Giulia Barone

Background: Lung resections in children are rare but critical for congenital lung malformations (CLMs) and acquired pathologies; few studies have analyzed the full spectrum of indications. This study evaluated indications, complications, outcomes, and temporal trends in a tertiary pediatric center. Methods: We retrospectively analyzed patients who underwent lung resection (2012–2024), focusing on indications, approaches, complications, and outcomes. Comparisons between pathologies (CLMs vs. acquired pathologies), approaches (thoracoscopy vs. thoracotomy), an temporal trends were evaluated. Results: Among 160 patients (mean age: 7.8 years), acquired lesions (68.6%) were more common than CLMs (31.4%), predominating in children under 8 years. Compared with thoracotomy, thoracoscopy (72.8% of cases, conversion rate: 22.8%) was correlated with shorter operative times (p < 0.001) and hospital stays (p = 0.001). The complication rate was 19.5%, with 71.9% of patients achieving disease-free, asymptomatic status at follow-up. Risk factors for conversion from thoracoscopy to open surgery included intraoperative adhesions (p = 0.003), underlying pathology (p = 0.013), and age < 8 years (p = 0.017). Compared with acquired lesions, CLMs were associated with fewer complications (14.3% vs. 23.1%, p = 0.041) and more favorable outcomes (89.2% vs. 64.7%; p < 0.05). Over time, the use of thoracoscopy increased (p = 0.012), with reduced operative time (p = 0.005); complication and outcome rates remained stable. Conclusions: Pediatric lung resections address diverse pathologies; outcomes are linked to the pathology, and CLMs are associated with lower complication rates in our cohort. Thoracoscopy has progressively become the preferred approach in the last decade, offering advantages particularly in postoperative recovery, though its success depends on careful, pathology-driven patient selection.

Background: Among the numerous complications associated with post-coronavirus disease 2019 (COVID-19) syndrome, neurogenic lower urinary tract dysfunction (NLUTD) has been rarely reported, particularly in the pediatric population. Case Presentation: This report presented three pediatric cases of NLUTD that developed following severe acute respiratory syndrome coronavirus 2 infection, with clinical features resembling Elsberg syndrome. These cases were notable for the severity of their urinary symptoms, which required specialized and individualized bladder management strategies. This case series aims to raise awareness of this emerging clinical condition, which may be underdiagnosed in children recovering from COVID-19. Pediatricians, general practitioners, and urologists should be vigilant in considering NLUTD as a potential diagnosis in children presenting with new or unexplained urinary symptoms. Early diagnosis and timely management are crucial to address these symptoms effectively and prevent potential complications, such as irreversible upper urinary tract damage or long-term bladder dysfunction. Conclusion: Further investigations are warranted to clarify the pathophysiological mechanisms underlying post-COVID-19 NLUTD. Moreover, long-term follow-up studies are needed to better understand the natural history and implications of this condition in the pediatric population, as well as to develop effective strategies for prevention and treatment.

Purpose Megacystis–microcolon–intestinal hypoperistalsis syndrome (MMIHS) is a well described clinical condition, but reports are focused on microcolon and intestinal hypoperistalsis, while data on bladder management are scant. Aim of the study is to present urological concerns in MMIHS. Methods Retrospective evaluation of clinical data on urological management of MMIHS patients treated in the last 10 years. Results Six patients were enrolled (3 male, 3 female). Three girls had prenatal diagnosis of megacystis (1 vesicoamniotic shunt was placed). All patients had genetic diagnosis: 5 had ACTG2 gene mutations and 1 MYH11 mutation. All patients were addressed to our attention for urinary symptoms, such as urinary retention, urinary tract infections, acute renal injury. Two patients presented frequent stoma prolapses. All children underwent a complete urological evaluation, and then started a bladder management protocol (clean intermittent catheterization, via urethra or cystostomy-tube placement), with improvement of urinary infections, upper urinary tract dilation and stoma prolapses, if present. All patients had good renal function at last follow-up. Conclusion We believe that MMIHS patients must be addressed soon and before onset of symptoms for a multidisciplinary evaluation, including an early assessment by a pediatric urologist expert in functional disorder, to preserve renal function at its best.