Pediatric retroperitoneal non-organ-originated malignancies: An analysis based on SEER database.

Retroperitoneal non-organ-originated malignancies are rare pediatric tumors with challenging diagnosis and treatment. The present study aimed to analyze the clinicopathological characteristics, treatment, and prognosis of retroperitoneal non-organ-originated malignancies. In the study, we included the pathological diagnosis of pediatric retroperitoneal non-organ-originated malignant tumors between 2000 to 2019 through the updated Surveillance, Epidemiology, and End Results database. We use the Kaplan-Meier survival curve to calculate the overall survival (OS) and cancer-specific survival (CSS). The risk of all-cause death and disease-specific death were analyzed using Cox proportional hazard regression model and Fine-and-Grey competitive hazard model, respectively. In the study, a total of 443 pediatric retroperitoneal non-organ-originated malignancies were included. Of them, only 22.3% of patients had no metastatic disease, 42.9% had distant metastasis and 34.8% had locally advanced diseases. The primary pathological tumor was neuroblastoma followed by germ cell tumor. The overall 10-year OS and CSS were 70.7% and 73.1%, respectively, and the 10-year OS and CSS of metastatic diseases were 54.4% and 56.6%, respectively. Older children, worse tumor stage at diagnosis, incomplete resection, and prolonged time from diagnosis to treatment were significantly associated with worse survival outcomes. Radiotherapy and chemotherapy did not significantly improve the prognosis of patients without complete tumor resection. The study indicated that most pediatric retroperitoneal non-organ-originated malignancies diagnosed with metastatic diseases have plagued treatment. Radiotherapy and chemotherapy are the main treatment methods for children unable to undergo complete surgical treatment. However, these treatments do not reach the same therapeutic effect as complete tumor resection after early diagnosis. Hence, early diagnosis and surgery for complete tumor resection are of utmost importance.

The Effect of the Duckett procedure on the Outcome and Prognosis of Children with Suburethral Cleft.

Background: Hypospadias is one of the most common malformations of the male genitourinary system. In recent years, the incidence of hypospadias is increasing year by year, which seriously affects normal urination and sexual function. Repairing hypospadias has always been a challenge in paediatric urology, requiring a variety of surgical techniques and science and art that requires intensive study. Despite the availability of over 300 surgical procedures and continuous improvement, there is still a high level of surgical complications. It is crucial to choose an appropriate and effective surgical method for the treatment of hypospadias. Aims: This study aimed to investigate the outcome and prognosis of children with hypospadias, using transverse cut foreskin island flap coiled urethroplasty (the Duckett procedure). Materials and Methods: A retrospective study was conducted on 100 children with hypospadias who underwent surgery in our hospital from December 2018 to December 2021. Based on the degree of hypospadias and the degree of penile curvature both in line with the Duckett procedure, the comparison group was treated with a one-stage Duckett procedure and the treatment group was treated with a staged Duckett procedure. The differences in the surgical condition, inflammatory factor levels, and complications between the two groups of children were observed and compared. Results: The length of hospital stay and VAS score in the treatment group were significantly lower than those in the control group, and the operation time and intraoperative bleeding were higher than those in the control group, with a statistical significance (P < 0.05). The success rate of one operation was higher than that of the comparison group, but the statistical comparison was not statistically significant (P > 0.05). There was no statistically significant difference in the inflammatory response between the two groups before surgery (P > 0.05), while the difference in CRP, IL-6, and calcitoninogen between the two groups after surgery was significant and lower in the comparison group than in the treatment group, which was statistically significant (P < 0.05). The clinical outcome of the children in both groups showed that the excellent rate of 92.00% in the treatment group was significantly higher than that of 74.00% in the comparison group, while the incidence of complications was significantly lower than that of the comparison group, and the difference was statistically significant (P < 0.05). Complications in children with poor surgical outcomes in both groups occurred mainly, early urethral stricture and cured by urethral dilatation or condition without improvement cured by urethrotomy. Conclusion: A comparative study of hypospadias treated with the staged Duckett procedure was more effective in relieving postoperative pain and inflammatory reactions in children, reducing postoperative complications and improving healing efficiency, providing some reference value for hypospadias surgery.