Aspiration
					Evaluation of a Possible Feeding Disorder
					Gastrostomy
					Jejunostomy
					Gastroesophageal Reflux and Delayed Gastric Emptying
					Complications of Gastrostomy and Fundoplication
					Surgical Outcomes of Enteral Access or Fundoplication
				Decubitus Ulcers
			Down Syndrome: Trisomy 21
				Gastrointestinal Malformations and Down Syndrome
				Other Operative Considerations in Patients with Down Syndrome
			Spina Bifida
				Latex Allergy Resulting in Intraoperative Anaphylaxis
				Hydrocephalus Drainage and Shunt Considerations
				Spina Bifida and the Acute Abdomen
				Esophagitis
				Neurogenic Bowel
				Antegrade Colonic Irrigation
		Conclusion and Future Directions
		Cross-References
		References
	35 Clinical Research and Evidence-Based Pediatric Surgery
		Introduction
		Common Types of Study Design
		Concept of Evidence-Based Medicine (EBM)
		The 5As of an EBM Cycle
		Asking an Answerable Clinical Question in the ``PICO´´ Format
		Searching for and Selecting the Best Available Evidence for a PICO Question
		Critical Appraisal of the Identified Evidence
		Interpreting the Internal Validity of a Study Result by Assessing the Role of Chance, Bias, and Confounding
		Look Out for Possibility of Bias in Relation to Different Study Designs
		Have Potential Confounding Factors Been Addressed?
		Examining the Role of Chance and Statistical Significance of the Result
		Examining the Clinical Significance of the Result
		Causality Assessment of the Result by Bradford Hill´s Criteria
		Is the Conclusion Applicable to the Patient in the Clinical Question?
		Clinical Research in Pediatric Surgery
		Constructing a Research Question and Designing the Study
		Planning the Logistics for a Clinical Research
		Data Acquisition and Analysis
		Sample Size Estimation
		Preparing for a Grant Application
		Communicating the Research Findings in an Evidence-Based Format
		Conclusion and Future Directions
		Cross-References
		References
	36 Tissue Engineering and Stem Cell Research
		Introduction
		Stem Cells
			Embryonic Stem Cells
			Somatic Cell Nuclear Transfer
			Induced Pluripotent Stem Cells
			Fetal Stem Cells
			Adult Stem Cells
		Scaffolds
			Naturally Derived Materials
			Synthetic Materials
			Natural Acellular Matrix
			Cell-Derived ECM Scaffolds
		Regenerative Medicine
		Conclusion
		References
	37 Patient- and Family-Oriented Pediatric Surgical Care
		Introduction
		Core Principles
		History of Patient and Family-Oriented Care
		Additional Resources
		Delivering News
		The Prepared Messenger
		Pre-managing One´s Personal Story and Pain
		Physical Presence
		Communicating News
		What to Say
		Conclusion and Future Directions
		Cross-References
		References
	38 Surgical Implications of Human Immunodeficiency Virus Infection in Children
		Introduction
			Infections
			Gastrointestinal Tract Disease
				Intra-abdominal Pathology
			Perineal Disease
			Malignancy
		Medical Aspects of Pediatric HIV Infection and Their Effects on Surgery
		Outcomes of HIV Infected Children Undergoing Surgery
		Factors Influencing Post-surgical Complications in HIV Infected Children
		HIV Exposed Uninfected (HIVe) Children
		Conclusion and Future Directions
		Cross-References
		References
Part II: Newborn Surgery: Head and Neck
	39 Choanal Atresia
		Introduction
		Epidemiology
		Embryology
		Suggested Etiology
		Clinical Features
		Diagnosis
		Management
		Endoscopic Technique
		Transpalatal Technique
		Controversies in Choanal Atresia Management
			Nasal Stents
			Mitomycin C
			Outcomes
		Conclusion and Future Directions
		Cross-References
		References
	40 Macroglossia
		Introduction
		Etiology and Pathology
		Presentation
		Diagnosis
		Management
		Surgery
		Conclusion and Future Directions
		Cross-References
		References
	41 Pierre Robin Sequence
		Introduction
		Epidemiology
		Etiology
		Genetics
		Clinical Features
		Airway Management
		Nutritional Management
		Cleft Palate
		Micrognathia/Retrognathia
		Skeletal Anomalies
		Ear Problems
		Cardiovascular Anomalies
		Ocular Anomalies
		Nasal Obstruction
		Conclusion and Future Directions
		Cross-References
		References
	42 Lymphatic Malformations in Children
		Introduction
		Classification
			Diagnosis
			Prenatal Management
			Postnatal Management
			Operative Approach to Classic Neck Lymphatic Malformation
		Conclusions and Future Directions
		Cross-References
		References
	43 Stridor in the Newborn
		Introduction
		Laryngeal Anomalies
			Laryngomalacia
		Vocal Cord Paralysis
		Subglottic Stenosis
		Subglottic Hemangioma
		Other Laryngeal Anomalies
			Laryngeal Clefts
			Laryngeal Web
			Congenital Laryngeal Cysts
			Laryngeal Lymphangioma
		Tracheomalacia
		Other Airway Pathology
		Conclusion and Future Directions
		Cross-References
		References
Part III: Newborn Surgery: Esophagus
	44 Esophageal Atresia
		Introduction
		Incidence and Etiology
		Embryology
		Associated Malformations
		Classification
		Diagnosis
			Prenatally
			Postnatal Symptoms
			Radiological Diagnosis
		Management
			Preoperative Management
			Operative Management
				Esophageal Atresia with Distal Tracheoesophageal Fistula (85%)
				Esophageal Atresia with Proximal and Distal Tracheoesophageal Fistula (1.5%)
				Esophageal Atresia with a Proximal Tracheoesophageal Fistula Only: A Long Gap Problem (1%)
				H-Type Fistula (4%)
				The Long Gap Problem (8.5%)
		Complications
			Early Complications
			Late Complications
		Long-Term Follow-Up
		Conclusions and Future Directions
		Cross-References
		References
	45 Congenital Esophageal Stenosis
		Introduction
		Pathology
		Epidemiology/Etiology
		Symptoms
		Diagnosis
		Treatment
			Nonsurgical Treatment
			Surgery
		Management of Complications Following Treatment
		Prognosis
		Conclusion and Future Directions
		Cross-References
		References
	46 Esophageal Duplication Cyst
		Introduction
		Embryology
		Relevant Anatomy
		Pathology
		Clinical Features and Presentation
			Antenatal
			Incidental
			Symptomatic
			Malignancy
		Investigations
		Management
			Thoracoscopic Surgery
			Thoracotomy
		Surgical Management of Various Types of Esophageal Duplication Cysts
			Cervical and Suprasternal Cyst
			Left-Sided Thoracic Inlet Duplication Cyst
			Right-Sided Thoracic Duplication Cyst
			Intra-abdominal Esophageal Duplication Cyst
			Neuroenteric Cyst
		Surgical Complications
		Conclusions and Future Directions
		Cross-References
		References
	47 Esophageal Perforation in the Newborn
		Introduction
		Classification and Etiology
		Diagnosis and Clinical Manifestations
		Management
		Conclusion and Future Directions
		Cross-References
		References
Part IV: Newborn Surgery: Chest
	48 Congenital Airway Malformations
		Introduction
		Patient Assessment
			Medical History
			Signs and Symptoms
			Diagnostic Studies
		Congenital Laryngeal Anomalies
			Laryngomalacia
			Subglottic Stenosis
			Vocal Fold Paralysis
			Posterior Laryngeal Cleft
			Laryngeal Atresia
				Congenital High Airway Obstruction Syndrome
			Subglottic Hemangioma
		Anomalies of the Trachea and Bronchi
			Tracheal Agenesis and Atresia
			Tracheal Stenosis and Webs
				Tracheal Webs
				Cartilaginous Ring Aplasia
				Tracheal Cartilaginous Sleeve
				Complete Tracheal Rings
			Tracheal Diverticulum and Tracheal Bronchus
			Airway Malacia
			Esophageal Bronchus
			Bronchogenic Cyst
			Bronchial Atresia and Bronchial Lobar Agenesis
				Bronchial Atresia
				Bronchial Lobar Agenesis
			Bronchial Stenosis
		Conclusion and Future Directions
		Cross-References
		References
	49 Vascular Rings
		Introduction
		Definition and History
		Frequency
		Embryology
		Forms
			Double Aortic Arch
			Right Aortic Arch
				Right Aortic Arch with Aberrant Left Subclavian Artery and Left Ligamentum Arteriosum
				Right Aortic Arch with Mirror Image Branching and Retroesophageal Ligamentum Arteriosum
			Pulmonary Artery Sling
			Vascular Rings Associated with Left Aortic Arch
				Left Aortic Arch with Right Descending Aorta and Right Ligamentum Arteriosum
				Left Aortic Arch and Left Ligamentum Arteriosum with Retroesophageal Right Subclavian Artery
		Clinical Findings
		Associated Syndromes and Noncardiac Conditions
		Diagnostic Tests
			Laboratory Studies
			Chest Radiography
			Barium Esophagram
			Echocardiography and Color Flow Doppler
			Computerized Tomography Scan, Magnetic Resonance Imaging, and Digital Subtraction Angiography
			Bronchoscopy
		Indication for Intervention
		Surgical Therapy
			Division of a Double Aortic Arch
				Traditional Thoracotomy Approach
			Video-Assisted Technique
			Right Aortic Arch
			Pulmonary Artery Sling
			Left Aortic Arch with Anomalous Origin of the Innominate Artery
			Results
		Conclusion and Future Directions
		Cross-References
		References
	50 Pulmonary Air Leaks of the Neonate
		Introduction
		Pneumothorax
			Presentation and Diagnosis
			Treatment
			Prognosis
		Pulmonary Interstitial Emphysema
			Presentation and Diagnosis
			Treatment
			Prognosis
		Pneumomediastinum
		Pneumopericardium
		Pneumoperitoneum
		Conclusion and Future Directions
		Cross-References
		References
	51 Chylothorax and Other Pleural Effusions in Neonates
		Introduction
		Anatomy and Embryology of the Lymphatic System
		Pathophysiology of Chyle
		Etiology and Presentation of Chylothorax
			Congenital Chylothorax
			Acquired Chylothorax
		Clinical Features of Chylothorax
			Presenting Symptoms
			Consequence of Continuous Chylous Flow
		Confirming the Diagnosis
		Management of Chylothorax
			Nonoperative Management
			Operative Management
				Pleuroperitoneal Shunts
				Other Surgical Alternatives
			General Management Principles
		Fetal Chylothorax (Hydrothorax)
		Other Pleural Effusions
			Hemothorax
			Empyema
		Cross-References
		References
	52 Congenital Malformations of the Lung
		Introduction
		Embryology
		Anatomy
		Congenital Pulmonary Airway Malformations/Congenital Cystic Adenomatoid Malformations
			Pathology
		Diagnosis
			Radiographic
		Clinical Features
		Management
			Fetal Therapy
		Postnatal Therapy
		Pulmonary Sequestrations
			Pathology
		Diagnosis
		Management
		Congenital Lobar Emphysema
			Pathology
		Diagnosis
			Presentation and Diagnosis
		Clinical Features
		Management
		Bronchogenic Cysts and Congenital Lung Cysts
			Pathology
		Presentation and Diagnosis
		Management
		Pulmonary Hypoplasia, Aplasia, and Agenesis
		Lung Surgery in Newborns
		Complications and Long-Term Outcomes
		Conclusions and Future Directions
		Cross-References
		References
	53 Congenital Diaphragmatic Hernia
		Introduction
		Etiology
			Embryogenesis
			Pathophysiology
		Diagnosis
		Treatment Modalities
			Prenatal Treatment
			Preoperative Treatment
			Operative Repair
			Postoperative Treatment
		Prognosis
		Outcome
		Congenital Eventration of the Diaphragm (CDE)
			Clinical Features
			Diagnosis
			Management
			Operative Repair
			Outcome
		Conclusions and Future Directions
		Cross-References
		References
	54 Extracorporeal Membrane Oxygenation for Neonatal Respiratory Failure
		Introduction
			Types of Extracorporeal Membrane Oxygenation
			Technical Equipment
			Surgical Technique
		Patient Management in ECMO
		Complications
		Conclusion and Future Directions
		Cross-References
		References
Part V: Newborn Surgery: Gastrointestinal
	55 Pyloric Atresia and Prepyloric Antral Diaphragm
		Introduction
		Pyloric Atresia
			Definition and Classification
			Epidemiology
			Etiopathogenesis
			Diagnosis
				Prenatal Diagnosis and Counselling
				Clinical Presentation
				Laboratory
				Radiologic Findings
				Differential Diagnosis
			Treatment
			Complications
			Outcome
		Prepyloric Antral Diaphragm
			Definition
			Epidemiology
			Etiopathogenesis
			Diagnosis
				Clinical Presentation
				Radiologic Findings
				Differential Diagnosis
			Treatment
			Complications
			Outcome
		Conclusion and Future Directions
		Cross-References
		References
	56 Infantile Hypertrophic Pyloric Stenosis
		Introduction
		Epidemiology
		Etiology
			Genetic Factor
			Extrinsic Factors/Environmental Factors
		Pathophysiology
		Clinical Presentation and Evaluation
			Clinical Presentation
			Evaluation
				Physical Examination
				Diagnostic Imaging
				Blood Chemistry
				Differential Diagnosis
		Management
			Preoperative Management
			Operative Care
			Nonoperative Treatment
			Prophylactic Antibiotics
			Postoperative Feeding
			Other Postoperative Considerations
				Postoperative Apnea
				Postoperative Emesis
		Conclusion and Future Directions
		Cross-References
		References
	57 Gastric Volvulus
		Introduction
		Etiology
		Pathogenesis
		Clinical Features
		Diagnosis
		Treatment
		Complications
		Conclusion and Future Directions
		Cross-References
		References
	58 Gastric Perforation
		Introduction
		Etiology
		Clinical Presentation
		Diagnosis
		Differential Diagnosis
		Perioperative Care
		Surgical Technique
		Conclusion and Future Directions
		Cross-References
		References
	59 Duodenal Obstruction
		Introduction
		Etiology
		Associated Malformations
		Prenatal Diagnosis/History
		Clinical Presentation and Diagnosis
		Preoperative Management
		Operation
		Incision
		Exploration and Identification of Pathology
		``Diamond-Shaped´´ Duodenoduodenostomy
		Side-to-Side Duodenoduodenostomy
		Operative Technique for Duodenal Web
		Laparoscopic Management of DO
		Postoperative Care
		Management of Persistent Megaduodenum by Duodenoplasty
		Outcome and Long-Term Results
		Conclusion and Future Directions
		Cross-References
		References
	60 Malrotation
		Introduction
		Epidemiology
		Pathophysiology
		Clinical Presentation
		Imaging Studies
		Surgery
			Open Ladd´s Procedure
			Laparoscopic Ladd´s Procedure
		Complication of Surgery
		Controversies
		Conclusion and Future Directions
		Cross-References
		References
	61 Congenital Hyperinsulinism
		Introduction
		Epidemiology and Types
		Histology
		Diagnosis
		Treatment
			Medical Treatment
			Surgical Treatment
				Diffuse CHI
					Open Near-Total Pancreatectomy
					Laparoscopic Near-Total Pancreatectomy
				Focal CHI
					Surgery for Focal CHI
					Focal Lesion in Head or Neck of Pancreas
					Focal Lesion in Body or Tail of Pancreas
		Postoperative Management
		Conclusion and Future Directions
		Cross-References
		References
	62 Jejunoileal Atresia and Stenosis
		Introduction
		Demographics
		Etiology/Pathophysiology
		Classification
		Pathology
		Prenatal Findings
		Clinical Presentation
		Postnatal Radiology
		Differential Diagnosis
		Management
		Postoperative Care
		Postoperative Complications
		Prognosis and Outcomes
		Conclusion and Future Directions
		Cross-References
		References
	63 Colonic and Rectal Atresias
		Colonic Atresia
			Introduction
			Etiology
			Presentation
			Diagnosis
			Management
				Preoperative
				Operative
				Postoperative
			Complications and Long-Term Results
		Rectal Atresia
			Introduction
			Etiology
			Presentation
			Diagnosis
			Management
			Complications and Long-Term Results
		Conclusion and Future Directions
		Cross-References
		References
	64 Duplications of the Alimentary Tract
		Introduction
		Pathogenesis
		Distribution and Presentation
		Clinical Features
			Lingual
			Esophageal
			Thoracoabdominal
			Gastric
			Duodenal
			Pancreatic
			Small Bowel
			Colonic
			Rectal
			Prenatal Diagnosis
		Associated Anomalies
		Imaging
		Surgical Treatment
			Esophageal
			Thoracoabdominal
			Gastric
			Duodenal
			Pancreatic
			Small Bowel
			Colonic and Appendiceal
			Rectal
		Conclusion and Future Directions
		References
	65 Mesenteric and Omental Cysts
		Introduction
		Clinical Presentation
		Diagnosis
		Differential Diagnosis
		Treatment
		Follow-Up
		Outcome and Conclusion
		Cross-References
		References
	66 Necrotizing Enterocolitis
		Introduction
			Epidemiology of Necrotizing Enterocolitis Worldwide
		Pathogenesis
			Risk Factors
			Mechanisms of Intestinal Mucosal Injury
			Histopathologic Findings
		Risk Factors for NEC in the Full-Term Infant
		Clinical Features
			Presentation
			Laboratory Findings
		Associated Comorbidities
		Management
			Nonoperative
			Operative Indication and Technique
		Outcomes
			Overall
			Postoperative Outcomes
			Long-Term Outcomes
				Gastrointestinal
			Neurodevelopmental Outcome
		Conclusions and Future Directions
		Cross-References
		References
	67 Meconium Ileus
		Introduction
			History
		Definition and Classification
			Simple MI
			Complex MI
		Epidemiology
		Pathogenesis and Pathophysiology
		Diagnosis
			Prenatal Detection
			Postnatal Presentation
			Imaging
			Laboratory Tests
		Differential Diagnosis
			Non-CF Related Meconium Obstruction
			Intestinal Atresia
			Intestinal Malrotation and Midgut Volvulus
			Hirschsprung´s Disease
			Meconium Plug Syndrome and Neonatal Small Left Colon
			Hypothyroidism
		Treatment
			Nonoperative Management
			Operative Management
			Simple MI: Operative Management
			Complicated MI: Operative Management
		Outcomes and Follow-Up
		Conclusion and Future Directions
		Cross-References
		References
	68 Meconium Peritonitis
		Introduction
		Etiopathogenesis
		Clinical Findings and Diagnosis
		Treatment
		Complications
		Conclusion and Future Directions
		Cross-References
		References
	69 Neonatal Ascites
		Introduction
		Etiology and Pathophysiology
		Clinical Presentation
		Diagnosis
		Management
		Conclusions and Future Directions
		Cross-References
		References
	70 Hirschsprung´s Disease
		Introduction
		Historical Overview
		Incidence
		Etiopathogenesis
		Pathophysiology
			Cholinergic Hyperinnervation
			Adrenergic Innervation
			Nitrergic Innervation
			Interstitial Cells of Cajal
			Platelet-Derived Growth Factor Receptor α+-Cells (PDGFRα+)
			Smooth Muscle Cells
			Extracellular Matrix
			Genetics Factors
			Associated Anomalies
		Diagnosis
			Imaging
			Anorectal Manometry
			Rectal Biopsy
		Differential Diagnosis
		Management
			Role of Colostomy
			Transanal One-Stage Endorectal Pull-Through Operation
			Operative Technique
			Laparoscopic-Assisted Pull-Through
			Postoperative Care
			Complications
			Anastomotic Leak
			Retraction of Pull-Through
			Perianal Excoriation
			Enterocolitis
			Constipation
			Soiling
			Long-Term Outcome
		Conclusion and Future Directions
		Cross-References
		References
	71 Hirschsprung-Associated Enterocolitis
		Introduction
		Incidence/Diagnosis
		Radiologic Imaging
		Differential Diagnosis
		Pathogenesis
		Treatment
		Preventive Strategies
		Conclusion and Future Directions
		Cross-References
		References
	72 Variants of Hirschsprung Disease
		Introduction
		Variants of HD
			Intestinal Neuronal Dysplasia (IND)
				Pathogenesis
				Epidemiology
				Clinical Presentation
				Diagnosis
				Management
				Outcome
			Hypoganglionosis
				Pathogenesis
				Epidemiology
				Clinical Presentation
				Diagnosis
				Management
				Outcome
			Internal Anal Sphincter Achalasia
				Pathogenesis
				Epidemiology
				Clinical Presentation
				Diagnosis
				Management
				Outcome
			Megacystis Microcolon Intestinal Hypoperistalsis Syndrome
				Pathogenesis
				Epidemiology
				Clinical Presentation
				Diagnosis
				Histological Findings
				Management
				Outcome
		Summary and Future Directions
		Cross-References
		References
	73 Anorectal Malformations
		Introduction
		Incidence
		Classification
		Associated Malformations
			Cardiovascular Anomalies
			Gastrointestinal Anomalies
			Sacral Anomalies
			Spinal Cord Anomalies
			Vertebral
			Genitourinary Anomalies
			Gynecologic Anomalies
		Anorectal Anatomy and Pathophysiology
			Sphincter Mechanism
			Sensation and Proprioception
			Colonic and Rectosigmoid Motility
		Clinical Findings and Initial Management
			Limited Posterior Sagittal Anorectoplasty
			Colostomy
			Management After Colostomy (High-Pressure Distal Colostogram)
		Anorectal Reconstruction
			Basic Principles
			Posterior Sagittal Anorectoplasty for Anomalies in Males
				Rectourethral Fistula (Bulbar and Prostatic)
				Recto-bladder Neck Fistula
				Imperforate Anus Without a Fistula
				Rectal Atresia and Stenosis (Hamrick et al. 2012)
			Posterior Sagittal Anorectoplasty for Anomalies in Females
				Vestibular Fistula
				Cloaca
				Cloacas with a Common Channel Shorter than 1 cm
				Cloacas with a Common Channel Length Between 1 and 3 cm
				Cloacas with a Common Channel Longer than 3 cm
			General Principles of Postoperative Care
		Outcomes
			Complications
			Continence
		Conclusion and Future Directions
		Cross-References
		References
	74 Congenital Pouch Colon
		Introduction
			Historical Insights
			Incidence
		Etiology
		Pathology
			Gross Pathology
			Histopathological Findings
			Classification
		History and Physical Examination
		Presentation
		Diagnosis
		Management
			Preoperative Management
			Operative Management
			Postoperative
		Complications
		Outcomes
		Conclusion and Future Directions
		Cross-References
		References
	75 Congenital Segmental Dilatation of the Intestine
		Introduction
		Etiology
		The Clinical Features and Diagnosis
		Criteria
		Pathology
		Treatment
		Prognosis
		Conclusion and Future Directions
		Cross-References
		References
	76 Short Bowel Syndrome
		Introduction
		Definition
		Incidence and Etiology
		Pathology
		Management
			Nutritional Therapy
			Supplemental Therapy
		Surgical Therapy
		Complications
		Prognosis
		Conclusion and Future Directions
		Cross-References
		References
Part VI: Newborn Surgery: Liver and Biliary Tract
	77 Biliary Atresia
		Introduction
		History
		Extrahepatic Pathology
			Cystic Biliary Atresia
		Etiological Heterogeneity
			Biliary Atresia Splenic Malformation (BASM) Syndrome
		Intrahepatic Pathology
		Epidemiology
		Clinical Features
		Diagnosis
			Blood Tests
			Imaging
			Liver Biopsy
			Cholangiogram
		Screening for Biliary Atresia
		Management
			Surgery: Kasai Portoenterostomy (KPE)
			Options and Alternatives
			Adjuvant Therapy for Biliary Atresia
				Corticosteroids
				Ursodeoxycholic Acid (UDCA)
				Chinese Herbs
			Postoperative Complications
				Cholangitis
				Portal Hypertension and Esophageal Varices
				Ascites
				Nutrition and Growth Failure
				Developmental Delay and Neurocognitive Function
		Outcome and Results
			Prognostic Factors
				Age at Kasai Portoenterostomy
				Surgical Experience
				Liver Histology and Biliary Remnant
		Conclusion and Future Directions
		Cross-References
		References
	78 Congenital Biliary Dilatation
		Introduction
		Etiology
		Embryology
		Anatomy
		Classification
		Clinical Presentation
		Diagnosis
		Treatment
		Incidental CBD
		Open Surgery
		Intraoperative Endoscopy
		Postoperative Complications and Management
		Malignancy
		Laparoscopic Treatment
		Outcomes
		Conclusion and Future Directions
		Cross-References
		References
Part VII: Newborn Surgery: Anterior Abdominal Wall Defects
	79 Omphalocele
		Introduction
		Embryology and Associated Malformations
		Antenatal Diagnosis and Perinatal Management
		Neonatal Resuscitation and Investigation
		Surgical Management
			Primary Closure
			Staged Closure
			Postoperative Management After Primary or Final Staged Closure
		Long-Term Outcomes
			Gastrointestinal and Nutritional Problems
			Respiratory Problems
			Psychological Problems
		Conclusion and Future Directions
		Cross-References
		References
	80 Gastroschisis
		Introduction
		History
		Prenatal Considerations
		Preoperative Assessment and Preparation
		Anesthesia
		Operative Procedure
		Primary Closure
		Staged Closure
		Postoperative Care
		Complications
		Outcome
		Conclusion and Future Directions
		Cross-References
		References
	81 Omphalomesenteric Duct Remnants
		Introduction
		Embryology
		Pathology and Clinical Presentation
			Meckel´s Diverticulum
			Umbilical Mucosal Polyp/Umbilical Cyst
			Omphalomesenteric Duct Cyst
			Persistent Omphalo-Mesenteric Duct (Patent or Obliterated)
		Management
			Meckel´s Diverticulectomy
			Excision of Omphalomesenteric Duct
			Excision of an Umbilical Polyp
		Complications
		Conclusion and Future Directions
		Cross-References
		References
	82 Conjoined Twins
		Introduction
		Etiology
		Classification
		Clinical Presentation
		Diagnosis
		Treatment
			Preoperative Ethical Issues
			Preoperative Meetings
			Separation
			Wall Reconstruction
		Complications
		Early and Long-Term Results
		Conclusion and Future Directions
		Cross-References
		References
Part VIII: Newborn Surgery: Spina Bifida and Hydrocephalus
	83 Spina Bifida and Encephalocele
		Introduction
		A Historical Perspective
		Embryological Development
		Classification and Pathogenesis
			Brain
			Spinal Cord
			Other Defects
		Spinal Dysraphism
			Spina Bifida Occulta
			Spina Bifida Cystica: Meningocele
			Spina Bifida Cystica: Myelomeningocele
		Etiology
			Genetics
			Dietary Factors
			Diabetes and Obesity
			Teratogens
		Prenatal Diagnosis
			Maternal Serum Alphafetoprotein
			Imaging
			Amniocentesis
		Clinical Management
			Prenatal Assessment and Counseling
			In-Utero Surgery
		Postnatal Assessment
			Inspection
				Motor Assessment
				Sensory Assessment
				Assessment of Bladder and Bowel Function
				Hydrocephalus
				Arnold-Chiari Type II Malformation
				Skeletal Abnormalities
			Investigations
			Parental Counseling
		General Management, Operative Treatment, and Technique
		Postoperative Management and Complications
		Long-Term Management and Outcome
			Medical Problems
				Urinary Incontinence
				Hydrocephalus
				Chiari II Malformation and Hindbrain Dysfunction
				Tethered Cord
		Lifestyle Concerns
			Intellect
			Ambulation
			Psychosocial Problems
		Encephalocele
			Classification
			Etiology
			Pathology
			Clinical Features
			Differential Diagnosis
			Investigations
			Treatment
				Operative Treatment and Technique
				Postoperative Care and Complication
			Prognosis
		Conclusion and Future Directions
		References
	84 Hydrocephalus
		Introduction
		CSF Physiology
		Pathology of Hydrocephalus
			Aqueduct Stenosis
			Spina Bifida and Chiari Malformation
			Dandy-Walker Complex and Posterior Fossa Cysts
			Neoplastic Lesions
			Posthemorrhagic Hydrocephalus
			Postinfective Hydrocephalus (PIH)
			External Hydrocephalus
			Overproduction of CSF
		Symptoms and Signs of Hydrocephalus in the Newborn
		Imaging and Investigation of Hydrocephalus in the Newborn
		Management of Hydrocephalus in the Newborn
			Nonsurgical/Medical Management
			Surgical Management
				External Ventricular Drainage (EVD)
				Subcutaneous Ventricular Access Devices (Reservoir)
				Ventriculosubgaleal Shunt
				Ventriculoperitoneal Shunt (VPS)
				Neuroendoscopy and Endoscopic Third Ventriculostomy (ETV)
				Fetal Surgical Therapy
		Shunt Operation Technique
			Ventriculoperitoneal Shunts
			Ventriculoatrial Shunts
			Postoperative Care
		Conclusions and Future Directions
		Cross-References
		References
Part IX: Newborn Surgery: Long-Term Outcomes in Newborn Surgery
	85 Long-Term Outcomes in Newborn Surgery
		Introduction
		Rationale of Long-Term Follow-Up Programs
		How to Analyze Long-Term Outcomes
		Long-Term Outcomes of Specific Newborn Surgical Conditions
		Long-Term Outcome in Children with Congenital Diaphragmatic Hernia
			Introduction
			Chronic Respiratory Tract Disease
			Gastroesophageal Reflux Disease
			Failure to Thrive and Growth
			Skeletal Abnormalities
			Neurological Deficits
			Health-Related Quality of Life
		Long-Term Outcome in Children with Esophageal Atresia
			Introduction
			Esophageal Morbidity
			Respiratory Morbidity
			Musculoskeletal Morbidity
			Other Issues of Long-Term Morbidity
			Quality of Life
		Intestinal Failure
			Definition and Causes of Intestinal Failure
			Incidence and Mortality
			Predictors of Intestinal Autonomy
			Growth and Development
			Intestinal Failure-Associated Liver Disease
			Quality of Life
		Hirschsprung´s Disease
			Rectosigmoid Aganglionosis
				Bowel Function
			Evolution of Bowel Function with Advancing Age
			Anal Sphincter Function
			Fecal Incontinence
			Constipation
			Urinary and Sexual Function
			Total Colonic and Panintestinal Aganglionosis
			Syndromic Hirschsprung´s Disease
			Hirschsprung´s Disease and Cancer
			Quality of Life
		Anorectal Malformations
			Low Anomalies: Long-Term Bowel Function
			High Anomalies: Long-Term Bowel Function
			Urinary Tract Problems
			Genital Anomalies, Fertility, and Sexual Problems
			Vertebral Anomalies and Myelodysplasias
			Quality of Life in Adult Patients with Anorectal Malformations
		Conclusion and Future Directions
		Cross-References
		References
Index