ObjectiveTo evaluate the rate of developmental coordination disorder (DCD) and its correlation to cognition and self-experienced health-related quality of life (HRQoL) in children born very preterm.DesignProspective follow-up study.SettingRegional population of children born very preterm in Turku University Hospital, Finland, in 2001–2006.PatientsA total of 170 children born very preterm were followed up until 11 years of age.Main outcome measuresMotor and cognitive outcomes were evaluated using the Movement Assessment Battery for Children - Second Edition (Movement ABC-2) and the Wechsler Intelligence Scale for Children - Fourth Edition, respectively, and HRQoL using the 17-Dimensional Illustrated Questionnaire (17D). The Touwen neurological examination was performed to exclude other neurological conditions affecting the motor outcome.ResultsEighteen children born very preterm (17 boys) (11.3%) had DCD, defined as Movement ABC-2 total test score ≤5th percentile. A positive correlation between motor and cognitive outcome (r=0.22, p=0.006) was found. Children born very preterm with DCD had lower cognitive scores than those without DCD (Full-Scale IQ mean 76.8 vs 91.6, p=0.001). Moreover, children born very preterm with DCD reported lower HRQoL than children born very preterm without motor impairment (17D mean 0.93 vs 0.96, p=0.03). However, HRQoL was higher in this group of children born very preterm compared with population-based normative test results (p<0.001).ConclusionsDCD was still common at 11 years of age in children born very preterm in 2000s. DCD associated with adverse cognitive development and lower self-experienced HRQoL. However, this group of children born very preterm reported better HRQoL in comparison with Finnish norms.

Background: Robot-assisted surgery demands a specific skillset of surgical knowledge, skills, and attitudes from the robotic surgeon to function as part of the robotic team and for maximal utility of the assistive surgical robot. Subsequently, the learning process of robot-assisted surgery entails new modes of learning. We sought to systematically summarize the published data on pediatric robot-assisted pyeloplasty (pRALP) to decipher the learning process by analyzing learning curves. Methods: This review followed the PRISMA guidelines. PubMed, EMBASE, Web of Science, and Scopus databases were systematically searched for ‘learning curve’ AND ‘pediatric pyeloplasty’. All studies presenting outcomes of learning curves (LC) in the context of pRALP in patients < 18 years of age were included. Studies comparing LC in pRALP versus open and/or laparoscopic pyeloplasty were also included; however, those solely focusing on LC in non-robotic approaches were excluded. The methodological quality was assessed using the Newcastle and Ottawa scale. Results: Competency was non-uniformly defined in all fifteen studies addressing learning curves in pRALP. pRALP was considered safe at all stages. Proficiency in pRALP was reached after 18 cases, while competency was estimated to demand 31 operated cases with operative duration as outcome variable. Conclusions: Pediatric RALP is safe during the learning process and ‘learning by doing’ improves efficiency. Competencies with broader implications than time must be defined for future studies.

Introduction: The purpose of this study was to investigate the epidemiology and characteristics of surgically treated ovarian lesions in preadolescent girls. Material and Methods: This was a retrospective cohort study including all 0-11-year-old girls operated at a single center from 1999 to 2016 for ovarian cysts, neoplasms, or torsions. Patient charts were reviewed for symptoms, preoperative radiological imaging, operative details, and histopathology. Results: We identified 78 girls resulting in a population-based incidence of 4.2/100 000. Infants (n= 44) presented with benign cysts (42/44, 95%, one bilateral), a benign neoplasm (1/44, 2%), and a torsion without other pathology (1/44, 2%). Torsion was found in 25/29 (86%) ovaries with complex and in 3/15 (21%) ovaries with simple cysts in preoperative imaging (p<0.001). Most infants were asymptomatic. Lesions in 1-11-year-old girls (n=34) included benign neoplasms (n=21/34, 62%), malignant neoplasms (n=5/34, 15%), a cyst with torsion (n=1/34, 3%), and torsions without other pathology (n=7/34, 21%). Torsion was more common in benign (17/21, 81%) than in malignant neoplasms (1/5, 20%) (p<0.020). Ovarian diameter did not differ between ovaries with or without torsion (p=0.238), or between benign and malignant neoplasms (p=0.293). The duration of symptoms in lesions with or without torsion was similar. Conclusions: The majority of surgically treated ovarian lesions in preadolescent are benign lesions with torsion. Surgery should be ovary preserving and performed without delay.