Advances in paediatric gastroenterology

• Published in: The Lancet (British edition) Vol. 390; no. 10099; pp. 1072 - 1082
• Main Authors: Tam, Paul K H, Chung, Patrick H Y, St Peter, Shawn D, Gayer, Christopher P, Ford, Henri R, Tam, Greta C H, Wong, Kenneth K Y, Pakarinen, Mikko P, Davenport, Mark
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 09-09-2017; Elsevier Limited
• Subjects: Abdomen; Antibiotics; Appendicitis; Appendicitis - surgery; Biliary atresia; Biliary Atresia - surgery; Child; Clinical trials; Complications; Cures; Disorders; Electrolytes; Enterocolitis; Enterocolitis, Necrotizing - surgery; Esophagus; Gastroenterology; Gastroenterology - trends; Gastrointestinal diseases; Gastrointestinal Diseases - surgery; Genetics; Hemorrhage; Hirschsprung's disease; Humans; Infant, Newborn; Laparoscopy; Medical research; Minimally Invasive Surgical Procedures - methods; Neonates; Pathogenesis; Pediatrics; Prenatal Diagnosis; Stem cells; Stenosis; Surgery
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(17)32284-5

Recent developments in paediatric gastrointestinal surgery have focused on minimally invasive surgery, the accumulation of high-quality clinical evidence, and scientific research. The benefits of minimally invasive surgery for common disorders like appendicitis and hypertrophic pyloric stenosis are all supported by good clinical evidence. Although minimally invasive surgery has been extended to neonatal surgery, it is difficult to establish its role for neonatal disorders such as oesophageal atresia and biliary atresia through clinical trials because of the rarity of these disorders. Advances in treatments for biliary atresia and necrotising enterocolitis have been achieved through specialisation, multidisciplinary management, and multicentre collaboration in research; similarly robust clinical evidence for other rare gastrointestinal disorders is needed. As more neonates with gastrointestinal diseases survive into adulthood, their long-term sequelae will also need evidence-based multidisciplinary care. Identifying cures for long-term problems of a complex developmental anomaly such as Hirschsprung's disease will rely on unravelling its pathogenesis through genetics and the development of stem-cell therapy.