Journal of Neonatal Surgery <p class="style58" style="text-align: justify; line-height: 16.5pt; background: white; margin: 12.0pt 0in 12.0pt 0in;"><span style="font-size: 11.5pt; font-family: 'Arial',sans-serif; color: black;"><strong>Journal of Neonatal Surgery (ISSN: 2226-0439)</strong> is peer-reviewed, open access, electronic journal that promotes the dispersion of quality research in the field of Neonatal Surgery. It is the only journal, fully dedicated to Neonatal Surgery- a developing specialty. The journal also provides an opportunity for learning “Medical Writing” to young pediatric and neonatal surgeons. Our editorial team works hard to guide new writers in this field. The journal publishes quality research that will improve outcomes of neonatal surgery, especially in resource-constrained settings. Our main aim is to reduce morbidity and mortality of neonatal surgery by publishing the latest trends in this discipline, in a special context to the developing countries. We invite pediatric and neonatal surgeons for their quality contributions to the Journal of Neonatal Surgery and help us achieve these goals.</span></p> en-US <h3>You are free to:</h3> <ul class="license-properties"> <li class="license share"><strong>Share</strong> — copy and redistribute the material in any medium or format</li> <li class="license remix"><strong>Adapt</strong> — remix, transform, and build upon the material for any purpose, even commercially.</li> </ul> <p><strong>Terms:</strong></p> <ul> <li><strong>Attribution</strong> — You must give <a id="appropriate_credit_popup" class="helpLink" tabindex="0" title="" href="" data-original-title="">appropriate credit</a>, provide a link to the license, and <a id="indicate_changes_popup" class="helpLink" tabindex="0" title="" href="" data-original-title="">indicate if changes were made</a>. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.</li> <li><span id="by-more-container"></span><strong>No additional restrictions</strong> — You may not apply legal terms or <a id="technological_measures_popup" class="helpLink" tabindex="0" title="" href="" data-original-title="">technological measures</a> that legally restrict others from doing anything the license permits.</li> </ul> (Dr. Muhammad Bilal Mirza) (Usama Aziz) Tue, 03 Jan 2023 03:02:01 -0500 OJS 60 Triple atresia: Staged repair Meryem Unal, Muhammad Fadli Abdullah, Hazlina Mohd Khalid, Mughni Bahari Copyright (c) 2023 Meryem Unal, Muhammad Fadli Abdullah, Hazlina Mohd Khalid, Mughni Bahari Tue, 03 Jan 2023 00:00:00 -0500 Fetal Lung Interstitial Tumor (FLIT): A case series <p>Background: Fetal Lung Interstitial Tumor (FLIT) is a rare benign lung tumor. There have been 18 cases of FLIT described in the literature. FLIT is characterized by a region of arrested lung development and must be differentiated from other congenital lung lesions with poorer prognoses.</p> <p>Case Presentation: We report the first two known cases of FLIT in Australia and New Zealand. In both cases, the patients developed respiratory distress at birth requiring intubation. Imaging revealed solid lesions and echocardiography demonstrated pulmonary hypertension. The patients underwent surgical resection without any complications or recurrence.</p> <p>Conclusion: FLIT is a rare benign congenital lung tumor that can be adequately managed with surgical resection.</p> Kah Ann Ho, Noemi A Fuentes-Bolanos, Andrew J Gifford, Ashish Jiwane, Dylan Wanaguru Copyright (c) 2023 Kah Ann Ho, Noemi A Fuentes-Bolanos, Andrew J Gifford, Ashish Jiwane, Dylan Wanaguru Tue, 03 Jan 2023 00:00:00 -0500 Management of massive air leak with persistent pneumothorax and pneumoperitoneum in a 1.2kg preterm neonate: A case report <p>Background: Pneumothorax is a life-threatening condition with potential iatrogenic causes which can extend to pneumomediastinum and pneumoperitoneum. Risk factors of spontaneous pneumothorax include prematurity, low birth weight, low APGAR scores, and cesarean-section delivery.</p> <p>Case Presentation: A 1255 grams preterm boy (Twin-2) was born at 28+3 weeks of gestation by emergency lower segment cesarean section. He showed signs of respiratory distress after uncomplicated endotracheal tube insertion which was required due to apneic episodes during continuous positive airway pressure ventilation. Recurring tube thoracocentesis and high-frequency oscillatory ventilation (HFOV) treated persistent right-sided pneumothorax and nonsurgical pneumoperitoneum, with improvement on day 10, gradual removal of five chest drains by day 19, and extubation on day 24. Transillumination and chest radiography were the main diagnostic investigations. Laryngotracheobronchoscopy on day 16 identified erythema and possible old injury at the carina. He was also treated for hypotension, suspected sepsis, and pulmonary hypertension and was discharged home on day 66.</p> <p>Conclusion: Identifying pneumothorax promptly is essential to reduce morbidity and mortality. Management is patient-specific and includes needle and tube thoracocentesis and often, mechanical ventilation. Our case demonstrates the challenges of managing a massive air leak in a premature newborn, who with adequate tube thoracocentesis and HFOV, successfully recovered from presumed iatrogenic persistent pneumothorax and pneumoperitoneum.</p> Heerani Woodun, Jeremy Thomas, Dushyant Batra, Nia Fraser Copyright (c) 2023 Heerani Woodun, Jeremy Thomas, Dushyant Batra, Nia Fraser Tue, 10 Jan 2023 00:00:00 -0500 Spontaneous perforation of Meckel’s diverticulum causing a partial small bowel obstruction: A case report <p>Background: Meckel’s diverticulum is a common congenital malformation in young children. Perforation of Meckel’s diverticulum in a neonate is a rarity and poses diagnostic and management challenges.</p> <p>Case Presentation: This patient is a former 26 5/7 week estimated gestational age infant who presented at 41 weeks corrected gestational age with abdominal distension and was discovered to have a perforated Meckel’s diverticulum that presented as a partial small bowel obstruction. Resection of the involved bowel and ileo-ileal anastomosis was performed.</p> <p>Conclusion: Small bowel obstructions should be considered as a potential presentation of a perforated Meckel’s diverticulum.</p> Simran Koura, Veronica Urbik, Richard Overman, Rohini Olson, Maja Herco, Shannon Longshore Copyright (c) 2023 Simran Koura, Veronica Urbik, Richard Overman, Rohini Olson, Maja Herco, Shannon Longshore Mon, 09 Jan 2023 00:00:00 -0500 A case of Aphallia associated with neonatal intestinal obstruction Omar Ajaj Copyright (c) 2023 Omar Ajaj Fri, 06 Jan 2023 00:00:00 -0500 Short Bowel Syndrome in neonates and early infancy <p>Short bowel syndrome (SBS) is the commonest cause of intestinal failure in neonates. SBS results from widespread damage to the small intestine, leading to loss of functional capacity of this organ. This is generally secondary to conditions like necrotizing enterocolitis, gastroschisis, intestinal atresia, and midgut volvulus. The small bowel usually adapts to this damage in due course of time. The clinician's role usually entails the management of parenteral nutrition and the fluid and electrolyte balance to tide over this phase. The management should be initiated as soon as the diagnosis is suspected, especially post-surgical resection of the bowel. This should comprise enteral nutrition, with proactive monitoring and supplementation of electrolytes and micronutrients. Intestinal lengthening procedures like the Serial transverse enteroplasty (STEP), and Longitudinal intestinal lengthening and tailoring (LILT) may be considered in infants, where medical therapy fails to correct the pathology. The intricate nature of the condition warrants a multi-disciplinary approach, involving clinicians, intensivists, and surgeons, which ensures the best neonatal outcomes, in terms of the survival rates in these babies.</p> Shivani Dogra, Nitin James Peters, Ram Samujh Copyright (c) 2023 Shivani Dogra, Nitin James Peters, Ram Samujh Sat, 14 Jan 2023 00:00:00 -0500 Constrained evidence-based practice Laraib Amjad Dudrah, Muhammad Bilal Mirza Copyright (c) 2023 Laraib Amjad Dudrah, Muhammad Bilal Mirza Tue, 03 Jan 2023 00:00:00 -0500 Improvement of Broviac catheter-related outcomes after the implementation of a quality management system: A before-and-after prospective observational study <p>Background: Because of the high rates of Broviac catheter complications, we started an urgent quality process to reduce this morbidity. The aim is to assess the efficiency of the main actions we have taken in enhancing our practice and improving Broviac outcomes.</p> <p>Methods: We included all neonates and young infants requiring surgical central venous access using a Broviac tunneled catheter. We compared the catheters’ outcomes before and after the implementation of a quality program based on a nurse teaching program, patient selection, and catheter management multidisciplinary protocol. The significance threshold was set at p&lt;0.05.</p> <p>Results: We included 94 patients: 51 in the protocol group and 43 in the control group. The complication rate was reduced from 60.3% to 25.5% with p=0.001. The lifetime of the catheter was improved from 11.3 ± 4.3 days to 19.1 ± 9 days with p=0.007. The catheter infection was reduced from 65.3% to 46.1% with p≤0.001.</p> <p>Conclusion: This quality improvement project shows the utility of a quality assurance program based on careful indications and patient selection, a nursing teaching program, and a multidisciplinary catheter management protocol, in reducing Broviac catheter-related morbidity.</p> Manel Kammoun, Anouar Jarraya, Saloua Ammar, kamel Kolsi Copyright (c) 2023 Manel Kammoun, Anouar Jarraya, Saloua Ammar, kamel Kolsi Tue, 03 Jan 2023 00:00:00 -0500